Can You Pick the Gender With IVF?

Last reviewed 2026-10-27

Yes. In an IVF cycle with preimplantation genetic testing, the laboratory reads the sex chromosomes of every embryo biopsied, and you choose which embryo is transferred. That identification is reliable to the point that error is a sample-handling event rather than a method limitation. But the question you are actually asking is different: will you end up with a child of the sex you want? That depends on whether this cycle produces a healthy embryo of that sex — and roughly half of your embryos will be the sex you did not ask for.

The two questions hiding inside one sentence

“Can you pick the gender with IVF” collapses two very different things:

The question	The answer	What decides it
Can the sex of an embryo be identified?	Effectively always, when the biopsy and lab work are done properly.	Laboratory technique. Not something you can influence.
Will I have a healthy embryo of that sex to transfer?	Often, but far from always. For some patients, not in the first cycle.	Your egg yield, your age, fertilisation, how many embryos reach day 5, and a coin flip on each one.

Clinic marketing answers the first question and lets you assume it answered the second. The gap between them is where disappointment lives, and it is entirely predictable from arithmetic.

The arithmetic nobody puts in the brochure

Each embryo is independently about as likely to be male as female. So the chance that at least one of your healthy, transferable embryos is the sex you want is simply one minus the chance that all of them are the other sex:

Healthy embryos after testing	Chance at least one is the sex you want	Chance none are
1	50%	50%
2	75%	25%
3	87.5%	12.5%
4	93.8%	6.3%
5	96.9%	3.1%
6	98.4%	1.6%
8	99.6%	0.4%

Read the first row again. A patient who produces one healthy embryo has a 50% chance, not a 99.9% chance. The accuracy figure in the advertising and the probability in this table are answers to different questions, and only the second one is about you.

This is why the single most useful thing you can ask a clinic is not “how accurate is the test.” It is: “for a patient of my age and history, how many euploid embryos does a cycle typically produce in your lab?” That number, run through the table above, is your real chance. A clinic that will not give it to you is telling you something.

What happens if none of them are the sex you wanted

You are not left with nothing. You are left with tested, healthy embryos of the other sex, frozen, and a decision that is harder than the one you thought you were making. People in this position generally take one of three paths:

Transfer anyway. The embryos are viable and tested. Many people who came for selection end up here and are glad.
Bank them and run another cycle. Combine the embryos from two or three cycles before transferring. This is the reason a “course of treatment” and “a cycle” are not the same purchase.
Keep them frozen and stop. Storage fees are real and recurring, and a decision deferred is still a decision. Ask what annual storage costs and what happens if you stop paying — this is in the consent paperwork, and it is worth reading before you sign it, not after.

Decide which of these three you would choose before the cycle starts, while it is an abstract question. It is a much worse question to face for the first time on the phone call where you are told the results.

Does this change your chance of a healthy pregnancy?

Selecting on sex does not make an individual embryo better or worse. What it does is shrink the pool you are allowed to transfer from, which can mean fewer attempts per cycle and, for some patients, more cycles overall. The testing step itself requires a biopsy of the embryo and freezing, so the transfer is a frozen one; that is now routine practice rather than a compromise, but it does mean a cycle takes longer from start to transfer than a fresh-transfer cycle would.

What about IUI, or choosing without IVF?

A definite answer requires looking at the embryo's chromosomes, and you cannot look at an embryo that is still inside the body. Everything offered outside IVF — sperm sorting before insemination, the Ericsson albumin method, timing and diet protocols, kits sold online — is at best an attempt to shift the odds, and most of it does not survive contact with the evidence. We go through each one on gender selection without IVF.

Want this worked out for your numbers?

Send your age, your AMH or antral follicle count if you have them, and whether you have done IVF before. We will run the arithmetic above for your situation and tell you what to ask. If an introduction we make leads to treatment, we may be paid a referral fee.

Ask a question

Can you pick the gender with IVF?

Yes. Preimplantation genetic testing identifies the sex of each biopsied embryo and you choose which is transferred. The identification is near-certain; your chance of having an embryo of the sex you want depends on how many healthy embryos the cycle produces.

If IVF gender selection is 99.9% accurate, is my chance of a girl 99.9%?

No. The accuracy figure describes identifying the sex of an embryo that already exists. With one healthy embryo your chance is about 50%, with three about 87.5%, with five about 97%.

What happens if all my embryos are the sex I did not want?

You will have tested, healthy embryos of the other sex. You can transfer them, run another cycle and combine the embryos before transferring, or keep them frozen. Decide which of these you would accept before the cycle begins.

Does choosing the sex reduce my chance of pregnancy?

Not for an individual embryo. It reduces the number of embryos you can transfer from, which for some patients means more cycles to reach the same outcome.

Can I choose the gender with IUI instead of IVF?

Not reliably. IUI with sorted sperm shifts the odds at best, and the published evidence for the sorting techniques is weak. A definite answer requires testing an embryo, which requires IVF.

Sources

Human Fertilisation and Embryology Authority (UK) — regulator's position on sex selection, which is permitted only to avoid a serious sex-linked condition — link
American Society for Reproductive Medicine Ethics Committee — opinion on the use of reproductive technology for sex selection for non-medical reasons — link

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