As Princess Kiko prepares to have her third child, the nation is focused on whether the Imperial family will have its first male born in 41 years.

If it’s a boy, he would be third in line to inherit the Chrysanthemum Throne, after Crown Prince Naruhito and the child’s father, Prince Akihito. A male birth would also effectively end any effort to revise the Imperial House Law, which does not allow a female to reign. Thus all eyes are on the baby’s gender.

According to Rikikazu Sugiyama, director of Sugiyama Ladies Clinic in Tokyo and an expert in obstetrics and gynecology, sex selection is a serious matter for many couples, not just royalty.

The fertility expert noted that, unlike the Imperial family, eight out of 10 patients at his clinic desire a baby girl, believing they are “easier to raise.”

“We can only have five new patients per day, and appointments are usually fully booked for about a month,” Sugiyama said.

The clinic has been able to succeed in 70 percent of its attempts to assist couples in having a baby of their chosen sex.

Although he acknowledged that a baby’s gender can be controlled almost perfectly if in vitro fertilization and implantation of a fertilized egg are conducted, the process would be “morally wrong” and thus he does not offer this option.

Instead, Sugiyama only recommends that patients use suppository jelly and calcium phosphate tablets.

Using one type of jelly will make the mucus in the vagina acidic, and under such conditions, sperm with X chromosomes have a better chance of reaching the egg and resulting in a female child.

If another jelly that turns the pH of the vagina into alkaline is used, sperm with Y chromosomes have the advantage, raising the chances for a male birth.

Both jellies are harmless, according to Sugiyama.

Women who are eager to have a boy are also advised to take calcium phosphate tablets to alter the pH of the vagina into an alkaline condition.

Female patients are also lectured to calculate their ovulatory cycle in order to comprehend the best timing to try the techniques.

Many couples ask Sugiyama about other sex selection methods that are believed to have spread over the Internet — including the myth that eating beef before sex results in a boy, or that certain positions during intercourse may be a factor in determining a baby’s sex.

Sugiyama has even heard of a mysterious Chinese calendar that predicts a baby’s gender depending on the date intercourse occurred.

“They are all myths, so I just tell my patients I’m sorry, I do not know that method,” he said.

Although some question the morality of sex selection, the jury is still out among bioethics experts.

Masao Fujii, president of the Japan Association for Bioethics and a professor emeritus at Taisho University in Tokyo, said it is tricky matter whether to condone or frown upon sex selection.

Although the association’s 1,300 members have not unified an opinion, Fujii believes such selection should be a matter for couples to decide on their own.

“There is no need to make a big issue out of whether a couple wants to select the sex of their child,” he said.

However, he added, it would be better to let nature take its course, since favoring one gender over another could ultimately lead to discrimination.

Meanwhile, patients are eager to try just about every sex selection option.

“If a married couple wants to raise either a girl or a boy, and there is a safe medical way to assist that, then there is nothing wrong with choosing the sex of the baby,” a 31 year-old nurse who asked not to be named said. “It’s always great to have a baby, but better if the baby is the preferred sex.”

The nurse, who lives in Fukuoka Prefecture and has two sons, began in March efforts to have a girl. She started recording her body temperature to calculate her ovulatory cycle and experimented with suppository jelly.

“Even though I might be disappointed if I don’t have a girl, I know that whatever the baby’s sex, I will love that child,” she said.

The nurse also believes a female should be able to ascend to the Imperial throne.

“There isn’t much that a man can do that a woman can’t, except for maybe heavy lifting,” she said.

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