Celebrating Pride: LGBTQ+ Family Building

At Progyny, we are proud to support all paths to parenthood and celebrate the many ways we build our families. In honor of Pride Month, we hosted a discussion about different LGBTQ+ family building options. This conversation included experts in the space, along with the personal experiences of those navigating their own journey.

This webinar featured:

Dr. Daniel Kaser, Reproductive Endocrinologist at RMA of NorCal
Stephanie Kalili, Progyny member
Jenna Willyard, Patient Care Advocate at Progyny
Thomas Lynch, Manager of Member Services at Progyny

Finding Your Path to Parenthood

When exploring different paths to parenthood as either an individual or a couple, there are many options to consider. An important place to start is identifying the clinic and doctor that is right for you. As part of the LGBTQ+ community, it is important to find a doctor and clinic that offer LGBTQ+ affirming care and take the time to find a care team that aligns with your family building goals. If you are a Progyny member you can use our provider search tool to help find a clinic. All Progyny in-network providers are vetted to be LGBTQ+ friendly and PCAs can help members find a provider that’s right for you and your family building goals.

Once you find the clinic and doctor that work best for you, the next step is scheduling your initial consultation where you and your doctor will discuss your medical history, go through any testing that is required, and discuss potential paths to parenthood. If you are an individual or in a same-sex couple that wants to have genetically related children, your path will include either donor sperm or donor eggs. Paths to parenthood involving donor tissue include:

Donor sperm options:

Intrauterine Insemination (IUI): Also called artificial insemination. A process where, either with or without medication, and after monitoring, sperm is inserted directly into the uterus using a catheter. IUI may be an effective treatment option for single women or same-sex female couples who have purchased donor sperm. This path is a less expensive option, however, has a lower success rate compared to other treatment paths such as IVF, and limits the involvement of both same-sex female partners.
In Vitro Fertilization (IVF): IVF is a more involved procedure and starts by stimulating the egg follicles of an individual with ovaries, followed by an egg retrieval. Those eggs will then be fertilized with the donor sperm and transferred to the uterus. This process allows for two options – transferring the embryo to the original individual’s uterus who had their eggs retrieved, or the embryo can be transferred to the other partner to carry, a process known as reciprocal IVF. IVF has a higher success rate and allows the option for both partners to be involved in the process, however it is a more involved and expensive path.

Donor egg options:

Gestational Carrier: This is a great option for either an individual with sperm or a same-sex male couple. While the surrogacy journey is an extremely detailed process, it all begins with donor eggs and sperm to create embryos. Once the embryo is created with the intended parent’s sperm, the process of finding the right gestational carrier comes next. The couple or individual will work with a known gestational carrier, or work through a surrogacy agency to help match them with their surrogate. Once the surrogate is chosen, they will undergo an embryo transfer. If successful, the surrogate and intended parents will create a plan for the pregnancy and beyond.

There are so many different options for individuals or couples in the LGBTQ+ community who are looking to grow their family. While the options listed above all include donor tissue options, there is another option to build the family – adoption. Similarly to surrogacy, this journey requires many steps along the way. Learn more here about what to expect throughout the process and key considerations.

Some individuals and couples already know the path they want to explore to build their family, but it can still help to have a conversation with your doctor to understand all your options. There is a lot to consider before deciding what might be right for you, whether that is through a financial aspect, how many medications or procedures someone is willing to go through, and if a couple wants both partners to be a part of the process. With all these decisions, the journey may take a little longer, so it is important to have patience and acknowledge the path may not be completely linear.

Choices to Make Along the Way

Building a family involves making many decisions along the way. After choosing the path that is right for you and identifying your clinic and provider, other decisions as related to your specific journey may include choosing donor sperm or eggs, identifying an adoption agency, or matching with a surrogate.

Selecting Donor Tissue

An important early decision for relevant paths to parenthood is identifying which intended parent’s sperm or eggs will be used. Often this is decided before meeting with a provider and makes moving forward to the next step quicker. However, your provider can also talk you through your options and help you decide how to proceed. If using an unknown donor, you will have to identify an egg or sperm bank. Your clinic will be able to refer you to some different sperm or egg banks for you to purchase tissue and Progyny members can also explore our in-network banks.

To help you select which sperm or eggs to purchase, the bank will have different resources available from each donor such as voice recordings, baby pictures, individual and family medical history, genetic information, and other descriptive information. Selecting donor tissue is a personal decision and everyone has their own priorities for what they are looking for but some questions you may ask yourself are:

Do you want someone with a similar genetic background?
Do you want someone who is anonymous, open, or has their identification fully disclosed?
What characteristics matter to you? Ethnicity? Height? Eye color? Education level?

Once the donor tissue is selected, if you are the person with ovaries planning to carry the child you will proceed with treatment, otherwise others may proceed with the surrogacy journey.

Explore this quick video to learn more about what to look for in an egg or sperm donor.

The Surrogacy Process

If you go through the surrogacy process, there will be more important decisions to make. After picking out the donor tissue and creating an embryo, you will need to also choose which surrogacy agency and gestational carrier will work alongside you during the journey. Your fertility clinic may have referrals for surrogacy agencies and all Progyny members can reach out to their PCA for vetted referrals. Surrogacy agencies provide different levels of services which can include gestational matching and screening, case management, support, counseling, legal services, and more. During the process both the gestational carrier and parent(s) will need to undergo psychological evaluations and obtain separate legal counsel to create a surrogacy agreement. When thinking about your timelines it’s important to factor in that surrogacy can be a lengthy process and there are many factors that can impact the journey.

To learn more about the surrogacy process, check out this resource: Understanding the Surrogacy Process | Progyny

The Adoption Process

Adoption can also be a lengthy process with many decision points along the way. All Progyny members have access to adoption coaches that can provide insight into the process, legal considerations, average costs, the various pathways, and agency referrals. Some of the key decisions to make along the way include deciding between an international or domestic adoption, selecting an agency and lawyer, and matching with a family. Having a list of questions is a great place to start to understand your priorities and to help you vet through the process.

Although each process can feel overwhelming at times, these decisions help you take a step closer to building your family, and Progyny is always here to support you along the way.

To learn more about the adoption process, listen to an episode from our podcast, This Is Infertility: Episode 120: Maybe a Baby? The Adoption Journey | Progyny

Support Throughout Your Journey

The family building journey often comes with many unknowns and it is important to have a village that will support.

If you are a Progyny member, your PCA is a great resource to provide support during this time. They are trained to support all paths to parenthood and can provide clinical guidance and also emotional support. In addition to your PCA, if you are going through an adoption or surrogacy journey or just have questions about the process, you will have access to Progyny’s adoption and surrogacy coaches (who are available to all Progyny members).

In addition to your Progyny and clinical team, many find social media to be a great resource to find community. Social media allows you to connect with others who are going on similar journeys and can help you feel less alone in the process. In addition to exploring others’ stories through hashtags, there are Facebook groups that can help connect you with people who are on the same path to parenthood. While social media is a great opportunity to meet people, it is important to not compare your journey to others as they are all unique.

Looking for additional resources and support throughout your journey? Check out these resources:

Q&A

I am trans and considering going through gender affirming therapy. What options do I have if in the future I want to build my family?

Before going through any gender-affirming therapies, talk to a reproductive endocrinologist (REI) at an LGBTQ+ affirming clinic to understand your options for the future, which may be freezing eggs, sperm, or even embryos. It’s important to understand that the hormones that are used during gender-affirming therapy stay in your system for a few months so if you decide in the middle of these treatments that you wanted to preserve your fertility, you will have to wait months before doing so.

How can I find the right doctor and clinic for me?

If you are a Progyny member, your PCA can help identify LGBTQ+ affirming clinics and you can also use the provider search tool to explore all the in-network clinics that are nearby. Once you have narrowed your options down to a few clinics, it is a great choice to do a deeper dive into the clinics and also their specific doctors to ensure their approach aligns with your goals and if you can connect with them. During your decision-making process, you do not have to stick with the first doctor you see. If you don’t feel like they are the right fit it is completely normal to look to other clinics who may work better for you. Each person is looking for something that works specifically for them, so it is okay to take time with this decision.

If you have any other questions related to this webinar, please don’t hesitate to reach out to education@progyny.com. If you are a Progyny member and have any questions about your benefit or coverage, please call 888.597.5065.

LGBTQ+ Family Building Resources

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