Ask The Experts – Gender Selection
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Dr. Carolyn Givens worked with thousands of in vitro fertilization patients over the last decade using a combination of attentive, personal care and advanced medical technology. More about Dr. Givens · Read Other Posts |
Pacific Fertility Center Team
Left to Right: Front: Philip Chenette, MD, Isabelle Ryan, MD, Carolyn Givens, MD
Back: Joe Conaghan, PhD, Carl Herbert, MD, Eldon Schriock, MD
Question: My husband and I have two boys and want to have a girl.
What are our options?
Answer: Gender selection is a complicated and difficult issue. Ethics aside, there really are only two proven methods. The first is a technique of sorting sperm cells called Microsort. If there is a healthy number of motile sperm present (no significant male infertility), the husband can fly to Southern California to the Microsort lab and have the sperm sorted. That sperm can then be used to inseminate the wife at Huntington Reproductive Center in Laguna Hills or can be frozen and shipped back to PFC for use in IVF. Because the technique results in such poor recovery of sperm, insemination may take several tries. This is why most of our patients will use the sperm in conjunction with IVF, in which case we can inseminate by single sperm injection (ICSI) several of the wife’s eggs, producing and then transferring embryos back to the uterus, and giving the couple a better chance of success. The sperm sorting method is much more efficient if the gender desired is female (see Microsort Facts below). We receive a report from Microsort about the estimated percentage of sperm that are X-bearing (female) vs. Y-bearing (male). Usually, for a female, that is about 85% and most couples interested in a girl are comfortable with those odds. For a male, the odds are lower (about 73%) and therefore, if a boy is really desired, most couples look to PGS (Pre-Implantation Genetic Screening).
With PGS, the patients undergo IVF with ICSI to create the embryos, and when the resulting embryos have 5-8 cells, a single cell is removed and analyzed for a number of chromosomes, including X and Y. If the couple wishes to transfer only the embryos of one gender, they will have to decide what to do with the remaining embryos. The technique is close to 93% accurate, which is a huge advantage over Microsort if male gender is desired. However, our most recent statistics with PGS indicate implantation rates tend to be lower. We do suspect that the procedure of removing a cell from the embryo may be decreasing the chances of successful implantation.
There are many more complex issues involved with PGS so we require our patients considering this process to meet with a genetics counselor (we work with the Perinatal Genetics program at California Pacific Medical Center for this counseling) to discuss the implications of undergoing this process in more depth.
– Carolyn Givens, M.D.
- Microsort Facts • Sperm sorting technique
- Two locations: Virginia and Southern California
- Must be younger than 40 years old (or using egg donor)
- Must be for Family Balancing (not first child)
- Low % of sperm recovered
- Efficiency for a girl is about 85%
- Efficiency for a boy is about 73%
For more info, visit the website: www.microsort.net
Tags: Gender Selection, Lab, PGS - Preimplantation Genetic Screening
