Gender Selection with IVF: Treatment Details & Cost

Quick Answer

Yes, you can choose the sex of your baby through IVF combined with preimplantation genetic testing (PGT), with accuracy exceeding 99.9%. The process involves creating embryos through IVF, biopsying each embryo at the blastocyst stage, sending cells to a genetics lab to identify XX (female) or XY (male) chromosomes, and then transferring an embryo of the desired sex during a frozen embryo transfer (FET). Gender selection is not a standalone service; it is an add-on to a standard IVF cycle. At CNY Fertility, the total cost of IVF with gender selection typically comes in around $11,000 to $12,000, compared to a national average of $27,000.

Fast Facts About Gender and Sex Selection

• Terminology. Gender selection, often referred to as sex selection, is the practice of choosing the biological sex of a future child. The terms are used interchangeably. The process is sometimes called family balancing when parents pursue it to have a child of one sex after having several children of the other.
• Accepted methods. While many theories suggest that diet or lifestyle changes can influence a baby’s sex, these approaches lack scientific evidence. Today, the only method of gender selection accepted within reproductive medicine is IVF combined with preimplantation genetic testing (PGT), sometimes called PGS or PGD.
• Scientific basis. The science behind sex selection is based on chromosomal differences. Females carry two X chromosomes (XX), while males carry one X and one Y chromosome (XY). By testing embryos created during IVF, doctors can identify which carry XX or XY chromosomes and transfer an embryo of the desired sex.
• The procedure. Gender selection is not a standalone service but an additional step within the IVF treatment process.
• Cost. Costs vary significantly between clinics depending on what is included. The national average cost of gender selection is about $4,500, in addition to the $22,000 to $35,000 cost of an IVF cycle with frozen embryo transfer. At CNY Fertility, gender selection costs closer to $2,000, with IVF and FET starting around $8,000 including medications, making it one of the most affordable options available. Many patients travel from across the country to CNY’s network of full-service clinics to take advantage of these savings.

How Does Gender Selection Work?

The sex of a baby is determined by two sex chromosomes. Egg cells from the female always carry an X chromosome, while sperm from the male carries either an X or a Y chromosome.

If a sperm with an X chromosome fertilizes the egg, the resulting embryo will be a girl (XX). If a sperm with a Y chromosome fertilizes the egg, the resulting child will be a boy (XY). In natural conception, this creates an almost even 50/50 chance of either sex.

With IVF and PGT, doctors can accurately identify whether an embryo is XX or XY, making it possible to reliably select the desired sex before transfer.

Sperm Sorting: Why It Is Not Reliable

Sperm sorting is a technique that attempts to separate sperm based on the fact that X-bearing sperm contain slightly more DNA than Y-bearing sperm.

Some methods use a centrifuge to sort by density; others use fluorescent dye to tag DNA. In theory, X-bearing sperm settle lower and appear brighter, making it possible to distinguish them from Y-bearing sperm.

Results have been inconsistent. While some studies show modest effectiveness, sperm sorting is not considered highly reliable and is not widely practiced in the United States. It is not offered at CNY Fertility.

Gender Selection with IVF and Embryonic Genetic Testing

Choosing the sex of your baby through IVF combined with PGT is the only method that offers virtually 100% accuracy.

Embryos are created through IVF, biopsied at the blastocyst stage, and sent to a genetics laboratory for chromosomal analysis.

Embryos are frozen while awaiting results. Once results are available, intended parents select an embryo of the desired sex and proceed with a frozen embryo transfer (FET).

Detailed Steps of IVF Gender Selection

Gender selection requires the full IVF process. It is best understood as two distinct treatment cycles: an embryo creation and testing cycle, followed by a frozen embryo transfer using an embryo of the desired sex.

Phase 1: Embryo Creation and Testing

Ovarian stimulation. The intended mother takes hormone-based medications to stimulate the ovaries to produce multiple mature eggs, rather than the single egg typically produced each cycle.

Medications usually begin on days 2 to 4 of the menstrual cycle and continue for about 10 days. More eggs retrieved means more embryos created, which increases the odds of having embryos of the desired sex available for transfer.

Egg retrieval. A minor procedure collects eggs from the ovaries, usually about 12 days after starting stimulation medications.

No incisions or general anesthesia are required. Patients receive light sedation while an ultrasound-guided needle retrieves eggs from the ovarian follicles. Collected eggs are immediately sent to the embryology lab.

The embryology laboratory. Inside the lab, five key steps take place:

• Isolation: An embryologist locates eggs in the follicular fluid and places them in nutrient-rich media that mimic the fallopian tube environment.
• Fertilization: Within about 4 hours of retrieval, eggs are fertilized using ICSI or conventional methods.
• Embryo development: Embryos grow in the lab for 5 to 7 days. Unlike standard IVF where embryos may be transferred on day 3, genetic testing requires embryos to reach the blastocyst stage, typically day 5.
• Embryo biopsy: At the blastocyst stage, a laser removes 3 to 6 cells from the trophectoderm (the layer that becomes the placenta). These cells are labeled and sent to a genetics lab for chromosomal analysis.
• Embryo freezing: After biopsy, embryos are vitrified (flash frozen) to preserve quality until test results are available. Freezing does not harm success rates and may improve outcomes for some patients.

Genetic testing. Testing is carried out by a third-party laboratory using Preimplantation Genetic Testing for Aneuploidy (PGT-A). This analyzes the number and type of chromosomes in each sampled cell, identifying whether an embryo is XX (female) or XY (male) along with broader chromosomal health information. With results in hand, intended parents and their clinic select the desired embryo for transfer.

Phase 2: Frozen Embryo Transfer

A frozen embryo transfer is simpler than the first phase and involves two main steps.

• Uterine lining development. The uterus must be optimally prepared for implantation. While a natural FET is possible, most patients take estrogen and progesterone before and after transfer to ensure the lining is receptive.
• Embryo transfer. An embryo of the desired sex is thawed from liquid nitrogen storage, loaded into a transfer catheter, and gently placed into the uterus through the cervix. The patient is considered pregnant until proven otherwise.

Is Gender Selection Legal?

In the United States, gender selection for non-medical (family balancing) reasons is legal. There are no federal laws prohibiting it, and it is practiced at fertility clinics across the country, including CNY Fertility.

The legal landscape varies internationally. Many countries, including Canada, the United Kingdom, Australia, and most of Europe, prohibit non-medical sex selection. Patients traveling internationally for fertility treatment should verify the laws in their destination country before pursuing gender selection abroad.

In the U.S., professional organizations like ASRM have issued ethical guidance on sex selection but do not prohibit it. Most clinics require patients to acknowledge they understand the process and its implications before proceeding. Decisions about which embryos to transfer and which to store or discard remain with the intended parents in consultation with their care team.

How Much Does Gender Selection Cost?

The total cost of gender selection includes both the gender selection fees themselves and the underlying IVF cycle costs.

Gender selection fees are generally split into two components:

• Fertility clinic biopsy fee: The fee for taking the embryonic tissue biopsy and preparing it for the genetics lab.
• Genetic lab fee: The fee charged by the genetics lab for chromosomal analysis, which determines the sex of each embryo.

Together, these fees average $4,000 to $5,000 nationally. At CNY Fertility, they typically range from $2,000 to $3,000.

Additional IVF cycle costs include:

• Base IVF: Covers most procedure-related expenses in a standard IVF package.
• Monitoring: Ultrasounds and bloodwork during ovarian stimulation to track hormone levels and follicle growth.
• Medications: Fertility medications to stimulate multiple egg development. More eggs typically means more embryos and a higher likelihood of having one of the desired sex available.
• Frozen embryo transfer (FET): Because genetic testing takes several days, embryos must be frozen while results are processed. Once the desired embryo is identified, it is thawed and transferred during an FET cycle.

Some clinics charge separately for ICSI, which is required in most gender selection cycles.

Total cost comparison:

Many patients travel from across the country to one of CNY Fertility’s full-service clinics to take advantage of these savings. Over half of CNY’s patients come from outside the immediate area, and CNY’s remote monitoring program makes it possible to complete most of the stimulation phase locally.

The calculator below makes it easy to see the full cost of gender selection at CNY, including genetic testing, frozen embryo transfer, and an estimate for medications.

Frequently Asked Questions

How accurate is IVF gender selection?

When performed with PGT-A, IVF gender selection is more than 99.9% accurate. The chromosomal analysis directly identifies whether an embryo is XX or XY, with no guesswork involved, and errors are extremely rare.

Does gender selection reduce IVF success rates?

Gender selection itself does not reduce the success rate of an embryo transfer. However, it does reduce the pool of embryos available for transfer, since parents may choose not to transfer embryos of the opposite sex. For patients with a limited number of embryos, this is worth discussing with your care team before proceeding.

Can you choose gender with IVF for family balancing?

Yes. Family balancing (pursuing a child of one sex after having children of the other) is one of the most common reasons patients request gender selection. It is legal in the United States and available at CNY Fertility regardless of how many children you already have.

What is the difference between PGT-A, PGS, and PGD?

These terms all refer to preimplantation genetic testing but have been used at different points in time to describe slightly different tests. PGT-A (Preimplantation Genetic Testing for Aneuploidy) is the current standard term. PGS (Preimplantation Genetic Screening) was an earlier name for the same type of testing. PGD (Preimplantation Genetic Diagnosis) typically refers to testing for specific inherited genetic conditions rather than chromosomal count. Gender selection uses PGT-A.

Is gender selection covered by insurance?

Elective gender selection is not typically covered by insurance. Some insurance plans cover IVF itself, which reduces the base cost, but the genetic testing component for sex selection is almost always an out-of-pocket expense. Approximately 25% of Americans have any form of IVF coverage, making cost one of the primary factors patients consider when choosing a clinic.

The Bottom Line

Gender selection through IVF and PGT is reliable, legal in the United States, and increasingly accessible. The process requires a full IVF cycle, so the total cost and timeline are those of IVF, not a simple add-on service. For patients who are already pursuing IVF, adding gender selection is straightforward and adds primarily the cost of the biopsy and genetic testing.

Success rates for IVF with gender selection are the same as for standard IVF, typically around 40% to 55% per transfer for women under 35. The genetic testing also provides information about broader chromosomal health, which many patients find valuable regardless of their gender preference.

At CNY Fertility, the total cost of IVF with gender selection runs roughly $11,000 to $12,000 all-in, compared to a national average of $27,000. To learn more or schedule a consultation with our specialists.