Dr. Jeffrey Steinberg, of the Fertility Institutes of Los Angeles and Las Vegas, is assisted by business manager Julia Vuille, right, who translates during
Dr. Jeffrey Steinberg, of the Fertility Institutes of Los Angeles and Las Vegas, is assisted by business manager Julia Vuille, right, who translates during a consultation with a couple from China about the gender selection process Monday, June 12, 2006, at his clinic in Los Angeles. Wealthy foreign couples are getting around laws in their home countries by traveling to the United States for medical procedures that can help them choose the sex of their next child. (AP Photo/Phil McCarten)

Researchers are finding the first evidence that some Asian immigrant families are using U.S. medical technology to have sons instead of daughters, apparently acting on an age-old cultural prejudice that has led to high ratios of boys to girls in parts of China and India.

The new research, produced by independent teams of economists who arrived at similar conclusions, focused on Indian, Chinese and Korean families who first had girls and then used modern technology to have a son.

With birth records in Santa Clara County showing that Asian mothers are more likely than white or Latino mothers to give birth to sons, the new data could reawaken a local controversy. Some local South Asian women have pressured area Indo-American newspapers and magazines in recent years to stop running ads for medical procedures that offer prospective parents the promise of a son.

For some South Asian couples, having a boy is a "status symbol," said Deepka Lalwani of Milpitas, the founder and president of Indian Business & Professional Women, a nonprofit business support network. "If a woman has male children, she feels in her family, certainly with her in-laws, that her status will go up because now she is the mother of a male child."

Such cultural pressures may explain the recent findings. A Columbia University study suggests that Chinese, Indian and Korean immigrants have been using medical technology, most likely including abortion, to assure their later children were boys. And a soon-to-be published analysis of birth records by a University of Texas economist estimates there were 2,000 "missing girls" from 1991 to 2004 among immigrant families from China and India living in the United States — children never born because their parents chose to have sons instead.

"We didn't expect to see a male bias. And for the first child, we didn't find one. It seems to appear after a first daughter and more strongly after a second daughter," said Douglas Almond, co-author of the Columbia study.

Among Indian families in Santa Clara County in the 1990s, Texas economist Jason Abrevaya found a 58 percent chance of having a son among families that first had two girls — significantly higher than the natural 51 percent chance of having a boy.

The teams found no comparable bias toward boys among white, African-American and Japanese-American families that first had girls.

Abrevaya found evidence that female infanticide, a practice documented in India and China, is not happening in the United States. The economists' data indicates only that some couples have manipulated the natural odds of having a son or daughter; it does not identify the means they used to do it.

"If gender-selective abortion is the cause for the unusual Asian, Indian boy birth ratios, then the abortion rate would be 20 percent to 25 percent of female fetuses who otherwise would have been the family's third or fourth child," Abrevaya said.

For Dr. Jeffrey Steinberg, the demand for a son is a business opportunity.

While abortion might have been the common medical procedure available for sex selection in the early 1990s, one of the methods advertised among ethnic communities today is PGD — preimplantation genetic diagnosis.

Steinberg, the medical director of the Fertility Institutes of Los Angeles and Las Vegas, uses PGD to harvest fertilized embryos, identify their sex after a few cellular divisions and implant the chosen gender. Chinese and Indian couples from the Bay Area, who pay as much as $18,000 per attempt to have a boy, are a major source of his clients, Steinberg said.

"Clearly among the Chinese population, there's heavy interest in male children. The Indian population also has a heavy interest in boys," he said. The U.S. is one of a very few countries that does not ban using techniques such as PGD for gender selection. (PGD was developed to screen for hereditary diseases such as cystic fibrosis). Among Steinberg's Chinese clients who use PGD to assure a son, 40 percent come from the Bay Area, 40 percent travel from China and 20 percent come from Southern California and the rest of the world. He also sees large numbers of Indian parents from the Bay Area.

"It's emotional for them, and it's emotional for us," Steinberg said. "They come in feeling that they owe me an excuse for wanting to be there."

Not all his clients are only interested in boys. Canadians, for instance, tend to prefer girls.

The normal ratio of boys to girls at birth is about 105 boys per 100 girls. But in parts of India and China, as ultrasound and other medical technology became available to reveal the sex of unborn children, the ratio of boys to girls aged 4 or younger jumped from 104 boys per 100 girls in 1981 to about 108 boys in 2001, according to a recent United Nations Population Fund report.

The preference for sons goes back 2,500 years in some parts of China, with economic and social roots through marriage dowries and other traditions. In India, some Hindus believe only a son can perform certain funeral rites for a father, and sons are expected to financially care for their parents in their old age.

Some who study the Indian Diaspora say son-selection may not die out, even in the U.S. Abrevaya, who found much stronger evidence for son-selection among Indians than among Chinese living in the U.S., worries that as PGD becomes less expensive, more people will use it.

Preeti Shekar, a Berkeley-based journalist and activist who said she believes there are "sexist and racist consequences" to medical technologies such as PGD, has urged a petition campaign to stop the ethnic media from running ads for Steinberg's clinic.

"There needs to be a lot of consciousness-raising," she said. "

One San Jose doctor received angry letters after he ran ads in India Currents magazine promoting "sex preselection" services.

Dr. Suresh Nayak uses a technique that selects sperm before conception to greatly increase the odds of having a child of the chosen gender. Nayak did not respond to telephone calls from MediaNews but highlights those services on his Web site.

In India Currents, Nayak defended his services as preferable to abortion.

"Being in the obstetrics-gynecology field, I see a fair number of couples terminating pregnancies of the 'undesired sex' after doing ultrasounds and amniocentesis," Nayak wrote.

"It is sad that the Indian culture that we love and are so proud of also has men believing that if they don't have a son to perform their last rites, their soul will never rest in peace.

"Whose fault is it for making them believe that?"

Reach Mike Swift at 408-271-3648.