Definition and Overview

Same-sex couple infertility refers to the physical hindrance faced by same sex couples who want to have children. It is considered as a medical issue as it can now be resolved using assisted reproductive technology (ART), which gives them access to a donor sperm (for female partners) or a surrogate mother (for male partners). To avail of such treatment procedures, same sex couples may undergo consultation at a fertility clinic or with a same-sex fertility specialist.

Causes of Condition

Same sex couple infertility is a medical issue caused by a partnership or marriage between two individuals of the same gender, who are unable to start a family without medical intervention.

Couples made up of two male partners may have the sperm needed to conceive but will need a female individual to carry the baby to term. On the other hand, female partners will need a donor sperm.

In some cases, there may be other possible hindrances, such as low sperm quality for male partners or an ovarian issue for female partners. Among men, hindrances to produce good-quality, healthy sperm include:

  • Genital injury or trauma
  • Illness or disease
  • Infection
  • Side effects of medications or other medical treatments, such as chemotherapy
  • Age

Among women, the ability to carry a baby to term may be affected by:

  • The general health of the reproductive system, especially the ovaries, fallopian tube, and the uterus
  • Irregular monthly cycle or ovulation issues
  • Weight issues

In such cases, same-sex couples may seek professional and medical assistance made possible by advanced assisted reproductive technology or ART to increase their chances of conceiving.

Key Symptoms

Same-sex couples are physically unable to conceive a child together, but they can still have a shared experience of having a baby with some assistance. If both partners are male, they can have their sperm collected and hire a surrogate mother who will be implanted with the sperm. If both partners are female and if at least one partner can produce high-quality eggs, they can have those eggs fertilized by a donor sperm. However, if such attempts to use a donor sperm or surrogate mother still fail to help the couple conceive, other reproductive issues may be explored.

The following are symptoms of male infertility that may hinder a male partner from producing good quality sperm:

  • Low sexual libido
  • Swollen testicles
  • Small and firm testicles
  • Erection problem
  • Premature ejaculation
  • Painful testicles

On the other hand, female partners who may have fertility problems may experience the following symptoms:

  • Acne breakout
  • Skin changes
  • Hair loss or thinning of the hair
  • Unexplained weight gain
  • Milky white nipple discharge (not caused by breastfeeding)
  • Painful sexual intercourse
  • Low sexual libido
  • Hair growth on the chest, chin, or lips

In addition, some symptoms involving a female partner’s menstrual cycle may indicate a fertility issue. These include:

  • Abnormal period (i.e. when the bleeding is lighter or heavier than normal)
  • Irregular periods
  • The absence of menstrual period for an extended time
  • Severe cramping
  • Severe back pain
  • Severe pelvic pain

If any partner experiences any of the above symptoms prior to seeking same-sex couple fertility treatment, they will have to undergo some tests, such as a sperm count (for male patients), blood and urine tests, and imaging scans, to determine whether they can produce good quality sperm or eggs to be used for the procedures. If not, other options may be considered.

Also, same-sex couples who have been trying to conceive through fertility treatments but fail to get pregnant even after a year of treatment should consider trying other available options.

Who to See and Types of Treatments Available

Same-sex couple infertility can be resolved with the help of specialized fertility clinics where the couple will be assisted by a team of fertility experts with special training in fertility technology. They are also called reproductive endocrinologists.

The existing assisted reproductive technology (ART) techniques for same-sex couples include:

  • Intrauterine insemination - Also known as IUI, this refers to a procedure wherein a donor sperm is implanted into one of the female partners’ ovaries to fertilize an egg. For this to be successful, it is important to perform the insemination procedure before the woman’s predicted ovulation date. To determine the best time for an insemination, fertility specialists will closely monitor the patient’s menstrual cycle. Both partners will also undergo some tests prior to the procedure to determine which partner is most suitable for the treatment. Since this procedure still ultimately relies on the natural fertilization of the egg, the higher the quality of the sperm, the better the chances of a successful pregnancy. For male couples using a surrogate mother, the success of the procedure will also be affected by many factors involving the surrogate’s health.

  • In vitro fertilization - An in vitro fertilization, more commonly known as IVF, is a procedure wherein an egg taken from a woman and a sperm taken from a man is combined in the lab. Thus, fertilization technically occurs in a lab dish, where it can develop for up to 5 days before being transferred into a uterus. Once an egg has been successfully fertilized, it can then be implanted back into a woman’s uterus. This can be used to treat infertility among either male partners or female partners. Female partners can also perform an in vitro fertilization together, wherein one partner donates the egg and the other receives the embryo and carries the baby to term. This means that one of the partners is the genetic mother or the source of the egg while the other is the birth mother or the partner who gives birth to the baby. This kind of modified in vitro fertilization procedure is also called “egg sharing,” and offers both partners a unique connection to their child.

  • American Society of Reproductive Medicine

  • The American Fertility Association
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