John and Kristen Magill of Grafton, Mass., have what you'd call a full house: They have three girls and twin boys who are about to turn 1 year old.
The Magills conceived their daughters naturally, but with sons Patrick and John III they entered a brave new world.
They were actually able to select their babies' sex.
"I always wanted a boy to, you know, play sports and stuff with, you know," John Magill said. "Not that I mind the girls. We love the girls, you know, and wouldn't trade them for anything. But you know, we just always wanted both."
The Magills had their sons through a process called pre-implantation genetic diagnosis. The procedure requires in vitro fertilization because embryos are screened for their gender before being implanted in the womb.
"I feel my family's complete," Kristen Magill said. "And I won't look back 10 years down the road [and say], 'I wish we'd tried to have a boy.' "
Designed to Screen for Genetic Disorders
But PGD was not originally created to help couples like the Magills. It was developed to help people like the Rinaldi family, who are prone to genetic disorders.
"If it wasn't for this procedure, I really believe we wouldn't have a baby," Diane Rinaldi said.
PGD tests embryos for disease by looking for defective chromosomes. This helps couples prone to miscarriage or who carry genetic diseases to have healthy babies. But PGD also can screen embryos for gender, which is how the Magills had their twin boys, with the aid of Dr. Jeffrey Steinberg's Fertility Institutes.
"We're coming up on 2,000 couples now that we've done PGD on," Steinberg said. "Eighty-five [percent] to 90 percent of those couples have done it simply for gender selection. And we're coming up on close to 940 babies."
There are no exact numbers on how many couples are doing this, but it's probably very low because of the high cost -- $18,000 for just one try. Also, the process requires IVF whether you are fertile or not, which turns off some interested couples.
There are other methods of trying to choose your child's gender, like Microsort's experimental sperm sorting program. But nothing has the nearly 100 percent success rate of PGD.
Gender Selection Controversy
This new use of PGD does not please one of the pioneers of the procedure, Dr. Mark Hughes, director of Genesis Genetics Institute in Detroit.
"I went into science and into medicine to diagnose and treat, and hopefully cure disease. And the last time I checked, your gender wasn't a disease," Hughes said.
Gender selection has been largely banned in a growing number of countries, including France, Canada, England, Australia, Japan and Germany. But the practice is unregulated in the United States, and American attitudes are mixed.
"About 40 percent of Americans approve of using genetic testing of embryos to pick the sex of their future child when it's not related to medical conditions," said Kathy Hudson, director of Genetics and Public Policy Institute in Washington, D.C.
Kristen Magill says she's not ashamed she chose her sons' gender.
"I think it's a good opportunity for a family in the same situation as us," she said.
Kristen Magill's friend, Bobbi Driscoll, has three boys and is considering trying PGD to have a baby girl.
"I'm just so excited I think it completes their family," Driscoll said. "Right now, I just still feel a void. Maybe over time it will pass or we'll decide to do something."