Frequently Asked Questions
WHAT IS GENDER SELECTION?
WHAT IS GENDER SELECTION? CAN YOU PICK THE GENDER OF A BABY?Gender selection is any attempt to pre-determine what sex a baby will be at birth. Today the term is also used to describe a fertility treatment process which increases the likelihood that a baby will be a born with the desired sex, either male or female. Historically, women often were blamed if a pregnancy didn't result in a male. The truth is that genetically it is the father’s sperm that determines the sex of a child. The sperm carries either an X (female) or Y (male) chromosome, whereas the egg only carries an X chromosome. With today’s advanced fertility techniques, it is possible to choose a gender during treatment so that the sex of the baby at birth is the sex you wanted.
WHAT WEEK IS THE BABY'S GENDER FORMED?The baby’s sex is determined at conception when the sperm fertilizes the egg with either a X (female) or Y (male) chromosome. The sex is one of the 46 chromosomes that makes up the genetic code of an embryo. The baby’s sex is fixed at conception and doesn’t change as the pregnancy progresses. Visually, you can see the baby’s sex using ultrasound as early as 10 – 12 weeks. DNA testing can detect it earlier, at 6 – 9 weeks. And even earlier on day 5 of embryo testing.
IN WHAT COUNTRIES IS GENDER SELECTION LEGAL?In most European countries gender selection is not legal. In these countries the sex of the baby cannot be revealed to parents even if it is known. Additionally, preimplantation genetic testing (which would allow us to know the sex of the baby) may not be allowed, as it is illegal to remove cells from the embryo. The United States has no restrictions on knowing or choosing the sex of a baby.
WHAT IS SPERM SEPARATION OR SPERM MICROSORTING?Multiple gender selection techniques have been tried with spermatozoa. For example, one approach, known as the Ericsson Method, relied on the observation that male sperm are lighter and swim faster, and so they should be able to be separated by weight using spinning. However, this approach has not held up to scientific rigor. Sperm microsorting is a much better technique. It differentiates between male and female sperm based on the amount of DNA that is in the sperm. Sperm carrying a X chromosome has approximately 2.8% more DNA than a sperm carrying a Y chromosome. By using a special dye, the sperm with more DNA material will shine more brightly, and this facilitates microsorting which separates the sperm by sex. It is a proven way to enrich a sperm sample for a gender preference.
DO NATURAL METHODS OF GENDER SELECTION WORK?Because the sex of the embryo is determined by the sperm, contrary to what some believe; there is nothing a woman can do, whether that is adopting a particular diet or following a Chinese birth chart, to influence the gender. Throughout history there have been many beliefs on how to influence a baby’s gender. For example, Aristotle believed the wind direction during copulation determined the sex at conception (it doesn’t). Another myth, that hot weather favors boy babies, is just a myth.
CAN YOU PICK THE BABY’S GENDER IN IVF?IVF, in vitro fertilization, is a form of assisted reproduction where the sperm and egg are combined in a lab into an embryo which is then implanted into the uterus. With embryo testing we can know the sex (gender). Accordingly, picking the gender pertains to choosing the embryo that is put back into the uterus as part of the IVF process. Of course, this assumes that there is a viable embryo with the gender you desire available for implantation.
HOW DOES GENDER SELECTION WORK?There are two steps that are both needed for successful gender selection. The first step is sperm microsorting, which is a technique that selects or sorts the spermatozoa based on the sex of the sperm. Tree of Life uses the Microsort Gender Selection Technology to help enhance your chances that the egg is fertilized with the right chromosome for the gender you desire. Secondly, gender selection is also dependent on embryo testing (also known as preimplantation genetic diagnosis), so that the embryo with the desired sex is picked for implantation into the uterus.
WHAT IS THE SUCCESS RATE OF GENDER SELECTION?Successful gender selection requires both sperm microsorting and preimplantation genetic testing. With microsorting you are enriching the spermatozoa prior to conception so that most sperm in the sample is the gender you desire. As far as effectiveness, microsorting can produce on average, a purity of 78% male sperm, and 90% female. The preimplantation genetic embryo testing confirms that the embryo is the right gender before placing it back into the uterus. With this testing and assuming that you have an embryo that is the right sex available for implantation, the success rate of gender selection is very high, 99%.
WHAT ARE THE RISKS OF GENDER SELECTION?These methods pose minimal risk to the embryo. With any laboratory procedures there can technically be some small risks. For example, there may be a small risk due to adding florescent dye to the sperm sample as part of the microsorting procedure. However, with the important method of preimplantation genetic testing of the embryo, any defects will be found prior to preimplantation. There has been no proven risk of birth defects with any of the procedures involved with gender selection. In fact, due to the genetic embryo testing, the possibility of a birth defect is lower with IVF than with natural conception.
SHOULD PARENTS BE ABLE TO SELECT THE GENDER OF THEIR BABY?If prospective parents have chosen IVF to help them have a baby, they will know the gender of the embryos as a result of the genetic preimplantation embryo testing. This testing reviews all the chromosomes in the embryo, making sure there are not missing ones and as well as checks the sex chromosomes of the embryo are normal. Since knowledge of the sex of the embryo is readily available to parents as a byproduct of the IVF process, an argument can be made that having the choice of gender selection is a reproductive liberty the parents undergoing IVF should have. Additionally, parents may want to choose a sex to avoid genetic defects (such as Hemophilia) present in only one sex. There may be other information, not just the sex, about the embryo that may factor in the decision of picking an embryo for implantation. A contrary argument is that gender selection is a form of eugenics. This is one reason why, in some countries, doctors are prohibited from sharing the gender of the embryo with the parents.
WILL INSURANCE PAY FOR GENDER SELECTION?Most insurance companies will not cover the sperm microsorting costs of gender selection. However genetic screening of the embryo may be covered to ensure that the baby will be normal and healthy.
WHAT IS THE COST OF MICROSORTING?The Microsort technique is a non FDA approved procedure in the US. So the sperm must be frozen in our fertility clinic and sent to our laboratory in Mexico which increases the cost. Currently the full cost (including the freezing and shipping) is $5,000.
DO YOU HAVE TO USE IVF WITH MICROSORTED SPERM?It’s a misconception that IVF can be avoided. This is because microsorted sperm is not a good candidate for sperm insemination. The process of freezing the sperm greatly reduces the chances of natural conception. The sorted sperm should only be used with IVF (in vitro fertilization). Sperm sorting was invented before genetic embryo testing and in the past, it was paired with insemination, but the results were variable. Maybe in the future it could be developed into a more reliable technique if the sperm did not have to be frozen for shipment.
DOES ICSI AFFECT GENDERICSI, intracytoplasmic sperm injection, is used to interject the sperm into the center of the egg, with the goal of achieving an embryo. Since it is the sperm that determines the embryo’s sex, ICSI doesn’t affect the baby’s gender in any way. It’s not possible to optically see which X or Y chromosome each sperm carries.
ARE ICSI BABIES NORMAL?Yes, babies conceived using ICSI during IVF are normal. Defects are very rare.
WHAT’S THE COST OF PGD / PGT / PGS EMBRYO TESTING?There are several different kinds of preimplantation genetic embryo testing. Costs vary depending on the type of test, but the cost starts at around $3,900. All tests use a biopsy of the embryo to check for either the number of chromosomes or a gene mutation. The PGS, preimplantation genetic screening, checks that all 46 chromosomes are there (including the two sex chromosomes). The PGD test is used to look for a potential known single gene defect that is present in the families of the parents. Remember that the chromosomes are the containers of all the genetic code for a baby, which is a lot of information! A useful way to think of chromosomes is to think of them as books. So, in some cases a more specific test that opens the book and looks for a specific gene may be warranted. PGT, preimplantation genetic testing, is a new term for both the PGS and PGD tests. The type of type is denoted with a suffix. For example, PGT-A checks the number of chromosomes. It also detects which sex chromosomes the embryo has (X and X, or X and Y). PGT-M checks for a gene mutation.
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