Get access to over 1,300 articles and reader Q&As
My wife and I are about to start our first round of IVF and really want a boy and a girl. We both grew up with big brothers and would love to have a boy first, then a girl. Can you choose the gender of your baby with IVF?
—Caitlin
It really depends on your particular fertility clinic and why a given gender is preferred.
First, a bit of terminology. Gender is a social construct that encompasses how someone identifies and presents themselves, whereas sex refers to someone’s reproductive organs and chromosomes (i.e., XX for female or XY for male). Because we can’t yet know how a future child may identify, most people in the field use the term sex selection.
In the U.S., you can choose to undergo IVF with preimplantation genetic testing for aneuploidy (PGT-A), which can provide information about the sex of embryos (and also about the number of chromosomes the embryo has). So, in that sense, the information is often available. It becomes a question of what your clinic will allow.
This is a controversial topic. On one hand, the whole point of technologies like IVF is to help people build the families that they want, and many of us, on some level, understand that the composition of that family — including the sex of any children — is a part of that.
On the other hand, there is a well-documented sex imbalance and gender discrimination in many parts of the world, particularly against women and girls. It’s, unfortunately, true that there is an entrenched preference for sons, though it may be decreasing in the U.S.
This concern about discrimination, as well as what a sex imbalance can mean for the long-term demographics of a population, makes many clinics hesitant to offer sex selection outside of a medical reason. Still, one survey found that upwards of 94% of clinics that offer PGT-A allowed sex selection for “family balancing” (having an even mix of male and female children) and patient preference.
Many clinics will allow for sex selection to avoid passing on particular genetic disorders, and the American Society for Reproductive Medicine recommends that each clinic have a written policy about what is acceptable. It’s worth reaching out to your clinic to understand what their policy is. Keep in mind that if you are interested in sex selection solely because of your preference, it may mean seeking care at another clinic.
Community Guidelines
Log in