For many couples, family balancing is part of family planning. They want to have a family that includes at least one son and one daughter. Historically, couples often had large families for several reasons: secure methods of contraception were unavailable, infant mortality was high, and gender balance in offspring was desired. In modern times, with secure means of contraception available and infant mortality no longer a pressing concern, many couples are content with much smaller families, but may still want to have some control over offspring gender.
Fortunately, for couples who want a child of each gender, family balancing has become less of a guessing game and more of a scientific certainty. Medical interventions have been developed that make it possible, in many cases, for parents to decide in advance on the sex of their offspring, and not to feel pushed to create a large family in order to produce a child of a particular sex.
In some countries, and in some cultures, there is a bias, both for financial and religious reasons, toward producing male offspring. Family balancing based on such reasons raises moral and ethical concerns. In certain countries where it is common, such as China and India, family balancing through artificial means has been legally banned, though it continues to take place. In the United States, family balancing through medical procedures is entirely legal. Assisted reproductive technologies (ART), such as preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS), can be readily performed in a medical laboratory after conception has taken place.
Although legal in the United States, family balancing must be given careful consideration because of its medical complexity and cost. For a couple seeking to balance their family, there are several steps involved:
- Consultation with a fertility specialist
- In vitro fertilization
- Preimplantation genetic screening/diagnosis
- Embryo transfer
The steps involved in family balancing, though time-consuming and costly, often lead to satisfying outcomes for the couples involved.