Choosing the Sex of Your Child: Everything You Need to Know

As it stands, there are two proposed methods of determining the sex of an unborn child. One method suggests that trying certain sex positions (e.g. missionary position when trying for a female child) and abiding by a special diet can improve your chances of having a child of a specific gender. This method has no known scientific backing. Scientific gender selection has the backing of the medical reproductive community and here we explore how it works.

1. What is sex selection?

The terms sex selection, gender selection, or family balancing are often used to refer to the process of using specialized lab testing to determine the sex of an embryo in its earliest stages.

2. How does sex selection work?

A couple trying to have a baby has a 50/50 chance of conceiving either a male or a female child. Knowing this, sex selection is made possible due to the presence of different chromosomal combinations in men and women. The male chromosome reads as XX, and the female chromosome reads as XY. To accurately select the sex of your future child, sperm containing the Y chromosome or an embryo containing the XY chromosome has to be accurately selected.

Sex selection via IVF

Sex selection is complementary to in vitro fertilization (IVF). IVF is a fertility treatment that involves three steps, egg harvesting, egg fertilization, and transplanting. To begin IVF the treatment, a hormonal jab is self-administered by the patient around the stomach area three days into the beginning of a new menstrual cycle. The purpose of this hormonal treatment is to stimulate egg production. After about 36 hours, the eggs are retrieved from the patient (or an egg donor) and fertilized with either donor sperm or sperm from a partner in a lab.

After fertilization, the fertilized embryo undergoes incubation for about six days in an incubator whose conditions mimic a womb’s temperature. This stage involves two types of preimplantation genetic testing, namely, preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS). For PGD testing, an embryologist examines the DNA of the fertilized egg to check for specific diseases e.g. cystic fibrosis, while PGS tests for chromosomal abnormalities. Once completed, the healthy embryo of the preferred sex is transplanted into the uterine cavity via a catheter.

Sex selection via IUI

Sexual intercourse only makes it possible for a small number of sperm to swim through a woman’s reproductive tract. To improve the probability of sperm reaching the fallopian tubes, artificial insemination by intrauterine insemination (IUI) is usually preferred. The higher the chances of sperm reaching the fallopian tube, the more likely fertilization will take place.

In IUI gender selection, a semen sample from either a sperm donor or partner is then taken through a washing technique where healthy sperm is then separated from the semen. Sperm washing, as this is sometimes referred to, also clears the semen sample of seminal plasma that could make it difficult for the patient to conceive. The sperm sample is then analyzed for its motility, morphology, and number. It is also at this stage that the desired sex is determined. When the patient is ovulating, the cleaned sperm sample is later inserted into the uterus through the cervix. This process can also be done with home insemination kits.

Sex selection can be elective or considered for medical reasons. This option suits the following:

• Couples who have previously lost a child and would like/prefer to have another of the same sex
• Couples who feel better equipped to parent a child of a specific sex
• Patients who are unable to produce healthy embryos of their desired offspring due to advanced maternal age (35 and above), low egg supply, low sperm count, or poor sperm quality
• Couples seeking to avoid gender-based genetic disorders e.g. muscular dystrophy passed through from the mother to her male offspring

Scientific gender selection is a reliable method used by established fertility clinics to determine the sex of your child. Consult a trusted fertility expert for more information.