“Asking who’s the ‘man’ and who’s the ‘woman’ in a same-sex relationship is like asking which chopstick is the fork.”
~ Ellen DeGeneres
Lesbian couples wishing to create their families have, relatively speaking, an abundance of options.
If both are healthy and without any significant medical/surgical history, there are two uteruses and two pairs of ovaries to work with. They can decide if one or both of them will participate in the conception and delivery of the child. They can also choose to reverse roles and have the alternate female deliver the next child.
If only one of them will be participating in the process, the simplest approach is to have the patient undergo donor sperm intra-uterine insemination (IUI) cycles (see section on Donor IUI). Alternatively, the patient may choose to use the donor sperm as part of an IVF cycle. Since there is a good chance that the patient does not meet the criteria to be called infertile, she has an excellent chance to conceive with IVF. The physicians at Conceive Fertility Center will counsel the patient regarding her individual chance for conception with IVF. As with all patients, success is very much dependent on her age and egg reserve status.
If both partners of the couple want to participate in the process, they can consider reciprocal IVF. Reciprocal IVF is an intriguing option for lesbian couples because both partners contribute significantly in the conception and birth of the child. The process is the same as for a regular IVF cycle, but it is divided between two women. In reciprocal IVF, one partner supplies the eggs, while the other partner is the gestational carrier of the pregnancy. The treatment is divided into two stages:
The partner donating the eggs goes through a traditional IVF cycle in which the ovaries are stimulated to produce multiple eggs. The eggs are then extracted from her ovaries and fertilized with donor sperm in the laboratory. The embryos are grown in the IVF laboratory for 5-6 days at which time they can be frozen for future use or they can be biopsied (for preimplantation genetic screening) and then frozen. The partner functioning as the gestational carrier is prepared for embryo transfer using a combination of estrogen and progesterone. When her lining is ready, one or two embryos are thawed and transferred to her uterus. The embryo(s) will hopefully implant in her uterus and establish the pregnancy. Progesterone is used to maintain the pregnancy until the placenta is fully formed.
If neither of the partners have fertility issues, either one can be the egg donor or gestational carrier. The physicians at CFC will evaluate each partner’s medical and obstetrical history and provide guidance as to the best choice. In general, IVF is more successful with eggs from a younger (age < 35) woman. Sometimes partners who don’t have fertility issues and have had a child with reciprocal IVF will reverse their donor and carrier roles for a second child, so that each has a biological relationship with one of the children, and each gets to experience pregnancy and childbirth.
We encourage couples considering these creative options to speak with a counselor beforehand to explore their expectations. In addition, discussions with a lawyer may be needed to ease concerns regarding parental rights after the delivery. The physicians at CFC have lawyers and counselors in which we have the utmost confidence to handle these issues.
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