LGBTQ+ Baby Making Options

This article is inspired by Tampa Bay Birth Network! You can find more information about the organization at their website: Tampa Bay Birth Network

Some people view not being able to get pregnant while in an LGBT relationship as a positive thing. Natural birth control right?! We must reconsider our words, as some LGBT couples really struggle through the fact that they cannot accidentally conceive or easily begin to try doing so, like a lot of heterosexual couples can. But, there ARE options!!

Choices Beyond Adoption

LGBT couples are four times more likely than heterosexual couples to adopt, likely many due to this challenge or by preferred choice, but what if your family simply does not want to adopt, but wants to have biological children? Your feelings are valid and there are choices beyond adoption!

First, it is very important to make a game plan when trying to conceive as an LGBT couple. What are the realistic options? What are the most cost-effective options? If the cost-effective options do not work, what will be the next step, and can you afford the more expensive treatments? How much money do you need to start saving for the treatments? Set goals for when you or your partner would ideally like to be pregnant! Start eating healthy, whether you are the partner contributing sperm to a carrier, you are the partner getting pregnant, or you just want to be extra healthy for that brand new baby that is going to be coming into your life.

Sperm Banks

If you will be using a sperm bank, there are a lot of different options, and a plethora of things to be looking for. Check the pricing! Is it affordable? What does the initial fee cover? What extra fees are there to view potential donors and once you have decided on one, what are the legal fees involved? What are the sperm shipping costs? How is their matching process? Do they have facial matching options? (This is where you can put a picture of anyone you want, including your spouse, and get matched up with donors that look like that person). Do you want the donor to be completely anonymous, have their contact information released when the child turns 18 (known as an Open-Identity Donor), semi-involved (in their life, but not as a parental figure), or do you want to co-parent with the donor? Do you know someone who will be a donor for you PERSONALLY? Most sperm banks have very strict qualifications as far as medical history, including relatives, luckily! Not all sperm banks are LGBT friendly though. Biogenetics, California Cryobank, Cryobiology, Idant Laboratories, Pacific Reproductive Services, Rainbow Flag Health Services and Fairfax Cryobank are known to be LGBTQ friendly.

Fun fact, there are also such things as Donor Sibling matching sites, where families that used the same donor, can talk about their kids and meet, if they would like to!

Types of Insemination

IVI – This is intravaginal insemination, meaning that donor sperm is placed in the vagina, as close to the cervix as possible, to travel up through the cervix, into the uterus, to meet an egg! This can be done at home with the right equipment, or in-clinic. A midwife, if they are willing, may also assist you, if you feel you want a professional alongside you, depending on state laws. IVI typically has a 10-30% success rate, depending on whether the sperm is washed or not (washed sperm increases chances, but this will have to be done in-clinic and can be more costly).

ICI– Intracervical insemination. This involves the use of a speculum, catheter and syringe to place sperm into the cervix, and then placing a sponge under the cervix to prevent mucus and sperm from leaking out, then is removed a couple hours later. ICI has a 5-30% success rate.

IUI– An intrauterine insemination also consists of a speculum, catheter and syringe, but the catheter will go a bit further, into the uterus for the best chance at sperm meeting an egg, and a sponge is again placed, and later removed. IUI success rates range from 2-40%.

IVF – In-vitro Fertilization is a bit more complex than any of the above listed methods. It requires eggs to be extracted from a donor or the intended carrier, whichever is best for your family, then matching those eggs with sperm from a donor or from one, or both, fathers! Embryos will develop to approximately 3-7 days old, and then be transferred into the carrier’s uterus. This is relatively the same process as surrogacy and involves a protocol of medications and lots of monitoring. It is certainly the most expensive but is sometimes the only option. IVF typically has a 40% success rate, but it truly varies per clinic and their different protocols.

Surrogacy

If you are considering surrogacy to grow your family, here are the things you should be considering!

Traditional Surrogate VS Gestational Carrier

  • Traditional Surrogacy involves using the carrier’s egg, so she would be biologically related to the baby. This may involve home insemination, in clinic insemination, IUI, or the full IVF process (extracting her eggs, creating an embryo or multiple embryos, and transferring the embryo(s) into her uterus).
  • A gestational carrier is simply hosting the embryo(s) and they are not directly biologically related to her; though if it is a a cousin, sister, daughter or any other relative, they will be distantly related. This involves basically the second half of IVF where ovulation is suppressed, lining is thickened, and embryo(s) are transferred. Progesterone and estrogen are supplemented to sustain pregnancy.

Review the laws of surrogacy in the SURROGATE’S home state, as those will be the laws that apply, not your home state. Read laws state by state here.

The process leading up to becoming an intended parent are as follows:

  • Decide on an Agency or Choose to go Independent (aka “INDY”)
  • Medical Evaluation
  • Disease/Drug Screening
  • Psychological Screening
  • Match With Your Surrogate of Choice & Pay for her to go through her process
  • Build up an escrow account for surrogate compensation, medical expenses and a little extra to cover bases
  • Decide on a lawyer to do your contracts
  • Provide sperm and/or eggs to clinic of choice to make into embryos to freeze or use fresh

You might be wondering, what is the process that the surrogate goes through?

  • Requirements: Must be between 21 and 50 (generally), not be on any type of government financial assistance (food stamps, WIC, or any variety of that), have had at least one healthy, complication-free and term pregnancy and be raising said child. People who have had gestational diabetes, pre-eclampsia, antenatal depression, pre-term delivery, hyperemesis gravidarum, placenta accreta, or any other complication may not qualify.
  • Background Check
  • Medical Evaluation (includes hysteroscopy, pap smear, pelvic exam, blood work)
  • Drug/Disease Tests
  • Psychological Screening
  • Follow all steps necessary to complete all necessary evaluations, contracts and follow RE protocol to raise chance of pregnancy

Contracts are so very important, so be sure to discuss these and more, in-depth, when considering matching with a surrogate.

  • Place of Birth (Hospital, birth center, home?)
  • Compensation (plus lost wages, gas, transfer fee, complication fees, any other fees that may need to be considered.. How will it be broken up, monthly, bimonthly, lump sum, etc?)
  • SET or DET (This is how many embryos you will transfer)
  • What circumstances is termination requested?
  • Involvement & Contact
  • Medical Decisions
  • Surrogate Providing Breastmilk
  • Placenta?
  • Ask questions if you are confused, make sure you and the surrogate are in AGREEMENT before either of you sign, or this may cause future conflict. Do not rush!
  • Contracts must be notarized

Once the surrogate gives birth, you will work out any final payments or paperwork that needs to be done, and you will take home your baby/babies!

Interested in Adoption?

If you decide that adoption IS for you, after considering these options, be sure to check out the laws in your state! You can find a state-by-state guide here.

Final Thoughts

A note about pronouns, respect and understanding for LGBT families in pregnancy, birth and postpartum: Please be sure you use a provider that respects you and your family enough to use proper pronouns. If you prefer non-binary or alternative pronouns, or non-gender specific references as opposed to ‘mom’ and ‘dad’ for example. If they cannot respect you enough to make this simple change, they will likely not respect you in birth, either!

Enjoy building your family!

With all our love and support, HERBAL.

 

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