Can you Choose the Gender of your Baby?

From the moment a couple find out that a baby is on the way, guessing the gender becomes a favorite pastime – so much so that mum-to-be often begins to think of everything in terms of pink for a girl and blue for a boy. But what if one could choose the gender of a baby and decide whether to have a girl or a boy. Indeed there are many couples out there who would like such a choice for social, cultural or personal reasons like balancing out a family. But is it at all possible and can you really choose the gender of your baby?

Overview of options

According to fertility experts, there is no definitely proven way of choosing the gender of a baby other than medical intervention techniques such as sperm sorting or a pre-implantation genetic diagnosis which can be performed only in laboratories and by qualified professionals. However theories abound on whether it is possible for parents to choose the gender of a baby by controlling the timing of the conception or by following a certain kind of diet, lifestyle and so on.

Among these, theories of gender selection based on timing have received some attention from the scientific community. Some experts have found that male sperm have an advantage over female sperm at the very beginning and the end of your fertile window1 while some others suggest that male sperm can survive longer than female sperm2. There are two theories about whether this is possible: the Shettles method and the Whelan method, both named after the person that devised them.

The Shettles method is based on the idea that male sperm move faster, but don't live as long as female sperm. So if you want a boy, you should aim to have sex as close as possible to ovulation, as the boy sperm will beat the girl sperm in the race to the egg. On the other hand, if you want a girl, you need to have sex two to four days before you ovulate. Shettles claims that it's 75 per cent effective for girls and 80 per cent effective for boys3.

The other is the Whelan method which suggests that biochemical changes earlier on in your cycle favour boy-producing sperm. So if you want a boy, you should have sex four to six days before your basal body temperature goes up which is an indication of impending ovulation. If however, you want a girl you should have sex two to three days before you ovulate. In the end however both these approaches remain only theories since no single approach has been found to offer a hundred percent guarantee in determining the gender of a baby.

Sex-selection kits

These days Do-it-yourself sex-selection kits are also available in stores which are make use of the timing theory to choose a baby’s gender. There are separate girl and boy kits costing about £100 and one of the most popular is MicroSort. These kits come with instructions, a basal thermometer, ovulation predictor test sticks, supplement tablets, and douches that are supposedly gender specific. While some manufacturers claim an incredibly high 96 per cent success rate, most fertility experts are of the opinion that there is simply not enough evidence to back up these claims.

Old Wives’ Tales

Almost every culture has its share of folklore which elaborates ways to help couples choose the baby they want. According to these, making love during the day, on even days, keeping wooden spoon under your bed and a pink ribbon under your pillow or drinking/eating plenty of dairy products will increase your chances of having a girl. On the other hand if you wish for a boy, you could try making love during night, on odd days, consuming meat and starchy as well as salty foods.

Medical intervention

While couples may have to depend on unreliable practices such as timing the conception, sex-selection kits or folk-lore to be able to choose the gender of the baby, medical science has made rapid strides in the technique. The most common medical technique for gender determination is Sperm Sorting according to which doctors try to separate male from female sperm. The most-used technique is Flow Cytometry, which is thought to be about 92 per cent accurate for girls, and 82 per cent for boys. Flow Cytometry works by adding a fluorescent dye to the male partner's sperm sample. Experts can then tell male from female by seeing how the dye binds to the genetic material in the sperm. Once sorted, the female partner can then be implanted with the chosen sperm using intrauterine insemination. Sperm Sorting is illegal in many countries like the UK, but the service is offered, for a considerable fee, in some other countries.

The other more complicated technique is pre-implantation genetic diagnosis or PGD; this is an in vitro fertilization (IVF) technique and in countries like UK available only to couples where one of the partners has a serious genetic disorder which can be passed on to the child. At the fertility clinic, embryos – male or female - are created from the eggs and sperm of both partners. After these are screened, a specialist implants two or maybe three embryos in the uterus of the female partner as part of IVF procedure.

Ethical considerations

Despite daily advances made by science and particularly in the field of fertility medicine, ethical considerations about being able to choose the gender of a child remain. There are many cultures in the world where women are seen as burden on families so much so that girls are denied adequate nutrition, education and other resources and in extreme cases female babies are killed off as soon as they are born. If gender selection techniques are made easily available, couples in such cultures would acquire an even more deadly arsenal in their preference for male babies which would ultimately lead to extremely skewed gender ratios and create conditions for social and cultural anarchy. So while there is nothing wrong with parents hoping for a baby of one particular gender, this can easily turn into a decision to discard an embryo of the unwanted sex and it is then that gender selection techniques become dangerous.

Even when a culture is not biased in favour of any particular gender and the choice appears to be motivated by personal concerns like balancing out a family, the practice of selecting the gender of an unborn baby is still riddled with complexities. There can be conflicting views between two partners on what gender the baby should have. Apart from this, there is the more serious argument that admission to life should not be conditional upon a child being a particular sex. Every baby that comes into the world has a right to be brought up in an environment of unconditional love, at least from parents, and gender-selection strikes at the very core of this premise.

Legal implications

One of the greatest markets for gender-selection techniques is thought to be Asia and Africa where cultural predispositions towards boys make female babies unwelcome. India for example has long been fighting social horrors like female foeticide and female infanticide. While the latter has been ingrained in many communities – like killing a female baby right after birth by strangulation or suffocation – modern medical techniques like ultrasound imaging have given rise to female foeticide. Parents-to-be now can be told the gender of their unborn child and if it is a daughter, many couples opt for an abortion rather than give birth to a girl child. Sex-determination tests with sonography have been banned in India for a while now.

While Female Infanticide Prevention Act has been around since 1870 in India, female foeticide has been more difficult to control since abortions are legal in this country as long as they are done for medical reasons. However the country passed The Pre-natal Diagnostic Techniques Regulations and Prevention of Misuse Act in 1994 to curb selective sex determination. With rapid improvements in diagnostic technology the Act was amended in 2003 in order that it became more comprehensive and was renamed the Preconception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act.

Even advanced countries where social status of women is not so precarious, views sex-selection methods with concern. As of now five nations Australia, Canada, China, India and the UK have banned gender selection by PGD. In UK for example it is illegal to choose a baby's gender; you can only do this if you have a serious genetic condition that you risk passing on to your children. For instance Duchenne muscular dystrophy only affects boys. A disease such as haemophilia almost always passes from the mother to son. In these circumstances, your doctor would use a girl embryo by PGD but the legal process is long and expensive and involves approval from Human Fertilization and Embryology Authority of the country.

Some countries like United States, Mexico, Italy and Thailand allow sex selection techniques since PGD is legal here. This has led to a new phenomenon called ‘reproductive tourism’ where people travel for gender selection and general infertility treatments such as PGD and IVF.

The United Nations has stated that it opposes sex selection for non-medical reasons, as does the World Health Organization (WHO), which has stated that sex selection for non-medical reasons “raises serious moral, legal, and social issues.” Principal issues include, “the distortion of the natural sex ratio leading to a gender imbalance” and because it can “reinforce discriminatory and sexist stereotypes towards women by devaluing females”4.

References:

1. James WH. 2008. Evidence that mammalian sex ratios at birth are partially controlled by parental hormone levels around the time of conception. J Endocrinol. 198: 3-15. Joe.endocrinology-journals.org [pdf file, accessed October 2012]
    
2. Van Dyk Q, Mahony MC, Hodgen GD. 2001. Differential binding of x- and y-chromosome-bearing human spermatozoa to zona pellucida in vitro. Andrologia. 33(4): 199-205
    
3. Shettles LB, Rorvik DM. 2006. How to choose the sex of your baby: the method best supported by scientific evidence. New York: Broadway books
    
4. World Health Organization - Genomic research centre - Gender and Genetics