Becoming parents raises many questions for every couple. This is also true for lesbian couples, most of whom still face obstacles in realising their dream of family happiness. Although same-sex couples are becoming more accepted in society, the road to baby bliss is often bumpy.

This blog aims to show you, as a prospective parent, that there are now many options available to lesbian couples when it comes to fulfilling your desire to have a child. In today's world, the classic family construct of mother, father and child is no longer the only way to have a family. Find out what treatments are available to help you create a rainbow family and what you need to consider.

The first step is counselling

In general, any fertility treatment involves a consultation with your gynaecologist. This will include an initial examination with ultrasound and blood tests. The latter will test for various diseases (e.g. HIV, hepatitis, syphilis) or antibodies (e.g. rubella).

In addition, the mother's hormone levels are examined in detail, especially follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH) and thyroid hormones (TSH, T3 and T4).

Ultrasound scans can detect any abnormalities or diseases (e.g. fibroids) that may affect the pregnancy.

Fertility treatment options for lesbian couples

As a lesbian couple, you have the same treatment options as heterosexual couples when it comes to fulfilling your desire to have a child. Which method is best for you will be determined during counselling and screening. Ultimately, many factors (e.g. age, fertility, pre-existing conditions) will influence the choice of method.

IUI - Intrauterine Insemination

The most common treatment for lesbian couples who want to have children is intrauterine insemination (IUI). This is considered to be relatively straightforward and involves inserting sperm directly into the uterus. During IUI, ovulation can be stimulated with medication, but even without hormone treatment, the success rate is between 10 and 15 per cent per attempt.

IVF with ICSI - Intracytoplasmic Sperm Injection

Intracytoplasmic sperm injection (ICSI) is also a common fertility treatment. Hormone stimulation may be required before the procedure, during which eggs are retrieved from the patient. Egg retrieval is usually done as an outpatient procedure under local anaesthetic. On the day of egg collection, the donor's sperm are injected. Within two to six days, an embryo develops in an incubator and is transferred to the uterus through a catheter. The success rate is between 20 and 50 per cent, depending on the number of embryo transfers and the patient's age.

ROPA "Reception of oocytes from partner" - shared motherhood

In heterosexual couples, both parents contribute to the pregnancy, so the child has genes from both the mother and the father. This is not possible in a lesbian partnership. However, there is an option: the so-called ROPA method, or shared motherhood. Put simply, the egg from one partner is transferred to the womb of the other. This means that you can both take an active part in the fertility treatment: one woman is the genetic mother and the other is the biological mother.

The ROPA method also involves hormone stimulation. Fertilisation can then be achieved using ICSI. During treatment, the uterus of the pregnant woman is also prepared for successful implantation. This is done by administering oestrogen and progesterone, which increase the density of the uterine lining.

Reasons for shared motherhood

The reasons for sharing a pregnancy are many and varied. Often it is a purely personal decision to share a pregnancy. But from a medical point of view, the ROPA method can also be useful in the following cases:

• when the quality of one partner's eggs is impaired
• When the oocyte reserve is exhausted (no more oocytes available)
• If one of the partners has a fallopian tube disorder
• Increased risk of hereditary diseases
• Failure of other procedures

Other options for lesbian couples: egg donation, embryo donation and embryo adoption

Unfortunately, as with heterosexual couples, you may not be able to have a child because you both have limited fertility.

If adoption is not an option for you, egg donation may be. However, this is only allowed in certain European countries. It is banned in Germany and Switzerland. This means that shared motherhood is only possible in countries where egg donation is not prohibited.

In the case of embryo donation and adoption, all parties involved are in a legal grey area. Whether there is a definitive ban on these procedures is often debated. However, in most clinics in neighbouring countries, both procedures are carried out.

I have written separate blogs about sperm donation and the ROPA method because these are often used by lesbian couples who want to have children.

In other blogs I will talk specifically about the options and regulations for parenthood after the birth of a child for lesbian couples in Germany, Austria and Switzerland.

https://yourivfsupport.com/sperm-donation-for-lesbian-couples/

https://yourivfsupport.com/lesbian-parenthood/

https://yourivfsupport.com/legal-situation-regarding-fertility-treatment-for-lesbian-couples/