State-of-the-Art Ways to Create Your Own Family
The urge to have a child is one that many people feel, whether they are straight, gay, lesbian, bisexual, or transgender. Most of us grow up in families, and we naturally want to have families of our own as we become adults. Families come in many flavors, and they are more inclusive these days than the old-time definition of “blood kin.”
But if you want to have a biological child of your own, there are many options now for LGBT individuals and couples which didn’t exist until recently. 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 explore your options and determine what’s right for you.
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, or, if you are over 34, you may want to go straight to a fertility specialist in order potentially to start your family faster.
Whichever of you is 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 for a nonprofessional to do.
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 for one partner to donate the eggs for IVF, and the other partner to carry the pregnancy. The baby is genetically related to the partner who donated eggs, while being carried by and born to the other partner. This is sometimes called shared maternity.
Yet another option is for each partner to become pregnant with sperm from the same donor. If you saw the movie, “The Kids Are Alright,” that’s what the lesbian couple did, so their children were genetically related (half-brother and half-sister, in the movie) through the sperm 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.
A couple with one or both transgender partners has unique needs and challenges with the legal and medical issues of gender reassignment which make starting a family complex. Many of the options described above which are available to lesbian couples or gay couples may be available to a transgender couple, depending on the stage of gender reassignment and the couple’s desire for a biological child.
Find a fertility center and a fertility specialist who is LGBT-friendly and sensitive to issues of gender reassignment to explore your options more thoroughly. The legal issues are particularly complicated. Consulting an attorney with experience in reproductive law is highly recommended.