Family Planning for LGBTQIA+ People

For people who are in a same-sex or transgender relationship, having a biological child can be more complex than it is for heterosexual couples. However, LGBTQIA+ couples have more options than ever to start or expand their families.

“Fortunately, a successful pregnancy can be achieved in a number of ways,” says Rachel Weinerman, MD, a University Hospitals reproductive endocrinologist at the UH Fertility Center. “As long as there are sperm, eggs and a uterus to carry the pregnancy, the dream of having a child can often be achieved.”

Options for Same-Sex Female Couples

Same-sex female couples have several options to have a baby, including intrauterine insemination (IUI), in vitro fertilization (IVF) and reciprocal IVF.

IUI

Also called artificial insemination, IUI injects sperm from an anonymous or known sperm donor into the uterus before ovulation to fertilize an egg. Some women are given medication to stimulate multiple egg follicles and increase the chances of fertilization.

IVF

IVF collects mature eggs from the ovaries and fertilizes them in a laboratory with sperm from an anonymous or known donor. If an embryo forms, it’s implanted in the uterus. IVF requires a combination of drugs to stimulate ovulation and support implantation, as well as surgical procedures for the egg retrieval and embryo implantation. It’s typically used when IUI doesn’t produce a successful pregnancy.

Reciprocal IVF

In this procedure, eggs are extracted from one partner and fertilized with donor sperm to create an embryo. The embryo is implanted in the uterus of the other partner, who will carry the pregnancy. This allows both partners to participate in the pregnancy process.

Options for Same-Sex Male Couples

Through a combination of egg donation, IVF and gestational surrogacy, it’s possible for same-sex male couples to have a baby in which one partner is the biological father.

Typically, an anonymous or known egg donor is selected. The eggs are combined in a laboratory using sperm from one or both partners. If successful, an embryo is implanted in the uterus of the gestational carrier, which may or may not be the same person as the egg donor.

Options for Transgender Individuals and Couples

“All of the fertility treatments available to same-sex couples are also available to transgender couples,” says Dr. Weinerman.

If possible, she recommends that transgender people plan for their future family before they begin treatment. Hormone therapy and gender-affirming surgery can both affect the ability to have children. “It’s important for people who are considering transitioning to talk with their physician about fertility preservation if they’re interested in having biological children.”

Fertility preservation options for transgender people include:

• Sperm banking: An option for transgender women before they transition, sperm banking collects and stores sperm. The sperm can be used later to fertilize a partner or donor egg using IUI or IVF.
• Egg freezing: An option for transgender men before they transition, egg freezing retrieves and stores eggs. The eggs can be fertilized later with sperm from a partner or donor using IVF.
• Embryo freezing: An option for both transgender men and transgender women, a person uses their own sperm or eggs to create embryos. The embryos are stored until the person is ready to have a baby, with a partner, a gestational carrier or by themselves.

Related Links

At the UH Fertility Center, we believe in inclusive, high-quality medical care for all of our patients, including LGBTQIA+ individuals and couples. We want all couples to have the same opportunities to achieve their goals and dreams of becoming parents. Fertility services we offer include egg retrieval and freezing, egg donation, sperm banking, intrauterine Insemination, in vitro fertilization and surrogacy.