Gender Selection IVF

It is noteworthy that couples tend to conduct IVF in order to determine the gender of fetus, whether male or female, and there are often used two methods that differ in terms of success rate in each, as follows:

• The technique of determining the gender of embryo through sperm sorting, where the rate of success in identifying female embryos 75% and males 85%, and is less expensive.
• The technique of determining the gender of embryo through pre-implantation genetic diagnosis (PGD or PIGD), where the rate of success in identifying both genders 99%, but it has a higher cost than the previous method.

 After the patient  discharged from the IVF  center. They are  sent home with directions about the remainder of day and for the ensuing 2 weeks.  They are instructed to undergo normal but reduced activity. Bed rest is not necessary.  All the patients have different medicines they go home with. 

The patients will report many sensations after the natural cycle IVF procedure.  Some will report cramping pain, while others will have bleeding.  Most of the symptoms are not important but will cause the patients to worry.  Some physicians have referred to these pains as being related to implantation.  No one knows if this is the case.  With implantation, the uterus is experiencing changes and cramping is one way that the uterus reacts.  It may also be related to getting a period.

Bleeding during this time period is also a common concern.  In many cases, this is a very light spotting or bleeding.  Some patients will refer to this as implantation bleeding, but it doesn’t explain all the causes because the timing is often wrong.  In most situations, the bleeding doesn’t mean anything but it could be the result of problems such as insufficient hormonal support for the luteal phase, causing the endometrial lining to shed.

One cause of the bleeding is when it occurs after the pregnancy has already been confirmed.  The bleeding could be a sign of an ectopic pregnancy.  If the patient experiences this type of bleeding, they need to contact their doctor. The only troublesome bleeding is if the bleeding is as heavy as a period. This might mean that a menstrual period is beginning because implantation has not occurred.  It could also be a sign of a period.  It can also happen in a multiple pregnancy.

In addition to the use of this type of laboratory techniques by couples to choose the gender of their child, laboratory fertilization in this way can identify genetic defects within embryos so that gynecologists and obstetricians can exclude unhealthy fetuses before being transferred to the uterus to complete the growth process, especially in cases where the family has a hereditary disorders record.

Before starting the actual steps of laboratory fertilization, gynecologists and obstetricians asks both spouses to have a range of tests including:

• Ovarian reserve assessment (AMH, FSH, AFC) to determine the quantity and efficacy of eggs in the ovaries.
• Semen analysis.
• Detect any infectious diseases in either spouse.
• Experience the steps of embryo transfer to the uterus; to determine the depth of the uterus and choose the most appropriate method to use after the actual laboratory injection.
• Examination of the uterine cavity by injecting it with fluid then imaging with ultrasound.

This technique includes the following two methods:

• Pre-implantation genetic diagnosis (PGD), including the following steps:

1. Obtain the eggs from the wife and the semen from the husband.
2. Leave the cells together in optimal conditions to begin fertilization and divisions.
3. On the third or fifth day approximately a sample of cells is taken and examined to determine the gender of the fetus and to examine the genetic defects that the embryo may carry on its genes.
4. Embryos are transferred to the uterus after about a week; to verify the results of the analysis, where the doctor inserts a speculum through the vagina to keep its walls open, and then inserts a catheter tube through the cervix into the uterus and then passes the embryos through this tube to reach the uterus, and this process is done using ultrasound for greater accuracy.

This technique is expensive and is often not carried out by fertility laboratories for the purpose of gender selection, but it is more specialized in verifying that embryos do not carry any genetic diseases.

• Gender selection by sperm sorting, including the following steps:

1. Get semen from the husband, and eggs from the wife.
2. Centrifuge the sperm to separate X (female) and Y (male). As a result of the spinning of the tube containing sperm in the centrifuge, a group of layers is formed according to the density, since the sperm X are denser.
3. Separate the formed layers after the centrifugation process and take the required sperm.
4. Place sperm that have been separated with the eggs and leave them in conditions optimal for fertilization.
5. Embryo transfer to the uterus after the formation of fertilized cells. The doctor will insert a laparoscope through the vagina to keep its walls open, then insert a catheter tube through the cervix into the uterus and then pass the embryos through this tube to reach the uterus, and this process is done using ultrasound for more accuracy.

After the eggs has been fertilized by the husband's sperm, the embryos are transferred to the uterus, but confirmation of pregnancy requires more time until the embryos are implanted in the uterus. Gynecologists and obstetricians often recommend the wife to undergo a home pregnancy test after a certain period (1 to 2 weeks). The determination of this period depends on the stage at which the fertilized cells were transferred, as following:

• Embryo transfer to the uterus on the third day of fertilization: where embryos are transferred during the stage of "blastocyst" and continue to grow within the uterus for about two days (fourth and fifth) and then begin to implant inside the endometrium, to complete this implantation on the seventh day, and begins on the eighth day HCG secretion (human chorionic gonadotropin hormone), HCG secretion continues in the next two days (9 and 10) more intensively, so the wife can conduct a urine or blood test on the eleventh day (11) to detect pregnancy.
• Embryo transfer to the uterus on the fifth day of fertilization: After two days of embryo transfer to the uterus, the blastocyst begins to implant itself in the uterus and this implantation is completed on the fifth day. On the sixth day, the placenta cells begin to secrete HCG and continue to secrete more during the next two days (7th and 8th), so a home pregnancy test or blood test can be done on the ninth day to detect the pregnancy.

Some women after IVF can experience some symptoms, most of which are normal and not worrying, such as: 

• Cramps, tingling or perhaps severe pain; this is normal due to the expansion of ovarian follicles.
• Bleeding during this period is very common, and is often very mild blood of pink or red color; often due to the implantation of the fetus in the endometrium or during the process of transfer of the fetus to the uterus.

After the embryo is transferred to the uterus and until waiting for the pregnancy to be confirmed (maximum period of two weeks), the mother is advised to rest completely and not to carry out any hard or exhausting work, and the need to avoid hot tubs or Jacuzzi.

It is important to note that it is possible to do the usual daily work and avoid those exhausting or stressful only after the process of vitro fertilization, and does not mean the intended rest not absolute movement, also it is preferred to refrain from intercourse for about a week.