The Truth About Sex Selection: By Kathryn Kaycoff-Manos, MA

This first post serves as a foundation for understanding sex selection. Many people don't understand the options that are available to them, in their own countries and around the world. There are several different options, and each option has a very different process. You may have seen the much-hyped ads by some American reproductive clinics promoting themselves as the one and only place to go for sex selection. So, if you're new to this or maybe researching your IVF abroad options from distant countries you need to know that these self-proclamations may sound like fact - but the truth is that many clinics all over the world offer these same services (although some countries and clinics have restrictions.) Sometimes these services are "hidden" under a different name or aren't listed on the clinic's website, but often all you have to do is call or email and ask if the clinic will do gender selection and you'll get your answer.

What is sex selection and why do it?

Sex selection is just what it sounds like - you get to pick the gender of your unborn child. So, why would you want to do this? Well, first off, you may have a genetic issue that is only passed down through one gender and not the other. Obviously, you might want to screen this issue out by not transferring any embryos of that gender. Secondly, and probably the most common reason for sex selection, is the desire to balance your family gender-wise. You may already have one or two or more boys (or girls) and want one child of the other sex. Another reason is that in your family or extended family, there is an overabundance of one gender and you are looking to add some diversity.

Whatever your reason, whether it's one of these or something else, the laws regarding sex selection vary country-to-country, sometimes state-to-state and even clinic-to-clinic. So, if the concept of sex selection/gender selection is something that piques your interest, you may want to do a little research before jumping in - for most that means finding out which method best suits your needs and which clinics offer it.

What choices are available?

Microsort®

There are a variety of paths you can take if you are looking to specifically have a boy or girl. One option available at some US clinics is a relatively new procedure called Microsort®. To explain it simply, any unprocessed sperm sample contains about 50% girl sperm (X) and 50% boy sperm (Y). The goal of the MicroSort® is to separate the X and Y sperm. At this time, it is not possible to separate it out and have a 100% pure sample of either male or female sperm but clinical tests show there is approximately a 91% chance of selecting the desired female designated sperm and 76% of getting a male sperm. Pretty good odds - especially if you are aiming for a girl. And better than the normal 50-50% that you get in nature.

One consideration before deciding to do Microsort® is that there are certain eligibility requirements which clients must meet before their clinic will/can allow them to use this procedure. Patients must:
Be in need of reducing the probability of inheriting gender-linked diseases or

Have a need for achieving family balancing and already have children of one gender and not the other.

At this time Microsort® is only available in the United States, has not been approved by the FDA (Food and Drug Administration) and is still in the experimental stages. That being said, more than 800 babies have been born using this technology. The cost is approximately $3500 US/cycle (not including other IVF or IUI cycle fees.)

PGD/PGH

Another option for gender selection is Pre Genetic Diagnosis (PGD). PGD is the only method that can guarantee your gender choice with almost 100% accuracy. Using PGD, embryos are tested for gender before being implanted in the womb.

To qualify for PGD, you usually need a minimum of seven embryos (per the requirements of most clinics.) The embryologist then removes one cell from each embryo on the third day of its development in the lab and then that one cell can be tested not only for gender, additionally at this time you can test for the most common chromosomal abnormalities. It takes two days for the testing to come back, so the embryos would be transferred to a healthy uterus 5 days after they were created.

For those who are carriers of rare genetic disorders, there is also Pre Genetic Haplotyping (PGH). PGH works the same way as PGD, except that the genetic testing technique is more advanced. This is a relatively new variation of PGD with the first pregnancies in 2006.

With both PGD and PGH your doctor will only transfer the embryos that are the correct gender and come back without any obvious abnormalities. The cost of PGD and PGH ranges from $3500 - $7000 depending upon the lab, clinic and type of testing performed.

PGD is a used globally - so you would not be limited to the United States - however, you would need to check with the particular clinic to find out if they offer PGD for sex selection (this is a different question than whether or not they offer PGD for ruling out chromosomal abnormalities.)

Sperm Spinning

Lastly, there is something called Ericsson method for sperm sorting - also referred to as "sperm spinning." The idea behind sperm spinning is fairly simple - sperm with X chromosomes tend to be heavier than sperm with Y chromosomes. So, in theory, spinning sperm in a centrifuge will separate out the male and female sperm, with the female sperm sinking to the bottom. Once the sperm spinning process is complete, the sperm of choice can be introduced to an egg either through insemination (IUI) or in the lab via IVF.

Sperm spinning has been in use since the 1970s and is the least expensive of the options mentioned - and possibly the best choice for those who are financially challenged in this already expensive process - but unfortunately it has the lowest rate of success. For those hoping for a girl approximately 5 of 6 succeeded, and for those hoping for a boy, 1 in 3 were successful.

Sperm spinning is widely available in both the United States and Europe, and the cost per cycle is approximately $660 - $1200 US (not including other cycle fees.)

The Final Word

The one wonderful thing about the world of infertility is that there are constantly new techniques being developed to fulfill and suit everyone's needs. So, if you don't see or find what you want today, there's a good chance someone will develop it tomorrow.

Kathryn Kaycoff-Manos is the Co-owner and Co-Director of Agency for Fertility Solutions, a US-based fertility consulting company that specializes in international clientele - including those coming to the US and those looking for international solutions to their fertility issues. You can contact Kathryn at: Kathryn@agency4solutions.com. Kathryn is the mother of identical twins conceived through the miracles of modern medicine.