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IVF gender selection and the ethics around it

By Nancy Nzalambi | July 13th 2020

“Many clients ask me how to have a male child. That’s the gender in demand,” says Dr Wanjiru Ndegwa-Njuguna, a fertility expert. 

“Gender selection does happen, but it is not 100 per cent certain,” she adds.   In her experience, even women tend to desire more male children despite already having other male children. Reason? Cultural norms which make couples inclined to have boys to have an heir to their name.

“In many of our African societies, if you haven’t named your fathers, your name just disappears,” she says.

China and India have a gender crisis. The male population outnumbers the female. Two years ago, Chinese men outnumbered women by 34 million. And men are dying of loneliness in their search for a bride. Even today, female newborns are still fewer because technology, that has been banned, is used to pre-select the preferred gender.  In Kenya, the problem is not as dire, as the latest census showed almost equal proportions between the two genders, with women making up 50.5 per cent of the population. However, about 15 years ago, an Economic study on Nyeri showed that women preferred to birth boys due to inheritance.

The quest for sex selection has been a hot topic for ages. There exist many theories out there that speculate to the parents’ ability to influence the sex of their future babies. The great philosopher Aristotle knew that gender was determined by the man’s spermatozoa. He, however, believed that the left testicle produced the X chromosome sperm while the right one produced the Y chromosome sperm. Based on this utterly wrong notion, parents in ancient Greece were advised — as absurd and as dangerous as it sounds — to tie off the man’s left testicle just before intercourse if they wanted a male child. Other cultures suggested that morning intercourse was highly likely to produce boys and other times of the day more favourable for conception of a female.

It is common scientific knowledge that women contribute the X chromosome while men contribute either the X or Y chromosome to make up their baby’s gender; XX for a female and XY for a male. However, due to some spontaneous and random variations, a child in rare cases may be born with intersex traits — having the anatomy of both genders in one body.

Pre-implantation Genetic Diagnosis

Pre-implantation genetic diagnosis (PGD) is an In vitro fertilisation procedure that is done to identify genetic defects in embryos before implantation. The procedure is regulated in many countries because of the unethical use of selecting genders. It is, however, a useful procedure that ensures that even people with diseases that can be passed on to offspring have a chance of having perfectly healthy children.

How is it used in gender selection?

“In PGD, the cells of a day-five embryo are tested to determine whether they are XX or XY so that the parents can select the one they want,” says Dr Wanjiru. She adds that due to its expensive price tag, the procedure is not offered widely in Kenya. Furthermore, she warns of the ethical issues enshrouding PGD since only the desired embryo is implanted.

“I personally find it unethical; because after selecting the embryo with the gender you want, what do you do with the other embryos?”  

 The Shettles Method

This was developed by an American doctor, Landrum Shettles. The method relies on the unique attributes of the sex chromosomes, ovulation, and timing of intercourse and the depth of penetration. The different attributes of the X and Y chromosomes confer some “advantage” depending on the timing of ovulation. The Y chromosome is normally smaller and moves with much speed as compared to its X counterpart. On the other hand, the slower and relatively bigger X chromosome lasts longer in the female tract due to its resilience to vaginal and cervical fluids than the Y chromosome.

With this in mind, to have a boy, intercourse should be at a time nearest to ovulation. This is on the day of ovulation or within two to three days after.  The Y chromosome sperm will move faster and reach the egg earlier than the X chromosome sperm. And if the sperms are deposited deep enough, swimming distance is reduced and the fast-moving Y chromosome increases the possibility of conceiving a boy.

Shallow sperm deposition, intercourse on days further away from ovulation, is speculated to favour sperm carrying the X chromosomes to reach to the ovum.

Does the method work?

This is debatable.  In the Shettles Method Book, he claims that it has a 75 per cent rate of success. And many claim it worked. However, some fertility experts say that it isn’t quite so cut and dry as there is no evidence that male and female sperm swim differently or they survive differently.

According to Dr Wanjiru, using the timing of ovulation could yield the desired result, however, patients are informed that the outcome could go either way. “The timing methods are not 100 per cent as we cannot totally control what will happen. Most of them do come out as boys, if you want a boy. It’s actually easier to get a boy than a girl.”

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