Thanks to modern screening and testing of embryos during in vitro fertilization (IVF), a fertility doctor can determine the IVF gender selection of a child before the implantation process via preimplantation genetic testing.
Choosing the sex of a baby has always been a topic of interest for many parents, whether it is for personal preferences, family balancing, or medical reasons. The advancement in technology has made it possible for people to select embryos of desired accuracy with a very high accuracy before beginning their pregnancy.
This article explores the methods available for sex selection in IVF, their effectiveness, ethical considerations, and how to make an informed decision.
Understanding Sex Selection in IVF
Sex selection refers to a process or technique that is used to influence whether your baby will be a boy or a girl before pregnancy begins or occurs. If we talk about IVF, sex selection generally takes place with the help of genetic testing of embryos formulated in a laboratory. This approach is quite different from natural conception, as sex is determined randomly by the sperm carrying chromosomes, either X or Y.
Why Choose Sex Selection?
There are several reasons, as mentioned ,why couples might consider sex selection:
- Medical reasons: To avoid sex-linked genetic disorders that affect only one sex, such as Duchenne muscular dystrophy or hemophilia, which predominantly affect males.
- Family balancing: parents like to balance their family, so if they already have a child of one sex, they wish to have another child of the opposite sex.
- Personal or cultural preferences: Personal or cultural reasons are another aspect that helps in preferring a child of a particular sex.
Methods of Sex Selection in IVF
1. Preimplantation Genetic Testing (PGT or PGD)
Preimplantation Genetic Testing (PGT) is the most widely accepted and reliable method accepted by people for choosing the sex of their baby during the IVF process. This is also known as Preimplantation Genetic Diagnosis (PGD) at the time of detecting genetic disease. This method involves following the given steps-
- After ovarian stimulation and egg retrieval, eggs are fertilized with sperm in the laboratory to create embryos.
- When embryos reach the blastocyst stage, generally during day 5, a few cells are carefully biopsied from each embryo.
- The biopsied cells undergo genetic analysis to identify the presence of X or Y chromosomes, determining the embryo’s sex.
- Here, the embryos with the required sex with the normal genetic profiles are selected for transferring into the uterus.
The accuracy attained with this method is nearly 100% for identifying and selecting the sex, thus making it the gold standard for sex selection in IVF.
2. Sperm Sorting Techniques
Before fertilization, sperm sorting methods aim to enrich sperm samples with either X (female) or Y (male) chromosome-bearing sperm. Techniques like flow cytometry or the Ericsson method separate sperm based on differences in DNA content or density:
- The Ericsson method uses a column filled with human serum albumin to separate sperm by weight, with X chromosome-bearing sperm being heavier.
- Flow cytometry sorts sperm by staining DNA and separating them based on fluorescence intensity.
The accuracy held with the sperm sorting technique ranges about 70% to 90% for selecting the particular sex as per requirement. This is quite lower than another technique, Preimplantation Genetic Testing (PGT). Moreover, sperm sorting is less commonly used today due to the superior precision of embryo genetic testing.
How to Choose a Boy or Girl with IVF: The Process
Consult a Fertility Specialist: You need to state your reason for sex selection while understanding the legal and ethical guidelines of your region, as some countries restrict non-medical sex selection.
Undergo IVF Treatment: The woman undergoes ovarian stimulation to produce multiple eggs, which are retrieved and fertilized in the lab.
Embryo Biopsy and Genetic Testing: Embryos are biopsied at the blastocyst stage, and cells are analyzed to determine genetic sex and screen for chromosomal abnormalities.
Embryo Selection: Only embryos of the desired sex and good health are selected for transfer.
Embryo Transfer: After choosing an embryo, it is implanted into the uterus while monitoring for a healthy pregnancy.
Pregnancy Confirmation: For confirming pregnancy, a test is performed after two weeks of embryo transfer.
Success Rates and Considerations
- IVF with PGT for sex selection boasts a success rate of nearly 99-100% in choosing the desired sex.
- The process also allows screening for genetic diseases, improving the chances of a healthy baby.
- Sex selection adds cost and complexity to IVF and may require ethical reflection on family goals and societal implications.
- Laws governing sex selection vary globally; in some countries, non-medical sex selection is prohibited.
Ethical and Social Implications
Sex selection raises ethical questions about gender preference, potential societal imbalance, and the psychological impact on families and children. Many fertility clinics require counseling to ensure parents understand the implications and make informed decisions.
Conclusion
Choosing a boy or a girl through IVF is now possible with high accuracy, primarily through Preimplantation Genetic Testing. This method allows parents to select embryos of the desired sex while also screening for genetic health. Couples interested in sex selection should consult fertility specialists to understand the options, success rates, risks, and ethical considerations. With responsible guidance, IVF sex selection can be a valuable tool for family planning, especially when medical concerns are involved.