Routes to parenthood: using a fertility clinic

For LGBT people who have a uterus, using a registered fertility clinic may be the most reliable method of conceiving. Using a clinic will give you access to screened, anonymous sperm and will ensure that you’re inseminated with it when you’re ovulating. Using a clinic also means you will be screened for any fertility problems and given appropriate treatment so you are most likely to conceive. However, using a fertility clinic is expensive – even the initial appointments are likely to cost several hundred pounds. You are unlikely to be able to access a clinic on the NHS unless you have already been trying to conceive unsuccessfully or have a previously proven fertility issue.

Trans people may use a fertility clinic to conceive a child using sperm or eggs which were stored before they started hormone therapy or before they had surgery. Click here for more information on gamete storage and other considerations for prospective trans parents.

Accessing a clinic

There are two routes to accessing a fertility clinic – contacting the clinic directly as a private client and getting a referral from your GP. You can find a list of all licenced UK fertility clinics by clicking here. If you are looking for a fertility clinic it’s a good idea to call around your local clinics to see what they offer and also taking recommendations from others who have already sought treatment. The Fertility Friends website has discussion forums on a range of issues, including information about fertility clinics.

In the past, there was a legal duty on fertility clinics to ‘consider a child’s need for a father’, which lead some clinics to turn away same-sex couples and single women. This was changed in 2009 and clinics now must ‘consider a child’s need for supportive parenting’. Discrimination on the grounds of sexual orientation or gender identity is illegal under the Equality Act – if you feel you’ve been discriminated against in this way you should seek legal advice

In 2013 NICE issued guidance on who can access fertility treatment through the NHS. This guidance isn’t binding so you’ll need to check with your local CCG what they cover. The NICE guidance states that couples must attempt to conceive before being considered for NHS treatment. 

Female same-sex couples must attempt to conceive six times through artificial insemination before they could be referred for fertility treatment. The guidance does not stipulate whether these attempts need to be made through a licenced clinic or whether self-insemination at home counts, though many CCGs will only fund treatment if you have first tried to conceive at a fertility clinic, meaning you would need to pay for artificial insemination before you are eligible for NHS treatment. Click here to read Stonewall’s guidance on NHS fertility treatment. There is currently no guidance on access to fertility treatment for trans people on the NHS – click here for more information on conception for trans people.

Legal recognition

If you are planning to parent as a female couple who both want to be recognised as parents of the child, both partners can be named on the birth certificate if you conceive using a registered clinic. Unlike for couples conceiving at home, you do not need to be married or civil partnered to each other for this to happen, as long as you both agree to being named as parents and your clinic completes the correct paperwork.   

It’s a good idea to get some legal advice to ensure you have considered all the legal implications before you start to try to conceive. LGBT Foundation, in association with O’Neill Patient Solicitors, offers free legal advice surgeries twice a month – click here for more information.

Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF)

There are various treatments available at a fertility clinic, but the two most common routes to conception are Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF). 

IUI consists of injecting specially processed sperm through the cervix directly into the uterus. The injection is timed to coincide with your ovulation. Sometimes you will also be given drugs to stimulate ovulation. The sperm used can be from a known or anonymous donor but if you are using sperm from a known donor (such as a friend) the clinic will have to hold this sperm for several months to ensure that the donor is free from STIs. If you are using sperm from an anonymous donor and would like more than one child you may be able to reserve some of the sperm for future use. 

For IVF treatment you will receive drugs to stimulate increased ovulation. The eggs you produce will then be extracted from you and fertilised in the laboratory. As with IUI, you can use sperm from either an anonymous or known donor. The fertilised eggs are then allowed to develop for several days before up to three of them are implanted directly into the uterus.  

IVF is preferred by some women, as it greatly increases your chances of getting pregnant, particularly if you have a known fertility issue. Through IVF it is also possible for the fertilised egg from one woman to be implanted into the uterus of another – this is an option preferred by some same-sex female couples as it gives both women a connection to the child. However, IVF is expensive (just one cycle of IVF typically costs about £5,000) and is also a comparably invasive procedure. You may be able to access IVF and other fertility treatment at a reduced cost if you agree to donate eggs for other women to use. 

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