No laws currently restrict the use of PGD, and certain states have explicitly exempted PGD from their laws restricting embryo research. Several higher courts have protected various kinds of prenatal testing as part of the reproductive right conferred by the Roe v. Wade decision. In 2001, the Ethics Committee of the American Society for Reproductive Medicine (ASRM), the main society and self-proclaimed watchdog of reproductive medicine, became embroiled in controversy when it supported parents' freedom to select the sex of their children for non-medical reasons, including "family balancing" or "the different meaning and companionship experiences that they expect to have." After a huge uproar, the ASRM revised its opinion to "discourage" such uses of IVF and PGD.

Federal courts have recognized reproductive rights in a variety of cases. In Lifchez v. Hartigan (1990), a federal court explicitly included the use of reproductive technologies among those rights when it struck down an Illinois abortion law as an unlawful infringement on a woman's right to privacy and reproductive freedom. The court said the law did not distinguish between prohibited "experimental" and permissible "therapeutic" medical procedures, thereby infringing on a woman's right to use assisted reproductive technologies such as in vitro fertilization. The court also held that the use of these and other technologies were part of a woman's fundamental right to privacy and reproductive freedom.

Critics are troubled by the ability to use medical procedures to choose a child's traits that are neither medically significant nor necessarily in the best interests of the child. At the same time, the majority of Americans resist any restriction on how they can exercise their right to reproduce.

Many believe that routine or on-demand prenatal testing and screening raises questions about our willingness and ability to accommodate genetic information in our existing system of social justice. Many argue that, at the very least, medicine's ability to routinize screening for "abnormalities" allows us to avoid issues for which we have no consensus. For example, is it appropriate to "prevent" disability by abortion? And what are the broader eugenic implications of the government having a stake in its people's genes?