LGBTQIA family building at a glance
- Fertility Specialists Medical Group (FSMG) is experienced in counseling couples and individuals within the LGBTQIA community about their options for starting a family.
- Our approach to reproductive care is to have personal, one-on-one conversations of a supportive and educational nature with each individual about the medical and emotional factors involved in treatment.
- Because of the various options regarding gamete (eggs and sperm) sources, ability or desire to carry a pregnancy, and desires to play a biologic role that may exist for LGBTQIA couples and individuals, the type of assisted reproductive technology available will vary. But it can include intrauterine insemination (IUI), in vitro fertilization (IVF), recipient of partner’s eggs (ROPE) and the use of nonidentified or identified donor eggs, sperm or embryos.
- We also provide references for psychologic and legal professionals with expertise in third-party reproduction for all our LGBTQIA patients seeking parenthood through our fertility treatments and services. The providers at FSMG believe everyone should be educated about their legal rights as a parent, including possible issues of parenting rights.
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LGBTQIA family building overview
The evolution of reproductive medicine has drastically improved the prospects of family building for members of the LGBTQIA community.
Everyone at FSMG embraces the American Society for Reproductive Medicine’s view that gay, lesbian, bisexual, transgender, queer or questioning, intersex, and asexual couples and individuals (as well as single heterosexuals) all have the same desires and rights to have a family as do heterosexual couples.
FSMG focuses on providing the best care for members of our LGBTQIA community, dedicating our experience and clinical best practices to developing individualized treatment plans.
Fertility Specialists Medical Group’s treatment services are described below. These choices may involve legal, financial, medical and psychological considerations, and we’ll help LGBTQIA patients through every step.
Fertility services for our LGBTQIA patients
Our fertility specialists will discuss the various treatment options with each LGBTQIA couple or individual.
We will also discuss the processes of each option, including the costs, the chances of success and the potential risks.
Fertility treatments for LGBTQIA individuals and couples include the following.
- Intrauterine insemination (IUI) places sperm in the uterus, either from a nonidentified sperm donor or an identified sperm donor
- In vitro fertilization (IVF) brings eggs and sperm together in our laboratory to create an embryo that can be implanted in the uterus for pregnancy. The egg source does not need to be the carrier of the embryos, so this is a wonderful way for lesbian couples to have a shared biologic role in family building.
- Donor sperm, eggs or embryos are forms of third-party assistance often used for family building.
- A gestational carrier (surrogate) will be necessary for couples or individuals who do not have a uterus. A gestational carrier is not genetically related to the baby she delivers for the intended parent(s). An embryo generated by or for the intended parent(s) is transferred into the uterus of the gestational carrier. Legal agreements are in place to ensure parenting rights in all cases of gestational carriage.
Fertility services for lesbians
The first question for lesbian couples to address is who wishes to play a biologic role.
Does one partner wish to be both the egg source and the carrier? Do they both ultimately want to carry, using the same sperm donor? Does one partner wish to be the egg source and the other the carrier? Our fertility specialists can help with this decision making by advising on prognosis, timing and cost of the various options.
With all of the above options, a sperm donor will need to be selected. Most couples choose a nonidentified donor (previously termed “anonymous”) through a sperm bank. All sperm banks are required to follow specific guidelines set forth by the FDA regarding infectious disease testing. Banks can vary significantly regarding the information they give on donor background, health history, physical characteristics, pregnancy history and genetic screening.
Some couples choose to use an identified donor (previously termed “known”), who is typically a friend or family member of the nonbiologically involved partner. Known donors are still required to be screened as prescribed by the FDA. A legal agreement must be in place to secure parental rights. Our team can provide local legal resources experienced in third-party reproduction.
Involving both partners in pregnancy through ROPE
If both partners would like to be involved in the pregnancy, they can consider reciprocal IVF, which we call recipient of partner’s eggs (ROPE). In this procedure, one partner provides the eggs to be fertilized via IVF and the other has the resulting embryo(s) implanted in her uterus to carry the pregnancy.
We recommend lesbian couples wishing to become parents seek legal and psychological counseling by professionals who specialize in third-party reproduction issues (see section below).
Fertility services for gay men
Same sex male couples or individuals will need the assistance of a gestational carrier and an egg donor for family building.
Egg donors and gestational carriers
An egg donor will need to be selected. Most couples or individuals choose a nonidentified egg donor through an egg bank. Options can include a “fresh” donation cycle in which an egg donor goes through IVF specifically for the couple or individual, or they may choose to use frozen donor eggs that have previously been collected and are cryopreserved in an egg bank.
All use of egg donors (whether eggs are collected fresh or frozen) are required to follow specific guidelines set forth by the FDA regarding infectious disease testing. Egg donor (cryopreserved) banks can vary significantly regarding the information they give on egg donor background, health history, physical characteristics, pregnancy history and genetic screening.
Some couples choose to use an identified egg donor (previously termed “known”), who is typically a friend or family member of the nonbiologically involved partner. Known egg donors are also required to be screened as prescribed by the FDA.
A gestational carrier is necessary to carry the pregnancy. The gestational carrier can be a family member or friend of the couple or found through a gestational carrier agency.
If a couple is building a family, they may choose to use sperm from one or both individuals to create embryos. Sperm is not mixed. Which eggs gets fertilized with whose sperm is known. If they choose to use both sperm sources, then which embryos will be transferred can be reviewed to optimize the couple’s reproductive goals.
We recommend gay couples or individuals seek legal advice and counseling (see section below) when they begin considering a family building plan.
Options for transgender, intersex & asexual couples or individuals
Transgender, intersex, and asexual couples and individuals may need third-party reproductive assistance to become parents.
One of our doctors will identify personalized needs and wishes for patients to develop an appropriate treatment plan. Our physicians are experienced and well-versed regarding options at various stages of transitioning. We will work with individuals and couples to address their reproductive wishes while still respecting their short- and long-term goals.
We recommend transgender couples and individuals receive psychological counseling and legal advice before undergoing any fertility treatments.
Why counseling is important for LGBTQIA family building
The American Psychological Association has found that effective parenting is not related to the sexual orientation of the parents. Yet in a rapidly changing social environment, LGBTQIA individuals and couples can face unique emotional and psychological factors, as well as many of the same parenting challenges heterosexual couples face.
We recommend infertility counseling with an expert on third-party reproduction for all our patients seeking parenthood through fertility treatments and services. Fertility Specialists Medical Group refers our patients to professional counselors in the area.
In many instances, legal counseling is also recommended, if not essential, to help LGBTQIA individuals and couples with legal issues that can arise regarding parenting rights.