So you’re thinking about growing a family. There is a lot that goes into this decision, but when you are queer and/or in a same-sex couple, there may be even more questions that need to be answered before you begin family planning. How are you going to get pregnant? If you don’t have sperm or eggs, how do you get them? If you aren’t going to get pregnant yourself, who will carry the pregnancy for you? How will you pay for this? And more…
There are many options for LGBTQ+ families that vary in treatment, procedure, and cost based on personal preference and needs.
Things to consider before growing your family
Get a family lawyer:
A family lawyer is really important for agreements that need to be in place for surrogates, donors, parenting, second parent adoptions, and more. These legal agreements protect the rights of everyone involved, including the future child.
Go for fertility testing or evaluations:
Understanding your fertility is important. Testing can be anything from a semen analysis to bloodwork, and even an ultrasound of the uterus and ovaries. Fertility services like testing can help you and your doctor better determine what the next step in your fertility plan might be. It also helps you understand what the next step might be in the fertility testing process.
Check for sexually transmitted infections (STIs):
It’s important to know if there is anything that may harm you or stop conception from happening. Doing an STI test can help you or anyone physically involved figure out what might need to happen before going into the more expensive processes and treatment plans. There are many places you can get tested and, if diagnosed with an STI, there are usually treatment options available.
Create a good support system:
The fertility journey may have its ups and downs, and having support beyond your fertility specialist (or reproductive endocrinologist) can be helpful. Find someone who can be there to listen and help you process what is going on. Maybe that’s working with a therapist or doula who can be there for your entire fertility journey and potentially offer expertise on fertility care and pregnancy. Or maybe it’s talking to family and friends about what you are going to do and exactly what you need from them. Create your fertility (and/or infertility) team to cheer you on and hold your hand when you need it.
The list above is a good place to start when it comes to planning. Now it’s time to go over what your options are when it comes to growing your family.
1. Intracervical insemination (ICI)
ICI is one method of conceiving with artificial insemination, sometimes referred to as the “turkey baster” method. Usually used when you have access to sperm and a person with eggs and a uterus, this process is ideal in some surrogate arrangements, or when you want to use your own eggs and uterus and a sperm donor.
With ICI, fresh, unwashed sperm is inserted close to the cervix during the peak of your fertile window.
You can find a sperm donation through talking with people you know (called a known donor), looking online, or accessing sperm through a sperm bank and using an anonymous donor. Finding sperm may take time, but you do have options. Once you find the right donor, make sure to get a detailed medical history and put the proper legal agreements in place, parenting or otherwise.
2. Intrauterine insemination (IUI)
IUI and ICI are similar with one significant difference: with IUI, the sperm is inserted directly into the uterus. It first goes through a process called washing. IUI is great if you or your partner want to use your own eggs and uterus, and also for surrogates who will use their own eggs. IUI has higher success rates than ICI and is typically done in a fertility clinic.
Washing sperm is essential to this process because some material found in semen needs to be filtered out before reaching the uterus to prevent irritation of the uterine lining. An IUI cycle may be unmedicated or medicated—the choice is up to you and your doctor.
Finding the right reproductive endocrinologist is essential to getting the best care for you and your family. Make sure you have people you trust on your side for when you have questions and to help you through any difficult and/or stressful moments.
3. In vitro fertilization (IVF)
An IVF cycle typically involves many different procedures and reproductive medicines. It tends to be one of the more intensive options for fertility treatments, but it does give you the ability to use whichever egg, sperm, and/or gestational carrier you want.
The IVF process typically starts with stimulation of the eggs. Once the follicles have grown to an appropriate size, you’ll receive a “trigger shot” to trigger the final maturation of the eggs before they can be retrieved. This is followed by an egg retrieval. Sperm will be collected (either from a partner or donor) and the eggs will be fertilized. The embryos are then transferred directly into the uterus.
IVF offers many options for queer people, one of which is reciprocal IVF. One partner uses their egg for the other to carry. Another option is with surrogacy, where an egg donor and gestational carrier are chosen separately.
If you are not able to carry a pregnancy, or do not wish to, you may want to work with a surrogate. There are 2 different surrogacy paths, traditional and gestational surrogacy.
In traditional surrogacy, you use the surrogate’s eggs and uterus. This means that you can conceive with ICI, IUI, or IVF. Traditional surrogates are usually family members or friends.
A gestational surrogate (also called a gestational carrier) is a person who does not supply the egg used in conception, but carries and gives birth to a child for another. A gestational surrogate in this way is not biologically linked to the baby. These surrogates can be found through different agencies or other means.
Surrogacy laws vary from state to state and can even restrict its usage against LGBTQ+ families. You can go outside of your state to utilize surrogacy if need be.
Hopefully these options can help you on your journey to grow your family. Although this journey can be difficult to navigate, there are so many options available. Good luck and thoughts to you and your family!