After more than 5 million births thanks to assisted reproduction in 2025, scientists and other fertility doctors now have enough hindsight on the various techniques of in vitro fertilization and its famous "option" i.e. choosing the sex of one's child.
If the choice of the child's sex remains a restricted option in many countries for ethical reasons and is therefore mechanically limited in terms of numbers, several tens of thousands of couples have recourse to this solution each year.
What is sex or gender selection in ivf fertility treatment?
It should be noted that, except in exceptional cases, this option of choosing the sex of the child falls into a specific category because it is not strictly speaking a fertility service. If we are going to see that it is imperative to go through the clinical phase of fertility to choose the sex of one's child, 99% of the couples who have recourse to this technique do not present fertility problems. Therefore, in most cases, complex fertility problems, tests, the possibility of sperm or egg donations, etc., must be excluded.
In rare cases, some couples who want to conceive and cannot do so naturally decide to have an in vitro fertilization with a choice of the child's sex, but this is rare.
Most of the time, women who present themselves for an in vitro fertilization with choice of the child's sex have had children and often 3 or 4 girls or boys.
The file is therefore often accelerated and we can easily consider an in vitro fertilization with selection of the child's sex the month following the request.
The application file will be constituted with the usual elements of any in vitro fertilization, namely the administrative part, medical tests, the question of fertility hormones, the need for the man to come and deposit his sperm etc.
► find out what is the best country for ivf with egg donation?
In practice, the constitution of an in vitro fertilization file with the choice of the child's sex will require the usual elements for the man, namely a recent spermogram and a blood test.
For the woman, a blood test and a pelvic ultrasound will also be required. As is often the case, it is not mandatory but strongly recommended that fertility hormones be taken. Fertility clinics never count this in their calculations, so it is an expense to be taken into account that we recommend, on average the cost represents about 15% of the cost of in vitro fertilization with sex selection of the baby.
Here are the 3 main techniques in 2024 to have sex or gender selection during your in vitro fertilization procedure:
PGT-M (Preimplantation Genetic Testing for Monogenic Disorders): This protocol is used when there's a risk of passing on a specific genetic disorder to the offspring. In this case, embryos created through IVF are tested to identify those that do not carry the genetic mutation associated with the disorder. Gender selection can be achieved as a byproduct of this testing, as embryos of the desired sex that do not carry the genetic disorder can be chosen for implantation.
PGT-SR (Preimplantation Genetic Testing for Structural Rearrangements) as most used protocol: This protocol is utilized when one or both parents have structural rearrangements in their chromosomes, which could result in chromosomal abnormalities in the offspring. PGT-SR involves testing embryos created through IVF to identify those with normal chromosomal structures.
PGT-A (Preimplantation Genetic Testing for Aneuploidy): This protocol is focused on screening embryos for aneuploidy, which is an abnormal number of chromosomes. PGT-A aims to identify embryos with the correct number of chromosomes, increasing the chances of successful implantation and reducing the risk of miscarriage. Gender selection can be integrated into this process by selecting embryos of the desired sex from those identified as chromosomally normal.
As one may have understood all these techniques are allowed in most countries when it comes to genetic testing for abnormalities but is banned in most countries when used to select the sex of a future baby as deemed to be a comfort option.
► Learn more with 10 useful questions about in vitro fertilization
There are different techniques to select the sex of the child. We will not mention the different more or less natural or ancestral techniques, as there are so many of them, and we will concentrate on the so-called modern techniques of sex selection.
It should be noted that technically all fertility clinics in the world can use the technique known as preimplantation diagnosis (PGD) to select the sex of the child, but in practice most of them are not allowed to do so.
Indeed, for ethical reasons that could be described as measures against eugenics, most countries in the world prohibit this method - and indeed any other method of selecting the sex of the child. Thus it is simply forbidden in 80% of the countries in the world, starting with Europe. The United States and some Mediterranean countries are however quite open on this issue.
It should be noted that this prohibition is found in bioethics laws in some countries but that others do not legislate on these questions and that therefore by default it is possible and authorized.
The prohibition is in fact that of a personal choice for purely personal convenience outside of medical issues. On the other hand, if for medical reasons it is necessary to determine the sex of the child in a laboratory for questions of genetic disease, this is perfectly possible. This is authorized and regulated in a very strict manner by the different laws of the countries. The fertility doctor will compile a file with genetic research and will not choose the sex of the child but will determine the sex of the child and its possible implantation by studying the embryo obtained by the mother. The use of this procedure remains quite rare and the file is quite complex to constitute.
Thus, preimplantation diagnosis seems to be the common method used by fertility clinics to choose the sex of one's child.
There are many other methods or ancestral practices but apart from two other more "scientific" methods, we generally focus on the PGD method of selecting the sex of the baby.
As you can see, choosing the sex of your child is an option in fertility clinics that is not available everywhere.
This is prohibited in 95% of the countries in the world for ethical reasons. According to the various laws of some countries, often called bioethics laws, we want to avoid eugenics, even if it is not really explained like that. The nature must choose the sex or not the man.
Thus all the countries of the European Union but also a certain number of countries of the Middle East or China formally prohibit this option.
That said, there are two types of countries that allow the choice of the sex of the child in an in vitro fertilization procedure. There are countries where this is clearly stated and authorized in the law, such as Lebanon, Cyprus, certain countries in the Urals or the United States.
There are others where nothing is said and this is the case in many African countries. By deduction one can then consider that it is authorized.
So where to do this? There are two usual criteria and a qualitative criterion to take into account.
The criterion of the price of the sex selection option and the place where it is practiced according to one's place of residence.
Thus, the choice of the sex of one's child is quite common in the United States, but the price is often prohibitive. The price of this option is often added to the in vitro fertilization procedure, whereas in other countries it is included. The average cost is $18,090 in 2025 without the fertility hormones, but it can easily reach $26,000 in California for example.
In addition, couples will choose the country where it is possible and legal based on geographic proximity. For example, some Americans travel to Europe or Asia for cost reasons, but this is rare.
As for Africa and the Middle East, Lebanon is often a popular destination:
Choosing the gender of your child with in vitro fertilization in Lebanon.
The other criterion besides price and destination is the quality or more precisely the technical qualities required to provide a sex selection service.
The technique of sex selection requires technical capabilities that not all fertility clinics have and it requires an efficient laboratory.
Thus, while it may be tempting to go to certain African countries, for example, not all fertility clinics have the necessary equipment to provide such a service.
You will have to choose according to your budget, the destination and the rating of the clinic. Generally, it is rarely a question of one or two isolated fertility clinics in the same country, but of a general medical environment that allows several fertility clinics to provide this service. In other words, choose a country that is recommended for this service and then choose a clinic that offers this service.
Determining a child's sex during IVF (in vitro fertilization) is primarily done using preimplantation genetic diagnosis (PGD) and sperm sorting techniques. The main methods used are:
1. Preimplantation Genetic Diagnosis (PGD)
This method involves analyzing embryos created by IVF before implantation. One or more cells from the embryo are removed to examine their DNA and determine their sex. Only embryos of the desired sex are then implanted into the uterus. This technique is the most reliable for selecting a child's sex.
2. Sperm Sorting (Microsort or Ericsson Method)
Before fertilization, the sperm is sorted to separate sperm carrying the X chromosome (female) from those carrying the Y chromosome (male). The sperm of the desired sex are then used to fertilize the egg. This technique is less accurate than PGD, with a variable success rate (70-90% depending on the method used).
Where is it legal in the world?
Sex selection for medical reasons (to avoid sex-linked genetic diseases, such as hemophilia) is permitted in several countries. However, for reasons of personal convenience (choosing the child's gender), it is heavily regulated and often prohibited for obvious ethical reasons.
- Permitted for medical reasons: United States, Canada, most European countries, Australia, Russia, India, Thailand.
- Permitted for personal convenience: United States, some Mexican states, Cyprus, some Central Asian countries.
- Prohibited or strictly regulated**: all European countries, including China.
For example, we recommend the island of Cyprus, which has an open legal environment, a strict framework and corresponds to what most couples want, and above all good technical infrastructure
► Choosing the gender of your child with your in vitro fertilization in Cyprus
Cyprus seems to meet most of the criteria needed to choose the sex of your child. The price is correct, it is around 6150 € in 2025 including in vitro fertilization + the service of selecting the sex of your child. The location is simple with many international flights. The fertility clinics all have recent equipment with good laboratories. The legal framework has not changed since 2005 and there are many happy births for a long time now.
November 2025
Sources: Wikipedia