Treatment Options
Much is being offered by practitioners and, especially over the Internet, as allegedly working treatment options to select ones offsprings gender. The truth is, however, that the real options are rather limited.
More specifically, there are only two options, which through studies have shown to be effective, and here is a brief description of both:
Sperm Sorting
This method is based on the long recognized principle that the (XY)-male determines the sex of offspring by either contributing a X-carrying or a Y-carrying sperm to the fertilization process. XX-women, of course, always contribute an X-chromosome. Consequently, based on the male contribution, the resultant embryo will be either XY (male) or XX (female).
Recognizing the importance of the male contribution to gender selection, various historical success claims have been based on the ability to separate X- from Y-sperm. Unfortunately, until recently, nobody could proof that their method really worked in improving odds towards one, or the other, gender. Only recently, a technique, which is based on the labeling of sperm with a fluorescence marker that can then be picked up by a so-called fluorescence cell sorter, has made inroads and proven effective. This technique is called MICROSORT® and is currently still offered only under experimental study conditions in an FDA-approved clinical trial.
CHR is part of a consortium of medical practices, which offers access to this trial. The trial is, however, administered by the organization that invented (and patented) this techniques, the IVF and Genetics Institute in Fairfax, Virginia.
MICROSORT, in our opinion, represents the only sperm sorting technique that has been proven to affect gender distribution. Most recent data from the still ongoing trial suggest that sorting for female will be approximately 90% successful, while sorting for male will be approximately 85% successful. These numbers are based on successful births after treatment. In other words,
sorting for female will be approximately 10%, and sorting for male approximately 15% inaccurate.
So far published data also suggest that this technique is safe and does not increase the risks for birth defects or other adverse outcomes in newborn. These data are, however, still preliminary and we strongly recommend that interested parties inquire further about risks and benefits of this technique with the trial administrator before deciding to pursue this option.
In Vitro Fertilization (IVF) and Preimplantation Genetic Diagnosis (PGD)
This technique, in contrast to sperm sorting, is a post-fertilization technique. This may be an important distinction for some because, in contrast to sperm sorting (a pre-fertilization technique), here embryos are produced through the fertilization of the womans eggs with the partners semen. In other words, this technique practically every time will also produce embryos of the unwanted gender, later raising the ethical, and practical issue, what to do with embryos of an unwanted gender? Options then are (1) to cryopreserve them for potential future use; (2) to donate them (usually anonymously) to another infertile couple; (3) to donate them to CHR for research purposes; or (4) to ask CHR to dispose of them in an ethical way.
The process here involves that the woman goes through an IVF cycle, like infertile women routinely do these days. Embryos generated in this cycle then undergo PGD on their third day after fertilization, when embryos usually have reached 6-8 cell stage.
At that point one of these cells is microsurgically removed from the embryos and its chromosomes (amongst them the X- and Y-chromosome) can be analyzed, allowing us to determine whether an embryo is female or male. Once each embryo is so defined in its gender, only embryos of the desired gender are transferred back into the womans uterus,
virtually guaranteeing a pregnancy of the desired gender.
This technique is, therefore, much more accurate than sperm sorting in predicting the gender of a pregnancy.
The technique has, however, additional advantages and disadvantages. A clear additional advantage is that, at the same time as examining the gender of each embryo, other chromosomes can also be checked. By doing this, the most frequent chromosomal abnormalities in human embryos, such as for example Downs syndrome, can be ruled out with considerable accuracy. Disadvantages are that the manipulation of the embryos may marginally reduce its chance for implantation in the uterus. Data available so far suggest, however, that the risk for birth defects is not increased following the procedure.
Before deciding to pursue this technique of gender selection, we strongly recommend a further detailed discussion of the advantages and disadvantages of this technique with your physician. You should also review the costs for each of these options with your physicians staff. A final choice between these two really working methods is, in the end, both, a medical, and an ethical, one with which patient and physician need to be comfortable with.
The various gender selection treatment options, starting with the most effective treatment option, include:
IVF/PGD Method
Microsort Method
Ericsson Method
Whelan Method
Skettles Method
Sex Selection Kits
