When people start exploring IVF, one of the most personal and sometimes surprising questions is: Can I choose gender in IVF? The answer isn’t a simple yes or no-it depends on where you are, why you want to do it, and what rules your doctor and clinic follow.
How Gender Selection Works in IVF
Gender selection in IVF doesn’t happen by picking an embryo out of a hat. It’s done through a process called Preimplantation Genetic Testing (PGT), specifically PGT-A or PGT-SR. After eggs are fertilized in the lab and grow into embryos over 5-6 days, a few cells are carefully removed from each embryo. Those cells are tested for chromosomes. Since females have two X chromosomes (XX) and males have one X and one Y (XY), the lab can tell you the sex of each embryo before it’s placed in the uterus.
This isn’t guesswork. The accuracy rate for determining sex through PGT is over 99%. It’s the same technology used to screen for genetic disorders like cystic fibrosis or Down syndrome. Gender is just one piece of the data.
Why People Want to Choose Gender
People choose gender for different reasons-and not all are the same.
Some families have a medical reason. If a serious genetic condition runs in the family and is linked to one sex-like Duchenne muscular dystrophy, which mostly affects boys-doctors may recommend selecting a female embryo to avoid passing it on. This is called medical sex selection and is widely accepted around the world.
Others want gender balance. Maybe they already have two boys and really want a girl. Or they lost a child of one gender and hope to have another. These are emotional reasons, and they’re real. But not every country lets clinics help with them.
In the U.S., clinics can offer gender selection for non-medical reasons if the patient requests it. In the UK, Canada, Australia, and most of Europe, it’s illegal unless there’s a medical need. India banned non-medical gender selection in 2003 to stop female feticide. China has similar restrictions.
What the Law Says Around the World
The rules vary wildly.
In the United States, there’s no federal law banning gender selection for family balancing. Many clinics offer it, but they must follow guidelines from the American Society for Reproductive Medicine (ASRM). They usually require counseling to make sure the decision isn’t based on bias or pressure.
In the UK, the Human Fertilisation and Embryology Authority (HFEA) only allows gender selection to prevent serious genetic diseases. Using IVF to pick a boy or girl because you want a daughter is not permitted.
Some countries, like Ukraine and Georgia, have become popular for medical tourism because they allow gender selection for non-medical reasons. But that comes with risks: clinics may not follow the same safety standards, and legal protections for patients can be weak.
Cost and Success Rates
Adding gender selection to IVF doesn’t come cheap. The base cost of one IVF cycle in the U.S. is around $12,000 to $15,000. PGT adds another $3,000 to $7,000, depending on how many embryos are tested. Insurance rarely covers it, even if you’re doing it for medical reasons.
Success rates aren’t guaranteed just because you pick the sex. Your age, egg quality, and how many healthy embryos you have still matter most. If you have five embryos and two are male, three are female, and only three are genetically normal, you might end up with just one or two that are ready to transfer-regardless of gender.
Some clinics promise a 90% chance of getting the gender you want. That’s technically true-if you have enough embryos to test. But if you only produce two or three embryos total, your odds drop fast. And if none of them are healthy, you’re back to square one.
Ethical Concerns and Risks
Gender selection isn’t just a medical decision-it’s a social one.
There’s real concern that widespread use for non-medical reasons could lead to gender imbalances. In places like China and India, son preference has led to millions fewer girls being born. Even in Western countries, some worry that choosing gender could reinforce harmful stereotypes or make people feel like children are products to be customized.
There’s also the risk of false hope. People might think selecting gender improves their chances of pregnancy. It doesn’t. A healthy embryo is what matters. Choosing a girl doesn’t make her more likely to implant. Choosing a boy doesn’t make him stronger.
And if you’re doing this for a specific reason-like replacing a lost child-there’s emotional risk too. The pressure to get the right gender can turn a hopeful process into a stressful one.
What Your Doctor Will Ask You
If you bring up gender selection, a good fertility specialist won’t just say yes or no. They’ll ask questions:
- Why do you want to choose gender?
- Have you considered the emotional impact if it doesn’t work out?
- Do you understand the costs and success rates?
- Are you aware of the legal limits in your country?
They might also suggest genetic counseling if there’s a family history of sex-linked disorders. This isn’t about stopping you-it’s about making sure you’re making a fully informed choice.
Alternatives to IVF Gender Selection
If you can’t or don’t want to use IVF for gender selection, there are other options-but none are reliable.
There are old myths about timing intercourse around ovulation, eating certain foods, or using special positions. None of these have scientific backing. Studies show they don’t work better than chance.
Some people try sperm sorting techniques like MicroSort, which separates X and Y sperm before insemination. But it’s not widely available, less accurate than PGT (around 70-80% for girls, 60-70% for boys), and not approved by the FDA in the U.S.
Bottom line: If you want real control over gender, IVF with PGT is the only proven method. Everything else is guesswork.
What to Do Next
If you’re thinking about gender selection:
- Check your local laws. Don’t assume it’s legal just because a clinic abroad offers it.
- Find a clinic that’s transparent about their process, success rates, and costs.
- Ask for data: How many embryos do patients typically produce? What percentage are genetically normal?
- Get counseling. Talk to someone who’s been through it-not just your doctor.
- Consider your emotional readiness. What if you don’t get the gender you want? What if you don’t get pregnant at all?
There’s no rush. IVF is already emotionally heavy. Adding gender selection shouldn’t make it heavier. Make sure your reasons are yours-and not shaped by pressure, culture, or fear.
Final Thoughts
Yes, you can choose gender in IVF-if you’re in the right place, have the right medical reasons, and are prepared for the cost and emotional weight. But it’s not a magic trick. It’s a medical tool, used carefully, with limits, and with consequences.
At the end of the day, the goal of IVF isn’t to build a perfect family picture. It’s to help you have a healthy child. Gender is just one detail. The rest-love, care, connection-is what really matters.
Is gender selection legal in the United States?
Yes, gender selection for non-medical reasons is legal in the U.S., but clinics must follow guidelines from the American Society for Reproductive Medicine (ASRM). Many require counseling to ensure decisions are thoughtful and not based on gender bias. However, not all clinics offer it, and insurance rarely covers the cost.
Can I choose gender with IUI instead of IVF?
No. Intrauterine insemination (IUI) doesn’t allow for gender selection. The sperm mixes naturally with the egg, and there’s no way to control which sperm fertilizes it. Techniques like sperm sorting exist but are not reliable or widely approved. Only IVF with PGT gives accurate gender selection.
How much does gender selection add to IVF costs?
Adding PGT for gender selection typically increases IVF costs by $3,000 to $7,000. This includes embryo biopsy, genetic testing, and lab analysis. The base IVF cycle usually costs $12,000-$15,000. Insurance rarely covers these extra costs, even for medical reasons.
Does choosing gender improve my chances of getting pregnant?
No. Selecting a specific gender doesn’t make an embryo more likely to implant or result in a live birth. Only the health of the embryo matters. If you have only one or two embryos left after testing, your pregnancy chances depend on their quality-not their sex.
What happens if none of my embryos are the gender I want?
You’ll have to decide what to do next. Some people choose to transfer the available embryos regardless of gender. Others may opt for another IVF cycle. It’s important to talk with your doctor and counselor before starting so you’re prepared for all outcomes. You can’t force nature to give you the gender you want if the embryos don’t match.
Can I choose gender if I’m using donor eggs or sperm?
Yes. If you’re using donor eggs or sperm, you can still use PGT during IVF to select gender. The process is the same: embryos are created in the lab, biopsied, and tested. The gender of the donor doesn’t affect your ability to choose-it’s the embryo’s chromosomes that matter.
Are there risks to testing embryos for gender?
The biopsy process carries a small risk-about 1%-of damaging the embryo, which could reduce its chance of implanting. However, modern techniques have made this very rare. The bigger risk is emotional: if you fixate on gender and the results don’t match your hopes, it can lead to disappointment. Counseling helps prepare you for all outcomes.
Why is gender selection banned in some countries?
Many countries ban non-medical gender selection to prevent gender imbalance. In places like India and China, strong cultural preferences for boys led to millions of missing girls. Governments stepped in to stop sex-selective abortions. Even in Western countries, ethical boards worry about reinforcing gender stereotypes or treating children like products.
