For one - there would not be three heterosexual couples.. At least one couple would be gay or lesbian. The remaining heterosexual couples would be constantly fighting.
One of the Friends would have a sibling as a regular on the show who would be a heroin addict. He (or she) would be made to have the funniest lines on the show.
One of the girls would have a baby out of wedlock and would be undecided on the baby's "actual" gender. The real father would be questionable until the last show of the season, where it would be revealed she was impregnated by an unknown donor at the local sperm bank.
All the women would be control freaks and the men would frequently cry.
Any questions?