LGBTQ Parenthood: What to Know as You Begin Your Journey

Having Children

So many LGBTQ couples have the same desire to be parents as straight couples do. Fortunately, there are ways in which lesbian and gay couples can do so.

A lot of decision-making comes with planning for any family. In the case of LGBTQ couples, one partner must choose to be the biological parent. For lesbian couples, one or both women can carry the child, or they can also choose to use a surrogate. For gay couples, the only option would be a surrogate, yet there is the ability to be genetically related.

In all cases, it’s important to research your options and avenues to take. A conversation with your doctor can help get the ball rolling. Some couples find it helpful to even seek legal counsel to help guide them. Click here to find a fertility specialist.

Dealing With the Challenges of Fertility

Anyone can be affected by fertility challenges, and it’s so important to have realistic expectations. Speak openly with your partner about your journey becoming parents together. Contrary to popular belief, fertility challenges are equally attributable to men and women.32

Common reasons for female fertility difficulties include:

  • Age (over age 35),
  • Ovulatory problems (hormonal imbalances, being excessively over or underweight)
  • Anatomical issues (blocked fallopian tubes, cervical disorders, uterine malformation), and
  • Medical problems (Endometriosis, adhesions, fibroids, Polycystic Ovarian Syndrome [PCOS], cancer treatments).

Male fertility difficulties include:

  • Sperm disorders (sperm count, volume, concentration),
  • Anatomical issues (scrotal varicocele, undescended testis), and
  • Functional issues (anejaculation, retrograde ejaculation, erectile dysfunction).

Learn more about your options below.

Biological fatherhood for men will include a surrogate. The surrogate is the woman who carries the baby from fertilization to birth for an individual or couple. Options for surrogacy include:

  • Gestational surrogacy: One partner's sperm is used to fertilize a donor egg, which is then implanted into a gestational carrier via in vitro fertilization (IVF).


  • Traditional surrogacy. One partner's sperm is inseminated into the cervix or uterus of a surrogate.

Today, most couples choose a gestational surrogacy arrangement. 

For all-female couples, biological parenthood is achieved through donor insemination. Donor sperm can be obtained from a sperm bank or from a known donor. There are a few insemination options that are unique to each couple’s motherhood experiences. They Include:

  • Intracervical,
  • Intrauterine, and
  • Intravaginal

Lesbians also have the option for collaborative pregnancy with a female partner via reciprocal in vitro fertilization (IVF), embryo donation, and surrogacy. Embryo donation involves using a fertilized embryo from an outside source containing genetic material from neither woman. One of the partners can carry the transferred embryo if they choose, or a surrogate may be used.

Assisted Reproductive Technologies

Assisted Reproductive Technologies, or (ART) include all fertility treatments in which both the egg and sperm are handled.

Techniques falling under this umbrella are:

  • In vitro fertilization (IVF),
  • Intracytoplasmic sperm injection (ICSI),
  • Assisted hatching,
  • Sperm or egg donation,
  • Preimplantation genetic diagnosis (PGD),
  • Egg/embryo freezing, and
  • Surrogacy.

ART procedures typically involve removing eggs from a woman’s ovaries, combining them with sperm in a laboratory, and returning them to the woman’s body or donating them to another woman. Keep in mind that they do not include treatments in which only sperm are handled, so intrauterine—or alternative—insemination would not fall into this category. It would also not include procedures in which a woman takes medicine only to stimulate egg production without the intention of having eggs retrieved. ART can truly help lesbian and gay couples have a biological child. Click here to find more information on ART

Egg Donation

Egg donation involves one woman (the donor) “donating” eggs so that another woman (the recipient) has the chance to conceive. In egg donation, in vitro fertilization (IVF) is performed in the usual manner, however the donor may also receive fertility medications to stimulate the production of multiple eggs in her ovaries.

At the same time, the recipient (a gestational carrier or surrogate) may also receive medications so that her cycle mirrors the cycle of the donor and her body is prepared and ready to receive the embryo. The egg is then fertilized in a laboratory and the embryos are implanted in the recipient’s uterus.

For more information have a conversation with your doctor to learn more about egg donation and determine if third-party reproduction is an appropriate option for you and your partner. Click here to find a fertility specialist.

If you and your partner decide to go ahead with having a child biologically, a fertility specialist can help you along the way.

A fertility specialist, or reproductive endocrinologist, specializes in treating reproductive disorders. These doctors have completed the same education and medical requirements as OB/GYNs. In addition, they have also finished a two- to three-year fellowship in reproductive endocrinology, passed specialized examinations (if board certified) and completed a two-year practice in reproductive endocrinology.

A reproductive endocrinologist:

  • Facilitates the process of getting pregnant (including alternate insemination [AI] and in vitro fertilization [IVF]),
  • Addresses any fertility issues, and treats both men and women

Need help finding the right specialist? Find one here


While adoption is of course not the only option for same-sex couples interested in expanding their families, it is something to consider.

It may be helpful to know that each state carries its own laws for same-sex couples seeking to adopt a child. However, all states must recognize out-of-state adoptions regardless of legal status in that particular state.

Types of adoptions include:

  • State/public agency adoption
  • Agency-open adoption
  • Open-independent adoption
  • International adoption

Other Helpful Resources

The following organizations can provide you and your partner with support and patient advocacy.

Click here to know to find helpful resources about fertility challenges

32. RESOLVE, Fast Facts About Infertility, 2014, Fact 3