- LGBTQ+ family building: Assisted reproduction fertility treatments offer proven methods to build families for lesbian, gay, bisexual, transgender and queer individuals and couples, whether or not infertility is an issue.
- Reproductive services: LGBTQ+ family building requires third-party reproductive assistance such as donated sperm, eggs or embryos, and treatments such as artificial insemination or in vitro fertilization (IVF).
- Louisiana’s LGBTQ+ family building laws include several restrictions and considerations for same-sex and transgender patients. We will provide a referral to an assisted reproductive technologies attorney who can help families better understand the restrictions.
- Required testing: LGBTQ+ patients and donors will undergo tests for hormone levels, sexually transmitted diseases, egg count and health.
- Using a sperm donor: LGBTQ+ couples can use a known or anonymous sperm donor, or work with a sperm bank.
- Reciprocal IVF: Allows both female (or transgender) partners to participate in the pregnancy.
What is LGBTQ+ family building?
Our fertility specialists are proud to welcome and treat LGBTQ+ individuals and couples on the road to parenthood. The Fertility Institute of New Orleans will help our LGBTQ+ parents-to-be through several steps on their journey to biologically-related children, including standard fertility treatments, third-party donor coordination, and social and family considerations.
Together we talk about all legal and emotional concerns, as well as the medical procedures and efforts necessary in each person’s circumstances to have a child of their own. We always recommend counseling and provide names of counselors who have experience working with patients undergoing third-party reproductive assistance.
The state of Louisiana has very specific laws regarding most aspects of LGBTQ+ family building. We advise our LGBTQ+ patients to seek the advice of an attorney who specializes in assisted reproduction technologies and the related Louisiana laws on embryos, surrogacy, adoption and LGBTQ+ rights. This helps patients completely understand and comply with Louisiana law regarding their individual treatment needs and helps ensure that our LGBTQ+ patients retain all their parental rights. We can recommend such experienced attorneys.
We are providing the following on reproductive services for LGBTQ+ family building for informational purposes. Louisiana law may restrict the use of some of the services described.
How LGBTQ+ reproductive services (fertility treatments) work
For example, lesbian couples need donated sperm to fertilize the egg of one partner. This can be the egg of the woman carrying the pregnancy, in which she can get pregnant using donor sperm through artificial insemination or IVF. Or the egg can be provided by one female partner, which is then fertilized in the lab and transferred into the other partner’s uterus for pregnancy. This process is known as reciprocal IVF.
Gay couples and individuals will typically need donated female eggs to fertilize with one or both partners’ sperm through IVF, as well as a female surrogate to carry and deliver the child.
Some LGBTQ+ couples may require a mix of such services. For instance, lesbian couples who present certain pre-existing health issues, including infertility, may need both a sperm donor and a gestational carrier. Various partner combinations involving sexual reproductive systems and gender identifications can result in the need to use infertility treatments.
Our fertility specialists can advise our patients on the available options and reproductive services needed.
Required testing for LGBTQ+ patients and donors
Planning a family for heterosexual and LGBTQ+ families alike starts with a general health evaluation and testing. This includes an initial exam covering a patient’s medical history, a pelvic exam and blood tests to measure thyroid function, blood type and immunity for viruses (like German measles) that could threaten the healthy growth of a fetus.
Both patients and donors are also tested for infectious diseases. The American Society for Reproductive Medicine recommends that anyone seeking third-party fertility treatment get a blood test to screen for sexually transmitted diseases, hepatitis and other viral conditions that could endanger the conceptus (embryo in the uterus).
Female or transgender male patients will also have a transvaginal ultrasound and bloodwork that examine the health and supply of eggs in the ovaries. The fertility specialist will also look for any blockages or damage to the fallopian tubes and uterus that might prevent conception.
We recommend genetic testing for all parties involved. This is a blood test that reveals any genetic disorders that might get passed on to the baby or hinder reproductive success. For example, if both the egg and sperm donors are carriers for the same congenital disorder, there is a 1 in 4 chance that the child will have the disease.
Lastly, for patients using third-party donors, all parties must be tested for cytomegalovirus (CMV). More than 50% of adults contract CMV, which is a type of herpes virus, by the time they are 40 years old, according to the Centers for Disease Control and Prevention (CDC). Most people don’t ever know they have it because the symptoms are similar to the common cold.
Patients and donors participating in LGBTQ+ fertility treatments must be tested because CMV causes birth defects and long-term health problems for a child. If a sperm donor carries this virus – even if the exposure was a long time ago – it could still live in the sperm. That means:
- A female (or transgender male) patient who HAS been exposed to CMV at any point and tests positive for antibodies can use sperm from a donor who’s tested either positive or negative.
- A female (or transgender male) patient who has NOT been exposed to CMV should only use sperm from a donor who tests negative for the virus.
Using a sperm donor
There are two ways to utilize a sperm donor. The first, and most common, way is for the patient to work with a third-party sperm bank. Our clinic facilitates usage of that donated sperm in artificial reproduction technologies for LGBTQ+ patients.
The second way is for patients to work directly with a sperm donor, either someone known or unknown, which is called directed sperm donation. Presently, The Fertility Institute does not use directly donated sperm.
Sperm donor considerations
Finding a sperm donor is not something to be taken lightly. There are many elements of arriving at a decision that make LGBTQ+ family planning unique.
Questions partners and individuals should ask include:
- What if the preferred sperm donator is a carrier for the same genetic disease(s) as the intended parents?
- Do they want to be able to select certain characteristics or attributes, such as ethnicity, height, education and other criteria?
- If they want more children at a later time, would they prefer those children to have the same sperm donor? If so, additional semen specimens may need to be frozen and stored for later use.
- How and when will they explain to the child, friends and family about the child’s parentage?
- What treatment plan has our doctor advised for them, IUI or IVF? That could determine the type of sperm specimen needed for optimal fertilization.
Reciprocal IVF for lesbian couples
One treatment option that we offer lesbian couples is the opportunity for both partners to take part in the pregnancy. Called reciprocal IVF, the procedure allows one partner to undergo controlled ovarian stimulation and egg retrieval; the egg is fertilized in the lab with donor sperm and the resulting embryo(s) is implanted into the other partner’s womb to carry the pregnancy.
Both partners use medication to synchronize their menstrual cycles. Then, as one partner undergoes the ovarian stimulation and egg retrieval process, the other uses medication to prime her uterus to accept the embryo. There is also an option to freeze the embryos for transfer to the uterus later.
LGBTQ+ family building through surrogacy
While The Fertility Center of New Orleans supports all members of the LGBTQ+ community in their dream of having a family, Louisiana’s strict surrogacy laws prevent our practice from providing reproductive services to gay couples in need of a gestational carrier surrogate. The following is provided for informational purposes on what gay couples can expect in surrogacy services.
Process and considerations for gay male (or transgender) couples in need of surrogacy
In order for gay men (or transgender women) to have a biologically related child, they need a female surrogate to carry the pregnancy for them. Most reproductive specialists recommend or require surrogates to be gestational carriers, meaning the surrogate carries the pregnancy created using donated eggs (eggs from a different woman) to achieve pregnancy, so the child she delivers is not genetically related to her.
For gay parents-to-be, there are a few options to acquire donated eggs.
- Receive a gifted donation of eggs from either a known or unknown female.
- Consult a third-party agency that recruits egg donors. These donors would go through the IVF process of egg retrieval; then the eggs can be frozen, or fertilized as embryos that are then frozen.
- Use an egg bank. With the advent of cryopreservation, frozen eggs have become the most efficient and cost-effective donor egg option. Patients can acquire eggs directly from third-party egg banks.