Same-sex couples face a number of barriers to fertility, the most obvious of which is that it still takes an egg and sperm to make a baby. This doesn't mean having a biological child is out of reach, though. Indeed, today's fertility medicine means that many same-sex couples can have a child in the same amount of time it takes a healthy heterosexual couple to do it. At the Center of Reproductive Medicine, we offer a comprehensive overview of your options, then help you choose the approach to fertility that works best for your needs.

The Role of Donors for Same-Sex Couples

Making a baby requires two different types of gametes -- the technical term for sperm and eggs. When you're a same-sex couple, you have only one type of gamete, which means you will need to rely on either donor eggs or donor sperm to have a child.

Donor eggs are typically more expensive than donor sperm, but whether you seek donor eggs or donor sperm, you'll have the option to peruse a catalog and choose a donor who meets your specifications.

Many same-sex couples opt instead to use the gametes of a family member or friend. For example, if one partner is donating his sperm, that partner might use the eggs of the other partner's sister, to ensure both partners have a biological connection to the baby. If you already have a donor lined up, this can minimize expense and time. We'll work with you to help you better understand the process and choose the best plan for your family's needs.

Male couples will also need to use a surrogate mother to gestate their baby. Choosing a surrogate can be a challenging process. We always recommend choosing someone who is emotionally stable, with a history of successful pregnancies. We can help you choose the right surrogate, then take steps to maximize her chances of getting pregnant on the first try.

Fertilization Options

There are two basic options for fertilizing an egg, whether the egg or sperm comes from a donor. Intrauterine insemination (IUI) is the simplest and least invasive option. We implant sperm into the egg directly through the cervix at a time that the woman is known to be ovulating. If the egg is healthy and the woman has no fertility issues, intrauterine insemination is often successful.

If intrauterine insemination fails or either party has a history of fertility problems, in vitro fertilization (IVF) is the next step. With this approach, the egg is extracted from the woman's ovary, then fertilized with sperm outside the uterus. In most cases, we give the woman drugs to encourage her to produce multiple eggs, so that there is a greater chance of pregnancy.

We then implant the embryos back into the woman's uterus, in the hopes that one or more will turn into a viable pregnancy. IVF has a slightly higher than average risk of producing multiple pregnancies. About 1 in every 4 tries is successful, even if you have a long history of fertility difficulties.

Fertility Problems in Same-Sex Couples

Same-sex couples can struggle with the same fertility issues that heterosexual couples face, including diminished ovarian reserve, low sperm count, low sperm motility, endocrine disorders such as low testosterone or polycystic ovarian syndrome, and chronic disease that reduce overall fertility.

When these fertility issues occur, same-sex couples are at an advantage. If only one partner has the problem, we can use the gametes of the other partner, helping to reduce your overall stress and expenses. If both couples have a fertility issue, or you hope to have a chance to use both partners sperm or eggs, then we work with same-sex couples to treat fertility issues. Often it's as simple as a blood test or simple scan of your reproductive organs, followed by short-term treatment that could even be covered by insurance.