LGBTQ+ family building is a beautiful thing, but it can get complicated quick. There are unique fertility challenges that need to be considered prior to starting your journey and you will likely need to use a third party to provide sperm or eggs or a uterus to create and/or carry a pregnancy. Additionally, there are other considerations that are worth discussing with a Fertility Specialist as you prepare to take the next steps. In this blog, we outline 5 key aspects of LGBTQ+ family-building that should be considered as you start the process of building your dream family.
1. Think About Your Dream Family
A good place to start on your family-building journey is to think about what you want your family to look like.
Here are some questions to consider:
- How many children do you want to have?
- Is the sex of your child important to you?
- Are you considering twins?
- Is it important for your child to be genetically related to you?
- Do you want your children to be biological or half siblings with each other?
- If you want more than one child, what you prefer their age difference to be?
- Do you want to be pregnant/have a child now or in the future?
If you have a partner, be sure to include them in this conversation and be open and honest with each other about your goals and dreams. Then, discuss your thoughts with a Fertility Specialist. In our initial consultation, we review your goals and your future family as you see it, and this forms the foundation of the treatment plan that we develop in order to achieve those goals.
If you are not sure about the answers these questions, that’s okay too. A Fertility Specialist can help you understand all your options and answer any questions you may have about the process.
2. Who Wants to Donate Their Eggs/Sperm or Carry the Pregnancy?
One of the amazing things about LGBTQ+ family building is that there are so many different ways to build a family and an individual or couple can decide how much or how little involvement they each want to have in the process.
For lesbian couples, consider whether both partners want to be involved in the process of making a baby. Reciprocal IVF is a great way for lesbian partners to both participate in building their family. One partner goes through IVF to stimulate eggs to grow. Once those eggs are retrieved, they are combined with sperm to create embryos. The embryo is then transferred into the uterus of the other partner who will carry the pregnancy and delivery the baby. Both partners can also choose to go through the IVF process to create embryos so that each partner has embryos with their own genetics. And if you use the same sperm donor for both IVF cycles, your embryos will be half siblings with each other.
Some partners prefer not to be involved, but instead serve as support for their partner to go through. We can also test both partners and use this information to help decide which partner may be the better candidate to contribute eggs or carry the pregnancy.
For gay couples, consider whose sperm will be used to create embryos and whether both partners want to contribute sperm and attempt to make embryos. Some gay couples will choose to both contribute sperm and combine them with the same egg donor to create embryos that are half siblings with each other.
Gay couples will also want to consider who they want to use as a gestational carrier. Some will choose a known gestational carrier like a family member or friend while others prefer to go through a third-party agency. Keep in mind the laws that state laws around third-party reproduction can vary. Some states have policies in place that make it difficult or even illegal to use a gestational carrier. California is very open to third-party reproduction with laws that are favorable for the LGBTQ+ community.
3. Using a Known Egg/Sperm Donor or An Anonymous Donor
If you are planning to use an egg donor or sperm donor to grow your family, you have two options. You can use an anonymous donor through an egg or sperm bank/agency or a known donor like a friend or family member.
Even though it may be tempting to use a known donor, there are several things you may want to think about. For one, a known donor will still need to be screened to make sure they are healthy and meet the criteria to donate gametes. Secondly, legal documents will need to be drafted to clarify the exact arrangement between the donor and the intended parent. And third, it’s worth thinking about how a known donor would potentially interact with your future child and the nature of their relationship, if any. These are some questions to consider:
- Does the donor want to be involved in your child’s life?
- How would this potentially impact the child?
- How would you feel if your relationship with the donor changed?
Using an anonymous egg or sperm donor can be legally simpler, but the process can also be more expensive.
4. Find a Clinic that is LGBTQ+ Friendly
This one is critical. Working with a fertility clinic and doctor that have expertise in LGBTQ+ family-building can make a huge difference in your experienceand success rate. Find a doctor and clinical team will help you navigate the journey and walk you through all your options. Having a dedicated third-party team is also helpful for managing the logistical aspects of your case. LGBTQ+ family building can get complicated, especially when it comes to using third parties, so working with a doctor and clinic that are LGBTQ+ friendly should be a priority consideration.
5. You Can Be LGBTQ+ and Also Have Infertility
Infertility does not discriminate. You can be LGBTQ+ and also have infertility. One of the biggest misconceptions when it comes to LGBTQ+ family building is that the only problem you have is that you need an egg donor or sperm donor or a uterus. Members of the LGBTQ+ community are just as much at risk of having infertility as anyone else. If you have ovaries, your age is the primary factor that affects your ovarian reserve as well as the quality of your eggs. If you have a uterus and wish to conceive, you could have blocked fallopian tubes, fibroids, or endometriosis, which could affect your ability to get pregnant. There could be problems with your sperm. In fact, male factor accounts for about one-third of cases of infertility.
Because of this, it’s important to undergo an evaluation to assess your fertility based on your goals and individual risk factors. This information will be helpful in navigating your options and ultimately helping you decide on the best strategy to build your family.
There are so many beautiful ways to build a family and for members of the LGBTQ+ community, there are unique fertility care needs and important factors to consider as you embark on this journey. Start by thinking about your goals and your dream family as you see it. Then work with an experienced fertility doctor and clinic who will support you and guide you every step of the journey.
Dr. Ghazal is a double board certified Fertility Specialist, a Southern California native, and an award-winning Top Doctor and Rising Star in the field. She specializes in all aspects of female and male infertility, IVF, egg freezing, LGBTQ+ family building, miscarriage & pregnancy loss, PCOS, ovulatory disorders, intrauterine insemination, fertility preservation for cancer patients, endometriosis, and preimplantation genetic testing. Her research has covered a wide variety of topics in the field of reproductive medicine including assisted reproductive techniques, embryo culture, fertility preservation, endometriosis, implantation, and IVF outcomes. She has authored numerous book chapters and articles that have been published in top journals and she has been invited to present her research at national meetings.