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Fertility treatment options for lesbian couples
Starting or growing your family as a lesbian couple is a deeply personal and exciting journey, but when it comes to fertility treatment, the options can sometimes feel overwhelming.
Whether you’re just beginning to explore what’s available or are narrowing down your choices, understanding the different routes – such as in-clinic donor insemination, IUI, IVF and reciprocal IVF - can help you make the best decision for you, your partner, and your future family.
Donor insemination
Donor insemination is typically carried out in a licensed clinic and involves using sperm from a known or anonymous donor and placing it into the uterus, cervix or vaginal canal of the partner who wants to become pregnant. It’s often seen as a natural, low-cost way to conceive. It should be noted, if you’re undertaking home insemination, the donor sperm can only be placed in the vaginal canal or potentially in the cervix.
Who is donor insemination suitable for?
This option may particularly appeal to lesbian couples who want a more intimate, low-intervention approach and potentially already know their donor, or who are unlikely to need more intensive forms of treatment. It may also be preferred for cultural or personal reasons.
How safe is donor insemination?
Home insemination carries medical and legal risks, especially when using unregulated donor sperm. Without proper screening, there’s a risk of passing on infections or genetic conditions. In addition, if you’re in a same-sex couple and not married or in a civil partnership, the donor will be considered a legal parent of any children born, in addition to the birth mother.
If you want to use donor insemination, it is always safer to have treatment using sperm from a regulated sperm bank and a licensed fertility clinic.
How successful is donor insemination?
Success rates vary depending on age, ovarian function and fertility health. Just as with natural conception, it can take several cycles to conceive.
How much does donor insemination cost?
On the face of it, donor insemination at home may appear to cost very little. However, the potential risks and subsequent costs that can arise greatly outweigh any initial cost savings compared to using a licensed fertility clinic. Donor insemination costs vary between clinics but can range from £1500 to £2500 per cycle.
IUI with donor sperm
Intrauterine insemination (IUI) with donor sperm is a fertility treatment where donor sperm is placed directly into the uterus (rather than the vagina) around the time of ovulation. This type of donor insemination, which increases the chance of an egg being fertilised can only be performed at licensed clinics.
IUI treatment can be stimulated, where fertility medications are used to encourage the ovaries to produce more eggs, or unstimulated, where the body does more on its own and treatment is timed according to natural ovulation.
Who is IUI with donor sperm suitable for?
IUI with donor sperm is often chosen by couples with no known female fertility issues who want to use donor sperm in a clinical, regulated setting.
If you have fertility issues such as low ovarian reserve or egg quality, blocked fallopian tubes, or severe endometriosis, IUI may not be suitable. It may also not be recommended if you’re in your late 30s or early 40s due to the decreasing likelihood of success as the number and quality of eggs you have naturally declines with age.
How safe is IUI with donor sperm?
Generally, IUI is a very safe procedure. The biggest risk of IUI is a multiple pregnancy occurring. Carrying more than one baby means they are more likely to be premature, have a low birth weight or be stillborn. Since a multiple pregnancy is more likely when undergoing a medicated cycle due to the higher chance of more than one egg being ovulated, monitoring is necessary.
How successful is IUI with donor sperm?
IUI with donor sperm success rates can vary for several reasons as mentioned above. Many people require multiple IUI cycles to conceive. At London Sperm Bank, our IUI with donor sperm live birth rates per cycle are:
- 20% for women under 35
- 14% for women aged 35-37
- 13% for women aged 38-39
(Data from 1782 cycles from 2019–2022, verified against HFEA records.)
How much is IUI with donor sperm?
You can expect to pay between £800 and £1,600 per cycle, not including the cost of any fertility medications or donor sperm.
At London Sperm Bank, we have different sperm sample types, specifically for different fertility treatments. Our IUI donor sperm is processed for treatment and costs £1630 per vial. We also offer ICI donor sperm, which is unprocessed and ideal for clinics that wish to wash the sperm in-house. This costs £1450 per vial.
IVF with donor sperm
In vitro fertilisation (IVF) involves fertilising an egg with donor sperm in a lab and transferring the resulting embryo into the uterus. IVF offers more control over the process, including selecting the best quality embryos and the ability to store embryos for future use.
Who is IVF with donor sperm suitable for?
IVF may be recommended as a fertility treatment for same-sex couples with fertility challenges (such as low ovarian reserve or damaged fallopian tubes), for those who have tried IUI without success, or when there is a need for genetic testing.
How safe is IVF with donor sperm?
IVF is a very safe fertility treatment, and most people who undergo IVF encounter no problems with their health or pregnancy. However, there are some risks to be aware of:
- Ovarian hyperstimulation syndrome (OHSS) which is a severe reaction to the fertility medications used in IVF treatment
- Multiple pregnancy if more than one embryo is transferred.
- Low risks of complications from the egg retrieval procedure.
How successful is IVF with donor sperm?
IVF is one of the most successful forms of fertility treatment and is typically three times more successful than IUI. As with any type of treatment, success rates can vary because of multiple factors, but at London Sperm Bank, our live birth rates for IVF cycles using donor sperm are:
- 47% for women under 35
- 36% for women aged 35-37
- 27% for women aged 38-39
(Data from 598 cycles between 2019 and 2022, verified against HFEA records.)
How much does IVF with donor sperm cost?
IVF is more expensive than IUI, with one cycle costing an average of £5,000, excluding donor sperm, medication and embryo storage fees. The cost of IVF-suitable sperm from London Sperm Bank is £1250 per vial.
Reciprocal IVF
Also known as shared motherhood, reciprocal IVF allows both partners in a same-sex female couple to play a biological role. One partner provides the eggs, and the other carries the pregnancy. It’s a powerful way for both people to be physically involved in creating a baby.
Who is reciprocal IVF suitable for?
Reciprocal IVF is a suitable fertility treatment for same-sex couples where both partners want a biological connection to the child, or where one partner has stronger fertility potential but the other wants to carry the pregnancy.
How safe is reciprocal IVF?
The risks are similar to standard IVF. Some medical screening is necessary, and counselling is offered to help couples prepare.
How successful is reciprocal IVF?
As with any fertility treatment, your chances of success with reciprocal IVF are based on factors such as age and general health, although they are generally comparable to standard IVF success rates.
How much does reciprocal IVF with donor sperm cost?
The cost for reciprocal IVF can vary significantly between clinics, but it does tend to be more expensive than standard IVF with donor sperm. This is because, as both partners are involved, additional testing, medication and appointments are generally required.
Who will be the legal parent?
In the UK, the partner who gives birth to a child will always be their legal mother. This is still the case in reciprocal IVF, where the other partner’s eggs are used.
If the legal mother is married or in a civil partnership, their partner will automatically be the other legal parent when the child is born. However, if you aren’t married or in a civil partnership, the non-carrying partner will not automatically be the other legal parent. For this to be the case, you will both need to consent before treatment begins.
Choosing the right path for you
Every couple is unique, and there’s no single ‘right’ way to grow your family. Here are a few things to consider when deciding which route to take:
- Health and fertility: Fertility testing for both partners can provide useful insights before committing to treatment and help manage your expectations.
- Emotional preferences: Talking openly with one another about considerations such as whether you want a biological connection or wish to carry the pregnancy can help you make your choice.
- Budget: IVF and reciprocal IVF are significantly more expensive than IUI, but IUI can take multiple cycles to achieve a pregnancy.
- Time: How quickly do you want to try to conceive? Some treatments take longer or may require more than one cycle, and age can be a significant factor for success.
Regardless of which path you take, finding a sperm donor is going to be an important component of fertility treatment for lesbian couples. Find out more about sperm donation for lesbian couples, including how to choose donor sperm, the donor sperm ordering process and using London Sperm Bank’s donor catalogue.