A balancing act: sex selection after pre-implantation genetic testing for aneuploidy for first versus second baby.

This article examines the frequency of sex selection among patients undergoing frozen embryo transfer (FET) after preimplantation genetic testing for aneuploidy (PGT-A) at a single urban academic fertility center in the USA. The study found that when both male and female euploid embryos were available, patients selected embryo sex more often when attempting to conceive a second child (62%) compared to the first child (32.4%), with 81.8% of second-child selections favoring the opposite sex of the first child, indicating a preference for family balancing. Selection rates for male and female embryos were similar for first births, but female embryos were more frequently chosen for second births. These findings highlight the role of PGT-A in enabling sex selection where permitted, though the study's generalizability is limited by its single-center design and incomplete data on patients' prior children.