The team at RMA of New York are leaders in state-of-the-art reproductive medicine. Their fertility clinic is led by an integrated team of doctors and scientists with extensive experience in fertility testing, IVF, egg freezing, and LGBTQ+ family building. Recently, we caught up with reproductive endocrinologist Dr. Buyuk who offered us some insight on the various Assisted Reproductive Technologies (ART) available to LGBTQ+ families.
First of all, what are the main ART options available for LGBTQ+ families?
The main options available to LGBTQ+ families to create their own family are mainly intrauterine insemination (IUI) and in vitro fertilization (IVF).
What are the primary options for same sex identifying couples?
While sometimes one member of the family prefers to get pregnant, at other times both members want to experience pregnancy, either at the same time or consecutively. One treatment option for pregnancy is using intrauterine insemination (IUI) using donor sperm. The donor sperm may be directed (someone the couple already know) or anonymous. The treatment cycle may be natural, taking advantage of the regular menstrual cycle, with the timing of the IUI using ovulation predictor kits or ultrasound monitoring. It may also be medicated, using medications that stimulate the egg growth, like clomiphene citrate or letrozole. If the tubes are blocked, if IUI treatments don’t result in pregnancy, or if there is another indication (for example, to prevent the transmission of an inheritable disease to the offspring), then in vitro fertilization (IVF) is another option. With IVF, it is also possible that one member of the lesbian couple may carry the pregnancy resulting from the use of her partner’s egg and donor sperm.
Same sex male identifying couples will always need IVF to have a baby if they want their own genetic child. For this purpose, the sperm from one of the members of the gay couple is used to fertilize the eggs donated to this couple. Then a gestational carrier (someone other than the egg donor) will carry the pregnancy.
What are the primary options for someone who is transgender?
If a transgender person wishes to have their genetic children in the future, then egg or sperm freezing before undergoing transgender treatment/operation is of paramount importance. The gametes harvested and frozen may be used in the future to create a family using IVF techniques.
What type of testing is necessary before beginning any fertility treatments?
There are a series of tests to be performed before attempting pregnancy. Some tests are related to evaluate the anatomy and function of the reproductive organs. For example, for females who will be the egg source, ovarian reserve testing that includes hormonal testing (anti-mullerian hormone, follicle stimulating hormone, etc.) and ultrasound examination of the ovaries (to count the number of potential eggs for that particular month) is performed. Various types of ovulation testing are also performed to detect regular spontaneous ovulation. These may include blood progesterone hormone testing one week before the next expected period, ovulation predictor kits, or simply a history of regular monthly periods. Examination of the uterus and the fallopian tubes using a test called hysterosalpingogram is one of the mainstays of fertility work up for the woman who will carry the pregnancy. Finally, a semen analysis is needed to ensure an adequate number of motile sperm in the semen.
What is the best piece of advice you have for LGBTQ+ families that are looking to become parents?
My best advice is “Do not wait” and get a consultation from a reproductive endocrinology and infertility specialist to plan your future family.
Dr. Erkan Buyuk is a board-certified reproductive endocrinologist and infertility (REI) specialist who practices at RMA of New York’s Eastside office. Prior to joining RMA of New York in 2019, Dr. Buyuk served as the Director of the Fertility Preservation Program and Reproductive Tissue Bank at Montefiore Medical Center in New York City.
Dr. Buyuk received his medical degree from Hacettepe University Medical School in Ankara, Turkey. He then completed an Ob/Gyn residency at Marmara University Hospital in Turkey, a research fellowship at Cornell University, a second residency at Maimonides Medical Center in Brooklyn, NY, and a fellowship in REI at the Albert Einstein College of Medicine / Montefiore Medical Center.