Transgender individuals have the option to preserve their fertility or undergo treatment to have a child right away, before they begin hormone therapy and transition.
Transgender Family Building
- Fertility preservation allows an individual to preserve their gametes (eggs or sperm), by freezing and storing them for future use.
- Fertility treatment allows an individual to try to have a child immediately.
Transgender Fertility: Male to Female
Prior to Transition if Single
If not partnered, or not yet ready to have children, sperm banking can be done before starting hormonal therapy. An IVF clinic or commercial sperm bank can cryopreserve (freeze) and store your sperm. It is recommended that you “bank” multiple specimens.
Costs incurred with this option include the actual freezing process to cryopreserve specimen(s), along with monthly/yearly fees to store them at the selected facility. Typical costs to freeze sperm samples ranges from ~$100-$200 (per sample), while monthly storage fees are usually between $10-$30/per month, depending on the clinic or facility you decide to work with.
Prior to Transition if Partnered with a Man
IVF (In vitro fertilization) with an egg donor and gestational surrogate will be necessary to have a pregnancy and birth. Your “banked” sperm can be used to inseminate the eggs received from the donor, and once fertilized, the embryos can be placed into the gestational surrogate to carry the resulting pregnancy. You have the option of using either an anonymous or a “known” egg donor (friend, co-worker, etc.).
Costs for Donor IVF can range from around $8,000-$20,000 (or more) for medical procedures, with the cost depending on several different factors, not only the clinic you elect to work with. As the patient/recipient, you have many options to consider regarding the cycle. For instance, an anonymous donor cycle typically costs more than a “known” donor cycle, while electing frozen donor eggs is typically costs less than a fresh donor cycle. Likely, one of biggest variables to cost is that of the fertility medications, since there is no way to know exactly how much medication a donor will need/use until the cycle is completed. This can be a benefit of using frozen donor eggs, since the cycle will have likely been performed (and completed) months prior to you receiving the eggs, the clinic can advise you of the exact costs associated with your donor’s medications. This will also assist you in being able to more accurately plan the financial aspect of the treatment process.
After Transition if Partnered with a Woman
Intrauterine Insemination with Banked Sperm
If partnered with a woman, conception may be attempted using banked sperm to inseminate the female partner through intrauterine insemination.
Costs associated with intrauterine insemination (IUI), are usually modest, when compared to most other fertility treatments. The laboratory must prepare the sperm sample, and a physician or Nurse Practitioner (or Physician Assistant) will perform the actual insemination. These combined costs typically range from $300-$500. The possibility does exist for additional costs, should the woman need any type of fertility medication (such as Clomid or Femara), blood tests to assess her hormone levels (such as Estrogen and Progesterone), or ultrasounds to aid in preparing her uterus for the IUI.
After Transition if Partnered with a Man
IVF (in vitro fertilization), using an egg donor to provide eggs and a gestational surrogate to carry the pregnancy, will be needed. Banked sperm can be used for insemination of the eggs.
There are several aspects to consider when enlisting the aid of a gestational surrogate in your treatment plan for having a child. In most cases, the IVF clinic will require a legal contract/agreement between you (the intended parent) and the surrogate, prior to initiating treatment. It is recommended to have the agreement drafted by an attorney both experienced and familiar with this type of agreement.
The New Hope Center, having worked with many couples over the years, and can provide you with the names and contact information to several attorneys who regularly work with these types of agreements.
Costs related to using a gestational surrogate include legal fees in preparing your agreement, those related to the fertility treatment and medications to achieve the pregnancy, and those for obstetrical care and delivery of the baby.
Although most insurance plans don’t cover the costs of fertility treatment, some do provide coverage for certain pre and post treatment care. With the changes in our current healthcare system, the option exists to purchase an individual health policy for your surrogate to cover her obstetrical care and the delivery of your baby, in the event her personal plan will not or if she does not have a personal health plan.
Transgender Fertility: Female to Male
Prior to Transition if Single
Prior to transitioning and starting testosterone therapy, you have multiple options for becoming pregnant-now, or to preserve your fertility for the future.
Intrauterine insemination using donor sperm
To become pregnant right away, you can have an intrauterine insemination using donor sperm. Depending on your age and any gynecologic or fertility related factors, you can also elect to do IVF (In Vitro fertilization) using your own eggs and inseminating them with donor sperm.
Egg or Embryo Banking
To preserve your fertility for later, you can elect Egg or Embryo banking (see below for further description).
Prior to Transition if Partnered with a Man
If partnered with a man, the easiest and least expensive option is “traditional” conception via sexual intercourse.
Prior to Transition if Partnered with a Woman
If partnered with a woman, prior to transitioning, you have the option to undergo IVF (In vitro fertilization) to retrieve your eggs, and have the female partner (not transitioning partner) carry the pregnancy. In this situation, donor sperm would be used to fertilize your eggs. This procedure is often referred to as Reciprocal IVF.
The cost of IVF starts at ~$6,800, while your final cost will depend on several factors. For example, cash patients who enroll in an IVF Discount program, such as The CARES© Program, can dramatically reduce your overall costs for treatment. While some health insurance plans do cover IVF, most (in Virginia) don’t, but others will pay for certain pre-screening blood tests or other necessary testing in preparation for you cycle.
Patients with questions about their health plan coverage for IVF, should contact our office to provide their most current insurance information. A Patient Service Representative will contact your carrier to verify the coverage and benefits on your plan.
Fertility medication is another factor to consider when preparing for IVF or similar treatment. It’s important to know what your plan benefits are, since some do provide coverage for fertility medications. If your plan does not, you’ll be relieved to know that several discount pharmacy plans do exist to assist you, and can provide a 10-75% discount off the cost of your drugs. The IVF coordinators at the New Hope Center are here to help you in applying for these discounts, as we want to ensure you get the best prices possible.
Egg and/or Embryo Banking
If having children prior to Female to Male transition is not possible, or you are not ready to have children at that time, the following options are available:
- To go through an egg retrieval and have your eggs cryopreserved (frozen) and stored for future insemination with donor or male partner’s sperm.
- To undergo the complete process of in vitro fertilization, but without having the embryos transferred at that time and rather, all of the viable/high quality embryos will be cryopreserved and stored.
In this scenario, if you become partnered with a man, you could attempt embryo transfer to a gestational surrogate to carry the pregnancy. Alternately, if you become partnered with a woman, embryos could be transferred to your female partner and she would carry the pregnancy.