It is our goal to help our LGBTQ community have equal opportunity in their reproductive choices. We have state-of-the-art reproductive technology within a fully equipped office, laboratory and surgery center. We offer donor insemination, egg donation, gestational carrier and surrogate arrangements with vetted providers tailored to your needs.
Your fertility journey with CRH&G will begin with an initial consultation with Dr. Najmabadi to discuss medical history, testing, potential treatment, and financial options. The next step is diagnostic testing here in our office to discover the level of fertility in either partner. Once testing is complete, you and Dr. Najmabadi will discuss a fertility plan that is right for you.
We are dedicated to helping patients also preserve their fertility prior to treatments. We offer treatment options to trans individuals and couples, both pre-and post-transition. We find that often the hormonal and/or surgery involved in transitioning can affect fertility and the ability to have a biological child in the future. Trans individuals considering transitioning have the option to preserve their future fertility. The freezing of eggs, sperm or embryos prior to hormone therapy or surgery allows an opportunity to add to the genetic makeup of any planned future offspring.
Let CRH&G help you start your fertility journey with personalized care & support. Call us today to set up your consultation!
Parenting for Same-Sex Female Couples:
When same-sex female couples begin their fertility journey, one of the first decisions you must make is who will carry the pregnancy. The partner carrying the pregnancy will proceed with an infertility work-up. If all tests come back normal, you will then select a sperm donor or use sperm from someone known to you that you may use to achieve the pregnancy. If you select an unknown donor, the cryobank sends the frozen sperm sample directly to CRH&G, where our andrologists will thaw and analyze it in our andrology lab. The next step you will undergo an intrauterine insemination or in vitro fertilization cycle.
Another LGBTQ family building option for lesbian couples is choosing to have one partner provide the egg and the other partner will carry the pregnancy. This is a more complex treatment protocol where we will test both partners and both will take medication to boost their fertility. This is an excellent way for both you and your partner to feel connected to the pregnancy and the child.
Co-IVF allows our same-sex partners to share in the process of pregnancy through an approach where eggs are extracted from one woman, inseminated with donor sperm to create an embryo, and then the embryo is transferred back to the other woman’s uterus to carry the pregnancy. Many of our lesbian couple patients have choosen this shared path. We have also had patients that have later wanted additional children and reversed who provides the egg and who carries the pregnancy.
Trans individuals or couples:
Trans individuals or couples wanting to create a family have several treatment options available depending on their gender at birth and which gametes (sperm and/or eggs) are needed for reproduction.
1. What is the simplest way to conceive for lesbian couples?
The simplest way to conception is to use a donor of your choice or from a high quality sperm bank that we have pre-reviewed, and time insemination through monitoring of a natural cycle, which we will do for you here at CRH&G.
2. What is the fastest and the least expensive way to conceive for lesbian couples?
Utilization of Intra Uterine Insemination (IUI) with donor sperm under the guidance of Dr. Najmabadi, preferably with Clomid enhancement of ovulation. Although seemingly more intense, careful monitoring and good timing will increase the success from single digits (4-9% in large studies of natural cycles) to 15-25% with Clomid combined with two donor sperm inseminations in an ovulation induction cycle. The chance of twins with Clomid is about 7-10% compared to 1.2% in a natural cycle.
3. Can we use fresh sperm of a friend or relative, instead of frozen sperm, which is less fertile?
Yes, the donor has to go through a full STD test prior to fertilization.Federal regulations strictly forbid the use of fresh sperm for insemination, because of the risk of transmitting infectious diseases through the sperm. All sperm used for insemination, with the exception of intimate partners, has to be frozen and quarantined for at least six months. The ‘donor’ has to go through STD testing, both before freezing and before thawing the sperm, and must be negative for HIV I and II, syphilis, gonorrhea, Chlamydia, CMV, Hepatitis B and C as well as HTLV on both occasions.
4. Can we use frozen quarantined sperm of a friend or relative?
Most fertility specialists will work with you, however, there are a few hurdles to overcome when using known donor’s frozen sperm: only 1 in 8 potentially fertile men will have sperm which will withstand the freeze thaw process and will have the minimal requirement of 5 million highly motile sperm available for insemination. Furthermore, the cost of testing, freezing and storing sperm can be substantial and is never covered by insurance. Although the benefits of using the sperm of your partner's brother, for example, are undeniable, both legal and social issues may complicate such an arrangement.
5. Will my donor insemination cycles be covered by insurance?
Most insurance companies do cover inseminations, but usually not the cost of the sperm. Your insurance is verified prior to any procedure being performed.
6. Why do you not recommend doing home insemination with a “Turkey Baster” and commercially available ovulation predictor?
Unfortunately, there are NUMEROUS reasons: 1) A home insemination is depositing sperm in the upper vagina, into a very acidic and unfavorable environment for the sperm, which will only allow very limited number of sperm to gain access into the cervical mucus and thus survive. 2) Ovulation kits measure the LH surge, which signals ovulation within 36-44 hours. However once the LH surge is detectable, progesterone has already risen and the cervical mucus has turned from watery and clear to cloudy and viscous. Thus, the best time for home insemination (cervical insemination) is 24-96 hours before the onset of the LH surge when the cervical mucus is the most favorable and protective for the sperm. In that sense, the ovulation kit only tells you, that you should have done it 2-4 days ago!
Parenting for Same-Sex Male Couples:
If you are a same-sex male couple planning to build a family through fertility treatments, you will meet with Dr. Najmabadi to discuss the details of using an egg donor and gestational carrier. The partner wishing to use his sperm will undergo a semen analysis to test motility (movement), volume, concentration, and morphology (shape) of the sperm.
CRH&G does not recruit gestational carriers/surrogate, but we will refer you to reputable agencies and attorneys who specialize in identifying gestational carriers. Once you have identified a gestational carrier/surrogate and she has undergone medical and psychological screening and legal contracts are in place, you may then select an egg donor. After the donor has gone through the egg retrieval process, you and/or your partner will provide previously frozen sperm samples that our in house embryologist will use in the insemination of the donated eggs. With close observation once the eggs are developed, Dr. Najmabadi will transfer the embryo to the gestational carrier/surrogate.
1. My partner and I are in a stable relationship and both of us would like to have children and if possible to continue our genetic lineage. What are our options?
There are several scenarios, which maximize the preservation of your and your partner’s genetic contribution to offspring. The option is to use an egg donor and inseminate the eggs during in vitro fertilization (IVF) with each of your sperm. For example, if there are 8 mature eggs, 4 could be inseminated by your and 4 by your partner’s sperm. In turn, embryos created by either your or your partner’s sperm would be implanted in the uterus of a gestational carrier.
Alternately your sister or a relative could donate the eggs or be your surrogate, which would be inseminated by your partner’s sperm or vice versa, circumstances permitting.
2. What effect does the gestational carrier/surrogate have on the genetic composition of a baby?
If the embryos implanted in the gestational carrier/surrogate originate from an egg donor and the sperm of one of the intended parents, the gestational carrier/surrogate has zero contribution to the genetic make up of the baby. Thus, she is solely providing a nourishing environment for the baby.