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3 Tips for LGBT Prospective Parents Who Want Biological Children

RMA Long Island IVF has been building families in the LGBT community for decades. We are proud to partner with The LGBT Network to provide information, education, support, and access to the most advanced traditional and holistic assisted reproductive technologies--all while understanding, respecting, and being sensitive to the unique needs of the LGBT community.

Heterosexuals generally assume they can create a biological child without medical intervention because their physical union provides the egg and sperm necessary to do so--and are consequently blindsided to learn after months of trying that they may be infertile and need medical intervention to conceive.

Conversely, virtually all LGBT couples and singles approach the prospect of biological parenthood knowing from the start that they will need medical intervention as well as the assistance of one (or more) known or anonymous donors to provide the missing biological piece(s) to create a baby and carry it. For example, lesbians know they need a sperm donor and gay men need an egg donor as well as a gestational carrier to carry the baby. Transgender couples and individuals may also need donors or just gestational carriers depending on their particular situation. But it’s the assumption that the missing piece is all they may need that can leave some people in for a devastating blow.

Because they are focused on the one (or two) missing piece(s) they know they need, the LGBT community may not realize the possibility that additional barriers to biological parenthood may also exist. They may assume they are fertile and able to contribute the biological piece (egg or sperm) they think they have covered-- only to find out down the line when they are ready to conceive that there may actually be a problem on their end.

For LGBT individuals or couples who want to be parents, learning that they not only need a biological contribution from the opposite sex but also that they have a problem producing the healthy eggs, sperm, or uterus they assumed they were contributing themselves can jeopardize or detour their pathway to parenthood. Even for gay or lesbian couples, it’s possible that biological or other factors would make the use of the sperm, eggs, and/or uterus of both members of the couple unavailable, unsafe, or inadvisable.

Fortunately, LGBT prospective parents may avoid or minimize such surprises by following these tips:

  • Schedule a fertility evaluation with a reproductive endocrinologist –ideally long before you plan on pursuing fertility treatment to conceive—to establish a baseline fertility status.

For men, this may include a semen analysis and/or physical examination. The semen analysis can detect problems with the amount of sperm, its motility, and its morphology because it examines whether there is low sperm count, whether it moves/swims sufficiently, and whether sperm is properly shaped. Depending on any problems uncovered, treatment options may be available to correct or improve the situation prior to attempting pregnancy. Women planning on using donor sperm from a known donor may encourage the donor to provide a semen sample for analysis in advance as well.

For women, a physical exam, including a transvaginal ultrasound and blood work is invaluable in ruling out or discovering fertility red flags. While not a guaranty of fertility, these combined tests give doctors great insight into potential problems like hormone imbalances, diminished ovarian reserve (when a woman’s supply of eggs is running out), fibroids and other uterine issues which could be red flags for a woman hoping to use her own eggs or her uterus to carry a pregnancy. Sometimes women may choose to have children sooner (or freeze their eggs) if they want to use their own eggs and sometimes surgery might be advised to correct certain uterine issues based on these findings.

Once a baseline evaluation has been established, future periodic evaluations compared against the initial findings are helpful in determining if any changes have occurred that might cause a couple to consider changing or accelerating their parenthood plans.  

RMA Long Island IVF’s Egg Freezing program is a great option for many younger women who are not ready to conceive for any number of reasons at the moment but would like to have their own young eggs frozen so they will be available for them to use in the future if they want to.

  • Genetic screening for those who know of or suspect a family history of genetic diseases or mutations, having an evaluation early – – and referral for genetic testing if indicated-- can save valuable time.

RMA Long Island IVF offers PGT (Pre-implantation genetic diagnosis or Pre-implantation genetic screening) for those using in vitro fertilization (IVF) technology to grow their families. That includes anyone using donor eggs or retrieving their own eggs through IVF. 

But it does not include anyone attempting to conceive through intrauterine inseminations (IUI) since—unlike in IVF--eggs in an IUI cycle are not removed from the body for fertilization in the lab.  So, any embryos created are inaccessible and therefore, not able to be genetically tested.

PGT enables testing of embryos for many genetic diseases prior to using them to establish a pregnancy. Those embryos screened and determined to be without the disease can be favored over others that carry the disease when deciding which embryos to use to establish a healthy pregnancy.

For some people, the need to screen for and know the genetic status of their future offspring leads them to use IVF technology so they can access PGT testing. For example, a woman concerned about passing on her family’s breast cancer gene might skip IUI with donor sperm in favor of an IVF egg retrieval with donor sperm so her resulting embryos could be genetically tested.

  • Pre-Transition Fertility Counseling and Evaluations are exceptionally important for the transgender community.

At RMA Long Island IVF, we are committed to helping transgender people become parents. Advancements in assisted reproductive technologies have created new family building options that were not available just a few years ago. Being evaluated by a reproductive endocrinologist before transitioning and ideally before beginning hormonal therapy will identify all the options currently available and allow them to preserve their eggs and/or sperm prior to transitioning.

This is so important that it needs repeating.

Moving forward with hormonal treatment and/or transition surgeries without consulting a reproductive endocrinologist first can be a decision that transgender individuals may regret later if it costs them the ability to access their healthy eggs or sperm to contribute to making a future biological child.

Today they may not be thinking about future biological children. Or they may think they don’t want them now or ever—and that may end up being the case. Or they may be dreaming of transitioning or actually be making surgical plans so they can finally move forward and live life as the gender they are rather than the one they were assigned. So understandably, the last thing they may want right now is to get in touch with the body parts and bodily functions they were assigned—like accessing their sperm if they’re transitioning to a woman or retrieving their eggs if they are transitioning to a man. But no one knows what the future will bring, so being counseled on their fertility options before transitioning can allow them to choose to safeguard and preserve their eggs or sperm now so they will have the option in the future to use them to create a child that is biologically theirs if they want to.

For those assigned female at birth who want to transition, egg freezing or embryo freezing allows them to use their own eggs in a future pregnancy in order to have a biological connection to the baby. Barring any uterine problems, they may also consider carrying a pregnancy in their uterus using their eggs or a donor’s or female partner’s eggs before transitioning, if desired. Depending on their particular situation, there are several family building and fertility preservation options for those assigned female at birth.

For those assigned male at birth who want to transition, their sperm is the key to having a biological connection to their future offspring. There are several family building and fertility preservation options for those assigned male at birth including using their sperm now in an IUI or IVF procedure, freezing their sperm for future use in an IUI or IVF procedure, or using their sperm to create embryos and freezing the embryos for future use in either a female partner or gestational carrier.

Knowledge is power. Having an initial fertility evaluation will shed light on the state of one’s overall fertility, the options available to repair or improve any problematic issues found, and puts them in a position to make the best choices to optimize their chances for biological parenthood this year or at some time in the future.

If you would like to schedule an initial fertility evaluation or would like more information regarding family building options at RMA Long Island IVF, contact us today to schedule a consultation.