In the 21st century, technology has opened many new doors for growing families. In the IVF world, major leaps forward have allowed us to produce happier, healthier children for parents that may have otherwise thought it was impossible for them to do so. For gender selection, the limits are no different; medical science now allows us to not only select gender like IVF in previous years, but it allows us to also use gender selection to help with an array of reasons, whether they be medical or personal reasons.
This article will review gender selection and why it may be an important aspect of your IVF journey. From preventing genetic diseases to addressing family balancing, gender selection is a common topic across many elements in the family-building process. Read on to learn more about how you and others can benefit from this option for your journey toward parenthood.
For the sake of this article, when we refer to gender selection, we are talking about choosing the biological sex of your children. During fertilization in an IVF cycle, embryos are created using both egg and sperm specimens. The sex of each embryo is determined by two chromosomes, one inherited from the egg source and one from the semen source. The type of chromosomes inherited (either X or Y) is what ultimately determines the sex of the baby. Females have 2 X chromosomes while males have 1 X and 1 Y chromosome.
It’s important to note that you or your partner may not be able to produce healthy embryos of your desired sex. This can be caused by your or your partner's age, egg supply, or specimen quality. In these cases, your doctor may recommend sperm or egg donation as a possible avenue.
Innovations in assisted reproductive technologies can identify the sex of an embryo in its initial stage. This stage is known as the blastocyst stage - when an embryo is made up of around 100 cells. Gender selection is the process of choosing the genetic sex of the child by testing the embryo(s) created through the IVF cycle in their initial stage and before being transferred into the uterus.
Gender selection is performed via genetic testing. Depending on the family-building goals, the amount of information received from testing can vary. For example, a family may be testing for a specific pre-existing genetic disorder and may also opt in for gender selection, while another family may only be interested in gender selection to balance their family. Either way, the choice to participate in gender selection is an incredibly personal one and is ultimately the parent's decision.
Genetic disorders occur when a mutation affects your genes. Carrying the mutation does not always mean you will end up with an actual disease. There are many types of mutations, including single-gene, multifactorial and chromosomal disorders. We receive half our genes from each biological parent and may inherit a gene mutation from one parent or both. Sometimes genes change due to issues within the mutations. This can raise your risk of having a genetic disorder. Some cause symptoms at birth, while others develop over time.
For chromosome disorders, those affected are either missing or have duplicated chromosome material.
Some commonly discussed chromosome disorders:
If you have a family history of a genetic disorder, you may need to consider genetic counseling to see if genetic testing is recommended for you. There are testing options, such as genetic carrier screening, preimplantation genetic testing, and prenatal testing.
PGS (preimplantation genetic screening, also known as PGT-A) is used to examine your embryo's overall chromosome level to detect any potential genetic abnormalities, and positively affect pregnancy success.
Gender selection can be done by PGT-A testing; this testing allows IVF physicians to determine the sex of each embryo tested. PGT-A testing can also identify chromosome abnormalities of the embryo(s) to limit genetic diseases from being passed to the offspring. With the current technique, PGT-A testing has over 98% of accuracy.
At PFCLA, PGT-A testing is recommended for most of the patients mainly for the reason of optimizing success. It is a patient’s decision on whether they want to proceed with knowing the gender of the embryo. This is also often performed if you are older than 37, as advancing age increases your eggs' risk of genetic abnormalities.
Some parents may be aware of a pre-existing genetic disorder and may need PGT-A for the health of their baby. For those who undergo IVF with PGT-A testing, the option of selecting the child’s sex is a bonus available from the genetic testing of the embryo.
Gender selection has become more common in recent years. Gender selection may be considered for medical reasons or for personal reasons. Below we touch on various reasons to consider gender selection while undergoing IVF.
Gender selection can be used to prevent or reduce the chances of developing some genetic-specific diseases. In some cases, conditions have a more severe impact on one gender than the other.
For example, Autism is four times more likely to be diagnosed in boys than girls and older women trying to conceive may have a preference for female embryos for this reason. Alternatively, if you or your partner are experiencing a form of a genetically transmitted disease that is sex-based and would like to mitigate the risk of your boy or girl receiving it, gender selection may be the best option for you.
Chromosomal abnormalities in embryos are commonly seen. For women older than 37, advancing age increases their eggs' risk of genetic abnormalities. By using the PGT-A testing, the embryos can be tested for abnormal chromosome aneuploidy; which could be a major cause of both implantation failure and repeat miscarriages.
This allows the IVF physicians to only transfer normal healthy embryos into the uterus. With the transfer of healthy embryos to the uterus, you have a better chance of IVF success. Studies and clinical data show an increase in pregnancy rates when genetic testing is used in IVF treatments.
Sometimes gender selection can be a personal choice and in fact, some families simply want to choose the gender of their child. Family balancing means that if a couple or individual always wanted a girl, but only had sons, they can select gender during IVF to ensure a balanced family.
Family balancing can also mean you and/or your partner may feel more equipped to parent one sex over the other. By going through IVF, you can choose to transfer the desired sex of the embryo into the uterus for implantation.
Gender selection requires careful consideration. It is an incredible option that can help families feel more prepared to raise their future children. It gives parents more flexibility when it comes to family building. There were limits on the number of children a family could have in countries such as Mainland China, gender selection with IVF gives many parents more choices. In some families, it is something that can lead to an overall happier family environment and a more fulfilled and enjoyable childhood.
There are many factors to consider when it comes to gender selection and IVF. At PFCLA, we always want to give patients multiple options when it comes to themselves and their families. Our fertility experts guide patients through the process with compassionate support. We review and evaluate each case and provide the best advice in each individual case.
If you would like to learn more about gender selection during IVF and why it may be a good option to consider, we encourage you to contact us by clicking the button below.