Assisted reproduction: options for gays, lesbians and trans

From the supportive belly to the freezing of gametes: understanding the options that the LGBTQIA+ population has for assisted reproduction

June is LGBTQIA+ Pride Month, a time when issues like same-sex families and trans people take on greater importance. Therefore, this is also an opportunity to explain assisted reproduction options for this population.

Assisted reproduction for same-sex couples has been legal in Brazil since 2015 thanks to a resolution by the Federal Council of Medicine. And, due to the bureaucracy in the adoption process, the search for human reproduction clinics by this public has increased significantly in recent years”, explains Rodrigo Rosa, human reproduction specialist and clinical director of Clínica Mater Prime.

Additionally, fertility has also become an increasingly important issue for trans people due to the impact of gender-affirming surgeries and hormone therapies on reproductive ability.

“In gender affirmation surgeries, which consist of the removal of the testicles or the uterus and ovaries, fertility is irreversibly damaged. But even trans people who are not subjected to this type of procedure can suffer from infertility at due to the use of hormones”, explains Fernando Prado, specialist in Human Reproduction, member of the American Society of Reproductive Medicine (ASRM) and clinical director of Neo Vita.

Although it is becoming more common, taboos and misinformation still surround the debate about fertility in LGBTQIA+ people. So, to clear up your doubts on the matter, the experts have explained below the assisted reproductive procedure options available for this population. Watch:

Male homosexual couples

Assisted reproduction for same-sex male couples tends to be more difficult. This is because, in addition to donating the egg, it is necessary to look for a supportive belly. In other words, a woman willing to carry the child.

“But there are strict rules regarding the joint belly, and the woman willing to give up her uterus for the operation must be over 18 years old and be a relative up to the fourth degree of one of the partners. In other cases she must be received authorization from the Federal Council of Medicine and, if there are no candidates to give up the uterus, it is not possible to perform the operation”, says Rodrigo Rosa.

After finding a supportive womb and an egg donor, it is up to the couple to decide which of them will be the sperm donor. “The egg is then fertilized in the laboratory and inserted into the uterus of the woman willing to carry the baby. After about 15 days it is already possible to verify the success of the operation”, explains the specialist.

“In some cases, in addition to medical monitoring, it is interesting that the couple also asks for legal support, since the woman who has given up the uterus can ask for custody of the child, since the child possesses the genetic material of all those who participated in the process,” says the doctor.

Female homosexual couples

In the case of homosexual couples, the assisted reproduction process is simpler. This is because only sperm donation is necessary which, like egg donation, takes place anonymously through material banks. With sperm, the couple can choose two methods: in vitro fertilization (IVF) or intrauterine insemination (IU).

“In vitro fertilization follows the same procedure as for male homosexual couples. But in this case the embryo is inserted into one of the members of the couple. Furthermore, the female homosexual couple who opts for in vitro fertilization can still carry out a shared pregnancy , a process in which one of the women gives up the egg while the other is responsible for gestating the baby,” explains Rodrigo.

The other option for same-sex couples is intrauterine insemination, popularly known as artificial insemination. “The operation essentially consists of inserting the sperm into the uterine cavity during the woman’s ovulation period, so that fertilization occurs naturally”, explains the specialist. According to him, in some cases, it is necessary to preventively stimulate ovulation through drug treatment.

Trans people

For trans people who wish to have biological children after hormone treatment, gamete freezing is the best option. “Cryopreservation is a freezing technique that can take place in oocytes, ovarian tissue, sperm and embryos. At a temperature of -196ºC, these structures keep their metabolism completely inactive, while preserving their vitality”, explains Fernando.

For example, transgender people assigned male at birth can freeze sperm, which is collected through masturbation. “Trans people assigned female sex at birth can freeze their eggs, which are collected, via a needle, directly from the ovaries after a period of hormonal stimulation,” explains the expert.

Therefore, when the patient is ready to have a child, the gametes are thawed for fertilization in the laboratory with the opposite gamete. In turn, it can come from a partner or a donor bank, in an in vitro fertilization (IVF) procedure.

“Cryopreservation of gametes should preferably take place before the start of hormone therapy. Freezing of oocytes and sperm can also take place after the start of hormone therapy. But in these cases the use of hormones must be suspended for a certain period However, this can compromise the quality of the biological material,” adds Fernando.

Source: Terra

Ben

Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.