Non-Invasive Prenatal Testing: a New Tool for Sex Selections?

Prenatal genetic screening through non-invasive pre-natal testing (NIPT) or otherwise called cell-free DNA testing became commercially available for clinical use in late 2011. However early applications of NIPT, which included the deter-mination of Rhesus D blood-group status and fetal sex, have started even before, after the presence of cell-free fetal DNA in maternal blood was described in 1997. The commercializa-tion of tests to detect chromosomal aneuploidies has been rapid, and global marketing is steadily increasing. NIPT was introduced in the United States and Western Europe in late 2011, and currently the tests are rapidly becoming available in the Middle East, South America, South and Southeast Asia, and Africa. Apart from well known benefits of NIPT, which are high accuracy compared to standard screens or invasive tests and lack of harm to the fetus (potential miscarriage), noninvasive prenatal tests are also capable of disclosing fetal sex starting from 5-7 weeks of gestation. In fact, the ability to determine fetal sex early in the pregnancy without the need for invasive testing was perceived as “a bonus” for women. This raises multiple ethical and social implications related to dissemina-tion and use of noninvasive tests in countries where abortions based on gender preference are common (China, India, now also in some Southeast European Countries (Albania, Monte-negro), South Caucasus (Azerbaijan, Armenia, Georgia). The pa-per aims to discuss existing policy regulations/ guidelines that address use of noninvasive technologies with regards to fetal sex disclosure in countries with sex-selective practices