Today, assisted reproductive technologies (ART) are a birth rate factor, which allows almost every person to give birth to a child, regardless of health. Fully reliable gender selection is only possible through pre-implantation diagnostics (PGD) as part of in vitro fertilization (IVF). Usually preference is given to boys, and the problem turns from individual family into a socio-gender problem, which can only be solved at the state level. While traditional methods of gender regulation involved selective abortions or killing of newborns («infanticide»), modern ART technically solves the issue at the pre-implantation stage, but entails ethical, psychological and financial problems that require special control. By prohibiting sex-selective abortions, the state limits the possibility of gender choice at the stage of conception to the risk of inherited diseases transmission due to fears of seriously disturbing natural gender balance, creating prerequisites for «genomocide». According to the National ART registries, Surveys of the International Federation of Fertility Societies for 2010–2019, Russian and foreign «hospital» statistics and the media, the article shows increase in the popularity of PGD that makes it possible to make a gender choice. In Russia, where the number of children in a family rarely exceeds two, and reproductive clinics perform all IVF programs, the choice of child’s gender is possible only with medically-justified PGD, and almost always performed at the expense of the patient. The only perspective in this situation is inclusion of such a PGD in the Compulsory Health Insurance system, when the gender of an unborn child becomes an additional, and its health — the main result.