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Family Balancing | Advanced Fertility Care

For family balancing and medical purposes, we provide gender selection services. Learn more about these services and their processes.

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What is Medical Gender Selection?

As our understanding of genetic diseases increases, and with it our ability to diagnose couples at risk to have children affected with a heritable genetic disease, we more frequently use the tool of preimplantation genetic screening (PGT-A) to genetically assess embryos prior to their implantation into the uterus. Some genetic diseases are only expressed in males, and parents, therefore, at times make a conscious choice to have only female offspring. When gender selection is used to prevent a genetic disease its indication is considered medical.

What is Family Balancing? (Elective Gender Selection)

In contrast, if the decision to choose a child’s gender is done for family balancing purposes, then the process is considered elective. Elective gender selection is the ability to increase the chances of having a child of a particular sex. The sex of a fetus is determined by two chromosomes, one inherited from the mother and one from the father. These chromosomes are either X or Y. The egg, from the mother carries an X chromosome and the sperm from the father carries either an X or a Y and this is what determines the sex of the baby. If a Y bearing sperm fertilizes the egg, the embryo is male. If an X bearing sperm fertilizes an egg, the embryo is female. It is possible to have an abnormal arrangement of sex chromosomes, however, this is rare.

We at Advanced Fertility Care operate within the appropriate standards of medical care and therefore respect and support an individual’s procreative autonomy, which is a person’s choice as to how, when and what children to have. We are happy to provide this service to any family which already has at least one child and wishes to benefit from family balancing.

Family Balancing Process

Gender selection utilizing in-vitro fertilization (IVF) with PGT-A, is the most accurate means of determining gender and will result in the gender of your choice in close to 100% of cases (some technical errors may happen, of course).

In this technique, embryos are produced from eggs and sperm of the couple. On the fifth or sixth day of embryo development, when the embryos have reached approximately 80-100 cell stage “blastocyst”, a laser is used to create a very small hole in the outer wall of the embryo allowing three to four of the outer cells that would form the placenta “trophoblasts” be carefully removed from the embryo. These cells are then prepared and sent to a genetic laboratory to analyze its chromosomal make up. This then allows us to determine whether the embryo, from which the cell was taken, was female or male. In addition, each embryo is also tested to make sure it has the correct number of chromosomes for all 24 pairs of chromosomes, thereby minimizing the risk of potentially transferring a chromosomally abnormal embryo regardless of the gender. Only embryos of the desired gender that have a normal number of chromosomes, are then transferred into the mother’s uterus, making this a very reliable technique of gender selection. The remaining embryos that were tested normal can also be preserved through cryopreservation (freezing) for use later, donated to others who have difficulty having children in a process known as embryo donation, or disposition at the will of the patient.


As part of the informed consent process prior to undergoing IVF with PGT-A, you will be required to sign a consent form giving us permission to proceed and acknowledge that all methods have limitations. Pregnancy success including the desired sex cannot be guaranteed with 100% certainty.

Schedule your consultation to learn more about your family balancing options with Advanced Fertility Care.