As women, Lesbians are no different than other women as it relates to fertility. Their fertility can be impacted by several factors including age, PCOS, fibroids, excessive weight and endometriosis. A woman with any of these factors can face issues in achieving a pregnancy, and such issues will impact your recommended treatment as well as your chances for success.
Methods for Biological Parenting for Lesbian Couples:
IUI (intrauterine insemination) with donor sperm
Intrauterine insemination (IUI) with donor sperm is without a doubt the most common process of conception utilized by lesbian couples, because their issue is usually one of not having an available sperm source. Sperm donors can be either known or anonymous, but due to FDA regulations, and the related requirement for infectious disease testing, it is typical to find a lower cost to utilize approved donor sperm.
An IUI is a relatively simple procedure and can be performed either during a natural menstrual cycle or a cycle in which ovulation is improved with the use of oral or injectable medications. Utilizing oral medications such as Clomid or Fenara offer a higher chance of pregnancy success in a shorter period of treatment. The IUI procedure is relatively painless and does not require anesthesia. It is performed by one of our physicians or a nurse practitioner in our state-of-the-art fertility center. An IUI procedure, if recommended, is complicated and less expensive than an IVF procedure.
Even though donor insemination is a relatively simple solution, success is dependent to a large degree on the quality of the donor sperm used. Our lab and clinical team will provide you with information on donor semen which is available from several reliable sperm banks. These donors are screened for transmissible diseases, such as Hepatitis B and C, HIV, Chlamydia, Gonorrhea, Syphilis, and Cytomegalovirus. Sperm is cryopreserved by the sperm bank and is quarantined for six months before it is available for purchase and use.
Sperm donor profiles are available online and summarize each potential donor’s family and medical history. A short personal narrative is usually available as well as information about the sperm donor’s physical characteristics such as eye color, hair color, skin tone and blood type. A donor’s ethnicity and education level are often specified, and many sperm banks offer pictures and other information on their sperm donors, some for an additional fee. You can easily arrange to have your specimens shipped directly from the sperm bank to The New Hope Center For Reproductive Medicine. New Hope has a state-of-the-art facility to keep your specimen frozen and safe for as long as needed until you are ready to utilize it. Storage fees will apply for cryopreserved specimens, and are assessed on a quarterly or yearly basis depending on the circumstance.
Using a Designated or Directed Sperm Donor
Today, some patients request to use a relative or non-intimate friend as a designated sperm donor. Utilizing a male sibling or another male relative of one of the females as the sperm donor to inseminate the alternate partner, would assure an even more complete genetic family. The directed sperm donor cannot be genetically related to the partner donating the eggs. A directed sperm donor will require a full panel of infectious disease screening and a six month quarantine of his frozen sperm. A directed sperm donation will undoubtedly be less expensive; however, it could potentially cause social complications in the future.
Although a directed family donor may not require compensation for their donation, the fees for infectious disease testing will likely cost more than simply purchasing sperm from a cryopreservation bank in most cases.
The directed donor sperm can be utilized for IVF or intrauterine insemination (IUI) or as part of an IVF cycle with egg donation. The New Hope Center follows the national guideline regarding infectious disease screening and quarantining of donor sperm from a non-intimate male. In such situations, we advise patients to freeze the sperm and wait six months before insemination in order to ensure that they will not be exposed to a sexually transmitted disease. We also direct our patients to obtain legal counsel before the insemination procedure.
Lesbian insemination is frequently easy and very successful, but it results in one of the partners with less than a full biological connection to the child. Reciprocal IVF allows both partners to be physically involved in the conception of their child. With this arrangement, one of the partners will donate her eggs, so she becomes the egg donor supplying the genetic makeup of the child, while the other partner would be the recipient of the embryo and carry the pregnancy; thereby creating the ultimate two-mother family. The new family would enjoy the legal recognition and social privileges of a complete dual motherhood.
Egg Donor Partner
The partner who will be providing the eggs for a reciprocal IVF cycle is required to undergo diagnostic fertility screening. This would include a review of medical records, blood testing, physical examination, screening for familial, genetic and infectious diseases, and a psychosocial evaluation. Because the eggs from one female partner would be used to create embryos that would then be transferred into the uterus of the other female partner, this process is considered tissue donation and falls under the jurisdiction of FDA regulations. FDA regulations would require screening for infectious and sexually transmitted diseases including Chlamydia, HIV, hepatitis, syphilis and gonorrhea.
After all of the diagnostic testing has been performed then the egg donor partner would start the fertility medication (gonadoptropin injections) to stimulate her ovaries to produce multiple eggs. After the follicles are mature, the eggs are retrieved through her vagina under ultrasound guidance and brief anesthesia at The New Hope Center. The only technical difference between standard IVF and reciprocal IVF is the involvement of two women. The medical procedures are virtually identical. After the eggs have been collected, they are fertilized with donor sperm or directed donor sperm. The directed sperm donor cannot be a blood relative of the egg donor partner, but can be a blood relative of the recipient partner.
Partner Carrying the Pregnancy (Recipient Partner)
If the plan is to do a fresh cycle, the cycles of both partners must be synchronized. This ensures that the embryos are placed in the recipient partner’s womb at the optimal time for implantation.
In order for both partners to be synchronized, at the time the donor starts her fertility medications, the donor would start the fertility medications to stimulate her ovaries to produce eggs, the recipient partner would start estrogen replacement prior to the donor partner starting her medications. While the egg donor partner would be receiving medication to mature her follicles, the estrogen the recipient partner would be taking prepares the lining of her uterus to be able to receive the embryos.Occasionally, an issue might arise and synchronization may not be possible, in that case any embryos created would be cryopreserved, vitrified, with the intention to transfer them in another cycle, this is referred to as a “Frozen Embryo Transfer” cycle.
When you are ready to create your dream family, The New Hope Center is ready to help with our professionalism, compassion and discretion.