Insemination and assisted reproduction

Insemination and assisted reproduction through processes like in vitro fertilization are two common ways for LGBTQ+ people to become pregnant. Whether you’re ready to start the process of trying to conceive or just gathering information, Family Equality is here to help you on this journey!

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The ABCs of Trying to Conceive

BBT stands for “basal body temperature,” which slightly increases just after ovulation. Some individuals take their body temperature before getting out of bed each morning to better track their cycle when trying to conceive.

CD stands for “cycle day.” Cycle Day 1 is the first day of menstruation.

CM stands for “cervical mucus,” a fluid produced during a menstrual cycle that increases in amount and consistency throughout the cycle, becoming clear and stretchy during ovulation.

ET stands for “embryo transfer,” a simple medical procedure following in vitro fertilization that involves placing a fertilized egg (embryo) into the uterus using a small catheter inserted through the cervix.

Frozen embryo transfer (FET) refers to a similar medical procedure where an embryo that was previously cryogenically frozen is thawed and then placed into the uterus.

EDD stands for “estimated delivery date” or due date, the day that a child is expected to be born based on the date of conception.

FMU stands for “first morning urine,” which contains the highest levels of hCG (see below). A pregnancy test is able to detect pregnancy sooner with a higher concentration of hCG than with urine used after the FMU.

HCG stands for “human chorionic gonadotropin,” a hormone that is created during pregnancy originating from a growing embryo immediately after conception — then later by the placenta. After implantation, the placenta emits hCG into a pregnant person’s bloodstream and can be detected by a pregnancy test.

ICSI stands for “intracyotplasmic sperm injection,” a procedure in which a single sperm is injected directly into an egg prior to IVF.

IP stands for “intended parent.”

IVI stands for “intravaginal insemination,” a non-surgical, minimally invasive process of placing sperm directly into the vagina. This method can often be done at home without medical providers.

IUI stands for “intrauterine insemination,” a procedure that involves placing sperm via a tube directly into an individual’s uterus to facilitate fertilization. The sperm can come from a partner or a donor and is performed in a doctor’s office.

IVF stands for “in vitro fertilization,” a procedure that involves removing eggs from an individual’s ovaries and fertilizing them outside of the body with sperm in a laboratory dish. The resulting embryos are then transferred into a uterus through the cervix. IVF can also be utilized in conjunction with donor eggs or donor embryos.

MS stands for “morning sickness.” During pregnancy, many people experience nausea, vomiting, lightheadedness, sensitivity to smell, and fatigue.

O stands for “ovulation,” the time in a cycle when the egg is released from the ovary. Ovulation usually occurs approximately 14 days before the next menstrual period is due.

PG stands for “pregnant.”

PVN stands for “prenatal vitamin.”

RE stands for “reproductive endocrinologist” or physicians specializing in reproductive endocrine disorders and infertility who have undergone additional fellowship training.

R-IVF stands for “reciprocal IVF,” a series of medical procedures in which eggs are harvested from one person’s ovaries, inseminated outside of the body, and transferred to another person’s uterus.

SET stands for “single embryo transfer,” the implantation of only one fertilized embryo into the uterus of either an intended parent or a gestational carrier via IVF to reduce the chances of multiples.

TTC stands for “trying to conceive,” an acronym common in communities of people who are. actively attempting to get pregnant.

TWW stands for “two-week wait,” the period of time between ovulation and taking a pregnancy test.

Trying to conceive as an LGBTQ+ person

First, congratulations on taking this first step to expand your family! This journey might come with unexpected challenges — but there are also so many joys and surprises along the way. As you embark on this path, remember to lean on your support system, develop a plan for the ups and the downs, work to find providers you can trust, and continue to cater to the activities that bring you joy.

And don’t forget: The whole process will be well worth the work in the end.

As you consider where to begin, it might be helpful to start with a fertility checkup, an exam typically covered by insurance that could reveal conception blockers you might not be aware of. For more information on finding an affirming fertility specialist, check out our directory!

Types of Insemination and Assisted Reproduction

For LGBTQ+ folks, there are many paths to pregnancy depending on your financial, emotional, and biological resources.

At-home insemination

Otherwise known as intravagination insemination or IVI, at-home insemination is a non-surgical, minimally invasive process of placing sperm directly into the vagina. This method can often be done at home without medical providers through needless syringes, cervical caps, and/or the help of a midwife or nurse practitioner.

At-home insemination is one of the more cost-effective options for achieving pregnancy, as it doesn’t usually require the additional support of a medical provider. LGBTQ+ couples pursuing pregnancy through insemination will often need either known or unknown donor sperm, which can cost between $25 (the lowest estimated cost for known donors) and $1,500 (the highest estimated cost for unknown donors) per vial. For those using a known donor, there’s an option to test the donor’s sperm, which will cost an additional $25 – $300. There are ways for prospective parents to offset costs based on certain choices, employment statuses, grants, and loans.

Intrauterine insemination

IUI is a minimally invasive procedure typically performed in a doctor’s office. With IUI, sperm is inserted via a tube directly into an individual’s uterus to facilitate fertilization.

IUI is a relatively inexpensive medical treatment compared to processes like IVF, with a price ranging from $250 to $4,000 per attempt. In addition, LGBTQ+ couples pursuing pregnancy through insemination will often need either known or unknown donor sperm, which can cost between $25 (the lowest estimated cost for known donors) and $1,500 (the highest estimated cost for unknown donors) per vial. For those using a known donor, there’s an option to test the donor’s sperm, which will cost an additional $25 – $300. There are ways for prospective parents to offset costs based on certain choices, employment statuses, grants, and loans.

In vitro fertilization (IVF)

IVF is a procedure that involves removing eggs from an individual’s ovaries and fertilizing them outside of the body with sperm in a laboratory dish. The resulting embryos are then transferred into a uterus through the cervix. IVF can also be utilized in conjunction with donor eggs or donor embryos.

On average, an initial IVF cycle costs between $12,000 – $15,000, plus an additional $1,500 – $6,000 for medication. Subsequent attempts through Frozen Embryo Transfers (FET) average between $4,000 – $7,000 per cycle.

If a sperm donor is needed, costs vary from $25 (the lowest estimated cost for known donors) to $1,500 (the highest estimated cost for unknown donors) per vial. For those using a known donor, there’s an option to test the donor’s sperm, which will cost an additional $25 – $300.

If an egg donor is needed, costs can increase by $25,000 – $30,000.

There are ways for prospective parents to offset costs based on certain choices, employment statuses, grants, and loans.

Reciprocal IVF

R-IVF is a series of medical procedures in which eggs are harvested from one person’s ovaries, inseminated outside of the body, and transferred to another person’s uterus.

This version of IVF has the same baseline cost of between $12,000 – $15,000 for the procedure. R-IVF has additional medication costs, adding $3,000 – $8,000 per cycle.

There are ways for prospective parents to offset costs based on certain choices, employment statuses, grants, and loans.

Additional resources related to LGBTQ+ pregnancy

Tracking Your Cycle and Preparing for Trying to Get Pregnant

Fertility for Transgender Women Before HRT: New Study Provides Answers

Trans Fertility: How Does Testosterone Affect Egg Health?

Average Costs for the LGBTQ+ Community to Achieve Pregnancy in the United States

Preparing for Pregnancy as a Non-Binary Person

Recurrent Pregnancy Loss

What is In Vitro Fertilization?

What is Intrauterine Insemination?

How to Give and Receive an Injection: A Guide For Fertility Treatment Patients and their Partners

Questions to Ask at your First Fertility Clinic Visit

Once Upon a Time, There Was a Much-Wanted Baby (Guess what! That Baby was You!)

LGBTQ Family Building Survey

2019 LGBTQ Family Building Guide

Parenting Options for the LGBTQ+ Community Handbook

Paths to Pregnancy Handbook

Glossary – Family Formation via Pregnancy

View our resource library

Working with an LGBTQ+ affirming clinic

Whether you’re working with fertility specialists to get pregnant at home or receiving more involved care at an IVF center, it’s important to screen potential sites so you can find providers that work for you and your family.

If you’re looking for providers competent in LGBTQ+ family-building, Family Equality recommends exploring our provider directory!

You can also print out and share our medical provider form to encourage your providers to make changes in their practice that foster a culture of inclusivity.

As you continue to work with your identified provider, we encourage you to participate fully in your family’s treatment. Ask questions, be transparent and communicative about your symptoms and experiences, and get support from outside sources like midwives or doulas if needed.

At or before your first visit, consider asking the following questions:

In what year was your clinic established?
What’s your live birth rate per IVF cycle?
What’s your rate of multiples?
What are the qualifications of your providers and staff?
Are you a member of the American Society for Reproductive Medicine (ASRM)? Do you follow ASRM guidelines on protocols concerning number of embryos transferred?
What percentage of your clients are LGBTQ+?
Has your clinic completed any cultural competency training for the LGBTQ+ community?
How do we become matched with a surrogate/donor through your program?
What are your fees?
What if it doesn’t work the first time? What are our options and costs for subsequent attempts?

Securing legal parentage after achieving pregnancy

Once you do achieve pregnancy, there are legal considerations related to genetic connections and establishing legal parentage.

If you’re looking for an attorney near you, visit the LGBTQ+ Bar Association’s interactive map and directory of family law attorneys.

As you search, consider asking the following questions:

Are you familiar and up-to-date with family laws affecting the LGBTQ+ community?
What additional legal steps, if any, need to be taken by my partner or by myself once our baby is born?
Does my partner need their own assisted reproduction attorney? What about our donor, do they require separate legal counsel?
Do you know of any pending legislation that could affect our family structure?
How do we initiate a second parent adoption?
Can both my partner’s name and my name be on the birth certificate?
Are any additional steps required in order for us to obtain a birth certificate or passport for the child(ren)? Will our baby be recognized as ours when we travel to other states and countries?
Will you be our liaison at the hospital?
What are your fees?

Looking for support on your LGBTQ+ pregnancy journey?

Family Equality hosts a virtual peer group every other Wednesday for any and all LGBTQ+ folks trying to conceive! Register today to receive log-in information.

Learn more and sign up