Planning to start a family may feel scary, difficult, and exciting at the same time. For LGBTQ+ families, planning a family may feel even more overwhelming given its many different options. It’s important to know what those options are and where to find support in your journey.
Fertility Options
Several fertility options exist for LGBTQ+ partners who want to have a baby. Here are some of the most common:
- Timed sexual intercourse with someone outside the partnership.
- Sperm donation if neither partner can produce sperm that will fertilize an egg.
- Egg donation if neither partner can produce eggs that sperm can fertilize.
- Inserting sperm directly into the uterus (called intrauterine insemination, or IUI).
- Inserting the sperm directly into the vagina at home with an insemination kit.
- In vitro fertilization (IVF), by which sperm fertilizes an egg outside the body in a lab. Then a specialist inserts the fertilized egg (the embryo) into the uterus.
- Using a gestational surrogate, which is someone with a uterus who is not the parent but carries the pregnancy and gives birth for the parents.
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Questions To Think About
When you begin planning for a family, you need to make sure your fertility specialist knows your preferences. These are some questions you might want to consider:
- How many children do you want?
- Do you want to conceive a child through sexual intercourse or through assisted reproductive technology (ART)?
- Is it important that your children are biologically linked to one or both parents? (Do you want the sperm or the egg to come from at least one of the partners?)
- Do you want to use sperm cells or eggs from a friend or family member who has volunteered to donate them?
- Do the partners want to take turns providing the sperm or the eggs?
- Would you prefer to use a sperm or egg donor you don’t know?
- Is there a friend or family member who has volunteered to carry the pregnancy?
- For couples in which both partners produce eggs, does one want to provide the egg while the other carries the pregnancy?
- Do you want different arrangements for different children you plan to have?
Family Planning for Same-Sex Male Couples
Gay men planning for a baby will want to find out how healthy their sperm is. Then they should decide whether both partners will provide sperm or only the partner with the healthier sperm.
Next, they will need to decide where they will get an egg. Some couples may choose an anonymous egg donor. Others may have chosen an egg donor they know who has agreed to donate.
Next, the couple should decide who will carry the pregnancy (serving as the gestational surrogate). The couple may use IVF to start the pregnancy, or the partner providing sperm may choose to have sexual intercourse with the carrier.
Family Planning for Same-Sex Female Couples
Women planning a baby together should first decide who will provide the egg. Some couples decide that one partner provides the egg while the other carries the pregnancy. In other cases, the person providing the egg may also carry the pregnancy.
Next, the couple should decide on a sperm donor. The sperm can come from a sperm bank, or the couple may have a sperm donor they know picked out. The couple can use IVF or the couple can choose sexual intercourse to begin the pregnancy.
Family Planning for Trans and Non-Binary Couples
The options for couples with trans or non-binary partners depend on their individual situations. If one of the partners can provide sperm, the couple may need to decide on an egg donor. If one of the partners can provide an egg, the couple may need to decide on a sperm donor.
If either partner is transitioning or plans to transition, they may choose to freeze their eggs or sperm for future use. For some trans or non-binary couples, one or both partners may have already preserved their sperm or eggs. If using frozen eggs or sperm, doctors can use IVF, and the couple should decide who will carry the pregnancy.
If one of the partners has a uterus and is able to carry the baby, they may choose that option. Or, even if one or both partners has a uterus, the couple may choose to use a gestational surrogate to carry the baby.
UPMC Fertility Specialists Are Here for You
No matter which options you choose, your UPMC specialists will be there to support you every step of the way. Be sure to ask your medical team any questions you may have along the way.
Sources
Assisted Reproductive Technology (ART). National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health. Centers for Disease Control and Prevention. Link