UNDERSTANDING OUR FEES
A SPECIAL PROGRAM FOR GENDER SELECTION PATIENTS -
TO BUY THEIR FERTILITY MEDICATIONS
AT SIGNIFICANT DISCOUNT. If there is no insurance coverage.
Sex selection Fee is $6500.
Paid to Brandeis Center
| IVF - Monitoring | Blood | Ultrasound | Egg Retrieval |ICSI Embryology Fee | Anesthesia | Embryo Transfer | Hatching | $3900 |
| EMBRYO BIOPSY | $600 |
| FISH ANALYSIS GENDER SELECTION FEE | $2000 |
WHY DO SOME GENDER SELECTION PROGRAMS CHARGE SIGNIFICANTLY MORE?
Each program has the ablity and right to charge
whatever they feel is fair.
Our fees for gender selection reflect
- our standard fee for IVF
- the additional expenses that we have
- specimen preparation
- laboratory fees for embryo biopsy & genetic analysis
WHAT IS THE SUCCESS RATE?
The success rate for sex selection is near 100%.
However we cannot guarantee in-vitro will work in every couple.
IVF/PGD FOR SEX SELECTION - 4 STEPS
Illustration from http://www.in-gender.com/
Step I - IVF CYCLE - FEE INCLUDES ALL EXCEPT MEDS
PGD for sex selection requires the prospective mother to undergo in-vitro fertilization procedures (IVF), even if she has no fertility problem, in order for the PGD sex selection procedure to be done.
- Stimulation - Fertility medications Bravelle, Repronex, HCG at end - are taken for 10 days to develop as many eggs as possible
During these 10 days, frequent blood and sonograms are done to monitor the response to these medications. - Egg Retrieval - Under anesthesia, the eggs are carefully and gently removed.
- Fertilization - On the same day as egg retrieval the sperm of the partner is used to fertilize the eggs.
- Embryo Development - Resulting embryos are incubated for 3 days, until they each have 6-8 cells.
- Embryo Biopsy (step II)
Gender Analysis (step III)
Embryo Transfer (step IV)
STEP II - BIOPSY - included in fee
PGD is then performed on the viable embryos [those that appear healthy, that divided at the appropriate time, and that do not show excessive fragmentation], as follows:
A cell is taken out of each embryo done by:
- A skilled and experienced embryologist, this generally does not damage or harm the embryo at all.
- A special hollow glass needle to pierce the embryo covering and ‘suck out’ one cell
STEP III - FISH ANALYSIS (FLORESCENT IN SITU HYBRIDZATION) - included in fee
FSH is used to determine boy (xy) vs girl (xx)
The human set of chromosomes (46 pairs) includes a pair of sex chromosomes
- XX in females
- XY in males
The ability to identify the sex chromosomes present in any embryo is the best way to know the gender of the embryo before it is implanted in the mother’s uterus.
DNA probes are used that specifically attach to either the X or Y chromosome in sperm, and emit
- a red/pink color for X-bearing sperm
- green for Y-bearing sperm.
Thus, the X- and Y-bearing sperm can be identified and counted under a microscope.
X and Y chromosomes as well as Chromosome-18 seen by FISH.
STEP IV - EMBRYO TRANSFER - included in fee
Only the embryos having the desired gender will be transferred or placed into the mother’s uterus.
The Genetics and IVF Institute of Fairfax, Virginia, developed a system called Microsort which sorts sperm cells according to whether they carry the X chromosome or the Y chromosome.
The sex of a child is determined by the specific sperm cell fertilizing the egg.
A sperm cell with an X chromosome will result in a female, and a Y-carrying sperm cell will result in a male.
Semen contains approximately 50% female and 50% male sperm cells. Any system designed to separate X- (female) and Y- (male) sperm cells must have
- The ability to identify and measure a difference between female and male sperm cells
- Separate the cells based on the measurable difference
- Directly determine the results of the separation process.
Illustration from http://www.in-gender.com/
The separation system is based on the fact that the X chromosome is substantially larger than the Y chromosome.
X-bearing sperm will contain more DNA than Y-bearing sperm, and this difference can be detected by an sensitive instrument called a flow cytometer.
MicroSort technology increases the proportion of X-bearing sperm to 88% on average in an X-sorted sample, and the proportion of Y-bearing sperm to 73% on average in the Y-sorted sample.
The X-sorted sperm are used for insemination if the couple desire a female child; the Y-sorted sperm if they want a boy.
However, through FISH, it is possible to check the sorted sample, and this step is particularly useful to improve accuracy in a Microsort-IVF procedure.
In this case, sex selection by Microsort can be as expensive – without guarantee of pregnancy - as by regular sex selection through the PGD-FISH analysis of embryo cells.
Earlier this year, the FDA allowed GIVF to continue its clinical trial of Microsort on a limited basis. It is not known how long it will take before the FDA actually approves Microsort to go on the market.
Since Micrrosort sperm selection has to be done in conjunction with a fertility procedure like insemination or IVF, the method does not guarantee pregnancy either.
For more information about Microsort, go to:
http://www.microsort.net/
ETHICAL CONSIDERATIONS
Although there are no laws regulating sex selection in the United States, reproductive physicians generally follow gudelines issued by the American Society for Reproductive Medicine (ASRM).
In 1999, the Ethics Committee of the ASRM issued a position paper stating this: “Because it is not clear in every case that the use of PGD and sex selection for non-medical reasons entails grave wrongs or sufficiently predictable grave negative consequences, the Committee does not favor its legal prohibition.”
It goes on to caution against non-medically motivated sex selection, discouraging its use for ethical reasons (gender bias and use of medical resources for reasons other than health).
Pre-conception gender selection by PGD , like PGD itself, is still considered ‘experimental’ because it is not part of the general standard of care.
