Lesbians who want to get pregnant have a number of options depending on their budget, health, fertility preferences, and personal values. The process often begins with a consultation with a doctor or fertility specialist since this can help with narrowing down options.

In this article, we will provide a list of lesbian pregnancy options and note some factors people may want to consider.

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Lesbians can use all of the same paths to pregnancy and parenthood that different-sex couples can. But those who wish to avoid sex with a person with a penis may need to use assisted reproductive technologies (ART) such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

These procedures may be an option for lesbian couples who have already undergone various fertility treatment options but are not yet pregnant. People should consider discussing options with a healthcare professional and may need to consult with a knowledgeable reproductive specialist.

The Centers for Disease Control and Prevention (CDC) provide an interactive map that allows people to locate fertility clinics near them in the United States. People can use this to learn about what services they provide, the types of patients they see, and their success rates.

Regardless of the specific path a lesbian couple chooses to take to parenthood, if one partner wants to become pregnant without having sex with a person who has a penis, the couple will need to use a sperm donor.

There are many options for doing this. The couple could ask someone they know to donate sperm. Or they can purchase sperm from a sperm bank, usually with the assistance of a fertility clinic.

Lesbians who use donor sperm can perform the insemination themselves or pursue insemination options at a fertility clinic.

Some lesbian couples may opt to use the egg of one partner and the uterus of the other, which requires the help of a fertility clinic. But if one partner intends to use both their egg and their uterus, it is often possible to get pregnant without specialist help.

About 6% of married heterosexual women under 45 years old cannot get pregnant after a year of trying. It is likely that a similar number of lesbian women have fertility issues.

Some fertility treatments, such as using medication to induce ovulation, can increase the odds of successfully getting pregnant without additional intervention. Others, such as IVF, require the ongoing assistance of a fertility doctor.

Intrauterine insemination (IUI)

IUI is a type of artificial insemination during which a doctor inserts sperm directly into the cervix or uterus, mimicking the process of fertilization that may occur during penile-vaginal intercourse.

If a couple uses donor sperm, the sperm will be pre-washed and prepared.

In some cases, the person undergoing insemination may take medication to increase the odds of pregnancy. Even without such medication, a doctor will use various monitoring techniques to pinpoint ovulation to ensure the timing is right.

In vitro fertilization (IVF)

IVF is a more complicated technique, in which a doctor fertilizes the egg outside of the body. It requires the doctor to remove eggs from the body first, then fertilize them, then wait for them to grow into embryos. At that time, the doctor implants them back into the uterus.

In most cases, IVF requires about a month of preparation, during which the partner who will be carrying the pregnancy takes various drugs to prepare the body for pregnancy and induce ovulation. The partner whose eggs the couple uses will need to undergo a separate procedure to remove the eggs.

Lesbian couples can choose to undergo reciprocal, or partner IVF. In this scenario, one partner donates eggs that a doctor transfers into the other partner’s uterus.

A lesbian can choose to have sex with a male partner if they are comfortable doing so, attracted to men, or the couple’s budget is very limited. The success of this depends on the timing of intercourse, as well as the fertility of both sexual partners.

Sex with a partner with a penis may have significant legal complications since the man may have a right to claim the child as his own.

Couples who use IVF sometimes end up with extra embryos they do not use. Some allow third parties to “adopt” these embryos.

This can save some time and money and may also be a good option if neither partner ovulates regularly or if both have other fertility complications. A doctor can then implant the embryos directly into the uterus of the partner who wishes to become pregnant.

Lesbian couples do not have to become pregnant to become parents. They may wish to consider other options such as:

Co-parenting

Lesbians can co-parent one another’s children. For example, a person who has children from a prior relationship may opt to raise them with their new partner.

In some cases, such as if the prior partner renounces their parental rights, the new partner may even adopt the child or children.

Fostering or adoption

Lesbian couples can sign up to be foster parents, either on a temporary basis or with the intention of adopting. Some couples opt to foster children they know, while many enter the foster care system.

Similarly, it may be possible to adopt a child. This could be a child the couple knows who needs a home, such as the orphan of a relative, or by seeking help from an adoption agency.

A popular myth suggests that children need two parents of different sexes. But numerous studies suggest children can thrive in many environments, and there is no evidence that children of lesbians fare worse than other children.

In fact, some research suggests they may actually do better on some measures of well-being.

For example, a 2020 analysis found that children raised by same-sex parents did better in school than peers raised by different-sex parents. A 2016 study found that children of same-sex parents are similarly well-adjusted with similar social skills to children raised by different-sex parents.

Lesbian couples may also have a more equitable distribution of household labor, distributing the load of parenting more evenly.

Lesbian couples may also face some challenges. They include:

  • Stigma and discrimination: Lesbian couples may face heterosexism discrimination, making the transition to parenthood more stressful.
  • Lack of social support: Some lesbians report less social support, especially if their families of origin reject them because of their sexual orientation.
  • Cost: In most cases, lesbian pregnancies incur significant costs, especially when using ART. A 2016 study estimates the average cost of ART in 2012 to be $28,829 per singleton pregnancy. Even when the cost of ART is minimal, lesbians may need to work with lawyers to ensure they are both legal parents of the child.
  • Legal concerns: While same-sex marriage has reduced some legal hurdles, some states continue to enact laws that may make it more difficult for two lesbian parents to claim their child, especially if the couple is not married.
  • Medical issues: Pregnancies that use ART, especially IVF, have higher rates of complications such as preterm labor, gestational diabetes, and pregnancy loss. But this may be partially due to the fact that people who use ART are more likely to have infertility and related health problems.
  • Provider issues: Some lesbian couples may struggle to find non-heterosexist providers, either when trying to become pregnant or for their prenatal care.
  • Emotional concerns: Some couples may struggle emotionally with the challenges of lesbian parenting, such as the fact that both parents cannot be a genetic/biological parent, or the rigors of ART.

Lesbian couples, and other members of LGBTQIA+ communities, have many options for becoming parents.

There are many fertility treatments available, such as IUI and IVF, which can help the couple become pregnant. Many reproductive clinics have significant experience supporting lesbian couples on their journey to pregnancy.

Additionally, some couples may instead opt to become parents without pregnancy and consider options such as co-parenting, adopting, or fostering children.