Genetic testing controversy overshadows medical tourism in Malaysia


Wealthy couples from Singapore and China flock to Malaysia for IVF genetic testing

Malaysia is becoming a medical tourism hub for IVF genetic testing. (Photo: Unsplash)

Posted: Jul 05, 2022 10:25 GMT

Updated: July 05, 2022 at 11:06 GMT

As many countries reopen their borders as the pandemic recedes due to increased vaccinations around the world, medical tourism from patients seeking IVF (in vitro fertilization) procedures banned in their country of origin but available abroad is on the rise again. One of the most controversial of these is sex selection by genetic testing of IVF embryos, a procedure known as preimplantation genetic screening (PGS) or preimplantation genetic testing-aneuploidy (PGT-A).

Although PGS (PGT-A) was originally developed to screen for genetically defective IVF embryos to prevent birth defects such as Down syndrome, it can also be easily used for embryo sex selection. humans. To date, PGS (PGT-A) is currently the best and most efficient sex selection method available on the market. If a woman becomes pregnant through IVF with this technique, the success rate of gender selection is close to 100%.

Fearing that these new reproductive technologies could further skew the sex ratio of their populations, many Asian countries with unbalanced sex ratios due to son preference, such as China and India, have banned the use PGS (PGT-A) for embryo sex selection in clinical IVF treatment. This is widely seen as immoral and unethical as it reinforces traditional gender biases and sexism, and encourages couples to favor having children of one sex over another – sparking much controversy in some Asian countries where women face strong societal and gender discrimination. grounded violence.

To circumvent these strict regulations, many wealthier couples from countries with such bans travel abroad to more liberal jurisdictions where PGS (PGT-A) for gender selection is permitted. In recent years, Malaysia has become a hub of medical tourism for the controversial procedure, with many well-established IVF clinics offering competitive medical fees to overseas patients. Indeed, the media reported that many couples from neighboring Singapore travel to Malaysia for embryo sex selection with PGS (PGT-A), as such a procedure is prohibited in the city-state. This has raised serious concerns among Singaporean health authorities, leading to the imposition of severe restrictions on the import of frozen embryos tested by PGS.

Many patients seeking to have PGS (PGT-A) embryo sex selected at Malaysian IVF clinics are ethnic Chinese from Singapore and China, as such a procedure is prohibited in their home countries. These patients often prefer Malaysia to Western countries, not only because of cheaper medical costs, but also because many fertility doctors can speak Mandarin.

In fact, some foreign fertility clinics in Singapore and China have collaborative ties with Malaysian IVF clinics that select sex with PGS/PGT-A. These clinics are allowed to initiate the IVF treatment process for their patients by performing hormone injections to stimulate egg production while the patient is still abroad, in order to shorten their stay in Malaysia for the procedure. of PGS sex selection.

Another alternative for Singaporean patients with busy schedules is to do the whole IVF treatment process in Singapore, but freeze all their embryos and export them to a Malaysian IVF clinic for the PGS gender selection procedure. However, they would then have to travel abroad for the transfer of the sex-selected embryos to the womb. On the other hand, the export of IVF embryos is prohibited in China.

The preference for sons and the obsession with having male heirs run deep in Chinese culture, even more so in the case of traditional Chinese family businesses, which tend to be more conservative than the general population. Although girls can now be educated and trained to become shrewd and capable businesswomen, they are not seen to carry on and carry on the family line. Instead, the children they bear are considered to belong to their husband’s family. Thus, if a traditional Chinese family business has no male heirs, all of its wealth is inherited by his sons-in-law, who belong to another family line. Additionally, the traditional Taoist/Confucian rite of ancestor worship requires male heirs to make prayer offerings to their deceased ancestors, lest their deceased family members become “hungry ghosts”.

In the early 20th century, famous Chinese Indonesian tycoon Oei Tiong Ham (aka Sugar King of Java) feared that his wealth would be inherited by his many daughters because Dutch colonial laws stated that he could not write a will that refused his daughters their rightful inheritance. . To escape these laws, he moved to Singapore, where he made a will that passed his entire estate to his sons upon his death in 1924.

It used to be common and socially acceptable for a wealthy Chinese to have multiple wives and concubines. By having more sons, a wealthy family could very quickly have many descendants through polygamy, effectively propagating and spreading their lineage into the general population. By having no male heir, family wealth will be passed on to sons-in-law, who in turn will abuse their inheritance to spread their own seed through polygamy.

Although times have changed dramatically and these old social norms are long gone, the ancient Chinese cultural traits that have evolved over millennia are irreducible and still persist. This could explain why the preference for sons and the obsession with having male heirs are so prevalent among traditional Chinese business families in Asia.

The opinions expressed in this article are those of the author and do not necessarily reflect the official editorial position of UCA News.

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