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Everything You Always Wanted to Know About LGBT Family-Building Options at Long Island IVF

By admin

June 16th, 2017 at 2:37 pm

 

Whether you are lesbian, gay, bisexual, transgender or queer/gender-fluid, you aren’t any different than heterosexuals who want to start a family but need medical intervention to do so.

You have the same dream of becoming a parent, the same longing in your heart for a baby of your own, the same frustrations and embarrassment about needing medical intervention for such a private matter, the same worries about affording and financing the treatment, and the same paralyzing fear of it not working.

And yet, you are different from the heterosexuals who are suffering from infertility. Your treatment needs are different. Your emotional needs are different. We understand that.

Long Island IVF pioneered IVF on Long Island, bringing Long Island its first IVF baby, first baby from a cryopreserved embryo and first donor egg baby. For almost 30 years, we’ve been serving both the heterosexual and LGBT communities on Long Island. Several of our staff are members of the LGBT community as well and many staff members were former patients—so we really do understand where you are coming from.

The easiest way to illustrate the differences between heterosexual and LGBT family-building is to begin with the similarities.

In heterosexual family-building, any number of factors may be causing the couple’s infertility. It could be female factors like poor egg quality, blocked fallopian tubes, uterine issues like fibroids, endometriosis, hormonal disorders like polycystic ovarian syndrome, recurrent miscarriage, and more. It could be male factor infertility due to poor quality sperm. Or it could be a combination of male and female factors—or simply be due to the frustrating diagnosis of “unexplained infertility”. When a couple is unable to get pregnant after 6-12 months of trying (the number of months differs based on age), they are considered to be infertile. Sometimes less aggressive medical approaches—such as intrauterine insemination (“IUI”) with or without ovulation induction do result in pregnancy. Oftentimes, more aggressive Assisted Reproductive Technologies (“ART”) like in-vitro fertilization (“IVF”) are in order.

Here’s a crash course in IVF 101.

In IVF, the goal is to have the woman develop more than the one mature egg she would normally produce in a typical monthly menstrual cycle. To accomplish this a woman’s ovaries are stimulated through the use of injectable hormone medications and careful monitoring by ultrasound and bloodwork so that at just the right time, the multiple eggs that have matured are retrieved from the ovaries transvaginally through needle aspiration under sedation. Then the eggs are either frozen or are combined with the partner’s sperm to produce embryos. The resulting embryos are then either transferred back into the woman’s uterus where they will hopefully implant and result in a pregnancy, or are frozen for future use, or a combination of the two options. Because the number of embryos transferred back into the uterus is both limited and controlled, IVF minimizes and virtually eliminates the risk of a multiple pregnancy, making it a safer treatment option.

Sometimes, a heterosexual couple needs help from a third party to build their family. They may need a sperm donor or an egg donor if the couple’s own sperm or eggs are not sufficient or of good quality. Or they may need a woman to act as a gestational carrier to carry their embryo(s) and resulting pregnancy if the uterus of the woman of the couple is either absent or not otherwise suitable.

Now let’s look at how LGBT family-building is different.

Well, for starters, virtually all LGBT couples need some kind of help from a third—or even a fourth—party in order to build their family. In fact, in virtually all cases, sex alone will never result in a pregnancy for the LGBT couple without outside intervention. So, while it does happen that a LGBT patient could have a medical factor making them infertile, in the vast majority of cases, LGBT couples seek out an infertility specialist to obtain the “missing contribution” that is required to make a baby. The exception is the transitioning individual who has not begun hormonal treatment to transition from male to female or from female to male.

Here are the general treatment options and the ways “missing contributions” for LGBT couples can be obtained. They are slightly more straightforward in the cases of lesbians and gay men than in transgender cases.

Lesbian couples:

Two women will need a sperm donor. Depending on their age and the health of their eggs and uterus, they can do IVF and may even be able to do an IUI. If doing IVF, some couples decide to use one woman’s egg and have the other woman carry the pregnancy in her uterus.

Gay couples:

Two men will need an egg donor. They will also need a gestational carrier who will carry the pregnancy in her uterus for them. Gay couples may decide to divide the number of eggs retrieved from the egg donor in half and then each partner may contribute a semen specimen to fertilize half of the eggs—thereby each being a biological father to the embryos that resulted from their contribution.

Transgender couples:

Transgender family-building is relatively new in comparison to lesbian and gay family-building which the LGBT community has been able to access for decades. There are varied options for transgender family-building, but they all require knowledge and proactive steps on the part of the transgender person.

The single most important takeaway from this article for transgender folks who do (or may in the future) want to have a biological child is this: See a reproductive endocrinologist BEFORE taking any medical or surgical steps on the transgender transition or sexual reassignment journey.

In “Woman to Man” reassignment, before the woman hormonally, medically, or surgically becomes a man, she should consider having her eggs retrieved and frozen for future use. Or if she has a male partner now, her eggs can be fertilized with his sperm and the embryos either implanted in her uterus now so she can carry the baby before she transitions, or if the woman does not want to carry the pregnancy and prefers to move ahead with the transition, then the embryos can be frozen and transferred into the uterus of a gestational carrier at any time.

However, if the woman who transitions prefers a female partner, then the couple has most of the same options as any lesbian couple. They could use either woman’s eggs with donor sperm and the resulting embryos could be implanted into the partner with the uterus or into the uterus of a gestational carrier if needed. Some couples choose his eggs and her uterus so both can be involved.

Now the opposite case.

In “Man to Woman” reassignment, before the man hormonally, medically, or surgically becomes a woman, he should consider having his sperm frozen for future use. Sperm freezing is so much cheaper and easier than egg freezing. If he has a female partner now and they want to become pregnant now, his sperm can be used to impregnate her through IUI or, if she undergoes IVF, then her retrieved eggs can be fertilized with his sperm and the resulting embryos either implanted in her uterus now or frozen for later use. Some couples choose his sperm and her eggs and/or uterus so both can be involved. If his female partner’s eggs or uterus are not optimal, they will need an egg donor and/or gestational carrier.

However, if the man who transitions prefers a male partner, then the couple has the same options as a gay couple. They could use either of their sperm with the egg donor’s eggs and transfer the resulting embryos into a (gestational carrier) woman’s uterus.

If you identify as queer or gender-fluid, you can utilize donor egg, donor sperm, a gestational carrier or any combination of the above options as they fit you and your partner.

Sadly, not all physicians realize or advise transgender individuals of their fertility-preservation and family-building options before the transition process has begun, so it is up to you to initiate the discussion or take action. It is absolutely critical that egg and sperm freezing be done before the hormonal, medical or surgical transition or reassignment begins. Or it will be too late.

Despite the current and uncertain political climate, there has never been a better time for LGBT members to pursue family-building. As a result of rapidly advancing ART, today’s LGBT community has choices beyond the noble but limited options of foster parenting and adoption—choices that allow for biological children. The lesbian and gay parents of recent decades have blazed a path of slow but ever-increasing acceptance that has not only benefitted today’s lesbian and gay parents, but has helped open the door for the transgender population to come out and claim their own fertility and parenting rights.

All people of reproductive age who are considering becoming parents at some point would benefit from a fertility screening by a reproductive endocrinologist—ideally sooner rather than later. At that exam, screening tests would be conducted to identify any actual or threatened obstacles to fertility, such as diminished ovarian function or premature ovarian failure or other factors in women, or sperm issues in men. Depending on what is found, proactive steps could be taken to preserve your fertility, including egg freezing for women who just want to preserve their young and healthy eggs for use at a future date.

Also file this important bit of information away and hope you will never need to remember it: If you or a loved one are ever faced with a cancer diagnosis and time allows for it, egg-freezing and sperm freezing done prior to starting certain chemotherapy or radiation protocols for certain cancers are options to preserve your fertility. That way, your healthy eggs and sperm are waiting for you when you’re ready to build your family after your cancer battle has been won. Be sure to call a reproductive endocrinologist to discuss fertility preservation before cancer treatment.

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 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. Click here for information and to preregister for the June 29th event.

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