asks a question that would have been unimaginable until recent times: “If people want to choose their baby’s sex before pregnancy, should doctors help?”

Many would-be parents indicate a preference for a baby of one sex or the other. Modern reproductive technologies allow for the testing of embryos before transfer to the womb. A new technology known as “sperm sorting” may allow further refinements. As the paper explains the options:

There are several ways to pick a baby’s sex before a woman becomes pregnant, or at least to shift the odds. Most of the procedures were originally developed to treat infertility or prevent genetic diseases.

The most reliable method is not easy or cheap. It requires in vitro fertilization, in which doctors prescribe drugs to stimulate the mother’s ovaries, perform surgery to collect her eggs, fertilize them in the laboratory and then insert the embryos into her uterus.

Before the embryos are placed in the womb, some doctors will test for sex and, if there are enough embryos, let the parents decide whether to insert exclusively male or female ones. Pregnancy is not guaranteed, and the combined procedures can cost $20,000 or more, often not covered by insurance. Many doctors refuse to perform these invasive procedures just for sex selection, and some people are troubled by what eventually becomes of the embryos of the unwanted sex, which may be frozen or discarded.

Another method, used before the eggs are fertilized, involves sorting sperm, because it is the sperm and not the egg that determines a baby’s sex. Semen normally has equal numbers of male- and female-producing sperm cells, but a technology called MicroSort can shift the ratio to either 88 percent female or 73 percent male. The “enriched” specimen can then be used for insemination or in vitro fertilization. It can cost $4,000 to $6,000, not including in vitro fertilization.

The desire for a baby of a specific sex is nothing new. A preference for a son to carry on the family line and offer financial assistance has long been a part of many societies. In most cases, infanticide has been the option of choice. Babies — most often baby girls — were killed outright or abandoned and left to die. In more recent years, prenatal testing has been used in order to determine the baby’s sex, and then allow for the abortion of the baby if it is the “wrong” sex.

The American College of Obstetricians and Gynecologists is opposed to sex selection “except in people who carry a genetic disease that primarily affects one sex,” the paper reports. The American Society for Reproductive Medicine, on the other hand, takes “a more relaxed view.” In reporter Denise Grady’s words:

Instead of opposing sex selection outright, it says that in people who already need in vitro fertilization and want to test the embryos’ sex without a medical reason, the testing should “not be encouraged.” And those who don’t need in vitro fertilization but want it just for sex selection “should be discouraged,” the group says.

The group encourages the use of sperm sorting. Why? “It is noninvasive and does not involve discarding embryos of the “wrong” sex. The society concludes that ‘sex selection aimed at increasing gender variety in families may not so greatly increase the risk of harm to children, women or society that its use should be prohibited or condemned as unethical in all cases.’ The group also says it may eventually be reasonable to use sperm sorting for a first or only child.”

Some parties to this debate speak of “gender balancing,” as if children are entities to be “balanced.” Professor John Robertson of the University of Texas, whose radical concept of “procreative liberty” would allow for all kinds of reproductive technologies, says the issue is really no big deal. “He concluded, ‘I think this will slowly get clarified, and people will see it’s not as big a deal as they think.’”

The desire for a baby of a specific sex is not new, and it ranges from a mild preference to an absolute determination — whatever the costs in money and morality. Any technology that creates custom human embryos undermines human dignity. And that, we should agree, is a very big deal.