LGBTQ Families

Our team of fertility experts at Virginia Fertility Associates is proud to serve the LGBTQ community. When gay, lesbian, bi and trans or gender queer couples and individuals desire to build a family, we offer multiple fertility services to help. There are few hurdles we can’t surmount together. At the Virginia Fertility Associates our top priority is you and your goals.

We understand that LGBTQ couples will face many decisions while planning a family. There are a variety of options. Come and visit us and you will find that our staff are friendly and professional, our facilities are state-of-the-art, our fertility experts can provide you with the latest fertility treatments and third-party reproductive services. We want you to be comfortable with our doctors and support staff.

Some of the challenging decisions to be made include: choosing the partner to be the biological parent, assisted reproductive techniques for HIV positive individuals, single intended fathers and mothers, determining who contributes the egg and who contributes the sperm, etc. You will have many questions. Let us discuss your family building options.

Biological parenthood for lesbian couples is usually easier than for gay men. Generally, there is no need for a surrogate, or donor eggs (depending on the age of the female whose eggs will be used). Either woman can carry the child, and either woman can donate eggs or they can choose a surrogate, an egg donor, and a sperm donor. In any case, Assisted Reproductive Techniques (ART) are the cornerstone of your opportunity to become a parent.

Below are a few of the assisted reproductive options for single parenthood

  • Single intended mother and sperm donation. Sperm donors may be friends, family members or anonymous donors. Today there are sperm banks that cater to LGBTQ families, and sperm can be harvested from a gay male. The single parent is artificially inseminated and carries her own child.
  • Single intended mother’s egg, donor sperm and a gestational carrier. The intended mother undergoes IVF ovulation, her eggs are fertilized with donor sperm and the resulting embryos are placed in the gestational carrier’s reproductive tract.
  • Single intended mother uses a traditional surrogacy with donor sperm. The surrogate’s eggs are used along with donor sperm. The surrogate is genetically related to child and carries the child.
  • Single intended father uses his own sperm, a donor egg and a gestational carrier. Currently Virginia law is evolving on this issue.
  • Single intended father uses his own or donated sperm, surrogate donates her eggs and carries to term.

Some assisted reproductive options for same sex parenthood

  • For gay couples, either man can donate sperm and become the biological parent. They will need a surrogate to carry the pregnancy, and assisted reproductive techniques will be involved in order to create a biological child. 
  • Same sex males use a gestational carrier with donated sperm from one of the couple, and donor eggs from a female who undergoes IVF.
  • Same sex female couples and reciprocal IVF, also called the two mom” approach. Lesbian couples can choose to retrieve eggs from one partner, inseminate the eggs with donor sperm, and have the embryos placed into the other partner, who will carry the pregnancy to term. This permits both female partners to participate in creating the child. Or, the couple agrees that one of them provides the eggs under IVF, uses donor sperm and carries the child.

Transgender Parenthood

Transgender individuals are no different in their desire to have genetically related children than heterosexual individuals.  However, transgender people often begin sexual reassignment at an early age, when reproductive desires have not yet been clearly expressed, or defined. The challenge is the impact of transition on fertility which may cause temporary or permanent sterility. This is why Virginia Fertility Associates recommends that trans individuals, including trans children and adolescents, receive counseling on the effects of transition and options for fertility preservation and reproduction before transition treatments, that may result in infertility.

Fertility preservation options include cryopreservation (freezing) of sperm, eggs, embryos, ovarian and testicular tissue. These can be used with assisted reproductive technologies to achieve their goal of genetically related children.

Trans women (male to female or MTF) may choose sperm freezing, surgical sperm extraction and testicular tissue cryopreservation to preserve their fertility. They may choose IUI of the female partner, IVF using donor or partner eggs, and their or donor sperm, and/or the partner’s uterus or a gestational carrier. Poor quality sperm and insufficient sperm can be improved with surgical sperm extraction. 

Trans men (female to male or FTM) who retain their ovaries and uterus may be able to regain fertility after discontinuing hormone therapy. Just as with cisgender (non-trans) gay or bisexual people, the quality of the eggs decreases as the individual gets older. Trans men can choose freezing eggs, embryos and ovarian tissue preservation. Trans men may undergo IUI using partner or donor sperm or IVF with their own eggs or partner’s eggs and or their own or their partner’s uterus or a gestational surrogate.

Bisexual Parenthood

Bisexual individuals who desire parenthood depend on whether they are partnered with an individual of the same sex or opposite sex. If they partner with the opposite sex their fertility issues are the same as heterosexual couples. If they partner with the same sex their issues are the same as those of a lesbian or gay couple. Thus, they can choose assisted reproduction services, adoption, surrogacy and co-parenting with someone who can get pregnant.

Gender Queer Parenthood

The same ART reproductive procedures are available to gender queer individuals.

Infertility and achieving pregnancy pose the same challenges for all men and women, regardless of sexual orientation. The excellent fertility specialists at Virginia Fertility Associates are here to help you achieve your dreams.

Assisted reproductive procedures

  • In Vitro Fertilization (IVF). IVF is the process where the ovaries are simulated to develop multiple eggs. The eggs are retrieved and inseminated with donor sperm in a lab to create embryos which are transferred to the uterus of the recipient. If no healthy eggs are available, an egg donor is an option.
  • Artificial insemination. The several types include intrauterine insemination (IUI), intracervical insemination (ICI), or intravaginal insemination.
  • Pre-Implantation genetic diagnosis (PGD)– Genetic screening of embryos for abnormalities
  • Possibly embryo freezing
  • Surrogacy – finding a woman to carry and deliver the pregnancy

HIV and Parenthood

Gay men who are HIV-positive can father children, because the HIV virus cannot infect sperm. But, the semen or surrounding fluid may be infected. That is one reason we use sperm washing to purify the sperm. In the alternative, artificial insemination using a sperm donor is possible.

Lesbian women – Artificial insemination allows a woman living with HIV to have children. The risk that a woman with HIV will transmit HIV to her child during pregnancy or labor and delivery has for the most part been eliminated in the U.S. through the use of HIV treatments and Caesarean section.

Note that donated sperm obtained from sperm banks is tested for HIV. Further, to avoid the risk of transmitting HIV through donated sperm, many sperm banks freeze and quarantine the sperm for six months. And before the frozen sperm is released for use, a new sperm sample is obtained from the donor and is tested for HIV.

When you work with Virginia Fertility Associates, in Richmond, VA, you or both you and your partner will discuss your desires and goals, and together we will consider all your options.