Medical contribution by: Stephen J. Greenhouse, M.D.
Shady Grove Fertility is proud to help gay and lesbian couples build their families with the assistance of fertility treatments. Our physicians and staff have created a comprehensive program for LGBT Family Building, including: sperm donation, insemination (IUI), in vitro fertilization (IVF), egg donation, gestational carriers, and a support services team who has pioneered counseling services designed for LGBT couples.
All patients will have an initial consultation with their physician to discuss their medical history, testing, potential treatment, and financial options. The next step will be diagnostic testing to discover the level of fertility in either partner. Once testing is complete, your medical team will develop a protocol that is right for you and treatment can begin.
Additionally, in accordance with American Society for Reproductive Medicine standards, anyone using donor sperm, donor egg, or a gestational carrier will meet with our Psychological Services team. This consultation will give patients the opportunity to explore their views on planned treatment, obtain resources, and discuss how and when to share third-party reproduction in an age-appropriate way with their future child.
Fertility Treatment for Lesbian Couples
When lesbian couples begin their fertility journey, one of the first decisions they must make is who will carry the pregnancy. The partner carrying the pregnancy will then proceed with day 3 bloodwork to test her hormone levels and a hysterosalpingogram (HSG), a test designed to examine the health of the uterus and fallopian tubes. If she has a good prognosis, the couple will then select a sperm donor to be used to achieve the pregnancy.
Selecting a Sperm Donor
While SGF does not have a sperm bank, we are very selective in choosing which cryobank to refer patients. For each of the sperm banks we recommend, all sperm donors go through a rigorous course of screening, as required by the FDA—physicals, family medical history screenings, genetic screening, psychological testing, and a semen analysis to name a few. This is to protect the recipient, ensuring that they will have access to the healthiest possible sperm. Suggested certified sperm banks include: California Cryobank, Fairfax Cryobank, Xytex Cryo, and Seattle Sperm Bank. SGF will work with other sperm banks, but they need to meet our criteria to ensure the best possible success.
The couple will select the sperm donor using the cryobank’s website. Sperm donors are anonymous, but a childhood picture is usually provided. Personal demographics are listed (i.e. hair color, height, race, etc.), as well as essays written by the donor. In the case of a known donor (i.e. a friend or family member), the recipient will still need to have an infertility work-up, as well as a consultation with our Psychological Services team. In addition, a quarantine period of 6 months for the sperm sample is required by the FDA in order for the cryobank to:
- test the donor sperm for sexually transmitted diseases
- freeze the sperm
- release the sperm to SGF
After the couple selects the donor, the cryobank sends the frozen sperm sample directly to SGF, where it is thawed and analyzed in our andrology lab. From there, the patient will undergo an intrauterine insemination (IUI) or in vitro fertilization (IVF) cycle using the donated sperm. An IUI is a simple procedure where the clinician places the sperm directly into the woman’s uterus. IVF treatment is a procedure in which mature eggs are retrieved from the ovaries, fertilized by the donated sperm in the lab, and then transferred into the woman’s uterus. The physician may recommend IVF if the partner carrying the child has tubal disease, endometriosis, age-related infertility, unexplained infertility, or other possible factors.
Donor Sperm Success Rates
The success rate of donor sperm is directly related to the age and ovarian reserve of the woman, as the sperm bank has already tested the donor sperm for quality. Read more about SGF’s 2013 IUI and IVF success rates.
Donor Egg Treatment
Another LGBT family building option for lesbian couples is when the couple chooses to have one partner provide the egg and the other partner carry the pregnancy. This is a more complex treatment protocol where we will test both partners and both will take medication to boost their fertility. This is an excellent way for both partners to feel connected to the pregnancy and the child.
Fertility Treatment for Gay Couples
Gay men planning to build a family through fertility treatments will meet with their physician to discuss the details of using an egg donor and gestational carrier. The partner wishing to use his sperm will undergo a semen analysis to test motility (movement), volume, concentration, and morphology (shape) of the sperm. SGF does not recruit gestational carriers, but your medical team will refer you to reputable agencies and attorneys who specialize in identifying gestational carriers.
The Gestational Carrier Process
A gestational carrier, or the woman carrying the pregnancy, is in no way biologically or genetically related to the child she is carrying. She is merely providing a nurturing environment in the form of a uterus for the child to grow for the gestational period of 40 weeks. A gestational carrier is not a traditional ‘surrogate,’ as a surrogate is someone who donates her egg and then subsequently carries the child.
After the couple has met with the agency/attorney, the prospective carrier (who has had successful pregnancies/live births previously) and the intended parents will meet in order to determine compatibility. If they decide to work together, an attorney will draw up a legally-binding contract at that time. The gestational carrier will also have to undergo medical and psychological screening. The average wait to be matched with a gestational carrier can run from approximately 2 to 6 months.
Additional Information about SGF’s Gestational Carrier Program
While SGF does not recruit gestational carriers, the following partners meet our standards for quality:
ART Parenting: 301-217-0074
Center for Surrogate Parenting: 410–990–9860
Create Family Connections: 866–407–4224
Family Forward Surrogacy: 301–320–3086
Melissa B. Brisman, Esq.: 201–505–0099
Surrogacy America: 888–587–8939
The Surrogacy Group: 410–990–0018
Selecting an Egg Donor
Once the couple has identified a gestational carrier and the carrier has undergone her medical and psychological screening and legal contracts are in place, they may then select an egg donor. While the majority of patients find a donor through our recruitment process, outside agencies are also an option. One of the major advantages for patients who do use SGF’s donor database is the ability to participate in the Shared Donor Egg program to reduce cost. Patients may also select donors through Donor Egg Bank USA’s frozen donor egg bank.
After the clinician has retrieved the eggs from the donor, one or both male partners will provide previously frozen sperm samples that the embryologist will use in the insemination of the donated eggs. Once developed, the clinician will transfer the embryo to the gestational carrier.
Gestational Carrier Success Rates
The success rates for a gestational carrier cycle are largely determined by the quality of eggs available and the health of the gestational carrier’s uterus. Traditionally, we see very successful outcomes in this program. Your medical team can provide you with an estimate of success once your testing is completed.
Since its inception, SGF has been at the forefront of integrating psychological support services into its fertility program. Our Psychological Support Services staff is located in-house and provides a multitude of services to patients, including private counseling appointments, access to support groups, and the most current literature in the field.
The mental health professionals at SGF are extensively trained and knowledgeable about all aspects of fertility counseling, including LGBT family building. They’re a valuable resource for patients who want to talk with someone about their experience or as they provide tools to help patients move forward on their path.