The world of “fertility” is full of myths, inaccurate information, and sensationalized stories that are often portrayed in the media and cause anxiety for hopeful parents-to-be. Unfortunately, this can sometimes lead to legislation, private policies, and cultural stigmas that create obstacles for people who require assistance to build their families, like the LGBTQ+ community.
In this blog, we’ll review the many definitions of infertility, including how social infertility affects the LGBTQ+ community. We’ll also cover how infertility, in general, might play a factor in your biological family-building journey. Lastly, we’ll review some of the common barriers to fertility treatment for LGBTQ+ individuals and couples, and what you can do to overcome them.
Skip to a section:
- What is the definition of infertility?
- LGBTQ+ Couples & Social Infertility
- For LGBTQ+ Dads-to-Be
- For LGBTQ+ Moms-to-Be
- Fertility Testing for the LGBTQ+ Community
- LGBTQ+ Infertility & Insurance
- The Challenges & Joys of Family Building
- More Family-Building Resources
What is the definition of infertility?
For most medical purposes, infertility is described as sperm and egg being exposed to one another for a year without conception. While some state language includes the term “insemination” as well, by and large, this definition doesn’t take the LGBTQ+ population into account. Furthermore, the diagnosis of “infertility” typically refers to a couple, which also excludes single parents from pursuing biological family building.
Sadly, the medical definition of “infertility” has long been outdated - but is often accepted as is, in black and white terms, by insurance providers. This inherently denies equal coverage to LGBTQ+ couples and single parents-to-be.
LGBTQ+ Couples & Social Infertility
Social infertility is a relatively new term that accounts for the family-building dreams of LGBTQ+ couples and single parents-to-be. In both instances, biological family building will require assistance from an egg and/or sperm donor and will most likely also require a fertility doctor, legal counsel and a mental health professional.
Aside from social infertility that affects essentially all cisgender couples in the LGBTQ+ community, there are additional fertility issues that may affect the LGBTQ+ population.
For LGBTQ+ Dads-to-Be
Men may make sperm every 90 days or so, but that doesn’t exclude them from experiencing infertility too. Potential causes of male factor infertility could be steroid or hormone usage, a past STD, age, smoking and/or drinking, or a combination of any of these factors.
Need a full refresher on the female reproductive system?
For LGBTQ+ Moms-to-Be
Infertility may include hormone disorders such as PCOS and endometriosis. Additionally, physical issues with the reproductive system could occur which might include fibroids or other uterine abnormalities. A previous STD could also impede normal reproductive system functioning.
Another possible cause of infertility for moms-to-be is advanced maternal age. While the “biological clock” concept is overplayed, it is also often misunderstood. The reality is that women are born with a set number of eggs, and unfortunately, quantity and quality do decline with age.
To illustrate this point with actual figures, at birth, there might be around 2 million eggs. However, that number drops by about 75% once puberty hits, leveling somewhere around 500,000. And though only one dominant egg is produced every month during adulthood, approximately 10,000 total eggs are lost each cycle.
By 37 or so, that number is down to 25,000, and likely far less than that when you factor in viability (quality), which is the likelihood that an egg is genetically/chromosomally normal and could result in a healthy pregnancy.
At this point, if you’re a mom-to-be, you might be thinking, “What?! Men make sperm every 90 days and we’re losing 10K eggs a month? That’s not fair!” And you’re right, it’s not fair, but that is why fertility testing is so important.
Fertility Testing for the LGBTQ+ Community
Fertility testing empowers you with information that can be used to map out your family-building journey. It also enables you to plan for family-building costs for services like IUI, IVF and/or surrogacy. With this knowledge in mind, you can also reach out to your insurance provider to determine what services and procedures are covered under your policy.
For moms-to-be, baseline fertility testing includes AMH testing, Cycle Day 3 blood testing, and Day 21 testing.
For dads-to-be, baseline fertility testing includes going for a semen analysis to evaluate your sperm quality.
For all LGBTQ+ singles and couples, genetic carrier screening is available and can help screen for a variety of genetic conditions. Additionally, genetic counseling is an important part of the process and is a major factor when it comes to selecting an egg or sperm donor.
Learn more about fertility testing for LGBTQ+ parents-to-be:
LGBTQ+ Infertility & Insurance
Too often, LGBTQ+ individuals are excluded from insurance coverage on the basis of the medical definition of “infertility.”
Thankfully, there are many organizations out there that are helping to move this conversation forward in addition to providing funding and resources, such as Family Equality Council. There are also fertility benefits-focused companies like Progyny that offer expanded coverage for LGBTQ+ individuals and couples.
While there is a growing number of family-building grants and resources available, you can also be a part of moving this conversation forward by advocating for change on a policy level. In order to accomplish this and for ways to inquire about your own benefits, we created a resource for you: What to Know About LGBTQ+ Family-Building Insurance Coverage.
The Challenges & Joys of Family Building
As our founder, Dr. Mark Leondires says, “It takes a village, but the village is out there.”
If you’re a member of the LGBTQ+ community, you have the advantage of knowing that there are resources out there. While many non-LGBTQ+ patients experience grief, shame, and sadness at the prospect of talking to a fertility provider, the LGBTQ+ community has the unique experience of approaching it with a different outlook. How’s that for positivity?!
So, while family building can be challenging for the LGBTQ+ community, it is often an exciting process too.
Choosing a provider who has extensive experience helping LGBTQ+ families grow and provides resources to support you throughout your journey is key to your success!
Wondering how to find a clinic that's right for you?
More Family-Building Resources
Looking for more support on your LGBTQ+ family-building journey? We've got you covered!
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