At 26, with a baby daughter, a Hong Kong mother and her husband wanted a second child. To make sure it would be a boy, they paid US$9,000 (S$11,000) and flew to Thailand, the last place in Asia where gender selection treatment is available and breaks no law.
"In Chinese tradition, a girl and a boy means good, perfect," said the mother, who requested anonymity. "There's nothing wrong with girls, but in Hong Kong and Chinese tradition all families like boys."
The mother is one of hundreds of women from mainland China, Hong Kong and Australia who visit Bangkok each year for in vitro fertilization (IVF) with the option of choosing the child's gender by discarding fertilized eggs, or embryos, of the unwanted sex. The only other countries where the technique is permitted and available are the United States and South Africa - in both cases at a higher financial cost.
The dozen or so clinics that offer the service in Bangkok say it gives parents the chance to "balance" the genders in their growing families, but medical authorities want the practice banned.
The Medical Council of Thailand, an independent agency that supervises the country's medical system, says it could encourage embryo trafficking.
Still, its efforts to stop IVF gender selection have been complicated by a number of factors. It has no powers to prevent clinics providing the service because there is no law governing its practice in Thailand. Despite years of lobbying, the issue has remained low on the list of political priorities for successive governments - a point underlined by Thailand's latest political upheaval and military coup.
In standard IVF practice, a woman's eggs are removed and fertilized before being returned to the womb. In gender selection IVF, only embryos of the desired gender are implanted, a practice mostly shunned amid concerns about couples making a choice on the right to life based on gender.
"Sex selection for non-medical reasons is not encouraged, but neither is it prohibited in the US, according to the latest guidelines," the American Medical Association says on its Website. As in Thailand, South Africa currently has no legal provision governing the technique.
The business is estimated to be worth about US$150 million last year, according to one Hong Kong agent who organises gender selection packages. Demand is growing about 20 per cent a year, some Thai providers told Reuters, with the number of clinics rising to meet it.
With parliament dissolved since last December and an army government now in power, calls for legislation remain in limbo. Thailand's Health Ministry referred questions to the Royal Thai College of Obstetricians and Gynaecologists, the only agency in the country which gathers specialised information about IVF treatment.
Prof. Clin. Wiboolphan Thitadilok, president of the college, said the agency is working on a fresh set of recommendations on IVF treatment in general. "We have worked to put this issue into law for more than 10 years" she told Reuters. "It's not an issue that politicians will pay much attention to."
Thailand now has 44 IVF clinics in total, with seven new facilities opened last year and two or three applications for new clinics being submitted every month, according to the college.
The Asian country has become the go-to destination for Chinese couples not willing to leave the gender of their baby to chance. They pay fees that can run close to US$30,000 in some cases for packages including a cycle of treatment lasting two to three weeks.
10,000 Treatments a year
Alfred Siu Wing-fung, a Hong Kong agent selling Bangkok gender selection packages to about 200 Chinese couples a year, said as well as people from poorer rural areas his business, Eden Hospitality, had strong demand from wealthy professionals wanting certainty about their offspring.
Siu estimates about 10,000 gender selection cycles were carried out in Bangkok last year, at an average cost of US$15,000 per treatment. While medical equipment and drugs are imported, clinics are staffed mostly by Thai doctors and nurses trained overseas.
He offers two packages: 280,000 Thai baht (S$11,000) for a basic service including flights and accommodation, and 900,000 baht for VIP treatment, including nannies and catering.
Interest is growing in Australia, where gender selection treatment is unavailable. Dr Robert Woolcott, director of Genea Ltd, the third-largest IVF company in Australia, said Genea routinely recommends that couples wishing to choose the gender of their baby visit Bangkok's Superior A.R.T. (for Assisted Reproductive Technology), a clinic it partly owns.
Overall, Australians numbering "in the hundreds per year" travel to Thailand for gender selection, Woolcott told Reuters.
Back in Hong Kong, the mother, now 28 with a healthy 18-month-old son, is planning for her third child. She probably won't go back to Bangkok.
"I think the third one should be natural," she said.