Schenker Joseph G
Department Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Jerusalem, Israel.
J Assist Reprod Genet. 2002 Sep;19(9):400-10. doi: 10.1023/a:1016807605886.
To review the current developments in the field of preconceptual sex selection and to discuss the cultural and religious perspectives as that accompany the scientific progress.
A survey of the major publications in Judaism, Christianity and Islam regarding the issue of gender selection. Examination of current methods of preconceptual gender selection revealed that in vivo methods such as timing of intercourse, the use of ovulation induction medications, and artificial insemination do not appear to affect the sex ratio to a clinically significant degree. In vitro separation of X- and Y-bearing spermatozoa by gradient techniques have been reported to alter significantly the sex ratio at birth. However, these trials were not controlled, and molecular biological techniques could not validate that these methods indeed change the Y- to X bearing spermatozoa ratio sufficiently for clinical use. Nevertheless recent scientific advances have made highly reliable preconceptual sex selection possible by using preimplantation diagnosis (PGD) or sperm separation by flow cytometry combined with AIH or IVF. At present, these methods have been used to avoid sex-linked disorders. Both involve the invasive procedure of IVF and thus are held by most as inappropriate for nonmedical indications. However, improvement in flow cytometry output of sexed spermatozoa might provide in the near future sufficient sorted gametes for artificial insemination. It may be that in the near future, an improvement in flow cytometry output of sexed spermatozoa will provide sufficient sorted gametes for artificial insemination. In such a case, the medical community will be forced to take a stand, whether this reliable noninvasive method of sexing will be allowed for social purposes and even if the practice of PGD should be allowed for nonmedical indications.
The requirement for a man to procreate by having a minimum of two children-a boy and a girl-is obligatory according to Jewish law. According to both schools, Beit Shamai and Beit Hillel, in order to fulfill the obligation of procreation at least one son is required. Therefore the application of sex preselection for nonmedical indications may by of practical importance using the method of sperm separation or sex selection of pre-embryo by PGD. According to Christian view, especially the one of the Catholic Church, gender preselection even for medical indications is forbidden. Islamic legal viewpoint is that fetal sex selection is lawful when it is practiced on an individual basis, to fulfill the wish of a married couple to have a boy or a girl through available medical means.
回顾孕前性别选择领域的当前发展情况，并讨论伴随科学进步而来的文化和宗教观点。
对犹太教、基督教和伊斯兰教中关于性别选择问题的主要出版物进行调查。对当前孕前性别选择方法的研究表明，诸如性交时间安排、使用促排卵药物以及人工授精等体内方法似乎不会在临床上显著影响性别比例。据报道，通过梯度技术在体外分离携带X和Y染色体的精子可显著改变出生时的性别比例。然而，这些试验没有得到控制，而且分子生物学技术无法证实这些方法确实能充分改变携带Y和X染色体的精子比例以供临床使用。尽管如此，最近的科学进展使得通过植入前诊断（PGD）或结合人工授精丈夫精液（AIH）或体外受精（IVF）的流式细胞术精子分离实现高度可靠的孕前性别选择成为可能。目前，这些方法已被用于避免性连锁疾病。两者都涉及体外受精的侵入性操作，因此大多数人认为不适用于非医学指征。然而，流式细胞术对分选精子的输出改进可能在不久的将来提供足够数量的分选配子用于人工授精。也许在不久的将来，流式细胞术对分选精子的输出改进将提供足够数量的分选配子用于人工授精。在这种情况下，医学界将被迫表明立场，即这种可靠的非侵入性性别鉴定方法是否会被允许用于社会目的，以及植入前诊断是否应该被允许用于非医学指征。
根据犹太法律，男子生育至少两个孩子（一男一女）的要求是强制性的。根据 Beit Shamai 和 Beit Hillel 这两个学派的观点，为了履行生育义务，至少需要一个儿子。因此，使用精子分离或通过植入前诊断对胚胎进行性别选择的方法，将非医学指征的性别预选应用可能具有实际重要性。根据基督教的观点，特别是天主教会的观点，即使是出于医学指征的性别预选也是被禁止的。伊斯兰教的法律观点是，当基于个人情况进行胎儿性别选择，以满足已婚夫妇通过现有医疗手段生育男孩或女孩的愿望时，这是合法的。
