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Today's Medicine

When Nontraditional Families Want to Grow

Starting a family

When most couples decide to have a baby, it’s an easy process. They simply stop preventing pregnancy. The male partner provides the sperm, while the female partner provides the egg and the uterus. The connection each partner has with the child is quite clear. 

But what happens in the setting of a same sex marriage or partnership? Just stopping a birth control pill isn’t going to do it.  

A lesbian relationship

In a lesbian relationship, the simplest path to conception is for one partner to undergo intrauterine insemination (IUI) using sperm from a known or anonymous donor. Prior to treatment, the partner planning to undergo insemination would undergo a quick and basic evaluation. The couple chooses a donor, and often an IUI can be performed that same month. 

Pregnancy rates approach 30 percent per month with this form of treatment. If the couple chooses to have another child in the future, the other partner might chose to provide the egg and carry the pregnancy, effectively making their children genetic half-siblings (assuming the same sperm donor is utilized).

Biological connection

Although this option is fairly straightforward and inexpensive, it doesn’t provide both partners a biological connection to the child. One partner has both the genetic and gestational relationship with the child. If this is the case, the couple may elect to go through an in vitro fertilization (IVF) cycle where one partner produces the egg and the other carries the embryo that is created. In essence, one partner retains the genetic connection, while the other has the gestational connection. The process of IVF is more invasive and expensive, but for some couples the benefits of this arrangement far outweigh any risks.

Gay male couples

As complicated as this might all seem, things are even more challenging for two men couples hoping to start their family. While there are now two sources of sperm, the couple is faced with finding both an egg donor and a gestational carrier. 

Some couples may have friends or family members that are willing to donate eggs or carry a pregnancy (i.e. act as gestational carrier). Others may opt to use a donor or carrier agency. Once a couple has been matched with their donor and carrier, all of the involved parties undergo health and fertility screening, and an IVF cycle is performed. One or both men can provide sperm to fertilize the eggs obtained from the donor. An embryo, or embryos, is then transferred into the gestational carrier. 

Reproductive laws vary from state to state, and there are generally contracts and lawyers involved for everyone’s protection. The good news is that success rates for couples using an egg donor are generally quite high – over 60 percent.

Know your options

The only way to determine which path is best for your family, is to learn about your options. If you’re in a same sex relationship and considering a pregnancy, the physicians at Methodist Reproductive Health Specialists are ready to help you start and complete your journey.

About the Author

Dr. Meghan Oakes is a reproductive health physician who specializes in helping couples with fertility issues.

You can visit Dr. Oakes at Methodist Reproductive Health Specialists on the campus of Methodist Women's Hospital.

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