For LGBTQIA+ individuals and couples, family forming is never straight forward. Luckily there are lots of fertility treatments and options out there. We’ve put together a list of the different options available, whether you’re looking to embark on family forming now or in the future. 

Quick facts:

• IUI and IVF are popular fertility treatments for couples where both individuals are assigned female-at-birth (AFAB).
• Shared motherhood can also be an option for AFAB couples where both individuals can physically participate in the process.
• Surrogacy is another option where an individual offers to carry a baby for a couple or another person. 
• Adoption can be a hard but hugely rewarding process for those who don’t want to undergo fertility treatment.

Sourcing sperm for fertility treatment

There are three options for sourcing sperm in the UK: 

1. A licenced sperm bank 
2. A fertility clinic 
3. From a consenting individual, you know personally

If you source your sperm through a HFEA-licensed UK fertility clinic or sperm bank, your donor will have been vetted and their medical history checked. This includes infections such as HIV and hepatitis or a history of any genetic disorders. 

The clinics will also be able to offer support and legal advice and each donor is only allowed to donate sperm to make up to 10 families. 

If you’re planning on bypassing a licensed clinic or sperm bank and using donated sperm either from a known donor or another source, it’s recommended to ask the individual to carry out their own medical checks before donation.

With using sperm from someone you know personally, there are legalities around who is the legal father of the child. It’s important to research this option thoroughly if this is a route you’re choosing to go down. 

If you would like to use a known donor but would still like all the legal protections around parenthood, you will still be protected if you carry out the insemination at a clinic.

Intra-uterine insemination (IUI) 

Intra-uterine insemination (IUI), also known as artificial insemination, is a type of fertility treatment that involves injecting sperm into the uterus (womb) using a special syringe-like device called a catheter. 

IUI is a commonly used fertility treatment for same-sex female couples, where one (or both) partners want to carry a child. For IUI, you’ll need to source some sperm—either through a licenced sperm bank or fertility clinic, or some couples opt to use a sperm donor that they know personally. 

As long as you are ovulating regularly and have no issues with your Fallopian tubes you should be eligible for IUI. 

However, IUI may not be recommended for you (or your partner) if you:

• Have blocked Fallopian tubes due to a pelvic infection or an underlying condition 
• Have decided you’d like to do shared motherhood (one partner’s eggs and the other partner carrying the pregnancy) 
• Have a low number of eggs (low ovarian reserve)
• Are in your late 30s or over 40 (with age the number of available good quality eggs naturally decreases, as do the chances of success, so IVF might be more appropriate)

Couples have the choice for the insemination process to take place in a licensed clinic, or they may opt to do this in the comfort of their own home to save them money and time. But, there are some legal risks if you choose this second option.

IUI is thought to be a less invasive and more natural process than IVF because it doesn’t involve as many medications.

In vitro Fertilisation (IVF) 

IVF is a fertility treatment where eggs are removed from the ovaries and fertilised with sperm in a lab. If an egg is successfully fertilised, the resulting embryo is transferred into the uterus. 

IVF is another popular fertility treatment for same sex-female or gender-diverse couples and is one of the most common in the UK. Again, it requires a sperm donor which can be sourced from a licenced sperm bank, fertility clinic or someone you know personally. 

IVF also forms part of the shared motherhood and surrogacy process.

Shared Motherhood

Otherwise known as Reciprocal IVF, shared motherhood is where eggs are collected from one partner, fertilised in a lab with donor sperm, and the resulting embryo is transferred to the other partner’s uterus for them to carry the baby. 

Shared motherhood can be a great option for couples where both individuals have working female reproductive anatomy, allowing for both partners to be physically involved in the family-forming journey.

Not all fertility clinics offer this treatment and eligibility depends on various factors such as your age, weight, lifestyle and medical history.

Surrogacy

Surrogacy is where an individual agrees to carry a child on behalf of another person or couple. 

Traditional or partial surrogacy involves the surrogate’s eggs being fertilised using the sperm from someone within the couple, to create the biological link to one of them. This is often used by male same-sex couples looking to form a family. 

Full or gestational surrogacy is when the eggs of the intended mother or a donor are used, and therefore, there is no genetic connection between the surrogate and the baby. 

Whilst surrogacy is legal in the UK, it is an altruistic process. Essentially this means it is illegal for a surrogate to receive any monetary gain from helping you on your journey to parenthood, and it is even illegal to advertise seeking a surrogate. A surrogate can receive expenses. 

There are a lot of other complicated legal issues to note about surrogacy. The most important is that the surrogate is the legal mother of the child when it’s born. This is even if the eggs and sperm used in the process are yours or were donated, and the carrier is not genetically related to the child. 

The surrogate has rights over the child until you receive a parental order from the court – so of course, it is vital to choose someone you trust. For these reasons, it is common for a close friend or family member to carry a child on behalf of the couple.

If you are looking for more information, please visit the Human Fertilisation and Embryology Authority (the regulatory body for fertility treatment in the UK) website or Surrogacy UK.

Coparenting

Co-parenting is a pathway some LGBTQIA+ couples are now choosing to go down. It usually involves two or more people who are not in a romantic relationship deciding to raise a child together. For example, a lesbian couple chooses to have a biological child with a gay male and agrees to raise the child collectively. 

They can choose to opt for fertility treatment such as IUI or IVF for this depending on age, medical history and sperm quality. Although this is something that has been going on for years, the rise of the internet has caused a shift in the way prospective co-parents may look for partners.

If you are choosing to go down this path, it’s important to understand the legalities. It is best to see an expert for legal advice on things such as who will be legal parents, and how parental responsibilities and financial responsibilities will be split before taking the plunge.

You can read more about co-parenting on the Stonewall website.

Adoption

All this insemination and surrogacy talk might make you realise that fertility treatment isn’t quite right for you, but they’re not the only options. Adoption or fostering is also a really rewarding route to becoming a parent—for both LGBTQIA+ couples and heterosexual couples. 

The road to adoption can be tough and bureaucratic, with many legalities involved. Again, a lot of research is needed to decide if this is the right approach for you. For more information on adoption, visit Adoption UK.

Fertility preservation for trans+ individuals

For trans and non-binary individuals seeking medical transition, fertility preservation can be an important step in preserving their future family-forming options. 

Both HRT and sex-reassignment surgery can impact long-term fertility. Egg, embryo and sperm freezing are all great options and ensure that if the time comes when you are ready to become a parent, you have the power to choose when and how you build your own family. 

For more information about trans and non-binary fertility treatments visit the HFEA.  

Download our guide: Family Forming for AFABs 

Still feeling overwhelmed or need more information about the different fertility treatment paths? 
Download our Queer Guide to Getting Pregnant, for everything you need to know about family-forming for people assigned female-at-birth including treatment options, sperm donation and fertility basics.