LGBTQ Fertility Care and Family Planning Support
There are many options and services available for LGBTQ individuals or couples to become parents. Our Women’s Health Connecticut network of providers welcome care for all expecting parents and offer treatment for reproductive health issues that may affect conception. Women’s Health CT has partnered with the Center for Advanced Reproductive Services (CARS), Reproductive Medicine Associates of Connecticut (RMACT) and Long Island IVF as resources for patients who may need advanced assistance to grow their families and provide support for LGBTQ individuals and couples. If you have any questions, your physician is available to offer guidance, or a referral to a fertility center. These providers offer individualized treatment planning for your growing family’s needs.
We spoke with the CEO of CARS, Paul Verrastro, and he suggested that the best place to start when considering fertility assistance is a consultation with a board-certified Reproductive Endocrinology and Infertility (REI) doctor to discuss your needs. In that consultation, “goals and options are discussed as well as medical intake. Diagnostic and screening tests may be ordered. There will also be a meeting with a Financial Services Representative to discuss costs.”
Fertility treatment options for cisgender gay, bisexual, or queer single women or couples:
Cisgender women have several options for conception assistance. The process often begins with a physical examination by a REI. They will provide routine baseline fertility testing and investigation to present multiple pathways for an individual or couple to decide upon. Paul suggests raising consultation questions, “related to the impact of age on female fertility and the process for obtaining donor sperm.” Recommendations for treatment options commonly include:
Intrauterine Insemination (IUI)
Known as the most common fertility treatment, IUI (also referred to as artificial insemination) is a procedure that inserts a concentrated donor sperm sample directly into a woman’s uterus near a predetermined optimal ovulation period. This method decreases the distance for sperm to travel to the fallopian tubes and provides an increased possibility for pregnancy.
In Vitro Fertilization (IVF)
IVF is a highly effective fertility treatment that implants a fertilized embryo in the uterus. Each treatment cycle begins with ovulation stimulation and the retrieval of the patient’s eggs. Viable eggs are fertilized with male sperm in a laboratory and then transferred back into the uterus.
Shared Conception (Reciprocal IVF)
Another alternative for lesbian couples who both want to participate in a single pregnancy is though shared conception. Following the IVF process, one partner’s eggs are fertilized with donor sperm. Then, the other partner is implanted with the embryos. Through this process, both partners are linked to the child.
Egg Donation or Gestational Carrier
Options are available for women who are infertile or have a medical issue that hinders pregnancy. The use of donor eggs offers an alternative for the IVF process when the patient’s eggs are not an available option. Additionally, gestational carriers are women that are implanted with an embryo and carry the baby for the patient with no genetic link between the carrier and child.
Fertility treatment options for cisgender gay, bisexual, or queer single men or couples:
It is possible for cisgender men to achieve fatherhood with the involvement of a gestational carrier, an egg donor, and semen from one or both partners. A commonly recommended starting point is to meet with an REI to provide semen analysis to address any issues with infertility and review available pathways to achieve pregnancy. For men, Paul suggests raising consultation questions, “related to the process for obtaining donor eggs and the pathway for obtaining a gestational carrier and associated costs.” Recommendation for treatment commonly includes:
Gestational Carrier with donor eggs
Gestational carriers are women that achieve conception through the implantation of an embryo through the In Vitro Fertilization (IVF) process. The embryo (fertilized egg) in this procedure is created in a laboratory with either or both partner’s sperm and a donor egg of their choosing, which can either be acquired by a known or anonymous egg donor. Accordingly, there is no genetic link between the carrier and child.
Fertility treatment options for transgender individuals and couples:
There are several options available for transgender men and women that are in the process of transition or have completed gender affirmation. Treatment will depend on individual circumstances and at which point they are in their transition. It is important to schedule a consultation and speak with an REI about your individual questions and concerns. Recommendations for treatment options commonly include:
Cryopreservation Prior to Hormonal and Surgical Transition
Freezing your genetic material before taking hormone blockers provides an opportunity to preserve reproductive cells for future use. It is important to note that if hormones have been introduced to the transition process, it is not too late to engage in cryopreservation for future family building use. Paul affirmed this, providing that, “studies have shown that ovarian and sperm production can return post hormone treatment.” Cryopreservation can be done with sperm, eggs and embryos for patients. Family planning options offer the use of eggs and embryos for In Vitro Fertilization (IVF) and sperm may be used for IVF or intrauterine insemination (IUI).
Assigned Female at Birth (AFAB)
Transgender men who have a uterus have the option of carrying a pregnancy, with usage of partner or donor sperm with IUI, or may require IVF using his own, a partner’s, or donor eggs. In IVF, embryos would be implanted into his own uterus, his partner’s uterus or into a gestational surrogate. If the patient has had a hysterectomy and cryopreserved eggs or embryos prior to transition, a cisgender female partner, or gestational surrogate may carry the pregnancy.
Assigned Male at Birth (AMAB)
Transgender women who still produce semen may provide a sample for cryopreservation prior to hormonal or surgical procedures that would inhibit reproductive ability. Cryopreserved sperm can be used with a cisgender female partner, or gestational carrier in IUI and IVF treatments. Patients who do not have a female partner may utilize a gestational carrier by obtaining eggs from a donor, which would then be fertilized with the frozen sperm, and the resulting embryos would be transferred to the carrier.
LGBTQ Reproductive Advanced Care Affiliates
The Center for Advanced Reproductive Services (CARS) is an academic affiliate of the UCONN School of Medicine. They are a full-service fertility center with locations in Farmington, Hartford and New London, Connecticut. CARS provides individualized clinical care to people experiencing infertility in a caring, sensitive, responsive and knowledgeable environment. In 2006, CARS began tracking LGBTQ patients as a distinct demographic and over 300 LGBTQ individuals and couples have been seen and over 175 babies have been born to LGBTQ families. CARS was one of the first fertility programs in New England to operate an internal sperm bank that became a prevalent resource within the local lesbian community. Since 1983, they are responsible for over 12,000 live births and surmise through historical analysis, the estimated number of babies born to LGBTQ individuals and couples to exceed 1,500. For more information please visit: CARS LGBTQ Program
Reproductive Medicine Associates of Connecticut (RMACT) is a full-service fertility center located in Norwalk, Danbury, Stamford, Trumbull Connecticut and Poughkeepsie, New York. They provide a comprehensive wellness program within a supportive environment. RMACT also holds a “LGBTQ Healthcare Equality Leader” designation from the Human Rights Campaign Foundation (HRC). The Healthcare Equality Index (HEI) is the national LGBTQ benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBTQ patients, visitors and employees. For more information please visit: RMACT LGBT Family Building and their blog, Gay Parents to Be, an informational resource and link to gay parenting services.
Long Island IVF is a full-service fertility center located in Melville, Brooklyn, Lake Success, East Patchogue, West Islip and Stony Brook, NY. They are committed to administering compassionate, inclusive care and provide detailed informational service offerings for LGBTQ individuals, emphasizing sensitivity and expertise in relation to the family building process. Long Island IVF also provides educational programming, including the seminar, “Building Families in the LGBT Community,” which is being held in conjunction with the Long Island LGBT Network. For more information please visit: Long Island IVF: Growing Families in the LGBT Community