Israelis Now Visit the West Bank to Pick Their Next Baby's Sex

Israel has a special committee couples can apply to if they’ve had four children of the same sex, but West Bank clinics make the service available to anyone who can afford the few thousand dollars

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In vitro fertilization. The Palestinian Authority still uses Jordanian law left over from the Jordanian presence in the West Bank.
In vitro fertilization. The Palestinian Authority still uses Jordanian law left over from the Jordanian presence in the West Bank.Credit: AP

“I wanted a brother for my firstborn son. We tried the natural way, but then I had three girls and I didn’t want to gamble and get pregnant a few more times. I wanted a guaranteed result and a final pregnancy.

“So I tried this process in Nablus. They do in-vitro fertilization for three male embryos to increase the chances that one of them will get implanted. And in my case, all three did, so now I have three more sons.”

This is how a 29-year-old woman from northern Israel, who requested anonymity, described to Haaretz 21 the process of choosing the sex in her latest attempt to get pregnant; she did it at a clinic in Nablus in the West Bank about two years ago.

Since this procedure is controversial both medically and ethically, only a few couples are eligible in Israel, and a special committee must grant approval. But in the West Bank the treatment is now available to everyone, and people pay privately.

An IVF procedure at Sheba Medical Center near Tel Aviv. Credit: Moti Milrod

In recent decades, technology has made possible the choosing of the newborn’s sex, provoking ethical questions, especially because many patriarchal cultures prefer males.

Thus in 2005 the Israeli Health Ministry established a committee to examine requests. Among Israel’s preconditions, a couple must have at least four children of the same sex and emotional problems stemming from this result.

According to the committee, in the first decade of its existence there were 784 requests to choose the baby’s sex, about 70 percent from Jews and 30 percent from Arabs. About 70 percent of the requests, and all the requests from the Arab couples, were for a boy.

According to the committee, 394 requests came in between 2018 and 2020, with 262 requests for a son. Only 70 were approved, though the panel didn’t say how many for each sex. Each request needs about two to three months to be handled.

An IVF syringe at Shaare Zedek Medical Center in Jerusalem. Credit: Ohad Zwigenberg

Looser laws

On the other hand, there are no clear directives on the subject under the Palestinian Authority, which in many spheres still uses Jordanian law left over from the Jordanian presence in the West Bank from 1948 to 1967. In this way, couples can bypass both the regulations and the Israeli committee and receive treatment there.

“Even in the best case, if approval is received from the committee, the cost of treatment in Israel is high, while the cost of the same treatment in Nablus ranges from 7,500 to 17,000 shekels [$5,270] including all the medication and the syringes,” says another mother from the north. She has four daughters and recently began treatment at the Dima Center for Infertility and IVF in Nablus, hoping to have a son.

“The process there is simpler,” she adds, and many women note the long wait for approval from the Israeli committee, another incentive to visit a West Bank clinic.

An incubator required in the IVF process, at Sheba Medical Center near Tel Aviv. Credit: Moti Milrod

Another woman from the north, a 27-year-old mother of four daughters, doesn’t suffer from fertility problems but also underwent IVF in Nablus to choose the sex of her next child. She says she wants to keep her family relatively small due to financial problems, and choosing the next child’s sex helps her do this.

Sociologist Himmat Zoubi believes that many Palestinian women are under great pressure to have boys, even at the price of risky treatment. But this situation isn’t unique to Palestinian society, as seen in the figures for requests to the Israeli committee. Zoubi says the Palestinian and Israeli societies share a similarity when it comes to encouraging birth: Both enlist the health system.

Islamic law

Another clinic that offers services for choosing the baby’s sex, the Razan center, has several branches including in Ramallah, Jenin, Bethlehem and Nablus. However, the health minister and the legal adviser to the Palestinian Health Ministry did not reply to queries on the legal framework under which these fertility centers operate.

According to one patient, according to Islam, “There’s a fatwa that constitutes religious approval, and ... choosing the baby’s sex is permissible. It’s enough to come to the center with a marriage certificate.”

On the other hand, Mahour Fawaz, the head of the Palestinian Islamic council responsible for fatwas, published the following fatwa in November: “The sex of the fetus should not be determined by medical intervention unless an illness has been discovered ... or if there will be serious harm in having a natural birth.”

He added, however, that such intervention is possible “if there are sterility problems, and on condition that the sperm is from the husband and the egg is from the wife, and the fertility process takes place in the woman’s uterus.” In other words, the subject appears to be controversial in terms of religion as well.

According to an official at the Dima Center for Infertility and IVF in Nablus, “Treatment is composed of four meetings. The woman must come to the center on the second day of her period to undergo general tests. After that she receives injections that strengthen and improve the quality of the eggs.

“During the second meeting we examine the success of the injections via ultrasound. At the third meeting there is surgery to retrieve the eggs and fertilize them in a laboratory; then we choose the embryos of the desired sex and return them to the uterus. The success rate for implantation is 80 percent and for getting the desired sex, over 90 percent.”

The Razan center did not reply to requests from Haaretz 21 by phone, but in an automatic reply on Facebook it said the process would take five meetings, with the success rate for embryo implantation at about 50 percent.

All told, Palestinian women in Israel and the West Bank are aware of the many medical, ethical and religious questions surrounding the process, but it helps them plan their families and keep their marriages harmonious, an issue they say is no less important for them.

Fatima Omar Khamaisi is a member of the Haaretz 21 initiative to promote voices and stories from Arab society in Israel.

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