How Long Does Gender Selection in Cyprus Take?

If you wish to come to Cyprus for the full treatment then you would need to be here on day 2 or 3 of your menstrual period and stay for approx 18 or 20 days depending on your egg/embryo development.  You can have all the necessary tests carried out in North Cyprus to determine the best treatment plan and medication protocol for your case.

If you have the stimulation at home then you will need to come to Cyprus on day 9 and stay for approx 10-11 days.  The longer you stay, the better so that the doctor can monitor you for a longer period of time.

Gender Selection in IVF

Gender selection in Cyprus (also called sex selection) is a medical procedure performed as part of IVF that allows you to choose the sex of your baby. Gender selection is done by means of PGS (preimplantation genetic screening). With PGS, embryos are screened and the healthier ones of the desired sex are transferred to the woman’s uterus. PGS is an additional service at euroCARE IVF which can offer peace of mind to those wanting to rule out chromosomal abnormalities in their offspring. The PGS procedure is carried out on fertilized eggs, or “pre-embryos” before embryo transfer.

Gender Selection in Cyprus For Family Balancing

Sometimes gender selection can be done for non-medical reasons. In this situation, a child of a specific gender may be desired for no apparent medical reason but purely because of a personal, social or cultural preference. This type of gender selection is called “family balancing”. The rationale is to diversify gender in the family.

The selection of the gender of a baby for non-medical reasons (family balancing) is available to euroCARE IVF patients through PGS Testing. Gender Selection is a by-product of the screening procedure performed during PGS  which allows future parents to select the sex of their baby with more than 99 percent accuracy.

Gender Selection Treatment

• IVF with PGS

Preimplantation Genetic Screening (PGS) is a test that examines the chromosomal material of an embryo. It can tell if there are missing or extra chromosomes within the embryo. With PGS, we can test the following 5 chromosomes: 13, 18, 21, XX and XY. Upon request, we can screen all 46 chromosomes. By analyzing the chromosomal structure, our medical team can rule out trisomy and monosomy disorders in the offspring including Down’s, Turner’s, Klinefelter’s and Edward’s Syndrome. Only embryos with a normal number of chromosomes will be transferred. PGS is 99% accurate in identifying chromosomal abnormalities and identifying gender.

Suitable candidates for PGS are the following category of patients:

• Women of advanced maternal age
• Couples with a history of recurrent miscarriage
• Couples with repeated IVF failures
• Male partner with severe male factor infertility

These patients are at greater risk of producing aneuploid (chromosomally abnormal) embryos. PGS decreases this risk by selecting only chromosomally normal embryos that have the best chance of implantation.

• IVF with PGD

Preimplantation Genetic Diagnosis (PGD) is a genetic test that examines the genetic makeup of an embryo. This test allows our fertility specialists to examine far beyond the appearance of an embryo. The chance of a healthy pregnancy is much higher when genetically normal embryos are transferred. Implantation is also improved thanks to PGD. To determine whether the embryos are genetically normal, a PGD analysis is carried out by our embryologists prior to their transfer to the mother’s uterus. The accuracy of PGD in determining genetic abnormalities exceeds 99%. PGD screens only five chromosomes to determine if there is a specific genetic condition present in the embryo.

Suitable candidates for PGD testing include:

• Couples with a family history of X-linked disorders
• Couples with chromosome translocations
• Carriers of autosomal recessive diseases
• Carriers of autosomal dominant diseases

PGD Genetic Diseases

The following three categories of conditions can be diagnosed using PGD: (1) sex-linked disorders, (2) single gene defects, and (3) genetic disorders.

How Gender Selection in Cyprus Works

PGS  and PGD testing are performed during IVF treatments in our clinic’s state-of-the-art laboratory. Three or five days after fertilization of the patient’s eggs using ICSI (intracytoplasmic sperm injection), one cell is removed from each of the embryos. Here is an overview of the screening process:

• One cell is extracted from the embryo by our experienced embryologist using a microscopic glass needle. The embryo biopsy does not damage the embryo nor hinders its growth.
• The cell’s chromosomal composition or genetic makeup is evaluated under a microscope in the genetic lab.
• A report about the quality and gender of each of the embryos is created.
• A decision as to the number, quality, and gender of embryos to transfer is made by our euroCARE IVF doctor together with the future parents.
• Gender selection in Cyprus ensures that only the healthiest embryos of the desired sex are transferred to the woman’s uterus.

How is the Gender of an Embryo Determined

The chromosomes carried by the sperm determine the gender of an embryo. Sperm can carry either an X or a Y chromosome. The woman’s egg always carries the X chromosome. If the Y chromosome is present in the sperm, then the resulting embryo will be male (XY). When two X chromosomes – one X from the sperm and one X from the egg meet, the result is a baby girl (XX).

IVF Gender Selection in Cyprus Process

1. IVF with PGS Timeline

The IVF treatment using PGS testing follows multiple steps in the following order:

Day 1 – First day of menstruation

Day 2 – Stimulation injections begin

Day 6 – An Ultrasound scan

Day 9 – Fly to Cyprus

Day 10/11 – Ultrasound can and hCG injection (when eggs are mature)

Day 13 – Egg & Sperm collection

           – Egg fertilization (ICSI method)

Day 16 – Embryo biopsy (cell extraction)

Day 18 – Embryo transfer (blastocyst day-5 transfer)

IVF Process with PGS

• Fertility Testing

The first important step in the IVF process using PGS is to undergo fertility testing.

For the female partner the following tests are usually required:

• Hormone blood tests to measure AMH (anti-mullerian hormone), TSH (thyroid-stimulating hormone) and prolactin levels.
• A blood test to check for HIV and Hepatitis B and C
• A transvaginal ultrasound scan to assess the antral follicle count (egg supply) and screen the ovaries and the uterine lining for any abnormalities.

The blood tests can be carried out at any time during the menstrual cycle. However, the scan should be done preferably before ovulation – around day 10 / 11 during your monthly cycle.

The male partner should do the following tests:

• A blood test to check for HIV and Hepatitis B and C
• Sperm analysis to measure the sperm count, morphology (shape) and motility (movement).

From the test results, our euroCARE IVF doctor will be able to determine the best treatment plan for you and give you a prognosis for success.

Once the doctor has confirmed the treatment plan, the ovarian stimulation phase can begin.

• Ovarian Stimulation

Day 1 of a patient’s menstrual cycle marks day 1 of the IVF treatment process.   Injections are to be administered from day 2 onwards until multiple eggs are produced.  A scan is required after the first 5 injections to check the size of the follicles (eggs) in the ovaries. The doctor may advise any changes to the medication protocol if necessary. 

You will have another ultrasound scan upon your arrival in North Cyprus.  When the eggs are ready, an hCG injection (also known as a trigger shot) is administered.  This stimulates the final maturation and release of the eggs in the ovaries.

• Egg Retrieval

36 hours after the hCG injection (trigger shot), the doctor will collect the mature eggs using ultrasound-guided aspiration. This is a simple procedure that takes only 20 minutes to complete. During the procedure, you will be under anesthesia. At this point, the sperm will be also provided by your partner. If you use donor sperm, a sample from your chosen sperm donor will be provided just in time for fertilization to take place after the eggs are being collected.

• Fertilization (ICSI)

Following a sperm sorting procedure, the collected eggs are fertilized with the sperm in an ICSI procedure. The fertilized eggs are then left to develop in the lab.

• PGS Testing

The biopsy is carried out on day 3 day after the egg retrieval (when the embryos consist of 7-10 cells).  

• Embryo Transfer

Our doctor will discuss with you the number and quality of embryos to transfer. On day 5 after fertilization, the best quality, genetically normal embryos of the desired gender will be placed into the woman’s uterus in a simple, painless procedure called blastocyst embryo transfer.

• Pregnancy Test

You can have an hCG blood test 12 days following embryo transfer to see the

result.

IVF with PGS Success Rates

PGS allows euroCARE’s medical team to identify any issues that may prevent pregnancy from occurring, which greatly improves the chances of IVF success. PGS success rates exceed 70% for women under 35 (see graph).

2. IVF with PGD Timeline

The treatment process will follow the below schedule (though may be subject to change):

Day 1 – First day of menstruation

Day 2 – Stimulation injections begin

Day 6 – Scan

Day 9 – Fly to Cyprus

Day 10/11 – Scan and hCG injection (when eggs are ready)

Day 13 – Egg and sperm collection

Day 16 – Embryo biopsy (cell extraction)

Day 18 – Embryo transfer (blastocyst day-5 transfer)

IVF Process with PGD

• Fertility Testing

The first step of the IVF process with PGD testing is to assess the level of fertility in each partner. This includes fertility testing for both the female and male partner.

For the female patient the following fertility tests are required:

• Hormone blood tests to measure AMH (anti-mullerian hormone), TSH (thyroid-stimulating hormone) and prolactin levels.
• A blood test to check for HIV and Hepatitis B and C
• A transvaginal ultrasound scan to assess the antral follicle count (egg supply) and screen the ovaries and uterus for any abnormalities.

The blood tests can be carried out at any time during your menstrual cycle. The scan should be carried out preferably before ovulation – around day 10 / 11 of your cycle.

Common testing procedure prior to IVF treatment for the male partner include:

• A blood test to check for HIV and Hepatitis B and C
• Sperm analysis to measure the sperm count, morphology (shape) and motility (movement).

Based on the test results, the euroCARE IVF doctor will be able to create the best treatment plan for you. Once the treatment plan has been confirmed, you can start taking fertility drugs to stimulate your ovaries.

• Ovarian Stimulation

Day 1 of your menstruation marks day 1 of the IVF cycle. Ovarian stimulation starts on day 2 and lasts for 10 to 12 days. Injections are administered on a daily basis to encourage the production of multiple eggs.  A scan is required after the first 5 injections to check the response of the ovaries. At this point, the doctor may advise adjustment to the medication protocol if necessary. Upon arrival in Cyprus, you will have another scan.  When the eggs are ready, the hCG injection (trigger shot) is administered. This triggers ovulation and release of eggs from the ovaries.

• Egg Retrieval

Once the hCG injection was administered, our doctor will collect the eggs within 15 minutes or so using a soft, thin tube.

• Fertilization (ICSI)

After the sperm has been provided, the mature eggs will be fertilized using an ICSI (intracytoplasmic sperm injection) method. The fertilized eggs (embryos) will then grow in a culture medium for a couple of days before being sent to the lab.

• PGD Testing

After embryos are created in the laboratory, they are grown for five to six days. On day five or day six, one cell will be extracted from all normal developing embryos. Embryo biopsy involves removing one cell from the trophectoderm, which is the outer layer of cells that allows the blastocyst embryo to hatch out of the zona pellucida. The embryos are frozen while the genetic material of the removed cells is tested in the lab. Once the results are ready, the PGD test results will be discussed with the patient(s), and a frozen embryo transfer (FET) is scheduled.

• Embryo Transfer

Only the best-quality and genetically normal embryos of the desired sex will be selected for the transfer day. Your age and the quality of your embryos will be taken into account when deciding on the number of embryos to transfer.

• Pregnancy Test

An hCG blood test 12 days after the embryo transfer or a urine test 14 days post transfer is carried out to see if pregnancy has occurred.

How Are Embryos Selected in IVF Following PGS/PGD

Embryos that have both a normal PGS/PGD test result and good quality can be transferred in a frozen embryo transfer (FET) cycle. These tests help our fertility team to identify the best embryos to transfer in order to achieve a successful pregnancy. The combination of normal genetic makeup with normal physical appearance indicates that embryos have the highest potential to become a healthy child. All decisions regarding the number and selection of embryo(s) to transfer and what to do with the remaining embryos are made together between the patient and the medical team.

Genetic Testing During Pregnancy

Neither PGS or PGD replace prenatal testing, such as cell-free fetal DNA testing, chorionic villus sampling (CVS) or amniocentesis. Although PGS and PGD are highly accurate, genetic testing is required during pregnancy to confirm the test results. The screening techniques during IVF do not replace prenatal genetic testing.

How Much is Gender Selection in Cyprus

• The price for IVF with PGS at euroCARE IVF starts at 5000 EUR
• The price for IVF with PGD starts at 5000 EUR

Gender Selection Procedure at euroCARE IVF

Thanks to the valuable genetic information, parents can now be sure that the transferred embryos have the best potential to result in a successful pregnancy and a healthy child. With the use of PGS and PGD testing, we can improve significantly the treatment outcome for patients with prior IVF failures.

As a by-product of the genetic analysis, it is also possible to determine the gender of the embryos. Our screening techniques are more than 99 percent accurate in identifying the gender of the embryo. With PGS and PGD, parents will not only have healthy, disease-free embryos for implantation, but also a child of the desired sex. No matter your reasons for gender selection in Cyprus, we can help you to create the perfect, healthy family you always desired. Talk to our patient coordinator to discover the available options for you!