Gender Selection

What is gender selection?

Gender selection in IVF treatment is a method used to determine the sex of the baby before the pregnancy process. This treatment, which is preferred in order to prevent diseases transmitted through genetic heritage and family planning, can only be applied by legal centers. For gender selection, the person or couple willing to have a baby should apply to the in vitro fertilization method. In the Turkish Republic of Northern Cyprus, the Preimplantation Genetic Diagnosis (PGD) method, which was used for sex selection in previous years, is carried out only for genetic screening purposes, not for gender determination, in accordance with the legal legislation issued on 21 June 2016.

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For gender selection, all processes required in infertility treatment such as male sperm analysis, ovarian reserve of the woman, ultrasound examination, and intrauterine evaluation are repeated exactly. Even if the couple has had a child before, it is obligatory to make some tests and examinations so that the drug doses to be used can be adjusted personally.

Microsort is one of the applications that will be preferred for gender selection in the Turkish Republic of Northern Cyprus. It is possible to say that the application is in accordance with ethical values ​​in terms of reducing the possibility of extra embryo production from the unwanted sex. In the Preimplantation Genetic Diagnosis method called PGD or PGD, it is prohibited to be applied by clinics because of the fact that it results in the destruction of embryos of unwanted sex.

What is the success rate in gender selection?

In general, factors such as egg and sperm quality, age, general health status, and genetics stand out as determining factors in the success in IVF treatments. In the treatment of gender selection, factors such as the quality of the patient’s egg reserve, age range, and general health history come to the fore. Generally, the success rate in younger patients is higher than in older patients. Factors such as the technological infrastructure preferred by the clinic for gender selection, working with an expert and experienced team that will closely deal with the process, hygiene and sterilization are also indicators that increase the success rate in treatment. For this reason, a reliable, experienced and professional IVF center should be preferred before the application.

Steps of gender selection implementation;

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Before gender selection treatment, there are tests and examinations that should be done specifically for women and men. Age is an important factor in gender selection treatment for women. For this reason, it is generally recommended to analyse ovarian reserves at an early age. At the same time, these tests, which are carried out to determine the general health status, the suitability of intrauterine conditions for pregnancy, are also a guide for treatment planning when necessary.

On the 2nd or 3rd day of menstrual bleeding, hormone levels such as LH, FSH, Prolactin, Estradiol, AMH, TSH are checked. The dose of the drug to be used is determined according to the results of endocrinological findings and ovarian reserves. On the same day, intrauterine and ovarian evaluation is performed with ultrasound.

Semen analysis, also known as sperm testing in men, is effective on gender selection. Gender selection treatment is applied with a technology called Microsort method for patients with sperm concentration higher than 50 million/ml. For this reason, patients who apply for treatment should have their sperm parameters measured.

It is also necessary for the woman and the man to have an infectious disease test before the treatment. After the relevant test and examination processes, if any situation that is not suitable for IVF treatment is not detected, the procedures are started.

How gender selection is done?

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The genetics of the egg cell of the woman, which consists of two X chromosomes, and the genetics of the sperm cell of the man are different structures. Each male sperm cell contains chromosomes called X and Y. The male can give both X chromosome and Y chromosome from the sperm cell during the development of fetus.  If the X chromosome from the male sperm cell combines with the X chromosome from the mother, a girl is born. Similarly, if the Y chromosome comes from the sperm cell and the X chromosome comes from the mother, the baby will be a boy.

With the method called Microsort, the sperm cells are separated as X and Y-bearing cells before fertilizing the egg. The other name of this method, which is applied in only a few centers in the world, is also known as sperm flotation method. In this method, in which sperm cells with X and Y chromosomes, which differ from each other in gene number and size, are separated in the laboratory environment. The success for boys is 75% and 90% for girls. Since the application is a mechanical separation, it can be done by DNA density.

Gender selection with Microsort IUI is generally performed for female patients in their 20s who have good egg reserve and who can respond to mild drug therapy. The primary criterion sought in men is that the sperm concentration is above 50 million/ml. In particular, sperm motility, number, concentration and morphology are among the factors that determine the course of the process.

Gender selection with Microsort IVF has similar features with IVF treatment. Merely, before the egg and sperm are combined, X and Y chromosomes are separated from the relevant sperm cell by Microsort method. In this way, there is a space to act in line with the directives of families regarding the baby’s sex.

Microsort method is usually done with inoculation (IUI) and microinjection (ICSI) methods. The method of inoculation is the application in which sperms selected with Microsort are used in ovulation, and the inoculation procedure continues besides sperm selection. The pregnancy rate varies depending on the age of the mother.

In the microinjection method, the expectant mother may need to use hormone medication from the beginning of the menstrual period in order to get efficiency from the egg cells. When the desired amount of egg cells is obtained, injection is applied to trigger ovulation. The sperm sample taken simultaneously is separated by Microsort process. According to the selected sperm, the fertilization phase is started. With the microinjection method, the sperm cells are injected into the egg cell one by one and the process is completed.