Artificial Insemination

Lesbian pregnancies are common today. While becoming a parent is important to most adults, lesbian parenting involves special concerns such as finding a sperm donor and determining which partner (or both) will experience the pregnancy and childbirth.

Selecting a sperm donor
A commercial sperm bank will give you very specific information about sperm donors, including ethnicity, higher education, occupation, physical characteristics, blood type, and more. Most sperm banks will provide the donor profiles for a fee.

If you choose to use a male friend or colleague as the sperm donor, you can make arrangements for the donor to undergo rigorous screening. The “directed donor” sperm will be frozen, quarantined and released to you only after repeated testing of the donor (at least 180 days later).  The ASRM Guidelines advise using sperm only from donors who fulfill the same rigorous criterion as for anonymous donors.

Pregnancy preparations
To get set on the path for pregnancy, it’s important to be in optimal health. A healthy mother helps reduce risks during pregnancy and increases the chances of a healthy baby. Here are some tips for a healthy pregnancy:

  • Take a daily vitamin supplement containing at least 400 micrograms of folic acid at least 3 months before you try to get pregnant.
  • If you are overweight, lose weight before you get pregnant to lower the chance of problems that can affect mother and baby.
  • If you are underweight, try to gain a few pounds before pregnancy. The extra weight may help regulate irregular menstrual periods, making it easier for you to conceive
  • Talk with a nutritionist about your diet to see if you are getting all the necessary nutrients and adequate protein, carbohydrates, and fat.
  • If you smoke, stop! Also avoid second-hand smoke, as this can hinder pregnancy.
  • If you are taking prescription drugs, talk with your doctor. Ask if you need to stop the drug or switch medications prior to pregnancy.

Pre-pregnancy testing
Along with a review of your medical history, pre-pregnancy testing involves many tests including the following:

  • Tests for sexually transmitted infections (STIs)
  • Lab for blood type
  • Physical examination and pap test
  • Test of your “ovarian reserve” (a blood test is done on day 2 or 3 of your cycle to measure levels of the hormones FSH and estradiol)
  • Basic hormonal tests for TSH and prolactin
  • Hormonal tests for women with absent or irregular periods.

Types of insemination
For a lesbian pregnancy, you’ll need to undergo artificial insemination using donor sperm. Here are the types of insemination used today:

  • Intra-cervical insemination (ICI).  This involves placing semen directly in the outer part of the cervix as would happen with natural intercourse. With the use of cryopreserved semen, there are lower pregnancy rates with donor insemination.
  • Intra-uterine insemination (IUI). This type of insemination involves injecting washed sperm directly into the uterus. It’s thought that IUI gives the sperm a “head start” a reaching the egg, and pregnancy rates with IUI are much higher than with ICI.

Timing of insemination
The fertility specialist will do the inseminations on two consecutive days. This timing is based on the detection of ovulation. Studies report higher pregnancy rates with two inseminations per cycle compared to only one insemination.

Assisted Reproductive Technology (ART)
Most women start the insemination process using their natural menstrual cycle. The pregnancy rates per cycle can be as high as 20 to 30 percent but these rates decline in older women. While younger women usually get pregnant after 3 to 6 insemination cycles, older women may have trouble conceiving and should see a Reproductive Endocrinology.

If you have irregular ovulation, your doctor may prescribe fertility drugs to stimulate ovulation. Fertility drugs increase the number of eggs released by the ovaries each cycle. The downside of fertility drugs include a greater risk of multiple pregnancy and other complications.

In vitro fertilization (IVF)
With in vitro fertilization (IVF), fertilization of your egg using donor sperm happens in the laboratory rather than in your body.  In general, pregnancy rates per cycle are higher for IVF when compared to IUI.

Pregnancy rates decline rapidly in the 40s, even using procedures such as IVF. This is why lesbian pregnancies conceived with the aid of an egg donor and a sperm donor are more common today.

Key considerations
For lesbian couples, egg donation is a key consideration, especially if the older of the two women wants to carry the pregnancy. The egg donor may be the younger women (genetic mother) and her partner is the birth mother (egg recipient).

Lastly, always check with an attorney for the laws in your state regarding both egg and sperm donation.