Two-mom families have the option of using sperm from a friend (known donor) or a sperm bank (anonymous donor). Using a known sperm donor through a fertility clinic is possible, but it involves a mandatory quarantine period for the sperm of 180 days. The law in Canada prohibits any payment for sperm or eggs. Each person should see a certified counselor to discuss the psychological side of using donor sperm or eggs. A fertility lawyer can help draft a sperm donation agreement and each person should get independent legal advice.
Anonymous donor sperm and intrauterine insemination (IUI) is a very common treatment performed at PCRM. The sperm is obtained directly from a sperm bank and shipped in frozen units to the clinic. Usually, the sperm comes from a bank in the United States and costs about $1000 per unit. (Because payment for sperm is illegal in Canada, sperm banks here get very few donations.) To perform IUI, the sperm is washed to remove the ejaculate fluid and then placed in a thin catheter to pass through the cervix and into the uterus.
Directed Egg Donation (Egg-sharing)
Lesbian couples can use eggs from one woman to create embryos and then have the other woman carry the pregnancy. This is called directed egg donation and it requires the use of in vitro fertilization (IVF). This is a more complex option than IUI because IVF is required; however some couples like the idea that each woman is physically responsible for part of the pregnancy. A lawyer can provide advice about a co-maternity agreement.
Gestational carrier (Surrogacy)
Gay men need to find both a woman to donate eggs and a woman to carry the pregnancy. The term gestational carrier refers to a woman who has no genetic relationship to the pregnancy (i.e. it was not created from her egg). A traditional surrogate donates both her egg and her uterus, so IUI can be used to achieve this type of pregnancy. In a fertility clinic, the most common situation we encounter is when two men each use their sperm to fertilize donor eggs. A fertility lawyer can help write the legal agreements and the application for parentage of the baby after it is born.
Trans women (or trans people with testicles) who want the option of having genetically-related children should ideally bank sperm before hormone treatment or having the testicles removed. Trans people already using hormones need to stop these for a number of months to see if sperm production returns.
Trans men (or trans people with a uterus and ovaries) who want the option of having genetically-related children should ideally freeze eggs before hormone treatment or having the ovaries removed. Trans people with a uterus who wish to become pregnant can do so using hormone therapy. The time off of testosterone that is required for the ovaries and uterus to regain function is variable.
See our HuffPost blog on this topic.