Boy? Girl? You Choose

updated 03/01/2004 AT 01:00 AM EST

originally published 03/01/2004 AT 01:00 AM EST

Tommy and Dana Paschal married in 1982 and were soon blessed with three baby boys. They were a happy, healthy family-even though, from time to time, Dana felt a little something, or someone, was missing. "I don't think she ever stopped wanting a girl," says her mother, Pauline Ferguson. "She was just afraid to try again."

Then, in August 2000, Dana picked up a magazine while strolling through her local Kmart. Inside was an article about a medical breakthrough that would allow couples to choose the sex of their babies. "I called [my husband] and said, 'I think I know how we can get our girl," says Dana, 36, a homemaker from Pleasant Garden, N.C. Her family scrapped plans for a cruise to the Bahamas, opting instead to try having a daughter through an experimental sperm-sorting procedure, in which Tommy's sperm were sorted in a way that allowed specialists to remove those with female chromosomes. Dana was then artificially inseminated and, after two attempts, became pregnant. On Oct. 12, 2001, Dana, Tommy, now 38, and the boys—T.G., 18, Kevin, 16, and Michael, 12—welcomed Heather Rene Paschal. "We got exactly what we wanted," says Dana, who paid $5,300 for the procedures.

Not so long ago, of course, no amount of cash could have bought the opportunity to decide the sex of your child. Even today many Americans object to what they see as parents playing God. But in the past few years—quietly at first and now through services touted on the Web—a growing number of fertility experts around the country have begun offering clients the ultimate form of family planning. "Personally, I think sperm sorting is a great idea," says Sonja Kristiansen, 41, a Houston fertility specialist who has helped two dozen couples choose the sex of their kids using the technology known as MicroSort. "In many couples, the mom wants a girl she can dress up and Dad wants a boy to carry on the family name. I already have two boys, but if I were to get pregnant again, I'd have a girl."

Since clinical trials of this procedure began in 1994, it has produced about 500 pregnancies and 420 babies, according to the Genetics and IVF Institute, based in Fairfax, Va., which holds the MicroSort patent. Some couples, like Nina and Rob Wagoner of Ventura, Calif., have opted for preimplantation genetic diagnosis (PGD), a more complex and expensive method—it averages $15,000 per attempt—in which doctors screen a fertilized embryo for its sex and genetic disorders, before implanting it in the mother. In 2003 the Wagoners, parents to three girls from Nina's previous marriage, read about PGD on the Internet and decided to try for a boy. Doctors implanted a total of three embryos, and Nina eventually delivered twins last Nov. 7—Jared and his sister Jordan. "I'm still in shock," says Nina. "It's just so wonderful to be able to say Jared is here."

Like the Wagoners, many couples see the new technology as an invaluable tool either for so-called "family balancing" or for guarding against sex-specific diseases. But some in the medical community advise caution. A number of doctors who offer gender selection refuse to perform it for first-time parents or those who don't need reproductive assistance. Others are concerned that if unused embryos aren't frozen or donated, they're discarded. And antiselection critics say manipulating sex sets a chilling precedent that could one day lead to a generation of "designer kids." "Children are not products you can buy like pets," says Boston University bioethics professor George Annas. "Why not select for eye color, height and strength? This is treating children like commodities."

Aware of possible moral objections, Kathy and Cliff Krug, a couple from Fairfax Station, Va., debated for six months before finally deciding to use sex selection in the wake of a pair of devastating events: Four years ago, Brien, the younger of the pair's two sons, was born with hemophilia, a hereditary disease that predominantly afflicts males. A third son, their doctor told them, would carry a 50 percent chance of having the disease. Then, two years later, Kathy's 62-year-old mother died of breast cancer. "I felt like it would be great to have this little girl to replace my mom," she says.

Both the Krugs are observant Catholics. They prayed for guidance but eventually decided not to consult their priest before joining a clinical trial for sperm sorting in October 2002. Kathy began taking a fertility drug and used a home predictor kit to determine when she was ovulating. When that day arrived, she and Cliff, who works for their family-owned moving business, hurriedly drove to the Genetics and IVF Institute near their home, where Cliff's sperm were sorted, then tested and artificially inseminated into Kathy. Even after she became pregnant, though, the waiting wasn't entirely over, says Kathy, because the MicroSort method has a 91 percent success rate for female births (as opposed to 76 percent for boys). "We waited 20 weeks to have a sonogram," she says. "The technician was quiet and I thought, 'Oh no.' But she turned and said, It's a girl,' and we were so excited." The Krug's daughter Abigail Anne was born July 10, 2003. "Now I've got my partner in crime," says Kathy.

Despite the moral qualms of many, gender selection is almost certain to grow, say some experts. "The vast majority of patients are average suburban parents who have two or three children of one gender and say they want another of the opposite sex," says Norbert Gleicher, who performs PGD at offices in New York and Illinois. "What is wrong with that?" Nothing, say Jose and Claudia Quintero of Miami, who have three daughters and, thanks to sperm sorting, a bouncing toddler named Joseph. "We thought about everything—our kids, our religion, what we would tell our baby. We came to the conclusion that it was worth it," says Claudia. "And it was. He's a miracle."

Bob Meadows. Michaele Ballard in Pleasant Garden, Giovanna Breu in Chicago, Melody Simmons in Fairfax Station, Wendy Grossman in Houston, Sandra Marquez in Los Angeles, Jennifer Longley in New York City and Kristin Harmel in Orlando

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