LGBTQ+ Fertility Care

• Fertility Care for Cisgender Gay Male Individuals & Couples

  The fertility journey for cisgender gay men typically involves several important steps to achieve their goal of building a family. These steps include:

  1. Consultation and Evaluation: During your consultation with a fertility specialist, medical history and any potential fertility concerns are discussed. If part of a couple, both partners may undergo fertility evaluations.
  2. Sperm Selection: Depending on the results of the fertility evaluation and/or personal preferences, partners will choose whose sperm will be used to create the embryo.
  3. Egg Donor Selection: Cisgender gay men typically work with an anonymous egg donor, who provides the eggs for fertilization. Anonymous donor eggs can be obtained from an egg bank and shipped to PCRM so they can be fertilized with your chosen sperm. To ensure our patients find the ideal egg donors they’re looking for, PCRM works with several accredited egg banks, including MyEggBank, the largest and most diverse egg bank in North America.
  4. Gestational Surrogate Selection: Cisgender gay men typically also work with a gestational surrogate or carrier, which is someone who carries a pregnancy and gives birth to a baby on behalf of someone else.
  5. Legal Considerations: Legal processes, such as surrogacy arrangements and parental rights, need to be addressed early on in the process. This can be difficult to predict, as reproductive laws vary from province to province. Fortunately, PCRM has worked with many excellent attorneys specializing in LGBTQ+ family-building and fertility law and will be happy to refer you to the right professional.
  6. Emotional Considerations: It’s strongly recommended that everyone involved in the family-building process see a certified counselor to discuss the emotional and psychological aspects of using donor eggs and/or a gestational carrier. Fertility Treatment: Once the chosen sperm has fertilized the donor egg and the resulting embryo has incubated for several days, the embryo is transferred to the surrogate’s uterus for implantation.
  7. Pregnancy: Once the surrogate becomes pregnant, the pregnancy is monitored very closely by a fertility doctor until it is time to transfer the surrogate’s care to an OB/GYN. During this time, the intended fathers get to be actively involved in their surrogate’s journey, attending medical appointments and getting ready for parenthood.
  8. Childbirth, Parenthood, and Beyond: After the surrogate gives birth to the baby, the child is transferred to you so that you can start bonding immediately. At this point, all legal processes for parental rights will be finalized. Most importantly, you get to take your baby home and start a new chapter of your lives as a growing family.

  At PCRM, we provide medical expertise throughout the family-building journey, as well as recommendations and guidance for emotional support and legal representation.

• Fertility Care for Cisgender Lesbian Individuals & Couples

  The fertility journey for cisgender lesbian couples and individuals typically involves several important steps to achieve their goal of building a family. These steps include:

  1. Consultation and Evaluation: The fertility journey begins with a consultation with a fertility specialist. During the consultation, medical history and any potential fertility concerns are discussed. If part of a couple, both partners may undergo fertility evaluations.
  2. Sperm Donor Selection: Cisgender lesbians generally work with either a known or anonymous sperm donor. Federal legislation enacted in February 2020 makes it more accessible to use a known sperm donor through a fertility clinic. However, many lesbian individuals and couples use donated sperm from an anonymous donor obtained through a sperm bank.
  3. Egg and Carrier Selection: Depending on the results of the fertility evaluation and/or personal preferences, partners will choose whose eggs will be used to create the embryo, as well as who will carry the pregnancy. This part of the process will also determine the type of fertility treatment used to initiate the pregnancy.
  4. Fertility Treatment: Depending on various factors, cisgender lesbian couples and individuals have the option of undergoing intrauterine insemination (IUI) or in vitro fertilization (IVF), both using donor sperm. With IUI, the sperm is washed to remove the ejaculate fluid and then placed into a thin catheter which is passed through the cervix and into the uterus. The sperm are deposited directly into the uterus so they can continue their journey to the fallopian tubes. With IVF, mature eggs are retrieved and fertilized using donor sperm.
  5. Reciprocal IVF: In some cases, one partner provides the egg and carries the pregnancy, however, lesbian couples also have the option of undergoing reciprocal IVF. In reciprocal IVF, one partner provides the egg to be fertilized; the ensuing embryo is then transferred to the other partner’s uterus, allowing both women to participate in the creation and birth of their baby.
  6. Legal Considerations: Legal processes, such as parental rights, need to be addressed early on in the process. This can be difficult to predict, as reproductive laws vary from province to province. Fortunately, PCRM has worked with many excellent attorneys specializing in LGBTQ+ family-building and fertility law and will be happy to refer you to the right professional.
  7. Emotional Considerations: It’s strongly recommended that everyone involved in the family-building process see a certified counselor to discuss the emotional and psychological aspects of using donor sperm.
  8. Pregnancy: Once the intended recipient becomes pregnant, the pregnancy is monitored very closely by a fertility doctor until it is time to transfer your care to an OB/GYN.
  9. Childbirth, Parenthood, and Beyond: At the point of childbirth, all legal processes for parental rights will be finalized. Most importantly, you get to start bonding with your baby immediately and bring them home so you can start a new chapter of your lives as a growing family.

  At PCRM, we provide medical expertise throughout the family-building journey, as well as recommendations and guidance for emotional support and legal representation.

• Fertility Care for Transgender / Gender-Diverse Individuals & Couples

  For transgender and gender-diverse families, the path to parenthood is unique, deeply personal, and transformative. We are committed to providing compassionate, inclusive, and expert care tailored to your specific circumstances. Our dedicated team is here to support you at every step, ensuring that your fertility dreams are respected and realized.

  • Fertility Preservation: In the past, transgender and gender-diverse individuals often faced a difficult choice between having genetically related children one day and pursuing their true selves through gender-affirming therapies, some of which can permanently alter the ability to naturally have a child. However, today, many trans people choose to freeze their eggs or sperm before undergoing hormone therapies or surgery. This makes it possible for you to eventually have a biological child without taking away your choices.
  • Fertility Treatment: Achieving pregnancy for transgender and gender-diverse families generally requires some type of fertility treatment. For gender-diverse individuals with ovaries and/or a uterus, they may undergo intrauterine insemination (IUI) or in vitro fertilization (IVF), depending on the situation. Gender-diverse individuals with testicles, on the other hand, can provide their semen so that it can be used in IUI or IVF. The timing and coordination of fertility treatments are also dependent on where you are in your gender-affirming journey. Your fertility specialist will help you find the best path to ensure your family-building plan is in line with your overall journey.
  • Third-Party Reproduction: Depending on the specific circumstances, transgender and gender-diverse folks sometimes need to work with a third-party person to achieve their goals of parenthood. This may be an egg donor, a sperm donor, a gestational surrogate, or a combination of any of the three.
  • Legal Considerations: If working with a third-party person to achieve your family-building goals, legal processes, such as parental rights, need to be addressed early on in the process. This can be difficult to predict, as reproductive laws vary from province to province. Fortunately, PCRM has worked with many excellent attorneys specializing in LGBTQ+ family-building and fertility law and will be happy to refer you to the right professional.
  • Emotional Considerations: It’s strongly recommended that everyone involved in the family-building process see a certified counselor to discuss the emotional and psychological aspects of fertility care, especially from a transgender or gender-diverse perspective. While having a child is an incredible and beautiful experience regardless of gender, it can also trigger feelings of gender dysphoria, depression, and anxiety for some gender-diverse individuals. PCRM can help you connect with a gender-affirming counselor to ensure your mental and emotional health is cared for throughout your family-building journey.

Frequently Asked Questions About LGBTQ+ Fertility and Family Building

• What fertility services are available for LGBTQ+ family building?

  At PCRM, our fertility care services are available without discrimination to everyone regardless of sexual orientation or gender identity. These services include fertility testing, IUI, IVF, fertility preservation, third-party reproduction (egg and sperm donation, surrogacy, etc.), genetic testing and counseling, and reproductive surgery.

• What legal considerations are there for LGBTQ+ individuals and couples using assisted reproductive technologies?

  In 1992, the Uniform Law Conference of Canada adopted the Uniform Child Status Act. This uniform act includes provisions for determining legal parentage where assisted reproduction is used and the birth mother and her husband (or male partner) intend to be the child’s parents. It does not deal with how to determine legal parentage where the birth mother is in a same-sex relationship, or where a child is born as a result of a surrogacy arrangement. To assign parentage in this setting; a legal contract directing parentage to the other partner must exist at birth.

• Can LGBTQ+ individuals and couples choose a known donor for fertility treatments?

  Yes, it is possible for LGBTQ+ aspiring parents to work with a known sperm or egg donor to achieve their family-building goals, however, when you work with a known donor, they must undergo all of the tests and screenings that an anonymous donor would have, including screening for infectious diseases. It’s more common for individuals and couples to use sperm and eggs that have been donated anonymously.

• Where can I obtain donor sperm and/or eggs?

  Donor sperm and eggs are typically sourced from sperm banks and egg banks. In most cases, donor eggs and/or sperm are imported from the United States. PCRM works with several accredited sperm and egg banks and can help you find an ideal match.