Gender Selection – Family Balancing

The desire of conceiving a child of a given gender (sex) has been present in society throughout the history of mankind. Until recently, selecting a baby’s gender was only a dream. Gender selection (sex selection) has become clinically possible and available in many in vitro fertilization programs. In fact, the demand for gender selection services has been steadily increasing. Two medical advances have been the driving forces that have allowed gender selection a possibility: improvement in the techniques of sperm selection (Microsort) and the ability to genetically assess embryos prior to transferring them back into the uterus (Pre-implantation Genetic Diagnosis-PGD).

When gender selection is used to prevent a genetic disease, the process is called “medical gender selection”. Some genetic conditions are designated as “sex-linked diseases”. Some of these sex-linked diseases are inherited via the mother but only the male offspring is affected (muscular dystrophy, hemophilia). In other cases, some conditions are more severely expressed in one gender over the other (Fragile X syndrome, autism in males).

Sometimes, gender selection can be “non-medical” or “elective”. In such cases, a child of a specific gender is desired by a couple without obvious medical indications. The most frequent non-medical indication for such gender selection is the so-called “family balancing”, in which one gender is already represented in a family and the other gender is desired.

To date, there are only two techniques that reliably affect the gender of a given embryo. One technique involves the experimental sperm-sorting technique, called Microsort and the other in vitro fertilization (IVF) with PGD. The gender selection technique of Microsort was developed by the Genetics and IVF Institute in Fairfax, VA. Microsort improves the chances for conceiving a girl in approximately 90% of the cases, while the approximate chance to conceive a male child is approximately 80%. In this method, sperm are sorted to the X-bearing and Y-bearing populations based on their weight. A sorted sample of the desired gender is then used in conjunction with intrauterine cycles (IUI) or IVF cycles. However, the Microsort is currently under FDA review and is not currently available in the United States.

Gender selection done through IVF with PGD consists of creating embryos with a couple’s eggs and sperm. On the third day after fertilization, when embryos reach the six to eight cells stage, the embryologist takes off one cell from each viable embryo. This cell is then analyzed for its chromosomal make up. In fact, the removal of a single cell from an embryo does not negatively impact the embryo’s growth or competency potential. This chromosomal analysis allows Dr. Gomez to determine which embryo is male or female. Subsequently, only the embryos of the desired gender are transferred back to the uterus. PGD gender selection is the most reliable method for gender selection, approaching 100% accuracy.

Gender selection is not available around the world. Couples, in many countries, have no choice but to seek this kind of medical treatment abroad. Thus, a good proportion of RMI’s overall patient population seeking gender selection services comes from overseas. We provide personalized treatment protocols and collaboration with reputable IVF centers in patient’s local areas whenever possible. RMI has also partnered with a few nearby hotels/motels to assist our out of town patients with their lodging needs. Please call our office for more information.

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