Sex Selection with IUI: Can you Choose a Gender with IUI?

One of the advantages of using Assisted Reproductive Technology (ART) such as IUI and IVF is the ability to determine the sex of the fetus at the beginning of pregnancy and even before implantation. In natural conception, the gender of the fetus is determined at the end of the first trimester of pregnancy using ultrasound, while in IUI or IVF methods, the fetus's gender is accurately determined in the initial days of conception. IUI Gender selection enables couples to have a child of the desired gender with a likelihood of success.

What Is IUI Gender Selection Procedure?

Intrauterine insemination, or IUI, is a method of treating infertility in which a sperm sample from a male partner is injected into a woman's uterine cavity. This procedure is employed in situations such as slow or improper sperm motility and a low sperm count in a sample.

The success rate of pregnancy by IUI in young patients is about 30-32%, which is lower than methods such as IVF; however, the lower cost and less invasiveness of this method are counted as its advantages. IUI treatment involves prescribing ovarian stimulation medicines to the female patient at the start of her menstrual cycle and subjecting her to continuous examinations.

A vaginal ultrasound is used to examine the growing process of the follicles. When the follicles reach an optimal size on days 12 to 16 of the menstrual cycle, an ampoule is injected to trigger ovulation. Placing the prepared sperm sample into the woman's uterus will be completed 32-40 hours after the injection. Pregnancy can usually be verified with a pregnancy test two weeks after injection.

Which Gender Selection Method Is Feasible?

There are a variety of ART techniques for gender selection, the most common of which is IVF treatment and PGD test. The PGD (pre-implantation genetic diagnosis) method can be used during the IVF process at the same time as the embryo development in the laboratory and has undergone several cell divisions. 

The IUI procedure cannot identify the sex of the fetus as precisely as IVF. The sex of the baby can be anticipated to some extent during IUI by distinguishing male and female sperms based on their movement or weight. According to the situations discussed, the best approach to detect the gender of the baby differs for each couple. The medical specialist introduces and employs the optimal procedure based on the couple's fertility status or type of infertility, their purpose of gender selection, the number of current children, and their financial state.

If IVF is required due to severe infertility issues and the parents insist on a specific gender, IVF treatment is considered the best option. However, if the IUI method can be used to get impregnated and the parents decide on a preferred sex for their child, the IUI procedure will be a better option.

Read more: IVF Gender Selection: Can you Choose Gender with PGD?

Causes and Reasons for IUI Gender Selection

The two primary reasons listed below can be pointed out in response to the issue of why some couples attempt IUI to determine the fetus' gender:

Maintaining Harmony in Families

When a couple has multiple kids of the same sex, they may wish for a different gender for their other child. In addition, if parents want to have a small number of children (for example, only one child), they may desire a specific gender for their child due to some economic or cultural reasons.

Preventing the Transmission of Genetic Diseases

Although many genetic diseases can affect both sexes (boys and girls) if transmitted, the likelihood of passing on hereditary diseases to a girl or boy child differs. For example, if the parents have a genetic disease such as hemophilia or muscular dystrophy, the infant boy is likelier to inherit it than the infant girl. In such cases, couples decide to have a child of a safer gender with a lower risk of transmission.

Preparations Before IUI Gender Selection

Gender determination requires planning to succeed. Because sperms tends to develop in 72 hours, it is better to select a diet that improves the quality of the produced sperms three days before the procedure. Natural zinc and minerals found in foods like pumpkin seeds, beef, eggs, nuts, and oats can substantially impact sperm quality.

Partners have to follow several rules for having sex before the IUI operation. For example, if a sperm disorder does not cause infertility, couples can have sex up to 24 hours before the procedure. If the operation is being performed due to a sperm disorder (low number or quality), young couples should abstain from sexual intercourse for at least 48 hours before IUI gender selection.

The night before the procedure, women should take a bath, and it's best if they don't wear makeup before they visit the treatment center. Eating a heavy meal the night before the procedure should be avoided. Thin soup is an excellent choice for female patients. Consuming any food or drink (even water) is prohibited after midnight.

How Does the IUI Procedure Determine Gender?

The male sperm sample is examined in the laboratory to determine the gender using the IUI method because the sex of the baby is decided based on the sperm chromosomes. During an IUI procedure, a semen sample is collected from the male partner, and the higher-quality sperm are separated and washed.

Afterward, considering the sperms' motility and speed, the sperms should be separated into groups according to their probable sex. Sperm with the X chromosome (female) moves more slowly than sperm with the Y chromosome (male).

After observing the sperm motility, they are categorized into two distinct groups, and those with the desired gender are injected into the woman's uterus. It should be noted that sperm contain XY chromosomes while eggs (female sex cells) only have XX chromosomes, so there is a 50% chance that the fetus will be a boy or a girl.

The semen is subsequently washed using specific techniques, and then the washed sperm is injected into the woman's uterus using a catheter. Women should use ovarian stimulation medications to enhance the number of eggs released throughout each cycle. IUI gender selection is an outpatient procedure that does not call for hospitalization.

Possibility of Twin Pregnancy in IUI Sex Selection

Compared to techniques like IVF, the likelihood of having twins or multiples with the IUI procedure is substantially lower regardless of the gender of the fetus. Due to proper ovarian stimulation and the option to select the desired number of embryos to be transferred to the woman's uterus, the IVF process offers a chance to grow more than one embryo.

In contrast, in the IUI method, the level of ovarian stimulation is lower, and sperms are injected into the uterus directly without fertilization. Hence, the embryo formation occurs inside the uterus. It is, therefore, impossible to anticipate how many fertilizations will occur inside the uterus, just like with a natural pregnancy. According to statistics, there is a 3% maximum possibility of conceiving twins through the IUI procedure.

IUI Gender Selection Pros & Cons

Advantages of IUI Gender Selection

The most significant advantages of gender selection by IUI are its ease of execution, rapid progress, low cost, outpatient treatment process, and the possibility of repeating it numerous times (if pregnancy does not occur). Due to the lack of 100% accuracy in gender selection with IUI, couples must research and inquire about the most skilled specialists and the most competent and successful clinics in this field.

IUI Gender Selection Disadvantages

Pregnancy and sex selection with IUI, like any other treatment method, may have drawbacks and concerns. As previously stated, medications such as ovarian stimulants are frequently used to perform IUI, which, while not essential, considerably boosts the treatment's odds of success.

A high dose of these medicines can cause disorders such as ovarian hyperstimulation syndrome in certain persons. During this condition, the enlargement of the ovaries causes considerable discomfort, and the accumulation of fluids leads to bloating and abdominal enlargement.

What Is the Success Rate of Sex Selection with the IUI Method?

The female patient's age affects the success rate of the IUI Gender Selection procedure. The success rate of this operation is 10-20% in women under 35 years old and roughly 2-5% over 40 years old. The reason for performing IUI can also impact its success rate.

If the couple does not have fertility problems, the IUI gender selection has a success rate of 7-10% per menstrual cycle. This likelihood rises to 15-25% if pregnancy drugs are used. Statistically speaking, most women become pregnant on their first try, but it takes two to three IUIs on average to become pregnant.

How Much Does the IUI Procedure for Gender Selection Cost?

The cost of sex selection with IUI is determined by factors such as the clinic where the procedure is administered, the equipment and facilities utilized, the doctor's expertise and experience, the couple's fertility status, and their expectations from the treatment. Although the final price of gender selection with IUI is decided by the Ministry of Health and Medical Education, due to their fluctuation, it is best to ask the clinic for the final fee before starting with the treatment.

Final Word

IUI Gender Selection is a simple and low-risk procedure with adequate accuracy, which has piqued the interest of many couples. This procedure reduces the risk of genetic diseases and maintains family harmony by helping select the preferred gender of the fetus. Couples should visit clinics with a high success rate and qualified and experienced specialists to maximize the chances of success of using the IUI gender selection method.