Gender selection, or sex selection refers to selecting the sex of your unborn baby prior to pregnancy. At North Cyprus IVF Centre, this option is offered to twogroups of patients: 1- Couples who would like to select the sex of their child due to a known genetic predisposition to a sex-linked (X-linked) condition. X-linked diseases aresingle gene disorders that point to the presence of gene mutations or gene defects on the X chromosome. Since males only acquire one copy of the X chromosome from the mother, only one mutated allele is sufficient to cause a sex-linked disease on males. This suggests that males are more prone to the majority of X-linked diseases compared to females.
2- Couples who already have children and would like to balance their family by having another child of the opposite sex. This group of patients usually have no fertility issues and are able to have healthy children via natural conception methods. However, natural conception may not always produce“balanced” offspring, therefore, assisted reproductive technologies come into play.
Regardless of your reasoning, gender selection can be legally offered at North Cyprus IVF Centre to both groups of patients.
When it comes to gender selection, there are a few important factors that help us identify which treatment method will be more suitable for your unique needs. These factors include the following:
-Age of the female patient: Female patient’s age is very important due to a number of reasons. First of all, as age gets older, the ovarian reserves tend to diminish at an increasing rate. Secondly, with increased age, genetic problems become more common, which increases the likelihood of genetic defects in children.
-Semen analysis results for the male patient: At North Cyprus IVF, we have a number of gender selection alternatives, and one of these is known as MicroSort, a sperm sorting technology, which can successfully sort the specimen into X and Y bearing cells. This technology requires that the male patient’s sperm parameters comply with minimum requirements, therefore, it is important to know about the sperm parameters prior to identifying the methods that will be employed in treatment. Therefore, even though the male partner may have fathered a child before, it will still be a good idea to have a semen analysis done, especially, if treatment program will include MicroSort, the sperm sorting technique.
-Hormone levels for the female patient: Hormone levels indicate the level of ovarian reserves as well as the quality of oocytes remaining in the reserves. This information helps us make a more effective assessment of your needs and carefully identify the right medication regimen. Therefore, if we know exactly what type of a reserve we are looking at, we can optimize the outcome of a treatment cycle by carefully calculating the dose of medication to be administered. This is a necessary step even if you have conceived naturally before. The purpose of the tests is not only to assess whether you are fertile or not, but rather, to tell us precisely what dose of medication will give us the desired results.
Based on this information, we will be able to identify the right mode of treatment, which is suitable for you. For more information on tests and interpretation, please go to “Infertility Testing”. Some patients often ask whether they still need to have these tests done even if they are fertile and have conceived before. The answer is yes! The purpose of these tests is to assess your level of fertility so that we can design the most suitable medication regimen in order to obtain most optimal results.
Gender Selection at North Cyprus IVF Clinic begins with the tests and screening. You will find more information about required tests as you scroll down to the bottom of this page. Once the testing has been done, we will be able to provide our recommendations for the gender selection method which is most likely to maximize your chances of success. Below are the methods employed in selection of the sex of your baby:
MicroSort for Sperm Sorting: Happy IVF Group is the only official clinic offering MicroSort sex selection technology in Europe, Middle East, Asia and Africa. MicroSort is a sperm sorting method which enables us to sort a sperm sample chromosomally into X (female) and Y (male) bearing cells. That way, by having a sperm sample sorted into two batches, we know which sperm batch has the capability of producing a male child and which one can produce a female child. The sorted sperm, in turn, is used to fertilize the female patient’s eggs so that pregnancy can be planned with a desired sex.
The MicroSort technology also has certain requirements. The semen sample of the male partner must contain a minimum number of motile sperm in the ejaculate so that the sort equipment can be used. For sperm samples that do not meet this criteria, the sort mechanism does not work properly and we cannot get desired results. If the sperm sample is found sufficient for MicroSort, and if the patients are willing to accept a lower accuracy of sex selection, the MicroSort technique can be used alongside with non-invasive IUI procedure as well as with IVF treatments.
Pre-implantation Genetic Screening (PGS): Our IVF laws do NOT allow for PGS to be used as a sex selection method unless there is a genetically inheritable X-linked disease that runs in the family, in which case, PGS becomes the only option of having a healthy child. Therefore, using PGS for family balancing is not an option. This is due to ethical reasons since PGS can only tell the gender of the embryos once the embryos have been created. Therefore, if choosing one sex over the other, almost half of the embryos would be destroyed for not being the “right” gender. In order to avoid this, we do not use PGS alone as a sex selection method.
Gender Selection Programs at Happy IVF Group
1) MicroSort IUI for Gender Selection
This treatment method is mostly suitable for fertile couples in their 20s, where the female patient’s ovarian reserves are still very well intact and a well response can be obtained with a very mild stimulation cycle. The male partner’s sperm count, concentration, motility and morphology are also very important when determining whether the sperm will be an ideal candidate for the MicroSort procedure or not. MicroSort procedure requires that the male partner has a semen sample which complies with minimum concentration, motility and morphology requirements.
MicroSort IUI works very much like regular IUI, where the female patient receives a very mild stimulation medication to produce multiple oocytes in order to increase the chances of pregnancy at the time of insemination. The MicroSorted sperm is injected intra-uterine in order to achieve pregnancy.
MicroSort for gender selection with IUI treatment has a very high accuracy of gender selection. Regarding success rates, MicroSort IUI has similar success rates to IUI treatment success rates, which is about 20-25% for women younger than 35 years of age, and about 10-12% for women older than 35 years of age. It should be kept in mind that MicroSort IUI may need several attempts before pregnancy can be achieved. If a higher chance of success is desired with gender selection treatments, IVF treatment should be considered rather than the non-invasive IUI.
2) MicroSort IVF for Gender Selection
This treatment option is more like regular IVF-ICSI treatment. The male partner’s sperm is sorted into X and Y bearing cells for gender selection, just like in the IUI option. However, as opposed to injecting the sorted sperm trans-uterine, female partner’s eggs are taken out and the sperm is injected directly into the nucleus of the egg for fertilization. In other words, IVF+ICSI does not let nature take its course, but rather, does the job in the lab environment.
IVF treatment requires that the female partner uses stimulation medication in order to produce a higher count and quality of eggs in a given menstrual cycle. It is through this medication protocol that we are able to obtain a higher count of eggs in order to increase your chances of pregnancy.
Pregnancy rates with MicroSort IVF are considerably higher than IUI since IVF procedures allow for multiple eggs to be fertilized and transferred back into the uterus.
IMPORTANT DISCLAIMER ***
Due to ethical considerations, we employ MICROSORT technologies ONLY as a gender selection method. However, it should be kept in mind that while PGS is not used for gender selection per se, it is still a very important component of our treatment program as it helps us choose the genetically healthy embryos for planning your pregnancy.
It is known that the risk of chromosomal aneuploidies (abnormalities) increases with age. As a woman ages, so do her eggs. This is called oocyte aging. Oocyte aging brings with it a number of problems:
– Increased rate of mitochondrial dysfunction
– Increased rate of chromosonal aneuploidy
– Increased rate of epigenetic problems.
As the oocyte ages, genetic problems are more pronounced. The graphic below displays the rate of chromosomal aneuploidy on embryos by maternal age:
Incidence of Chromosomal Aneuploidy with Age
The figure indicates that when a woman is around the age of 30, about 25% of her embryos will have a genetic abnormality. This means that after an IVF treatment, about one-fourth of her embryos will be genetically abnormal.
At about 35 years of age, this number goes up to about 32%, meaning, approximately one in three embryos will have a genetic abnormality.
At the age of 42, approximately 60% of embryos during an IVF cycle will be abnormal.
In natural pregnancies, these embryos either do not generate a pregnancy, or they do not survive so they end up in a very early miscarriage.
During IVF treatments, it is very important that while selecting the sex of the baby, we also make sure that the embryos that we transfer into the uterus are genetically healthy. For this end, after selecting the sex of your baby with MicroSort, it is important to screen your embryos with PGS so that we can select the genetically healthy embryos for pregnancy.
3) MicroSort IVF with Pre-Implantation Genetic Screening
Combining MicroSort and PGD is the best gender selection method there is, espectially for patients older than 30 years of age, with limited ovarian reserves. This treatment option is only offered at our clinic in Northern Cyprus. This method allows you to select the sex of your child with the MicroSort method, without wasting your embryos.
Once your embryos have been created using MicroSort sex selection method, they are incubated using optimal growth conditions and once they reach the ideal size, they are biopsied for Pre-Implantation Genetic Screening. While we don’t use PGS as a gender selection method on its own, it is a genetic technology that allows us screen the chromosomes of your embryos for major genetic disorders so that we can make sure your embryos are free of genetic disorders as well as being of desired sex.
Cost of Gender Selection at Happy IVF Group
The cost of gender selection treatment depends on which treatment option is chosen. The cost of the medical treatments are specified next to each treatment heading. However, you should keep in mind that certain costs are not included in the provided quotes. These are:
-Cost of medication, which depends on the type of treatment and the dose of medication to be administered. It is very difficult to predict this before knowing the type of gender selection treatment you would like to opt for and your hormone levels, which will determine the dose that we will prescribe.
-Cost of your airfare and accommodation for the duration of your treatment. You will be expected to stay in Cyprus for about 8/9 days.
-Cost of infectious disease screening prior to handling of your gametes, which is performed by our own laboratories for high level safety precautions. The cost of infectious disease screening for both partners is 200 Euros.
How to get started?
The starting point of any treatment is an effective assessment of the couple to be treated. This is very important when deciding on the type of treatment to be followed and the dose of medication regimen to be administered in order to optimize the outcome of your treatment.
For the female partner, we will need the following done on day 2 or 3 of menstrual period:
-FSH, LH, Estradiol, Prolactin, TSH and AMH hormone tests
-Baseline ultrasound scan for follicle tracking and uterine observation
For the male partner, we will need a semen analysis done with Kruger method assessing sperm volume, count, motility, morphology, pH and round cellcount.
Additionally, both partners will need to undergo infectious disease screening before egg and sperm samples can be handled at North Cyprus IVF laboratories. These tests need to be administered at our own laboratories for safety purposes as laboratory contamination is a very serious issue. The cost of infectious disease screening for both partners costs 200 Euros.
Depending on your location, we may be able to recommend a local physician for the initial testing and follow up screening prior to your arrival in Cyprus. Once you have had your tests done, we will be able to make an assessment of your fertility level and decide on further course of treatment. At this point, wewill be able to design your treatment protocol and provide you with a prescription so that you can obtain your medication. Your treatment calendar will also be provided, which will be a summary of medication use and things to do on a daily basis while you are preparing for your treatment.
This way, you can have your preliminary work carried out locally and come to Cyprus for a total of 8/9 days to finalize your treatment. However, if you would like to have your entire treatment here from start to finish with all your preliminary testing and screening, it will be necessary to come here on day 1 of yourmenstrual period and stay in Cyprus for a total of 20 days.
Success Rates with Gender Selection in Cyprus
Success with any fertility treatment will depend on a number of factors. Among these factors are the ages of the patients, ovarian function and oocyte quality of the female patient, uterine conditions of the female patient and the sperm quality of the male patient. All these factors are important when assessing success. The younger the age, and the higher the ovarian activity (ovarian reserves), the higher the chance of success with fertility treatments. Once our patients undergo the tests and screening outlined above, our team of experts will make an assessment of fertility levels and quote you with a customized chance of success with treatment.