Times have changed for the LGBT community. Things are far from ideal, but acceptance of the LGBT is steadily increasing. Besides, technology is slowly allowing members to transcend biological limits imposed by their sex.
For example, same-sex unions, such as a lesbian couple, used to become unable to bear their children. Their sole option to have a child used to be through adoption. Advanced in reproductive health care are now creating new ways for these couples to have a child connected to them biologically. These methods are already available to the public and offered in some countries. Further experimental techniques currently being tested will allow same-sex couples to have children that share their genes.
Indeed, there are now several options for a lesbian couple to carry a child. There are currently two commonly-available options:
- In vitro fertilization, or IVF, done in laboratories, results to embryos implanted in one of the partners
- Artificial insemination, where sperm from a male donor is used to impregnate one of the partners
In Vitro Fertilization Procedures
Compared to artificial insemination, IVF procedures are more detached from the usual process of reproduction. As the name implies, in vitro fertilization is a lab procedure, with the fertilization process happening outside of the female body.
Generally, doctors extract eggs from one of the partners. The choice of who will supply the egg depends on several factors, such as fertility, general health, as well as where the person is in the menstrual cycle. Of course, there is also the consideration of personal preferences.
The chosen person is usually monitored closely for signs of ovulation. In many cases, she has to take medication that stimulates egg production. Once ovulation occurs, the eggs are extracted and processed using laboratory techniques. Many eggs used since fertilization rates are usually lower for in vitro fertilization compared to normal reproduction.
Sperm is obtained from a suitable donor and placed inside the extracted eggs.
The resulting zygotes are nourished and left to develop for a few days. They implant the most promising ones on the uterus of the partner who will carry the child. The rest of the eggs are usually for backups, just in case of implantation fails.
A lesbian couple would usually have one partner supply the eggs and have the other partner carry the child. This setup allows both of them to have a biological connection with the child. For those who are part of a lesbian couple who wants to carry a baby but has a history of infertility, Nina Resetkova, MD, MBA says “We many need to initiate treatment with IVF to treat her infertility. Potentially, that’s her only way to get pregnant.”
The advantages of in vitro fertilization are mostly the result of having fertilization done externally. Many diseases and conditions can cause permanent scarring of the Fallopian tubes, which can block the egg from going down into the uterus. Typically, these disorders render affected individuals sterile, but IVF allows them another chance to become pregnant.
Disadvantages of IVF include its high cost, as well as higher complication rates. In some areas, there might be insufficient clinics and health centers that are proficient enough in IVF.
Another option for a lesbian couple to become pregnant involves artificial insemination. Donor sperm is collected and implanted into the reproductive tract of one of the partners.
Artificial insemination comes in two varieties. The sperm may be placed directly in the vagina using a special syringe. This option is relatively straightforward and can be done at home as long as the tools are available.
Another option is to place the sperm within the uterus itself, which results in increased fertilization rates due to the closer proximity to the ovaries. However, there is also a higher chance of infection, and the procedure must be in a clinical setting.
Dr. Vaishali Sharma MD, says “The best part is that during the artificial insemination, the sperm used during the treatment is tested for any genetic disorder. This way, it reduces the chance of any disorder being transmitted to the child from a parent.” Artificial insemination is cheaper and comes with fewer complications. However, it may not be an option for people who have damaged reproductive tracts. Artificial insemination is also less participative, as it only allows one partner to participant in the process.
Choice Of Sperm Donor
For both IVF and artificial insemination, the choice of a sperm donor is essential. A lesbian couple usually has two options.
One option is to obtain sperm from a sperm bank, which is a facility that collects and processes sperm. Sperm banks screen donors thoroughly for any sexually transmitted diseases, so the risk of acquiring one is minimal if a couple goes by this option. However, couples cannot choose the actual donor, as all donors are anonymized. “Typically, we recommend using an anonymous donor because when using a known donor, there are many other challenges legally that can also stall the process,” Candice Perfetto, MD, fertility specialist adds.
Another option is to obtain sperm from a donor contacted by the couple. The couple gets to choose the donor, which is one significant advantage of this technique. However, rigorous screening must be done to ensure that no diseases are passed on to the partner or the baby. Legal work is also mandatory, as donors may later argue for custody rights of the child.
Currently, there are no commercially available procedures that allow a lesbian couple to have a child that shares their genes. The closest is to utilize a sperm donor that is genetically related to one of the couples.
However, there are experimental techniques that seek to change this scenario. One method relies on the use of stem cells, which are cells that can turn into any other cell of the body. Theoretically, it should be possible to obtain stem cells from each partner, then turn them into sperm and egg cells. Fertilization can be through IVF.
So far, animal trials show promising results. The procedure was used successfully in mice to produce healthy sperm and egg cells from stem cells. However, experiments with humans are still far from complete. While human stem cells can convert to progenitor cells that give rise to sperm and egg cells, the resulting cells are still immature.
More research needs to be done for this procedure to become commercially available. Even then, the method prioritized treating couples which may be unable to produce sperm and egg cells due to injury or disease. However, the future holds great promise, as this procedure may eventually allow a lesbian couple to have a child that has their genes.
Countries Where A Lesbian Couple Can Get Married
Of course, getting pregnant is just part of the story. Having and raising a child may be more difficult if the state does not acknowledge the union of the partners in the first place. Despite the increasingly progressive views towards LGBT relations, many countries still do not recognize same-sex unions.
Government recognition grants partners several rights, as well as access to health care and other considerations for married couples. Hence, it is essential to consider places where same-sex couples can get married. For now, here is a list of countries where same-sex unions are recognized:
- The Netherlands
- South Africa
- New Zealand
- United States