Gay and lesbian couples can undergo assisted reproductive techniques to build their family without being diagnosed with infertility. Both female partners in a lesbian couple may have viable eggs, and the male partners in a gay couple may have normal sperm, but in either case the other component is needed to produce a pregnancy. Gay couples generally will seek an egg donor and a gestational carrier, and lesbian couples will most commonly use donor sperm.
Once the use of sperm and egg is determined, the couple’s assisted reproduction process proceeds as normal, progressing from intrauterine insemination (IUI), to in vitro fertilization (IVF) – possibly with Intracytoplasmic sperm injection – until a pregnancy is achieved (in one of the female partners for lesbian couples, or in the surrogate for gay couples). Additional steps, such as genetic screening and pre-implantation genetic diagnosis may also be performed on the fertilized embryos if necessary.
If either or both partners of a lesbian couple suspect they are infertile, they can undergo standard fertility tests and evaluations:
Gay couples suspecting infertility can also be examined for infertility factors and effects of lifestyle, or a vasectomy reversal can reverse the effects of a previous vasectomy.
In 2009, the American Society for Reproductive Medicine Ethics Committee released a report for all of its members stating that assisted reproductive clinics “should treat all requests for assisted reproduction equally without regard to marital status or sexual orientation.” The full report may be found on the ASRM website.