In this webinar, Gad Lavy, M.D., F.A.C.O.G., Medical Director and Founder of New England Fertility and Melissa Brisman, JD, are explaining family building options for LGBTQ+ patients.
Let me just speak of the medical side. This is really true for any treatment that we offer or that we recommend. People come to us to have a baby. By the time they come to us, want to have it immediately. On the other hand, they want to obviously keep it as simple as possible. These two things are always in my mind when I talk to couples.
As I said before, for lesbian couples, there is the option of doing an insemination which is still considered assisted reproduction but it’s on the very low-tech end of the process. What usually I recommend is that you have a simple evaluation just to make sure everything is working, hormones, ovulation, the uterus and the fallopian tubes. Then decide how to conduct the treatment, whether to take some fertility drugs or just do a natural cycle and do the insemination. When you pick a sperm donor, it can be someone that you know, a friend. You can do that or it could be an anonymous donor, someone who has donated to the sperm bank. There are many differences but I think the big difference, from a practical perspective, is that the donors from the sperm bank have already had all their testing done, the sperm is frozen and ready to be used. If you have a friend who wants to be a donor, we require that they go through all the screening. They have to have normal sperm but they also have to do essentially what I just described for egg donors. They have to do the medical screening and the psychological screening. They have to have a legal contract defining exactly their role. Some US states require that the donor sperm is frozen for six months before it can be used and the donor has to be tested again. So it’s a little bit more cumbersome to use a known sperm donor. For some people, it’s really important because even though it’s more difficult, you know the person, who they are, their personality. It’s a whole different thing to have somebody who’s willing to donate. This is a sort of a discussion that we have and I think most people will choose to use the friend and even though it’s a little bit more cumbersome to do that.
From a legal perspective, it has its benefits and it has its risks. It is definitely riskier in the sense that sometimes a friend can act like a dad and there can be parental right issues. Also, you have to really look at the state law and make sure that you’ve complied with it so that the donor is not a dad. He can’t be a donor and a dad. A sperm donor can’t have the kid once a month and start paying for things because then he might become a dad under the law. There are a lot of legal issues that we need to discuss but, definitely, it can be done. In the US we have to make sure the state law or the clinic law and all of those aspects are done. It can be a little bit more expensive to use a friend because of the testing which can add up sometimes. Before though that you use your friend what I would always suggest is that you consult with dr. Levy, have your genetic test done and your friend’s genetic test done because if he has a rare disease or has a recessive gene that you also have, that can produce a child with cystic fibrosis or Tay-Sachs [disease] then he may be eliminated quickly. You just want to make sure that from a genetic perspective he is an appropriate donor. And make sure that he has sperm.