Preconception sex selection: a survey of visitors to an internet-based health forum

The aim of this survey was to explore the attitudes towards gender selection, focusing on people who were affected by infertility and also familiar with advanced technologies such as the internet. A questionnaire was posted on a German internet site targeting infertile people with a wish for a first or another child. Nearly all respondents (736/742) were female. Most respondents (82.7%) were firmly against sex selection if the techniques used would require several treatment cycles and corresponding costs for the couple. Even if, hypothetically, sex selection could be achieved by simply taking a ‘pink’ or ‘blue’ pill before intercourse, only 19% would take this option. More respondents had some interest, if any, in conceiving a girl as first child or next child (27% girl versus 11% boy). A positive attitude towards sex selection was more likely if the respondents had a preference for either a boy or a girl (odds ratio [OR] = 12.8, P < 0.01) and, or had an unbalanced family (OR = 1.8, P = 0.03). Although this survey is based almost exclusively on answers from women, it seems reasonable to conclude that a widely available service for preconception sex selection for non-medical reasons would not cause a severe gender imbalance in Germany.