IVF and Gender Selection: Is It Possible to Choose the Sex of Your Future Child?

Nowadays, the world of technologies offers us many opportunities, especially for couples struggling with infertility problems such as PCOS, endometriosis, erectile dysfunction, blocked fallopian tubes, premature ovarian failure, uterine fibroids, low-quality eggs, low quality of sperm, unexplained infertility. Assisted reproductive technologies can offer fertility treatments such as In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI). Thanks to assisted reproductive technologies, many opportunities can help couples have a baby. In the beginning, the team will need to undergo tests, and after getting the results, the fertility specialist can say which type of fertility treatment will be suitable and safe for recipients because sometimes couples will need not only one treatment but combinations of treatments for a having a baby. The best choice is to visit a fertility specialist for finding out the causes of infertility or impossibility to conceive and then rely on the reason your doctor, and you will choose treatment.

The most popular and effective fertility treatment is IVF. In Vitro Fertilisation is a technique where eggs are fertilized by sperm in the laboratory to develop new embryos, and then these embryos are then put into a woman's uterus. But during IVF treatment, assisted reproductive technologies can offer additional treatments such as cryopreservation of sperm, eggs, embryo, ICSI (Intracytoplasmic Sperm Injection) or Preimplantation genetic diagnosis (PGD). Embryo preimplantation testing is a screening of embryo cells that are usually performed on embryos for checking on genetic diseases or abnormalities with the IVF technique. A regular and healthy embryo contains 46 pairs of chromosomes. The 23 chromosomes come from sperm, and the other 23 chromosomes come from the egg. In the case of an embryo with less than 46 chromosomes, it is considered chromosomal abnormalities. There are a few types of preimplantation genetic testing: PGT-A (preimplantation genetic testing for aneuploidy), PGT-M (preimplantation genetic testing for monogenic or single-gene defects) and PGT-SR (Preimplantation genetic testing for structural rearrangements of the chromosome). Usually, PGT can be recommended for women of advanced maternal age, couples who had multiple IVF cycles, couples who want to increase the success rate of IVF, couples who already had a recurrent pregnancy loss. But besides providing information about chromosomal abnormalities, PGD can give information about the gender of the future child.

Gender selection is an option that prospective parents may choose if they wish to select the sex of the future child. Gender selection can be performed by separating sperm and implanting only the embryos with the desired sex or through genetic testing.

With advances in IVF and Preimplantation Genetic Testing, it has become possible to select the sex of your child with virtually perfect accuracy. During this method, a small number of cells from an embryo made via IVF are removed from an embryo several days after fertilization and sent to a genetics lab for chromosomal analysis. After a biopsy, embryos are immediately frozen to await the results from genetic testing. After the results are in, the intended parents decide which embryo to thaw and transfer a frozen embryo. This option can allow recipients to choose the sex of child with 99% accuracy.

Gender selection involves In Vitro Fertilization that consists of 5 steps:

Ovarian Stimulation

During the first step, a woman takes medication to produce healthy eggs. Most months, women make only one egg, but with IVF, they stimulate 10-15 eggs to increase their chances of becoming pregnant.

Egg Retrieval

The next step of IVF treatment involves the harvesting of eggs. Egg retrieval is done while a woman sleeps under a general anaesthetic. Once completed, an embryologist examines the eggs under a microscope to count them.

Fertilization

The next thing that happens is the fertilization of eggs and sperm. The timing is crucial here. The eggs are retrieved, and then, after a few hours, they're fertilized with sperm. There are two ways to fertilize an egg: Conventional insemination or ICSI. In conventional insemination, the sperm is placed in a dish containing an egg to allow them to fertilize on their own. In ICSI, one sperm is injected into the cytoplasm of a fertilized egg using a needle.

Blastocyst Culture

Once the sperm fertilizes the egg, it becomes an embryo. The embryo is then placed in a unique incubator by an embryologist, where the embryo is provided with the proper condition to develop and grow. Adequate monitoring of the embryo is done for 5-6 days.

Embryo Transfer

The final step is Embryo Transfer. Once the embryo develops to the blastocyst stage, it is implanted into the uterus using a small tube called a Catheter. It usually takes place within 3-5 days after fertilization. Once the embryo is transferred to the uterus, it is allowed to the implant, and a blood test is carried on after two weeks to measure the hormone HCG.

During the procedure of gender selection, it will be required to do additional testing for an embryo that can take a few days for getting results. Moreover, sex election will require two cycles of treatments. The first cycle consists of the making and testing embryos, and the other process consists of transferring the embryo to the woman's uterus.