Vietnamese people go abroad to choose the sex of their fetus. In the photo: a doctor from a hospital in Thailand gives advice and simulates the process of IVF to choose the sex of the fetus – Photo: TRUC QUYEN
Tuoi Tre reporters spent many days traveling from the South to the North, even to Thailand - a place called "the industrial center of human creation" by fetal sex selection brokers - to find the answer to the question: Why is the gender gap at birth in Vietnam still at an alarmingly high level?
Watch the series: The pain of choosing the sex of the fetus
Vietnamese law strictly prohibits the act of choosing the sex of a fetus, but why does this painful situation still occur?
Tuoi Tre 's verification shows that there is a "market" for reproductive support, providing services for choosing the sex of fetuses, operating quietly.
With the "assistance" of professionals, many couples easily achieve their wishes by openly expressing their desire to have a "baby like the father" (boy) or a "baby like the mother" (girl).
Source: General Statistics Office; Ministry of Health and results of implementing national gender equality goals in 2023 in localities of the Government (unit: number of boys/100 girls) - Graphics: N.KH.
Ho Chi Minh City: "Anything can be done"
According to research, with a price of only 200 - 250 million VND, many obstetricians at clinics and hospitals in the country are willing to provide IVF (in vitro fertilization) services, along with fetal gender screening for couples in need.
From a Facebook page called “IVF Saigon – high-tech infertility treatment”, we contacted for advice on IVF, choosing to have a son. A staff member confirmed that “this is a sensitive issue, online consultation is not possible”, and asked us to come directly to the address on Ly Chieu Hoang Street, Ward 10, District 6 for further consultation.
On the afternoon of January 5, when we arrived at this address, we were quite surprised to find that this was a newly established private reproductive support hospital, ranked as “basic level” by the Ho Chi Minh City Department of Health in the recent review of technical expertise.
After completing the procedures, we were led to examination room number 108 to meet Dr. HCC (on the hospital's website, this doctor is introduced as the medical director). Before the consultation, this doctor asked us to turn off our phones, not to record or videotape.
Understanding the need to do IVF to choose to have a son, Mr. C. immediately said: "Stop talking about boys and girls, everything can be done, actually there is nothing to it."
Doctor TTT advises patient on choosing the sex of fetus - Photo: DAN THUAN
He then transferred us to a staff member for a price quote. Accordingly, the total cost of the IVF service to have a child as desired is 250 million VND, calculated from the time of the first embryo transfer.
The Facebook page named “Obstetrics Clinic – Specializing in IVF…” also “bordered” on choosing the gender of the fetus. Once again, the consultant said “it’s not convenient to say much” and invited them to the clinic for a doctor’s consultation.
On the afternoon of January 7, we arrived at the clinic on Tran Binh Trong Street (District 5). At that time, there were many patients waiting for Dr. TTT. When he learned about the customer's needs, Dr. T. said "this is banned in the country", but then still agreed to do IVF to choose a boy with a commitment of a success rate of 70 - 80%.
Surprisingly, after a while of consultation, Dr. T. “revealed” that except for the examination and ovarian stimulation which would be performed at the clinic, the egg retrieval, embryo creation, culture and transfer would be performed at the reproductive support hospital (District 6). This was also the hospital that we had approached before.
Here, the cost from the start of the procedure until the first embryo transfer is 250 million VND, with 4 embryos biopsied. Of which, the IVF cost is 150 million VND, and the embryo biopsy to choose a boy or girl is 100 million VND.
“Actually, it’s cheaper to do it here now, a few days of doing it in Hanoi is 450 million VND. We sent it to Hanoi to do it, now there are too many people, they do a lot of poor quality” – Doctor T. urged us to do it quickly.
Many patients in the waiting area also said that the reason for choosing this clinic to “give trust, exchange hope” was because Dr. T. was very famous in the press and on social networking sites with the ideal of breaking the piggy bank to build a cheap clinic for poor infertile workers.
The gender ratio at birth in some provinces and cities is up to 120 boys/100 girls - Source: General Statistics Office; Ministry of Health and results of implementing national gender equality goals in 2023 in localities of the Government (unit: number of boys/100 girls) - Graphics: N.KH.
Hanoi: openly done at the hospital
Unlike in Ho Chi Minh City, in Hanoi, couples are quite open in expressing their desire to choose the gender of their child when performing IVF, and can even do it right at major hospitals.
Present at a hospital in Hoang Mai district on December 17, 2024, we were received by a CTTH doctor. “The main purpose of the IVF we are doing is not to choose the sex of the fetus, that is a violation of the law, even if you are pregnant, I am an ultrasound doctor and revealing the sex of the fetus can result in having my license revoked and being fined.”
However, this doctor advertised that the hospital was implementing a technique to screen embryos for some chromosomal abnormalities and said that this was the technique that customers were "desiring".
“That means in the sea of embryo abnormalities, I will circle a tiny area called the “chromosomal abnormalities” area and I will examine that area. From that result, I can accidentally know the gender of the embryo,” Dr. H. advised.
Doctor H. advises that new technology being applied can answer the question of the fetus's gender - Photo: DAN THUAN
In response to concerns about the accuracy rate when performing the chromosome survey process, Dr. H. explained: “After the examination, the results will have three situations: the first is that the embryo is abnormal and cannot be used, the second is that the embryo is normal like the mother, the third is that the embryo is normal like the father. These three possibilities can all come to us at a very random probability. The rate is hard to say, but usually only about 10% are not as expected.”
Also according to Dr. H., during the process of screening embryos to see if they are “like the father” or “like the mother”, at this point, the hospital will “answer” the patient about the gender of the embryos.
“According to the law, when the hospital holds the results and knows the gender, they are not allowed to inform the patient of the gender, it is forbidden. However, at this time, if… the gender is known, it can still be answered,” Dr. H. suddenly lowered his voice.
The cost of performing a full package of IVF services and embryo sex screening at this hospital ranges from 150 to 200 million VND for a smooth process. Of which, the cost of sex screening for each embryo is 10 million VND and couples who want to use this technique must be legally married.
After the consultation, we asked Dr. H. again about whether IVF at the hospital could choose the sex of the fetus. The doctor clicked his tongue and blamed us for not understanding: "You still don't understand what I'm saying. At this point, it's still possible," Dr. H. said.
Continuing to find a large fertility support center in Hanoi, we were warmly welcomed by a sales staff named BL.
Before that, from Ho Chi Minh City, we received a phone call from L., instructing us on how to speak "subtly enough" so that doctors could easily support us.
“You shouldn’t say from the beginning whether you want a boy or a girl, because it’s against the rules. If you happen to be a reporter or something, it will affect their career. Don’t say that (choosing a boy or a girl – PV), I will guide you on how to talk to the doctor tactfully enough so that they can easily support you,” BL advised.
Accordingly, BL instructs that when talking to doctors, just avoid saying "ask for embryo screening, choose a healthy baby" and the doctors will understand.
On the morning of December 17, we were scheduled to meet the IVF doctor of this center. This doctor advised the client to prepare mentally because that “desire” (to have a son) may not be able to get the “desired” embryo until the end.
Leaving the consultation room, we were immediately informed that Dr. L. agreed to do the procedure (ie, do IVF to choose the baby's gender as a boy) and quoted the price of the IVF service (including embryo screening) ranging from 218 - 238 million VND.
“With this price range, the number of embryos specified for screening is 5 embryos. If the customer does not need to screen the embryo's gender before transfer, the cost is lower, ranging from 150 - 172 million VND,” BL said.
Source: Ministry of Health – Synthesis
The right to life of the fetus
In Vietnam, the rights of fetuses are not as clearly defined as the rights of a born human being. However, the law and ethical concepts still show respect and protection for fetuses through the right to life, the right to inheritance and the right to health care.
* Vietnam Constitution 2013: the right to life is a basic right of every human being. Although there is no specific provision on fetuses, Vietnamese social ethics and traditional culture promote life, including fetuses.
* The 2015 Civil Code (Article 13) stipulates: “A fetus enjoys civil rights when it is born and alive”. This means that the fetus is recognized for its rights from the time it is in the mother's womb, as long as it is born alive.
* The 2015 Civil Code (Article 660) stipulates: a fetus has the right to inherit property if the testator dies before the child is born. This right is reserved until the fetus is born and alive.
* Vietnamese law encourages pregnant women to protect their pregnancy and avoid risks that affect the development of the fetus, and discourages abortion based on gender discrimination or unethical reasons.
Source: Ministry of Health – Synthesis – Graphics: N.KH.
Gender selection of fetuses in any form is strictly prohibited.
Clause 2, Article 7 of the 2003 Population Ordinance strictly prohibits gender selection of fetuses in any form.
Article 10 of Decree 104/2003/ND-CP stipulates that it is strictly forbidden to propagate and disseminate methods of creating fetal sex in the form of organizing talks, writing, translating, duplicating books, newspapers, documents, pictures, photos, video recordings, audio recordings; storing, circulating documents, means and other forms of propaganda and dissemination on methods of creating fetal sex; diagnosing to choose fetal sex by means of determining through symptoms, taking pulse, testing blood, genes, amniotic fluid, cells, ultrasound...
Clause 3, Article 99 of Decree 117/2020/ND-CP of the Government stipulates the level of administrative sanctions for violations in the medical field such as the act of prescribing or instructing the use of drugs to obtain the desired fetal gender; providing tools, drugs, and supplies to obtain the desired fetal gender; researching methods to obtain the desired fetal gender (except in cases permitted by law) will be fined from 15 to 20 million VND.
In addition, a medical facility that commits one of the above acts shall be subject to an additional penalty of suspension of operations for 1-3 months. A person who commits one of the above acts shall have his/her medical practice certificate revoked for 1-3 months. The remedial measure is to force the destruction of the instruments, drugs, and supplies used to commit the act of providing instruments, drugs, and supplies to obtain the desired gender of the fetus.
When did Vietnam have gender imbalance?
The latest statistics from the Department of Population (Ministry of Health) show that Vietnam began to experience a gender imbalance at birth since 2006, when the sex ratio at birth was 109.8 boys/100 girls (the natural sex ratio at birth fluctuates between 104 - 106 boys/100 girls).
Although the rate of increase in the sex ratio at birth has been controlled, it is still at a high level, from 2012 to now it has always been maintained at over 112 boys/100 girls (the figure in 2023 is 112).
This ratio is particularly on the rise in some provinces in the Red River Delta. And if the gender imbalance at birth remains as high as it is now, it is estimated that Vietnam will have a surplus of 1.5 million men by 2034 and increase to 2.5 million by 2059. This will leave unpredictable consequences for the economy, society and political security.
Source: Ministry of Health – Synthesis – Graphics: N.KH.
Reducing Gender Gap:
Many solutions, results are not as expected
In recent years, the Ministry of Health, specifically the Department of Population, together with the United Nations Population Fund (UNFPA) have coordinated with many agencies and localities to organize many seminars to provide information on the consequences and implications of gender imbalance at birth and measures to control and prevent it.
Recently, at the discussion session in the hall (7th National Assembly session on May 29, 2024), delegate Hoang Thi Thu Hien (Nghe An) raised the issue of increasing gender disparity at birth as the clearest manifestation of gender inequality.
To better control, this delegate proposed that it is necessary to supplement legal regulations to ensure the feasibility of controlling gender imbalance at birth, and to comply with legal regulations prohibiting gender identification and gender selection at birth at medical facilities. However, this situation is still increasingly alarming.
Regarding solutions, since 2016, the Prime Minister has issued Decision No. 468 approving the project "Controlling gender imbalance at birth in the period of 2016 - 2025", with the goal of effectively controlling the rate of increase in the sex ratio at birth, moving towards bringing this ratio to a natural balance; the goal in the period of 2016 - 2020 is to reduce the rate of increase in the sex ratio at birth to below 0.46 percentage points/year so that this ratio is below 115 by 2020.
However, according to the Department of Population (Ministry of Health), after 8 years of implementing Project 468, the rate of increase in the sex ratio at birth has been controlled but is not stable and is still high compared to the natural balance. On average, it decreases by 0.03 percentage points per year (the sex ratio at birth in 2016 was 112.2 and by 2023 it will be about 112).
Recently, in the draft guidelines for implementing population work in 2025, the Department of Population determined to set a goal of reducing the gender imbalance at birth to 111 boys/100 girls.
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Read next episode: Identifying the "boss" of brokers
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