Today’s scientific advancements have made it possible to select the gender of your child. Embryologists are now able to create or identify embryos of a certain sex. The ability to do this grew out of procedures already in place to perform genetic testing for medical reasons. It has only recently been opened up to non-medical, elective reasons such as “family balancing.” Cost, eligibility requirements, and moral or ethical conflicts make this not for everyone. We’ll go through some of the details in this article so you can see what options are available out there.
Pre-Implantation Genetic Diagnosis (PGD)
In this procedure, embryos created through IVF are tested for genetic disorders and gender. It was introduced in 1989 solely as a way to help couples with genetic disorders reduce the risk of having a child with the same condition. It is still widely used today for this reason, and also for women over 35 with a history of miscarriages. The testing will select embryos that are most likely to implant and result in successful pregnancy. Very few (literally only 3 or 4 in the US, and almost none overseas) will perform PGD for non-medical sex selection.
A cycle of pre-IVF fertility medications, egg retrieval, and in vitro fertilization is done. The embryos undergo genetic testing before implantation, rather than just a microscope check as is done in a normal IVF cycle. The embryologist will determine the health of the embryo, any potential genetic abnormalities, and gender. At this point, a decision will be made as to what to do with the information you receive. In PGD, only two embryos will usually be transferred since the weaker ones have already been selected out.
PGD is almost 100% effective in selecting embryos of the desired gender for implantation. Just like IVF, you will have the ability to freeze embryos for later implantation and save the cost.
The procedure can cost of up to $20,000. Like the cost, it shares many of the same negatives of IVF—invasive procedures, medications, risk of multiples. Perhaps the hardest thing about undergoing this procedure for the purpose of gender selection is that you have to decide what to with the embryos of the unwanted gender. Even if you are certain that you want a boy or a girl, this can be a very difficult decision. Will you freeze them for later, destroy or donate them?
In this procedure, instead of selecting the already fertilized embryos by their sex, the male and female producing sperm are separated and then the desired gender producing sperm are inserted into the uterus using intrauterine insemination (IUI).
This procedure is based around the X chromosome having about 3% more DNA than the Y chromosome, and therefore the sperm cells containing the X chromosome being bigger. A sperm sample is colored with dye and illuminated with a laser. The bigger female-producing sperm will glow brighter than the male-producing sperm, as they have absorbed more dye with their bulkier selves. The sperm is then separated by sex and the desired gender sperm are transferred to the uterus via IUI. Microsort can also be used with IVF, but would only do so in infertility cases where IVF was required. The practitioners of this method claim that it is 90% effective in choosing girls, and 74% effective in choosing boys.
Microsort can be used to prevent transmission of X-linked disorders (those that women can pass to buys but not girls), such as hemophilia. Because this procedure does not require that IVF is used (unless it is necessary for fertility reasons), you do not have the costs or risks associated with the much more invasive procedure. You will also not have to decide what to do with extra embryos.
Microsort is not approved by the FDA. It very recently (Spring 2012) failed to pass the clinical trial portion of testing to achieve this approval. It is therefore not currently available in the US. Prior to this restriction, there have been around 500 babies born in the US whose gender was selected by Microsort. It is a very new procedure (first available in 1995) and as such, the risks are not yet known. And of course, it cannot guarantee gender because we are unable to completely exclude all of the sperm on unwanted gender in a semen sample.
This method of gender selection is named for the doctor who developed it, Dr. Ronald Ericsson in 1970. It is based on the theory that male producing sperm swim faster than female-producing sperm. Ericsson claims that the procedure is 78-85% effective in choosing boys and 73-75% effective in choosing girls, many in the medical community doubt these numbers.
A semen sample is poured through albumin in a test tube. As the sperm naturally swim down, it is observed as the male sperm reach the bottom faster. Slow and fast swimmers are separated out and the desired sperm in introduced in the uterus or cervix via IUI or ICI. If the desired sex of the baby is female, then the woman is also given Clomid in conjunction with the procedure as it is shown to increase the chances of having a girl.
This is a much less expensive procedure, costing around $600. It is non-invasive and relatively safe. It is also more available, even in states where there are restrictions on gender selection procedures.
There is no guarantee of success. The claims of its effectiveness are disputed and some research says it is no higher than 50%.
There are many techniques that people have used for years to try and control the sex of their unborn baby. Everything from diet, sexual positions to the timing of intercourse is commonly used. Here are some of them:
This method suggests scheduling intercourse on specific days of your menstrual cycle to get a desired gender. According to the theory, male sperm move faster but don’t live as long as female sperm. In order to have a boy, you should have sex as close as possible to ovulation. If you want to have a girl, then have sex 2-4 days before ovulation so that it is the girl sperm that is still around when you ovulate.
Another theory of the Shettles method says that more acidic environments are harmful to the male sperm, but do not affect the female sperm in the same way. Shallow penetration (and the sexual positions that best facilitate this) favors female conception because the area is more acidic, inhibiting the weaker male sperm. Conversely, deep penetration will deposit the faster swimming male sperm closer to the uterine opening where it is less acidic and will better its chances of out swimming the slower female sperm. Also, female orgasm is said to make the environment more conducive to male conception as it makes it more alkaline.
The claims are of 75-90% effectiveness, but they are widely disputed.
This method also suggests scheduling intercourse on specific days of your menstrual cycle to get a desired gender. The Whelan method directly contradicts the Shettles method. It is based on the theory that chemical changes that may favor male sperm occur earlier in the menstrual cycle. If you want to have a boy, have sex 4-6 days before you basal body temperature (BBT) goes up at the start of ovulation. If you want a girl, wait to have sex 3 days before ovulation.
Dr. Whelan claims only 68% effectiveness in conceiving a boy, and 56% effective in conceiving a girl.
Sex Selection Kits
Yes, you can get an at home kit for everything! These are gender-specific kits based on the Shettles method. They include: A basal thermometer, ovulation predictor sticks, douches to prepare the vaginal environment, and vitamins and herbal extracts. These kits cost about $200 from several online sources and thousands have been sold across the US. These sources claim success rates of between 78-96%, but this is heavily disputed by the medical community.
Bottom Line on Gender Selection
This is a subject that is becoming increasingly controversial as we continue to make great strides in scientific research. As we acquire the knowledge and then the ability to do more and more, issues arise as to what and how we are to use that knowledge. Although many believe that any embryonic genetic testing is above and beyond our rights as humans, the main controversy here is the use of such technology for non-medical gender selection. To many of us who are struggling with infertility and clinging to that hope of someday conceiving a child, the thought that one sex is preferable to another is unthinkable. But the issue is out there, and it is only going to become more and more prevalent as the science gets better and more advanced. You and your partner will know what is right for you. There is plenty of information out there to read and to be informed about the options available to you.