There are a few genetic conditions that are more common in one sex than another, and choosing the sex of your child can help avoid heartache. In other cases, a family with a lot of children of one sex may want to ensure at least one child of the opposite sex. Or maybe a couple just wants to be sure they have one of each. Whatever the reason, gender selection is here to stay, and the two methods available today are highly effective.
X & Y and IVF
Before discussing the two best available methods of gender selection, it’s helpful to have a general understanding of the process and terms.
X & Y: In general, semen contains a 50/50 ratio of X (female) and Y (male) sperm. The X sperm is slightly larger than the Y sperm, as it has approximately 2.8 percent more total DNA. In a typical conception, sperm from the male meets with an egg released by a female. If the egg is fertilized by an X sperm, a girl will be born, a boy if it’s a Y sperm.
IVF: With in-vitro fertilization (IVF), an egg from the woman is injected with sperm obtained from the man. In a typical IVF procedure, the sperm is not tested for male or female chromosomes, so the chances of conceiving one or the other are still approximately 50/50.
IUI: With intrauterine insemination (IUI), sperm is injected directly into the uterus. In a typical IUI procedure, the sperm is not separated into X and Y.
MicroSort Sperm Sorting
The method has a success rate of 91 percent for a girl and 76 percent for a boy. MicroSort sorts sperm using a technique called “flow cytometry.” The sorting technology is based on the larger X chromosome. The idea behind MicroSort is if that a woman is inseminated with mostly X sperm she is more likely to conceive a girl, and with Y sperm a boy.
MicroSort is used with either IUI or IVF. Insemination via IUI can only be done in a MicroSort facility because it must be done using fresh semen. MicroSort has two locations, Fairfax, Virginia, and Laguna Hills, California.
IVF is done at a collaborative physician’s office and the semen sample can be obtained in one of two ways. One is to collect it at a MicroSort facility and ship it, frozen, to the physician’s office. Alternatively, it can be collected at the physician’s office, then frozen and shipped to a MicroSort facility. Once there, it’s thawed and separated, re-frozen, shipped back to the physician’s office, and then thawed for the IVF procedure.
Pros and Cons of MicroSoft
MicroSort is a less expensive choice than the alternative for those who would like to influence the gender of their child, but aren’t absolutely determined to have one sex over the other. However, it does cost several thousand dollars.
With the freeze/thaw cycle of the IVF procedure, there is a higher possibility that the sperm will be damaged and there will be less viable sperm available. Dr. Mark Leondires, medical director of Reproductive Medicine Associates of Connecticut, says because of that potential for damage, MicroSort is recommended for a male with a great sperm count. MicroSort is also not guaranteed. Each batch of X sperm contains about 10 percent Y sperm, and each batch of Y sperm about 24 percent X sperm. It’s possible to go to a great deal of trouble and expense and not have a child of the desired sex. And, points out Dr. Leondires, if someone is willing to go through IVF, they may as well use PGD and be assured of the outcome.
Preimplantation Genetic Diagnosis (PGD)
This method has a success rate of 100 percent. PGD is always used with IVF. It enables the physician to choose the specific embryos to implant into the mother. Not only is the embryo guaranteed to be the desired sex, it’s also screened for genetic diseases, and abnormalities.
With PGD, eggs are collected from the mother and fertilized with the father’s sperm. The embryos are incubated for three days and then one cell is removed for testing. This one, tiny cell contains the entire DNA sequence necessary to identify gender as well as disease. Once an appropriate male or female embryo is chosen, or more than one if available and indicated, it is implanted in the uterus of the mother.
Dr. John J. Rapisarda, of the Fertility Centers of Illinois, says for the patient who must choose a gender because of genetic reasons, he would recommend PGD along with MicroSort to increase the chances of getting an embryo of the desired sex.
PGD Pros and Cons
PGD guarantees the sex of the child, but it’s pricey, adding about $5,000 to the cost of an IVF procedure (more if MicroSort is also used). Sometimes, the process of removing the cell from the embryo for analysis can damage the embryo, leaving it useless for implantation.
General Pros and Cons
For those who need to choose their baby’s gender based upon the risks of a serious genetic abnormality, high-tech gender selection is a blessing. “I would recommend MicroSort with IUI for the couple who would just like to influence gender, but want some element of nature taking its course, and PGD if they are planning to undergo IVF anyway,” says Dr. Leondires.
However, gender selection with IVF presents the same moral dilemmas inherent in any IVF procedure, namely: what happens to the unwanted embryos? The American Society of Reproductive Medicine’s stance is that gender selection for a non-medical reason is not ethical.
It’s also not a good choice for those who already have compromised fertility. If you’re processing the sperm with MicroSort or only using a portion of the embryos with IVF you’re compromising the cycle overall, Dr. Rapisarda. “I’ve had people request gender selection who aren’t good candidates for conception overall and yet are willing to compromise their chances further. Gender selection is not something someone who is already dealing with significant fertility issues should be focused on.”