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Fertility For Single People And Same Sex Couples

You’ve decided to go for it – now what? If you are single or in a same-sex relationship and have made the momentous decision to have a baby, you may not know where to begin.

Help is at hand. We sat down with one of the UK’s most esteemed fertility experts Dr Gorgy, who is Medical Director of leading London IVF clinic The Fertility and Gynaecology Academy, to find out more about how it all works.

Dr Amin Gorgy

What Options Are Available For Same Sex Couples And Single Parents?

‘Patient choice is key,’ Dr Gorgy said. ‘But of course options will depend upon the needs and fertility profiles of the parents-to-be. It’s not a case of one-size-fits-all.’

Fertility For Single People And Same Sex Couples

Single Women Can Have Intrauterine Insemination (IUI) With Donor Sperm Or IVF With Donor Sperm

Intrauterine Insemination (IUI)eew3 is a relatively simple procedure, whereby sperm is injected into a woman’s womb when she is ovulating. The use of ovulation stimulation drugs makes conception more likely.

In-vitro Fertilisation (IVF) involves aspiration of eggs from a woman’s ovaries before fertilising them with sperm in the lab. Then, the fertilised egg is returned to the woman’s uterus to grow.

If you have fertility problems, IVF is a more successful option. That’s why it’s wise to undergo fertility screening at the beginning of your journey – it can save time and money in the long run. However even when there are no fertility issues, IVF has a better chance of working than IUI.

Fertility Choices For Same-Sex Female Couples

As with single women, depending upon the fertility profile of the carrying woman and the couple’s choice, they may opt either for intrauterine insemination or IVF.

When it comes to IVF, there are a number of different options. Often, one woman carries the baby using her own eggs (and obviously donor sperm). But sometimes a couple wants one partner to carry the baby using the other partner’s eggs, to enable one woman to be the birth mother and the other to be the genetic mother.

Fertility Choices For Single Males And Same-Sex Male Couples

Clearly this is more complicated, because a man cannot carry the baby himself, so he needs a surrogate. These issues apply whether the patient is a single male, or a same-sex male couple. They can either use the eggs of the surrogate, or they can get donor eggs from another woman.

Surrogacy

Generally speaking, couples or single people must find their own surrogate, either through personal networks or a specialist agency. Early on in the process, patients should be briefed about all this, and a good fertility doctor will provide information on the kinds of processes involved, as well as ethical, legal, and emotional implications.

In cases of same-sex male couples, they can receive legal guardianship of the baby after being issued with a Parental Order. To receive the Parental Order, they need to meet certain conditions. Single people cannot apply for a parental order, and must adopt the baby instead.1 That is why if you are thinking about surrogacy, you should get legal advice early on.

Surrogacy involves rigorous screening and preparation. Commissioning (intended) parents (those receiving the baby) need to have investigations including chromosomal testing, and give complete medical history so that any health implications can be looked at – for example infectious diseases that could pose a risk either to the surrogate or the baby. Of course, the surrogate is required to undergo extensive screening too, and will also be briefed on any potential emotional or psychological issues.

Since HIV has a lengthy incubation time, the sperm of the commissioning parent must be quarantined until the man has undergone HIV screening six months after he gave his sample. With new testing techniques (NAAT test) the quarantine period can be reduced to only one month. That’s why it’s a good idea for patients to provide sperm early on in the process, to save time.

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What Choices Are There Around Sperm And Egg Donors?

Any woman or couple can use an anonymous donor, or a known donor as they wish, but the donor must go through the appropriate screening and counselling. There are different sperm banks around and couples or single women can find donors matching their criteria.

‘Donors are rigorously screened and the sperm will have been quarantined for some time before the sample is retested, to protect against the spread of infectious diseases,’ Dr Gorgy said. Egg donors must be thoroughly screened too. They are usually sourced through a specialist egg donation agency or bank either in the UK or abroad, but a few clinics including The Fertility and Gynaecology Academy, have an egg donation programme offering high quality donor eggs in London.

For Same-Sex Female Couples, Who Should Carry the Baby?

It is completely the patient’s’ choice, so long as there are no health concerns in relation to the carrying mother, or the egg donor.

REFERENCES

 [1] https://www.gov.uk/become-a-childs-legal-parent

 

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