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Sex Gender Selection

“Prof, How Can I Get A Baby Girl?” Question from FaceBook 2018

The art and practice of gender selection has been in contention even before the biblical times. Evidence in the old Greek, Egyptian, Asian and Yoruba mythology have asked and explored the same question over the centuries. The culture that imbibes male supremacy over females has been more implicated. The given answers have varied across the ages but they are rather anecdotal, unconvincing and unscientific. However, there are now methods that can give up to 100% in the modern era. The lady who asked this question, of an unknown age, who responded to our write up on Heavy Menstrual Bleeding (HMB), has 3 boys. Arguably, this must have been a topic remote from HMB but of utmost importance to her psyche. It is therefore prudent to have a synopsis on the subject as a response to our FB friend who represents the mind of thousands of women: “What do I need to do to be able to have a particular gender for a baby?”

1. Natural Methods

Coital or sexual position
Some enthusiasts of sex or gender selection have for ages prescribed sexual position for selecting the sex of the baby. It is believed that the deeper the penetration the more likelihood of conceiving a male child. This prescription is borne out of the hypothesis that male – Y spermatozoa are weaker but faster than female – X spermatozoa. The closer to the fallopian tube where fertilisation takes place, the higher the chances of the Y spermatozoa reaching the egg. Such positions of deep penetration include the “doggy” and the standing positions.

Closeness to ovulation
Sexual intercourse closer to ovulation has an increased possibility of producing a male child. The faster Y chromosomes spermatozoa swim up ahead of the X spermatozoa and fertilise the egg in the fallopian tube. The slower but more resilient X spermatozoa can survive longer and has more chances of fertilising the egg in later dates.

Female Orgasm
It is advised that the female partner has an orgasm first during copulation. If this takes place, the chances of a male conception is higher. It is hypothesised that the secretions that follow orgasm in females enhances the male Y spermatozoa to swim faster and fertilise the egg.

Higher perineal temperature
A survey done in the past suggested those wearing boxers as against briefs have more predilections to having a male gender. This is attributed to the rather higher temperature in the groin of brief users that denature the less resilient male spermatozoa and allow the females to overtake the faster Y swimmers.
It is to be noted that all of these assertions are mostly unproven and unscientific. Some clinical trials were conducted especially with the ovulation time and results were adjudged to be equivocal. It is therefore rather difficult to prescribe one method in the natural intervention over another. Individual couple can try one or combinations of the above in an attempt to select the gender of their offspring.

2. Laboratory Methods

Spermatozoa Screening techniques
The accuracy of separating the male Y chromosomes spermatozoa from the x spermatozoa and resulting in desired gender is about 65%. The semen is separated in the laboratory. The initial spermatozoa count must be high and an intrauterine insemination may be performed.

Preimplantation Genetic Diagnosis (PGD)

This is an expensive venture in the developing economy. It is not done in isolation but for other indications like those with family history of sex linked chromosomal disorders or those needing IVF for any indication. It is the gold standard for sex selection. The accuracy is 100%. With this technique, a cell is taken off the 8-cell embryo in the laboratory and processed. At this stage screening could be done for chromosomal defects like Down’s trisomy, Klinefelter syndromes etc. Even, you can choose the colour of your baby’s iris and the whole paraphernalia of the “designers babies”. This embryonic biopsy does not cause any untoward damage to the foetus. The required gender in the pool of several embryos could be transferred to the womb.
In some of the fertility centres in Nigeria, PGD is in place and can be assessed but we advise our patients that it is done in patients with a high index of possibility of a sex-linked disorder.
The socio-demographic implication of gender selection should not be taken for granted. The natural balance of female to male ratio of 51:49 would have some yet unknown significance. Disturbing this natural balance may alter the natural dynamics. It is only for medical indications will gender be selected. The national assembly has a law to enact to regulate the practice of laboratory gender selection now or in the nearest future. This is in place in many countries especially in Asian countries. If there is a risk of genetic anomaly e.g. sickle cell and the less aggressive traits and sex-linked disorders, and you will like to have a PGD, kindly contact your gynaecologist.

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