Building Families, Embracing Diversity: IVF and the Queer Community

Queer couples come in many forms, with diverse combinations of gender identities and sexual orientations. Yet, one common desire among many across the LGBTQ+ community is a deep yearning to open their hearts – and their homes – to children.

Since 1978, when the world witnessed the birth of the first "test tube baby," IVF (in vitro fertilization) has offered couples of all sexual orientations and gender identities a route to parenthood. For queer families in particular, IVF has become a crucial option for family building.

Inclusive and Tailored Fertility Care

The 90+ clinics comprising The Prelude Network, North America's largest and fastest-growing network of fertility care providers, allows LGBTQ+ families to access services that cater to their unique needs. The fertility clinics in The Prelude Network pride themselves on offering respectful, attentive care that is built on inclusion and expertise.

Dr. Daniel Shapiro of Reproductive Biology Associates in Atlanta, Georgia highlights some of the specific challenges faced by same-sex female couples, such as finding the right sperm donor and navigating sperm donation cycles. "There are many ways to manage these processes," Dr. Shapiro says, "but the core challenge is ensuring everything is done correctly and with the right support."

Reproductive Biology Associates – as its website notes – is well experienced in meeting that challenge; the clinic has been helping LGBTQ+ families achieve their dreams of parenthood for over 30 years. "We believe everyone deserves the chance to build a family in a supportive environment," RBA explains at its site. "By leveraging leading technologies and guided by compassion, we help gay, lesbian, and transgender people have children."

Unique Pathways to Parenthood

The ways in which queer couples create families can be both diverse and beautiful. For example, two female partners may deepen their bond by having one partner carry a pregnancy using the sperm of a donor and the egg of the other partner. Dr. Shapiro mentions that his own daughter and her wife are considering this path.

Another unique option for same-sex female couples is reciprocal IVF, where each partner carries an embryo created with the other partner's egg. This process not only creates a biological connection between the parents and their child, but also fosters emotional intimacy between life partners.

Fertility clinics like Reproductive Biology Associates also serve transgender and gender-diverse couples, whose family-building journeys can be more nuanced. For example, some trans men may wish to preserve their fertility before undergoing hormone therapy or gender-affirming surgeries. "I've cared for trans men who froze their eggs before starting testosterone therapy," says Dr. Shapiro, referring to fertility preservation. The practice of freezing sperm or eggs before transitioning – known as fertility preservation – allows transgender individuals the possibility of having their own biologically-related children later on.

Beyond Medical Care: Emotional Sensitivity

While medical expertise is crucial, the emotional and social aspects of fertility care are just as important. The LGBTQ+ community faces well-documented healthcare disparities, and finding a provider who respects and affirms their identities can be transformative.

Dr. Shapiro recalls one of his first trans patients, a man who was nervous about being misgendered or deadnamed. "He was shaking" from anxiety, Dr. Shapiro remembers, but, guided by the expertise of the providers working with him, he proceeded with fertility preservation by freezing his eggs.

That was more than a decade ago – and just recently the patient reached out to Dr. Shapiro's clinic, saying he was beginning his gender-affirming journey. "He still has his uterus, but because of body dysmorphia, he won't use it," Dr. Shapiro shares. A gestational carrier, perhaps a partner, could carry the pregnancy instead.

Gestational carriers play a vital role in IVF for male same-sex couples, as do egg donors. IVF, in all its forms, is about bringing together the right combination of sperm, eggs, and a womb. The fertility experts at The Prelude Network help coordinate these complex arrangements in order to bring families to life.

Building Trust and Community

Dr. William Ziegler, a physician with Reproductive Science Center of New Jersey, works with many members of the LGBTQ+ community, especially from the nearby Asbury Park area, which is known for its alternative lifestyle community. That community, Dr. Ziegler notes, is tight-knit.

"Word spreads when people find a physician who is open-minded and willing to help," he says. Perhaps as a result, "We are seeing some more trans people that, prior to going through their transition, want to retrieve eggs and freeze them," Dr. Ziegler adds. "Or, one partner may want to save embryos now [for implantation] later. So, we do a lot of family planning, I guess is a way of putting it."

While some patients are planning for years down the line, others are ready to embrace their parenting journeys right away. A different set of questions come into play at that point. "We've had families where a trans male partner has been on testosterone because they are transitioning," Dr. Ziegler recounts. "It's one of those things that we look at their medications and we say, 'Are we going to get him off of those hormones? How are we going to address this?' The issue is, if somebody is on hormone replacement and you stop it, they may have some adverse effects from that. They may have decreased libido, decreased energy. It's just, "What do we need to do for them that makes them comfortable enough to proceed?'"

Intersex patients can present still more complex cases. "If someone is born with congenital adrenal hyperplasia, which means the external genitalia is ambiguous, you don't know whether they are male or female," Dr. Ziegler notes. "But let's say they do have a uterus. If the ovaries are acting okay, and they have a uterus, how large is that uterus, and is it able to [accommodate a pregnancy]? Is the endometrial lining able to be built up, or are we able to retrieve eggs?"

It's with a focus on medical facts, as well as compassion for patients and their dreams, that The Prelude Network's providers find solutions and chart a path forward.

Education and Guidance Every Step of the Way

For many patients, the first step is simply education. "We often see same-sex couples who are just looking for information. There's so much misinformation out there, and our job is to help them understand what IVF is and how it can work for them," says Dr. Ziegler. He emphasizes the importance of counseling for all IVF patients – whether they're using third-party donors or not – to ensure all parties are aligned and fully informed.

Despite the complexity of IVF, providers in The Prelude Network strive to make the process as smooth as possible. "We help families take the first step in the journey," says Dr. Ziegler, "and whatever we can do to help them finish it, we're here for."