For members of the LGBT community, starting a family is not as easy as
it is for heterosexual couples. Luckily, the technology and expertise
exists to aid LGBT patients in their pursuit of building a family.
For lesbian women, the easiest and most frequently utilized method of conceiving
is through intrauterine insemination (IUI) using donor sperm. Sperm can
be obtained from a known donor, typically a friend or family member, or
it can be purchased from one of the many sperm banks around the country.
All donor sperm must be screened for infectious diseases including Hepatitis
B, Hepatitis C, HIV, Syphilis, Gonorrhea and Chlamydia. When sperm is
purchased through a sperm bank, these tests have already been performed
and the sperm is released for use. When known donor sperm is obtained,
these tests have to be run and the sperm frozen and quarantined for 6
months. At the end of the quarantine period, the infectious disease tests
are rerun and, if the results are negative, the sperm is released to the
patient for use.
The IUI process is straightforward and usually painless. At the time of
ovulation, as determined by ovulation predictor kits, ultrasound, and
possibly blood work, the patient comes in for the procedure. The sperm
is thawed and then inserted into the uterus using a small, flexible catheter
the size of a coffee stirrer. After 5 minutes of rest, the patient is
free to go and resume all of her normal activities.
Sometimes back-to-back IUIs are performed such that sperm is inseminated
on the day preceding ovulation and the day of ovulation. Though this does
add cost to the process, pregnancy rates are slightly improved. The decision
between one or two IUI's in a cycle will be determined by the patient
and her doctor.
For gay males, the process of starting a family is more complicated unless
adoption is the chosen method. The couple will have to select an egg donor
as well as a gestational carrier (GC). The egg donor is usually a young
woman in her 20's with an excellent supply of eggs. She can be someone
known to the couple or an anonymous egg donor screened by an infertility
center. Just as with donor sperm, the egg donor must be screened for all
infectious diseases. She also is screened for genetic conditions such
as Fragile X, spinal muscular atrophy, and cystic fibrosis. In most fertility
clinics, the donor is also evaluated by a psychologist before she is cleared
to donate her eggs. Once all the above testing is completed, the donor
undergoes ovarian stimulation as part of an in vitro fertilization (IVF)
cycle. Her eggs are retrieved transvaginally, at which time they become
the property of the gay couple. Alternatively, the couple may purchase
frozen donor eggs from an egg bank. Regardless, once the eggs are obtained,
one or both of the men's sperm can be used for the fertilization process.
Once the embryos are created, they need a place to grow. This is where
the GC comes into play. A GC is a woman who is willing to carry a pregnancy
for someone else. Typically, she is someone who has already been successful
in carrying a baby such that she has a “proven uterus”. She
also must go through rigorous medical and psychological screening before
being allowed to serve as a GC. The GC's uterus is prepared for pregnancy
with a combination of estrogen and progesterone hormones. Once the embryo
is ready, it is transferred to the GC's uterus via a catheter placed
through the cervix. If she conceives, she will carry the pregnancy and
then turn over the baby at the time of delivery to the intended parents.
To make sure there are no legal complications, detailed legal contracts
are drawn up to protect the intended parents and their offspring.
All patients using donor sperm or donor egg are guided through the process
by our team of caregivers including doctors, nurses, nutritionists, and
As my gay male friend explained to his daughter, who was conceived using
a GC and an egg donor, “We have a very interesting family!”
We, at ACRM, hope to assist many more members of the LGBT community in
building their own “interesting families”!
For more information about LGBT Family Building, sign up to attend our
free seminar on Tuesday, October 24, 2017 by
clicking here. To schedule an appointment, please contact us by calling 678.841.1089.