TRIO is proud to help members of the 2SLGBTQIA+ community grow their families. We believe in equal opportunities and are committed to providing a welcoming and supportive environment for all our patients.
This article will outline some common routes to parenthood for 2SLGBTQIA+ family planning. For a bespoke discussion about how we can help you achieve your goals, please get in touch.
Family Building for Assigned Male at Birth Couples
A popular family-building option for couples is surrogacy with egg donation.
Egg Donation
The two types of egg donation are:
- Known Egg Donation: Someone from your personal life donates their eggs to you. A known donor will go through a comprehensive screening process to ensure they are suitable for donation. This will include a thorough check of their medical history and attending counselling sessions.
- Anonymous Egg Donation: Someone who is unknown to you selected through an online egg bank. All donors provided by an egg bank will have already gone through the screening process.
Embryo Creation
Once you have selected your egg donor, you (or your partner) will provide sperm to have in vitro fertilization (IVF) with/ without intracytoplasmic sperm injection (ICSI). Your TRIO doctor will be able to advise which treatment option is ideal for you.
If you have a known donor, they will take stimulatory drugs to encourage multiple eggs to develop in their ovaries. These will be retrieved during an egg retrieval procedure. If you have selected an anonymous donor, the eggs will be flash-frozen at the donor bank and thawed on-site at TRIO to create embryos with sperm.
Surrogacy
Your surrogate can be someone you know from your personal life, such as a friend or family member, or someone who was previously unfamiliar to you.
There are a few different types of surrogacy arrangements possible, with the most common being gestational surrogacy. A gestational surrogate does not provide the eggs used to create the pregnancy and is therefore not biologically related to the child(ren).
TRIO’s third-party coordinators can connect you with the right agencies and support you need to ensure your surrogacy journey goes as smoothly as possible.
An embryo will placed into the uterus of your chosen surrogate, who will carry the pregnancy.
Family Building for Assigned Female at Birth Couples
A common family forming route is fertility treatment with sperm donation.
Sperm Donation
The two types of sperm donation are:
- Known Sperm Donation: Someone you know from your personal life. They will need to undergo a detailed screening process to ensure they are suitable for donation.
- Anonymous Sperm Donation: An unknown donor you select from an online sperm bank. The sperm bank will send frozen straws of donor sperm to the TRIO lab ready for your treatment.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a commonly used treatment for people using donated sperm. A cycle of IUI can either be medicated or unmedicated, and your TRIO doctor will be able to advise which option is right for you.
- Medicated IUI: The partner undergoing treatment will take drugs to encourage egg development in the ovaries. Once the eggs reach a suitable stage of development, a ‘trigger’ shot will be administered to mature the eggs and support ovulation. Shortly after this shot, the partner having treatment will attend the clinic for the IUI procedure.
- Unmedicated IUI: The partner having treatment will be closely monitored during their natural menstrual cycle. to monitor for ovulation. When ovulation has occurred, either naturally or with the help of a trigger shot, they will attend the clinic for the IUI procedure.
During the IUI procedure, prepared donor sperm will be inserted into the uterus using a thin catheter. The sperm will then swim to the fallopian tubes to fertilize the ovulated egg(s) and create a pregnancy.
In Vitro Fertilization (IVF)
Another popular option for people using donated sperm is in vitro fertilization (IVF). During IVF, the partner whose eggs will be used in treatment will take stimulatory medications to encourage multiple eggs to develop in the ovaries.
Once the eggs have reached a suitable stage of development, they will be retrieved from the body during an egg collection procedure. Following this, the eggs will be combined with prepared donor sperm in an IVF lab for fertilization to occur with or without intracytoplasmic injection (ICSI). Your doctor will be able to advise you which option is most suitable for you
The fertilized eggs (now called embryos) will develop in the lab for around 5 days before being frozen or placed in a uterus to create a pregnancy. Your doctor will review with you the pros and cons of fresh embryo transfer. embryos of suitable quality can be frozen for use in the future.
Reciprocal IVF
Same-sex assigned females at birth couples have the option of using a technique called reciprocal IVF. During reciprocal IVF, one partner provides the eggs to be fertilized and the other carries the resulting pregnancy. This technique allows both partners to be involved in the pregnancy process.
Family Building for Transgender People
Fertility Preservation
If you think you may want to have biological children in the future, guidelines recommend freezing your gametes (eggs or sperm) before undergoing any gender-confirming treatments that impact fertility (1). This could include hormonal therapies or operations that remove the sexual organs.
If you are currently taking hormonal medication, it may still be possible to preserve your fertility.
Understandably, for many, the fertility preservation process can be highly emotional. Our TRIO fertility counsellors are specially trained in helping and supporting patients through this potentially challenging time.
Family Building Options
There are many routes to parenthood as a transgender person, and how you decide to build your family will be unique to you. It will depend on factors like your relationship status, and whether you and your partner (if you have one) have gametes available for treatment. Depending on your circumstances, you may require donated gametes and/or a surrogate to help create your family.
How Can TRIO Support You?
At TRIO, we foster a community of inclusive care. We practice inclusivity in everything we do, with some examples including:
- Regular training for all staff about providing outstanding care to 2SLGBTQIA+ patients
- Always using preferred names and pronouns
- Gender-neutral consent forms when possible
- Gendered and gender-neutral washrooms are available on-site
- A support group specifically for 2SLGBTQIA+ patients
We want you to feel happy, safe, and supported during your time with TRIO. Because of this, we are always open to feedback about how we can improve. Please send any ideas to info@triofertility.com; we’d love to hear from you!
References
(1) https://www.fertstert.org/article/S0015-0282(15)01867-1/fulltext
