For same-sex couples wishing to become parents, there are more options available than ever before. Advances in technology along with knowledge of fertility treatment becoming more widespread means that it is becoming increasingly common for same-sex female couples to turn to IVF clinics to help them start a family. The two options for same-sex couples undergoing fertility treatment are intra-uterine insemination (IUI) and in-vitro fertilisation (IVF). IUI involves monitoring the cycle until the eggs are fully mature before injecting donor sperm into the womb at the time of ovulation. In IVF, on the other hand, eggs are removed from the ovaries and fertilised outside the body before being placed in the womb.
IUI or IVF: IUI and IVF both come with their own set of benefits and disadvantages. IUI is often the first choice of fertility treatment for same-sex couples because it is shorter, cheaper and much less invasive than full IVF treatment. On the downside, IUI is less likely to be successful than IVF, with a 15% success rate for women under the age of 35 compared to a 35% success rate for IVF, and this often makes couples decide to choose IVF as an ultimately more cost-effective method.
Which partner will undergo treatment: this can be one of the biggest decisions when undergoing fertility treatment. Sometimes both partners will attend a consultation together and both have their fertility assessed. They then decide who will undergo the treatment based upon these results. In some cases couples decide that the partner with a lower ovarian reserve should undergo treatment first before their fertility declines and in others that the partner with a better ovarian reserve should have treatment first as it is more likely to be successful. Another option with IVF is that one partner donates the eggs while the other carries the embryos. Ultimately you must make the decision that feels right for you.
Selecting donor sperm: another big decision is selecting donor sperm. Sperm donors can be either known or anonymous. Known donors include friends and family members. Sometimes a relative of the partner who is not undergoing treatment will donate sperm so that both partners have a genetic connection to the child. Alternatively, sperm from an anonymous donor can be bought from a variety of clinics and sperm banks. In the UK, only information on the donor’s height, ethnicity, hair and eye colour and occupation is available and the donor remains anonymous until any child born turns 18. More detailed information can be obtained if you choose sperm from overseas sperm banks such as Cryos and the European Sperm Bank.
Legal factors: the law on parenthood changed in 2009, since when both partners can be registered on the birth certificate of any child born from licensed fertility treatment. All couples undergoing treatment will be required to fill in consent forms around legal parenthood at their chosen clinic before treatment. For couples who are in a marriage or civil partnership, both partners will automatically be recognised as parents of the child unless they explicitly specify otherwise on these consent forms. For couples who are not in a civil partnership, the correct consent forms must be filled in prior to treatment to ensure that parenthood is recognised. Married couples or those in a civil partnership will also automatically both be recognised as parents if the treatment is conducted at home or in a clinic abroad. However, couples who are not married or in a civil partnership will not both automatically be recognised as parents under these circumstances and one partner will have to register to adopt the child after birth. This is why it is important to use a licensed clinic for treatment.
Which tests and consents are needed: for the partner undergoing egg collection/insemination, infectious disease screenings must be undertaken, including HIV, Hepatitis B core antibodies, Hepatitis B surface antigens and Hepatitis C. These tests can usually be undertaken at the GP surgery, but if done privately cost around £150. If the eggs are being given to a partner to carry, the partner giving the eggs will also have to undergo donor screening. Both partners will also have to complete a number of consent forms at the clinic prior to treatment which confirm parenthood and specify what will happen to any genetic material in the event of separation or death.
Emotional implications: bringing a child into the world is emotional under any circumstances, and can be even more so as a same-sex couple. With fertility treatment there is always the possibility that it might not succeed, and undergoing treatment can be a rollercoaster experience. There is also the added complication that only one parent will have a genetic connection to the child (unless donor sperm is obtained from a relative of the other partner). With same-sex couples as with all couples using donor gametes, implications counselling is required with a trained counsellor before undergoing treatment.