Los Angeles has one of the largest Gay, Lesbian, Bisexual and Transgender (GLBT) communities in the country. This past weekend, Dr. Winkler and I, had the opportunity to address a group of prospective GBLT parents about non-traditional family building options. The group is called “Maybe Baby” and is sponsored by the Los Angeles Gay and Lesbian center. The head of the group happens to be a former patient of our center, the Center for Fertility and Gynecology, who is happily raising a pair of beautiful twins with his partner.
At the meeting, which took place at the West Hollywood recreation center, Dr. Winkler and I discussed a variety of topics which pertain to fertility treatment in general as well as matters which are specific to the GLBT community. The topics included:
Physiology/ Natural Conception.
We discussed the basic physiology behind conception and the anatomical structures which make it possible. While many people have not thought about the male and female reproductive systems since 7th grade health class, our description and review served as the foundation to understand all of the fertility treatment options going forward.
It is important to remember that most GLBT couples are not “infertile” in the traditional sense of the word. In some ways, the greatest hurdle to becoming pregnant for GLBT couples is logistical rather than physiological. With that being said, we believe that it is reasonable to conduct some basic fertility testing prior to commencing treatment. The basic tests will depend on the couples gender and desires. First, we consider it important to assess ovarian reserve through ultrasound based antral follicle count, day 3 FSH and estradiol as well as AMH. Additionally, it may be reasonable to ensure that a woman’s fallopian tubes are open and that her uterus is normally shaped. This is assessed through a test called an hysterosalpingogram (HSG). Additionally, we recommend testing male factors through a semen analysis prior to beginning treatment.
Finally, the talk addressed the multitude of treatment options available for GBLT couples. Intrauterine insemination (IUI), where prepared sperm is placed into the uterus of a woman who is close to ovulation, was the first option discussed. Next, IUI combined with ovarian stimulation was described. This is often referred to as controlled ovarian hyperstimulation or COH. Subsequently we talked about in-vitro fertilization (IVF), and the techniques involved with this amazing technology. Lastly we discussed oocyte donation and surrogacy. These last 2 variations of IVF are especially relevant to GLBT couples as they allow the greatest flexibility for utilizing both partners in the conception process.
We enjoyed the opportunity to speak to this excited and enthusiastic group. At the Center for Fertility and Gynecology, we truly believe that all people have the right to become parents. If you have more questions about family building for same sex couples, please contact us at (818) 881-9800. We would be happy to speak with you.