How IVF and Gender Selection Work | Your Fertility Friend

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Gender Selection and IVF

Even as recently as a few years ago, telling your friends and family you were going to pay to choose the sex of your baby would have sounded ludicrous. Now, the idea is becoming common place.

As IVF rises in popularity, so does the option to choose your child’s gender at conception. Today, helping couples choose to have a boy or girls has become a million dollar industry as parents are eager to take the decision into their own hands, no matter the cost.

If you’re considering gender selection with IVF, read on to learn more about what it means for you, your IVF journey, your future family, and even, potentially, society as a whole.

How gender selection works

Gender is determined by chromosomes. Females carry only X chromosomes, while males carry both X and Y.

Sperm either contain male or female chromosomes, which is why there is basically a 50/50 chance of conceiving either sex. If female sperm fertilizes the egg, the embryo will carry two X chromosomes, resulting in a girl.

If male sperm reach the egg for fertilization, the embryo will have one X and one Y chromosome, creating a boy. Gender selection seeks to manipulate the combo that comes up so parents can choose if they have a boy or a girl.

Is it possible to choose the baby’s gender?

The short answer is “yes,” it is possible to choose your baby’s gender. Like with most things, there are multiple approaches to do so.

Some are conducted in a lab with high accuracy, like gender selection with IVF. And others, like the Shettles Method, are based on less proven science.

We’ll dig deeper into the various options later on. Gender selection with IVF is by far the most accurate gender selection method, relying on preimplantation genetic screening to choose gender with virtually 100% accuracy for couples undergoing IVF.

What is preimplantation genetic screening (PGS)?

Preimplantation genetic screening, or PGS, has been used for more than a decade to help couples going through IVF select embryos with normal genetics (free of disease and abnormalities). The screening is used to select the most viable embryos for implantation—increasing chances of carrying a healthy baby to term via IVF.

This process also avoids passing along life altering or life threatening genetic diseases and abnormalities to children.

The PGS process begins with the same steps as an IVF cycle—fertility medications, egg retrieval and manufactured fertilization in a lab. The embryos are left alone to grow for 3 to 5 days as they divide into multiple cells.

When the embryos are around 5 days old, a couple of cells are harvested to use for the preimplantation genetic screening. An evaluation of the DNA of the cells then takes place to determine if dangerous genes are present in the cells, and therefore the embryo.

PGS usually takes about a week to complete and embryos are frozen during this time as you await results before implantation.

Though it was first used only to detect genetic abnormalities, PGS has now become a detector of embryo gender for use in gender selection with IVF. Embryos that are identified as free of genetic threats and, if the parents choose, of a preferred gender, are then used for the implantation process.

Embryos free from genetic issues are then frozen for potential use in later cycles. Most couples do not weed out embryos for freezing by gender.

Selecting gender by using preimplantation genetic screening during IVF is the most effective way to choose your baby’s gender. But that accuracy comes at a price.

Using preimplantation genetic screening to choose the sex of your child is virtually 100 percent accurate, which is impressive. Potentially more impressive is its price tag—PGS can run you up to $20,000.

Who is eligible for gender selection

Completely reliable gender selection is only available through PGS as part of the IVF process. That means it is only available to couples undergoing IVF.

IVF is extremely invasive and costly, so it would never be recommended to undergo IVF for the sole purpose of choosing the sex of your next child. IVF is used to overcome fertility issues in both men and women. Couples who are not seeking IVF are not eligible for gender selection.

While it’s becoming more common to enlist the use of preimplantation genetic screening solely to seek one gendered baby or another, you may find some hesitation if you’re planning on undergoing the testing for the sole purpose of choosing the gender of your baby.

If there is no history of genetic abnormalities in your family, there is not likely a medical reason to utilize PGS and some are still on the fence as to whether it should be used just for that.

Preimplantation genetic screening is also pricey on top of an already high IVF bill, so you may consider just how badly you’d like a baby boy or girl specifically.

Prerequisites for gender selection and IVF

The prerequisite for gender selection with IVF is that you be going through IVF for other reasons. Most fertility clinics recommend gender selection for families who already have one child and seek “gender balance” in their family make up.

Some families may have a history of a disease or disorder that affects one gender or the other, which may also make them a candidate for gender selection with IVF.

Sometimes couples do not have very many embryos to use during IVF. If that’s the case, gender selection may not be an option as it diminishes the number of embryos even further. Couples who are not experiencing any fertility issues and seek out reproductive technology to choose whether they have a boy or girl will not be accepted by any above board fertility clinic.

Success rates for gender selection and IVF

Gender selection with IVF is highly accurate, carrying a success rate of 97–99.99%.

The sex of the baby your desire does not matter when it comes to success rates for gender selection with IVF. Choosing your future child’s gender via IVF is the most accurate option available to parents wishing to dictate the sex of their baby.

Common reasons for gender selection

Deciding to select the gender of your next baby is not always an easy choice. There are many reasons that you may consider gender selection when undergoing IVF, including some that are more serious and others that aren’t.

Here’s are most common considerations:

Medical reasons

Gender selection has somewhat of a vein reputation as naysayers categorize all parents pursing gender selection as being in the pursuit of “designer babies” based solely on their personal whim and non-medical based reasons. That, however, is simply not the case. Gender selection can be quite helpful for specific and unavoidable medical based reasons.

If one partner has a dangerous genetic disposition a couple may choose to use gender selection to reduce the risk of passing on sex-linked genetic issues.

Risks of having a child with hemophilia, muscular dystrophy and Fragile X syndrome can all be reduced by using gender selection. Sex-linked genetic disorders, which are passed down through the maternal genes, are more common in males since the mother gives him her X sex chromosome.

In the case where a female is a carrier for one of these diseases, the couple may choose to have a girl to reduce the risk and avoid giving birth to a baby boy with serious health issues.

Personal reasons

“Family balancing” is a term used to describe couples who choose to select one gender or another to even out the number of males and females in their nuclear family. It is the most common reason couples use PGS to select the sex of their baby.

Couples may see family balancing if they have had multiple children of the same gender or have just one child and hope to end up with one boy and one girl.

Social reasons

Perhaps the most controversial reason to choose gender selection is for social reasons. Families may desire to carry on a family name or keep a specific ratio of sons and daughters in their family.

Some parents also choose the sex of their baby to give them a leg up in society (e.g. choosing to have a boy to avoid sexism and other disadvantages experienced by women).

Why gender selection is controversial

The reason why gender selection is so controversial can be summed up by saying that some people do not think it’s the role of humans to “play God.”

Creating “designer babies,” as some have deemed them, flirts with a line of control that some people reserve for a supreme being. Those who believe conception begins at birth also find issue with the selection, and subsequent destruction, of embryos as they move through the PGS process.

To them, it’s wrong to destroy an embryo simply because it’s one sex or another.

Gender selection also has social implications, especially if it were to get out of hand. The societal impacts of any significant gender imbalance could be catastrophic, beginning with strengthening stereotypes about the non-dominant gender and moving to ruining the reproductive cycle of a generation.

These moral and ethical considerations and societal implications are all part of the reason gender selection is not performed on couples who do not need IVF.

Gender selection pros and cons


  • Controls family size by avoiding attempts to have additional children solely to “try” for the other sex
  • Family balancing allows you to choose the gender makeup of your nuclear family
  • You know the sex of the baby from day one, giving you more time to plan for a boy or girl
  • You can use it to avoid passing along certain sex-linked genetic issues and increase your chances of having a healthy baby
  • You and your partner get to make the choice together


  • Gender selection is pricey, even above and beyond the high cost of IVF
  • While it is close to 100% accurate, there is no guarantee that PGS will work for you to conceive the gendered baby of your choice
  • You eliminate the element of surprise in finding out the sex of your baby

The costs of gender selection with IVF

Gender selection with IVF costs anywhere from $1,000 to $5,000 per cycle.

This is on top of the other IVF costs, which run about $20,000 to $25,000 with PGS per cycle.

Are there financing options to pay for gender selection?

You are more likely to succeed at financing your IVF procedure as a package than the gender selection portion individually.

Many fertility clinics offer financing options that cover all parts of the IVF process, including gender selection.

Choosing the best fertility clinic for gender selection and IVF

To find a fertility clinic whose well-versed in gender selection with IVF, research their preimplantation genetic screening.

The stronger the team is at PGS, the better results they will produce when it comes to gender selection with IVF. More and more, PGS is becoming a standard service offered by fertility clinics, but some still do not offer it.

Look for a clinic with a history of the service—the longer the better, although the technology has not been around for much more than a decade.

Other methods for gender selection

Gender selection with IVF is far and above the most accurate type of gender selection.

Other methods, like the Shettles Method, rely on a mixture of science and opinion to increase chances of having a boy or girl, but can far from guarantee it. The Shettles Method capitalizes on the varying characteristics of male and female sperm and suggest ways—such as abstinence, sexual position and timing of intercourse—that can help sway the gender one way or another.

Another laboratory method available called sperm sorting involves dying sperm to mark them as male or female, splitting them up and then using IUI to only insert on or the other to result in that gender embryo. This method is more accurate than the Shettles Method but pales in comparison to gender selection with IVF.