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What Is Family Balancing?

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Introduction: Crafting the ideal family often includes the desire for a balanced gender representation among children, a circumstance that natural reproduction doesn’t guarantee due to its 50-50 gender conception chance. For families where all or most children are of one gender, family balancing offers a solution through advanced reproductive treatments such as in vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD). 

These medical advancements provide the ability to select the gender of the embryo before pregnancy, ensuring a more balanced family dynamic. This article explores how family balancing works, its benefits, and considerations for couples looking to influence the gender of their future children.

Family Balancing Benefits

For many families, the perfect composition of children requires that both genders are represented. This is not typically assured with natural reproduction although statistically there is a 50-50 chance of either gender being conceived. It is not uncommon for families to have all or the majority of children being of one gender. Family balancing allows couples to make use of reproductive treatments like in vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD) to better balance the gender representation in their offspring.

These treatments provide a means to determine the gender of an embryo with 100% accuracy before it is implanted in the uterus of the woman. Should pregnancy be successful, the couple is better assured of the gender of their baby.

Targeted Treatments

This treatment is targeted at couples who already have one or more children and want to have a subsequent child that is of the gender not represented or underrepresented.

It is however possible to undertake family balancing from the first pregnancy. In some cases, there could be personal, medical, or cultural reasons that would make a couple want to control the gender outcome of their first child. Family balancing would then allow the couple to choose whether to have a male or female child as their firstborn.

How Does It Work?

Family balancing requires the couple to go through an IVF treatment. The woman will undergo hormone fertility treatments to help boost the growth of multiple eggs from the ovaries. Once the eggs are mature, they are retrieved through aspiration. The procedure can be done in the doctor’s office, with the patient being under anesthesia.

The eggs are then fertilized in a laboratory setting using sperm taken from the man. The fertilized eggs are allowed to develop to the pre-embryonic stage. Once at least 6-8 well-defined cells of blastomeres form, a few are microscopically extracted for genetic testing or pre-implantation genetic diagnosis (PGD). This testing will determine the genders of each pre-embryo by amplifying the DNA and ascertaining if they carry XX (female) or XY (male) chromosomes.

Genetic Testing

It can also be used to screen for any chromosomal abnormalities that would lead to developmental problems or birth defects. Using the results of the genetic testing, one or two of the pre-embryos of the preferred gender can then be transferred into the uterus of the woman. You can decide on the number of pre-embryos to be transferred in consultation with your doctor. Where more than one pre-embryo is transferred, there is the possibility of conceiving multiples.

The chances of getting pregnant will be influenced by multiple factors including the woman’s health condition, age, and reproductive history. Even where more than one pre-embryo is transferred into the uterus, there is no guarantee that the procedure will result in a pregnancy.

Preservation of Eggs and Pre-Embryos

This is partly why multiple eggs are stimulated and retrieved during IVF treatment. The eggs and pre-embryos can be preserved through freezing for future treatments without the need of putting the woman through more hormonal treatments and egg retrieval procedures. In the event, the woman does not become pregnant, the pre-embryos that were frozen and are of the desired gender can then be transferred later in another attempt. Note that pre-embryos that were tested and found to have chromosomal abnormalities may be discarded.

Benefits of Family Balancing

A couple may have personal, cultural, or medical reasons to want to conceive a child of a particular gender. Often, the desire for family balancing stems from already having a child or children of one gender and wanting representation of the opposite gender. Hence the term ‘balancing’.

Genetic Conditions and Gender Selection

There may however be certain genetic conditions passed down through one or both parents that may be worse for children of a specific gender. In such cases, the parents may not want to risk conceiving a child that will suffer from the condition when there is an option to have another of the opposite gender who will not suffer the same consequences.

It is also common for couples that have already had a child with inherited genetic conditions to want to ensure subsequent children are not going to suffer the same affliction.

Chromosomal Abnormalities and Family Balancing

The genetic testing involved in family balancing is also beneficial where there is a higher risk of chromosomal abnormalities resulting. Women that are over the age of 37 years and couples with a history of recurrent miscarriages caused by such abnormalities are ideal candidates for this treatment. These groups are at a higher risk of conceiving a child with chromosomal abnormalities.

Others may simply feel they are best equipped to cater to the care and needs of a child of a particular gender. Parents that have lost a child will also often want to have another that is of the same gender.

In reality, there are many reasons why a couple may want to have control over the gender of the child they will conceive. Whatever concerns you have about this, you can raise it during initial consultations with your doctor to see how best to work out the problem. Keep in mind that family balancing is a costly and invasive process that does not fully assure you will achieve the desired results. It is however a scientific process that can improve chances of success.

What Happens to Unused Pre-Embryos?

There are chances that you will have several viable unused pre-embryos after you have undergone treatment. You can choose to have these pre-embryos frozen and preserved for later use. This is ideal where there have been challenges conceiving.

Since there is no assurance the transfer will result in pregnancy, storing these pre-embryos is a good way to ensure you can repeat the procedure without having to go through the early stages of treatment again.

Options for Unused Pre-Embryos

You may also want to consider donating these pre-embryos to another couple with infertility issues. They can also be donated for medical research. Discuss your options with your doctor.

If the couple has fertility or genetic conditions that may compromise the quality of the pre-embryos, it is also possible that no viable unused pre-embryos will remain.

Conclusion: Family balancing provides a scientific method to influence the gender of your future children, addressing personal, cultural, or medical needs in the process. While the journey involves a significant commitment, both emotionally and financially, it offers families the opportunity to achieve their desired family composition. Consult with your healthcare provider to explore all your options and carefully consider if this pathway aligns with your goals for starting or expanding your family.

FAQs: Frequently Asked Questions

1. What Is Family Balancing?

Family balancing is a reproductive procedure that allows couples to choose the gender of their child, often achieved through in vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD). It helps families achieve a more balanced gender representation among their children.

2. How Does Family Balancing Work?

Family balancing involves IVF, where the woman’s eggs are fertilized with the man’s sperm in a lab. The resulting embryos are genetically tested to determine their gender, and embryos of the desired gender are then implanted into the woman’s uterus.

3. Is Family Balancing Accurate?

Yes, the genetic testing involved in family balancing provides 100% accuracy in determining the gender of the embryos before implantation.

4. Who Should Consider Family Balancing?

Family balancing may be considered by couples who already have children of one gender and wish for the opposite gender. It can also be pursued for personal, medical, or cultural reasons, and in cases of genetic conditions that may affect one gender more severely.

5. Can Family Balancing Be Used for the First Child?

Yes, family balancing can be performed even for a first pregnancy if there are personal, medical, or cultural reasons for preferring a specific gender.

6. What Are the Success Rates of Family Balancing?

The success of family balancing depends on various factors including the woman’s age, health condition, and reproductive history. While the genetic testing is accurate, the overall success rate may vary based on these factors.

7. What Happens If the First Transfer Doesn’t Result in Pregnancy?

If the first embryo transfer does not result in pregnancy, couples can use frozen pre-embryos for subsequent attempts without undergoing the initial stages of treatment again.

8. Are There Risks Involved with Family Balancing?

Like any medical procedure, family balancing carries risks such as those associated with IVF, potential multiple births, and the invasive nature of the treatment. It is important to discuss these risks with your doctor.

9. What Happens to Unused Pre-Embryos?

Unused pre-embryos can be frozen for future use, donated to another couple struggling with infertility, or donated for medical research. Couples should discuss these options with their doctor to decide the best course of action.

10. Is Family Balancing Expensive?

Yes, family balancing is a costly process involving multiple steps such as IVF, genetic testing, and potential multiple rounds of treatment. It is important to consider the financial implications before proceeding.

  • Published on : Wednesday October 20, 2021
  • Last updated : Thursday July 4, 2024
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About the author

Michelle Tan is an IVF Consultant with 12 years of experience in fertility consulting. Having personally undergone IVF and surrogacy, she brings firsthand insight and empathy to her work. Based in Singapore, Michelle frequently travels to clinics in Bangkok, Phnom Penh, and Bishkek, sharing her expertise and supporting patients on their fertility journeys.