What do the latest figures say?
The HFEA’s 2017 Trends and Figures statistics report a 12% increase in same sex female couples seeking fertility treatment between 2016 and 2017. Same sex couples now make up 5.9% of all patients having treatment in the UK. In particular, there has been an upsurge in the same sex female patients using their own eggs and a sperm donor which has increased from 10% in 2005 to 32% in 2017.
Has the LWC seen an increase in same sex female couples?
The LWC has seen an increase in same sex female couples seeking fertility treatment. In April 2005, the donor anonymity regulations changed which meant that both egg and sperm donors can be identifiable and contacted by donor conceived children when they reach the age of 18 (if they chose to do so). This meant that same sex women felt reassured that their child would be able to establish contact with their genetic father if they wanted to. The perception was that a different type of donor would emerge with donors more mature and having thought through their decision to donate with more care than when previously anonymous.
In 2009 there was a change to legal parenthood with the introduction of the “WP and PP” forms which allows the patient’s partner to be a legal parent. This was a very positive development for same sex couples as it meant that non-birth partners could be registered as second parents. Previously the non-birth mother had to adopt the child.
What fertility treatment options are there for same sex female couples?
IVF by its very nature has a much better success rate than Intrauterine Insemination (IUI) but it may not be the option for everyone for a variety of reasons and not all of them may be clinical. I will always individualise and personalise the treatment for each patient. If there are no concerns about ovulation and blocked fallopian tubes, then I will advise IUI.
Intrauterine Insemination is a less invasive and less expensive treatment option compared to IVF. The donor sperm sample will be thawed, prepared and transferred in to a thin catheter ready for insemination. A speculum is introduced in to the patient’s vagina to open the cervix before the catheter is inserted and the sperm released. IUI can take place either on a “natural cycle” or “stimulated cycle” where medication is taken to stimulate the ovaries ahead of the procedure.
When is IVF needed?
I normally advise most same sex female couples to try three to six intrauterine insemination cycles before attempting IVF. However, if the patient has a history of pelvic inflammatory disease, chlamydia infection or abdominal surgery (all of which can be risk factors for tubal problems) they should consider IVF. If the patient has a low egg reserve IVF may also be needed. Sometimes, the couple want IVF due to its higher success rate. In this instance, I will recommend IVF with a lower dose of ovarian stimulation medication. Some couples may also wish to take part in the egg-sharing programme and share the eggs collected during their IVF cycle with an unknown recipient to not just reduce the cost of their treatment but also as a way of ‘giving back’ as they are using donor sperm themselves.
What is Shared Motherhood?
More same sex female couples are now taking part in our shared motherhood programme. Shared motherhood or intra-partner egg donation allows both partners the opportunity to be involved in the baby even before its birth. It simply means that one partner provides the eggs and is the genetic mother and one partner carries the pregnancy and is the birth mother – a win-win situation for both!
Shared motherhood requires the partner providing eggs to undergo an egg collection. These eggs are then fertilised with donor sperm in the laboratory to create embryos. The best-looking embryo will then be transferred to the partner wishing to carry the pregnancy. Any other embryos can then be frozen and stored for the future.
Where can same sex couples find donor sperm?
The LWC’s partner clinic the London Sperm Bank would be my go-to place for finding donor sperm. As a UK HFEA registered sperm bank, it meets all the regulatory requirements regarding donor recruitment and screening and ensures there is a strict ten family limit. Regulations in the UK mean that all donors are anonymous to the recipients of the donation. All donor profiles are online which means the patient can select the donor in the privacy of her home and at a time which is convenient.
It is also possible to import sperm from abroad. Although some overseas banks may share more information, you need to bear in mind that the ten-family limit applies only to donor sperm used in the UK. The same donor can be used in treatment for any number of families overseas as not all countries put a limitation on the number of families created. Another point to note is that not all overseas sperm banks have been certified for exporting sperm to the UK, so you should check with your LWC clinic before purchasing any sperm from overseas.
Some patients want to use a family member who is a non-blood relative or friend as a known sperm donor. A known donor must undergo the same screening tests as an anonymous sperm bank donor which means that samples must be frozen and quarantined before use. Treatment will also be dictated by the sperm quality of the known donor; for instance, if the sperm count or motility is low, the patient will require IVF with ICSI even if there are no fertility issues with her.
For more information about the treatment options available for same sex couples at the LWC or to book your consultation with Dr Thackare, please contact us.