Can I Choose Gender in IVF? What Really Happens During Gender Selection

When people start exploring IVF, one of the most common questions that comes up is: Can I choose gender in IVF? The answer isn’t simple yes or no-it depends on where you live, why you want to do it, and what medical guidelines you’re following. In the UK, gender selection for non-medical reasons is illegal. But that doesn’t mean it’s impossible to influence the outcome. Let’s break down exactly how it works, what’s allowed, and what really happens behind the scenes.

How IVF Works-Before Gender Comes Into Play

IVF, or in vitro fertilization, starts with stimulating the ovaries to produce multiple eggs. These are then retrieved and fertilized in a lab with sperm. The resulting embryos grow for 3 to 5 days. At this point, doctors can check them for chromosomal health before transferring one into the uterus. This step is called preimplantation genetic testing (PGT). It’s not done to pick gender-it’s done to find embryos with the right number of chromosomes. Abnormal embryos often lead to miscarriage or genetic conditions like Down syndrome. So PGT is about improving the chance of a healthy pregnancy, not about choosing boy or girl.

What Is PGT-A and PGT-SR? (And Why They’re Not for Gender)

There are different types of PGT. PGT-A checks for chromosome count. PGT-SR looks for structural chromosome issues, like translocations. Neither is designed to select gender. But here’s the catch: when you test chromosomes, you automatically find out the sex. That’s because one of the 23 chromosome pairs is the sex chromosome-XX for female, XY for male. So if an embryo is tested, the lab will see whether it has two X chromosomes or one X and one Y. That information is recorded. But in the UK, it’s illegal to use that information to choose which embryo to transfer unless there’s a medical reason.

When Is Gender Selection Allowed in the UK?

The Human Fertilisation and Embryology Authority (HFEA) allows gender selection only to prevent serious sex-linked genetic diseases. These are conditions that mainly affect one gender because of how they’re inherited. For example:

• Duchenne muscular dystrophy-almost always affects boys because the faulty gene is on the X chromosome.
• Hemophilia A-mostly passed from mother to son.
• fragile X syndrome-more severe in males, though females can be carriers.

If a couple has a history of one of these conditions, they can go through IVF with PGT to avoid transferring embryos of the gender at risk. A woman who carries the hemophilia gene, for instance, might choose to transfer only female embryos, since daughters would be carriers but not usually affected. Sons, however, have a 50% chance of having the disease. In these cases, gender selection is a medical tool-not a preference.

What If I Just Want a Boy or Girl?

If your reason is personal-maybe you already have three girls and want a boy, or you’ve always dreamed of raising a daughter-the UK does not allow this. Many people assume clinics will quietly let them choose. They won’t. UK clinics are tightly regulated. Any attempt to select gender for social reasons can result in fines, loss of license, or criminal charges. Even if you travel abroad, UK law still applies if you’re a resident. Some clinics in the US, Mexico, or Ukraine offer gender selection as a standard service. But if you’re based in the UK and return home with a child conceived this way, you’re not breaking the law by bringing the child home-but you *did* break it by undergoing the procedure outside the legal framework.

Are There Natural Ways to Influence Gender?

There are myths about timing sex, diet changes, or even sleeping positions affecting gender. None of these have solid scientific backing. The Shettles method, for example, claims that having sex closer to ovulation increases the chance of conceiving a boy because Y-sperm swim faster. But studies show no consistent effect. A 2022 review in the British Journal of Obstetrics and Gynaecology found no reliable evidence that any natural method changes the odds beyond the natural 50/50 split. IVF with PGT is the only method proven to work-but even then, only for medical reasons.

What About Gender Prediction in Early Pregnancy?

Some people think ultrasound or blood tests at 10 weeks can help them "plan" for gender. That’s not true. These tests detect gender after conception. They don’t influence it. In fact, the UK bans non-medical gender disclosure before 12 weeks under the Human Fertilisation and Embryology Act. So even if you find out you’re having a boy, you can’t use that to make decisions about future pregnancies or embryo selection.

Why Do Some Countries Allow It?

In places like the US, gender selection is legal and often marketed as part of "family balancing." Some clinics offer it for $3,000-$7,000 extra on top of IVF costs. But this raises ethical questions. Critics argue it reinforces gender bias, skews population ratios (as seen in parts of China and India), and turns reproduction into a consumer choice. The UK’s strict stance reflects a broader European view: human embryos shouldn’t be selected based on traits like gender unless disease prevention is involved.

What Happens If I Try to Get Gender Selection Outside the UK?

Some couples travel to clinics in Cyprus, Georgia, or the US for gender selection. They think they’re "just getting IVF" and don’t mention their real goal. But clinics that offer this service usually require signed consent forms stating the reason. If you lie, you risk legal consequences if you’re ever investigated. Plus, there’s no guarantee the clinic will deliver what they promise. Success rates vary. One 2023 study in Fertility and Sterility found that even in top US clinics, gender selection via PGT had a 98% accuracy rate-but only if the embryo was properly biopsied and tested. If the lab makes a mistake, you could end up with the opposite gender.

What Are the Real Risks of Gender Selection?

Even when done legally for medical reasons, PGT carries small risks. The biopsy process can damage the embryo in about 1-2% of cases. Not all embryos survive testing. And if you’re only transferring one embryo (as recommended in the UK), you might have no embryos left to transfer if all the "correct" ones are abnormal. Some couples end up needing a second cycle. There’s also emotional strain. People who go through IVF already face high stress. Adding gender expectations can make it harder to cope if things don’t go as planned.

What Alternatives Exist If I Want More Control?

If your goal is to have a child of a specific gender for personal reasons, you have limited options:

• Accept the natural odds-each pregnancy has a 50% chance of either gender.
• Adopt-you can choose the gender of the child you adopt in many UK adoption agencies.
• Use donor sperm or eggs with known gender outcomes-but this doesn’t change the randomness of conception.

There’s no ethical workaround in the UK. And honestly, most people who try to force gender end up feeling disappointed-even if they get the gender they wanted. The child’s health, personality, and future matter far more than whether they’re boy or girl.

Final Thoughts: It’s Not About Choice-It’s About Ethics

The UK doesn’t ban gender selection because it’s technically hard. It bans it because society decided that reproductive technology shouldn’t be used to fulfill preferences. This isn’t about controlling parents-it’s about protecting children from being treated like products. In a world where gender roles are still evolving, choosing a child’s sex based on tradition or preference sends a message we’re still trying to unlearn.

If you’re considering IVF and have concerns about gender, talk to your fertility specialist. They can explain your options within the law. If you’re struggling with gender expectations, many clinics offer counseling. You’re not alone in feeling this way-but the system is designed to help you focus on what really matters: a healthy baby.