LGBTQIA+ assisted reproduction facts
- Our family building and reproduction services for LGBTQIA+ families are individualized based on your family-building goals.
- LGBTQIA+ assisted reproduction is often referred to as third-party fertility.
- LGBTQIA+ reproduction options depend on each unique situation and include using a gestational carrier (surrogate), intrauterine insemination, using an egg or sperm donor, as well as IVF (in vitro fertilization) or reciprocal IVF.
- LGBTQIA+ couples or individuals often opt to have legal counseling about the rights of parents, and the use of a gestational carrier or donor eggs require legal agreements to be in place prior to initiating treatment.
What are LGBTQIA+ assisted reproduction and fertility services?
The reproductive medicine options used to help LGBTQIA+ couples and individuals fulfill their family goals have been used in reproductive technology for years. These fertility services enable LGBTQIA+ patients to have a child of their own by adding the missing piece of the male or female reproductive systems necessary to conceive. That is why LGBTQIA+ assisted reproduction is often called third-party fertility.
LGBTQIA+ individuals and couples may also experience other infertility issues that would require fertility treatments.
The success of these assisted reproduction and fertility services depends on many factors. These include sperm and/or egg health, as well as the overall health of the individual carrying the pregnancy.
Fertility testing for LGBTQIA+ couples and individuals
Fertility testing is an important part of the family-building process for all patients, not just heterosexual individuals who generally seek fertility services after failing to conceive naturally. We strongly encourage that all patients undergo a basic reproductive health assessment prior to initiating treatment. This is essential for the physician to develop the right treatment plan.
Fertility testing begins with an in-depth conversation about medical history, physical exams and more. When appropriate, this should involve both individuals in a couple.
Fertility testing for lesbian couples
For lesbian couples, fertility testing is unique in that both partners may participate in the process. This can be done through reciprocal IVF using one woman’s egg (fertilized through using donor sperm), followed by the transfer of that embryo to the partner’s uterus. Fertility testing for both partners assesses each partner’s reproductive health and chances of successful treatment.
Genetic testing may also be applicable if there is a family history of complications. This can help prevent birth defects in a child as well as indicate whether or not preimplantation genetic testing should be performed to screen embryos created through IVF for genetic defects that can prevent a successful pregnancy.
Fertility testing for gay couples
For male gay couples, a semen analysis evaluates one or both partners’ sperm for count, shape, movement and overall health. After an egg donor is identified, the resultant eggs can be fertilized by either partner or they can be split where each partner is given the opportunity to fertilize half of the eggs.
We also offer genetic testing to gay males if there is a family history of genetic complications. As with lesbians, this could result in preimplantation genetic testing. Genetic testing can be done for all people, not just gay and lesbian couples or individuals.
Fertility testing for gestational carriers (surrogates)
Fertility testing is also important for gestational carriers, often referred to as surrogates, who may be used for LGTBQIA+ individuals or couples to carry a pregnancy.
Using donor eggs, sperm or embryos
For LGBTQIA+ people, the use of donor eggs, sperm or embryos may be necessary. Donors of sperm, eggs or embryos may be known or anonymous to the LGBTQIA+ couple or individual.
A known donor can be a family member or friend. Some patients find it beneficial to have a relationship with the donor. The benefit of a family member is that the resulting child will have genetic material related to the LGBTQIA+ parent.
An anonymous donor is selected through a donation agency, which contains a database of qualified candidates. Through the agency, patients can get information about the potential donor’s physical characteristics, race, educational background, health, personality and more.
It is important to get in touch with an attorney to outline the rights, responsibilities and roles of all parties involved in egg, sperm or embryo donation. We also recommend counseling with a professional experienced in third-party reproduction to address the various legal and emotional considerations in this process. Your physician can provide you with the resources necessary to help with this process.
Donor sperm must undergo a thorough screening process to protect mother and baby. The sperm is screened for certain infections, including HIV, hepatitis B, syphilis, gonorrhea, chlamydia, trichomoniasis, streptococcal species and cytomegalovirus (CMV).
The sperm is also screened for white blood cells, which can indicate reproductive tract infections. Sperm donors also need to provide a thorough medical history.
Egg donors are most often used for gay couples or individuals but may also be used by others in the LGTBQIA+ community. As with sperm donors, egg donors are rigorously screened for any potential health or fertility problems as outlined by the U.S. Food and Drug Administration (FDA).
Gestational carriers or surrogates
Some LGBTQIA+ patients, especially gay male couples, need assistance in carrying the pregnancy. The recommended process is to utilize a gestational carrier. This involves a woman who will carry an embryo created through IVF using another person’s eggs, meaning she will not be genetically related to the child.
The state of Texas has unique laws regarding traditional surrogacy. These can be addressed by one of our physicians at the time of a consultation.
Both traditional surrogates and gestational carriers can be known to the LGBTQIA+ couple or individual or found through an agency.
Gestational carriers must also undergo fertility testing, as well as counseling to ensure the woman understands the psychological issues related to gestational surrogacy. These include how to manage her relationship with the parents, how to cope with attachment issues and how to deal with any long-term effects.
Intrauterine insemination (IUI)
For lesbian couples, women or transgender men who wish to become pregnant and have no infertility problems, IUI may be a good, lower-cost option.
If testing indicates no infertility, a fertility specialist injects prescreened and washed donor sperm (known or anonymous), into the “active” patient’s uterus at the time of ovulation. The use of oral or injectable fertility medication may be recommended to increase the chances of fertilization depending on the results of an initial fertility test.
IVF for LGBTQIA+ couples and individuals
In vitro fertilization (IVF) for same sex couples and individuals is the same process as for anyone who uses donor eggs, donor sperm or donor embryos. For all hopeful parents, IVF is a multi-step process including ovarian stimulation and egg retrieval (from the patient or an egg donor), fertilization of the eggs with sperm (from the patient or a donor) in the lab, and embryo transfer to the woman’s uterus (either the patient or a gestational carrier/surrogate).
Reciprocal IVF is much like a standard IVF procedure, but in this case, one female or transgender male partner’s eggs are retrieved and combined with donor sperm to create embryos. The other female or transgender male partner serves as the gestational carrier, so the embryo is transferred to her uterus.
The steps for reciprocal IVF include the following.
- During reciprocal IVF, one partner serves as the egg donor. The FDA regulates all egg donations, whether the eggs are provided by donors known or anonymous. Egg donors are required to receive genetic and medical screening.
- The partner who is providing the eggs will need to take hormonal fertility medications to stimulate the ovaries so there is a good supply of eggs available for the retrieval procedure.
- After the egg retrieval phase of reciprocal IVF, the eggs are combined with donor sperm in the IVF lab and one (or more) of the resulting embryos is transferred within three to five days in a fresh embryo transfer cycle. In a frozen cycle, the embryos can be frozen for later transfer. For a fresh cycle, both partners will need to take fertility medications so that their menstrual cycles can be synchronized.