LGBT+ Fertility Treatments: Here’s What You Need To Know About Having A Baby
There’s no greater decision than the choice to have children. But for LGBT+ people, fertility treatments tend to come as standard. At the Fertility and Gynaecology Academy, we know that every family is different and has its own distinct needs. We work with a broad range of families and inclusive, sensitive patient care is key.
If you are an LGBT+ couple or individual that is ready to start a family, you’re probably wondering: What’s the best way forward? Here we lay out common paths to making your dream of a baby a reality.
In the UK, the number of LGBT+ receiving fertility treatments is rising swiftly, with more and more couples taking steps to have children.
Female Same-Sex Fertility Treatment
Female same-sex couples* will generally conceive one of two ways: Intrauterine Insemination (IUI) which is also often referred to ‘artificial insemination’, or In Vitro Fertilisation (IVF).
Either way, a sperm donation is required.
Intrauterine insemination involves first filtering through semen in a lab to select the most effective sperm, before placing it directly into a woman’s womb. Sometimes, a woman will undergo ovulation induction first.
For IVF, a woman receives hormone injections to stimulate the production of her eggs for harvesting. These eggs are then retrieved under sedation and fertilised with sperm in the laboratory, creating embryos which are then placed back into her uterus to grow.
In cases where there are problems with the sperm or there has been a previous failed or poor fertilisation in IVF cycle, Intracytoplasmic Sperm Injection (ICSI) may be recommended. This process is the same as conventional IVF, except that sperm is micro-injected directly into mature eggs in the laboratory.
It depends. Some female same-sex couples try IUI first because a round of IVF is more expensive and invasive than IUI. Crucially however, IVF has higher success rates. For this reason, especially when age or fertility might be an issue, many lesbian couples go straight to IVF.
Furthermore, some lesbian couples choose IVF because they want a chance for both mothers to have a biological connection to the pregnancy, and ‘reciprocal IVF’ offers that.
When both women in a lesbian partnership want and can be biologically involved in a pregnancy, reciprocal IVF can help. In such cases, one partner has her eggs harvested and fertilised (as explained above). Afterwards though, the fertilised egg is inserted into the uterus of the other woman, whose womb has been prepped for pregnancy with helpful hormones. Obviously, only the DNA of the first woman is carried on to the baby. But both partners share the pregnancy in a remarkable way.
Whether you opt for IUI or IVF, you’ll of course need a sperm donation.
UK law does not allow the purchase of sperm or eggs, and donors generally do it out of public good will. It’s legal only to pay expenses.
Some lesbian couples know and trust someone who is all too happy to donate sperm on the women’s terms, and an at-home insemination results in pregnancy – yay!
For many, many female same-sex couples however, the stars just don’t align that way. They don’t know any such man, or they have understandable apprehension about the reliability of ‘contracts’ that may well not stand up legally if things unravel. Or they do try ‘DIY’ to no avail.
Dr Gorgy, Fertility Consultant at The Fertility & Gynaecology Academy explains: “Whether you know your donor, or a clinic offers you helpful links (as we do for our patients), opting for insemination through a clinic is far safer. The sperm will always be checked for infections, and the family history of the donor will be combed through in case of any genetic diseases. This is why the HFEA (the organisation that regulates fertility treatments in the UK) advises against DIY insemination, recommending clinic insemination instead.”
UK sperm banks also offer detailed matching criteria for prospective mothers: including height, body weight, eye colour, hair colour, skin colour and ethnic background, and even education and religion if requested.
Male Same-Sex Couples: Having A Baby
For male same-sex couples, having a baby requires finding a woman prepared to carry the baby to term, either through surrogacy or a co-parenting arrangement. Here, we take a look at the most frequently asked questions.
Within this process, you can use the eggs of the surrogate (‘partial surrogacy’) or co-parent herself, or donated eggs (full surrogacy). With the first option (partial surrogacy or co-parenting), sperm will need to be inserted into the surrogate or co-parent’s uterus (intrauterine insemination, or IUI), or the eggs and sperm will be mixed in the IVF lab, and then the fertilised egg will be put into the womb of the surrogate or coparent, to grow and develop (In Vitro Fertilisation, or IVF).
With partial surrogacy, the HFEA still recommends conducting the process via a licensed fertility clinic.
With full surrogacy the eggs will be retrieved from the egg donor and fertilised with the sperm in the IVF lab. The embryo will then be replaced in the uterus of the surrogate mother who would be a different woman from the egg donor.
If there are found to be problems with the sperm or there has been failed or poor fertilisation in a previous IVF cycle, Intracytoplasmic Sperm Injection (ICSI) may be recommended. This process is the same as conventional IVF, except that sperm is micro-injected directly into mature eggs in the lab.
Sometimes gay couples seek a surrogate through friends or family, finding it helpful to conduct such a complex, intimate process with someone they already know and trust.
If this is not feasible or desirable, you’ll need to search via other avenues. Here at the Fertility and Gynaecology academy we offer surrogacy treatment but we are not involved in recruiting surrogates – indeed legally no fertility clinic can. You’ll need to conduct either a personal search or go via a specialist agency. You can read more about the surrogacy process at FGA here.
Many LGBT+ couples also set up co-parenting arrangements, whereby between two and four people organise fertility treatment for conception and then share custody when the baby is born.
Whether you opt for surrogacy or a co-parenting arrangement, there are crucial legal, emotional and logistical issues to work through, and it’s imperative to be informed. You might find helpful signposting information here and here.
Information For People With Other Forms Of Sexual Orientation
Please also note that trans or non-binary people may have extra fertility considerations to think about because some treatments for gender dysphoria such as hormone therapy can affect fertility. You can read more about things to consider here.
Support On The journey
Like almost any attempt to make our deepest dreams come true, fertility treatment can be arduous and emotionally taxing for any couple or individual. For LGBT+ people there may be extra concerns and considerations, for example regarding co-parenting or surrogacy. So do reach out to friends, family, and helpful organisations to support you through the process.
* In the interests of medical clarity, we use ‘male/female’ and associated pronouns to refer to reproductive capabilities, realising of course that gender identification and expression can vary.
There’s no greater joy than holding your baby in your arms. At the Fertility and Gynaecology Academy we’re experts in helping to make that happen for any couple. To book a consultation with one of our expert team, call 020 7224 1880 or email info@fertility-academy.co.uk.
