Can You Choose Gender with IUI?

For couples experiencing unexplained infertility, deciding to start or grow your family with the help of fertility treatments often comes with questions such as "What are the chances of success if I use assisted reproductive technologies like intrauterine insemination (IUI) and in vitro fertilisation (IVF)?" and "Is it possible to select the gender of my baby if I get artificial insemination?"

If you’ve ever wondered whether IUI and other similar assisted reproductive technologies offer the option to choose to conceive either a boy or girl, you're not alone.

Let’s demystify the process and help you make sense of the science and the rules behind gender selection with IUI and other similar fertility treatments.

What is the IUI gender selection procedure?

IUI gender selection, also known as sperm sorting or gender selection through artificial insemination, is a technique used to increase the chances of conceiving a child with a specific gender.

The procedure involves separating the sperm cells based on their genetic content, either carrying an X chromosome (which results in a girl) or a Y chromosome (which results in a boy).

Breakdown of the full procedure

Before the IUI procedure, you may need to take fertility drugs. You can use ovarian stimulation medications like clomiphene citrate (Clomid) or letrozole, or gonadotropin injections like follicle-stimulating hormones (FSH) and luteinising hormones (LH) to stimulate your ovaries, thereby enhancing the growth and maturation of your eggs.

The egg development is tracked using transvaginal ultrasounds and hormone blood tests; once the eggs are mature, monitoring focuses on ultrasound to assess size and readiness, along with blood tests for oestradiol and LH to help time ovulation and insemination.

Your partner or donor's semen sample is then collected and then processed using a technique called sperm sorting, which separates the sperm cells based on their gender.

The sorted sperm sample of the desired gender (X or Y chromosome) undergoes sperm washing and is then inserted into your uterus using a thin IUI catheter guided through the cervix. This procedure aims to bring the sperm closer to the egg, increasing its chances of fertilisation.

Gender selection in IUI allows couples to choose a gender, providing them with greater control over their family planning. However, it is important to note that gender selection during IUI is not 100% guaranteed. The procedure is also not considered a medically necessary treatment and is usually performed for personal family reasons.

Couples opting for this procedure should often seek guidance and assurance from their fertility specialists regarding their IUI babies' gender.

How does it work?

The sperm sample is examined in the laboratory to determine the gender using the IUI method because the baby's sex is decided based on the sperm chromosomes.

During an IUI procedure, a semen sample is collected from your partner or donor, and the higher-quality sperm is separated and washed.

Afterwards, the sperm are divided into groups based on their probable sex. The most common sperm sorting techniques include methods such as the "swim-up" or centrifugation, which attempt to separate X-carrying and Y-carrying sperm based on differences in their size, weight, or motility. The female sperm with the X chromosome travels more slowly than the male sperm with the Y chromosome.

The semen undergoes sperm washing, and then the washed sperm is injected into the woman's uterus using an IUI catheter.

Afterwards, you can return to your normal activities. It is usually  recommended to take a pregnancy test two weeks after the procedure to confirm pregnancy.

Can you choose gender with IUI?

Sperm sorting techniques used with IUI can increase your chances of having a boy or a girl, but the outcome is not certain nor guaranteed. The success rates of conceiving your preferred gender are much higher than with natural conception but still far from 100%.

Most fertility specialists consider these methods to be "gender swaying" rather than true gender selection, as a significant percentage of pregnancies result in the non-targeted gender. Studies indicate that the success rate for achieving a desired gender is around 50%. This probability is similar to the natural odds of conceiving a male or female child.

Medical professionals also reiterate that IUI does not reliably allow parents to choose their babies' gender.

If you need personalised recommendations and tailored advice about the possibilities of conceiving a specific gender via IUI, please consult a fertility specialist. Request an appointment with Thomson Medical today.

Gender selection in other fertility treatments

Other fertility treatments, such as IVF, offer more precise gender selection through pre-implantation genetic testing (PGT), also known as pre-implantation genetic screening (PGS).

A few cells are taken from each embryo during PGT. A genetic analysis of these cells determines which have an XY chromosome pairing (boys) and which have an XX chromosome pairing (girls). Finally, viable embryos of the desired sex are selected for embryo transfer.

IVF with PGT is far more accurate for gender selection than IUI but is generally reserved for medical reasons in many countries, including Singapore.

When is gender selection in IUI recommended?

There are several personal and medical reasons that may make someone consider gender selection. The most common reasons for gender selection in IUI include:

• To prevent passing on a sex-linked genetic diseases

• Family balancing

• Personal preference or other nonmedical reasons

However, in most places, gender selection is only recommended for preventing the transmission of serious sex-linked genetic disorders.

In many countries, attempting to select gender for non-medical reasons – such as family balancing – is restricted or not permitted. You should always verify the laws and guidelines in your country before considering gender selection.

Is gender selection allowed in Singapore?

Gender selection for non-medical reasons is strictly prohibited in Singapore. Even in IVF, selection of embryos based on gender is only permitted under very limited medical circumstances – such as preventing sex-linked genetic conditions – and only in government-approved facilities. For personal preferences or family balancing, gender selection via any fertility treatment is not allowed in Singapore.

FAQ

Can I have intercourse after IUI?

What if my IUI cycle fails?

How can I ensure I get pregnant with a girl or boy?

Can gender selection happen accidentally during IUI?

What is sperm sorting, and is it available in Singapore?

If I have twins from IUI, can I select one gender per twin?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.