Couples rely on IVF to have baby boys

The couple, both 34 and from the northern Vinh Phuc Province, say they have been unlucky in that all five IVF attempts failed either to faulty embryos or a faulty Y (male) chromosome.

Thao married her husband in 2010 and their first child was a girl. With her husband being the oldest son, the expectation is that she, too, will produce a male heir.

When they decided to have a second child, they opted for IVF, which works by combining a woman's egg and a man's sperm in a laboratory to create an embryo. It also enables sex selection before the embryo is implanted in the uterus.

Mai Huong and her husband, both of whom work for the government, also had a girl child and decided to shell out more than VND100 million (over $4,000) for IVF to have a son.

"I don't want to be a topic of discussion for not bearing a son for my husband's family," she says.

The women with vastly different educational, economic, and social backgrounds were all coerced into giving birth to a son.

Many other Vietnamese women too find themselves in a similar situation.

Two boys the northern Thanh Hoa Province in 2019. Photo by VnExpress/P.D

According to a 2020 report by the United Nations Population Fund (UNFPA), Vietnam is among the three countries with the greatest sex ratio imbalance at birth along with China and India.

Son La, Hoa Binh, Bac Giang, Hung Yen, Ha Nam, and Ba Ria - Vung Tau provinces have a sex ratio of more than 120 boys for every 100 girls.

According to a 2014 report by the General Statistic Office, married couples who are better educated and economically well-off are more likely to desire sons.

The preference for male children has existed in Vietnam for a long time and is the primary source of the sex ratio imbalance at birth.

Recent changes have also contributed to this phenomenon like low birth rates and sophisticated and easily accessible reproductive technologies.

If one wanted to undergo IVF until a decade ago, they had to travel to Thailand or Singapore and spend billions of dong. In recent years IVF techniques and technologies have progressed enormously in Vietnam.

The cost of IVF at more than 40 institutions and hospitals in the country that offer the procedure is VND70-100 million, or only equivalent to 20-25 percent of the cost in other countries.

Since 2017 Vietnam has had the highest number of IVF procedures performed annually in Southeast Asia.

For instance, in 2019 some 35,000 were done in the country.

It is unclear how many of these cases involved sex selection, but the use of IVF to give birth to a boy is a hot topic on social media, with people listing reliable IVF centers and doctors and even talking about what coded language to use so that the medical staff understand that one wants a son.

According to Ha Thi Quynh Anh, a UNFPA specialist on gender and human rights, the mentality of desiring males and degrading girls has had severe implications.

According to the 2020 World Population Report, the long-standing preference for boys in Vietnam’s society terminates 40,800 baby girls before they are born every year.

According to estimates, if the sex ratio at birth continues to remain unchanged, Vietnam will have a surplus of 1.5 million males aged 15-49 by 2034, and more than 2.5 million by 2059.

If this scenario plays out, Vietnamese men will almost certainly have to seek brides like China and India.

UNFPA regional director for Asia and the Pacific, Bjorn Andersson, said at a conference in Vietnam in early October that around 140 million women are believed to be "missing" around the world as a result of the preference for sons and gender-biased sex selection, which is a pervasive form of gender inequality and discrimination.

He said it is critical to recognize that sex selection based on gender stereotypes is largely a problem of gender inequality and violates women's human rights.

Sex inequality has occurred in China, South Korea and India, and governments there have taken numerous initiatives to bring the birth rates of boys and girls closer to parity.

Mai Huong is pregnant with her second baby girl. Photo courtesy of Huong

Many measures have been taken in Vietnam too to combat gender imbalance, including a fine of up to VND20 million for using tools, drugs or applications to determine the sex of the fetus and researching into methods to select the sex.

Thao and her husband were unhappy after seven years of IVF treatment to conceive a son and spending up to VND1 billion.

She says: "I could not believe it when I took a test in my ninth week of pregnancy and discovered I had a son. After five failed IVF attempts, it feels better than winning the lottery now that I have naturally conceived a son."

Thao is now in her fifth month of pregnancy.

As for Huong, she was told to see a fortune teller after her IVF procedure failed. She was greatly relieved to hear the man say giving birth this year will increase her chance of having a son.

However, an ultrasound at 12 weeks showed that the baby was a female.

She says: "We are not sad after learning about the baby's sex and have stopped caring about what people say. All we need is a healthy baby to be born."