Document Type : Original Article


1 Fertility and Infertility Research Center,

2 Student Research Committee, Department of Research and Technology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

3 Fertility and Infertility Research Center


Advances in modern medicine are resulted from unrestricted and unlimited research
disregarding many essentials of a research including ethical issues. Following ethical issues,
many of unwanted pregnancies and abortions can be avoided. Several factors such as medical
issues including X linked disease, has encouraged couples to select traditional or modern
techniques in selecting the gender of their children. Some of these methods are corrected
Swim-up method or washing of spermatozoa, Percoll gradient sperm separation method, grass
wool column filter method method, albumin separation method, microsort method using FISH
(Fluorescence in situ hybridization), free electrophoresis method, Ph adjustment method, pre
implantation genetic diagnosis (PGD)/fluorescence in situ hybridization. This technology is
confronted with many ethical issues. Ethical considerations PGD in the SEX SELECTION differ in
different religions and their perspectives on this issue. In this this review, electronic databases,
books and Internet sites were completely searched and full articles including required keywords
and techniques were obtained and reviewed. The rites and religions, were different and had
legal perspectives and opinions about PGD. In some non-Islamic countries there are strict rules
to control the use of technology. Some of these methods are costly and even risky. They also
involve ethical issues such as legitimacy of the conceived fetus; recommending final touches
in sex selection is still considered a taboo and a big issue in some cultures or mono-sexual
families. Islamic views and beliefs are more flexible and the use of these technologies are
allowed to preserve the health and lives permit. Islam strongly favors humanity and supports
different issues if they are not in conflict with the primary concept of legitimate reproduction
and are beneficial to human beings.


1. Azizi F. Clinical Research Ethics. J Med Ethics 2008;2:33‑48.
2. Sermon KD, Michiels A, Harton G, Moutou C, Repping S, Scriven PN,
et al. ESHRE PGD Consortium data collection VI: Cycles from
January to December 2003 with pregnancy follow‑up to October
2004. Hum Reprod 2007;22:323‑36.
3. Macklin R. The ethics of sex selection and family balancing. In
Seminars in reproductive medicine. New York, Beijing: © Thieme
Medical Publishers; 2010.
4. Benagiano G, Bianchi P. Sex preselection: An aid to couples or a
threat to humanity? Hum Reprod 1999;14:868‑70.
5. Shushan A, Schenker JG. Prenatal sex determination and selection.
Hum Reprod 1993;8:1545‑9.
6. Carson SA. Sex selection: The ultimate in family planning. Fertil
Steril 1988;50:16‑9.
7. Fugger EF. Clinical experience with flow cytometric separation
of human X‑and Y‑chromosome bearing sperm. Theriogenology
8. Fugger EF, Black SH, Keyvanfar K, Schulman JD. Births of normal
daughters after MicroSort sperm separation and intrauterine
insemination, in‑vitro fertilization, or intracytoplasmic sperm
injection. Hum Reprod 1998;13:2367‑70.
9. Robertson JA. Preconception gender selection. Am J Bioeth
10. Seidel GE Jr, Johnson LA. Sexing mammalian sperm-overview.
Theriogenology 1999;52:1267‑72.
11. Schenker JG. Gender selection: Cultural and religious perspectives.
J Assist Reprod Genet 2002;19:400‑10.
12. Michelmann HW, Gratz G, Hinney B. X‑Y sperm selection: Fact or
fiction? Hum Reprod Genet Ethics 2000;6:32‑8.
13. Schulman JD, Karabinus DS. Scientific aspects of preconception
gender selection. Reprod Biomed Online 2005;10(Suppl 1):111‑5.
14. Holt WV, O’Brien J, Abaigar T. Applications and interpretation of
computer‑assisted sperm analyses and sperm sorting methods in
assisted breeding and comparative research. Reprod Fertil Dev
15. Malpani A, Malpani A, Modi D. Preimplantation sex selection for
family balancing in India. Hum Reprod 2002;17:11‑2.
16. Robertson JA. Extending preimplantation genetic diagnosis: The
ethical debate Ethical issues in new uses of preimplantation genetic
diagnosis. Hum Reprod 2003;18:465‑71.
17. Dahl E. Ethical issues in new uses of preimplantation genetic
diagnosis should parents be allowed to use preimplantation genetic
diagnosis to choose the sexual orientation of their children? Hum
Reprod 2003;18:1368‑9.
18. Catt SL, Sakkas D, Bizzaro D, Bianchi PG, Maxwell WM, Evans G.
Hoechst staining and exposure to UV laser during flow cytometric
sorting does not affect the frequency of detected endogenous
DNA nicks in abnormal and normal human spermatozoa. Mol Hum
Reprod 1997;3:821‑5.
19. Land JA, Yarmolinskaya MI, Dumoulin JC, Evers JL. High‑dose
human menopausal gonadotropin stimulation in poor responders
does not improve in vitro fertilization outcome. Fertil Steril
20. Basille C, Frydman R, El Aly A, Hesters L, Fanchin R, Tachdjian G,
et al. Preimplantation genetic diagnosis: State of the art. Eur J Obstet
Gynecol Reprod Biol 2009;145:9‑13.
21. Van Steirteghem AC, Nagy Z, Joris H, Liu J, Staessen C, Smitz J,
et al. High fertilization and implantation rates after intracytoplasmic
sperm injection. Hum Reprod 1993;8:1061‑6.
22. Coonen E, Dumoulin JC, Ramaekers FC, Hopman AH. Optimal
preparation of preimplantation embryo interphase nuclei for analysis
by fluorescence in‑situ hybridization. Hum Reprod 1994;9:533‑7.
23. Mullis K, Faloona F, Scharf S, Saiki R, Horn G, Erlich H. Specific
enzymatic amplification of DNA in vitro: The polymerase chain
reaction. Cold Spring Harb Symp Quant Biol 1986;51:263‑73.
24. Soini S, Ibarreta D, Anastasiadou V, Aymé S, Braga S, Cornel M,
et al. The interface between assisted reproductive technologies
and genetics: Technical, social, ethical and legal issues. Eur J Hum
Genet 2006;14:588‑645.
25. Cieslak‑Janzen J, Tur‑Kaspa I, Ilkevitch Y, Bernal A, Morris R,
Verlinsky Y. Multiple micromanipulations for preimplantation
genetic diagnosis do not affect embryo development to the
blastocyst stage. Fertil Steril 2006;85:1826‑9.
26. Newson AJ. Ethical aspects arising from non‑invasive fetal
diagnosis. in Seminars in Fetal and Neonatal Medicine. Netherlands:
Elsevier; 2008.27. Hansen M, Bower C, Milne E, de Klerk N, Kurinczuk JJ. Assisted
reproductive technologies and the risk of birth defects‑a systematic
review. Hum Reprod 2005;20:328‑38.
28. Simoncelli TM. Pre‑Implantation genetic diagnosis: Ethical
guidelines for responsible regulation. The international centre for
technology assessment. Available from: http://www.
pgd% 20guidelines.pdf [Last accessed on 2008 April 18].
29. Schieve LA, Meikle SF, Ferre C, Peterson HB, Jeng G, Wilcox LS.
Low and very low birth weight in infants conceived with use of
assisted reproductive technology. N Engl J Med 2002;346:731‑7.
30. Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major
birth defects after intracytoplasmic sperm injection and in vitro
fertilization. N Engl J Med 2002;346:725‑30.
31. Mukhopadhaya N, Arulkumaran S. Reproductive outcomes after
in‑vitro fertilization. Curr Opin Obstet Gynecol 2007;19:113‑9.
32. Botkin JR. Ethical issues and practical problems in preimplantation
genetic diagnosis. J Law Med Ethics 1998;26:17‑28.
33. Preimplantation genetic diagnosis. Wikipedia. Encyclopedia.
Available from: http://www.en.
Preimplantation‑ genetic‑ diagnosis. [Last accessed on 2010 Jul 15].
34. Thornhill AR, deDie‑Smulders CE, Geraedts JP, Harper JC,
Harton GL, Lavery SA, et al. ESHRE PGD Consortium ‘Best practice
guidelines for clinical preimplantation genetic diagnosis (PGD)
and preimplantation genetic screening (PGS)’. Hum Reprod
35. Eisenberg VH, Schenker JG. Pre‑embryo donation: Ethical and legal
aspects. Int J Gynaecol Obstet 1998;60:51‑7.
36. Grazi RV, Wolowelsky JB. Preimplantation sex selection and genetic
screening in contemporary jewish law and ethics. J Assist Reprod
Genet 1992;9:318‑22.
37. Jacobsen R, Møller H, Engholm G. Fertility rates in Denmark in
relation to the sexes of preceding children in the family. Hum Reprod
38. Jalal Abbasi‑Shavazi M, McDonald P. Fertility decline in the Islamic
Republic of Iran: 1972–2000. Asian Popul Stud 2006;2:217‑37.
39. AGH GE‑H. In Vitro Fertilization and test tube baby. Dar El Iftaa,
Cairo: Egypt. 1980;1225:3213‑3228.
40. Gad El Hak A, Serour G.Some gynecologyical problems in the
context of Islam. The International Islamic center for population
studies and research. Cairo, Egypt: Al Azhar University; 2000.
41. Serour GI. Religious perspectives of ethical issues in ART 1. Islamic
perspectives of ethical issues in ART. Middle East Fertil Soc J
42. Serour G. Ethical considerations of assisted reproductive
technologies: A Middle Eastern perspective. Middle East Fertil
Soc J, 2000;5:13‑8.
43. Sura AL Bakara, H.Q. 2:185.
44. Schenker JG. Women’s reproductive health: Monotheistic religious
perspectives. Int J Gynaecol Obstet 2000;70:77‑86.
45. Serour GI, Dickens BM. Assisted reproduction developments in the
Islamic word. Int J Gynaecol Obstet 2001;74:187‑93.
46. Fasouliotis SJ, Schenker JG. Ethics and assisted reproduction. Eur
J Obstet Gynecol Reprod Biol 2000;90:171‑80.
47. Nasim A. Ethical issues of biotechnology and genetic engineering:
An Islamic perspective. Proceedings of 11th I AS conference on
biotechnology and genetic engineering for development in Islamic
word. Morocco, Rabat: 2002: p. 1‑12.
48. Larijani B. Medical genetic ethics Islamic view and consideration in
Iran. DARU J Pharm Sci 2006;14(Supple 1):48‑55.