Through assisted reproduction and the help of a fertility specialist, those in the LGBTQ+ community wishing to have biological children have family building options. Of course, as is the case with many heterosexual couples, LGBTQ+ couples and transgender individuals will need to take the necessary steps to optimize and preserve their fertility.

The Path to Parenthood: Basics

According to a recent Gallup poll , the number of American adults who identify as lesbian, gay, bisexual or transgender has increased to more than 7 percent, double the percentage from 2012. With nearly 18 million adults identifying as LGBTQ+, that number is expected to grow as younger generations become adults.

Genes are made of DNA, which is essentially an instruction manual for your cells and how they function. You receive half of your genes from your mom and half from your dad in the form of chromosomes. These genes determine your features, which is why you may have your mom’s brown eyes and your dad’s long legs.

So how do you begin your parenthood journey as a member of the LGBTQ+ community? Here we provide options and information to help you follow the path that works best for you.

Just as no two families are alike, no two pregnancies are alike and how you get there often looks quite different from anyone else’s journey regardless of sexual orientation. But the basic biology of reproduction remains the same: sperm and egg come together and sperm must fertilize the egg.

For most members of the LGBTQ+ community, the path to parenthood involves a “petri dish” and donated genetic material, either sperm or an egg(s). And same-sex male couples, or couples who don’t have a uterus, will have a gestational surrogate carry their pregnancy. Below are options available for couples and individuals in the LGBTQ+ community.

IVF

In vitro fertilization (IVF) involves harvesting eggs from a person’s ovaries and fertilizing them with another person’s sperm. In order to produce several eggs at one time, the female takes fertility boosting hormones and is then monitored through ultrasound and blood tests to determine the optimum time for harvesting the eggs.

Once retrieved, the eggs are transferred and fertilized in the lab and observed until they reach the blastocyst stage (around day five). At this point, the parents may choose preimplantation genetic testing to confirm there are no chromosomal abnormalities before being transferred to the uterus

For same-sex male couples, IVF provides a way to use an egg from a friend, relative or anonymous donor together with sperm of one of the partners. Using a relative’s egg of the non-sperm donating partner helps maintain a biological connection.

Same-sex female couples or transgender individuals who retain a uterus also benefit from IVF.
In this case, the partner with the optimum eggs (or the partner you both agree on) is prepped for egg harvesting and eggs are fertilized using donor sperm–either from an anonymous donor or from a friend or a relative of the non-egg donating partner. The embryos are observed and the healthiest are transferred into the uterus of the partner carrying the pregnancy.

In all cases, embryos may be cryogenically (frozen) preserved for later use.

Reciprocal IVF

The reciprocal IVF process for same-sex female couples is a great way for both partners to be biologically and physically involved in the pregnancy. Following the same course as a regular IVF cycle, the eggs are harvested from one partner and then transferred to the other partner’s uterus. Both partners are then prepped with different hormonal medication so the cycles sync up and the carrier partner is ready at the time of the embryo transfer. Providing each partner is healthy with viable eggs and an intact uterus, lesbian couples who want more than one child may choose to switch roles with the next pregnancy.

IUI

Same-sex female couples may opt for intrauterine insemination (IUI), which is less time-consuming and less expensive than IVF. During the IUI procedure, donor sperm is inserted directly into the uterus using a very small cannula (plastic tubing).

Third Party Donor Eggs and Sperm

Third Party includes egg donors, sperm donors, donated embryos, and gestational carriers/surrogates.

With same-sex male couples, the egg donor will provide the eggs that will be combined with one of the male partner’s sperm to create an embryo or embryos. Similarly, with lesbian couples, a sperm donor will fertilize the eggs of one partner to create an embryo or embryos. In both same-sex cases, couples wishing to have more than one child may choose to use the eggs or sperm of the other partner in the future.

There are also situations when neither partner’s genetic material is viable and, in that case, both donor sperm and egg may be necessary, or couples may investigate donor embryos.

Same-sex female couples may find that neither is able to carry the pregnancy, and someone transgendering from female to male may no longer have a uterus.In both cases, using a gestational carrier/surrogate is a great option.

Gestational Carrier

A gestational carrier is someone who provides their uterus to carry your pregnancy, but has no biological connection to your child. You and your partner will be advised to consult an attorney who specializes in this kind of contractual arrangement.

Having someone you know donate sperm or eggs, or be your baby’s surrogate, can be a sticky situation. In addition to the potential for legal issues (and all states differ so be sure to consult an attorney), there may also be some emotional fallout. Your doctor can help refer you to a counselor to ensure all are emotionally prepared for this path to parenthood.

Finding Your Best Family-Building Option

Halo Fertility is an inclusive clinic specializing in LGBTQ+ fertility. No matter what your path to parenthood looks like, Halo is here for you. Contact us today.