Fertility care for lesbian couples

Lesbian couples who would like to start or extend their family need specific fertility treatment that will result in a pregnancy and childbirth[1]. The outcome of lesbian couples is based on experience during pregnancy, delivery, and the professionalism of healthcare providers[2]. Moreover, the fertility state of one or both partners may be an additional factor for building a family.

Sperm donation

Female same-sex couples require sperm donation to become pregnant. A sperm donor is a man donating his sperm to an LGBTQ couple or individual to fertilize eggs through artificial insemination or in vitro fertilization (IVF), where one partner contributes her eggs, and the other carries the pregnancy.  The female same-sex couple can choose a known donor, e.g., a relative, a close friend. Before donation, a licensed sperm bank must screen a known donor. There is a popular option to choose an anonymous donor, who has not agreed to contact a child. But upon 18 years, the offspring may request any additional information about their donor[3]. This data must be supplied from records or by attempting to contact the donor. The child has the right to request contact with his or her donor.

  • The request should be in writing form and include the required information that helps confirm the offspring’s identity and parent/recipient.
  • The donor must be informed of the request. The donor will make a decision whether to allow anonymous contact with the offspring or not.
  • The contact may be provided per email, written letter, or telephone conversation and determined by mutual agreement between the donor and offspring.
  • Additional communication is possible if mutually agreed upon by the donor and offspring. 

The couple can also prefer an open-identity donor, who gives the future child an opportunity to contact him after turning 18 years.

The pair will be provided with a list of donor sperm banks. All prospective donors undergo detailed screening of their medical and family history and genetic testing to exclude possible carrier conditions that could result in the conception of a child with a genetic disorder. The sperm recipients should think about which characteristics are crucial for them. Is that height, education, work, or color of hair or eyes? The best match should be found based on genetic information and the couple’s wishes. Donated sperm is frozen and isolated for six months before using it to be confident that the donor does not have an infectious disease. 

In addition to sperm donation, some lesbian couples necessitate using donor eggs to conceive due to the absence of ovaries or the inefficiency of the ovaries to release mature eggs in both women. Eggs may be donated by family members, e.g., sisters; friends, or anonymous donors. 

In vitro fertilization (IVF)

The donated sperm can be combined with a woman’s egg (or donor egg) in a lab during IVF, creating an embryo that will later be implanted into the recipient woman’s uterus. In summary, lesbian couples have such fertility options:

  • IVF, using the eggs of one partner, which are fertilized by donor sperm and implanted into the uterus of the same partner (traditional IVF)
  • IVF, using the eggs of one partner, which are fertilized by donor sperm and implanted into the uterus of another partner (Co-IVF)
  • IVF, using the eggs of one partner, which are fertilized by donor sperm, and the embryo is implanted into a surrogate mother’s uterus.
  • IVF, using donor eggs and donor sperm, the embryo is implanted into one of the partners.
  • IVF, using donor eggs and donor sperm, the embryo is transferred to a surrogate.
  • IVF, which uses eggs from both partners and donor sperm and transfers the embryo to one of the partners.
  • IVF, using eggs from both partners and donor sperm, the embryos are implanted into both partners.

Co-IVF gives a chance to each partner to contribute in the best way for their reproductive health and the future child’s health[4]. A critical component of Co-IVF is deciding each partner’s role during the process. In some situations, only one partner has quality eggs, and another has an ovary dysfunction. Sometimes, one partner may have her uterus removed, and another has a healthy uterus. 

Intrauterine insemination (IUI)

The intrauterine insemination method means that one of the partners is inseminated with donor sperm and carries the pregnancy. During the IUI cycle, oral or injectable fertility medications may be prescribed to stimulate ovulation. Alternatively, insemination can be timed during the natural ovulation cycle. To determine an optimal time to schedule the IUI procedure, an ultrasound is used to monitor the ovaries and eggs. Just before ovulation, sperm is put directly into the uterine cavity through a small catheter. Approximately two weeks later, a pregnancy test is taken. 

Meta description: Valuable information for lesbian couples preparing to build a family. 

References

  1. Bushe S, Romero IL. Lesbian Pregnancy: Care and Considerations. Semin Reprod Med. 2017 Sep;35(5):420-425. doi: 10.1055/s-0037-1606385.
  2. McManus AJ, Hunter LP, Renn H. Lesbian experiences and needs during childbirth: guidance for health care providers. J Obstet Gynecol Neonatal Nurs. 2006 Jan-Feb;35(1):13-23. doi: 10.1111/j.1552-6909.2006.00008.x.
  3. Lampic C, Skoog Svanberg A, Sydsjö G. Attitudes towards disclosure and relationship to donor offspring among a national cohort of identity-release oocyte and sperm donors. Hum Reprod. 2014 Sep;29(9):1978-86. doi: 10.1093/humrep/deu152.
  4. Chloe Getrajdman, Joseph A. Lee, Alan B. Copperman. Co-IVF for Same-Sex Female Couples. Semin Reprod Med 2017; 35(05): 415-419. doi: 10.1055/s-0037-1605380.