Is a woman with three previous male children more likely to have a female child in her fourth pregnancy?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: January 28, 2026View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Sex Probability After Three Boys

No, having three boys does not increase the likelihood of having a girl in the fourth pregnancy—each pregnancy has an independent probability of approximately 51% male and 49% female, regardless of previous children's sex. 1, 2

The Biological Reality

The sex of each child is determined independently at conception by which sperm (X or Y chromosome) fertilizes the egg. The overall sex ratio at birth consistently favors males at approximately 1.05:1 (51-52% boys), and this ratio remains constant for each individual pregnancy regardless of prior children. 2, 3, 4

Key Evidence Points

  • Norwegian registry data analyzing over 540,000 women with multiple births found that the sex composition of already-born siblings had no influence on the sex of the next child. 1

  • Danish population study of 1.4 million births confirmed that while families with boys were more likely to continue having boys, this reflects biological heterogeneity (some couples may have slightly higher propensity for one sex) rather than any compensatory mechanism. 2

  • Japanese cohort study of 62,718 women showed the first birth maintains a male-biased ratio of 1.055, and subsequent pregnancies follow similar patterns without reverting to balance previous sex distributions. 3

Why the Misconception Exists

The appearance of sex "balancing" in populations stems from three factors that do not apply to individual couples: 1, 2

  • Behavioral selection bias: Families with all boys or all girls are more likely to continue having children attempting to get the opposite sex, creating an illusion of eventual balance in population statistics. 1

  • Between-family variation: Some couples may have slightly different baseline probabilities (possibly 48-54% male) due to biological factors, but this is fixed for that couple—not changing with each pregnancy. 2, 4

  • Statistical misunderstanding: The "gambler's fallacy" leads people to expect independent events to balance out in small samples, when this only occurs over very large populations. 4

Clinical Implications

For preconception counseling, couples should understand: 1, 2

  • Each pregnancy carries roughly 51% chance of male regardless of family composition
  • No biological mechanism exists to "correct" for previous same-sex children
  • Family planning decisions should not assume sex balancing will occur naturally

References

Research

[Why do some women only give birth to boys or to girls?].

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2005

Research

Sex ratios, family size, and birth order.

American journal of epidemiology, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.