LGBTQ+ Fertility
Whether you’re a same-sex couple, transgender individual, or single LGBTQ+ person, there are many fertility services to help you achieve your dream of parenthood. Recommended fertility treatments depends on your family goals, reproductive health, and personal preferences. Below is an overview of the most common fertility treatments and family-building methods available.
1. Intrauterine Insemination (IUI) for Same-Sex Female Couples
Intrauterine insemination (IUI) is a simple and effective fertility treatment commonly used by same-sex female couples and single women using donor sperm. IUI involves inserting sperm directly into the uterus during ovulation.
Donor Sperm: Couples can choose from anonymous or known sperm donors. Many sperm banks offer detailed donor profiles, including medical history and personal characteristics.
2. In Vitro Fertilization (IVF) for LGBTQ+ Families
In vitro fertilization (IVF) is a more advanced fertility option that may be ideal for same-sex couples or individuals. IVF involves stimulating the ovaries to recruit multiple eggs, retrieving those eggs, fertilizing them with sperm in the embryology lab, and transferring the embryo(s) to the uterus.
Reciprocal IVF: For same-sex female couples, IVF can allow one partner to provide the eggs, while the other partner carries the pregnancy. This method allows both partners to have a biological connection to the baby.
Surrogacy: For male couples, IVF combined with surrogacy is a common route. One or both partners can provide sperm, and the embryo is transferred into a gestational carrier, who carries the pregnancy to term.
3. Surrogacy for Same-Sex Male Couples and Transgender Women
Surrogacy is an option for same-sex male couples, transgender women, and anyone who cannot carry a pregnancy. There are two main types of surrogacy:
Traditional Surrogacy: The surrogate’s egg is fertilized with sperm from one of the intended parents or a donor. The surrogate has a genetic link to the baby.
Gestational Surrogacy: An egg from the intended mother or from an egg donor is fertilized with sperm from one of the intended parents or from a sperm donor, and the embryo is transferred in the gestational carrier (GC). The GC has no genetic link to the baby. Essentially almost all cases of surrogacy are gestational surrogacy.
Surrogacy can be used alongside donor eggs and sperm, allowing for various genetic combinations based on a patient’s needs.
4. Sperm Donation for Same-Sex Female Couples and Transgender Men
For same-sex female couples, single women, and/or transgender men, sperm donation is a vital part of family building. Donor sperm can be used with treatments like IUI or IVF to achieve pregnancy.
Anonymous Donor: Sperm can be obtained from a sperm bank where donors remain anonymous but provide a profile with a number of their personal characteristics, childhood photos and medical history.
Known Donor: Some couples or individuals may prefer to use sperm from a known donor, such as a friend or relative.
5. Egg Donation for Same-Sex Male Couples and Transgender Women
Egg donation is commonly used by same-sex male couples, single men and transgender women- when there is no available eggs. Donor eggs can be fertilized with one partner’s sperm, and the resulting embryo is transferred to a gestational carrier (or transgender male partner, if applicable and if uterus is intact).
Anonymous or Known Donor: Like sperm donation, egg donation can come from either anonymous or known donors.
Egg Banks: Egg banks allow individuals to select eggs based on the donor’s characteristics, medical history, and preferences.
6. Fertility Preservation for Transgender Individuals
For transgender individuals, fertility preservation is a key consideration before starting gender-affirming treatments, such as hormone therapy or surgeries that may impact fertility.
Egg Freezing: Transgender men who wish to have biological children can freeze their eggs before starting testosterone therapy or undergoing surgery (such as oophorectomy). The frozen eggs can be fertilized with sperm later.
Sperm Freezing: Transgender women can freeze sperm before starting hormone therapy or undergoing surgery. The sperm can be used to fertilize an egg via IUI or IVF in the future.
Preserving fertility before beginning gender-affirming treatments allows transgender individuals to have biological children later, even if they have undergone irreversible changes.
Legal Considerations in LGBTQ+ Family Building
Building a family as an LGBTQ+ individual or couple can come with unique legal considerations, particularly around parental rights, surrogacy agreements, and donor arrangements. It’s important to work with an experienced reproductive lawyer who specializes in LGBTQ+ family law or third party reproduction to ensure that all parties’ rights are protected. It’s important to know that family laws, particularly as it pertains to third party reproduction and surrogacy is highly variable between states.
Parental Rights: In some regions, the non-biological parent in same-sex couples may need to go through second-parent adoption or parentage orders to secure legal rights of their baby.
Surrogacy Laws: Some regions do not allow commercial surrogacy and in all cases, surrogacy agreements must be structured to ensure that the intended parents are recognized as the legal parents at birth.
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