Israeli parents who have at least four children of the same sex and want one of the other sex can now apply to a health ministry committee for approval of preimplantation genetic diagnosis at their own expense.
Professor Avi Yisraeli, director general of the health ministry, who issued the directive on the recommendation of experts on bioethics, said the new seven member body would approve sex selection of embryos for social reasons only in very unusual cases.
Except for one case officially approved by the ministry, all procedures done at Israeli hospitals for preimplantation genetic diagnosis have, until now, involved a family history indicating a high risk of serious genetic disorders. Such disorders include Tay-Sachs disease and familial dysautonomia (both of which occur mostly in Jews), as well as thalassaemia, myotonic dystrophy, neurofibromatosis, fragile X syndrome, haemophilia, and Marfan's syndrome.
Now the committee, which comprises experts in law, medical genetics, and obstetrics, a social worker, and a clergyman, will decide whether a couple or single woman can choose, for social reasons, the desired sex among the resultant embryos through in vitro fertilisation and preimplantation genetic diagnosis.
The only approved case so far of sex selection for non-medical reasons was that of an ultra-Orthodox couple who wanted to have a girl for complex religious reasons. The couple wanted a child but the husband was infertile, which meant that the wife would have to undergo in vitro fertilisation using donated sperm. But the husband was also a kohen (of the priestly tribe), which meant that, according to custom, the couple's son would be expected to recite the priestly blessing in the synagogue. But if the son was not the father's biological son he would not be allowed to do so. That would have required the couple to reveal the child's origins to everyone in their community, which the couple did not find acceptable.
Israel's policies on in vitro fertilisation are among the world's most liberal, with fertility units in every general hospital and with the health funds covering the cost of producing two babies for any infertile woman under 45 who wants them.
But the health ministry's chief adviser on ethics, the gynaecologist and Orthodox rabbi Mordechai Halperin, declared that there is no justification in Jewish law for performing in vitro fertilisation and preimplantation genetic diagnosis for couples who are not at high risk of genetic disorders and who do not have fertility problems. It would, however, be up to the committee to decide the exact criteria.