Snips –n– Snails … or Piggytails?

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Science has a way to help parents in the quest for a baby of either gender.

Jennifer Thompson was confident the baby she was carrying – her second – was a girl. After all, the northern Virginia mom had followed the suggestions in the book How to Choose the Sex of Your Baby (Broadway; $13.95) from timing intercourse a few days before ovulation to having sex only in the missionary position. So when the sonogram image left no doubt that her daughter was in fact another son, a shocked Thompson burst into tears. “I didn’t want to be just a “boys’ mom,” she explains.

Although Thompson says she fell completely in love with her son when he was born, she still felt a void that could only be filled by little pink socks, ribbons and curls. Thompson became a mom on a mission, searching the world (via its wide Web) for a better way to ensure baby number three truly was her dream daughter.

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Her quest for pink booties landed her at the Genetics and IVF (GIVF) Institute in Fairfax, Va., where a clinical trial is underway to test the safety and efficacy of a new sperm-sorting process called MicroSort. After two rounds of intrauterine insemination or IUI (she failed to get pregnant either time), and one successful in vitro fertilization (IVF), Thompson got her girl. “Our family wouldn’t be complete without her,” says Thompson, who makes no apologies for taking the extra steps to ensure her last baby would come home swaddled in pink.

The Birth of Sex Selection

Throughout history, parents have tried to influence their children’s gender. In ancient Greece, men believed they could father a boy if they had sex while lying on their right sides. French men in the 1700s tied off their left testicles in the hopes of producing male offspring. Bookstore shelves are filled with titles like the one Thompson used. Even with these attempts, a couple’s odds of naturally conceiving their dream son or daughter remained 50/50 – until the birth of the first “test tube baby” in 1978 ushered in a brave new world of baby making.

Today, with advances in assisted reproductive technology, couples can get help conceiving a baby, and they can choose the child’s sex. And everyone – from the yearning parents, to fertility specialists, to medical organizations, to bioethicists – has differing opinions as to whether this progress is a societal blessing or a curse.

The Ericsson Method: Upping the Odds

Around the time IVF was born, Ronald Ericsson, Ph.D., pioneered a process that separates male and female sperm by spinning them in a centrifuge: smaller, lighter male sperm float to the top, while the larger, heavier female sperm sink. Via IUI (the process doesn’t work with IVF), women are inseminated with the sorted sperm containing a higher ratio of the desired gender. Although the Ericsson Method is relatively affordable at $2,000 per cycle and not medically invasive, its success rate of 70 to 75 percent for the desired gender is still a gamble many couples aren’t willing to take.

PGD: The Gender Guaranty

The most successful gender selection method, pre-implantation genetic diagnosis (PGD), is a highly specialized form of IVF that was developed to screen for sex-linked diseases such as hemophilia or Duchenne’s muscular dystrophy that predominantly afflict boys.

Typically, a woman undergoing IVF is given a series of hormone injections to boost egg production. After the eggs are surgically removed, they’re fertilized in a laboratory with her partner’s sperm. In a routine IVF procedure, the fertilized embryos are transferred back to the woman’s uterus; but with PGD, a single cell is removed from each embryo. By analyzing these cells, doctors not only can tell which embryos are healthy, they can also distinguish – with almost 100 percent accuracy – the boys from the girls. For sex selection purposes, embryos of the preferred sex (which are not necessarily the healthiest ones) are then used in the IVF process.

For many years, PGD was used as it was intended: to save couples from the heartache of bearing ill children. But eventually couples who were already forking over thousands of dollars for infertility treatments began asking to use it too – not to screen for diseases, but to get their coveted son or daughter. Fertile couples soon followed suit, and much to the dismay of some members of the medical community, many doctors acquiesced.

The fact that fertile couples with no history of disease are creating embryos simply to get a child of their choosing is a point of contention for many. At the heart of the controversy is the fate of the fertilized, healthy embryos of the “wrong” sex. While couples can donate their leftover embryos to other families, most choose to have them destroyed or donate them to research (where they’re eventually destroyed). It’s these latter acts that some people say – based on religious or moral beliefs – violates human life. And the procedure carries a hefty financial risk. IVF treatments start at $15,000 with an additional $2,500 – $3,500 charge for PGD.

Even though it’s a near sure-thing that the selected embryos are the desired gender, there’s no guaranty a pregnancy will occur (many couples must try two or three times to conceive). While a few insurance companies cover a portion of the costs for medically-necessary infertility treatments, none pay for sex selection.


MicroSort: A Family Balancing Act

Like the Ericsson Method, the MicroSort process relies on the fact that female chromosomes are bigger (they hold almost three percent more DNA) than males. During the MicroSort process – sperm is stained with a fluorescent dye. The slightly larger female sperm soak up more of the dye and glow brighter, making it easier for a sperm-sorting machine called a cytometer to filter out the unwanted gender. At present, this process is more successful sorting for girls (90 percent) than for boys (73 percent).

Couples can choose either IUI (at a cost of up to $4,500 per treatment) or IVF (at a cost of $3,000 for each sperm sort, plus $15,000 for each IVF treatment). Prequalifying tests, medications, consulting fees and other miscellaneous expenses are extra.

Debating the Right to Choose

A survey conducted by the Genetics and Public Policy Center, a division of Johns Hopkins University’s Berman Bioethics Institute, revealed a nation divided as to the propriety of sex selection for non-medical reasons (40 percent support it, 60 percent do not). In focus groups, participants embraced MicroSort as a better alternative than PGD, even while expressing disapproval of the family balancing concept. “The idea that you could pick future offspring that meet certain design specifications was troublesome to people,” explains Kathy Hudson, Ph.D., the center’s founder and director.

It’s no wonder we’re ambivalent; even our nation’s medical organizations don’t agree. Both the American Medical Association (AMA) and the American College of Obstetrics and Gynecology (ACOG) oppose sex selection for family balancing claiming the practice serves no medical purpose and is sexist because it places a higher value on one gender over another. But the American Society for Reproductive Medicine (ASRM), the organization most fertility specialists look to for ethical guidance, has given the nod to preconception methods like MicroSort, but not to the post-conception PGD.

While researchers contend we’re far from being able to select characteristics such as intelligence, hair color or height, detractors say sex selection has us sliding down a potentially dangerous slippery slope.

Does 1 Daughter + 2 Sons = 1 Balanced Family?

Although the Thompsons and hundreds of families like them are thrilled with their bundles of joy, not every couple gets what they ordered. One Florida couple spent close to $15,000 at a MicroSort partner only to come home with their third bouncing baby boy. But all the naysaying doesn’t bother Thompson, who wrote a book about her experiences, Chasing the Gender Dream (Aventine; $12.95), to help other couples through the sex selection process. “As sex selection becomes more widely available and accepted, there are going to be a lot of kids conceived this way,” she says. And if her daughter someday asks about her birth? “I’ll tell her she was conceived as her brothers were. With love.”


 

learn more locally

the center for reproductive health
www.reproductivehealthctr.com
321-8899

nashville fertility center
www.nashvillefertility.com
321-4740

facts behind the folklore

Long before babies were conceived in labs, grandmas touted these no-tech ways for conceiving a son or daughter. While these might sound far-fetched, there’s actually some fact behind the folklore.

  • Choose the right sexual position. The rear-entry position is recommended for couples wanting a boy because it deposits the weaker male sperm closer to the egg and farther away from the vagina’s acidic environment. Try the missionary position if you want a girl because the shallow penetration will kill more of the male sperm.
  • Go for the O. (If you want a boy, that is.) When a woman climaxes, the vagina becomes less acidic and more alkaline, which makes it easier for male sperm to survive. Plus, the contractions that accompany an orgasm help move the male sperm into the cervix.
  • Monitor the moon. Women’s menstrual cycles (and therefore ovulation) can be affected by the monthly push and pull of the moon’s electromagnetic field. For a girl, have sex when the moon is full; for a boy, when there’s a quarter moon.
  • Watch what you eat. Six weeks before conception, start a diet rich in potassium (red meats, vegetables and salt) if you want a boy, or one that’s high in calcium and magnesium (milk, cheese, cereals, beans) if you want a girl. These gender diets are thought to change the pH level of a woman’s body: an acidic environment is good for creating girls, while an alkaline environment is better for boys.
  • Go north (or south). Like magnets, sperm have a certain degree of polarity and will head for the negative pole. For a boy, the couple should face north during intercourse; for a girl, face south.

Jeannette Moninger is a freelance writer.

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