For LGBTQ+ couples, starting a family has become much more accessible. Research has shown that 15% of same-sex couples have children in their household.
This article will explore the different fertility options for lesbian couples to start a family.
First, an LGBTQ+ couple will want to complete a fertility assessment. This assessment requires no commitment to treatment but allows couples to access their fertility information to make the best decisions for their family.
Fertility assessments provide important information regarding your fertility. Using the results from this assessment can help couples determine how they should start their family.
Building a Family as a Same-Sex Lesbian Couple
Lesbian couples wanting to build their family through assisted reproduction technology (ART) will need an egg, a sperm donor, and a uterus to carry the pregnancy. Working with a fertility clinic can help gay couples achieve all the necessary tools to create their baby.
Options to consider include intrauterine insemination (IUI), in vitro fertilization (IVF), reciprocal IVF, donor sperm, and gestational surrogacy. The prospect that suits you best depends on factors such as age, fertility health, and personal preferences for your family.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) involves placing sperm inside a uterus to fertilize the egg. This method gives the sperm a head start but does still require the sperm to reach and fertilize the egg itself. IUIs are less invasive and more affordable than in vitro fertilization.
Before IUI, your doctor may recommend ovulation-stimulating medications. This will require careful monitoring to determine when the eggs are mature. The IUI procedure will be performed around ovulation, usually 24-36 hours after the surge in luteinizing hormone (LH) that indicates ovulation will occur soon.
The procedure only takes a few minutes and is quick and painless. The semen sample is washed during the procedure by the lab to separate the seminal fluids. Next, the sperm is directly inserted into the uterus. You will be asked to rest for a short period in the office after the procedure, and then you can return to normal activities.
The success rate of IUI can be as high as 20% per cycle, depending on age, infertility reason, and if fertility drugs were used. Women under the age of 35 have a 10-20% success rate, and women over 35 have a 2-5% success rate. The cost of IUI will vary depending on what type of insurance coverage you have and how much your doctor's fees are. It usually costs about $2,000-$4,000 without insurance, less than other treatment options like in vitro fertilization.
In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) is an assisted reproductive technology where the fertilization of an egg with sperm is done manually in a laboratory dish. The embryos are then transferred to the uterus.
Before the procedure, fertility medications will be prescribed to stimulate egg production. A transvaginal ultrasound will be used to examine the ovaries, and blood samples will be taken to evaluate hormone levels.
The specialist retrieves the eggs and mixes them with the sperm in a laboratory dish. Once fertilization has occurred and embryos have grown into blastocysts, the embryos are implanted into the carrying partner’s uterus. If successful, implantation usually occurs within six to ten days. Any embryos not used can be frozen and stored for future use.
While undergoing IVF, you should not drink any alcohol, smoke, or use any herbal supplements. Exercise is encouraged, but competitive athletes may need to modify their workout routine. You should let your doctor know if you are taking any medications, as some are unsafe to take while pregnant. In addition, you should avoid NSAIDS like ibuprofen, Motrin, or Aleve.
The success rate of IVF will depend on reproductive history, maternal age, infertility causes, and lifestyle factors. Success rates in the United States are as follows:
• 41-43% for women under age 35
• 33-36% for women ages 35 to 37
• 23-27% for women ages 38 to 40
• 13-18% for women ages over 40
The total cost of IVF will vary depending on insurance coverage and the treatment plan. The average cost for one IVF cycle is $15,000-20,000.
Reciprocal IVF (RIVF)
Reciprocal IVF is another great option for lesbian couples. This is similar to traditional IVF, where eggs are retrieved, fertilized, and grown into embryos in a laboratory dish, and then one is implanted into the uterus in the hopes of achieving a successful pregnancy. Reciprocal IVF involves taking the eggs from one partner, fertilizing them with donor sperm, and then transferring an embryo to the other partner's uterus to carry the pregnancy. The goal is for the embryo to implant in the uterus and eventually develop into a fetus.
This process allows both partners to have a role in the pregnancy journey. One partner provides a genetic connection to the child, while the other has a biological bond through carrying it. Medically, one partner is considered the egg donor, and the other partner is the gestational surrogate.
The success rate will be similar to traditional IVF and depends on reproductive history, maternal age, and lifestyle factors. Depending on the treatment plan, the cost can be anywhere from $20,000-$30,000.
Lesbian couples typically use donor sperm to build their family. Sperm can be purchased from an anonymous donor in a sperm bank, or some couples may ask a friend to donate. The donor and sperm sample undergo screenings for infection and genetic diseases before the sperm is sent to the doctor’s office for use.
The cost of using donor sperm varies. One vial of sperm ranges from $400-$2,000. The success rate of conceiving using donor sperm has a variety of factors. It depends on age, history of pregnancy, method of insemination, and the number of inseminations per cycle. Women with no record of infertility problems and under 35 have the highest chance of getting pregnant.
Gestational surrogacy has gained popularity in LGBQT+ families as it allows them to start and grow their family using their genetic makeup. Some couples may opt for using eggs from both parents with the hope of fertilizing one from each, resulting in two children who are genetically related to both of them. The cost of a gestational carrier (surrogate) ranges from $40,000-$150,000, including IVF. The fee will depend on the type of arrangement, the individual gestational carrier (surrogate), and the state where the surrogacy cycle takes place.
Finding a gestational surrogate can be done through a private contract or by working with a surrogacy agency. With a private contract, the couple will choose their gestational carrier with the help of an agency. If the couple is interested in using a surrogacy agency, the agency will help them find their gestational surrogate, set guidelines for the pregnancy, and formalize a contract.
It is essential to consider LGBTQ+ fertility legal considerations. When relying on treatments like egg and sperm donation or surrogacy, consulting with an attorney with experience in reproductive rights is recommended.
The laws that govern LGBTQ+ family building vary from state to state and can be complex. Working with a knowledgeable attorney who can guide you through the legal considerations related to fertility is important. This can include managing agreements with donors, establishing your legal parentage, protecting your parental rights even if you're not biologically related to your child, and ensuring your child's citizenship if you and your partner live in a different country.
Starting Your Family
The growing awareness of fertility options for lesbian couples makes it possible for them to start their own families. Options include IUI, IVF, Reciprocal IVF, donor sperm, and gestation surrogacy. Contact one of our knowledgeable counselors today at Dominion Fertility to let us help you start your pregnancy journey.