Fertility issues faced by same-sex couples when trying to conceive

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Building a family is an important step for everyone, but when two partners are of the same sex, having children becomes more complicated. When a couple is gay or lesbian, they will miss at least one important part of it. concept puzzle.

“To get pregnant, you need sperm, eggs and uterus,” said Amanda Adeleye, MD, assistant professor of obstetrics and gynecology at the University of Chicago School of Medicine and reproductive endocrinologist. In the absence of these elements, couples need help-usually from a fertility clinic.

A gay couple’s pregnancy journey

Gay couples start at sperm, Any partner can contribute. What they lack is an egg and a uterus, which are usually not from the same woman. “The general consensus is that this is unethical and poses too many potential problems for the couple because the baby carries the woman’s genetic material,” said Jennifer L. Eaton, director of the Department of Reproductive Endocrinology and Infertility. Say. Students at the Women’s and Children’s Hospital in Providence, Rhode Island, and the Warren Alpert School of Medicine at Brown University.

carry on

Instead, most gay couples use donor eggs and pregnancy carriers, or Substitute, It can be a friend, a family member, or a woman the couple finds through an intermediary. Mark Leondires, MD, and his husband have two different agents, each representing the two children.

Leondires, founder and medical director of the Connecticut Association of Reproductive Medicine (RMACT), said pregnant carriers must go through a “rigorous screening process.” There is a series of tests to ensure that her uterus is healthy enough to become pregnant, free of infectious diseases, and emotionally ready to undergo the process.

The ideal pregnancy carrier should be between 21 and 45 years old, in good health, and have at least one child of its own. Eaton said that the last part is very important. “We know they are capable of carrying pregnancy And there is a history of a healthy baby. She added: “Studies have shown that women who have given birth to their own children are less likely to develop attachments to the babies they hold for others.” “

The couple also chose donor eggs, which are usually frozen from the egg bank.Eggs are thawed and fertilized by sperm In vitro fertilization (IVF), cultured in the laboratory, and then transferred to the uterus of the pregnancy carrier.

The pregnancy journey of a lesbian couple

The female couple enters this process with their eggs and uterus, but they have an important decision. Who will be responsible for the pregnancy and who will provide the eggs? The answer boils down to a combination of personal choice and biology.

Lorie Mason (Lorie Mason) and her wife Shannon (Shannon) began the process of having their first child at 42 years old. They decided that Shannon, who was nearly 8 years old, would use her eggs to conceive. “I had to do all these fertility treatments,” Lorie Mason said.

From there, the couple can decide to buy sperm from the donor through the bank, or ask friends or family members. Lorie Mason said that they looked for donors for several months, and the process was like buying a house. “We are looking for people with Polish background, because I want to integrate them into my culture. And blue eyes, because I have blue eyes. We obviously want to have people in a big family who don’t have any major diseases.” She said. They also hope that there will be an open process where their children can one day choose to meet with donors.

carry on

For lesbian couples, the most direct and cost-effective way is through intrauterine insemination (IUI), in which the fertility clinic places donor sperm directly in the uterus of their partner.The clinic can choose to adjust the IUI to a time consistent with the natural state of the woman ovulation, Or use drugs to induce ovulation.

However, IUI does not always work properly. The couple went through seven cycles without luck. In the end, they turned to in vitro fertilization (IVF), which was the first attempt.

When both parties want to be part of the process, they can use reciprocal IVF. A partner provides eggs and is fertilized by IVF.Another partner received Embryo And get pregnant. But because IVF is expensive and more invasive, “usually, this is not the first route between couples,” said Dr. Suneeta Senapati, assistant professor of obstetrics and gynecology at the University of Pennsylvania Hospital and third-party supervisor for reproduction at Penn Fertility Care.

Hurdle

The way to Parenthood Same-sex parents are full of obstacles. Twenty years ago, many gay couples had to give up having their own children due to lack of fertility. “That’s our’accountability’,” Leon Dires said.

Even now, gay and lesbian couples still face emotional, financial and legal obstacles.Masons are jealous of their straight boyfriends, they seem to pregnancy effortless. Shannon Mason (Shannon Mason) said that having two children is “a lot of work, and very emotional and expensive.” “This is one thing we can tell the children,” Lorie Mason added. “You’re right. We wanted to have you.”

Enter the clinic

Simply finding a fertility clinic that works with gay couples can be challenging. A study found that only half of the pages of fertility clinic websites have LGBTQ-related content. Compared with clinics in the Northeast and West, clinics in the Midwest and South are less inclusive.

It is important to use clinics that are experienced during pregnancy for gays and lesbians. Senapati said: “When using eggs and sperm, there are some very specific procedures that need to be used, not a pair.”

cost

Starting with the eggs or sperm that the couple needs, every part of the fertility process costs money. A woman’s advantage is that she already has an egg and a uterus, but a small bottle of sperm costs nearly $1,000. If a lesbian couple wants a genetically related child or is worried that they will not get pregnant at one time, then they may need to purchase a few bottles from the same donor in advance.

IUI costs between $300 and $1,000 per attempt. Even if there are no fertility issues, the chance of pregnancy per cycle is only 15% to 20%. The average cost per IVF attempt is $12,000 to $15,000, which does not include the cost of medication.Fortunately, for Lorie and Shannon Mason, they were able to sign up Clinical Trials Paid for their IVF. “But even drugs cost $3,000,” Lorie Mason said.

carry on

For men, the extra cost of surrogacy services-the agency plus IVF up to $150,000-is prohibitive. And it may require multiple embryo transfers to get pregnant.

carry on

Even if same-sex couples are lucky enough to have Health insurance Covered Infertility treatment Like IVF and IUI, they may not be eligible. Insurance coverage does not usually come into effect until a couple has had unprotected sex for at least 12 months without conception, excluding gay and lesbian couples.

Some non-profit organizations provide grants or scholarships to help offset the cost of fertility treatment, including Cade Foundation (cadefoundation.org), Baby Quest Foundation (babyquestfoundation.org) and “Parental Journey” (journeytoparenthood.org). Organizations such as the American Society for Reproductive Medicine (asrm.org) and resolve (resolve.org) can also help couples find funding and other resources.

Legal barriers

When same-sex couples have children, partners who are not genetic parents will need legal documents to have any rights over the children. In most states, people who give birth to children are considered legal parents, which means that pregnancy carriers must give up their parental rights in order to promote this process. Senapati said that because of the legal challenges involved, “we recommend that couples meet with a reproductive lawyer.”

Emotional problems

For same-sex couples, having children can be a stressful and sometimes frustrating process. Even in the best case, fertility treatment may not be possible on the first attempt.

As women enter their 30s or higher, they are less likely to conceive in any given cycle. “It takes a lot of time, it takes a lot of time, emotional determination, perseverance and strength,” said Taraneh Nazem, MD, PhD in reproductive organs. Endocrinologist And infertility specialists at RMA in New York.

Acceptance may be another issue. Although non-traditional families are becoming more and more common, sometimes friends and family do not join right away. Senapati said: “In some cases, people may not have the support they want or feel very lonely in the process.”

carry on

Reproductive journey psychologist It is priceless before trying to imagine. “We met a Mental Health Professionals with extensive third-party copying experience, they guided our decision-making,” Leondires said. Psychologists can also help you decide how to tell your child their origin story one day.

Nazem said that another place the couple turned to was an online or face-to-face support group. “The support group is the key to this process-knowing that you are not the only one who breaks barriers or tackles challenges.”

By number

114,000 -The number of same-sex couples raising children in the United States.

twenty four% -Number of female couples with children.

8% -Number of male couples with children.

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