Making Infertility Inclusive

Infertility occurs when an individual or couple cannot conceive after at least 12 months of trying. Today, about 15% of couples struggle to get pregnant. However, these figures often refer to heterosexual or cisgendered couples only. LGBTQ+ individuals and couples struggle with fertility too. Redefining infertility means supporting those who can’t get pregnant or want a biological connection to the child. More and more fertility clinics are using in vitro fertilization (IVF) to help LGBTQ+ couples start families.

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LBGTQ+ fertility challenges

The LGBTQ+ community has several fertility challenges to navigate. Gay, lesbian, and transgender patients can have similar fertility challenges to heterosexual or cisgender patients. These include low sperm count, hormonal challenges, fallopian tube blockages, and many others. Some same-sex couples simply need donor sperm for intrauterine insemination (IUI). There is also a subset of patients that have fertility challenges due to hormone therapies or surgeries. IVF is one of the most effective options for most of these challenges.

IVF, donors, and surrogacy

IVF involves embryo creation in a fertility clinic using egg and sperm samples. The embryo is surgically implanted into the uterus and monitored for pregnancy. A fertility clinic may be able to extract sperm or eggs from one person to use in the IVF process. However, in most cases, the process will require either donor material or a surrogate. For instance, donor sperm can help female same-sex couples conceive through IVF, especially if one or both individuals have fertility challenges. In addition, donor eggs and a gestational surrogate may be necessary for gay couples, transgender women, or nonbinary couples.

Consider reciprocal IVF

The concept of IVF opens several options for LGBTQ+ couples. For instance, same-sex lesbian and trans-men couples can participate in the process with reciprocal IVF or partner IVF. The fertility clinic will extract eggs from one partner. This partner takes the necessary hormone medication to produce multiple mature eggs. When the clinic produces the embryos, often using donor sperm, the embryos are implanted in the other partner, who will carry the child to term. This process allows genetic and biological participation from the couple. Reciprocal IVF has the same clinical outcomes once both persons are healthy.

Third-party IVF considerations

IVF is a powerful tool for LGBTQ+ couples to start or grow a family. In many cases, a third party will be involved through a surrogate or donor. The couple can decide on potential surrogates or donors. In some cases, a family member can do one or both. Couples must decide on a donor or surrogate agency when this isn’t an option. The fertility clinic can help couples navigate this difficult decision, particularly with finding an inclusive surrogate, for the best possible outcome. If the couple provides egg or sperm, the clinic will also perform an analysis to determine viability. Sometimes, an infertility diagnosis is only revealed at this point. Fortunately, other procedures like intracytoplasmic sperm injection (ICSI) with IVF and preimplantation genetic testing (PGT) can help.

Family matters

LGBTQ+ couples have several options today that were not available decades ago. IVF allows gay, lesbian, and trans couples to start or grow families. The process is understandably more challenging but not impossible. Fertility clinics are leading the charge to help people achieve the dream of having a genetically or biologically linked family. Over time, the process will become more accessible.

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