Starting a family is a deeply personal and exciting decision, but for many queer couples, it can also feel overwhelming. Traditional narratives around conception often leave little room for LGBTQ+ perspectives, making it crucial to highlight more inclusive family planning options. Whether you’ve long dreamt of parenthood or are just beginning to explore the possibilities, understanding the pathways available is an important step in building the family you’ve envisioned.

Queer family planning comes with its own set of challenges. Navigating the medical, legal, and emotional aspects of conception can sometimes feel like a maze, especially when the process doesn’t always reflect your lived experiences. But it’s also an opportunity to explore what parenthood means to you and your family.

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Thankfully, advancements in inclusive conception methods have opened doors for LGBTQ+ individuals and couples. Numerous foundations and programs can also help fund various conception methods, depending on one’s needs, geographical region, and other factors. Below are sections describing each conception method and links to funding options.

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Conception methods

When it comes to family-building, the methods you choose are as important as the people involved. From medical procedures like in vitro fertilization (IVF) and intrauterine insemination (IUI) to options like surrogacy and natural conception, every method offers its own unique pathway to parenthood.

Each of the options below can be tailored to meet the needs of each family.

In Vitro Fertilization (IVF)

In vitro fertilization, or IVF, is a popular method for queer couples. The process involves fertilizing an egg outside the body and then implanting the embryo into a surrogate’s or parent’s uterus. This method may require selecting an egg donor, sperm donor, and/or surrogate, and it often involves legal and medical consultations to ensure everything goes smoothly.

The stages of the IVF process are as follows:

1. Stimulation: Fertility drugs are taken to increase egg production. 
2. Egg retrieval: A minor surgery to remove eggs from the ovaries. 
3. Fertilization: Sperm is mixed with the eggs in a lab. 
4. Embryo culture: Laboratory staff monitor the embryos to ensure they are growing properly. 
5. Embryo transfer: One or more embryos are placed in the uterus

For more information, you can visit the Pacific Fertility Center and the RMA Network, which offer guidance and support for LGBTQ+ families.

Reciprocal IVF

Reciprocal IVF is a unique option for same-sex couples egg-producing who have wombs. This option allows both partners to participate biologically in the pregnancy. One partner provides the eggs, which are fertilized with donor sperm, and the other partner carries the pregnancy.

The process mirrors traditional IVF but is split between the two individuals, allowing both to have an active role in conception. You can learn more about this process at the UCSF Center for Reproductive Health and Extend Fertility.

Legal considerations are key for families pursuing reciprocal IVF to protect parental rights. Clinics offer tailored counseling and resources throughout the process. On average, this treatment costs upwards of $20,000, with additional expenses for sperm donors.

The financing options listed under the IVF section of this article also apply to reciprocal IVF.

Intrauterine insemination (IUI)

Intrauterine insemination, or IUI, involves placing sperm directly into the uterus to increase the chances of fertilization. IUI is simpler and less invasive than IVF, which makes it more affordable.

The stages of the IUI process are as follows:

1. A sperm sample is collected from a sperm-producing patient
2. The sperm is washed and processed in a laboratory to ensure healthy, active sperm cells
3. The egg-producing patient receives a trigger shot or other medication to induce ovulation
4. The patient with a vagina lies on an exam table
5. A speculum is placed in the vagina
6. A thin, flexible catheter is inserted through the cervix and into the uterus
7. The washed sperm is slowly injected through the catheter

Success rates for IUI are lower than other methods, ranging between 5 to 25% depending on age and fertility factors — generally, the older the incubating patient, the less successful the procedure. Some patients have to undergo multiple IUI cycles before conceiving.

IUI may not be an ideal option for patients who have experienced severe endometriosis, male factor infertility, fallopian tube diseases, or a history of pelvic adhesions or infections.

Funding options for IVF and IUI

If financing is a concern, you can inquire about payment plans directly through your chosen clinic, explore medical financing loans or scholarships through programs like the National Infertility Organization, the Fertility Preservation Financial Assistance Program, or various foundations, IVF charities and grant programs.

Surrogacy

Surrogacy involves a third-party individual carrying a child for someone else and allows individuals without a uterus or heterosexual reproductive capacity to have a biological connection to their child.

For sperm-producing people, surrogacy often includes using their sperm along with an egg donor; for egg-producing people, this can include using their eggs with a sperm donor — either way, a separate gestational carrier (or surrogate) would bring the baby to term.

The stages of the surrogacy process are as follows:

1. Select a surrogate: The intended parents choose a surrogate who meets their health and emotional criteria. 
2. Screen the surrogate: The surrogate undergoes medical and psychological screenings. 
3. Create embryos: The intended parents undergo IVF to create embryos using their own or donor eggs and sperm. 
4. Transfer embryos: The embryos are transferred to the surrogate’s uterus using a catheter. 
5. Confirm pregnancy: The surrogate takes a blood test to confirm pregnancy. 
6. Monitor pregnancy: The surrogate is monitored by a doctor until 10 to 12 weeks of pregnancy. 
7. Deliver the baby: The surrogate gives birth to the baby. 

About 4,000 surrogate births occur in the U.S. each year, according to the Cato Institute. U.S. laws around surrogacy can be complicated and are designed to help ensure that gestational surrogates aren’t exploited.

Funding options for surrogacy

Surrogacy is among the most expensive paths to parenthood, with costs ranging from $70,000 to $150,000. Additional legal fees are also common. The RMA Network offers resources and support for those considering surrogacy. Financial assistance exists for those in need through support organizations and grants.

Adoption

Adoption offers homes to children in need and remains a meaningful and impactful way to expand your family. Both domestic and international options are available, though queer couples may face different challenges depending on the region’s laws regarding LGBTQ+ adoption or each agency’s religious or cultural affiliation.

Adoption allows individuals to form families outside of traditional biological ties, ensuring every family is uniquely its own.

The stages of the adoption process are as follows:

• Research and choose an agency: Decide whether to work with a private agency, a state agency, or consider international adoption. 
• Application and pre-approval: Complete an application with personal details, medical history, and references, followed by an initial screening process. 
• Home study: A licensed social worker will conduct a comprehensive evaluation of your home environment, financial stability, and ability to parent. This may include a criminal or work history background check.
• Matching with a child: Once approved, you will be matched with a child based on your family profile and the child’s needs. 
• Meeting and bonding: Visit the child in their placement setting to get to know them and build a relationship. 
• Placement: If the match is successful, the child is placed in your home on a temporary basis. 
• Court hearing and finalization: Attend a court hearing to legally finalize the adoption.

Adoption fees vary widely: Domestic adoptions can cost $20,000-$50,000, while foster-to-adopt programs (covered below) are more affordable.

Foster to Adopt

Foster-to-adopt programs give children in the foster system a chance to find permanent homes. For queer families eager to adopt but cautious about upfront costs, this can be an accessible pathway to parenthood. It’s also a chance to provide love and stability to older children who often wait the longest for adoption placement.

The foster-to-adopt process has several stages:

• Initial Steps
  • Contacting an agency: Reach out to a child welfare agency in your area to express your interest in fostering with the goal to adopt. 
  • Application and screening: Complete an application, undergo background checks, and participate in a home study process. 
  • Training: Complete mandatory training on foster parenting and child welfare issues. 
• Fostering Period
  • Placement: Once approved, you may be matched with a child to foster. 
  • Maintaining contact with biological parents: Depending on the case, you may need to work with the child’s biological parents to facilitate visits or support reunification efforts. 
  • Regular caseworker visits: A caseworker will regularly visit your home to monitor the child’s well-being and assess the progress toward potential adoption. 
• Decision to Adopt
  • Parental rights termination: If the biological parents are unable to provide a safe home, the court may terminate their parental rights, opening the possibility for adoption. 
  • Discussion with the agency: Discuss your intention to adopt the child with the child welfare agency. 
• Adoption Process
  • Formal adoption petition: File a petition to adopt the child with the court. 
  • Court hearings: Attend court hearings to finalize the adoption. 
  • Legal finalization: Once the adoption is finalized, you become the child’s legal parent. 

Fees for foster-to-adopt programs are generally lower than private adoptions, though there are legal considerations to address. Organizations like Child Welfare Information Gateway offer guidance and resources for those interested in this path.

Funding options for adoptions

Many organizations, such as AdoptUSKids, provide resources and support for LGBTQ+ individuals and couples looking to adopt. Financial resources are available through groups like the National Foundation for Adoption and the National Adoption Foundation. One can also find various grant organizations via Lifesong, American Adoptions, the Child Welfare Information Gateway, Fund Your Adoption, Wide Horizons for Children, All for Children Adoption, and ChildWelfare.gov.

Conception Through Sex

For some queer individuals and partners who can biologically impregnate or concieve, conception through sex is also a possibility. While it may appear less daunting, it still involves its own set of challenges, such as managing hormone treatments or navigating gender dysphoria.

Ovulation tracking, sexual frequency, healthy lifestyles, sperm quality, and medical and psychological consultations are all factors to take into consideration when considering this conception method.

Depending on your circumstances, working with a supportive OB-GYN or fertility specialist can ensure the viability of conception through sex. It’s also important to negotiate legal agreements about parental rights, child rearing, and custody before conceiving through sex.

Donors

In addition to the above methods, donors play a crucial role in helping LGBTQ+ couples build their families. Whether it’s sperm, egg, or embryo donation, these generous contributions provide the genetic material needed for conception.

Organizations like Ovogene and California Cryobank offer extensive databases of donors, ensuring a wide selection to match diverse needs and preferences. These institutions also provide support throughout the donor selection process, making it easier for couples to find the right match.

Below is an overview of donor options for LGBTQ+ couples:

Known Donors

Using a known donor means selecting someone you know personally, like a friend or family member, to donate sperm or eggs. This option can offer a sense of familiarity and connection, but it also comes with potential legal complexities.

Generally speaking, donors may have to undergo medical exams to asses fertility, identify any potential hereditary diseases, and test for sexually transmitted infections. Donors will undergo a collection process to collect sperm or egg samples and may need to make financial arrangements for cell storage and procurement.

It’s essential to have clear agreements in place to prevent future disputes over parental rights. Legal advice is strongly recommended, and resources like this guide from Lake Toback DiDomenico can provide guidance on navigating these legal waters.

Unknown Donors

Choosing an unknown or anonymous donor involves selecting someone from a donor bank who has no personal connection to the recipient. This option often simplifies legal matters, as anonymous donors typically relinquish all parental rights.

• Strict Screening: Donors undergo extensive medical and psychological evaluations, including physical examinations, infectious disease testing, genetic screening, and background checks to ensure their health and suitability for donation. 
• Limited Information: While the recipient can access information about the donor’s physical characteristics, family history, and sometimes even interests, their full identity remains anonymous. 
• Legal Considerations: Legal agreements are typically signed by the donor and the intended parents to clearly establish parental rights and ensure the donor has no legal claims to the child. Other times, the donor may want to receive information or maintain contact with the donation recipients.
• Sperm/Egg Bank Access: Most often, unknown donors are found through sperm or egg banks where the donor’s samples are collected, tested, and stored for later use. 

When choosing an unknown donor, it’s important to consider

• Donor profile details: Review the available information about the donor’s physical traits, medical history, and family background. 
• Psychological implications: Understand the potential emotional aspects of using an unknown donor, especially regarding the child’s future questions about their biological heritage. 
• Legal guidance: Consult with a reproductive law attorney to ensure all legal aspects of the donation process are properly addressed. 

Many sperm and egg banks, such as California Cryobank, offer detailed profiles of their donors, including genetic screening results, to help prospective parents make informed decisions.

Types of Sperm Banks

Sperm banks are evolving to offer more transparency and choice (though it is essential to educate yourself on the ins and outs of commercial sperm banks). Traditional banks provide a wide range of anonymous donors, while newer platforms like Seed Scout aim to make the process more transparent by offering more detailed donor information. These banks often provide financing options to help manage the costs associated with donor sperm.

While sperm banks can deal with either anonymous or known donors, they can also facilitate donor arrangements like a “semi-open donor arrangement” where a donor and recipient can decide how much information is shared or an “open door arrangement” where a donor and recipient exchange more details and wish to maintain a relationship. Some donors may initially wish to keep their identities a secret but then agree to allow their identifying information to be released to offspring once they turn 18.

Sperm banks can offer several vial types, including the following:

• IUI-ready sperm: Washed sperm that’s concentrated and has high motility
• ICI-ready sperm: Unwashed sperm that can be washed in-house by a fertility clinic for insemination
• IVF/ART-ready sperm: Sperm that’s prepared to optimize fertilization potential in IVF procedures

Types of Egg Banks

Egg banks function similarly to sperm banks, offering a selection of donor eggs for those who need them. They provide detailed profiles and genetic information to ensure compatibility and quality.

Similar to sperm banks, egg banks may have anonymous or known donors as well as “open door” or “semi-open” arrangements.

Institutions like Ovogene specialize in helping LGBTQ+ families find the right egg donor, offering support and guidance throughout the process.

Funding options for sperm or egg donation

These banks also often have financing plans to assist with the costs involved in egg donation. Additional funding programs can be found through some of the organizations listed in the sections above, as well as through the Alliance for Fertility Preservation and Cofertility.com.

Your family, your way

Family planning is a journey, and it’s okay to take your time exploring your options. Remember, there’s no “right” way to create a family. What matters most is the love and care you’ll provide to your child. Whether you choose IVF, adoption, or any other method, your family will be unique and special.

If you’re feeling overwhelmed, take a deep breath. Start by talking with your partner (if you have one) about your dreams and concerns. Then, consider reaching out to a fertility specialist or adoption agency to learn more about the options that interest you most. And don’t forget — there are lots of resources out there to help you along the way. From support groups to financial assistance programs, you don’t have to go through this journey alone.

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