It would have been so beneficial to learn alternate versions of “the birds and the bees” when attending sex education in high school, particularly when it comes to having children as a same-sex couple. Although sex education classes may be more evolved these days, it was definitely not something that we went over when I was growing up.
For those lesbian couples out there who want to have children, it can feel a little overwhelming to figure out where to start and how to get there. Hopefully after reading this article, you will have at least some of your questions answered and some resources you can refer to while planning your family.
Once you have decided you want to start a family, making an appointment with your doctor should be the first thing on your list.
“Lesbian couples face certain challenges and expenses when starting a family that most hetero couples avoid by virtue of having all the necessary parts,” said Scott Brown, Director of Client Experience & Communications at the California Cryobank. “In order to minimize the impact of these challenges, the best thing to start with is a plan.”
“We had no idea where to start with this process,” moms Katherine and Karyn told us. “Our advice would be to find an OB you like—shop around if needed. We talked to our OB, and they had a nurse practitioner on staff who used to work in a fertility clinic, so we made an appointment with her. She explained all the options, and process, and also said they would do the inseminations at their office.”
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Creating a plan ensures you can answer the more obvious questions, such as how many children you want or who will carry the baby, but it also includes some more daunting tasks like contacting an attorney. Scott Brown says that, above all else, couples should “consult an attorney to make sure you understand the state and federal laws to best protect the rights of the non-birth mother as well as establishing a donor contract if using a known donor.”
You’ll also have to decide whether you want to purchase sperm or have a friend or family member donate, as well as finding out what will be covered under your insurance if anything. If you are opting to purchase your sperm through a cryobank, one vile will give you one insemination cycle and run you anywhere from 400 to 800 dollars.
“Success rates are about 20-25%,” Scott said, “so it is recommended to purchase multiple vials so that the donor does not sell out, forcing the couple to choose a new donor–especially if siblings are in the plan.” Once the sperm is purchased, you can opt to either have it shipped to your physician or directly to your home, depending on how you or your partner want to be inseminated.
“We had it shipped to our infertility specialist’s office,” said moms Carien and Jen. “It cost close to $200 for shipping. We are now paying $300 a year for storage for the vial we have left and will continue to pay that until we are ready for number two. In reality, we will probably purchase another couple of vials soon from the same donor and store those as well until we’re ready.”
Although many lesbians opt to purchase sperm through an anonymous donor (lesbians make up 55-60% of the clients at the California Cryobank), there are others who would rather have sperm donated by a friend or family member. If this is an option you are considering, it is important to make sure that you decide the type of relationship the donor will have to the child and make sure you are legally prepared when it comes to the rights of your child.
“It is critically important to contact an attorney,” Scott said, “so that a legal donor contract is in place and the donor’s parental rights are officially terminated unless they are planning on co-parenting.”
In addition to being prepared legally, it is also important that your known donor is healthy enough to donate as well as the fact that it could add some extra time in getting pregnant.
“Make sure you have the donor go through a screening process to make sure he isn’t carrying STDs, serious genetic issues, and has quality sperm,” Scott said. “They will have to pay for this, and it can be done by Cryobank or other similar facilities. The donor will most likely have to make multiple deposits that will be frozen and quarantined for six months at which time he will be retested for STDs. Using a known donor generally adds nine months to a year to the process.”
Once you know where you will be getting the sperm, you need to determine how you or your partner will be inseminated. So what are some of the pros and cons for being inseminated at home vs. at your OBGYN office?
“The biggest advantage of using a physician is that they can use ultra-sound and medication if necessary to make sure the insemination is done at the exact right time,” Scott said. “Also, if the attempt is unsuccessful, there is no way to know at home if the vial was thawed properly, if insemination was done properly, etc. A doctor will insert a catheter through the cervix into the uterus, depositing the sperm right at the opening of the proper fallopian tube. A home insemination is done at the cervix, leaving the sperm to fight the way up to the egg, basically mimicking traditional conception.”
For many women, inseminating at home can feel like a more intimate way for the non-carrying partner to be involved. Although it may not be in the comfort of your own home, most physicians attempt to make the non-carrying partner as much of a part of the process as possible.
“Most physicians will allow the partner to actually push the plunger on the syringe and inject the sperm–in essence, actually impregnating the partner,” Scott said.
In addition to making sure the one who will carry the baby is healthy, there are tests that need to be done in order to make sure the process if working.
“Depending on where you choose for your insemination, there may be various levels of monitoring,” Katherine and Karyn said. “For us at our OB, Karyn would go in once for the OB to check the size of her eggs using an ultrasound and have blood work done to check her hormone levels. Once you get close to your scheduled ovulation time you need to use an Ovulation Predictor Kit (OPK) to see when you actually ovulate. When you get a positive, you go in the next day for the insemination. After the insemination, you start the approximate two-week waiting period to see if the insemination was a success.”
Cost can be a major issue for couples, specifically those who do not have insurance to cover the process.
“It’s not sperm that costs the most when trying to get pregnant if you go the route we did,” Carien and Jen said. “It’s the testing and the blood work and the ultrasounds and the actual IUI and more testing and more blood work. We were very, very lucky to get pregnant on our second try! My insurance has since dropped infertility coverage, so nothing is covered now all office visits, tests, lab work and procedures will need to be paid for out of pocket.”
No matter how you decide to start your family, each couple’s experience is different and it is important to be patient and not give up hope.
“Don’t give up, it will take time,” Katherine and Karyn said. “I repeat, it will take time, be patient even on the emotional ups and downs. We tried six times and then took a three-month break over the summer to research IVF options and reevaluate our financial situation. We ended up getting pregnant on the seventh try. It takes a while for straight couples to get pregnant, too— they just get free sperm.”