The combination of in vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD) technologies allows for the determination of the gender of the pre-embryo(s) generated by a couple seeking family balancing through assisted reproductive treatment. The combination of IVF and PGD is the most precise way to determine if an embryo is male (XY) or female (XX) with nearly 100% accuracy (the technique carries approximately a 1% technical error rate therefore the gender of the embryo cannot be guaranteed). Couples who already have at least one child of a particular sex and are interested in having another child of the opposite sex are welcome into our family balancing program using our highly successful IVF and PGD experience at our state-of-the-art, on site fertility center.
Couples seeking family balancing will be scheduled for consultation with a fertility specialist at one of our 5 conveniently located IVFNJ locations to discuss the process in detail. A discussion involving the benefits, risks and limitations of the procedure will be carried out and a consent form will need to be signed allowing the process to start. In addition, a medical and diagnostic evaluation of the couple is necessary to determine if the procedure can be successful for you. Financial specialists are available in each office to discuss all the issues involving insurance coverage and out-of-pocket expenses associated with these procedures.
Once the above steps are concluded, the family balancing procedure begins with the IVF portion of the process. IVF involves the use of hormone pills and injections to regulate and control the growth of multiple eggs from the ovaries in a synchronized fashion. When the eggs reach maturity they are surgically harvested under ultrasound guidance and anesthesia during an office procedure. Each egg is then fertilized with sperm in the laboratory. The fertilized eggs begin dividing as they grow into the pre-embryonic stage. Three days into the cell division process, a pre-embryo usually contains 6-8 well defined cells (called blastomeres). The PGD portion of the process starts here by microscopically removing one of the blastomeres from all of the pre-embryos and submitting them for genetic testing. In approximately 48 hours the results of the biopsy will identify the gender of each of the biopsied pre-embryos as male (XY) or female (XX). As mentioned, these results are approximately 99% accurate. PGD results can also inform the parents about genetic information beyond gender, such as screening for Down’s syndrome, if desired. Usually, one or two of the pre-embryos of the desired sex are selected to be placed into the uterus through a simple office procedure without anesthesia called “embryo transfer”.
In some occasions, a couple will produce extra pre-embryos beyond the ones that were transferred back to the uterus. There are several options for such couples. One option would be to freeze these spare embryos in our IVFNJ cryopreservation facility in order to preserve the ability of trying to conceive again if the first attempt was not successful. This strategy would prevent having to start the IVF and PGD processes all over again. Even if these spare embryos happened to not be of the desired sex this time around, they may still be frozen and used in the future to further expand your family, especially since declining fertility potential is to be expected over the years. In addition, if such frozen embryos are not used by you in the future they could be donated to our highly sought after and successful embryo donation program. The above mentioned strategies avoid unnecessarily discarding pre-embryos and promote the best use of family balancing through IVF/PGD technology for the benefit of fertile and infertile couples alike.
The physicians and staff of IVFNJ are pleased to offer family balancing opportunities to couples. At the same time, we take great care to preserve and respect the moral integrity of pre-embryos created in the IVF lab and the use of medical technology for non-medical purposes. To that end we have abided to the recommendations of the governing body of assisted reproduction in the US, the American Society for Reproductive Medicine (ASRM), that states “the most prudent approach at present for the non-medical use of these techniques (IVF/PGD for family balancing) would be to use them only for gender variety in a family, i.e., only to have a child of the gender opposite of an existing child or children.” (Fertility and Sterility Journal, Vol. 75, No. 5, May 2001. Ethics Committee Report)