The Journey to Parenthood for LGBTQ+ Families

August 30, 2020Grace Firmin-Guion BA (Hons)

Much like humans, the families we’re born into come in all shapes and sizes, but regardless of which mould it fits – family is family. At Hertility, we celebrate families of all kinds, which is why we’re proud to offer routes to care for LGBTQ+ families seeking new mini-members.

For any couple, beginning the journey to parenthood can be daunting – no matter who you’re starting a family with. But for same-sex and gender diverse couples, the road to parenthood can cause even more head-scratching, especially when considering the variety of treatments and paths available. We’ve broken down the different routes for LGBTQ+ families looking to grow, to make your baby-making voyage slightly simpler.

Intra-uterine insemination (IUI) 

IUI is a common path same-sex female couples and those opting for surrogacy often embark on.

If you are in a same-sex female couple, the first thing you need to figure out is a sperm donor. You can either request someone you know to be your donor or use a licensed sperm bank either through a fertility clinic or on your own.

Coming to what IUI is now..

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

As long as you are ovulating regularly and have no issues with your Fallopian tubes you might 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.

If you source your sperm through a HFEA-licensed UK fertility clinic or sperm bank, then you don’t need to stress about the donor’s health risks. This is because your donor’s family history will have been checked for any serious genetic conditions and the donor will have been checked for infections such as HIV, hepatitis, etc. The clinics will also be able to offer support and legal advice.

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 might be risky because they won’t have been screened for the conditions or infections above which could impact the health of the pregnancy or the baby. This can also create issues around who is recognised as the legal father so we’d recommend staying clear of this option.

In a licensed clinic in the UK, the donor can only donate sperm to make up to 10 families. This minimises the possibility of two children from the same sperm donor unknowingly having a relationship. There are cases of unregulated donors reporting having conceived up to hundreds of children which could have implications for your future child and how many genetically-related siblings they have.

In vitro Fertilisation (IVF) 

IVF treatment is another method used to help LGBTQ+ people become parents!

We have broken down the IVF process in more detail for you here, but essentially it is when your and your partner’s (or a donors) egg and sperm are either retrieved from storage or collected at the clinic and fertilised in the fertility clinic laboratory. IVF forms part of the shared motherhood and surrogacy process and can be used by female same-sex and gender-diverse couples. 

Shared Motherhood

Otherwise known as Reciprocal IVF, shared motherhood is a popular option for same-sex female couples or in gender-diverse couples where both parties possess their female reproductive anatomy.

Shared motherhood is when one partner undergoes stimulation and egg collection, donor sperm is used for insemination, and the other partner carries and gives birth to the baby. This method allows for both partners to be emotionally and physically involved in the family-forming journey.

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

Surrogacy

Surrogacy is an option male same-sex couples looking to fulfill their parenthood dreams usually need to opt for. The process involves choosing a suitable surrogate who agrees to carry the child on behalf of a person or couple.

Traditional or partial surrogacy entails the surrogate’s eggs being fertilised using the sperm from someone within the couple, to create the biological link to one of them.

If you (or your partner) have undergone gender-affirming surgery or you have a medical condition that might impact your ability to carry a pregnancy to term, you may opt for another type of surrogacy. 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 iIt 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. There are a lot of other complicated legal issues to note about surrogacy. The most important being that once you have found a suitable carrier, they are technically the legal mother of the child when it is 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’s (the regulatory body for fertility treatment in the UK) website or Surrogacy UK.

Coparenting

Co-parenting is a pathway some LGBTQ+ couples are now choosing to go down. It usually involves two or more people who are not in a relationship deciding to raise a child together. A lesbian couple chooses to have a biological child with a gay man or couple 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 part, it is 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 even fostering are also great ways to add members to your LGBTQ+ family.

Now, it’s no secret that the road to adoption isn’t a walk in the park, and of course, there are many legalities involved, but the benefits come in bounds.

If you are looking for more information, please visit the Adoption UK website

Fertility preservation

Babies might not quite be on the brain whilst you’re dealing with the stress of having a body that does not match your identity, but thinking about your fertility future is important if you’re transitioning and want to have babies in the future.

Hormonal treatments used in the process and reconstruction surgery may unfortunately damage your fertility long-term. This is why many individuals take steps to ensure their fertility is preserved before beginning their transition. This can be done via egg, sperm or embryo freezing.

This ensures that if the time comes where you are ready to become a parent, you have the power to choose when and how you build your own family. The process of egg/sperm freezing also grants the ability to have your own biological child. 

For more information about trans and non-binary fertility treatments click here. 

If you’re still feeling overwhelmed or you’d like more information about the different fertility paths?- Download our guide for everything you need to know about family-forming for people assigned female at birth including treatment options, sperm donation and fertility basics.

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