Same-sex couples face different fertility options and issues from heterosexual couples who can attempt conception without any medical help. Lesbian couples require an outside source of sperm while gay men require an egg donor and uterus.

However, before addressing the technical aspects of diverse medical family-building options open to same-sex couples, it is crucially important to firmly establish who are the Intended Parent(s), because it is the initial intent that legally determines parental rights and responsibilities.

Whereas many same-sex couples pursue a family jointly with the intention of having two co-parents, some lesbian women and gay men seek a child(ren) as the sole Intended Parent even though they may be in a same-sex relationship at the time. Different circumstances require different consents and legal documents.

Lesbian WomenPartner IVF.pdf

Lesbian women most commonly pursue pregnancy through the IUI procedure (What is intra-uterine artificial insemination?) using either sperm of an anonymous donor from a sperm bank or semen from a directed/known donor. A directed/known sperm donor generally is not an Intended Parent but the exact boundaries of mutual rights and responsibilities under such circumstances are best spelled out in a legally binding contract drafted by an attorney specializing in third-party parenting.

A directed/known sperm donor undergoes donor eligibility determination in accordance with the FDA regulations and policies of the Alta Bates IVF Program within 7 days of semen collection and freezing. Depending on whether risk factors are identified, the recipient/Intended Parent can decide about the need for and the duration of quarantine in consultation with the treating physician. The FDA’s required donor screening needs to be completed within 7 days of the IUI procedure, so artificial insemination with fresh sperm is usually not feasible.

Anonymous sperm donors are never considered Intended Parents, so no direct legal contract is necessary between such a donor and the recipients. Sperm banks release sperm from anonymous donors only after a 180-day period of quarantine with retesting. Same-sex lesbian couples and single women may have particular interest in using a sperm donor willing to have his identity released when the offspring reach maturity (I.D. release). Whereas most commercial sperm banks are just beginning to offer this option, I.D. release sperm donors are available through The Sperm Bank of California and Pacific Reproductive Services.

Partner IVF (in vitro fertilization) is a high-tech fertility option open to lesbian couples who desire a biological link between each partner and their children. Under this arrangement one partner and Co-Parent undergoes ovarian stimulation and egg retrieval to provide the eggs which are fertilized with donor sperm in the laboratory and then some of the resulting embryos are transferred into the uterus of the other partner and Co-Parent. Thus the egg donor partner has a genetic link while the partner carrying the pregnancy maintains a gestational link to their offspring.

To maximize the chance of a successful pregnancy, it is usually best if the younger partner, who has better ovarian reserve, is the egg donor. Frequently, however, only one of the partners desires to go through pregnancy and delivery which then determines the roles assumed by the two partners. The success rate of Partner IVF depends on the age and ovarian reserve of the egg donor partner and the uterine status of the partner carrying the pregnancy. Older Intended Mothers who require both donor eggs and donor sperm may wish to consider pregnancy initiation with donated embryos.

Gay Men

Gay couples and single gay men pursuing family building have essentially one medical option: pregnancy initiation with egg donation and gestational surrogacy. This approach preserves the Intended Fathers’ genetic link to the children and has become known as gay surrogacy.

The technique allows for fertilization of some of the eggs with sperm from each partner thus providing each Intended Father with a genetic link to a child. If the Intended Parents elect to have two embryos transferred into the surrogate, then one embryo fertilized with each partner’s sperm can be replaced. The gestational surrogate may be a family member or she may be an unrelated fertile woman.

Another scenario involves fertilization of eggs donated by a sister of one of the Intended Fathers with the sperm of the other Intended Father for transfer into a gestational surrogate. The main drawback of family building with an egg donor and gestational surrogacy is its high cost, but the live birth rate is excellent. That’s why some gay couples pursue adoption as a more affordable alternative.

Our same sex patients come to us from Berkeley, Oakland, Sacramento, San Francisco, the Bay Area and surrounding communities.