Last updated date: 02-May-2023
Originally Written in English
Can I choose the sex of my baby if I have IVF?
In Thailand, it is common for couples to want to have a baby boy. There may be several reasons for this, and often it is because a couple has daughters and would like a son. It is possible to choose the sex of your baby, although it is something that is quite strictly regulated by the Thai government, which is obviously to protect all parties. A member of our team will be able to speak to you about this in more detail on an individual basis.
As the top fertility clinic in Bangkok, we always work within the laws of the Kingdom and medical ethics to ensure that everything is done correctly. We always speak to both parents, together and separately, to ensure that both are entirely comfortable with the decision. Our doctors must be satisfied that it is a joint decision, and only at this point will they agree to commence treatment and explain the process.
How can you select the sex of a baby?
As the sex of a baby is determined by the male's sperm, the sperm must be sorted into male and female in a process known merely as sperm sorting. Alternatively, it can be done using a technique called Preimplantation Genetic Diagnosis (PGD) which also involves IVF treatment. Most parents prefer PGD as it allows them to select which embryos are implanted back in the womb. The process is also used to check for genetic defects as well as selecting if the embryo is male or female.
What is Preimplantation Genetic Diagnosis (PGD)?
Preimplantation genetic diagnosis (PGD) is a therapeutically viable tool for preventing the transfer of monogenic hereditary illnesses from one generation to the next. The main technological challenge is that there is no universal formula for all mutations, therefore each gene locus requires a personalized, tailored design to make the diagnostic precise enough to be used in PGD, where DNA is limited and a quick response is sometimes required for fresh embryo transfer.
Preimplantation genetic testing is an alternative to conventional post-conception diagnostic techniques (such as amniocentesis or chorionic villus sampling), which are usually followed by the agonizing option of terminating a pregnancy if the results are adverse. PGD and PGS are now the sole alternatives for preventing a high chance of a child being born with a genetic illness before implantation. It's an appealing way to prevent heritable genetic disorder and avoid the problem of having to terminate a baby due to a negative prenatal diagnostic.
Why is Preimplantation Genetic Diagnosis (PGD) preferred?
As with everything connected to medical science, the latest techniques are generally the best. PGD is a modern, painless technique which involves removing a few cells from the embryos which have developed in the laboratory. Once the embryos have been checked for genetic disorders and the sex has been determined, healthy embryos, chosen by both the parents and the doctors, can be implanted back in the womb using IVF. It is a process that gives parents peace of mind on several levels.
Primary candidates for PGD
These include the following:
- Couples having a history of X-linked illnesses in their family. Couples with an X-linked illness in their family have a 25% chance of having an afflicted embryo (half of male embryos)
- Couples with chromosomal translocations, which can result in implantation failure, recurrent pregnancy loss, or kids with mental or physical difficulties
- Autosomal recessive disease carriers. Carriers of autosomal recessive illnesses have a 25% chance of having an embryo afflicted.
- Autosomal dominant disease carriers. Carriers of autosomal dominant illness have a 50% chance of having an embryo afflicted.
In Vitro Fertilization (IVF) in Korea
Infertility treatment in South Korea encompasses a wide range of methods, ranging from natural birth control through hormone stimulation, pharmacological therapy, and assisted reproductive technologies: In Vitro Fertilization (IVF), also known as ICSI, hatching, and embryo transfer (blastocyst), is a reproductive technique that helps couples create a child. An egg (from the female partner or a female donor) and sperm (from the male partner or a male donor) are mixed in the laboratory during this operation. This egg and sperm combination creates an embryo that can be placed into the uterus of a female partner or a gestational carrier.
What you need to know about In Vitro Fertilization (IVF) in South Korea?
At ovulation, the ovary produces an egg, which travels via the Fallopian tube, where it meets the sperm and is fertilized. The fertilized egg travels to the uterine cavity and implants in the thicker uterine lining.
IVF therapy stimulates the ovaries to generate a large number of eggs, which are subsequently retrieved and combined with sperm in the laboratory, allowing fertilization to take place. The growing embryos are continuously watched, and the healthiest embryos are put into the uterus for implantation.
IVF refers to a set of techniques used to treat infertility in women over the age of 40. Ovulation Disorder, Premature Ovarian Failure, Fallopian Tube Damage, Endometriosis, Unexplained Infertility, Uterine Fibroids, Impaired sperm production or function, Previous tubal sterilization or removal, Genetic Disorder, or Fertility Preservation for Cancer Patients can all be treated with it.
What does an In Vitro Fertilization (IVF) Procedure Involve?
IVF is a lengthy procedure that might take months to finish. Despite the fact that this process increases your chances of becoming pregnant, there is no assurance that it will work for everyone.
You and your spouse must first undertake a number of tests, including sperm analysis, ovarian reserve testing, infectious illness screening, mock embryo transfer, and uterine cavity assessment, before beginning IVF operations. Following the screening, you will both undertake IVF procedures:
- Fertility medications are medications that are provided to stimulate your ovaries and boost egg production. Because it is predicted that some eggs would not mature or be fertilized after retrieval, several eggs must be generated. A transvaginal ultrasound will be done to evaluate the ovaries during this stage, as well as a blood test to assess your hormone levels.
- Your eggs will be extracted during a small surgical procedure. This operation will include guiding a needle into each of your ovaries for egg extraction utilizing cutting-edge ultrasound technology. In most cases, propofol-based anaesthetic will be utilized throughout the surgery.
- Sperm sample - Your spouse will now be asked to provide a sperm sample, which will be blended with your removed eggs in order to fertilize them. If you're going to use donated sperm, it'll be taken out of the freezer and treated the same way.
- Insemination - The eggs and sperm will be combined together and kept in a laboratory dish for fertilization in this technique. Intracytoplasmic sperm injection (ICSI) may be done if there is a poor chance of conception. A single sperm will be inserted directly into the egg, and the eggs will be constantly examined to see if fertilization occurs.
- Embryo Transfer- Cell division occurs after successful fertilization; fertilized eggs are now known as embryos. Following egg extraction and fertilization, these embryos will be implanted to your uterus in 3-5 days. One or two embryos can be transferred into a woman before the age of 40, and three embryos can be transferred into a woman above the age of 40. To avoid the potential of multiple births, the number of embryos to be transplanted must be limited.
What is sex selection with IVF?
IVF does not tell anything about the embryo's sex on its own. A doctor removes a woman's eggs and fertilizes them in a Petri dish in the traditional way. After a few days of growth, the doctor examines the embryos under a microscope and implants one (or more) of the embryos that appear to be the most viable in the mother.
Women and couples have had the option of adding a screening phase to their IVF cycle for the past 20 years, which determines a lot about the embryos, including gender. In 2013, screening for particular disorders was used in 6% of IVF treatments. According to a 2008 study of clinics in the United States, 74% provide the service.
Pre-implantation genetic screening, or PGS, is a sort of more broad screening that includes extracting one cell from the embryo and examining its chromosomes. While physicians do the test, the rest of the embryo is frozen. It aids physicians in determining which embryos are the most viable and excluding genetic abnormalities that cause Down syndrome and Turner syndrome.
Some doctors have argued that manipulating the embryo in order to do the screening carries "intrinsic risk" to the embryo. Despite these concerns, there is currently no evidence that it is unsafe. But when you've got millions of babies (who were screened in this way), you get less and less concerned that you are doing harm.
If anything, the screening step may lead to safer pregnancies. The better job doctors can do at determining which embryos are most viable, the more likely they may be to implant only one embryo and reduce the epidemic of multiple births in this country.
Why is choosing the sex of a baby becoming more popular?
It would be inaccurate to assume that choosing the sex of a baby is something that only happens in Thailand, it happens globally, and indeed, many couples travel to Thailand to receive the treatment. Here are just a few of the common reasons why people decide to select the sex of their baby.
In many cultures, Thailand included, families wish to have a boy in order to continue the male line of the family. In the past, this has resulted in families having several babies (which they couldn’t afford), until a male was born. Unfortunately, some of these babies were malnourished and neglected, and by choosing the sex of a baby, this is a problem that if not eliminated, is at least reduced.
Culturally, some parents are more loving to one sex
In western society, this is something that no one would admit, but in some other cultures, parents are openly more loving to one sex than another. If this is the case, and you and your partner are prepared to admit this, it would be advisable to select the sex of your baby to avoid any neglect. If this would make you and your family happier, then it is probably the best for all concerned that you follow this path.
- Family planning
We often have parents come to us explaining that they would like to have either a boy or girl next as they already have a child or children of one sex. IVF can be used to help to give parents the best chance of selecting a baby of their chosen sex. It is a point that also ties in with the cultural issues that we raised in point one.
- Medical reasons
Some families may have a history of hereditary medical problems which only affect one gender. If the doctors believe that you are potentially at a high risk of passing on the genetic condition. In that case, it may be advisable if you want to have children to decide the sex before they are born in order to remove the problem of the baby being born with a congenital disorder. In many cases, it will also help to remove the defect from future generations.
- Preparation time
Wherever you are in the world, having a baby is an expensive experience. By knowing if your baby will be a boy or girl at conception, it gives parents longer to prepare. It is a reason which has become less of a priority in the recent years with ultrasounds being able to detect the sex of a baby early in the pregnancy, but it is still a reason for some couples. Choosing the sex of a baby for practical reasons can sometimes receive some disapproval, so parents should also be prepared for this.
- Overcoming the loss of a son or daughter
The loss of any child is naturally hard for parents to take, but for some, the grief can become unbearable. It is quite common for families to crave another son or daughter to ease some of the distress. As medical professionals, we are acutely aware that the parents should never view the new human life as a replacement, more as a welcome addition to the family. It has been proven around the world that this has helped many families overcome the trauma of losing a child.
Ethical considerations about sex selection
Selecting a child's sex for medical reasons is unethical, but doing so for family balancing, cultural, or personal preferences may raise ethical difficulties for some. IVF provides sex selection services in accordance with the American Society for Reproductive Medicine's recommendations. This includes only allowing our patients to choose their sex after a full discussion about the potential ethical issues.
Sex selection, for example, can be used to favor one sex over another, which some people consider sexist or discriminatory. It can lead to sex imbalance, especially in societies where one sex kid is valued more than the other. There's also the ethical question of what to do with unused embryos of the opposite sex, such as when a couple wants a boy but only has female embryos, or when a pair has numerous embryos of both sexes but only wants a girl.
Unused embryos can be stored for future use in a pregnancy, donated to another couple in need of a viable embryo, donated for scientific study, or discarded. Many people find these selections to be quite tough. As a result, we discuss these difficulties prior to sex selection and, if necessary, recommend patients for therapy.
Myths about a baby’s sex
The Shettles Method, established by Landrum Shettles in the 1960s, is the source of several urban legends. He based his views on the fact that sperm with the Y chromosome, which conceives a newborn boy (XY), is lighter, quicker, and less durable than sperm with the X chromosome, which conceives a female (XX) (XX). This notion has given rise to several conception myths.
- Myth 1: Allow the lighter, quicker Y-chromosome sperm to reach the egg first by having intercourse closer to ovulation. Intercourse occurring later in the cycle allows the X-chromosome sperm to outlive the Y-chromosome sperm. Intercourse two days before ovulation is recommended, but she notes that this will merely improve the chances of conception and will have no effect on the sex of your kid.
- Myth 2: According to Shettles, having a deeper intercourse allows the quicker Y-chromosome sperms to reach the egg first. Deeper intercourse would have no effect on sperm delivery to the egg.
- Myth 3: Women should eat more potassium to boost their chances of having a son. Although there was a link between potassium and producing a male child, there was only a sliver of evidence that this was a viable strategy. In reality, the number of women in the study who had a boy changed by only 5%.
- Myth 4: Women who take an expectorant (like cough syrup) can make their cervical mucus more fluid, making it easier for Y-chromosome sperm to pass through.
- Myth 5: Changing the vaginal pH factor can help. It favors a female if you use a vinegar douche to make the vagina more acidic. It favors a male if you make it more alkaline with a baking soda and water douche. Baking soda douches will not modify the sex probabilities. We do not suggest these approaches since they might be dangerous to women, especially the baking soda.
Could choosing the sex of baby can lead to gender bias?
At least in the United States, there is no indication that allowing parents to choose the gender of their child would result in an overabundance of girls or boys. There is prejudice against women, but I don't believe there is an overwhelming bias in the use of assisted reproductive technology, at least not in my experience "toward one of the sexes. There are worries that society value boys more than girls, notably in several Asian nations However, this might be a cultural stereotype to some extent.
Even if sex selection is unlikely to distort the gender ratio in the United States anytime soon, there is a philosophical worry that parents should not have such power over their children. By making love depend on the kid being a specific thing, in this example, a boy or a girl, sex selection contradicts the notion of unconditional love and commitment.
The gender of a kid has an impact on how a parent loves their child. They adore their kids. It's not that they believe one gender is superior to the other; rather, they believe that having a child of this gender would be ideal. This type of thinking can occur when a couple, for example, already has three boys and wishes to try for a girl, a notion known as family balance.
It is possible to choose the sex of a baby using IVF in Thailand so long as both parents are comfortable and the doctors are confident that the decision is being made for the right reasons. To reinforce the point mentioned at the start of the article, we would never compromise the rules of the land or medical ethics in order the grant a couple a child of a chosen sex, regardless of how much they pleaded with us.