Same-sex female couples who want to start a family have to take into consideration a lot of different factors compared to a heterosexual couple who aren’t experiencing any complications and do not require medical intervention. From treatment type and cost, to location, timings, and which role each female will play, there’s a lot to think about.
The options available to lesbian couples include, but are not limited to, insemination at home, IUI (intrauterine insemination), IVF (in vitro fertilisation), and shared motherhood (reciprocal IVF or intra-partner egg donation). Let’s take a look at each of the various treatments below.
At home conception
Although it’s possible and may appear easier and cheaper, same-sex female couples are strongly advised to avoid using a private sperm donor without a clinic if possible. Sperm donors who donate via a fertility clinic are subject to rigorous health tests, receive the correct counselling, and all of the legalities are taken care of by the clinic. Whereas, doing it all without a clinic means that the donor could be considered as the legal father, with rights and responsibilities over your child. This is not the case when using a fertility clinic.
If individuals or couples decide to go ahead with inseminating without a clinic there are several ways to find a sperm donor. This includes using someone they already know, finding someone suitable on a reputable donor introduction website, or by using an overseas sperm bank that will ship the donation to a clinic. Should people choose to use a known donor or meet someone through a website, all parties need to be clear on the expectations and levels of involvement should the process result in a successful birth.
In terms of the process itself, there are a range of home insemination kits that can be purchased online. Conceiving at home ensures a host of benefits such as a relaxed environment, lower costs, and it can be turned into a special moment shared with your partner.
Intrauterine insemination (IUI)
Intrauterine insemination, more commonly known as IUI or artificial/donor insemination, is an in-clinic fertility treatment that is a common option for people using donated sperm. This process is not only used by same-sex female couples but also by single women and some heterosexual couples who may be experiencing unexplained fertility issues. The process involves a sperm sample – either from an unknown or known donor, such as a partner – being analysed and separated. The best quality sperm are then injected directly into the female recipient's uterus at the time of ovulation in order to fertilise the egg naturally inside the body. It can be conducted without medication, with the female’s ovulation being closely monitored over a number of months in order to calculate the best time for implantation. IUI can also be medicated (known as stimulated IUI), where fertility drugs are used to encourage the production of multiple eggs to be released at a set time, however this could result in twins or triplets. This procedure closely mimics a natural conception and, especially when unmedicated, is a less invasive fertility treatment. It also tends to be much less expensive at approximately a quarter of the cost of one IVF cycle. HFEA (the Human Fertilisation & Embryology Authority) estimate it to be between £350 to £1,000 per cycle. However, the success rates per cycle for IUI are a lot lower than other fertility options and are estimated to be approximately a third of the success rates for IVF. This means that people may need to try several IUI cycles to be successful.
In vitro fertilisation (IVF)
Another common fertility treatment is IVF, or in vitro fertilisation, which is often an option for same-sex couples, heterosexual couples who are struggling to conceive naturally or those who have been unsuccessful in other fertility treatments. This treatment is commonly aided with fertility medication, however it is possible to go through the process as a natural cycle IVF (no fertility drugs at all) or as a mild stimulation IVF (fewer fertility drugs). The process involves the collection of a female’s eggs to be fertilised by sperm outside of the body in a laboratory. Embryos are given two to six days to develop, before the strongest is selected and placed directly into the womb for it to hopefully continue to develop into a baby.
For many people, a single cycle of IVF takes around four to six weeks to complete however this will always differ due to an individual’s circumstances. This involves a number of different stages such as pausing the production of natural hormones, using medication to boost egg supply, the extraction of the eggs, the fertilisation of the egg with the sperm, using medication to prepare the womb lining for implantation, and finally, the transfer of the embryo to the recipient’s womb.
IVF is considered to be one of the most invasive forms of fertility treatment as well as one of the most expensive at around £5,000 for one cycle. But that’s not including initial consultations or the cost of freezing any other viable embryos that are created. Some people are eligible to have IVF treatment on the NHS, although it is very much a postcode lottery since decisions on who can and cannot have this treatment are made locally instead of nationally. However, depending on certain circumstances, it is considered to be one of the most successful.
This fertility treatment is similar to the traditional method of IVF in which an egg is fertilised by sperm outside of the body. Shared motherhood, which is also known as reciprocal IVF or intra-partner egg donation, involves both females in a same-sex lesbian couple giving the pair of them the opportunity to be a part of the baby.
In the same way as IVF, the eggs of one partner will be collected following a course of fertility medication to stimulate the production of as many eggs as possible. However, once the egg has been fertilised and has transformed into a viable embryo, it is then transferred into the womb of the other partner. Therefore the egg donor is known as the ‘biological mother’ and the partner who carries the baby and experiences the pregnancy is known as the ‘birth mother’. This way, both partners can share in the experience and journey.
Shared motherhood is a safe and viable option for same-sex female couples. However, it can be rather pricey. Only available at private clinics, one cycle of shared motherhood can cost in the region of £6,000 and that’s not including the freezing and storage for any other fertilised embryos.
For more information on various treatment options, check out the HFEA (Human Fertilisation & Embryology Authority) website and identify your CCG (Clinical Commissioning Group) to find out whether you are eligible for fertility treatment on the NHS.
Read about all of the trials and challenges one lesbian couple has faced during their fertility journey.
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