Lesbian, gay, bisexual and transsexual couples have essentially the same menu of choices in assisted reproductive technologies as straight couples, with some obvious and fundamental differences. Lesbian or gay couples generally are not diagnosed as infertile before using the services of a reproductive clinic. They may enter the reproductive clinic completely fertile and capable of producing fertile eggs or sperm. A lesbian couple generally will seek a sperm donor, possibly also an egg donor. A gay couple generally will seek an egg donor and gestational surrogate.
Once those choices are made, in consultation with a reproductive specialist, the fertilization proceeds along the same steps—intrauterine insemination, and if unsuccessful, in vitro fertilization—generally proceeding with one member of a lesbian couple or with the gestational surrogate for a gay couple. These couples also may avail themselves of genetic screening and pre-implantation genetic diagnosis of their fetus.
Lesbians who suspect they are infertile or want to be tested may undergo the same series of tests and evaluations as non-lesbian women: assessment of fallopian tubes, assessment of ovarian reserve, use of laparoscopy to diagnose endometriosis, uterine fibroids, polycystic ovarian syndrome. The uterine cavity needs to be proven normal by saline infusion sonogram and or hysteroscopy. If either member of a gay or lesbian couple suspects they suffer from infertility, reproductive clinics have a range of tests to examine the male factors of infertility and diagnose infertility in women.
Dr. Massey has been an advocate of LGBT family building since early in his career, receiving an award from the Feminist Women’s Health Center for his efforts. Similarly, Dr. Servy has been an LGBT family building advocate for the Augusta area.
In 2009, the American Society for Reproductive Medicine Ethics Committee released a report for all of its members stating that assisted reproductive clinics “should treat all requests for assisted reproduction equally without regard to marital status or sexual orientation.” Read the full report.