An interview with Dr. Sam Najmabadi, the medical director of the Center for Reproductive Health & Gynecology, on LGBT family building.
Dr. Najmabadi, what options are currently available for a gay couple interested in having their own children?
Same sex male couples have to use an egg donor and a surrogate. The egg donor and the surrogate can be one in the same or it can be an egg donor giving eggs and we would do in-vitro to get the eggs out and then transfer into a surrogate. With all couples in advance to the process we do an STD test and a semen analysis for men. (Women also do a hormone test). All patients contributing to the egg or sperm are tested genetically.
Females can purchase sperm for in home insemination or insemination by a doctor into the uterus with or without medication. If intrauterine insemination does not work then further testing is needed and then the next step would be IVF. We can also remove the egg from one partner inseminating with semen from donor and then putting the egg into the other partner so that each person can be a part of the process.
Can you explain the process of finding an egg donor and gestational carrier?
A gestational carrier carries eggs from a donor. The process of finding an egg donor and gestational carrier starts with a consultation with your endocrinologist. You will then select an agency to work with. The agency will help you find an appropriate donor and surrogate.
Once the donor or surrogate is chosen they have to be medically cleared for the process. Then they have to go through legal clearance, with all the appropriate contracts. This process may take a few weeks to a few months.
After finding a donor and carrier—what needs to be done from a medical point of view?
This varies by needs of the patient. For egg donation—the donor is screened then stimulated for retrieval of eggs. For surrogates—after being screened—we prepare the uterus with hormones for transfer of embryos. For sperm donors—after being screened—we will need it either fresh or frozen for the treatment.
What effect—if any—does the gestational carrier have on the genetic composition of a baby?
Zero. The gestational carrier does not contribute to the genes of the baby. Only the sperm and egg donor. That is where the DNA comes from.
What are some obstacles we need to be prepared for during this process?
If at any point if someone has a positive STD panel this can derail the process. If anyone contributing to the creation of the baby has abnormalities—that will decrease the odds or make the process not possible. We may have to look at alternative ways of getting pregnant.
Is it possible to have a healthy baby if my partner is HIV positive? How safe is sperm washing?
Yes—it is possible as long as their viral count is negative. Sperm washing—depending on the type of washing done coupled with viral testing—can be safe and reduce transmission at very low levels.
Is there anything we haven’t asked you that you would like to share with our readers?
There are many ways for gay couples to plan for a family! We encourage people to come and have a consultation to discuss ways to preserve their fertility by freezing their sperm for a future date or help them with any other process to create a family.
For more info, or to schedule a consultation call 310-360-7584
or visit reproductive.org.