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Selecting the Sex of Your Baby
Common reasons to use sex selection.
A family may want to use gender selection and select the sex of a baby because:
- They may want to prevent a sex-linked genetic disease, many of which are inherited by the mother, but only affect male children. Or, they may want to prevent a disease that affects males more severely, such as autism or Fragile X. "The medical reasons are usually medical conditions with prevalence in male offspring where families want to avoid males for that reason," says Norbert Gleicher, M.D., a New York fertility doctor and medical director of the Center for Human Reproduction (CHR).
- The family may have psychological reasons, which are also considered medical. For example, the family has lost a child and wants to have another child of the same gender.
- The family may have non-medical reasons, which would be elective sex selection. One of the non-medical reasons may be that the family has one or more children of one sex and now wants to have a child of the other six. This would be called family-balancing.
Because there is no sperm sorting method currently available for sex selection (Microsort did not receive approval from the Food and Drug Administration), to choose the sex of their baby, currently a couple in the United States must do in vitro fertilization along with preimplantation genetic testing. This is also the most accurate method — with approximately 99 percent accuracy.
Sex Selection for Medical Reasons
When a couple chooses to have sex selection for medical reasons, they can choose to do preimplantation genetic diagnosis (PGD). PGD screens out embryos for a specific genetic mutation that is associated with the disease the family is at risk of passing on.
Or, the family may choose to use preimplantation genetic screening (PGS). "Many couples choose [PGS] especially if they already have boys, they don't want anymore boys," Dr. Gleicher explains. "So they don't care about having another boy even if the boy does not have the disease, they simply want to have a girl. So they choose not to do a single gene PGD ... but they choose to go for a gender selection, which in terms of testing the embryo is a much simpler and less costly approach than doing a single gene diagnosis."
The method of genetic analysis for PGS that CHR uses is fluorescent in situ hybridization (FISH). "We do a Day 3 embryo biopsy and take off one blastomere and determine whether it is a female or male embryo," Dr. Gleicher says. "And we use FISH to do that, and FISH is very accurate in doing that and very cost effective. By Day 5, we have an answer, and we transfer only the desired gender."
Sex Selection for Non-Medical Reasons
In 2001, the Ethics Committee of the American Society for Reproductive Medicine (ASRM) declared gender selection "ethical" in principle.
If you are interested in sex selection for non-medical reasons, research your options at different fertility clinics. While some fertility clinics may offer the procedure to everyone, others only offer it to patients that fit a certain criteria; for example, only in cases where there is another reason to do in vitro fertilization.
"We are offering it in accordance with the ethical criteria for sex selection published by the ASRM a number of years back," Dr. Gleicher says. "So we do not do it for first pregnancies —it has to be family balancing purposes, and there must be a reason for IVF. "
Policies for Sex Selection, Gender Selection or Family balancing vary from country to country, and clinic to clinic. Cut through the leg-work and ask FertilityAuthority which clinics preform PGS by you.