Gender Selection: What You Need to Know

by | Aug 9, 2020 | Uncategorized

spermIt’s exciting for parents-to-be to find out whether they’re having a boy or a girl. Many people are hoping for one or the other—maybe you already have a boy and want a girl this time, or maybe you grew up in a family of all daughters and want the same for your own family. Whatever the reason, that preference can be a strong one; many of these parents would love the chance to choose whether they have a girl or a boy.

The idea that you can choose the gender of your child may seem like a futuristic one, but in reality, the technology has been available for decades, and you have access to it at fertility clinics all over the country! Gender selection is the topic of much debate; there are a variety of implications you need to consider, which is why it’s important to understand what it is, what it’s not, and when it’s an option for you.

Why Do Some Parents Want to Choose the Gender of Their Baby?

In some cases, there are medical reasons to choose the gender of your baby, such as when the child is at risk of a genetic disorder or disease related to a specific gender. There are lots of other reasons, too:

  • Parents might want to ensure they have both sons and daughters in their families. For example, they might already have three girls and want to make sure their fourth baby is a boy, especially if they’re not intending to have any more children.
  • Certain cultures and religions value having a boy as the first-born, and parents may feel intensely personal and societal pressure to have a boy.
  • Some parents are only planning on having one child, and they want the experience of raising a child of specific sex for personal reasons.

Gender selection is deeply personal. It can be a matter of health or preference, and it’s more common than you might think.

How Prevalent is Gender Selection?

This is not especially rare, and it’s certainly not secretive, but it doesn’t get discussed often enough because it is a taboo subject for many people. When model Chrissy Teigen and her husband John Legend shared publicly that they chose to have a girl, they faced some criticism, indicating there is still a lot of misunderstanding about why people would do it and what’s involved in the process.

Gender selection is a choice you have at nearly 73 percent of fertility clinics in the United States, with almost 94 percent of those offering the technology under specific circumstances not related to the health of the baby, which is called non-medical sex selection. About 81 percent of those clinics allow gender selection for unspecified purposes.

Even couples who are not experiencing fertility issues may pursue gender selection for their next baby. Although there are fewer clinics that offer gender selection to couples without infertility, the majority do, both for family balancing and personal, unspecified reasons.

How Does Gender Selection Work?

There are two primary approaches, neither of which can guarantee the preferred gender with 100 percent certainty. The first has been around since the 1970s and involves sorting the sperm prior to conception, using centrifugation to separate male and female sperm based on their subtle difference in their motility. Female sperms are about  3% heavier than male sperms and thus tend to swim slower and stay in the upper layers if the separation media after centrifugation. The gradient centrifugation method can be combined with intrauterine insemination (IUI), gives about 60 percent accuracy, and is relatively inexpensive.

A more complex and accurate sperm sorting method was the Microsort™ method using flow cytometry and fluorescent staining that can offer female (XX) sperm purity of 88 percent and male (XY) sperm purity of 73 percent. After Microsort processing, the sperm sample contains only enough sperm for IVF and not for IUI. In addition, the sorting cost can be several thousand dollars. Microsort is currently not available in the US.

The second approach of gender selection is through pre-implantation genetic testing (PGT), a process in which embryos are screened for aneuploidy and the identity of sex chromosomes. The embryo with normal chromosomes and the chosen gender is transferred into the uterus at a later time. This is a preferred method because you can test for genetic abnormalities at the same time, which can help you decide if you need to make a gender selection for medical reasons. In fact, some parents choose to have PGT out of concern for the health of the baby because they know one or both parents carries an abnormal gene. In the process of finding out whether their child will have a disease or disorder, they also find out the sex of the embryos.

Is Gender Selection an Option For You?

Every fertility clinic has its own guidelines regarding when to allow gender selection. At IVFMD, we offer the technology for medical reasons and for family balancing: if you have a boy and want a girl or vice versa, then gender selection is an option for you. You must already have at least one child of the opposite sex to choose the gender of your next baby.

It’s important to remember that while we can test the embryo for chromosomal makeup, there is no way to guarantee the embryo suitable for transfer will be your desired gender. It is possible to go through the process only to discover every embryo is of the same gender, which may be the one you prefer—or it may not be.

Weighing that possibility is an important part of deciding whether you want to pursue gender selection for the purpose of family balancing. The cost of the process may not be worth it to you if, in the end, you don’t get to choose, after all. Before you make a decision, we’ll sit down with you to discuss how important gender selection is to you and how likely it is to be successful.

If you have some viable male and female embryos, you will choose the ones you want to implant. We encourage you to donate the remaining embryos so another family has the opportunity to welcome a baby home.

Of course, you may choose PGT for medical reasons at any time. It is beneficial for patients over the age of 35, those who have experienced multiple miscarriages or failed IVF cycles, those with chromosomal translocations, or those who want to be screened for genetic diseases. PGT can detect aneuploidy or genetic mutations with more than 98 percent accuracy.

For more information about PGT and gender selection and whether it’s right for you, please contact us. Our fertility specialists are happy to discuss the options so you can make the best choice for you and your family.

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