Gender Selection (Sex Selection)
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Gender Selection - Which Method Works Best?
Dr. Norbert Gleicher discusses the most reliable methods for gender selection.
Gender Selection Overview
Gender selection, or sex selection, is a fertility procedure used to choose the gender of a baby prior to conception. While the desire to choose whether a baby would be a boy or a girl has been present throughout human existence, it is only recently that the technology to do so has become clinically possible and available. With improvements in gender selection technology, demand for gender selection has also been growing steadily.
Two medical advances have been the driving forces behind the increasing demand for sex selection: 1) improvements in understanding of genetic diseases and 2) improvements in the ability to genetically assess embryos before transfer into the uterus (called Preimplantation Genetic Diagnosis or PGD).
Reasons for Gender Selection
Gender Selection for Medical Reasons
CHR Publications on Gender Selection
- Human Reproduction
When gender selection is used to prevent a genetic disease, the process is called "medical gender selection." In some cases, the so-called "sex-linked diseases" are inherited via the mother but only male offspring are affected (muscular dystrophy, hemophilia, etc.). In other cases, conditions are more severely expressed in one gender (Fragile X syndrome, autism in males, etc.) than the other. Medical reasons for gender selection can, however, also be psychological: a single female may feel better equipped having a daughter than a son; parents who lost a child may feel a strong need for a child of the same gender.
Elective Gender Selection
Sometimes gender selection can be "non-medical" or "elective." In such cases, a child of a specific gender is desired without obvious medical indications. The most frequent indication for such gender selection is "family balancing," when one gender is already represented in the family unit and the other gender is desired.
Methods for Gender Selection
We urge you to be careful with most of the "expert" advice you might find on the Internet in regards to gender selection methods. The truth is that most of the methods simply do not work. There are only two techniques that reliably affect gender: One is PGD with In Vitro Fertilization (IVF) , and the other is an experimental sperm-sorting technique, called Microsort™.
Pre-Implantation Genetic Diagnosis with IVF
In gender selection using IVF and PGD, embryos are created from the couple's eggs and sperm . On the third day after fertilization, when embryos have reached 6- to 8-cells, one of the cells is removed from the embryo, to be analyzed for its chromosomal makeup. (The removal of the cell at this stage does not negatively affect the embryo's growth competency.) This chromosomal analysis allows us to determine whether the embryo is male or female. Then, only the embryos of the desired gender are transferred to the uterus.
PGD gender selection is the most reliable method for gender selection, approaching 100% accuracy (although, of course, there are always possibilities for technical errors).
Advantages of Gender Selection at CHR
CHR is a world renowned fertility center in New York, NY. Although CHR performs a significant number of IVF+PGD gender selection cycles each year, unlike many "gender selection clinics" that only perform gender selection procedures, CHR's main focus is providing the most advanced fertility treatments to patients with complicated cases of infertility while pursuing important clinical research in this area. The same dedication to the most advanced care personalized to the medical needs of each patient applies to gender selection treatments performed at our center. The table below summarizes some of the advantages of gender selection at CHR:
Significant experience with gender selection
Medications are administered over the course of about 21 days to suppress normal ovarian function.
In-house PGD for highest accuracy
In contrast to most other IVF centers, which biopsy their embryos in house but send out the embryonic cells to another laboratory where the genetic analysis is performed, CHR performs PGD fully in-house. This ensures highest accuracy and safety for our PGD process, assuring that embryos never leave the confines of CHR.
Legal family balancing in the US
United States is one of the few countries in the world that permit gender selection for medical reasons and family balancing. Couples in many other countries, therefore, seek treatment abroad in the United States, to pursue the dream of completing the family, or avoiding certain genetic diseases presenting only in one gender. CHR has become one of the leading U.S. centers for gender selection, and as a result, a significant number of our patients for gender selection come from overseas (with gender selection being just a minute part of the center's IVF activities).
International gender selection
We have developed a number of ways to minimize your length of stay in New York City, while maintaining the high success rates CHR is known for via personalized treatment protocols and collaboration with reputable local IVF center in patient's local area (where possible). You can read the basic treatment logistics here, for long-distance patients. You can read about how our gender selection program in New York City works for long-distance patients here.
Notes for Patients Considering Microsort™ Gender Selection
The other method for reliable gender selection is Microsort™, developed by the Genetics and IVF Institute in Fairfax, Virginia. In its initial clinical trial, Microsort™ was shown to improve chances of gender selection for female to approximately 90%, while the approximate chance for a male child hovered at around a slightly lower 85%. In this method, sperm is sorted to X-bearing sperm and Y-bearing sperm, and only the sperm that bear the chromosome for the desired gender (X for a female child, Y for a male) is mixed with the eggs to fertilize.
However, after a long FDA review period following the initial clinical trial, Microsort™ failed to obtain FDA approval for clinical use. Therefore, Microsort™ is currently not available in the United States as of March 2012, leaving IVF + PGD as the only reliable gender selection method now available to patients.
Key Facts about Gender Selection at CHR
Gender Selection Consultation
Reliable gender selection is a complex process that involves medical, social, and for some patients, ethical issues. To help you reach the best treatment decision, we recommend beginning a detailed discussion with one of CHR's physicians. As a first step, complete the contact form below to determine if you'll qualify for our program.
Written by Norbert Gleicher, MD
Last Updated: December 31, 2013