Pride Month Spotlight on Family-Building Options for Same Sex Couples

The World Health Organization defines reproductive rights as the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.

In celebrating Pride Month this October, our team would like to spotlight some of the most advanced family building options available to same sex couples at Cape Fertility to ensure they too can have the children to start or grow their families. In a video, Dr Lizle Oosthuizen elaborated on the different options available, depending on whether the same sex couple is female or male, and on whether donor sperm or eggs are required.

Same sex female couples

For a same sex female couple to have a baby, donor sperm and either IUI (Intrauterine Insemination) or IVF (In Vitro Fertilisation) treatments would provide the means to achieve a pregnancy.

Sperm donations

Donor sperm is donated by healthy generous young men who help couples they will never meet to build their families.

At Cape Fertility, we have our own sperm bank, called the Cape Cryobank. Through Cape Cryobank, couples can look through the profiles of available anonymous sperm donors and select their top choices. The profiles provide only information about the donors’ physical characteristics, education, hobbies and interests, and medical history. Donors and donor recipients never meet and never receive any identifying information about each other.

In order for the donor sperm to fertilise an egg and become a pregnancy, two fertility treatments may be considered: IUI and IVF.

Both IUI and IVF aim to improve the possibility of an egg being fertilised by sperm. This is necessary because there’s only a narrow window of time in each menstrual cycle during which natural fertilisation of an egg by sperm can take place – when a healthy mature egg is ovulated and is met by healthy sperm in the fallopian tubes.

IUI treatment

IUI is the most common treatment for same sex female couples, and it can be done in two ways: in a natural menstrual cycle or in a medicated cycle of the partner who will carry the pregnancy.

A natural cycle is the first choice for women who ovulate reliably on their own. About 12 days after the start of a cycle, an ultrasound will be used to measure the size of the follicles (the little bags of fluid in which the eggs grow). Certain blood tests can also reveal where a woman is in the natural process of ovulating. If the follicles are the right size, the egg inside should probably be mature and about to ovulate – it usually takes about 36 hours for the egg to be released. This means that the IUI procedure can be scheduled to ensure that when the egg ovulates, there will be sperm in the fallopian tubes to fertilise it.

In a medicated cycle, the woman who will carry the pregnancy takes certain medications that ensure more control over the timing of the ovulation and the IUI treatment. This may be necessary for different reasons, for example, a woman may have polycystic ovaries or another reason for not growing an egg or ovulating on her own. There are a variety of medications in tablet form or injections.

In a medicated cycle, an ultrasound and/or blood tests are also used on day 11 or 12 to find follicles that are ready to trigger. At the right time, the patient has what is called a trigger injection, which starts the 36-hour ovulation process. As a result, the insemination procedure can be timed very precisely.

On the day of the insemination procedure, the donor sperm sample, which has been thawed in the laboratory, is placed in a syringe and attached to a very small catheter.

The insemination procedure is very simple and done in an examination room, it is similar to having a pap smear. It shouldn’t be painful and most patients don’t feel discomfort at all. The fertility specialist will insert a speculum into the vagina to allow the little catheter with sperm to be inserted through the cervix – the mouth of the womb – and the sperm to be very slowly injected to the top of the uterus. After the IUI procedure, patients can continue with their daily activities.

After roughly two weeks, a pregnancy can be done. The success rate for IUI is generally around 25% per cycle – the same as for a couple trying to conceive naturally when there are no fertility challenges. However, it is important to understand that the outcome is highly individualized and not every couple will achieve success on the first attempt. Even if the timing is perfect, the quality of that egg and that sperm plays a big part, and the fertilised egg or embryo must still travel all the way through the fallopian tubes and then to the uterus to implant successfully. Factors that also play a big part are age and the presence of other factors that might influence fertility, for example, tubal problems, endometriosis or polycystic ovaries.

Your fertility specialist will try four and six cycles with IUI before reevaluating the treatment, but again this is very individualised.

IVF treatment

IVF is another option for fertilising the egg for same sex couples.

It also opens a wonderful option for same sex female couples, involving both partners in the pregnancy itself: one partner provides her eggs and the other partner carries the pregnancy.

The partner providing the eggs will undergo medical stimulation before her eggs are retrieved and then fertilised with the donor sperm in the lab. The resulting embryos are grown in the lab for a few days, before the other partner undergoes the IVF procedure during which the embryos are placed in her uterus.

IVF also opens the door for an egg donation, where this might be necessary. If the partners in the same sex couple are older, they may face challenges with poor egg quality that reduce the possibility of conceiving, and donor eggs provide a solution.

Same sex male couples

For same sex male couples, surrogacy or adoption are the tried-and-tested ways of building a family.

Traditional surrogacy is now seldom used as it involves a surrogate’s own eggs being artificially inseminated with the intended father’s sperm, which means she is the genetic mother of the child.

Gestational surrogacy using IVF is a more modern approach to family building. In this type of surrogacy, donor eggs are fertilised in a lab with sperm from one or both male partners – or from a sperm donor. The fertilised eggs are then transferred to the surrogate’s uterus. Where necessary, the sperm can also be supplied by a donor.

Where to find the ideal family building option for you

Your first step to finding the ideal family building option for you and your partner is simply to contact us by clicking here…

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.