'I decided my child's sex over the phone': Why parents are leaving Korea to get IVF

A woman holds a baby in a nursery at a hospital in Ilsan on Aug 27. [NEWS1]

 
Sohan, a Korean woman in her mid-30s who asked to be identified by an alias, flew to Bangkok, Thailand, in June of last year to get in vitro fertilization (IVF). She'd chosen Thailand in order to transfer a male embryo — gender selection via IVF is illegal in Korea.
 
Sohan and her husband wanted assurance that they would have a son since their firstborn child is a daughter.
 
The couple welcomed a son about 10 months later and became the family they had always envisioned.
 
While Korea is mired in a birthrate crisis — claiming one of the world's lowest figures of 0.75 children per woman in their reproductive years — gender-selective IVF remains strictly prohibited by the Bioethics and Safety Act. 
 

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The current legal framework rendered the idea of choosing a child’s sex a social taboo. However, interests among parents show a different reality.
 
Sohan told the Korea JoongAng Daily last Saturday that she was not the first Korean to have undergone gender-selective IVF abroad.
 
“I first learned about it several years ago because my friend’s relative had tried gender-selective pregnancy in Hong Kong,” said Sohan, who has received many inquiries about overseas gender-selective IVF after sharing her experience on her blog. 
 
Gender selection: tabooed realm in Korea
 

An ultrasound scan after Sohan received a male embryo at a Thai clinic [SOHAN]

 
In Korea, the Bioethics and Safety Act, enacted in 2005, prohibits the fertilizing of eggs with the purpose of selecting a specific sex. Any medical professionals performing gender-selective fertility treatment can face up to two years in prison or a fine of up to 30 million won ($21,640).
 
The ban of gender-selective pregnancy initially aimed to reduce abortions, especially in the 1980s and 1990s, when the preference for sons over daughters was pervasive in Korean society.
 
Under the law, pregnant mothers, including those who received IVF, are mandated to wait until around the 15th week of their pregnancy to find out the sex of their babies based on ultrasound scans.
 
But no legislation bars Koreans from undergoing fertility treatment overseas.
 
Sohan, for her part, has not observed much male favoritism among parents pursuing IVF.
 
“Most people who contacted me were those who already had children,” Sohan said. “They just wanted their next child to have a different sex than their already-born children.”
 
How does gender-selective IVF work?
 

Agreement forms about gender-selective in vitro fertilization in Thailand. Patients undergoing the procedure must sign each copy, prepared in Thai and English. [SOHAN]

 
Unlike Korea, countries such as Thailand, Cyprus and the United States allow parents to decide the sex of a fertilized embryo based on preimplantation genetic testing (PGT) results. PGT examines abnormalities in an embryo.  
 
However, Korean obstetricians tend to withhold gender-related information when notifying aspiring parents of test results, unless they detect signs of hereditary disease.
 
Sohan explained that the medical processes of IVF in Korea and Thailand remain nearly identical, except that parents in Thailand have the ability to undergo three additional stages: screening the embryo for gender, freezing the embryo before implantation and selecting an embryo of a certain sex.
 
Although IVF in Korea can be completed within two to three weeks, Sohan's process took two months. She extracted her eggs in early April of last year and had the embryo transferred in early June.
 
“As it takes time to determine the gender of fertilized embryos, they should be kept frozen until implantation,” Sohan said. “The Bangkok-based clinic informed me of the status on how fertilized eggs are incubated on a daily basis via email, and I decided my second child’s sex over the phone.”
 
Sohan also told the paper that she had paid 450,000 Thai Baht ($14,200) for the gender-selective IVF. A round of IVF in Korea — without choosing the embryo's gender — is approximately 2 million won.
 
She returned to Korea after an injection of the male embryo as a mother expecting a son.
 
In Seoul, she headed to a maternity clinic and told doctors that she had “received IVF overseas and wanted to confirm her pregnancy." She did not reveal details of her procedure.
 
Double-edged sword
 

The image shows how Sohan's fertilized embryos were incubated. [SOHAN]

 
Some Koreans have called for the legalization of gender-selection IVF, contending that it could help boost the country's low birthrate.
 
A 2024 petition submitted to the National Assembly urged the government to permit parents to select the gender of their second child. The petitioner wrote that the uncertainty of having another child of the same sex often discourages parents from having additional children. 
 
The petitioner wrote, “Families with two sons might want their third child to be a daughter and vice versa for those with two daughters.” A total of 442 people endorsed the petition.
 
In online forums in Korea, those who claimed to have siblings of same sex said they would like have a third one of a different sex to bring gender diversity to their families, arguing that mothers can better relate to daughters in some cases as fathers can for sons. 
 
Yet, some sociologists say that gender-selective reproduction is not the right solution for Korea.
 
Lee Min-ah, a sociology professor from Chung-Ang University, warned that the procedure might "medicalize the process of conception and pregnancy." Lee also said that the fundamental cause of Korea’s low birthrate is more related to social factors such as difficulties in raising children.
 
“Korea’s birthrate crisis would not be resolved by giving parents opportunities to choose the gender of their children,” Lee said. “The issues of parenting and gender roles should be addressed with greater weight for the population crisis.”
 
Another sociology professor, Lee Yeon-jin of Kookmin University, also opposed the legalization of gender-selective IVF, adding that it is “unlikely to be the means of reversing the [falling] birthrate.” She noted that IVF done for family balancing had done little to raise births. The professor called on Korea to pursue better balance between work and child care and provide meticulous economic support for pregnancy and parenting as Sweden and France do.  
 
“Gender-selective IVF can leave a impression that the society tolerates sexual discrimination in both directions,” Lee said.
 

BY LEE SOO-JUNG [lee.soojung1@joongang.co.kr]