"It Inevitably Raises the Question of Sex Selection"
11 Jun, 2007 07:10 pm
The British company DNA Worldwide raised a controversy last month by launching on the internet a home test called ?Pink or Blue? that tells the sex of the baby just six weeks into pregnancy. Dr Jean-Marc Costa, a specialist of prenatal diagnoses, answers our questions.
The test is based on the fact that cell-free fetal DNA is released in maternal blood very early during pregnancy as soon as 6 weeks of gestation. This fetal DNA circulates at very low levels but can be detected by molecular technologies such as polymerase chain reaction. If Y-chromosome derived sequences could be detected, that means they are from fetal source and therefore the fetus is male. On the contrary and by default, if theses sequences could not be detected, then the fetus is supposed to be female.
In an interview in Le Monde earlier this month, you said that you couldn’t understand how DNA Worldwide came to a conclusion with such a small blood sample. Does that mean that this technique is not fully reliable?
Our specialized lab, like some others, usually perform this test starting from a large blood sample (at least one ml of plasma or serum) This condition is necessary to reach the highest level of sensitivity required to obtain reliable results. I am therefore highly surprised that such a test, starting from a simple finger-prick of blood, could be efficient enough!
Such a diagnosis at just six weeks obviously raises ethical issues. What is your position?
It inevitably raises the question of sex selection. My position, which is shared by the European scientific community, is that such tests must only be performed in a medical context. However, in most European countries the impact of such a test has to be downplayed. For example, it is more considered as a gadget in France (they only have to wait until their 20 week scan to find out). But it would probably be different in developing countries! In India for example, despite the laws banning the use of ultrasonography for gender selection and selective abortion, the practice is still widespread. This type of kit, due to its simplicity could increase this phenomenon and lead to even larger mass gender selection.
Contrary to France, Great Britain has authorized the commercialisation of this test. Does Europe lack a bioethics policy?
I don’t think that Europe lack a bioethics policy as most countries do not approve sex selection and have already laws that regulate many bioethical issues (for example Code de la Santé Publique in France).
But there is an indisputable hypocrisy of some countries to avoid the question while asserting that it is not about a medical test!
Dr Jean-Marc Costa is the vice-director of the Laboratory Pasteur-Cerba in France.
Interview by Clementine Fullias
