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A Scottish couple plans to use the new Human Rights Act to seek permission to choose the sex of a child.

Alan and Louise Masterton, from Monifieth, near Dundee, lost their only daughter Nicole in a bonfire accident and want to have a girl by in-vitro fertilisation (IVF).

Current rules on the use of the techniques - administered by the Human Fertilisation and Embryology Authority (HFEA) - ban choosing the sex of a baby unless there is a pressing medical reason.

The Mastertons now plan a court challenge based on two parts of the European Convention on Human Rights - recently fully incorporated into UK law in the Human Rights Act.

If they fail, they could go to the US to have the procedure carried out, according to Dr Nancy Dickey, from the American Medical Association.

"Legally speaking, this couple could go to America and find a place to accomplish what they want," said Dr Dickey, who is attending an international conference in Edinburgh.

"Ethically speaking, we would have substantial concerns about conceiving a child then determining whether to continue a pregnancy based solely on gender."

Nicole 'irreplaceable'

The couple, who have four sons, argue that they have a sound case for wanting a girl and repeated their assertion that they were not seeking a "designer baby".

They said they tried for 15 years to have a girl and lost their only one at the age of three.

They have asked to use a technique known as pre-implantation genetic diagnosis (PGD) as part of the standard IVF process.

Speaking on the BBC's Good Morning Scotland, Alan Masterton said: "We're not looking to replace Nicole. We're intelligent enough to be aware that we can never replace Nicole.

"What we're trying to do is help heal our family again and have another daughter."

Mr Masterton also dismissed suggestions that there was not a pressing medical need for his wife to give birth to a baby girl.

He said: "We have psychologists' reports and also our family's GP reports which prove beyond any shadow of a doubt that the psychology for a daughter in our family existed long before Nicole was born."

Clinics refused

Asked about fears that this would open the doors to sex selection for trivial reasons, Mr Masterton said: "This is exactly the point that our own situation turns on.

"We actually applied to the HFEA to have the specifics of our case considered. However, we believe that our application was circumvented and the HFEA have effectively made any progress impossible."

The authority said the correct approach for the couple was to find a willing clinic and ask it to apply. However, all five clinics with the expertise wrote back with refusals.

The HFEA has also acknowledged the "procreation or tourism" phenomenon where couples can travel to different countries with different regulations to seek particular treatments.

In the US, for example, there is little regulation of embryology and what there is varies from clinic to clinic, while many European countries follow the UK line.

Mr Masterton said he was convinced the clinics would not risk their reputations by attempting to change the guidelines and he believes the authority knew that.

'Deep-rooted fear'

Richard Holloway, the Bishop of Edinburgh and the Primus of the Scottish Episcopal Church,and former member of the HFEA board said that there was a deep-rooted public fear over sex selection.

He said: "I think that the HFEA is basically cautiously responding to these instinctive feelings.

"I think, in this case, it probably ought to look hard at it because, while you could probably make a case for a general regulation that sex selection is a bad thing, there must be exceptional circumstances.

"I would think this one probably was, and I hope they can get to a centre and get the centre to send in an application to the HFEA and that's what they're waiting for."

Dr Hugh McLachlan, a specialist in medical ethics at Glasgow Caledonian University, said: "I think there are two issues.

"I think in general that they should be given the chance to choose the sex of their baby. I think there is no good argument against that.

"Now I think to apply under the new legislation - the Human Rights Act - is a pretty desperate attempt, when other attempts have failed.

"I'm not saying that it should work. I suspect it might not work."

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bbc news world uk international foreign british online service

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BBC News | SCOTLAND | Baby sex choice battle

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A Scottish couple plans to use the new Human Rights Act to seek permission to choose the sex of a child. Alan and Louise Masterton, from Monifieth, near Dundee, lost their only daughter Nicole in a bonfire accident and want to have a girl by in-vitro fertilisation (IVF).

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Designer BabiesPre-implantation genetic diagnosis (PGD) or embryo biopsy

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Designer BabiesPre-implantation genetic diagnosis (PGD) or embryo biopsy

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Pre-implantation genetic diagnosis (PGD) or embryo biopsy

The cell contains all the genes of the embryo and short gene sequences from it are then positioned onto tiny microarrays ("biochips") for screening. A single DNA sample can be screened for tens of thousands of gene sequences.

PGD involves the production of an embryo outside the body, by in vitro fertilisation (IVF), followed by removal and subsequent testing to destruction of one of the cells. IVF is a very invasive process, particularly for the woman, and the odds of a healthy baby being born after a single IVF cycle are quite low. At present there is little evidence to suggest that removing one of the cells of a four-cell embryo effects subsequent development.

Since its beginning in the mid 1990s there have been about 200-250 cycles of IVF where PGD is involved in the UK, and about 1300 worldwide, although this number is increasing each year. PGD pregnancy rates can range from 17-40% per cycle depending on the genetic condition.

By comparison over 18,000 pre-natal tests are performed each year in the UK. This incudes amniocentesis where a sample of amniotic fluid is withdrawn from inside the membranes surrounding the developing foetus at about 16 weeks of gestation. The baby's cells in the amniotic fluid are tested for chromosomal disorders such as Down's syndrome. By this time, the woman is in the second trimester of her pregnancy, and may have to face the distressing choice as to whether to terminate the pregnancy.

The Ethical Issues

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The cell contains all the genes of the embryo and short gene sequences from it are then positioned onto tiny microarrays ("biochips") for screening. A single DNA sample can be screened for tens of thousands of gene sequences.

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*In this case, the newborn essentially has five parents: the birth parents who provided the egg and sperm, the surrogate mother who carried the baby, and the parents who will raise the baby. Now, since we had decided to use "18 Ways" in the title, I wanted to make absolutely sure this was an accepted list. Could PGD be considered a way to make a baby or merely a test performed before choosing a way? Should nuclear transfer and cloning be on the list? After all, they had produced animal babies but as yet no human babies. Another call to Dr. Grifo revealed that he stood by his list.At the end of his list, Cohen added "etc., etc."

"Eighteen ways to make me? I'm speechless."

The 18 Ways (And Then Some)
by Sarah Holt

To be safe, I emailed the list to other specialists, and they came up with yet more ways to make a baby. Dr. Douglas Powers, scientific and laboratory director at Boston IVF, a fertility and IVF center, said that if you paired ICSI with numbers 12 through 16 on Grifo's list, you'd have five more ways. That brought us to 23.

Clearly, 18 is an arbitrary figure. Suffice it to say that couples who cannot conceive naturally have a doctor's bag full of potential options to choose from. Though they should choose carefully, specialists in the field stress. "While there are many ways one can produce a baby, one should always consider them in the context of their safety and efficacy," says Dr. Zev Rosenwaks of Cornell University. "This implies not only safeguarding against medical risks but also paying great attention to the emotional and social manifestations of the procedures involved." (For more information on assisted reproduction, see The 18 Ways (And Then Some) | Search | Site Map | Previously Featured | Schedule | Feedback | Teachers | Shop
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Resources.)

Sarah Holt produced the NOVA program "18 Ways to Make a Baby."

Photos: WGBH/NOVA

Dr. Jacques Cohen, scientific director of the Institute for Reproductive Medicine and Science at Saint Barnabas Medical Center in Livingston, New Jersey, fired back an email in which he said "There are many more ways of making babies than 18. Can I add some more?" He listed several techniques that add to those mentioned by Grifo and Powers, and here they are, edited for clarity and numbered appropriately:

When I first heard there were 18 ways to make a baby, I was flabbergasted. Dr. Jamie Grifo, a specialist in reproductive endocrinology at New York University Medical Center, casually mentioned the fact in an interview that I taped with him for this NOVA program.

Imagine my amazement when I learned that there were actually many more than 18.

Before producing the film, I probably would have been surprised to hear there were more than three or four. Like most people, I was familiar with artificial insemination and in vitro fertilization and frozen embryos, but not much more. While working on the program, I had come to have a layperson's understanding of some of the latest techniques, which have futuristic names like Intra-Cytoplasmic Sperm Injection and Preimplantation Genetic Diagnosis. Nevertheless, I was initially hard-pressed to come up with 18 ways.

Eventually I did, and I ran the list past Dr. Grifo to ensure it was accurate. It was, and here it is.
Note: Click on highlighted terms for a definition.

1. Natural sex

2. Artificial insemination-of mother with father's sperm

3. Artificial insemination-of mother with donor sperm

4. Artificial insemination-with egg and sperm donors, using surrogate mother

5. In vitro fertilization (IVF)-using egg and sperm of parents

6. IVF-with Intra-Cytoplasmic Sperm Injection (ICSI)

7. IVF-with frozen embryos

8. IVF-with Preimplantation Genetic Diagnosis (PGD)

9. IVF-with egg donor

10. IVF-with sperm donor

11. IVF-with egg and sperm donor

12. IVF-with surrogate using parents' egg and sperm

13. IVF-with surrogate and egg donor

14. IVF-with surrogate and sperm donor

15. IVF-with surrogate using her egg, sperm from baby's father

16. IVF-with surrogate using egg and sperm donors*

17. Cytoplasmic transfer**

18. Nuclear transfer and cloning

**The U.S. Food and Drug Administration has recently asked the specialists that perform this experimental procedure to submit it for FDA approval, so it is currently not available.

#17 on Jamie Grifo's list.

#25 on Jacques Cohen's list.

1. After freezing the unfertilized eggs.

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NOVA Online | 18 Ways to Make a Baby | The 18 Ways (And Then Some)

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In this case, the newborn essentially has five parents: the birth parents who provided the egg and sperm, the surrogate mother who carried the baby, and the parents who will raise the baby. Now, since we had decided to use "18 Ways" in the title, I wanted to make absolutely sure this was an accepted list.

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Thousands of infertile couples could benefit from a new IVF procedure that can dramatically improve the success rate of having a baby through artificial reproduction.

Scientists believe they can double or even triple the proportion of healthy babies born as a result fertility treatment with a relatively simple technique that takes a series of time-lapse photographs of the developing IVF embryos.

On average only about 24 per cent of IVF embryos implanted into women in the UK lead to live births but the researchers believe this could be increased to 78 per cent using the new technique for selecting the best embryos.

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Sharing the full story, not just the headlines

"I believe it is the most exciting breakthrough we've had in probably 30 years," said Professor Simon Fishel, managing director of the CARE Fertility Group, where the technique was developed.

"Every IVF practice in the world is unintentionally and unwittingly putting back into the womb unviable embryos that don't make babies," Professor Fishel said.

"We hope to see a paradigm shift in terms of IVF. It's a game changer for everybody to have such an uplift in live birth rates. This is the beginning of something revelatory," he said

Each year, licensed clinics in Britain carry out about 60,000 IVF treatments but most of them end in failure, causing immense emotional upset to couples, many of whom have paid between £5,000 and £10,000 for each treatment cycle.

The new procedure, which costs £750, identifies the best embryos to be implanted into the womb based on the time it has taken to develop between two key stages in the early life-cycle of the embryo.

Thousands of time-lapse pictures are taken during the first few days of an IVF embryo's life and these are used to identify the time between the first appearance of the fluid-filled cavity, called the blastula, and the final moment before the embryo "hatches" from its protective shell.

Scientists have discovered that when this period lasts longer than about six hours, the IVF embryo is likely to be carrying an abnormal number of chromosomes, called aneuploidy, which will lead to a failure of the pregnancy.

A preliminary study, published in the journal Reproductive Medicine Online and based on a retrospective analysis of 88 IVF embryos of 69 couples, found that the time-lapse technique could have improved the success rate of life births in this particular group of patients from 39 per cent to 61 per cent.

Even better success rates can be expected once the procedure is refined and applied to the wider population of infertile couples seeking IVF treatment, Professor Fishel said.

"Our work has shown that we can easily classify embryos into low or high risk of being chromosomally abnormal. This is important because in itself this is the largest single cause of IVF failure and miscarriage," he said.

"The beauty of this technology is that the information is provided by a non-invasive process. So far we have seen a 56 per cent uplift compared to conventional technology, giving our patients the equivalent to a 78 per cent live-birth rate," he added.

Normally, IVF embryos in an incubator are checked manually each day by embryologists but the time-lapse cameras are able to do this automatically by taking pictures every 10 minutes without interfering with embryo development, said Alison Campbell, embryology director at Care Fertility in Nottingham, who developed the computer algorithm controlling the analysis.

"With time-lapse we have the ability to view more than 5,000 images over the same time period to observe and measure more closely each stage of division and growth. As a result of continuous monitoring we have demonstrated that delays at defined points indicate abnormal development," Ms Campbell said.

Martin Johnson, a fertility expert and editor of the journal where the work is published, said further "prospective" studies comparing the technique to existing methods of embryo selection are still needed before the procedure is recommended as standard treatment. "There are caveats with this research....and for these reasons we have to be cautious," he said.

Sue Avery, director of Birmingham Women's Fertility Centre, said: "Unfortunately the study does not compare this exciting new approach with standard practise in embryology in which embryologists already look for the best embryos to place in the womb. Until the new technique is compared to current practise we cannot know whether different embryos are being chosen."
Egg timing: Key stages
The developing embryo (image one, above) goes through two key stages when the fluid-filled cavity or "blastula" first forms (image two) and when the blastula is fully formed before the embryo "hatches" (image three).

The time between the two is used to judge whether the embryo is viable, with no defects in chromosome numbers. If the period is longer than six hours, the embryo is at high risk of abnormal chromosomes, which will inevitably lead to complications. Time-lapse photographs can indicate which embryos have a shorter time-period between these two points, and so which embryos are best for implantation into the womb.

Steve Connor

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'Most exciting breakthrough in IVF treatment in 30 years' could triple

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Thousands of infertile couples could benefit from a new IVF procedure that can dramatically improve the success rate of having a baby through artificial reproduction. Scientists believe they can double or even triple the proportion of healthy babies born as a result fertility treatment with a relatively simple technique that takes a series of time-lapse photographs of the developing IVF embryos.

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Drawing the Line: When IVF Doesn't Work - BBC Sounds

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Catch up on your favourite BBC radio show from your favourite DJ right here, whenever you like. Listen without limits with BBC Sounds.

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Catch up on your favourite BBC radio show from your favourite DJ right here, whenever you like. Listen without limits with BBC Sounds.

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The Decade That Invented the Future: The 1970s - 1978: IVF - BBC Sounds

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Catch up on your favourite BBC radio show from your favourite DJ right here, whenever you like. Listen without limits with BBC Sounds.