By Dr Edward Tamale-Sali

When God created living things in the beginning, He created a male and a female (Genesis 2:18). The male came into being with a potential to prove a male seed and the female to provide a female seed.
These two seeds once fused together, they replicate or propagate that particular species. This is the way God made it and this is the science or biology of it. We cannot change it.
It is good. If it were not made this way, there would not have been any existence of both the animal and plant species.
God is the Maker of science and we are just learning exactly how He made things into existence. We are actually scratching the tip of an iceberg to say it simply!

Giving birth

When a woman gives birth, the first question she usually asks the midwife, or the birth attendant who is at the end of her body is: What is it?
A boy or girl? Then the midwife answers or affirms what she has seen. In about 99.9 per cent the midwife has only two alternative answers.
She will say: “It is a girl, madam. Congratulations!” Or: It is a boy, madam. Congratulations!”
In 0.1 per cent she may hesitate to give an answer, and will not congratulate the mother when there is an ambiguity in the genitals of the baby.
Thank God it is rare but it does happen. In future we can take this up in greater details and discuss it. But let’s return to the 99.9 per cent where we are sure about the baby’s gender.

The male sperm

In human beings as well as in the animal kingdom, the sperm factory (testis) produces both a male (boy) and female (girl) making sperm.
These sperms are produced in large quantities in millions per hour. A normal sperm count in a man is about 20 million/ml or a teaspoonful.
Normally a man will produce 3-5 teaspoonfuls per ejaculate. This works out about 60-100 sperms produced per ejaculate.
In theory, this man can produce the entire population of Uganda, Kenya and Tanzania if there was a chance to do this. This is how God made these things and it is amazing (Psalm 139:14-15).

In the illustration above, the white seeds (X) represent the female spermatozoa; whereas the black seeds (Y) represent the male spermatozoa. The male sperms are a mixture of boy and girl spermatozoa.
The white seeds in the illustration represent the egg (seed of a woman). These eggs are produced by the ovaries. The seed of a woman has only X (rib) chromosomes. Making of human being is the union of X or Y sperm from a man and X (rib) chromosome from a woman. The egg of a woman is always X

Adam’s rib

Most of you must have read, in the Bible, that in the beginning God first created a man. This man’s name was Adam. He lived alone for a long time till God, decided to make him a wife (woman).
God took Adam to His operating theatre, made him sleep (first surgical operation ever recorded) and removed a rib, which eventually became Adam’s wife.
God called this being Eve, and He gave her to Adam (Gen 2:21-25). He told Adam that Eve was his wife.
God went on further to make it very clear in verse 24: “Therefore shall a man leave his father and mother, and shall cleave unto his wife and they shall be one flesh”.
It was God’s idea to institute marriage between a man and a woman and no other ways or combinations that we see today among human beings. Outside this God-enacted constitution of marriage, other unions become a sin.
It is a sin to have a union between a man and a man or a woman and a woman or between a man and a dog, and so on.

Meaning of the rib

Now we know that what God removed from Adam was what we know as an X chromosome.
As we know today, the man carries XY sex chromosome and the woman only XX sex chromosomes.
I do believe this. As explained above the man carries boy and girl sperms.

Parents can now choose the sex of their next child using gender selection

Man determines gender of babies

Based on the above facts, it is the man who determines the gender or the sex of his offspring.
It is not the woman. If a boy-carrying sperm fuses with the egg (which is always X, then the resultant offspring will be XY – a boy. On the other hand, if the sperm is a girl-carrying sperm (X) this will be XX – a girl.

Women punished for producing only girls

In many communities in the world, blame is on the woman for producing only one set of gender.
In some of these communities, if a woman kept on producing girls only, it could lead to marriage dysfunction, and occasionally, a divorce.
This particular man then goes out and tries other woman in search for getting a boy. Because of ignorance of science, this particular man blames his spouse or wife for nothing. It is also true that some kingdoms have disappeared because of this controversy or ignorance of this science.

How science can help where nature fails

This science is called Pre-Implantation Genetic Diagnosis or Screening (PGD/PGS).
This is like selecting white or black seeds only from a mixture of black and white seeds and you want to plant a particular colour.
This is what we also do in determination of a certain gender/sex. Since we know, that it is the man who determines sex because of his capacity to produce both X and Y sperms, it becomes very easy for us to determine the sex through the science of IVF and embryology.
In IVF we can make embryos. The union of a sperm and an egg makes embryos.
When we are doing this, we do not know if that particular sperm is a boy or not.
This is still a mystery. God has hid this. So what we do, we make embryos? These embryos are potential human beings.
I need to point out that not all embryos become human beings. Some of these embryos are defective and therefore do not progress to become human beings.
With the embryos which continue to grow, we can take a biopsy and determine if that embryo is a boy or girl or sickle cell affected or any other single gene disease condition it may have. This is amazing.
We have been doing this at Women’s Hospital International & Fertility Centre in Bukoto for more than 15 years.
It has brought happiness in many families and many marriages which were on ‘rocks’ have been saved. We transfer the selected embryos into the woman’s uterus, knowing what we are planting.
If that woman became pregnant, the accuracy of getting what they wanted is 100per cent. We have never got it wrong among over 100 patients we have handled in sex selection.

Indications for sex selection

Before I give some of these indications, we need to point out as I mentioned above, that it was God’s idea of creating a man in the first place, and then a woman at a later date.
If God wanted to give Adam a companion, He would have created another man and called him, John, for example. But He did not do this.
He also did not create a woman independently. But He removed a rib from Adam. This rib is the genetic material. He used this to create a woman.
So both the man and the woman would have similar characteristics genetically. He balanced the family at 1:1 ratio.

Balancing the family

There are couples that have had one single gender for example boys or girls and wish to balance this.
This is natural and is not a sin or wrong to do it. It is their choice and is a good idea.
I have come across many couples who have had eight girls in a row. When this happens, the obvious thing is to try to balance the gender.
In theory if they continued having more babies, they will get a boy since the sperm of the man contains boy and girl sperms in a ratio of 1:1.

Want a boy

In some communities, especially in Africa, Middle East and other parts of Asia, a man is regarded as the head of a family.
This is also biblical. In the event the father died, he would like to leave behind an heir who will continue the lineage of that particular family, look after the business, and so on.
Also a man in these communities is regarded as the defender from dangerous animals such as lions. But these arguments are on the decline.

Sex linked disorders/diseases

There are certain diseases that tend to affect one particular gender, for example: Haemophilia, a common Y linked disorder in male infertility, Red-green colour blindness, Duchenne muscular dystrophy, Fragile X, and Male pattern baldness.


In some countries, gender selection is banned because of misuse and discrimination or preference for a particular gender.
This has led in some of these couples to carry out abortions in preference to a particular gender.
I think that governments in some of these countries are quite right to ban this treatment because of criminal involvement by some people. In Europe, one consideration is that women and men are equal and what a man can do a woman can also do. This is also correct in these developed countries.

Our clinic policy

In our clinic, we will only undertake such a request, if the couple wanted to balance their family. We do not do it for a couple that have never had children and only want a certain gender.
Our next issue will be on Sickle Cell Disease, and how we can get sickle cell free children using similar technology.

Be blessed.
Fertility Specialist/Gynecologist


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