IVF and Sex Selection

IVF has been in use since the late 1900s to assist individuals or couples to build their families, where natural conception was proving challenging. IVF treatments occur in phases, and one phase in particular can enable potential parents to determine the sex of their embryo before the implantation phase.

Whereas there may be some controversy over whether sex selection is ethical, there is a real medical precedence that would warrant such a decision. Additionally, not every couple who undergoes IVF does sex selection, and for those who do, there are psychological and legal considerations to make. 

Let us discuss IVF and sex selection in more detail in order to demystify this process and bring a more holistic perspective, particularly for those who would want to consider this option as they build their families.  

Sex vs. Gender

In our changed world, sex and gender are no longer synonymous. Studies have shown that they are different, where ‘sex’ comprises biological characteristics such as the reproductive organs, chromosomes and hormones that contribute to the natural physical appearance of a person. ‘Gender’ on the other hand comprises experiences, behavior, lifestyles and roles that span across a spectrum of identities. With medical science pushing boundaries and breaking barriers, it is possible for a person’s sex to differ from their gender.  

Sex Selection Legality

Whereas sex selection is permitted in the United States, the American Society of Reproductive Medicine (ARSM) has raised concerns in relation to the ethics of sex selection, as well, there is much concern and contention within society about it. In most European countries, India, Canada, and China, sex selection is illegal, and must be supported by a legitimate medical reason in order to warrant its use.

Reasons for Choosing Sex

In typical practise, sex selection is done when there is a medical reason such as hereditary conditions or diseases that affect one sex more disproportionately than the other. These hereditary conditions have the potential to have a negative impact on the quality of life one could have. 

For example, some diseases are passed down through the X chromosome, which would affect the male embryos fertilized from that sperm sample. Therefore choosing female embryos would give the children born a fighting chance. Since females have two X chromosomes, there is the potential of the disease leaving one of them untouched. 

Whereas medical precedence is a genuine reason for sex selection, it is not the only reason that potential parents have for choosing to build their families this way. For some, it is based on their desire to have just one child, or to have an even number of children of each sex.

How Sex Selection Works

The medical term for sex selection is preimplantation genetic testing or PGT. PGT is done once the eggs are fertilized, but before the embryo is implanted into the uterus. In the regular IVF procedure, after fertilization, the embryos are left to develop on their own for several days before implantation. On the fifth day, PGT protocols are done by taking a small biopsy of the embryo. They are completely accurate in identifying the sex of an embryo. There are two types of PGT protocols that can be done, as we shall see below:

Preimplantation Testing for a Monogenic Disorder

This protocol, also called a PGT-M or PGD test, tests for single-gene disorders, as well as diagnoses hereditary conditions like polycystic fibrosis, Tay-Sachs disease and sickle cell anemia. A medical practitioner can also identify chromosomal count anomalies, as DNA abnormalities are the leading causes of early miscarriage. 

Preimplantation Testing for Aneuploidy

This protocol, also known as a PGT-A test, is another test used to identify chromosomal anomalies in the mitigation against miscarriage. It can also identify disorders such as Down Syndrome, but it is limited in identifying specific disorders in the way the PGT-M test can. 

The Cost of PGT

Preimplantation testing costs usually range between $1,000 and $4,000 and is charged as a separate cost from the cost of the IVF treatment. Health insurance covers do cover IVF treatments in whole or in part, depending on the provider. The cost of PGT may or may not be covered and it is recommended that one contacts their provider to know the extent of their cover for fertility treatments. 

Conclusion

The use of PGT protocols have helped potential parents to mitigate against challenges that could have been faced in the future, had the protocols not been included in their fertility treatments. Where as society may demonstrate understanding and compassion for medical conditions, there is much controversy on the use of PGT as a matter of preference. 

As many nations across the world continue to outlaw the practice, providers are urged to exercise what is termed ‘ethical caution’ in addressing matters of sex selection. As a result, fertility clinics have put policies that regulate the use of PGT.  Contact Virginia Fertility & IVF if you have any queries regarding hereditary concerns you may have as you consider building your family. We can be reached at any of our locations across the country.