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. 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 nor 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 anaesthesia.
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. 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.
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’.
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.
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.
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.