Inclusive Family Building Options

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State-of-the-Art Ways to Create Your Own Family

The desire to have a child is one that many people feel, and everyone deserves the chance to build a family. Thankfully, there are a variety of ways to become a parent regardless of gender identity or sexual orientation. Adoption is a wonderful option for many, but if you want to have a biological child of your own, there are many options now for LGBTQ+ individuals and couples.

Assisted Reproduction for Gay Couples

For a male same-sex couple to become parents, it’s necessary to have an egg donor and a gestational surrogate. An egg donor may be known to the couple or may be an anonymous donor from a pool of screened donors. A gestational surrogate (also known as a gestational carrier) is a woman who will carry the pregnancy but has no genetic relationship to the baby since her egg is not used.

Many fertility centers have egg donation programs or are affiliated with such programs. There are also agencies which match potential parents with gestational carriers, and the fertility clinic you choose may be able to provide you with options.

One or both partners can provide sperm to fertilize the eggs. The sperm provider(s) will undergo FDA mandated screening and testing at the fertility center’s andrology laboratory and will provide a semen sample for use in an IVF treatment cycle.

The donor eggs will be fertilized by semen from one or both partners. The gestational carrier is prepared to go through an IVF cycle and is implanted with one or more embryos which have developed from the fertilized eggs. When she becomes pregnant, she then carries the baby to term.

Some states do not allow gestational surrogacy while others do, so it may be necessary to find a surrogate in another state than the one you live in. It’s very important to consult an attorney with expertise in reproductive law and third party parenting. Both the couple and the surrogate will need legal representation and need to have a clear understanding of all the issues involved, including compensation and health insurance for the surrogate.

Fertility Options for Lesbian Couples

Lesbian couples can pursue a family with essentially the same assisted reproduction treatments as a heterosexual couple, with the addition of donor sperm. The best place to start the process is for one or both of you to visit an OB/GYN and get checked out. If you are over 34, you may want to consult a fertility specialist sooner than later to get a head start on building your family.

The partner who intends to carry the baby will need a complete fertility workup. If the carrier is using her own eggs, i.e. will be the biological mother, her ovarian reserve and the quality of her eggs will be major factors in the success of fertility treatment. Depending on the results of her tests, IUI with donor sperm may be an option, or your fertility specialist may recommend IVF. Some women try vaginal insemination at home. You should be aware that home insemination often does not work, since the sperm has to be at the correct temperature and placed close to your cervix, which is not easy to accomplish outside of a professional setting.

The donor sperm may come from a sperm bank recommended by your doctor or fertility clinic, or from a known donor. If you use a known donor, he will need to go through routine screening to help protect your health and that of your baby. There are a number of legal issues involved with using a known donor, and many fertility clinics will not use “volunteer sperm” due to legal issues with paternity, custody, and other factors.

Another option is to pursue reciprocal IVF, otherwise known as co-maternity. In reciprocal IVF, one partner donates her eggs to use in IVF, and the other partner to carries the pregnancy. The baby is genetically related to the partner who donated eggs, while being carried by and born to the other partner, allowing both mothers to have an active role in building their family.

Yet another option is for each partner to become pregnant with sperm from the same donor. Of course, this is only an option if both partners are able to become pregnant, either with or without assisted reproductive therapy.

Again, it’s highly recommended that you get legal counsel before starting treatment to build your family. Laws on same-sex parenting differ from state to state and change often, so it’s best to investigate how to manage as you move forward, both for your own interests and for your child’s interests.

Fertility Options for Transgender Individuals

When one or both partners is transgender, a couple may have unique needs and challenges that could make starting a family complex. Depending on the individual’s path to transitioning, which may include gender affirming surgery and/or hormones, there can be a variety of complex legal and medical implications. For transgender people who plan on undergoing gender affirming surgery and wish to have a biological child in the future, fertility preservation is an option that allows them to cryogenically preserve their eggs or sperm for use later on. Many of the options described above may also be available to a transgender person, depending on the stage of transitioning they are in.

Regardless of your gender identity or sexual orientation, it is important to find a fertility center and a fertility specialist who is knowledgeable and sensitive to the needs of LGBTQ+ populations, allowing you to explore your family building options more thoroughly. It’s also best to keep in mind that laws on third-party reproduction vary tremendously from state to state, so you may want to consult an attorney experienced in reproductive law as you determine the path that’s right for you.