Can you choose the sex of your baby?

There is a recent news report that a doctor was found guilty of professional misconduct by the Medical Council of Hong Kong. While it is unclear what the exact charges are, it appears that a doctor was charged with prescribing unnecessary treatment to an expecting mother, claiming it would increase the chance of conceiving a boy.

First of all, what the doctor prescribes is not effective at all. There are currently only 3 scientific methods for sex selection:

1. Sperm sorting, by a technique called flow cytometry
2. Preimplantation genetic diagnosis and screening of embryos
3. Selective abortion

The first two methods are connected to in-vitro fertilisation (IVF), while the last is the only option in natural conception and is by far the most extreme and controversial.

While prescribing unnecessary treatment may be a sufficient basis for professional misconduct by itself, this case further touches on the issue of sex selection, which is explicitly prohibited in the Code of Conduct of the Medical Council of Hong Kong:

36.6 Sex selection for social, cultural or other non-medical reasons should not be performed.

The same is also in the Code of Conduct of the Council on Human Reproductive Technology:

13.2  Sex selection for social reasons or for reasons other than the avoidance or prevention of the birth of a child with a severe sex-linked genetic disease is prohibited under the Ordinance.

The grounds for medical abortion are set out under s 47A of the Offences against the Person Ordinance (Cap 212):

(1) Subject to this section, a person shall not be guilty of an offence under section 46 or 47 when a pregnancy is terminated by a registered medical practitioner if 2 registered medical practitioners are of the opinion, formed in good faith that—

(a) the continuance of the pregnancy would involve risk to the life of the pregnant woman or of injury to the physical or mental health of the pregnant woman, greater than if the pregnancy were terminated; or

(b) there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormality as to be seriously handicapped.

Furthermore, sex selection for non-medical purposes is a serious criminal offence under either ss 15(3)(b), 39 of the Human Reproductive Technology Ordinance (Cap 561) or ss 46 or 47 of the Offences against the Person Ordinance (Cap 212).

It may often be overlooked, but sex selection is under tight regulation in Hong Kong. Medical practitioners providing pre-natal genetic screening and diagnostics should exercise caution and provide counselling with reference to the Code of Conduct. Unless medically indicated, there should not be any suggestion of sex selection.