Parenthood is a gift that should be experienced by those who wish to start a family and know deep in their hearts that they are ready to take on the responsibilities that come with such an important life-changing decision. This applies to both different- and same-sex couples, as well as transgender partners. Despite the unique fertility circumstances LGBT couples face, the truth is that there is a wide range of reproductive options to choose from. For instance, lesbian couples can opt for a sperm donor and combine the treatment with IVF (in vitro fertilisation) or IUI (intrauterine insemination). Gay men will require a carrier for the pregnancy and an egg donor while trans women and men seek to care for family-building or fertility preservation before, during, and after their surgical or medical transition. The guide below provides all currently available family-building options for LGBT couples.
Fertility Treatments for Same-Sex Male Couples/ Gay Couples
You and your partner will need to decide who will be the sperm donor (whose sperm you are going to use for IVF) and then meet with your physician to go through the details of using a gestational carrier and egg donor to achieve pregnancy. If the eggs come from one of the partners’ female relatives, the resulting embryo (and consequently, child) would be biologically related to both men if the other male partner’s sperm fertilises her eggs.
Now, when it comes to the partner that will donate his sperm, he will need to undergo testing before the IVF procedure begins. As for the egg donor(s), it might be someone you know or an egg donor from our comprehensive egg donor pool from screened and healthy women. It should be noted that the outcome of IVF is tightly related to the age of the egg. This is because the older we get, the more our fertility diminishes. For that reason, we always prefer young and healthy egg donors between the ages of 22-26. After an egg donor is selected, she undergoes meticulous screening, which involves infectious, genetic, psychological, and medical tests before the collection and cryopreservation of eggs.
The same applies to sperm donors, who are advised to quarantine sperm as recommended by the World Health Organization. Some of these tests are conducted in a way to minimize the risk of infectious disease transmission, which is why they are completed after the quarantine period. Needless to say, gestational carriers are also evaluated psychologically and medically before being selected for the program.
Some couples choose another option – both partners donor sperm. Half the eggs are fertilised by the male partner’s sperm, while the other male partner’s sperm fertilises the other half. In any case, the sperm donor(s) undergo a semen analysis first to test the morphology, concentration, volume, and motility of their sperm. So, the family-building options for gay male couples are:
Traditional surrogacy – We use a surrogate's egg (or eggs) and fertilise it (or them) with one of the male partner’s sperm or donor sperm.
IVF using donor eggs and donor sperm (embryo donation) – We combine sperm and eggs from donors and then implant the embryo into a surrogate’s uterus.
IVF using donor eggs and sperm from one male partner (or both) – We combine eggs from an egg donor with the sperm of the male partner (or both) and implant the embryo into a surrogate’s uterus.
Notes:
IVF involves stimulating the ovaries to produce more viable eggs, then removing them from the ovaries of the donor and fertilising them in vitro (a fluid medium) by sperm (from a donor or a make partner). The last step includes transferring the resulting embryos to the uterus of the surrogate to establish a successful pregnancy.
We may be able to combine the sperm of both male partners with different batches of donor eggs, which increases the chances of having twins. In this case, each embryo will have the same biological mother but different fathers. To determine the child’s father (if only one is born), we can perform a DNA test.
We may require infectious disease testing. In some countries, such as North Cyprus, it is even dictated by law to perform these tests within a very strict timeline.
A legal contract will be required when using an egg donor, gestational carrier, or known sperm donor to obtain legal clearance and protect all parties involved. Therefore, our legal team will be supporting you with this procedure.
Fertility Treatments for Same-Sex Female Couples/ Lesbian Couples
For lesbian couples, IVF is necessary if one partner chooses to carry the pregnancy and the other to donate the eggs. The partner that will donate her eggs then undergoes ovary stimulation (hormonal treatment to help the ovaries boost their egg production). The eggs are harvested, fertilised, and transferred into the other partner’s uterus, who will carry the pregnancy.
Finally, suppose none of the female partners can produce viable eggs (for whatever reason|) or have a hereditary disease that they would prefer not to take any chances to pass it on to their offspring. In that case, they can consider using donor eggs. These could come from friends, family members (i.e., sisters), or anonymous egg donors.
So, the family-building options for lesbian couples are:
IUI – Also referred to as artificial insemination, we use the female partner’s eggs and fertilise them with sperm from a known or anonymous donor.
IVF – We use donor sperm to fertilise the female partner’s eggs (or donor eggs). You could also opt to have eggs from both partners. Or use donor sperm and eggs from both partners and implant the embryo(s) into both partners.
Donor eggs – We use donor eggs to fertilise by donor sperm and then implant the resulting embryo into the female partner’s uterus (the one that will carry the pregnancy).
Surrogate – We use donor sperm and donor eggs to produce viable embryos via IVF that are then implanted into one of the female partner’s uterus.
The treatment process is quite simple. The couple decides who will become the pregnancy carrier and will then undergo blood work to test her hormone levels. She will also be required to have more fertility work-ups that include an HSG (hysterosalpingography) to determine the health of her fallopian tubes and uterus. If all checks out well, the couple will be asked to choose a sperm donor, so they can have their eggs fertilised. Then, the mature embryos are placed in the pregnancy carrier’s uterus to achieve the pregnancy. In the case of IVF, a more complex treatment protocol is needed and involves medications.
Fertility Treatments for Transgender Couples
Before we begin, let us note that you should speak to your physician before any surgical or gender-affirming hormone tests about freezing your eggs or sperm prior to undergoing any fertility treatment that could affect your fertility. That being said, it is paramount that trans men and women stop their hormone therapy before they start their fertility treatment, so they give their bodies the chance to return to fertility again. The time needed to achieve that varies. In some cases, it may not even be an option anymore due to irreversible changes in fertility. Depending on your particular circumstances and individual situation, the course of treatment available varies as well. So, you might require a gestational surrogate, sperm donation, or egg donation.
Trans Women – The Available Fertility Treatments
You could opt for:
Sperm freezing – This is also called sperm cryopreservation.
IUI – A cisgender female partner uses intrauterine insemination.
Donor eggs – IVF using partner or donor eggs.
Donor sperm – IVF using a sperm donor.
Gestational carrier – A surrogate may be required for IVF instead of the partner’s uterus.
Important Notes About LGBT Family-Building
As already mentioned before, we recommend having an initial consultation with your physician to go through your financial options, potential treatment, and medical history. Then, diagnostic testing is the way to go to help reveal any obstacles that might hinder pregnancy or fertility – this can be performed at our clinic since we have the most sophisticated equipment and laboratories. As soon as this stage is finished, our fertility experts can develop a strictly customised protocol, so the best treatment for your case can begin.
If you are using an egg donor, sperm donor, or a gestational carrier (aka the use of a third party for reproduction), it is critical that you have an informative meeting with our mental health team first, irrespective of your gender identity or sexual orientation. Kindly note that this is merely an evaluation of any kind. On the contrary, the meeting will enable us to determine how to best support you and your future offspring around 3rd party conception-related issues.
Finally, take into consideration that besides the treatment options and fertility procedures referenced above, cryopreservation (sperm or egg freezing) is a very popular (and recommended) option available to preserve future fertility. It is a useful solution for couples that undergo gender affirmation treatment or wish to delay pregnancy.
Schedule your Consultation
We are proud to be able to help members of the LGBT community, whether gender non-conforming or transgender, grow their families and taste the pleasures of parenthood. We offer a wealth of options and high-tech care to make your family-building dreams a tangible reality for you. Please do not hesitate to contact us and schedule an appointment with one of our physicians. We will be excited to hear from you!
