Teghan Polgaise recalls the moment she gave birth to her third child — a third boy — and her feelings of disappointment that she didn't get a girl.
"I was a bit like — 'really? Again?'" Polglaise, 34, told The Feed.
So she and her partner travelled to the US to select the sex of their fourth child via IVF — a practice that is illegal in Australia. It would end up costing them about $30,000 to have a girl, plus another $10,000 once flights and accommodation were factored in.
Polglaise had strong relationships with her sisters growing up, sharing bedrooms for 17 years. She wanted a daughter of her own to have that kind of bond with another female in their home.
"I'm really close with my sister … I feel like I raised her," she said.
"Instead of going to Greece [which] we had planned for our honeymoon, I said, 'Do you reckon we could go to America and just give it one shot?' And [my partner] was like, 'Sign me up.'"
The American sex-selection industry working with Australians
IVF sex selection for non-medical purposes was made illegal in Australia in 2004.
The Australian National Health and Medical Research Council (NHMRC), which advises the government on policy, said at the time that sex selection is an "ethically controversial issue" — stating sex selection should only be used to reduce the risk of a genetic condition.
Outside Australia, in countries such as the US, there's been an increase in sex selection through IVF clinics, "prompting couples from around the world to travel [there]", according to a 2023 report by the American Society for Reproductive Medicine.
US-based clinics set up websites that include Australia in their domain name and advertise directly to Australian families. The sites guide families through the process, with some even offering a personal nurse.
Teghan said the process was "extremely straightforward".
"They do a lot of the work for you communicating with America, and then they just send you all the forms that you need … you're not having to explain yourself all the time," Teghan said.
Dr Daniel A. Potter is a Los Angeles-based reproductive endocrinologist who advertises his services in Australia through a website he has set up. He says he's seen a steady increase in interest from Australians seeking sex selection.
Teghan Polglaise and her partner had three sons when they selected a baby girl, undergoing IVF in the US. Source: SBS
He said he's seen mostly women seeking daughters undergoing the procedure.
"I think that there's a certain portion of women out there who have always envisioned having a girl since they were little girls — modelling motherhood."
The sex selection process starts in Australia with bloods taken. Once in the US, embryos are genetically analysed to determine the sex, before being transferred to the womb. This process is known as preimplantation genetic diagnosis.
The US-based IVF clinics quote anywhere from US$20,000 ($30,000) to US$30,000 ($45,000) for the total procedure.
President of the Fertility Society of Australia and New Zealand, Dr Petra Wale, says overseas clinics are exploiting people's desires for sex selection by encouraging Australian families to pay more for the procedure than they should.
"There's a cost there that's quite extraordinary when you see it … that's just another example of someone taking advantage of the process," Wale said.
In contrast, IVF Australia quotes about $6000 in out-of-pocket costs for a first cycle of IVF treatment.
Ethical dilemma
When doing the sex selection process, a couple can end up with embryos that aren’t the desired sex. This is when patients can be faced with an ethical dilemma, according to Melbourne-based fertility specialist Alexander Polyakov.
"You have the other embryos that are stored that are the opposite gender of what you want … then there is a question of, is it ethically permissible to discard those embryos based just on the gender?" he said.
US-based IVF clinics quote anywhere from $30,000 to $45,000 for the total procedure. Source: Getty / Getty Images
"The increase is driven mostly by the public's awareness that this is actually technically possible and can be done, but is not legal in Australia … another factor is that the size of a typical family is decreasing as people have fewer children at an older age."
He thinks sex selection should be legal in Australia for family balancing.
"If someone has two or three children of the same gender, then want an opposite gender, I don't see anything particularly wrong with that," he said.
Bernadette Tobin from the Plunkett Centre for Ethics at the Australian Catholic University believes IVF sex selection commodifies childbirth.
Fertility specialist Alexander Polyakov says more Australians are inquiring about IVF sex selection.
"Almost inevitably embryos will be created and then deliberately discarded … the inherent worth of these human embryos will be violated."
She is concerned legalising the process in Australia could cause a sex imbalance in society.
"Cultural preferences, as known in some other countries, for children [generally males], will be further introduced into Australia … preferences which fail to recognize the equality in worth of every human being, regardless of sex, age, ability, health," Tobin said.
In patriarchal societies such as India and China, the preference for male children has led to the misuse of medical technology, mostly via selective termination of female foetuses.
Polyakov isn't concerned that legalising sex selection in Australia would have negative effects on sex balancing.
"This is expensive and quite labour intensive as well — so on the population level, I don't believe that gender balancing will be affected at all because only a very, very small minority of people would want to do this," he said.
Doing sex selection yourself
A 2018 report from Reproductive Health, a peer-reviewed academic journal, found that 14 per cent of 1267 random Australian respondents believed IVF sex selection should be legal for "family balancing" for a second child, and 19 per cent for a third child.
Teghan Polglaise now has a five-month daughter.
She is aware of patients who have "desperately" tried to do their own sex selection "and are forced in the current climate to do so", by getting pregnant naturally and terminating when they find out the sex.
Now with a five-month-old daughter, Polglaise says she has no regrets about going to the US for sex selection and says her family would have been smaller if they hadn’t.
"I said to my husband that I would've quite happily stopped at three if we weren't going to do it. And then I would've just complained the rest of our lives."
