In vitro fertilization (IVF) using donor eggs has become an increasingly popular option for couples struggling with infertility as well as LGBTQ+ families. One question that often arises is whether it is possible to choose the gender (sex) of the baby when doing donor egg IVF. In this article, we will explore the answer to this question.
First off, let’s understand gender vs. sex
Gender and sex are two distinct concepts that are often used interchangeably, but they refer to different aspects of a person's identity.
Sex refers to the biological and physiological characteristics that define a person as male, female, or intersex. This includes chromosomes, hormones, and reproductive organs. In most cases, a person's sex is determined at birth based on their physical anatomy.
Gender, on the other hand, refers to the socially constructed roles, behaviors, and expectations that are associated with being male, female, or non-binary. Gender is often expressed through a person's appearance, clothing, interests, and personality traits. It is a complex and multifaceted aspect of identity that can vary widely between cultures and over time.
It's important to note that gender and sex are not always aligned, and it's possible for a person's gender identity to differ from their biological sex. While “gender selection” is the term traditional used, it’s actually “sex selection” of the embryo.
What is gender selection and how does it work?
To answer this question, it’s important to understand the IVF process. During IVF, eggs are extracted from a woman's ovaries and fertilized with sperm in a laboratory. Once fertilized, the resulting embryos are monitored for development before being transferred to the uterus of the intended mother or a gestational carrier. In donor egg IVF, the eggs used for fertilization come from a donor, rather than the intended mother.
Gender selection with IVF is a process in which a family finds out the sex of the embryos before the embryo is transferred. This is typically done using preimplantation genetic testing (PGT), a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex.
There are various reasons why someone may want to use gender selection through IVF. One common reason is “family balancing”, where a parent may want to have a child of a particular gender to balance out the gender distribution in their family. For example, a couple with three daughters may want to try for a son.
Another reason is related to genetic disorders that are linked to a specific gender. Some genetic disorders, such as hemophilia, are more common in males, and parents who are carriers of the gene may want to select a female embryo to reduce the risk of passing on the disorder to their child.
Can I select my baby’s gender when doing donor egg IVF?
When it comes to choosing the gender of the baby in IVF, it is possible to do so through PGT. As stated above, PGT is a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex. The embryos of the desired sex can then be selected for transfer.
However, it's important to note that PGT is not 100% accurate. The technology used to analyze the embryos is highly sophisticated, but it is not perfect. There is still a small margin of error (<1%) that can result in the wrong gender being selected for transfer.
Some fertility clinics have guidelines around gender selection, and will only transfer the best quality embryo based on morphology. Furthermore, PGT testing for sex selection can add time and cost to your journey.
Is gender selection ethical?
Gender selection for non-medical reasons raises some ethical concerns, and some countries even have laws that prohibit it for non-medical reasons.
Some argue that gender selection perpetuates gender stereotypes and reinforces the idea that one gender is preferred over another. Other critics argue that allowing gender selection could lead to a slippery slope of other forms of selective breeding, such as selecting for traits like intelligence or athleticism. Furthermore, gender selection is expensive and may only be available to those with the financial means to access it, creating a divide between those who can afford it and those who cannot. Overall, the ethical considerations of gender selection are complex and depend on individual circumstances.
There are various reasons a family may want to choose a baby’s gender while undergoing donor egg IVF. From medical reasons to family balancing, it’s important to talk to your doctor if gender selection is important to you. Remember, gender selection of embryos is not always accurate, and there is a small margin of error that can result in the wrong sex being selected. Ultimately, the most important goal of any fertility treatment should be the health and well-being of the baby and the family.
Meera Shah, MD, FACOG, is a double board-certified OBGYN and reproductive endocrinology and fertility specialist at NOVA IVF in Mountain View, California. She is a Founding Medical Advisor at Cofertility. Dr. Shah has authored numerous research articles on topics ranging from fertility preservation, pregnancy loss, reproductive genetics, and ethnic differences in IVF outcomes. Her medical practice incorporates the highest level of evidence-based medicine and the most cutting edge technologies to optimize outcomes for her patients. Dr. Shah applies this approach to her work with Cofertility, ensuring that Cofertility remains up-to-date on latest medical advancements and research in third-party reproduction and reproductive endocrinology in general. When Dr. Shah isn’t busy working with her patients at NOVA IVF, she enjoys playing pretty much any sport, learning new piano pieces on YouTube, and spending quality time with her husband and three boys. You can find her on Instagram providing fertility-related advice and education at @dr_meerashah.
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