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Who Will Carry the Baby in LGBT Family-Building? (Part One): For Gay Men

By Tracey Minella

January 26th, 2018 at 3:58 pm

In family-building for heterosexual couples, this is not generally a question. But in LGBT family-building, single gay men or gay couples who want a baby that shares a genetic connection with them, the first question to answer is: Who will carry the baby?

Except in cases where a single gay man or both partners in a gay couple have male factor infertility, sperm is usually readily available for baby-making purposes. But the need for a woman’s egg– as well as a uterus in which the baby will grow– is obvious. Fortunately, there are donor programs at Long Island IVF.

In general, and depending on where they live, gay men can choose either a surrogate OR an egg donor and gestational carrier to carry the baby. Both of these options involve another woman carrying the pregnancy for the single gay man or gay couple as intended parent(s), so it helps to understand the difference, even though surrogacy is not legal in New York State.

In a surrogacy arrangement, the woman surrogate uses her own egg to become pregnant with the gay intended parent father’s sperm. Just to be clear –and to the relief of all involved –the pair does not have sexual relations to establish the pregnancy. Instead, a semen specimen is collected from the gay man who intends to be the biological father, and it’s processed and frozen in advance. The surrogate will be monitored for ovulation (when the egg is released from the ovary and the limited window for conception begins). At that time, in a fast and simple office visit, the father’s specimen is thawed and deposited into her uterus via a thin catheter– through a procedure called an intrauterine insemination, or (“IUI”).

If the IUI is successful, the surrogate carries the pregnancy to term, and gives the newborn to the gay father(s) upon birth, thereafter relinquishing her parental rights (in the manner dictated by that particular state’s laws). The newborn is genetically-linked to both the surrogate birth mother and the gay father. Again, this is not an option in New York.

Those of a certain age may remember the infamous New Jersey “Baby M” case of the mid-80s, which thrust the validity of surrogacy agreements into the national limelight. The birth mother, who was genetically-connected to the baby, changed her mind and wanted to keep the baby instead of turning her over to the biological father and his wife, who were the intended parents pursuant to a surrogacy contract.

A long legal battle ensued, and in a nutshell, the court ruled that the paid surrogacy agreement was invalid and against public policy, and that the birth mother and the biological father were the baby’s legal parents. Further, the case was remanded to Family Court for a judge to decide which parent would be awarded legal custody of the baby, using the “best interests of the child” standard that’s used in regular child custody cases. Custody was given to the father, but the mother was awarded visitation rights. *

Times have changed.

While surrogacy in some form is legal in some states, the advancements in reproductive medicine that followed in the decades since Baby M have now made the use of gestational carriers and donor eggs not only medically possible and popular, but also often the only legal way to have someone carry a baby for you.

Gestational carrier with donor egg is the alternative option to surrogacy for a gay man or gay couple to have a genetically-linked baby and it’s the only legal option in New York State. It involves finding two different women to help you– an egg donor and a gestational carrier. That’s how it’s different from surrogacy.

First, the egg donor only provides the eggs, not the uterus. She could be someone you know (like a sister or friend) or could be an anonymous donor who you select after reviewing an extensive profile of donor egg candidates. At Long Island IVF, we have pre-screened donor egg candidates ready to help you build your family.

Lady #2 is the gestational carrier. She only provides the uterus, not the eggs. She can be someone you know, or someone you don’t yet know but who you select through an agency. In most cases, you will get to know and develop a relationship with the gestational carrier.

With the gestational carrier and donor eggs option, the woman chosen to be the egg donor undergoes what is essentially an in vitro fertilization or (“IVF”) procedure up to the point of the egg retrieval. That means she will receive hormonal injections, bloodwork, and ultrasound monitoring of her ovaries (and the developing follicles/eggs inside them) over a period of a few weeks. The purpose of the treatment is for her to produce multiple egg-containing follicles rather than the one egg she would normally produce that month.

When the time is right, the eggs are retrieved prior to ovulation by a reproductive endocrinologist using a transvaginal needle aspiration procedure and injected with the sperm from the gay man (or men) intended parent(s) in the hope that fertilization occurs.

placed in a petri dish with sperm from the gay man (or men) intended parent(s) in the hope that fertilization occurs.

The resulting fertilized eggs, now known as embryos, will be frozen (a/k/a cryopreserved) until such time as they are ready to be thawed and transferred into the waiting uterus of the chosen gestational carrier. [Note that if pre-genetic screening (“PGS”) is elected, it is done prior to the freezing of the embryos.]

The thawed embryos—generally one or two– are placed into the gestational carrier’s uterus through a thin catheter in a fast and simple procedure performed by the reproductive endocrinologist, aptly called “the transfer”. The intention is for an embryo to implant in the uterine wall and a healthy pregnancy to result. If the gestational carrier gets pregnant, she turns the baby –who unlike in surrogacy has no genetic connection to her – –over to the gay man (or men) who is the intended parent(s).

In accordance with applicable state laws, these women are generally well-compensated for their time and effort. Because of the need for gay men to involve two different women in the process, costs are higher than what lesbians and straight couples using assisted reproductive technology typically incur. However, the good news is that a single egg donor cycle may produce enough eggs that gay male intended parents may be able to build their families through more than one pregnancy using just the eggs retrieved from that initial cycle. So, future pregnancy attempts would require the compensating the gestational carrier, but not the egg donor.

Here is how that could work: They might transfer 1-2 embryos into the gestational carrier on the first try (leaving the rest frozen), and if successful, they have a baby (or two). Then maybe a year or more later, they transfer another 1-2 embryos into the same (or another) gestational carrier, and if successful, they have another baby (or two). And so on, until all the embryos are used or they no longer want to use the embryos for additional children.

While there would be the expense of the gestational carrier for each birth (as well as for the medical treatment expenses for the gestational carrier to undergo a frozen cycle), there would be no additional egg donor costs– until you exhausted your supply of embryos from the first egg donor. As exciting and promising as this process is, each case is different and no program can guarantee a baby in the end for any couple. That said, we do have patients who have successfully used embryos retrieved from a single IVF cycle to build their multi-children families—a child at a time—in separate births spaced a few years apart.  So, there is reason to consider this wonderful family-building option that wasn’t available—especially to gay men—all that long ago.

[The second part on this topic on who will carry the baby—for lesbian singles and couples—will be posted next month.]

If you are a gay man or lesbian—single or married– interested in family building, Long Island IVF has decades of experience helping the community become parents.  Please contact us today for more information or to schedule an initial consultation. In addition, follow us on social media for info on our many free upcoming events.

We are proud to partner with the LGBT Network to provide the community with information, education, support, and access to the most advanced traditional and holistic assisted reproductive technologies. We also understand, respect, and are sensitive to the unique needs of the LGBT community when it comes to building its families.

This year, Long Island IVF is celebrating a milestone–our 30th anniversary. If you are ready for parenthood, we would love the opportunity to assist you with your own milestone.




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The Egg Donor and LGBT Family-Building

By Tracey Minella

July 20th, 2017 at 12:07 pm

Despite making decades of progress, obstacles, frustrations, and inequities are still part of daily life for the LGBT community. And for same-sex couples who want to build a family, having to seek medical attention to do so is an unwelcome but necessary reality. It’s particularly frustrating when simple biological necessity–rather than an infertility diagnosis–lands the couple in the fertility doctor’s office.

Depending on the particular couple’s situation, the “missing piece” they seek could be anything from the relatively inexpensive and easy intrauterine insemination (“IUI”) with donor sperm to the more involved and costly in vitro fertilization (“IVF”) using an egg donor and sometimes a gestational carrier. Very often, egg donation is needed in LGBT family-building.

What is egg donation?

In egg donation, a healthy young woman (the egg donor) agrees to undergo what is essentially an IVF procedure that ends at the egg retrieval stage when her eggs are turned over to a person/couple (the egg recipient/s) who uses them to create their family. The egg donor undergoes hormonal injection treatments over a couple of weeks designed to make her ovaries produce multiple mature eggs, rather than the single egg generally produced each monthly cycle.

As in IVF, the egg donor’s mature eggs will be retrieved, but instead of keeping the eggs for her own use, she donates them to another person/couple. Her role is done upon retrieval of the eggs. The donated eggs are then fertilized with the sperm of a male partner or a sperm donor and the resulting embryos are transferred to the uterus of the female partner or gestational carrier.

When is an egg donor needed?

The simple answer is: Anytime a single person or couple–heterosexual or homosexual–needs an egg to create a baby. That’s either because the woman trying to become pregnant can’t or doesn’t want to use her own eggs or because the single person or couple seeking parenthood is male. Gay men, lesbians with egg-related challenges, and some transgender people will need an egg donor.

How does it work for LGBT family-building?

A gay man or couple could have all the love in the world to give a child, but still needs an egg from a woman in order to make a baby. And a uterus, too. The embryo created from the egg donor’s egg and the sperm of the gay man/men or sperm donor needs to be transferred into the uterus of yet another woman –a gestational carrier – – who will carry the pregnancy to term. The gestational carrier, who has no biological tie to the baby, turns it over to the proud daddy or daddies at the time of birth.

Lesbian couples (or single women) using a sperm donor may be able to conceive with an IUI or through IVF using their own eggs. But sometimes, they may need an egg donor if there is an issue with egg-quality, genetic, or other concerns. (If there are uterine issues, a gestational carrier may also be needed to carry the baby.)

In certain situations, transgender people will need an egg donor. It is important to note that transgender people who transition from female-to-male can have their own eggs retrieved and frozen for future use (and male-to-female transgender people can their freeze sperm for future use) — if done prior to taking any medical or surgical steps on the transgender transition or sexual reassignment journey. Be sure to see a reproductive endocrinologist to discuss these options before it’s too late.

If you would like more information on LGBT parenting options  or would like to schedule an initial consultation with a reproductive endocrinologist, the doctors and staff at Long Island IVF have been helping build LGBT families for decades and would be happy to help you. With several offices throughout Long Island and one in Brooklyn, we’re conveniently located near you.

As a partner of the LGBT Network on Long Island, Long Island IVF is committed to continuing to build families for the LGBT community through cutting-edge medical technology, complementary holistic therapies, and sensitivity to all patients’ individual needs.

Long Island IVF, along with the LGBT Network, offers free LGBT family building seminars every June and periodically throughout the year.

Register here for our next free “Building Families in the LGBT Community” event, which will be held on October 26, 2017 at the LGBT Network at 34 Park Avenue, Bay Shore, NY. Follow our blog, Twitter, and Facebook for more information.

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