Choosing the gender of your baby is a question that comes up often among intended parents considering IVF and surrogacy. In the United States, gender selection is legal in many states and has become increasingly common, especially for those pursuing family balancing or seeking to avoid sex-linked genetic conditions.
In this article, we will explain how gender selection works during IVF, whether it is legal, why some parents choose it, what it costs, and what to consider before making that decision. We will also provide a brief overview of how laws vary in other countries.
Is Gender Selection Legal in the U.S.?
In the United States, gender selection is legal in many states and is often offered by fertility clinics as part of IVF treatments. There are currently no federal laws prohibiting the use of embryo sex identification for non-medical reasons. This means that clinics are generally free to offer this option, and intended parents are free to request it when available.
The most common method for gender selection in the U.S. is through PGT-A, which is already widely used to screen embryos for chromosomal health. Since the test also reveals the sex of the embryo, choosing to transfer a male or female embryo becomes a possible and legal step in the IVF process.
Although it is legal, the availability of gender selection may vary slightly depending on the clinic’s policy or the state’s regulatory environment. Most major fertility centers in the U.S. do offer gender selection, especially in states where IVF practices are less restricted.
The ethical framework surrounding gender selection continues to be a topic of discussion. However, in practice, many intended parents make this choice as part of deeply personal decisions related to family planning, medical history, or emotional readiness.
International Overview of Gender Selection Laws
While gender selection is permitted in many parts of the United States, the legal situation is very different in other countries. In most of Europe, gender selection for non-medical reasons is either heavily restricted or entirely banned. For example, in countries like France, the United Kingdom, and Germany, choosing the sex of the baby is only allowed if there is a strong medical justification, such as avoiding a serious sex-linked genetic disorder.
Canada also prohibits non-medical gender selection, and many fertility clinics there follow strict ethical guidelines aligned with national laws. Other countries, such as Australia or India, have enacted laws specifically banning the use of technology to influence a child’s sex for personal or cultural reasons.
Because of these restrictions, some international intended parents look to the United States to access options that are not available in their home country. The flexibility of the legal framework in the U.S., combined with access to advanced reproductive technologies, makes it a destination for those seeking a broader range of choices in family planning.
How Gender Selection Works with IVF
What Is PGT-A?
Preimplantation Genetic Testing for Aneuploidy (PGT-A) is a laboratory procedure used during in vitro fertilization (IVF) to assess the chromosomal makeup of embryos before implantation. This test helps identify embryos with the correct number of chromosomes, known as euploid embryos, which have a higher chance of leading to a successful pregnancy.
During pre-implantation genetic testing for aneuploidy, a few cells are carefully removed from each embryo at the blastocyst stage (typically five to six days after fertilization). These cells are then analyzed to determine the number of chromosomes present. This process allows for the identification of embryos with chromosomal abnormalities, which can lead to implantation failure, miscarriage, or genetic disorders.
PGT-A also reveals the sex chromosomes of each embryo. By identifying whether an embryo has XX (female) or XY (male) chromosomes, intended parents can choose to transfer an embryo of their preferred sex. This makes PGT-A a reliable method for gender selection during IVF.
Embryo Transfer Process
After PGT-A testing, the fertility clinic provides a report detailing the chromosomal status and sex of each viable embryo. Intended parents, in consultation with their medical team, can then select an embryo that aligns with their family planning goals.
The selected embryo is transferred into the uterus of the gestational surrogate in a procedure known as embryo transfer. This process is standard in IVF treatments and is not influenced by the sex of the embryo. Choosing the gender does not introduce additional medical risks for the surrogate or the future child.This approach is typically used in gestational surrogacy, where the surrogate carries a baby with no biological connection to her.
It’s important to note that while PGT-A provides valuable information, the availability of embryos of a specific sex cannot be guaranteed. Factors such as the number of embryos produced and their chromosomal health can influence the options available for transfer.
Why Do Parents Choose Gender Selection?
Family Balancing and Personal Motivations
One of the most common reasons for gender selection is family balancing. This refers to the desire to have a child of a different sex than existing children. For example, a couple who already has two boys might wish to have a girl to complete what they see as a balanced family unit.
In some cases, intended parents may also carry a long-held vision of their future family that includes a specific gender. These motivations are often deeply personal and rooted in emotional experiences, relational dynamics, or the simple hope of sharing a unique bond with a child of a particular sex.
Choosing the gender of the baby is not about valuing one sex over the other. Rather, it is often about fulfilling a vision that feels emotionally meaningful for the individuals involved.
Medical Considerations
In certain situations, gender selection is recommended for medical reasons. Some genetic disorders, such as Duchenne muscular dystrophy or hemophilia, are sex-linked and primarily affect male children. Other conditions like Fragile X syndrome or adrenoleukodystrophy (ALD) are also linked to the X chromosome and may present more severe risks depending on the child’s sex. In these cases, selecting a female embryo can reduce or eliminate the risk of transmitting the condition.
PGT-A or other forms of preimplantation genetic testing can be used not only to identify the sex of the embryo, but also to screen for specific inherited disorders. Gender selection becomes part of a broader reproductive strategy focused on protecting the health of the child and easing the emotional and medical burden on the family.
This form of selection is not based on preference. It is a medical decision, made in consultation with fertility specialists or genetic counselors, and tailored to each family’s unique health history.
Cost and Accessibility of Gender Selection
What’s Included in the Cost
Gender selection adds several steps to the standard IVF process, and each of these steps comes with its own cost. The primary additional expense comes from PGT-A testing, which allows embryologists to analyze the chromosomes of each embryo, including identifying its sex. This procedure requires advanced laboratory technology and skilled specialists, which explains its higher cost.
On average, PGT-A testing ranges between $3,000 and $6,000, depending on the fertility clinic, the geographic location, and the number of embryos biopsied. This is in addition to the base cost of an IVF cycle, which itself may range from $12,000 to $20,000 or more. If donor eggs or donor sperm are used, or if more than one IVF cycle is needed to produce viable embryos, the overall cost of the surrogacy journey can rise substantially.
It is also important to account for related costs, such as medication for ovarian stimulation, embryo freezing or storage, and the eventual embryo transfer to the surrogate. These elements are not always included in the initial quote, which is why requesting a detailed cost estimate from the clinic or agency is essential.
Financial Guidance Through Agencies
Navigating the financial side of IVF and gender selection can be overwhelming, especially for first-time intended parents. Many agencies and fertility clinics offer financial guidance or access to fertility coordinators who can help clarify what each step costs and when payments are typically due.
Some agencies partner with financing institutions or fertility loan programs that offer structured payment plans tailored to the surrogacy and IVF process. Others may provide package pricing that includes PGT-A and other services, which can sometimes be more affordable than paying for each step separately.
Working closely with a knowledgeable team helps intended parents understand the difference between essential procedures and optional services. This not only reduces stress but also empowers families to make decisions that match their priorities and budget, while staying fully informed at every stage.
Religious or Ethical Debates on Gender Selection
Gender selection is a subject that naturally brings up ethical and sometimes religious concerns, particularly when it is done for non-medical reasons. While the procedure is legal in much of the United States, some individuals and communities may question whether choosing a child’s sex interferes with natural processes or promotes biased preferences.
Within American society, opinions on gender selection vary widely. Some people see it as a valid part of reproductive freedom and family planning, especially when it helps fulfill a deeply personal or emotional vision of family life. Others view it as a sensitive area that must be approached with caution to avoid reinforcing outdated gender stereotypes.These choices often raise broader questions about what makes surrogacy ethical, especially when it involves decisions like embryo selection or gender preference.
Religious perspectives on gender selection also differ. Certain faith traditions encourage acceptance of any child as a gift, regardless of sex, while others may allow for medical exceptions in the case of preventing hereditary disease. Fertility clinics and professionals are generally trained to approach these decisions with respect and sensitivity, offering guidance that is medically informed while being mindful of individual beliefs.
Ultimately, whether or not to choose the gender of a baby is a decision that belongs to the intended parents. As with many aspects of assisted reproduction, it requires careful reflection and support from trusted professionals.
Potential Limitations or Considerations
While gender selection is a safe and widely available option within the IVF process, it is important to understand its potential limitations. First, the ability to choose a specific sex depends entirely on the embryos that are created during the IVF cycle. In some cases, a cycle may produce only a small number of viable embryos, and it is possible that none are of the desired sex.
Even when multiple embryos are available, not all of them will pass PGT-A screening. Some may be found to have chromosomal abnormalities, and others may not develop properly in the lab. This means that intended parents hoping to choose the gender of their baby need to remain open to the possibility that their options could be limited by biological factors beyond anyone’s control.
It is also important to approach gender selection with realistic expectations. While it can be a meaningful part of family planning, it should not become a source of emotional pressure or disappointment. Having a clear and compassionate conversation with a fertility specialist or genetic counselor can help intended parents prepare for different outcomes and navigate the process with confidence and clarity.
Why Choose Surrogacy by Faith?
Surrogacy by Faith offers a distinctive approach to the surrogacy journey by combining medical excellence with strong ethical and spiritual values. The agency is run by a team of former surrogates who understand the process firsthand and provide deeply personalized support. As a faith-based agency, it emphasizes compassion, prayerful guidance, and respect for the sanctity of life throughout the entire experience.
Surrogacy by Faith does not support pregnancy termination except in rare medical emergencies and works with clinics that align with this philosophy. The agency is also known for its generous surrogate compensation packages and its commitment to transparency and care at every stage of the journey.
For intended parents considering surrogacy, the best way to start the journey is by exploring the intended parent application process. Women interested in becoming surrogates can learn more about the steps involved by reviewing the surrogate mother application process.
Sources:
Human Fertilisation and Embryology Authority: https://www.hfea.gov.uk/treatments/treatment-add-ons/pre-implantation-genetic-testing-for-aneuploidy-pgt-a