title: Paternity balancing.
abstract: BACKGROUND
  Gestational carriers and egg donors have been used by 'traditional' and now increasingly, gay couples. Three gay male couples, all using egg donors and gestational carriers with semen from both partners, had triplets. All desired reductions to twins for the standard medical indications, but requested, if reasonably possible, to have twins with one fathered by each partner.
  
  
  METHODS
  Following our usual clinical protocol, we performed chorionic villus sampling at 12 weeks on all fetuses obtaining FISH and karyotype. For paternity analysis, 14 polymorphic molecular markers on villi were compared to DNA samples from the two men to include or exclude each.
  
  
  RESULTS
  Standard assessments were all normal. Paternity testing showed that one partner fathered two of the triplets, and the other one. In all cases, one of the 'twins' was reduced with good clinical outcomes ensuing.
  
  
  CONCLUSIONS
  Paternity balancing increases options for satisfying family planning desires of gay male couples. We believe it comparable to gender preferences in reductions, i.e. it can be considered but only completely subservient to any clinical criteria. Paternity balancing raises similar ethical issues as reduction with gender preferences, but may increase patient autonomy and mainstream acceptance of stable, gay families.
authors.affiliation: Comprehensive Genetics, New York, N.Y., USA.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Evans
authors.forename: Stephanie
authors.initials: S
authors.lastname: Andriole
authors.forename: Eugene
authors.initials: E
authors.lastname: Pergament
authors.forename: Jamie
authors.initials: J
authors.lastname: Speer
authors.forename: Jenifer
authors.initials: J
authors.lastname: Curtis
authors.forename: David W
authors.initials: DW
authors.lastname: Britt
mesh_terms: D000328:Adult; D015193:Chorionic Villi Sampling; D005190:Family; D005260:Female; D018451:Homosexuality, Male; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D059785:Karyotype; D008297:Male; D008875:Middle Aged; D010334:Paternity; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000941:ethics*; D059286:Pregnancy, Triplet