How Indian couples are spending crores to have a baby boy

“Family balancing” procedures are fertility packages marketed to couples who want a child of a particular sex, especially a boy. They combine IVF with preimplantation genetic testing, which can reveal an embryo’s sex. Surrogacy may be added when the intended mother cannot or does not carry the pregnancy. The practice matters because Indian law does not allow genetic testing to be used for sex selection.

A typical package may begin with hormone treatment and egg retrieval. The resulting embryos are tested, and an embryo of the preferred sex is selected for transfer. Some clinics reportedly ask Indian couples to visit Dubai for only 24 hours for egg retrieval, then return later for the IVF procedure. In Colombia, one client said surrogacy took three to four months.

These services are offered through cross-border reproductive care. Packages can cost ₹15 lakh to ₹1.7 crore, depending on destination and services. Clinics and agents promote them as “family balancing,” sometimes promising nearly 100% success. The demand reflects continuing son preference and the limits of India’s reproductive-law framework.

The investigation found Indian couples travelling to the UAE, especially Dubai, the US, Colombia and Georgia for IVF or surrogacy linked to sex selection. Egypt also appeared as an option for a smaller group. These destinations form part of a growing cross-border reproductive-care market aimed at couples seeking a male child.

Prices vary sharply by country and service. Overseas IVF and surrogacy packages reportedly cost between ₹15 lakh and ₹1.7 crore. A Colombian client quoted in the report paid about $60,000, or roughly ₹57 lakh, for a surrogacy process lasting three to four months. In Georgia, gender selection was quoted at $16,360.

The US price for comparable gender selection was quoted at $33,760, making Georgia more than 50% cheaper on those figures. Clinics may also structure treatment around short visits, such as a 24-hour Dubai trip for egg retrieval. Travel, treatment and surrogacy arrangements are packaged together.

The demand is substantial enough to draw Indian clients to clinics across several countries. The investigation found dozens of prospective parents travelling abroad, particularly from Indian metropolitan areas. One New York fertility provider said at least 100 Indian couples visit his facility each month for IVF or surrogacy, with at least half choosing gender selection.

Dr Deepak Gulati said these clients mainly come from Delhi, Mumbai, Chennai, Bengaluru and Hyderabad. Clinics in Dubai and Colombia also promote “family balancing” packages through websites, Instagram videos and reels. Sources said agents in India help find clients and negotiate treatment deals. The reported demand is therefore supported by both direct clinic marketing and local intermediaries.

The preference for sons sits within a wider demographic imbalance. India’s sex ratio at birth was 929 girls for every 1,000 boys in NFHS-5, covering 2019-21. The article links the overseas market to this continuing male-child preference, which practitioners say remains strong among some wealthy families.

Clinics abroad can offer embryo sex selection because the destinations described in the article permit PGT-A to identify an embryo’s sex. Their rules therefore allow providers to combine embryo testing with IVF or surrogacy for “family balancing.” The article does not list each country’s specific statute, but it identifies the regulatory difference between these destinations and India.

In India, PGT-A is legal, but its use is strictly regulated. It may be used to detect chromosomal abnormalities, not to choose whether a baby will be male or female. Couples seeking a male child therefore travel to places where clinics advertise this service openly. The treatment can involve embryo testing followed by transfer of the selected embryo.

This legal contrast helps explain the growth of cross-border reproductive care. Indian couples can access the technology at home for medical purposes, but not for sex selection. Overseas clinics market the prohibited use as part of costly packages, creating a route around India’s ban for families able to pay.

Preimplantation genetic testing for aneuploidy, or PGT-A, examines embryos created through IVF before one is transferred for pregnancy. The article describes it primarily as a test for chromosomal abnormalities. It also says the test can identify an embryo’s sex, making it central to overseas “family balancing” packages.

The process works by creating embryos through IVF, testing them in the laboratory, and choosing one for transfer. Where local rules permit sex selection, clinics can use the test results to identify a male or female embryo. Some packages add surrogacy, allowing another woman to carry the selected embryo. The article does not provide laboratory details beyond this testing-and-selection process.

India permits PGT-A, but only within strict limits. It may detect chromosomal abnormalities and cannot be used to choose a baby’s sex. In contrast, the destinations described permit its use for sex identification. That difference helps drive wealthy Indian couples abroad, despite costs reaching ₹1.7 crore.

India’s assisted-reproduction and surrogacy rules are part of the explanation for treatment abroad. A Hyderabad-based fertility expert said the 2022 ART law, introduced to curb commercial surrogacy, has added complexity. He argued that this complexity drives even genuine cases outside India, while access to a male child becomes an additional attraction.

Overseas clinics then make the journey easier to buy. Clinics in Dubai and Colombia promote “family balancing” through websites, Instagram videos and reels. Sources said agents in India scout for clients and negotiate deals. Some Dubai clinics reportedly pitch a 24-hour visit for egg retrieval, followed by a later trip for embryo transfer or IVF. Packages may include testing, IVF and surrogacy.

The result is a market that connects restrictive rules at home with permissive services abroad. Clinics advertise high-tech laboratories, tailor-made packages and almost 100% success rates. Rising ART costs and tighter visa rules have not stopped wealthy couples, according to the report, but the article does not measure the market’s total size.

When families repeatedly select male embryos, the immediate result is fewer female embryos chosen for transfer among those families. At a wider level, this can reinforce the son preference already reflected in India’s sex ratio at birth: 929 girls for every 1,000 boys in NFHS-5 for 2019-21. The article presents overseas selection as part of that continuing bias.

The report does not measure how many births result from these procedures or calculate their demographic effect. It does show that at least half of the 100 Indian couples visiting one New York provider each month choose gender selection. Most of that provider’s Indian clients come from major metros, suggesting access is concentrated among families with substantial resources.

If the practice expands, its social effect could include stronger pressure to produce sons and a wider divide between families able to buy reproductive choices and those who cannot. It could also make the existing birth imbalance harder to correct. These are possible implications; the article itself does not provide long-term outcome data.