One of the treatment options offered at North Cyprus IVF Clinic is gender selection. Couples may choose gender selection treatment for a number of reasons. A couple may already have children but they may want to select the sex of their next child for family balancing purposes. Alternatively, a couple may want to opt for gender selection for genetic disease prevention purposes in cases where a certain sex may have a predisposition to certain genetic linked diseases.
Even if you do not have any infertility problems and you are able to conceive naturally on your own, gender selection will still require you to undergo infertility testing so that we can make an assessment of your unique fertility level so that our specialists can identify the right protocol of treatment suited for you. This is the most important step before having treatment. At North Cyprus IVF Clinic, we offer a number of gender selection treatment options and deciding which option is better suited for you will depend on a number of factors. These are as follows:
- Age of the female patient
- Previous history of conception
- Hormone levels of female patient to be assessed on day 2 or 3 of her menstrual period along with an ultrasound scan for identifying antral follicle count.
- Semen analysis for the male partner. We will need to know about details of semen parameters.
When it comes to gender selection, a number of options will be available to you depending on the above criteria:
The first method of gender selection is via the MicroSort technology. MicroSort is a patented sperm sorting technology which allows us to sort the sperm into X and Y bearing cells. In other words, we are able to sort the sperm into male and female bearing cells before proceeding with any treatment. However, MicroSort procedures requires that the sperm is within certain parameters. There are restrictions with respect to sperm count, concentration, motility and morphology in order for a sperm sample to qualify for the MicroSort procedure. For instance, the sperm concentration will need to be higher than 60 million/ml in order for the sort equipment to process the sperm. Otherwise, the procedure may fail. For this purpose, we will need to see the male partner's semen analysis report so that an assessment can be made.
It should be known that MicroSort does not provide 100% accuracy. It is about 90% accurate for female selection and about 75% of male selection. The sort mechanism operates based on the principle of DNA volume, therefore, defected sperm cells can create an equipmental misinterpretation, thus reducing the level of accuracy to 90% and 75%.
Pre-Implantation Genetic Diagnosis (PGD):
The second method is the pre-implantation genetic diagnosis / screening (PGD or PGS for short). PGD is a method of chromosome screening after the embryos have been created in the lab setting. This method requires that the female patient undergoes an egg retrieval procedure first (after an ovarian stimulation program in order to obtain multiple eggs). The eggs retrieved will then be fertilized with the male partner's sperm sample in order to create embryos. This is very similar to the IVF/ICSI treatment procedures. The only difference comes in after embryo creation. With IVF/ICSI procedures, the created embryos are incubated for a few days until they reach a certain cellular growth level and then become ready for embryo transfer. With PGD technique, before the embryos can be transferred into the uterus, a genetic screening is performed. With this genetic screening, our geneticist is able to screen either 5 of the main genetic disease prone chromosomes or the entire set of chromosomes for standard genetic abnormalities. While screening for abnormalities, X and Y chromosome screening also reveals the sex of each embryo, therefore, PGD is not a gender selection only method, but rather a more comprehensive system of gender screening as well as screening for major genetic disorders for genetic disease prevention.
Based on this information, couples are offered a number of alternative gender selection treatment options depending on the criteria specified above, earlier in this section. The options are as follows:
Gender Selection Treatment Options:
1- MicroSort IUI: This option is the least invasive gender selection option for fertile and younger couples who would like to specify the sex of their next child for family balancing purposes. The MicroSort sperm sorting technology is coupled with the IUI (Intra-Uterine Insemination) method in order to assist couples to conceive a child of desired sex. As mentioned above, MicroSort is not a 100% method for gender selection. However, it will give you a very high level of chance for having a child of desired sex. The IUI procedure itself is one of the least invasive fertility treatment options. Due to its lower level of success chance compared to IVF treatments, IUI is usually recommended for fertile couples in their 20s or perhaps early 30s. After 30 years of age, success rates with IUI treatment will drop substantially, making it an ineffective method of treatment for couples in higher age brackets.
2- IVF with PGD: This treatment option is geared for a broader range of couples. The IVF part of this treatment option is exactly like the IVF/ICSI treatement. In order to maximize your chances of success, we will ask that you undergo the testing process described above. Once we make an assessment of level of your fertility, we will be able to prepare a custom treatment protocol for you by identifying the right medication dosages. With a successfully prepared medication protocol, we will aim to obtain as many good quality oocytes (eggs) as possible without involving and risk of ovarian hyper stimulation. Follicles that contain the mature eggs will be aspirated during a procedure called egg retrieval and once the eggs have been isolated from these follicles, they will become ready for fertilization. ICSI procedure will be used in order to fertilize these mature eggs with the highest quality sperm hand selected by our embryologists. After the fertilization process, embryos will be left in the incubator for a few days until they reach a desired level of growth so that the embryologist can perform an embryo biopsy for PGD testing. After PGD testing, our geneticist will be able to identify which embryos are of desired sex and also free of genetic disorders. Once these embryos reach the blastocyst stage, they will be ready for the embryo transfer procedure.
3- MicroSort IVF with PGD: This method is often recommended for couples in higher age brackets. When the female patient is in a higher age bracket, it is very likely that her ovarian reserves have been depleted and the quality of her eggs are now less optimal. This means that the egg retrieval procedure is likely to yield less number and quality of eggs. With a lower count and quality of eggs, we may not be able to obtain as many embryos as we like to have. For this end, using the MicroSort procedure for the sperm sample (given that the sperm sample qualifies for this procedure) will allow us to make sure that majority of the embryos will fertilize into embryos of desired sex, thus allowing us to maximize our chances of success.