What are my options for starting a family? The LGBTQ+ Guide

Written by Virtus Health
25 Feb

 

LGBTQ+ fertility

Written by Dr Bronwyn Devine, fertility specialist at IVFAustralia

When it comes to starting a family, there are many wonderfully diverse ways it can happen.

As a fertility specialist, I see many transgender patients and members of the LGBTQ+ community, and understand that it can be an overwhelming process when you start to consider your options.

Whether you are just starting to research, or you’ve already begun the process, our doors are always open to have a chat and find out how we can help you achieve your dreams of having a family.

So, what are your options?

Same-sex female and those requiring donor sperm to conceive

Same-sex female couples will need to use donor sperm in order to help grow their family. I always recommend those requiring donor services to do so through a fertility clinic, because this is a safe and effective way of achieving pregnancy, as every donor goes through a rigorous screening process.

Treatment options using donor sperm

Generally people will come through first and try an intra-uterine insemination (IUI) cycle, because this tends to be more straightforward than IVF.

In NSW, if you undergo 3 insemination cycles using donor sperm and don’t fall pregnant, you would qualify for a Medicare rebate if you then decide to try IVF.

Some couples will try an ‘at home insemination’, where the sperm is usually put in at the top of the vagina. But the difference with doing IUI at a fertility clinic, is that the donor sperm is firstly cleaned in the laboratory, spun down so as to get the absolute best swimmers, and then carefully injected into the uterus – which much closer to where the egg is located! We can either do this at the time of your natural cycle, or induce ovulation with medication.

If insemination doesn’t work, or if something more technical is required, you can do IVF or ICSI.

IVF or ICSI can be done using your own eggs with donor sperm, or you can in fact use your partner’s eggs, if your partner has eggs, and these eggs can be fertilized with donor sperm to create an embryo. The embryo can then be transferred to the uterus of the other member of the couple, which is called Embryo Sharing.

This can be a beautiful way for a couple to have a baby together. But it’s really up to you how you would like to grow your family!

Same-sex male or if you require donor eggs and/or surrogacy to start a family

Most commonly, if you’re a same-sex male couple, you will require an egg donor and surrogate in order to help create your family.

You may wish to ask a friend or relative to provide a donor egg, but of course the egg donor cannot be a relative of the person providing the sperm.

It’s important to be aware that while overseas clinics may have paid egg donation programs, embryos created overseas may not be able to be shipped to Australia due to legislation.

There are communities online such as Egg Donor Angels and Egg Donation Australia which can provide support and help find egg donors.

And surrogacy IS legal in Australia, as long as the surrogacy is altruistic. Compensation can be covered by the intended parents for things such as travel, obstetric care, etc., but they cannot be paid specifically for surrogacy.

At IVFAustralia, we aren’t able to procure or recruit a surrogate for you, but we are of course happy to assist you throughout the surrogacy process once you have found a surrogate. Surrogacy Australia and Growing Families are also a great resource for those starting out this process.

You can read more about surrogacy in Australia here.

Options for gender diverse people

Some of the options I’ve already discussed can of course apply to gender diverse people, but there can also be specific recommendations for those who have started or are considering starting an affirming medical or surgical therapy. This is because these therapies sometimes have the potential to limit your fertility down the track.

Many transgender, transsexual and gender nonconforming people will want to have children, and ever since 2014, the World Professional Association for Transgender Health (WPATH) states that anybody who seeks to transition should be advised and certainly be given the option to preserve their fertility.

You may or may not choose to go down the fertility preservation route, but it’s important to be aware of the options.

Fertility preservation options can include:

  • Sperm freezing
  • Embryo freezing (fertilizing eggs and then freezing those embryos)
  • Egg freezing
  • Freezing gonadal tissue (much less common and not as viable for someone considering transitioning)

Egg freezing can be done at any time during your transition. If you’ve been using testosterone, you will need to stop the testosterone for a brief period of time, then have injections for about two weeks. Monitoring and blood tests will reveal the growth of the eggs, and after two weeks you’ll undergo a minor surgical procedure to remove your eggs without incisions or stitches. You can then resume your testosterone treatment once the procedure is over.

What about carrying a pregnancy?

If a uterus is present, successful pregnancy is possible, regardless of prior testosterone use.

For those born without a uterus or those who have undergone hysterectomy, pregnancy and birth are not yet possible.

At IVFAustralia, as well as our sister clinics Melbourne IVF, TasIVF, and Queensland Fertility Group, we provide a comprehensive and supportive donor program to assist anyone needing donor sperm, eggs or embryos; or a surrogate to help you have a baby.

If you would like to learn more, feel free to contact us at 1800 111 483.

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We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at [email protected].



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Sperm Donation: Giving the gift of life

The obsession with the celebrity world seemed to lift to new heights recently, when Australian media reported on a UK based sperm donor service that stated it aimed to match women with anonymous celebrity dads when it launched in the New Year.  Marketing to celebrity obsessed women, the service claimed women will give their child ‘a head start in life’ by using sperm from a ‘proven winner’.

sperm

The service later turned out to be a hoax, but it attracted a lot of media interest; not only because the concept of a celebrity sperm donor service was so ridiculous, but because in countries like the UK and Australia where there is a severe shortage of donor sperm, any service that promises to have the solution to sourcing local donor sperm is going to capture the attention of those needing it. 

Australia has been suffering a sperm donor shortage for years.  Sperm donation in the UK and Australia is an altruistic act for men with a genuine desire to help individuals or couples who can’t have children for medical or social reasons.   Men who do donate in Australia are those that have experienced the joys of fatherhood themselves, and who wish for others to have the same opportunity; or those that have no prospect of becoming fathers themselves but wish to help others achieve their quest for a baby.

As societal trends have evolved over recent years, the demand from single women and same sex couples wishing to access donor sperm has increased (10% increase at IVFAustralia in the last three years), while the number of sperm donors has been steadily declining for the last decade. At IVFAustralia, we normally have around 15 to 20 donors at any one time, while demand usually requires 30 to 40 donors.

Using a sperm donor is the only opportunity for these women to have a child of their own and to experience the joys of parenthood.  We are actively searching for young Australian men to become sperm donors, to help these women achieve their goal of becoming mothers.  So, if you are a healthy male aged between 25 and 45, I urge you to continue reading.

It takes a special kind of person to consider donating, let alone to actually go through with the process.  Even for men who have a genuine desire to help others, there are some concerns which may put them off the idea.

Full anonymity is no longer possible in Australia. The potential for a child to seek out their genetic father is now a requirement. This does not mean being confronted at your front door by an 18 year old claiming that ‘you are my Dad’. A child will be able to find out if they are the result of donor conception by approaching a Government register, on which your name will have been lodged by the original treating clinic. Depending on the State, you will be contacted to notify you of the enquiry, and be given the opportunity to make contact – much in the way adopted children are linked with their original parents. This openness dissuades many potential donors.

All donors are required to discuss this issue in formal counselling sessions, and if the man has a partner, they are also required to attend the counselling sessions to ensure they understand the social, ethical and legal implications before consent forms are signed. Payment for sperm donation is also illegal, however compensation for time spent at appointments is available.

While there are occasional sensational media articles highlighting the possible implications of donation, such as legal parentage rights, rights over the child’s upbringing or any financial obligation, I encourage anybody considering becoming a sperm donor and concerned about these issues to consider these facts.

Legislation in Australia is designed to protect the rights of the donor, the recipient, but most importantly the children resulting from sperm donation. Over the years, legislation has been guided by donor conceived children - now in their late 20s and early 30s. There has, therefore, been a move away from complete anonymity, as it is deemed in the best interests of the child to have the right to know their biological origins, and to have the right to contact their biological father in the future.

Under current legislation, where the sperm donor is ‘clinic recruited’, the law protects the identity of both the donor and the recipient, until the donor conceived person turns 18 years of age. At this time, identifying details of the donor may be released to the donor conceived offspring if they request them (the donor’s information is kept on a central donor registry). Contact between a recipient and an anonymous sperm donor prior to the donor conceived child turning 18 years of age, can however be established where both parties have provided consent.

In terms of future parental obligations, laws in most States mean that sperm donors whose semen is used in assisted reproductive treatment will normally be presumed for all purposes not to be the legal father of any resulting child.  This is regardless of whether or not he is known to the woman or her partner (female or male). This means that the child has no rights to any financial or other consideration from the donor, while the donor has no parental rights over the child.
Whenever I deliver a baby conceived through donor sperm, it is such a joy to see a woman cuddling her ‘so wanted child’ .I truly admire the generosity of the donor who has felt it appropriate to help out in this situation.

In addition to the single women, we also have many infertile couples, in whom the problem is a lack of sperm production in the male. Donor sperm will be their only chance to produce the pregnancy that they so desire.

Sadly, we need more men to consider becoming sperm donors to help the hundreds of women across Australia fulfil their desire of becoming mothers.  Men should ideally be healthy, and aged between 25 and 45.  If you, or anyone you know, are interested in learning more, contact our sperm donor nurse who will talk to you confidentially about what is involved.

To find out more about becoming or using donor sperm, visit our websites:

> Sperm Donation in Sydney
> Sperm Donation in Queensland
> Sperm Donation in Melbourne
 

Virtus Health
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There’s a sperm donor shortage in Australia – but only 20% of men know about it

The leading fertility clinics in the Virtus Health group, including IVF Australia, Melbourne IVF and Queensland Fertility Group, have joined forces to research sperm donation in Australia.

What did we find out about Sperm Donation?

Only 20% of men are aware that there is a shortage of sperm donors in this country.

While the majority of Australians are aware of the need for blood and organ donation, the requirement for sperm donors is largely unknown.

Who uses sperm donation?

Used by patients as either part of an In-Vitro Fertilisation (IVF) cycle, or via Intrauterine Insemination (IUI), donor sperm can help overcome male factor infertility (15%), or help same-sex couples (35%) and single women (50%) have a child.

What are the common motivations for donation?

The same research also discovered that the common reasons for wanting to donate sperm included:

  • Helping others to have a family (38%)
  • Knowing other people going through fertility treatment (24%)
  • Knowing my sperm count and quality could be assessed at donation (20%)
  • Everyone deserves to be a parent if they want to be (18%)

Sperm donors in Australia can be known to the recipient or recruited via the clinic. Many couples and individuals choose their sperm donor through a clinic, as knowing the demographic profile of the donor but not their identity is a preferred option. In these cases, children of sperm donors are able to access their biological father’s details when they are 18 years old.

The reason for this is that in the past, many donor conceived individuals have reported extreme distress about the absence or lack of information about their biological parents. Nowadays, the exchange of this information, once the child has turned 18 years of age, is considered to be an important part of the use of donated sperm.

While Australians cannot be paid for their sperm, most clinics reimburse donors for legitimate expenses. Sperm donors in Australia are typically aged 25-45, with or without their own families, and of any sexual orientation.

De-identified donor sperm can be used to create up to five or 10 families, depending on what state they’re in, please check with your local state for family limits. Unlike popular belief from movies such as Vince Vaughn’s ‘Delivery Man’. Donors need not worry – fathering 500+ children from their sperm donation is a scenario only Hollywood can create.

Would you or someone you know now consider sperm donation?

After seeing the results of this research, we want to raise awareness of the need for more sperm donors in Australia. If it is something that you would consider talk to your local clinic for more information.

Sperm Donation in Australia Infographic

Sperm Donation in Australia infographic

 

* Research conducted by Woolcott Research in March 2012. 
Virtus Health
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Paternity, Maternity, Equality

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.
 
In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.
 
So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.
 
When you access the donor program there are a few extra decisions you need to make.
 
Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)
 
When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.
 
For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.
 
In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites. 


 * IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne
2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org 

Virtus Health
25 Feb

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