Top Questions LGBTQ+ Patients Ask About Fertility Treatment
Starting a family is a deeply personal journey, and for LGBTQ+ individuals and couples, it can come with unique questions and considerations. Whether you're exploring IUI, IVF, donor conception, or surrogacy, it's normal to wonder how the process works and what options align with your identity and goals. At Aspire HFI, we’re committed to providing inclusive, affirming care for all paths to parenthood. Below, we’ve answered some of the most common questions LGBTQ+ patients ask when beginning fertility treatment.
1. What fertility options are available for same-sex female couples?
Same-sex female couples have several options to consider:
- Intrauterine Insemination (IUI: Donor sperm is placed directly into the uterus during ovulation, typically in the partner who will carry the pregnancy.
- In Vitro Fertilization (IVF): Eggs are retrieved from one partner or a donor, fertilized with donor sperm, and the resulting embryo is transferred to either a partner’s uterus or a gestational surrogate, depending on your family-building plan.
- Reciprocal IVF: One partner provides the eggs, and the other carries the pregnancy via IVF, allowing both to share a biological connection to the child.
2. What are the fertility options for same-sex male couples?
What are the fertility options for same-sex male couples?
- Egg Donation: An egg donor provides the eggs to be fertilized—either fresh (retrieved specifically for a coordinated embryo transfer) or frozen from a donor egg bank—depending on your timeline, preferences, and fertility plan.
- Gestational Surrogacy: A gestational carrier (surrogate), carefully selected to align with your needs and preferences, carries the pregnancy.
- IVF: Sperm from one or both partners is used to fertilize the donor eggs, and the resulting embryo is implanted in the surrogate.
Aspire HFI provides comprehensive services, including assistance with selecting egg donors and coordinating with gestational carriers, to support you through this process.
3. What are the fertility options for transgender and non-binary individuals or couples?
Fertility care is highly personalized and available to people of all gender identities. For many transgender and non-binary individuals, fertility preservation is an important first step, especially before beginning gender-affirming care.
- Transfeminine individuals (AMAB) may choose to freeze sperm before starting gender-affirming hormone therapy
- Transmasculine individuals (AFAB) can freeze eggs prior to beginning gender-affirming hormone therapy
- Some may also opt to pause hormone therapy temporarily to pursue egg or sperm retrieval later.
When you’re ready to grow your family—either on your own or with a partner—there are several options available, depending on your anatomy, treatment history, and goals.
- Carrying a Pregnancy: Trans men and non-binary individuals with a uterus may choose to carry a pregnancy, using their own eggs and donor sperm. If you’ve undergone hormone therapy, you may need to stop temporarily to resume ovulation.
- Use of Donors and Surrogates: Depending on your anatomy and goals, your care plan may involve donor sperm, donor eggs, or a gestational surrogate.
- Partner Involvement: If you're in a couple, there are ways for both partners to be involved, whether that means using one partner’s eggs, having the other carry the pregnancy, or both, depending on what is medically possible.
4. What should LGBTQ+ families know about legal protections and parentage?
Legal parenthood isn’t always automatically granted to both partners in LGBTQ+ families, especially when donor sperm, eggs, or gestational carriers are involved. Even if both names are on a birth certificate, additional legal steps, like second-parent adoption or pre-birth orders, may be necessary to secure parental rights.
Because laws vary by state and family structure, it’s wise to consult a reproductive law attorney early in the process. Aspire HFI can connect you with trusted legal professionals who specialize in LGBTQ+ family-building to ensure your parental rights are protected from day one.
Supporting Every Path to Parenthood
No matter your identity, relationship structure, or path to parenthood, you deserve fertility care that respects who you are. At Aspire HFI, we’re proud to support LGBTQ+ individuals and couples with inclusive, expert care every step of the way. If you're ready to explore your options, schedule a consultation with our team—we're here to help you build the family that's right for you.
