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Several options are available for choosing the sex of your child, but none are guaranteed.
Besides slipping the stork some extra cash, would-be parents have a number of options for choosing the sex of their child. The methods range from the natural (such as using particular positions during intercourse) to the high-tech (such as sorting sperm).
Couples have a 50/50 chance of conceiving a boy or a girl through plain old-fashioned intercourse. Yet there are some people who might want to stack the odds in their favor, either for cultural reasons, for dreams of raising a son or a daughter, or to balance out their families. Others do it to prevent their offspring from inheriting sex-linked genetic diseases.
Whatever the reason, health experts worry that some parents will place unrealistic hopes on a sex-determination technique and become disappointed whether or not they succeed. The method could either fail to produce a baby of the desired sex, or the right-gendered kid could grow up with traits that contradict with parental expectations. In this case, ethicists worry about the welfare of the child.
In addition, no preconception approach is foolproof, according to an ethics committee report in the May 2001 issue of Fertility and Sterility. Some popular strategies reportedly even fall under the category of foolery.
Of course, this list may not necessarily include your great grandmother's "tried and true" formula for choosing the baby's sex. Some doctors just chuckle at such schemes and say that as long as the advice doesn't hurt mom or baby, then there may be no harm in trying.
The Shettles method is arguably the most well-known natural strategy for choosing the sex of your child. Developed three decades ago by Landrum B. Shettles, MD, PhD, the plan involves timing intercourse to a woman's cycle and assuming certain sexual positions.
In his book How to Choose the Sex of Your Baby, Shettles explains that the male (Y) sperm is smaller, faster, and more short-lived than the female (X) sperm. Because of this, it is better for boy-desiring couples to have sex closest to the time when a woman's egg is released (ovulation). This way, the speedy male sperm could get to the egg sooner than the female one.
The Y chromosome apparently also enjoys an advantage over its counterpart when the sperm is discharged as close as possible to the opening of the cervix. This is achieved through rear entry intercourse (man enters woman from behind).
Parents desiring a girl, on the other hand, are encouraged to have sex in the missionary position (face to face, man on top) about two to four days before ovulation so that by the time the egg comes, only the heartier, more resilient X sperm will remain in the woman's reproductive tract.
The Shettles method has reportedly been effective at least 75% of the time, with the rate slightly lower for girls than for boys. Pat Buie, a registered nurse from Canada, incorporated Shettles' method into her sex selection plan -- described in her book Choose the Sex of Your Baby Naturally -- and claims to have a 95% success rate.
Many fertility experts question the value of natural sex selection strategies such as the Shettles method.
"There's no real evidence to show that they work," says Sandra Ann Carson, MD, president of the American Society for Reproductive Medicine, noting that such techniques are as effective as random sex in producing a baby of the preferred sex.
J. Martin Young, MD, a pediatrician in private practice in Amarillo, Texas, reviewed medical literature on sex determination and found that the Shettles method fared worse than random sex, with a 39% success rate in choosing the sex of your child.
Shettles' ideas seem to make sense, but they're a little too simplistic and not based on scientific research, says Young, who authored two books on the subject. In How to Have a Boy and How to Have a Girl, he describes a strategy that opposes Shettles'.
"If you would like to have a female, you would schedule intercourse to be as close to the time of ovulation as possible," says Young. "If you would like to have a male child, you would have intercourse a number of days before to try to increase the probability."
The success rate for this strategy of choosing the sex of your child, says Young, can be as high as two chances in three (about 67%), if done properly.
The odds of choosing the sex of your child may be even better with the help of technology. According to the fertility experts contacted by WebMD, MicroSort -- a method that involves separating the male sperm from the female -- is the current gold standard.
"The only effective method that I feel would be useful for sex selection is the MicroSort technique," says William Gibbons, MD, director of the EVMS Jones Institute for Reproductive Medicine.
Carson agrees. "I think sperm sorting is probably the most viable method that we have right now, but it's probably most effective when it's used in combination with in vitro fertilization."
MicroSort, which is licensed by the Genetics and IVF Institute in Fairfax, Va., is undergoing an FDA clinical trial. The technique involves separating X- and Y-bearing sperm by using laser light, dye, and a machine called a flow cytometer. Once the sperm are divided, the specimens are inserted back into the woman through artificial means, such as in vitro fertilization.
A news release issued in October 2002 from the Genetics and IVF Institute reports that MicroSort has a 91% success rate among couples wanting girls, and a 73% rate for those wanting boys.
MicroSort, however, isn't the only high-tech method for choosing the sex of your child. Other more controversial strategies include preimplantation genetic diagnosis (PGD), and chorionic villus sampling (CVS) -- both of which are used to detect medical illnesses but can also be used to distinguish sex.
To determine sex, PGD involves examining an embryo taken from the uterus and replacing only the embryo of the desired sex. In CVS, chromosomes of the fetus are analyzed in early pregnancy. There are reports that some people who find out they have an unwanted gender through this technique end up asking for an abortion.
The American Society for Reproductive Medicine recommends neither PGD nor CVS as a sex selection method for couples looking to balance the gender ratio in their families.
WebMD Feature Reviewed by Brunilda Nazario, MD
SOURCES: Fertility and Sterility, May 2001. Landrum B. Shettles, MD, PhD, and David M. Rorvik, How to Choose the Sex of Your Baby: The Method Best Supported by Scientific Evidence. Pat Buie, Choose the Sex of Your Baby Naturally. J. Martin Young, MD, FAAP, How to Have a Boy and How to Have a Girl. Sandra Ann Carson, president, American Society for Reproductive Medicine (ASRM). ASRM web site. MicroSort web site. William Gibbons, MD, director, EVMS Jones Institute for Reproductive Medicine.
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Boy or Girl? Early Signs of Your Baby’s Sex
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Boy or Girl? Early Signs of Your Baby’s Sex
We’ve all heard about the early signs that can help pregnant parents predict their baby’s sex. But do you truly know how biological sex is determined and which of these signs are reliable? Read this article to learn more about predicting your baby’s sex.
When you find out that you’re pregnant, your top priority is of course to have a healthy pregnancy and a healthy baby. However, many people want to know their baby’s sex from the moment they get a positive pregnancy test! 
Maybe you’ve been thinking about unisex baby names, or maybe discovering your baby’s sex could help you decide on a name and prepare for their arrival. Many parents use their child’s biological sex to decide what color clothing and nursery decorations to buy. 
The process through which sex is determined is called human sexual differentiation. You probably won’t find out your baby’s sex until a few months into your pregnancy, but it was set in stone at the moment of conception.
The baby’s genes determine sex. All eggs contain an X chromosome, while sperm can have an X or a Y chromosome. If the egg is fertilized by a sperm cell carrying an X chromosome, the resulting XX embryo will be female. However, if the sperm cell has a Y chromosome, the embryo will have male XY chromosomes.
At first, all embryos look the same regardless of sex. At the fifth week of your pregnancy, your baby will have a structure called a “gonadal ridge” (or “genital ridge”). Until week seven, they will develop the precursors of the sex organs. Then, over the next five weeks, your embryo starts producing hormones that stimulate the development of their sex organs.
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All sex organs come from the genital ridge. The ovaries are equivalent to the testicles, meaning they are formed from the same cells, and the clitoris and the penis are equivalents. So once those hormones kick in, the genital ridge begins differentiating into these structures.
For most fetuses with XY chromosomes, the genital ridge starts to lengthen into a penis by week 11. Tiny buds will form the prostate around week 14, and the urinary system is formed by week 16. Testicles descend into the scrotum at around weeks 26–31, and the penis continues growing during the third trimester.
For most fetuses with XX chromosomes, primary ovaries appear around week 12. Between weeks 14 and 20, they fill up with 6–7 million primitive eggs. These eggs reduce in quantity up until birth, at which point there are about 1–2 million eggs left. Two structures called the paramesonephric ducts fuse to form the uterus and vagina around week 16 of pregnancy.
There are lots of old wives’ tales and myths about how to predict the sex of your baby. Here’s the truth about five supposed pregnancy signs for a girl:
One of the most common myths surrounding a baby’s sex is that having a higher bump means you’re having a girl. However, this is not true.
The biggest factors that determine the way your bump looks are your physical condition, the number of pregnancies you’ve had, your abdominal muscles, and your total weight gain during pregnancy.
Some people think that the estrogen produced by a female fetus can affect the mother’s temperament, causing mood swings. However, anyone who’s pregnant can experience mood swings due to their own hormonal fluctuations: these mood changes aren’t related to the baby’s sex.
Another popular belief is that the copious hormones produced by a female fetus can cause more severe cases of morning sickness. But severity of nausea and vomiting varies from person to person, and even the same person can have different experiences during different pregnancies.
Have you ever heard the saying that a baby girl steals her mother’s beauty? Some people believe that if you’re having a girl, you’ll develop oily or dull skin and acne. This is another falsehood. Pregnancy hormones can be unpredictable, and they affect each person’s skin and hair differently.
Research has shown that anywhere between 50 and 90 percent of all people experience food cravings at some point during pregnancy. A common myth is that a female fetus causes cravings for sweets, and a male fetus causes cravings for savory and salty foods.
The truth is that a person’s cravings are more likely to be related to their nutritional requirements than to the sex of their baby. There’s also a theory that the food a person craves may partially depend on their culture.
Just as carrying high is supposed to mean that you’re having a girl, it’s widely believed that a lower bump means your baby is a boy. However, there’s no evidence to back up this theory, and as stated above, the shape of your bump is determined by other factors. 
This is the opposite of the myth that having a girl will “take away your beauty.” Many people believe that if you’re carrying a boy, your skin will look healthier, and you’ll have thick, lustrous hair.
In reality, these changes depend solely on pregnancy hormones. Some people develop skin pigmentation or acne, while others will have thicker hair and a “pregnancy glow.”
Does anyone sincerely believe that having a boy means that a pregnant person will avoid mood swings? Unfortunately, it’s not true. The biological sex of your baby won’t have any impact on whether you’ll have mood swings. They’re a very common occurrence.
It’s no wonder so many people believe in these myths — they have an almost 50 percent chance of being right. These are some of the tests that your health care provider can use to determine your baby’s sex:
NIPT is a method of testing for the likelihood of genetic abnormalities in the first trimester. This maternal blood test poses no risk to the fetus. It’s usually used to detect Down syndrome in high-risk pregnancies, but it can also detect the sex of the baby. The accuracy of the test is around 98 percent.
This is the most common way to determine your baby’s sex, and most low-risk pregnancies find out the baby’s sex this way between the 18th and 22nd week of pregnancy. It’s accurate and completely safe for the fetus.
Using a sample of amniotic fluid, amniocentesis can detect genetic abnormalities and your baby’s sex. This method is invasive and is usually done in high-risk pregnancies.
CVS is an invasive test that requires a sample of placenta to diagnose Down syndrome or other chromosomal abnormalities. It can also determine the baby’s sex as early as week 10 of pregnancy.
Some parents may wish to only have a baby of a certain sex. This may be due to the wish to avoid sex-linked diseases or as a matter of preference. In certain countries, it’s legal to select the sex of your baby by undergoing IVF. Embryos are produced in the laboratory and tested for sex, after which only embryos of the chosen sex are implanted.
Amniocentesis and CVS are primarily carried out when fetal abnormalities are suspected, and both tests pose certain risks. They are not recommended as ways to determine the sex of the fetus.
It’s normal to want to know your baby’s sex, but being a healthy parent with a healthy baby is the ultimate goal. Maintain healthy nutrition during pregnancy, monitor the fluids you consume during pregnancy, stay active, and when your baby arrives, you might realize their sex isn’t that important after all!
Walsh, Kate, et al. “Maternal Prenatal Stress Phenotypes Associate with Fetal Neurodevelopment and Birth Outcomes.” PNAS, National Academy of Sciences, 26 Nov. 2019, www.pnas.org/content/116/48/23996.

Mayo Clinic Staff. “Fetal Development: What Happens during the 1st Trimester?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 12 July 2017, www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302.

Mayo Clinic Staff. “Fetal Ultrasound.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 Jan. 2019, www.mayoclinic.org/tests-procedures/fetal-ultrasound/about/pac-20394149.

“Genital Ridge.” Genital Ridge - an Overview | ScienceDirect Topics, www.sciencedirect.com/topics/engineering/genital-ridge.

Hill, Mark A. “BGDB Sexual Differentiation - Late Embryo.” UNSW Embryology, 2020, embryology.med.unsw.edu.au/embryology/index.php/BGDB_Sexual_Differentiation_-_Late_Embryo.

Paxton, Steve, et al. “The Leeds Histology Guide.” The Histology Guide, www.histology.leeds.ac.uk/female/FRS_ova.php.

“Female Reproductive System: Structure & Function.” Cleveland Clinic, 19 Jan. 2019, my.clevelandclinic.org/health/articles/9118-female-reproductive-system.

“Gonadal Ridge.” Gonadal Ridge - an Overview | ScienceDirect Topics, www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/gonadal-ridge.

“Is a Pregnant Woman's Chance of Giving Birth to a Boy 50 Percent?” Scientific American, Scientific American, 15 Nov. 2004, www.scientificamerican.com/article/is-a-pregnant-womans-chan/.

“Female Age-Related Fertility Decline.” ACOG, Mar. 2014, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/03/female-age-related-fertility-decline.

A, Aatsha P. “Embryology, Sexual Development.” StatPearls [Internet]., U.S. National Library of Medicine, 30 May 2020, www.ncbi.nlm.nih.gov/books/NBK557601/.

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