The lab is part of the Fertility Institutes, a clinic set up by Jeffrey Steinberg, one of the most prominent gender selection doctors in the United States. In his spacious, oak-paneled office down the hall, Steinberg is surrounded by photos of his own naturally conceived children. His clinic is the world leader for this gender selection technique, known as preimplantation genetic diagnosis (PGD). “We’re by far number one. Number two is not even a close second,” he said.
The United States is one of the few countries in the world that still legally allows PGD for prenatal sex selection. The procedure was designed in the early 1990s to screen embryos for chromosome-linked diseases. It is illegal for use for nonmedical reasons in Canada, the U.K., and Australia.
Steinberg’s gender-selection patients are typically around 30 years old, educated, married, middle to upper class. They also typically have a couple of children already, unlike the women in his waiting room undergoing in vitro fertilization and hoping to conceive any child at all.
Statistics on gender selection are sparse. A 2006 survey by Johns Hopkins University found that 42 percent of fertility clinics offered PGD for gender selection. But that was half a decade ago, before many clinics undertook aggressive online marketing campaigns to drive the demand.
Gender selection is the primary business at Steinberg’s Fertility Institutes, with nurses casually asking couples in the waiting room whether they, too, are interested in selecting the gender of their baby. Business quadrupled when Steinberg started advertising PGD for gender selection.
Steinberg said he never intended to make gender selection his niche. But then the ethics committee of the American Society for Reproductive Medicine, a nonprofit organization that attempts to set standards in the industry, came out against prenatal sex selection for nonmedical reasons in 1994. The group said the practice would promote gender discrimination and was an inappropriate use of medical resources. That made Steinberg angry.
“I took it on as a challenge,” he said. “The fact that they didn’t like it, and the fact that I saw nothing wrong with it, made me more aggressive.”
He advertised in Indian-American and Chinese-American newspapers. Local groups accused him of stoking cultural biases for boys in those communities, and his ads were pulled by the publishers.
In 2009, Steinberg came under a worldwide media firestorm when he announced on his website that couples could also choose their baby’s eye and hair color, in addition to gender. He revoked the offer after receiving a letter from the Vatican. Steinberg seems to enjoy the attention, whether good or bad. After all, the publicity only helps bring in more patients to his clinics.
Many women who undergo PGD for gender selection discovered the procedure in online forums. Reading the posts on these forums is like entering another world. Users adorn their avatars with pink and princess imagery. They talk about their desperation to have daughters. They share notes on the process of going through PGD, recounting in detail their own experiences: blood-test results, drug effects, in vitro cycles.
Daniel Potter, the medical director of the Huntington Reproductive Center, has written more than 1,000 posts for in-gender.com and answered forum members’ questions about the procedure and its costs. He arranged in-person and phone consultations with forum members, including Megan Simpson. In 2011, he even started a personal website where he calls himself the “gender selection expert.”
From posting on message boards to using Twitter, Facebook, and YouTube, fertility doctors have appropriated 21st-century marketing methods to bring a 21st -century technology to the masses. Competition is stiff for search-friendly domain names for clinic websites and sponsored Google search ads. For example, there’s genderselection.com, not to be confused with gender-selection.com. There’s also gender-select.com and genderselectioncenter.com, all websites maintained by fertility clinics promoting PGD. These sites are filled with glossy stock photos of happy families, polished YouTube videos of doctors making their pitch, and patient testimonials in numerous languages.
In May 2008, Simpson and her husband traveled to California to undergo PGD at the Laguna Hills branch of the Huntington Reproductive Center. There, she met up with some of the women she had made friends with online. “We went shopping and picked out girly clothes and dreamed of the day we could have a baby to wear them,” Simpson recalled.
Three days after arriving in California, Simpson underwent egg retrieval surgery. Eighteen eggs were retrieved; of these, 11 were mature and were fertilized.
Her husband left after the surgery to return home and take care of their three boys. After resting for five days, Simpson returned to the clinic for her embryo transfer.