Men having babies: Not as tricky as it seems!
Not all couples are created the same. Fertility clinics practice inclusion, and all types of couples and families are welcome. Fortunately, assisted reproduction has come a long way since the first IVF in 1978 and the birth of the first IVF baby, Louise Brown. Now, we are able to help not only heterosexual couples, but also same-sex male and female couples, transgendered individuals and couples, and single men and women achieve their dreams of starting a family.
Same-sex male couples represent a unique population of patients. To make a baby, you need sperm, eggs, and a uterus. For same-sex male couples, finding eggs and a uterus has obvious challenges, but working with a fertility clinic can make the journey easier!
After connecting with a fertility doctor and clinic, both men will do basic routine bloodwork and semen analyses to check the quality of their sperm. Depending on the couple’s wishes, one or both partners may contribute sperm to create embryos. The trickiest part is often deciding whose embryo will be transferred first into the surrogate!
Making an embryo requires sperm to be combined with eggs. Where do these eggs come from? Egg, or oocyte, donors are women who offer to donate their eggs to a couple to achieve pregnancy. These women are generally young, under the age of 35, and have excellent fertility. Once they are recruited to be an egg donor, they undergo rigorous medical, genetic, and psychological screening to make sure they will be adequate donors.
Once accepted, egg donors undergo IVF stimulation with fertility drugs (injections) to produce up to 20 to 25 eggs. These eggs are fertilized in the IVF laboratory with one or both partner’s sperm to create embryos. Because the egg donors are young, the majority of embryos produced are viable and have a high chance of achieving a pregnancy.
When choosing an egg donor, couples should remember that their child will inherit the genetics of the donor. So, choosing a donor who is of similar ethnic background and who has physical characteristics that are desirable to the couple (i.e. hair color, eye color, height, education, etc.) are important. Donors also often write a personal statement to reflect their personality. Typically, most donors are anonymous (not known to the couple), but some couples will use known donors, such as a friend or a sister of one of the partners.
Once embryos are created with donor eggs and with sperm from a same-sex male couple, a gestational surrogate is necessary to carry the pregnancy. Gestational carriers, or GCs, are women with proven successful pregnancies and deliveries, often of their own, who volunteer to carry pregnancies for other couples. They undergo medical and psychological screening by fertility clinics to ensure that the chances of achieving a successful pregnancy are high.
GCs usually take hormones (estrogen and progesterone) to prepare the lining of their uterus for implantation of a donor egg embryo. Often, these embryos are tested genetically (with preimplantation genetic testing) to ensure that a normal embryo is being put into a surrogate and that the chances of pregnancy are high. In general, one embryo is transferred, because the goal is a healthy mom and baby and to avoid multiples and complications with twins.
When selecting a surrogate, you’ll want to make sure she is healthy and medically cleared to carry a pregnancy, but your relationship with the surrogate is of equal importance. This is the woman who will carry one and perhaps more than one child for nine-plus months, so a good relationship is important. Typically, prior to selecting a surrogate, a couple will have multiple conversations and in-person meetings to make sure the GC is the right one for them. A social worker can help to guide these conversations, and a legal agreement is also needed with the surrogate prior to transferring embryos.
While this seems complicated, finding an egg donor and surrogate is not as hard as it seems, and many fertility clinics are well equipped to assist patients find donors and surrogates to help fulfill their childbearing dreams. The process does, however, take time, and the time from initial consultation to embryo transfer can last six months or even a year.
If you’re in a same-sex male relationship and you think starting a family is in your future, see a fertility specialist sooner than later to plan and take initial steps. Choose a clinic that has experience working with egg donors and surrogates (this will often be listed on the clinic’s website, or you can call the clinic to inquire). Also, consider attending one of the Men Having Baby conferences. These conferences happen all over the world, and many clinics come to give information about their services. It is a great place to learn about the process and find out which clinic is right for you. It’s never too early to get started!