Selective embryo transfer is becoming an option for couples at risk of transmitting an inherited disorder. The embryos are produced by standard IVF techniques. One or two cells are removed (embryo biopsy) from the 6-10 cell embryo and evaluated for the disorder. Only embryos shown to be free of the disorder are transferred into the uterus. Although 25% of the early embryonic cells are removed, the remaining cells have been shown to survive and produce perfectly healthy babies.

The technological advances in IVF such as selective embryo transfer open up potentially serious ethical issues. It is technically possible, for example, to determine the sex of the embryos, which leads to sex selection. A couple may have several boys but no girls and some seek IVF with sex selection. Technically, IVF with embryo selection according to sex is possible although this is a difficult ethical issue that has already engendered debate in the medical literature. Most of us working with infertility feel unhappy about the concept of selection for non-medical reasons but society will have to address this option in time. In the UK it is illegal to undertake sex selection.


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