Using Non-Invasive Methods to Choose Gender; Sex Selection with Diet and Determination of Ovulation Time in Iran.

Background: Families, especially fathers, are continuously interested in selecting the child's sex in most societies. This study was conducted to Use non-invasive methods to choose gender in order that sex selection with diet and determination of ovulation time in Iran.
Methods: This study was a clinical experimental trial of convenient samples conducted as a retrospective study. Overall, 285 women were referred to Dr. Farhud's Genetic Clinic in 2013 and 2014 in Tehran, Iran. For two years (from June 2013 to Jun 2015), samples were followed-up. Participants used diet, the timing of ovulation, and considering lifestyle to have the sex selection.
Results: Overall, 88 women became pregnant in the first group among 179 participants in 2013, and talking to the participants showed that 82.95% achieved the wanted gender. Fifty-two women became pregnant among 106 participants in 2014 in the second group and 86.79%, achieved the wanted sex.
Conclusion: Diet and ovulation timing could be very efficient, and it is recommended that families Use safe procedures such as natural, and non-invasive methods to achieve the wanted sex for gender balance.

Introduction

It is common to select the child’s sex and the tendency to have a son in many cultures. The requirement or benefit of physical strength, war, helping in agriculture tasks, continuing father’s profession, caring for the elderly, inheriting property, continuing their family name and talent can be the cultural basis to prefer the male child. The fate of gender selection affects the death of the daughter or newborn after birth directly, and also the preference of the child after birth will discriminate between boys and girls in terms of assigning the food, money, kindness, education, and other sources of wealth and prosperity (1). Placing the baby in an unfavorable mental and physical condition Causes improper growth of the baby’s physiological parameters (2,3).

Lack of proper nutrition in pregnant women can increase fetal growth and low birth weight (4). Since infant mortality in the first 72 h of birth is the highest (5). The risk of death of a newborn girl is threatened in societies where there is a gender preference. Moreover, neglecting micronutrients can cause a variety of diseases in girl children (6,7). Unfortunately, ethnicity affects infant mortality (8). Therefore, the development of infants and children varies according to gender, birth weight, environmental factors, and living conditions (9).

Different methods for sex selecting

Sexual preference is frequent and striking in most parts of the world. The results of a country sampling are very different and inconsistent according to (age group, region, and researchers), such as Nepal and India listed in Table 1.

Table 1:

Interest in male gender in countries throughout the world

	Author	Country	Year	Number of participants	Percentage of male gender preference
1	Srivastava et al (10)	India	2014	308 women aged 15 to 45 yr old	28.1
2	Kumar Nithin et al (11)	India	2015	132 women with a mean age of 27	55.7
3	Dhande et a (12)	India	2016	220 married women from village aged 15 to 49 yr old	95
4	Roy et al.(13)	India	2017	116 women aged 15 to 49 yr old	52.58
5	Zubair et al. (14)	Pakistan	2007	301 women aged 15 to 45 yr old	30.9
6	Atif et al. (15)	Pakistan	2016	385 women aged 15 to 45 yr old	24.3
7	Rai et al.(16)	Nepal	2014	100 women with a mean age of 31	64.3
8	Thapa et al.(17)	Nepal	2018	200 women aged 15 to 45 yr old	13
9	Inyang Etoh et al. (18)	Nigeria	2016	453 women with a mean age of 29	64.9
10	Al-Akour et al. (19)	Jordan	2012	335 women aged 15 to 45 yr old	14.9
11	Fejes et al. (20)	Hungary	2006	200 women aged 15 to 45 yr old	23.5
12	Edgar Dahl et al. (21)	America	2006	197 women aged 18 to 49 yr old	39
13	Ahmadi et al. (22)	Iran	2015	100 women aged 18 to 45 yr old	55

The initial sex ratio, i.e fertilized eggs with the male sex, is about twice that of the girl, but male fetuses are more vulnerable compared to the female fetus, which induces abortion in the first weeks of fertility. In other words, the sex ratio in aborted fetuses is about 80% male.

The adult sex ratio (ASR) is a demographic feature of the population (19). There are changes in sex ratio according to race, ethnicity, and maternal age. The sex ratio (number of boys by the girls) is 105 among whites and about 103 among African Americans (20). Differences in sex ratio are also observed in other countries of the world. In some countries, a sex ratio of more than 107 has even been reported, while other countries have reported lower rates (21). It is remarkable that the sex ratio is very high, reported from 109 to 113 in some countries, such as China and India, which is an artificial sex ratio, due to human interventions (22).

Genetic factors are largely included in these sex ratio differences. Of course, humans can also affect the sex ratio. In some countries, human interventions intervene the biological process of sex ratio, including Taiwan, India, China, and South Korea (23). It is worth noting that Earthquake (24), war (25), men’s psychological stress (26), the effect of parent’s age (27), seasons (28), determining the time of ovulation and diet (29) are factors that affect sex ratio.

Reasons for pre-pregnancy gender selection include “ Medical reasons such as preventing the birth of children with sex-linked diseases”, “ couples prefer a certain gender because they have one or more other children of the same sex”, “Gender preference is frequently preferred because of cultural, social, and economic reasons”, “as a result of policies that couples must adopt to limit reproduction to have a child”, “Prevent deliberate abortions after identifying the sex of the fetus!” and “Preventing the number of unwanted children to realize the wanted sex and so the family economy”.

There is a gap in many societies that are unaware of pre-pregnancy gender choices. when there is a prejudice against a particular gender in some societies. If it can not change gender preference, it can instead help people in those societies to achieve the desired gender. Therefore, this way can prevent unwanted gender harm to some extent. In addition, sex selection before pregnancy can prevent the transmission of sexually transmitted diseases.

This study was conducted to examine the relationship between child sex and time of ovulation and nutrition, before pregnancy and the superiority of the natural method over invasive method in Iran.

Methods

This study is a clinical experimental trial of convenient samples conducted in a retrospective study. This study was conducted on 285 eligible women aged 25 to 44 yr, at pre-pregnancy, in which sex selecting was studied in Farhud’s Genetic Clinic in Tehran Iran. For two years (from Jun 2013 to Jun 2015) .Consequently, collecting retrospective data from parents’ reports were used.

Three months before trying to pregnancy, the women were monitored for nutrition and ovulation. Using a combination of high sodium and potassium foods will increase the likelihood of having a male child, and foods with high calcium and magnesium will increase to form a female fetus. Accordingly, the composition of food in the pre-pregnancy period, particularly in women, can change that group’s sex ratio (29,30). Male sperm carrying a chromosome (Y) is smaller than the female sperm carrying a chromosome (X) and hence, has a faster speed; accordingly, sexual intercourse should be done in proportion to the time of ovulation (31,32).

Intercourse in the days before ovulation was recommended to have a daughter (a female child), and attempting to conceive on the day of ovulation was recommended to have a son (a male child).

Inclusion criteria: Women aged 25 to 44 yr old referred to the clinic were interested in using sex selection instructions.

Exclusion criteria: 1- Illiterate women who could not follow orders 2- Men who had problems with spermogram disorder 3- Women who had high blood pressure 4- Women who had thyroid problems 5- Women who had neurological problems. 6- Women with secondary infertility.

Demographic information (based on education, age, employment, type of delivery, etc.) was homogeneous in both groups of participants. Men with a normal spermogram test were included in the study. Men with abnormal spermograms (hypospermia) were treated with medicine and recommendations to have a healthy lifestyle.

Results

Participants studied in a group of 179 people in 2013 and a group of 106 people in 2014. Overall, 88 women became pregnant in 2013 among 179 participants in the first group, and 53 women became pregnant in 2014 in the second group among 106 participants (Table 2).

Table 2:

Percentage of success in achieving the wanted sex in 179 participants (2013) and 106 participants (2014)

Number of children born	Wanted sex	Unwanted sex	Success percentage
88	73	15	82.95
53	46	7	86.79

Discussion

The sample used in this study is a kind of clinical trial, without control, and was selected from the convenient samples referred to Dr. Farhud’s Genetic Clinic. Overall, 285 individuals participated in the study from Jun 2013 to Jun 2015. Adjusting the time of sexual intercourse according to the time of ovulation and observing the pre-pregnancy diet in couples were specified to be effective on the sex ratio in this research.

A success rate between 70% and 90% was observed in a number of studies similar to these studies that were conducted based on selecting the child’s sex in different populations (27,29,31–34) According to the current study, 82.95% and 86.79% can success the wanted sex selection using the diet method and ovulation time.

The human population has long considered gender as the first and most important differentiating factor among individuals, and today such an attitude dominates some communities. Many studies may consider child sex selection as a kind of gender discrimination. Unfortunately, in societies where gender preference exists, girls are at risk from infancy to adulthood. Both physically and mentally, girls’ health is at risk (1). As in societies that have a gender preference, when a woman becomes pregnant and everyone around her is waiting to hear the news of the boy’s pregnancy. When the fetus becomes a girl, the woman may be ignored. The pregnant mother may also be physically and mentally stressed (35). Placing the baby in an unfavorable mental and physical condition Causes improper growth of the baby’s physiological parameters(2–4,35,36).

The secondary sex ratio of fetuses who are born is usually determined at 106 male fetuses to 100 female fetuses, and in summary, is estimated 106 (37). Naturally, according to the sex ratio in society, the likelihood of having a son or a daughter is about 50/50 without using gender selection methods.

A study has reported a considerable reduction in the number of male births since 1950 in Denmark, Sweden, the Netherlands, the United States, Germany, Norway, and Finland (33). Improper conditions increase the likelihood of giving birth to a girl. An earthquake in a Japanese city in 1995 decreased the secondary sex ratio (24).

Other study reported that has been conducted during World War II on Austrian and German populations specified that the likelihood of having a female child was higher than a male child at that time (25). Psychological stress caused by severe and difficult events in life is possible to change the sex ratio by influencing the loss of sperm by transferring the y chromosome (26). A significant relationship between child’s sex and parents’ smoking and will increase the girl’s birth (38). Fertilization season is a potential factor that can affect the sex ratio (28). Months of birth and sex ratio were different, and pregnant mothers were more expected to have girls in the summer and winter compared to the spring. Pregnancy season may affect the child’s birth (39).

Noorlander reported that Y sperm has a small head and moves at a higher speed compared to X sperm. The difference in sperm size is caused by the difference in their DNA content that male sperms have less DNA content compared to female sperms. Male sperm (y) is less resistant to environmental changes and is more vulnerable than larger sperm (X) (30,40). When the male body is influenced by environmental stressors, such as heat and chemicals, x sperms indicate more resistance compared to y sperms (41). Men’s environmental contact with chemicals such as lead will disrupt the physical structure and reduce sperm motility and fertility in men (42). Air pollution influences sperm motility and reduces sperm motility, especially y chromosome-carrying sperms (43). Many environmental pollutants decrease sperm number and motility and increase the conditions to give birth to female children (41).

Diet methods and determining the time of ovulation increase the success rate from 50% to even 90% (27,29,31,33,34). Couples those interested to gender selection are more in improving gender balance and the prevention of sex-linked diseases in Iran, and consequently, they act to select the child sex, and gender preference may infrequently be observed in some ethnicities (22). Families can likely achieve their wanted gender using these methods in a perfectly safe, natural, non-invasive, and economically reasonable way.

Conclusion

It is significantly effective to apply diet and ovulation timing in this study. Families use safe, natural, and non-invasive methods to achieve the wanted sex to have a gender balance. This study’s methods are more economical compared to the invasive and laboratory methods and ensure avoiding serious risks and hormonal complications in invasive methods (IVF and PGD). Thus sex selection is appropriate so that people in certain communities can determine the sex of their baby before pregnancy and strive to obtain it. In this way, it may prevent the birth of babies who are not of the desired gender of the parents.

Journalism Ethics considerations

Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.