Gender selection, also known as sex selection, is a controversial aspect of fertility treatment that involves choosing the sex of a child prior to conception. While gender selection for non-medical reasons is prohibited in many countries, it may be allowed in certain cases where there is a medical reason or a risk of genetic disorders associated with a specific gender.  

The process begins with an initial consultation with a fertility specialist to discuss the reasons for pursuing gender selection and assess the individual or couple's medical history, fertility challenges, and treatment options. The healthcare provider will determine if gender selection is medically indicated and permitted according to local laws and regulations. Most couples that choose to have this type of procedure already have several boys or girls and therefore don't have fertility problems.

Preimplantation genetic testing (PGT): In cases where gender selection is permitted for medical reasons, such as to avoid the transmission of genetic disorders linked to a specific gender, preimplantation genetic testing (PGT) may be performed as part of the IVF process. PGT involves testing embryos created through IVF for genetic abnormalities or specific genetic conditions before they are transferred to the uterus. After fertilization, the embryos undergo culture and development in the laboratory. At the appropriate stage, typically around day 5 or 6 of development, one or more cells are removed from each embryo for genetic testing. The cells are analyzed to determine the genetic sex of the embryos and to screen for chromosomal abnormalities or specific genetic conditions.

Based on the results of genetic testing, only embryos of the desired gender and with normal genetic characteristics are selected for transfer into the woman's uterus. The embryo transfer procedure is typically performed in a fertility clinic's procedure room, and one or more embryos are transferred into the uterus using a thin catheter inserted through the cervix.
 
It's important to note that gender selection for non-medical reasons is not universally accepted and may be subject to legal and ethical considerations. Additionally, the availability and legality of gender selection procedures vary by country, and patients considering gender selection should consult with a qualified healthcare provider and familiarize themselves with the relevant laws and regulations in their jurisdiction.

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