LGBTQ+ Fertility Care

When using a sperm donor, individuals and couples have the option of using sperm from a known or anonymous donor. A known donor is usually a friend, relative, or acquaintance who a patient asks to donate their sperm, whereas an anonymous donor is found in a sperm donor database. The choice to use one type of sperm donor over the other is a highly personal decision that depends on several factors.

Many people like the idea of using sperm from someone they know or are related to. This option certainly has its advantages, but it also can raise concerns about parenting or interpersonal friction. Using an anonymous donor alleviates many of these concerns, but isn’t a perfect solution for everyone. 

Even though your donor may be anonymous in name, you will actually know a lot of information about them, including their medical history, ethnicity, physical features, and personality characteristics. Some sperm banks also provide baby pictures or current photos. In general, sperm banks only accept high-quality candidates who have passed several rigorous screening measures to ensure that they are free of diseases, fertility problems, and genetic abnormalities.

Regardless of what your preferences are, AFCC will provide counseling to help you and your partner (if applicable) make the decision that’s best for your family building goals. If you choose to use a known donor, we will make sure that all legal agreements and contracts establishing parental rights have been properly drafted, signed, and notarized before taking the next step. We will also provide counseling for your known donor. Should you choose to use an anonymous donor, we can help you connect with a reputable sperm bank and offer advice on how to find the ideal sperm donor.

At AFCC, our Egg Donor Program consists of both fresh egg donation cycles as well as frozen donor eggs. There are pros and cons to both options, and the best decision for you will be highly dependent on what your family building needs and goals are. 

With a fresh donor egg cycle, you will have access to a higher yield of available eggs for embryo creation, making it an ideal option for families who want to have multiple genetic siblings using the same egg donor. When using a fresh donor egg, the cycles of the recipient and donor must be synchronized so that the embryo can be created soon after egg retrieval. The embryos can then be frozen for future use or implanted into the recipient’s uterus. If there are multiple embryos, you also have the option of implanting one and freezing the rest for future pregnancies.

Frozen donor eggs, on the other hand, do not require synchronization. Once you have chosen your egg donor, ovarian stimulation and embryo transfer can happen according to your timetable. The overall cost per treatment cycle is also typically lower than when undergoing a fresh egg donor cycle.

The technology responsible for the freezing and thawing of frozen donor eggs and embryos has advanced significantly during the past few years. At AFCC, our expertise in this technology allows us to maintain frozen donor egg success rates that are fairly comparable with fresh egg cycles. We do this by carefully selecting which donor eggs to freeze as well as maintaining a meticulously controlled laboratory. We also work closely with My Egg Bank for embryo creation using frozen donor eggs.

Whether you are using a fresh or frozen donor egg, the process of choosing an egg donor is similar. We maintain two databases, one for egg donors available for fresh cycles and one for frozen donor eggs. We are constantly recruiting new egg donors to add to our extensive and diverse database, and always have approximately 60-80 Chicago-area egg donors available. 

We have light versions of both databases which contain basic details about each available donor and donor egg, such as age, ethnic origin, hair color and texture, height, weight, education level, and occupation. The full database will grant you access to more comprehensive details, including medical history, social history, family history, psychological evaluation results, IQ test results, and photographs. Throughout this process, we can provide assistance to help you find the egg donor or frozen donor egg that best suits your needs.

Donor sperm insemination is a process in which a female is inseminated with the sperm obtained from a donor. For many women, this procedure can be performed to coincide with natural ovulation cycles without the need for fertility medications. For women who are in their late 30s or older or women who have been unable to conceive through donor insemination during a natural cycle in the past, fertility medication may be recommended.

Insemination is performed through a procedure called intrauterine insemination (IUI). In this procedure, a semen sample is treated with a special laboratory process known as sperm washing. This separates the sperm from the other components of the semen and creates a semen sample that is highly concentrated in a small volume. On the day of ovulation (natural or stimulated using medication), the concentrated semen sample is placed into the uterus using a catheter.

In vitro fertilization (IVF) is a form of assisted reproductive technology that involves the retrieval of mature eggs from a woman’s ovaries so that they can be combined with sperm in a laboratory. The resulting embryos are then transferred into the uterus. IVF is often recommended for women who:

• Are over the age of 38
• Have fallopian tubes with structural issues
• Have severe cases of endometriosis
• Have experienced several failed ovarian stimulation with IUI cycles in the past

In the first step of IVF, medications are used to stimulate the egg follicles contained within the ovaries. In a normal menstruation cycle, one follicle develops one egg, which is released through the fallopian tubes. In IVF, fertility medications trigger multiple follicles to mature several eggs at once. The eggs are then retrieved using a vaginal ultrasound and an aspirating needle. By developing and retrieving multiple eggs at once, there is a greater chance of fertilizing and implanting a viable embryo.

Once retrieved, the eggs are combined with sperm in a petri dish so that fertilization can occur naturally. If successful, the resulting embryo(s) is allowed to develop over the course of a few days.

In a fresh embryo transfer, the embryo is implanted into the uterus three to five days after fertilization. In frozen embryo transfer, the embryo is frozen instead of being transferred immediately. Using a rapid freezing process known as vitrification, the embryo is flash-frozen into a glass-like structure. Embryos can remain in this frozen stasis for an indefinite period of time.

Intracytoplasmic sperm injection (ICSI) is a process in which a single sperm is injected directly into a mature egg using a tiny glass microneedle. This technique is sometimes used in IVF when there is a low sperm count or poor sperm motility.

Gestational surrogacy is a form of third-party reproduction in which a woman agrees to carry a pregnancy and give birth to a child for an individual or couple. In LGBTQ+ family building, surrogacy is most frequently used by same-sex male couples. However, surrogacy is also used by single or lesbian women who have uterine abnormalities or other conditions that make pregnancy unsafe for them.

Similar to egg donors and sperm donors, gestational surrogates are rigorously screened to ensure that they are physically, mentally, and emotionally healthy enough to carry a pregnancy and give birth. In addition to the medical processes, intended parents and surrogates must also consider financial, legal, and logistical details. At AFCC, we will help you navigate the surrogacy journey.

Reciprocal IVF is an option available to lesbian couples in which one partner provides the egg and the other partner carries the pregnancy and gives birth, also known as the gestating partner. In this process, a standard IVF procedure is performed by stimulating one partner’s ovaries to produce more eggs than normal. Once the eggs are retrieved, they are fertilized in a laboratory using the couple’s sperm of choice, which can come from a known or anonymous sperm donor. 

Once fertilized, the ensuing embryo is ready to be implanted into the gestating partner’s uterus. Before this occurs, the gestating partner will take several hormonal medications to suppress ovulation and prepare the uterus for embryo implantation. Reciprocal IVF allows both women to play a major role in the birth of the child – the partner who provides the eggs is the child’s genetic mother while the gestational partner is the birth mother.

Fertility preservation is an option for people who want to keep their family building options available in the future. For people with ovaries, the process is known as egg freezing; for people with testicles, the process is known as sperm freezing. Also known as cryopreservation, fertility preservation is commonly used by those who are about to undergo cancer treatment, have high-risk occupations, or simply want to delay family building.

Cryopreservation is useful for transgender individuals who are considering gender-affirming surgery. By preserving your eggs and sperm ahead of time, you still have the option of having a genetic child in the future.