Join us for the the third and final installment in Progyny’s three-part Journey to Fatherhood webinar series discussing male infertility and alternative paths to fatherhood (see part 1 and part 2). We discussed different treatment options and things to consider as a single father by choice or male in a same-sex couple, such as asking for support and setting boundaries.
Journey to Fatherhood: Same-sex Couples and Single Fathers by Choice
- Bradford A. Kolb, MD, FACOG, Reproductive Endocrinologist at HRC Fertility and a member of Progyny’s Medical Advisory Board
- Brandon Johnson, MHS LGSW, Owner of Infertility Isn’t Inferior
- Dr. Georgia Witkin, Head of Member Services Development at Progyny, Assistant Professor of OB-GYN and Reproductive Sciences and Assistant Clinical Professor of Psychiatry at Mount Sinai
Treatment Options for Same-sex Couples and Single Fathers by Choice
Family building for same-sex male couples and single fathers by choice may look very different from others. Historically these groups have only been able to adopt, but with advancement in reproductive technology, now can explore surrogacy and egg donation.
Looking for an egg donor can bring up many questions. Do you want the donor to be known or anonymous? Should you ask your partner’s sibling or have your partner ask your sibling? Do you have strong preferences on physical characteristics like skin color, eye color, or hair color?
The time it takes to find an egg donor can vary in length. For some, it might take a few weeks, for others it might take over a year—these timelines often depend on the traits you prioritize and screen for. Timing can also depend on how many eggs the donation clinic has available.
Donors must undergo extensive testing before being accepted as a donor. A physical examination, complete medical history, and psychiatric evaluation must be cleared before the donation.
A gestational carrier is the person that will carry the child to term and is often called a surrogate. You can use a gestational carrier’s eggs, but it is more common to use donor eggs with a gestational carrier.
A common misconception is that the gestational carrier is a passive incubator for your developing baby. This could not be further from the truth. When a baby is growing within the uterus, the baby uses the carrier’s body to build its own. And therefore, it is important to think about the entire picture when it comes to a gestational carrier—not only would a gestational carrier be contributing some of their genetic material, but their body will also be used as the building blocks for your developing child.
Gestational carriers must have:
- A physical examination (including physical checks on the uterus)
- A medical history analysis (including vaccinations, blood work, mental health history)
- Already had an uncomplicated pregnancy
Because of the impact the uterus and eggs have on a developing baby, those carrying a child for another couple must be cleared physically, mentally, and medically. Epigenetics is a term used to describe the ability of genes to turn on or off in the presence of certain triggers (can be environmentally, past medical disposition, etc). When you are looking for a gestational carrier, it is important to make sure the carrier understands the responsibility of carrying a child because epigenetics of a carrier can impact the lifetime of your child.
Finding the Right Clinic or Agency
Find the right fertility clinic and surrogacy agency is imperative. To help get things started, we have a checklist about things to consider when searching for the right fit.
Some key points to consider when looking for a clinic and agency include:
- How close is the fertility clinic to your house or work?
- What’s the communication like with the staff? How quick are they to call you or your partner back? What does the availability look like for off hour or after-hours?
- Do you feel comfortable asking questions and interacting with the staff? Do you feel heard and valued?
- Is there an existing relationship between the fertility clinic and surrogacy agency? If not, what will the collaboration process look like?
- Do you know anyone who has used this clinic or agency before? Were you referred to an agency or clinic by your doctor or by a friend or coworker?
Before you confirm your surrogate, it is a good idea to send the surrogate’s profile to your physician so they can confirm from a medical perspective that this surrogate is a good match for you medically.
This whole process—from matching with a surrogate to getting the surrogate cleared medically—often takes around a year. A normal time frame for matching with a surrogate ranges three to six months and the medical screening can take another three to six months.
No matter where you are in the family building process, support is key. Any type of roadblock when you’re looking to build your family can feel insurmountable, but many others have been in the same position. Whether you look for a therapist, a support group, or just some moral support from loved ones, checking in and asking for support can lighten the load these processes can add to your life.
Looking for a Therapist or a Support Group
Finding an external support system can be incredibly helpful, especially if the individual or group has had a similar experience. Having this support can increase your validation in both your struggles and successes. Plus it also gives you an individual or group that can relate to your experiences.
Building resiliency with a trained professional can also equip you with tools and resources to tackle any major life challenge. For many, infertility and difficulties building their families is the largest challenge they will face. Being able to set expectations and manage various difficult emotions can not only keep you in a healthy mindset, but also make relationships somewhat easier to maintain.
Here are some questions that can help guide you:
- How can I manage my expectations?
- What is my biggest fear about this process?
- How can I communicate my insecurities to myself? How can I effectively communicate them to my partner, physician, or therapist?
- What is a mantra that might keep me positive? Brandon suggests “Straighten your crown. Hold yourself up. Infertility does not take away your manhood. We will get through this and find a solution. You are more than just your fertility,” or “There is more to me. There is always a way.”
Asking for Support from Your Partner, Family and Friends
Therapy is not for everyone. If you don’t feel like sharing your story with strangers, turning to existing family, friends, and partners can also help you feel supported and loved. Being able to ask for what you need might change daily, so making sure you give yourself time to check in with yourself is key.
If opening up to others is challenging for you, start slow. Try to identify one person who you consider to be the most trusted person and start there. Whether it is your partner, a family member, or lifelong friend, opening up to someone who makes you feel heard and seen is important. As you start to feel more comfortable, slowly expand your circle to include other close family members and friends that can continue to lighten the emotional load you might be feeling.
If opening up to loved ones is still too daunting, try looking at external sources like Facebook groups or Reddit threads to connect with others on anonymity levels you can control.
Regardless of how you seek or look for support, it is important to set boundaries. Making sure you communicate what you’re comfortable sharing (or not sharing) can help assert confidence and control over a situation which can otherwise feel uncontrollable. Statements like “it’s not for lack of trying,” or “we’re working on it, and we will let you know,” can directly remind others that this is your story, your experience, and your journey.
Five Tips on Staying Proactive in the Family Building Process
The family building process is challenging and can take months or years. Thinking ahead about your personal family building goals is one way to be proactive about pursuing those goals.
- Talk to your partner and your doctor – One way to get out ahead of any potential family building challenges is to check in with your doctor early. Spending a few years thinking about your options is great but talking to your doctor and partner (if you have one) about what is realistically the best choice can save you lots of time and energy and get you moving sooner towards that outcome of expanding your family.
- Understand your options – Think back and discuss some of those questions brought up earlier about surrogacy versus adoption. What clinics are around you? Do you know anyone who has pursued similar routes? What does your health and your partner’s health look like? What is your own genetic or medical history? Who is going to be the one to donate sperm? Having a handle on some of these basic questions can set you up well for a thoughtful discussion with your physician and help direct your clinic or surrogate search process.
- Begin looking to build your support group – No matter the route you choose, you will need support. Either looping your friends or family in or reaching out to a therapist or support groups can help you lay the groundwork for support before the process really gets going.
- Check in on yourself – The stress of waiting for results, the cost, balancing work, and office visits can all affect relationships. Because of this, it’s important to check in with yourself and see how you’re feeling and what you might need. As mentioned earlier, these feelings and needs are expected to change. Nothing is “wrong” with you if one day you’re feeling hopeful and the next day you’re not.
- Dealing with a partner who is not engaging with discussion – Although it may be challenging at first, discussing how your partner fits into the family building process, what roles they want to play, how the two of you can live together and continue to work on your relationship, is important in continuing to build a solid family base. If a partner is not comfortable having this discussion off-the-cuff, try setting a weekly time to discuss. Knowing there is a scheduled time for these discussions might be helpful. If your partner continues to put up walls and dismiss the conversations, you might suggest them talking to a professional.
Progyny is proud to support all paths to parenthood, include same-sex couples and single fathers by choice. If you are a Progyny member, your Patient Care Advocate is always available for emotional support or fertility advice. Please don’t hesitate to reach out.
To learn more videos, articles, infographics, and podcasts about family building, visit Progyny’s education page.