Everything You Always Wanted To Know About LGBT Family Building But Were Afraid To Ask
The recent uproar over designers Dolce and Gabbana’s negative remarks about conceiving through IVF (In Vitro Fertilization) or ART (Assisted Reproductive Technology) has put the spotlight on Lesbian and Gay parenting and families.
This is a good thing. The more we talk about it, the more we normalize it!
Although LGBT parenting and families are becoming part of the new normal, it is still more complicated for these couples than it is for heterosexual couples.
There are many ways to approach conception. The safest approach is to sit down with a good reproductive endocrinologist who has experience in this area to discuss all your options.
For women who see the gynecologist on a regular basis, by the time they are ready to have a baby, the process can be a little less intimidating than it is for gay or single men who want to conceive; however it can still be confusing.
I will try, in this article, to give you the basic concepts that I give to my patients when they walk into the office with a desire to have a family and absolutely no idea about how to start.
For Men: You need a sperm, an egg and a uterus.
For gay couples – you have two sperm sources, so sperm is usually not an issue; however, I will do blood and sperm testing to assess your general health, and the health of your sperm.
If both of you want to be a baby-daddy, then I usually recommend that you decide who will go first; as having twins can be risky and having two babies carried by two separate women at the same time can be extremely complicated and prohibitively expensive. We can create two batches of embryos at the same time – one group using sperm from one partner and one batch using sperm from the other partner, but we do not recommend putting more than one embryo back at a time as twins create significant health risks for both the mother and the babies.
You also need eggs, as well as, a uterus. Most women have both of these but it is better for you as a gay couple to have the eggs and uterus come from two separate people.
Here in the US, your rights as parents can be protected by a good reproductive lawyer if the egg donor and the gestational carrier or gestational surrogate are two separate people.
Then, if all the paperwork is done correctly and the carrier deliveries in a state that recognizes your rights as parents and your agreement, you can expect to have your parental rights upheld and have both of your names on the birth certificate, and/ or, have at least one father (the one who contributes the sperm) on the birth certificate and have the other father proceed safely with a second parent adoption.
However, if the woman that contributes the egg, also carries the baby, she is known as a traditional surrogate and is legally the mother regardless of any agreements you may sign. This situation is extremely risky in terms of custody of the child and is not recommended. No reputable reproductive endocrinologist in this country will knowingly assist with a traditional surrogacy arrangement for this reason.
Where do you start? Many couples will have a team of people to help them with this process: more than one doctor, lawyers for you, for your donor, and your carrier, an agency that finds you a carrier, perhaps one that finds you a donor. There are many options and choices – I realize, it can be extremely overwhelming.
My recommendation is to start with a good reproductive endocrinologist at an IVF center that has experience with egg donation, gestational carriers, and with gay and lesbian couples. A reproductive endocrinologist is a physician trained in obstetrics, gynecology, reproductive endocrinology and infertility. As a reproductive endocrinologist, I do not handle your legal agreements, but I will coordinate with all the people on your team, help find you the people that you need, and put the entire cycle together for you from beginning until your carrier is 8 weeks pregnant and out of the danger zone. Then you are ready to be referred to a good obstetrician who will deliver your baby.
We will start with a conversation and make sure that you are educated on all aspects of the process – medical, logistics, psychological, legal, financial, etc.
This is a big project and it can be very rewarding; but it should be done right to make sure that everyone involved stays healthy, and that your parental rights are protected. This allows you the best chance possible to have a healthy baby.
For Women: You also need a sperm, an egg and a uterus.
Since donor sperm is easily, safely, and relatively cheaply available from multiple appropriately licensed sperm banks across the country; becoming a parent for lesbian couples and single women can be easier and cheaper than it is for single men and gay couples.
One of the most popular options is to undergo insemination with frozen thawed donor sperm. The use of frozen thawed donor sperm allows for thorough screening of the donor, quarantine of the frozen sperm for 6 months, and retesting of the donor to confirm that the sperm does not carry any infectious diseases that could be transmitted. You should have a thorough evaluation to make certain that your body is healthy, ready for pregnancy, and that there are no fertility issues like blocked tubes or abnormal ovulation.
Co-maternity is becoming more and more popular. Co-maternity is when one intended mother contributes the egg and the other intended mother carries the pregnancy. This creates a situation where you have two biologic mothers. This requires IVF – the mother contributing the eggs, takes injectable medications to stimulate multiple egg production, and then has her eggs retrieved in a minor outpatient procedure. The eggs are inseminated with donor sperm and embryos are created. The best embryo is then transferred to the other mother’s uterus. The carrier mom is usually on medications to synchronize her cycle with the egg mother’s cycle so that the uterus will be receptive to the embryo at the right time.
There are a lot more things to discuss, but this covers the basics. Take a look at our website for more detailed information. Consider coming in for a conversation with me or one of the other doctors, so you can get all your questions answered.
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Thanks for taking the time to read!