Article written by Audrey Hickey and reviewed by Dr. Aimee Eyvazzadeh, host of the Egg Whisperer Show and Marea Goodman, Licensed Midwife and Certified Professional Midwife
If you’re a lesbian couple thinking about getting pregnant or have already started trying to conceive (TTC), welcome! This guide is designed to help you and your partner explore your fertility options, including Intracervical Insemination (ICI), Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), and Reciprocal In Vitro Fertilization. You’ll also learn about the costs of each option, get insights about choosing a sperm donor, and see some resources to help you along the way.
It may seem like a lot of information at first glance, but you’ve totally got this!
Lesbian pregnancy and fertility options for those who want to start a family
As a lesbian couple, you have tons of options when it comes to starting a family. In this section, you’ll discover the four main fertility options for lesbian couples trying to conceive: Intracervical Insemination (ICI), Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), and Reciprocal In Vitro Fertilization.
You may know this already, but it’s worth repeating—no one option is better or worse than another. The one you choose is a personal decision and will depend on your medical history, personal preferences, and budget. That being said, it’s important to remember that these fertility treatments may require multiple attempts.
Regardless of which option you choose, your fertility journey can start at-home with an option like ICI or with an initial fertility consultation. During this appointment, your doctor will review your medical history, perform diagnostic testing, and discuss financial options. Once you’ve settled on a path forward, you and your partner will discuss the specifics of your chosen option and treatment can begin.
Home Insemination (ICI)
Intracervical insemination, often shortened to ICI and known as home insemination, is the simplest option of the four main techniques currently used. It can be done at a doctor’s office or at-home (more on that later)! ICI involves transferring sperm directly into the female reproductive tract, right at or near the cervical opening A.K.A. the door to the uterus.
If you choose the home option, you can use a specially designed syringe like Mosie to transfer the sperm. If you prefer going to a doctor’s office, the doctor will use a catheter (a thin, flexible tube) with a syringe attached to the end to deposit sperm to the opening of the cervix.
Intrauterine Insemination (IUI)
If ICI isn’t possible, or hasn’t worked, your provider may recommend trying intrauterine insemination (IUI). Intrauterine insemination can be performed in a doctor’s office or with a midwife at home.
During the IUI procedure, the doctor or midwife uses a syringe and a long, thin tube called a catheter to inject washed sperm into the uterus via the cervix.
If getting care through a fertility doctor, in preparation for the IUI procedure, they will likely run blood tests and perform a vaginal ultrasound to monitor your cycle and confirm that you’re ovulating. They may also prescribe fertility medications and have you use ovulation predictor kits at home in order to identify the best time for insemination.
During the procedure itself, your provider will fill a vial with “washed” sperm. The doctor washes the sperm using special equipment designed to eliminate supporting cells, semen, and slower sperm from the sample. This process selects the best available sperm and reduces the volume of fluid going into your uterus.
Once the sperm is washed, your provider will take the sample and attach it to a long flexible tube. Next, they’ll insert the tube through your cervix and deposit the sperm inside your uterus. The goal is for the sperm sample to meet an egg and create a baby.
All things considered, the procedure is pretty fast. You may have some discomfort, cramping, and possibly light spotting. But most people don’t experience any pain.
In Vitro Fertilization (IVF)
During in vitro fertilization (IVF), a doctor collects mature eggs from your ovaries and fertilizes them using fresh or frozen “washed sperm” outside of the body. After a few days, the doctor transfers the fertilized egg(s) (embryos) to your uterus.
The goal is for the embryo to implant and develop inside the uterus. Alternatively, you can choose to freeze the embryos and undergo a frozen embryo transfer at a later date.
To start an IVF cycle, you’ll do “Day 3” bloodwork to test hormone levels and undergo an x-ray procedure called a hysterosalpingogram (HSG). The HSG is a fifteen-minute procedure that allows the doctor to verify that your fallopian tubes are open and that the inside of the uterus is normal.
After these initial tests, you’ll start taking injectable hormones for a few weeks to create several mature eggs at the same time. The idea here is to have more eggs available so the doctor can create and deposit more embryos, giving you a greater chance of getting pregnant.
Before the doctor implants the embryos, you’ll also take some medicine to help prepare the uterus for implantation.
Lesbian couples may also be interested in reciprocal IVF. Similar to the standard IVF procedure, eggs and sperm are combined outside the body and the embryos are implanted. The difference with reciprocal IVF is that one partner provides the eggs and the other carries the pregnancy.
This gives the partner providing the eggs a genetic link to their offspring, while the partner carrying the pregnancy maintains a gestational link.
If you and your partner choose this route, and you are doing a fresh transfer, both of you may be asked to take oral contraceptive pills to synchronize your cycles before any other procedures can happen. Think of them as “fertility planning pills.” Once that happens, you’ll both undergo blood tests and take medications to boost your fertility. In addition, the partner donating eggs will undergo an egg retrieval procedure. Couples may also choose to do a Frozen Embryo Transfer (FET) and/or PGT-A,
Where can I get sperm to fertilize my eggs?
As a lesbian couple trying to conceive, finding sperm to fertilize your eggs is one of the most important steps to getting pregnant. This process can feel a little overwhelming, but luckily there are plenty of resources to help you out.
One option is to use a known donor. This could be a brother, cousin, or friend who volunteers to give a sperm sample to you and your partner. Collecting the sample can be done at a lab, in a doctor’s office, or even at home depending on the method of insemination you choose. Afterwards, you have the option to analyze the sample for sperm count, mobility, and possible genetic abnormalities.
You and your partner can also choose an anonymous donor from a sperm bank. This option allows you to browse hundreds of donors in order to find the perfect one.
All reputable sperm banks screen potential donors for genetic diseases, chromosomal abnormalities, and STDs that could be transmitted through the sperm. In addition, you’ll have information about the donor’s physical characteristics, general health, race, educational background, and career history.
For even more information about things to think about when choosing a sperm donor, check out this article!
How much does it cost for a same sex couple to have a baby?
Bringing a new life into the world as a lesbian couple is a joyful experience, but does come with some costs. These costs will vary based on which fertility option you choose, which procedures are covered by your insurance provider, and the number of attempts it takes to get pregnant.
That being said, there are some costs associated with most fertility procedures. These include:
- Doctor’s appointments for general health screenings, genetic testing, and ultrasounds before, during and after your pregnancy
- Medications (for IUI and IVF treatments)
- Sperm samples
With that in mind, let’s check out some estimates for the various fertility options available.
Cost of ICI
An ICI cycle at a doctor’s office ranges from $200 to $350. This doesn’t include the cost of a new patient appointment, preconception testing or the sperm sample (between $400 to $1,000 per frozen sperm vial), nor does it cover the costs of sperm analysis.
If you choose to try ICI at home, you should account for the cost of the sperm (if any) as well as the syringe and ovulation tests. Mosie Baby is an affordable option for both: the Mosie Baby kit (2 syringes plus collection cup and detailed instructions) and the Mosie Baby ovulation predictor kit.
Cost of IUI
One cycle of IUI can range anywhere from $400 to $2,000 out of pocket. The exact amount will vary based on the clinic you choose and your insurance.
In addition to the cost of the IUI cycle, you’ll also have to factor in fertility medication costs, as well as sperm sample costs. The cost will vary depending on whether your doctor prescribes oral or injectable medications. Out-of-pocket oral medication costs between $30 and $130, while injectable medications range between $3,500 and $5,500.
Cost of IVF
The cost of an IVF cycle varies between treatment centers and locations. On average, you can expect to spend between $10,000 and $50,000 without insurance. In addition to the cost of the procedure itself, the medications add an additional $1,500 to $4,000.
You should also think about the cost of preimplantation genetic testing for aneuploidy (PGT-A). This procedure identifies potential genetic defects within embryos. Out of pocket, these tests can run between $4,000 and $10,000.
All told, the average IVF patient can expect to spend between $30,000 and $60,000 if insurance doesn’t cover the procedure.
Given the elevated costs of IVF, many people shop around in order to find the most affordable options. Some travel to other states or countries for treatment, whereas others elect a center that includes more than one attempt in their pricing.
Resources for lesbian mothers to-be
Getting pregnant as a lesbian couple is exciting, but it can also feel really overwhelming and challenging at times. When you’re feeling like that, always remember, you’ve got this!
And if you need some extra help, there are tons of great resources to assist you and your partner during your pregnancy journey.
Read on to learn about resources from national support organizations, websites, books, and more!
National Support Organizations
- National Center for Lesbian Rights - A non-profit, public interest law firm in the United States advocating for equitable public policies affecting the LGBTQ community. It also provides free legal assistance to LGBTQ clients and their legal advocates.
- Family Equality Council - A coalition of gay parenting groups across the country that sponsors an annual conference of lesbian and gay parents and their children.
- Our Fertility Foundations Digital Course with Connecting Rainbows - This course will provide you with everything you need to know – from start to finish – on growing your family with donor sperm.
- Mombian - A blog where lesbian moms can connect, share personal stories and stay updated on LGBTQ policy changes.
- Gay Parents To Be - A website providing information about donors, fertility treatments, and more.
- Mosie Baby - Our blog provides helpful conception 101 articles.
- The Egg Whisperer - Dr. Aimee Eyvazzadeh started her weekly Egg Whisperer Show as a way of promoting fertility awareness. Met with her characteristic kindness and humor, Dr. Aimee’s focus on the Egg Whisperer Show is to provide information to her audience that they can not find anywhere else, and present it in a way that is accessible, and easy to understand.
Abbie & Julia - Abbie and Julia, a lesbian couple, share life as new moms. They discuss topics like inseminating at home with The Mosie Kit, pregnancy, and family life.
- Allie & Sam - Lesbian couple Allie and Sam share their IVF journey!
- The Next Family - Lesbian couple Susan and Brandy share how they started their family, including their challenges with conception.
- Gay Parent Magazine- This “mom-and-mom” publication started in 1998 as a print magazine and has since evolved into a full blown website, blog and resource guide for everything LGBTQ parenting.
- We Are Family Magazine - This online magazine is made by LGBTQ families, for LGBTQ families. In addition to helping you plan your family, We Are Family gives parenting advice.
The Ultimate Guide to Pregnancy for Lesbians: How to Stay Sane and Care for Yourself from Pre-conception Through Birth - Rachel Pepper
This is the book for lesbian couples wanting to get pregnant. You’ll find all kinds of practical information about everything from fertility treatments to labor.
And Baby Makes More: Known Donors, Queer Parents, and Our Unexpected Families - edited by Susan Goldberg and Chloë Brushwood Rose
This anthology includes personal essays written by lesbian moms, gay dads, donors and children of donors. While light on practical advice, it will definitely help you get some perspective on the complexities of DIY family making.
Journey to Same-Sex Parenthood: Firsthand Advice, Tips and Stories from Lesbian and Gay Couples- Eric Rosswood
Published in 2016, this is one of the newer books on the list. The author divides the book into five sections for LGBTQ couples: open adoption, foster care, surrogacy, assisted reproduction, and co-parenting. You’ll also find stories by LGBTQ parents woven throughout, as well as practical tips.
- If These Ovaries Could Talk: The Things We've Learned About Making An LGBTQ Family - Jaimie Kelton and Robin Hopkins
Inspired by their podcast of the same name, authors Jamie Kelton and Robin Hopkins share insights about the most commonly asked questions when it comes to creating an LGBTQ family. Not only is it in-depth, but it’s also funny, serious, uplifting, emotional, and powerful.
- If These Ovaries Could Talk - Two lesbians talk about making and raising babies with weekly guest speakers.
- The Gayest Show on Birth - Moms Karyne and Kate release weekly shows about their path to becoming moms to baby Ari, including their reciprocal IVF journey.
- LezBeMommies - Created by a queer mom and mindset coach, this podcast covers topics about lesbian pregnancy, including conception, parenting, and general health.
There’s a lot to think about when you’re a lesbian couple TTC, but hopefully you’re feeling a little more informed. Take as much time as you need to research, think about your options, and discuss what you want your pregnancy journey to look like as a couple. Whether you choose ICI, IUI or IVF, we wish you lots of success. If you have any questions or need support, please reach out!