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Top Questions and Answers: LGBT Family Building

written in partnership with Southern California Reproductive Center
March 7, 2014

Increasingly, LGBT women and men are having biological families. We spoke with the doctors at Southern California Reproductive Center, to get answers to top questions on how to get started building your family if you are in a same sex relationship, are transgendered, or have a transgendered partner.

How would you define a LGBT-friendly fertility center?
Dr. Shahin Ghadir: An LGBT friendly fertility center is one that understands the special needs and circumstances of an LGBT couple and has the appropriate individuals addressing all these issues. Also, it entails a caring doctor that treats patient with respect and listens to their concerns and needs.

How can patients find a fertility center that is LGBT-friendly?
Dr. Carrie Wambach: Patients want to seek out a fertility clinic with a lot of experience. If
many same sex couples are using one particular clinic, it¹’s a good indication that clinic is LGBT-friendly. Patients will also benefit from finding a clinic that has excellent third party resources, who will help coordinate and guide a couple though donor sperm, donor egg and surrogate services.

What can a lesbian patient/couple expect during a consultation regarding insemination with donor sperm?
Dr. Wendy Chang: Based on a thorough review of her past medical, gynecological and surgical history, the patient will first undergo appropriate testing. This usually consists of blood tests and ultrasound for hormonal status and ovarian function, as well as a procedure to assess the normalcy of the uterus and fallopian tubes. Early in the process, patients will also be asked to select a sperm source. This may be a close friend who is devoted to sharing the pregnancy journey, or an anonymous donor selected from a reputable cryobank. The initial consultation will include a discussion on how to best select and screen potential sperm donors. Her age, ovarian and sperm function and test results will help determine the best options: this may range from simple insemination to in vitro fertilization (IVF). Ultimately, the final treatment decision will be tailored towards each individual patient.

What can a gay male/couple expect during a consultation regarding using a gestational carrier with donor egg?
Dr. Hal Danzer: The consultation will begin with the physician (Reproductive Endocrinologist) reviewing the couples’ medical history and asking what specific qualities the couple would like the egg donor and surrogate to have. The physician will also discuss the range of genetic testing that can be done on the egg donor, as well as the genetic testing that can be utilized on the embryo, before it is implanted into their surrogate. Testing is also available to determine gender, should the couple prefer to parent one gender in particular. The physician will also explain the unique technology available at Southern California Reproductive Center, so that the couple can understand and appreciate the notable advantages of using state-of-the-art technology when nurturing an embryo in vitro. These technologies greatly assist the process to select embryos with the highest rates of implantation potential, and only a single transferred embryo is required in most situations. As a result, multiple births can be avoided, should they not be desired by the couple.

Can transgendered women and men have biological children?
Dr. Mark Surrey: In the case of female to male transgendered individuals, there are options for fertility preservation, allowing you to have biological children:

  • If you have not undergone testosterone therapy or surgery, your eggs may be frozen, or fertilized with the sperm of a male partner or sperm donor, and the resulting embryos may be frozen for later use.
  • If hormone treatment has been initiated, it might be an option to halt treatment to allow egg production to restart, and then freeze the eggs, or fertilize them with the sperm of a male partner or sperm donor, and freeze the resulting embryos.

In the case of male to female transgender individuals, there are options for fertility preservation, allowing you to have biological children:

  • If hormone therapy or surgery has not yet taken place, you may bank your sperm.
  • If hormone treatment has been initiated, it might be an option to halt treatment to allow sperm production to restart, and then freeze the sperm.
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