Does IVF, ICSI, or similar treatments result in more boys or girls than expected?
Since the beginning of time about 51% of children born are male and 49% are female. That is the "sex ratio" of naturally conceived children. IVF with or without ICSI is thought to affect this ratio for a myriad of reasons. Male stress, low male testosterone levels, and certain lifestyle factors might influence the ratio of male sperm to female sperm men carry. Furthermore, the technique of sperm selection might favor the female sperm, egg prepared for IVF fertilization (not ICSI) might be more "welcoming" to male sperm, male embryos develop faster so are more likely to be selected for embryo transfer (i.e. they might be graded higher than female embryos), and there are other laboratory factors that might also disrupt the expected sex ratio.
A recent review of over 27,000 births after IVF with and without ICSI examined the percentage of boys and girls born from IVF, IVF with ICSI with ejaculated sperm, IVF with ICSI with testicular sperm. Here are the highlights of their findings:
. IVF produces more boys than ICSI (53.1% boys)
. ICSI with ejaculated sperm produces more girls (48.2% boys)
. ICSI with testicular sperm produces more girls (47.7% boys)
. Blastocysts are more likely to be boys than day 3 embryos (52.9% boys)
When looking at sperm factors, men with low sperm motility were more likely to produce girls than boys.
Does this matter? Honestly, probably not. Babies born from IVF and/or ICSI represent a small percentage of all children born, so the influence of a few percentage points on the ratio of males to females is insignificant in the larger population. It is interesting, though. So how did I answer the question "Does IVF make more boys than girls?" Like so many questions, the answer is "depends" as it depends on whether you do IVF or ICSI, how we get the sperm, and how well the sperm swim. Overall it's still darn close to a coin toss, whether you get a boy or girl from treatment. Isn't that part of the magic in all this science?
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