Breaking Barriers: How LGBTQI+ Families Are Thriving Through Assisted Reproductive Technologies

Medically Reviewed by Dr. Silvana Chedid on September 9, 2026

LGBTQI+ individuals and couples today have more paths to parenthood than at any point in the history of reproductive medicine. Depending on individual circumstances, options can include intrauterine insemination, in vitro fertilization, reciprocal IVF, donor eggs or donor sperm, gestational surrogacy, and fertility preservation for transgender, nonbinary, and intersex patients planning a family before or during medical care that may affect fertility. The right combination depends on each person’s or couple’s anatomy, relationship structure, and family-building goals, and a fertility specialist can help map out which pathway fits best.

At Chedid Grieco, our LGBTQI+ family-building program combines decades of experience in reproductive medicine with inclusive, judgment-free care. Every patient works with a team that takes time to understand their specific goals, whether that means using donor gametes, coordinating with a gestational carrier, or preserving fertility ahead of gender-affirming care. This article looks at the full range of LGBTQI+ family building, including the transgender, nonbinary, intersex, and legal questions that a couple-focused overview often leaves out.

What Are the Family-Building Options for LGBTQI+ Individuals and Couples?

Assisted reproductive technologies offer multiple pathways to parenthood, and identifying the right combination of fertility treatments starts with understanding what each option involves. The most common approaches include intrauterine insemination (IUI), in vitro fertilization (IVF), and egg or sperm donation, each tailored to a patient’s specific anatomy and goals.

For couples where both partners have a uterus, IUI with donor sperm often serves as a first step, allowing one or both partners the chance to carry a pregnancy. IVF may be recommended when IUI has not been successful, or when a couple wants to use one partner’s eggs while the other partner carries the pregnancy. Couples where neither partner can carry a pregnancy typically need both an egg donor and a gestational carrier, while transgender and nonbinary individuals may pursue different combinations of these treatments depending on their anatomy, any hormone therapy, and their family-building timeline. For a closer look at the options couples most often weigh, see our guide to fertility options for same-sex couples.

Key treatment options for LGBTQI+ family building include the following:

• Intrauterine insemination with donor sperm for a less invasive first-line approach
• IVF using partner or donor eggs, which allows flexibility in family-planning decisions
• Comprehensive egg donation programs with a range of donor options
• Gestational surrogacy coordinated with experienced agencies and legal teams
• Fertility preservation for transgender, nonbinary, and intersex individuals before or during medical treatment

Our multilingual team, fluent in English, Portuguese, Spanish, and French, works to make sure language is never a barrier to receiving clear information and compassionate care.

Reciprocal IVF and Other Pathways for Same-Sex Couples

One option that female same-sex couples ask about often is reciprocal IVF, sometimes called co-maternity IVF. In this approach, one partner provides the eggs, which are fertilized and transferred as embryos into the other partner’s uterus, so both partners can take part in the physical experience of pregnancy in different ways. Reciprocal IVF is not medically necessary in the way IVF may be for a couple facing infertility, but many couples choose it because it allows both partners a biological and physical connection to the pregnancy.

Male same-sex couples generally build their families through a combination of donor eggs, IVF, and gestational surrogacy, since neither partner can carry a pregnancy. This path involves more coordination, including legal agreements with a gestational carrier and screening through the egg donation program used for the cycle. Our team helps intended parents understand each step, from donor and carrier matching through embryo transfer, so the process feels less overwhelming. Couples comparing this route in detail can read our article on surrogacy and egg donation for same-sex male couples in Brazil.

Egg Donation and Its Role in LGBTQI+ Family Building

Egg donation plays a particularly important role in helping many LGBTQI+ families reach their goals. Male same-sex couples rely on egg donors to provide the genetic material needed for pregnancy, and some female couples choose donor eggs if one partner has a fertility diagnosis that makes using her own eggs less likely to succeed, or simply because they prefer that option.

Our clinic maintains a donor database with a range of donor profiles, allowing intended parents to find a match that fits their preferences. As an FDA-registered tissue establishment with New York State tissue bank licensing, we hold donor screening and egg handling to rigorous safety and quality standards, and our team provides counseling throughout the process so intended parents understand each step before moving forward. In Brazil, egg donation follows the Federal Council of Medicine’s rules, which we explain in our overview of what Brazil’s CFM resolution means for egg donors and recipients.

Fertility Preservation for Transgender and Nonbinary Individuals

Gender-affirming hormone therapy and some surgical procedures can affect future fertility, which is why many transgender and nonbinary patients choose to pursue fertility preservation before starting treatment. For people who produce sperm, this typically means banking sperm before beginning estrogen or other feminizing hormone therapy. For people who produce eggs, this can mean freezing eggs or embryos before testosterone therapy begins, since testosterone can affect ovarian function over time, though its effects on fertility are not considered permanent for everyone.

Because timing matters, we encourage transgender and nonbinary patients to speak with a fertility specialist as early as possible in their transition planning, ideally before starting hormone therapy. Some patients who are already on hormone therapy can still preserve fertility, sometimes after a planned pause coordinated with the clinician who manages their gender-affirming care, and that decision should always be made together rather than by the fertility team alone. Preserved eggs, sperm, or embryos can later be used with a partner, a gestational carrier, or through IUI consultations and IVF cycles, depending on what family-building path a patient chooses down the road.

Fertility Planning for Intersex Patients

Intersex is an umbrella term for many different variations in sex characteristics, and fertility potential varies widely from one variation to another. Some intersex people produce eggs or sperm and may be candidates for the same treatments described above, while others may not have viable gametes and may build a family through donor eggs, donor sperm, donor embryos, a gestational carrier, or adoption. Because the picture is so individual, general statistics are rarely useful, and a careful review of a patient’s medical history and any previous surgeries or hormone treatment is the place to start.

When a medical team is considering surgery or hormone treatment that could affect fertility, a conversation about fertility preservation beforehand can keep options open. Our role is to explain what is realistic for each patient, respect their own language for their body and identity, and coordinate with the other clinicians involved in their care.

Legal Parentage Considerations for LGBTQI+ Families

Medical treatment is only one part of building a family. Parentage law varies by country and, in the United States, by state, and it can affect couples who use donor gametes, reciprocal IVF, or a gestational carrier. Even when both parents’ names appear on a birth certificate, many family law attorneys recommend a court-issued parentage judgment or confirmatory adoption so that both parents’ legal relationship to the child is recognized if the family later moves or travels. Families who conceive abroad and return to the United States also need to plan for documentation and, in some cases, citizenship paperwork for the child.

We are not a law firm and cannot give legal advice, but we strongly encourage intended parents to consult an attorney who focuses on assisted reproduction before treatment begins. Our article on why a reproductive attorney matters during fertility treatment explains what that conversation typically covers.

What Research Shows About Outcomes for LGBTQI+ Family Building

Research and clinical guidance increasingly support equitable access to fertility care regardless of relationship status, sexual orientation, or gender identity. The American Society for Reproductive Medicine has stated that fertility services should be available to individuals and couples regardless of marital status, sexual orientation, or gender identity, and in 2023 the society broadened its definition of infertility to include people who need donor gametes or other medical help to build a family, whether they are single or partnered.

Outcomes for LGBTQI+ patients pursuing IUI, IVF, egg donation, or gestational surrogacy generally track with the same factors that affect any fertility patient: age, ovarian reserve, sperm quality, and the underlying reason for treatment. When donor eggs are used, the donor’s age and health typically matter more than the recipient’s. Because success is never guaranteed and can vary significantly from person to person, we focus on setting realistic expectations from the first consultation and adjusting a treatment plan as needed based on how each cycle responds.

How Chedid Grieco Supports LGBTQI+ Family Building

Building a family as an LGBTQI+ individual or couple can involve more logistical and legal coordination than traditional conception, from donor selection to gestational carrier agreements to fertility preservation timing. Our team works to simplify that process by coordinating directly with donor banks, legal teams, and, when relevant, a patient’s other medical providers, so families are not left to manage every detail on their own.

We also recognize that inclusive care goes beyond the treatments themselves. That means using a patient’s correct name and pronouns, avoiding assumptions about family structure, and building a treatment plan around each patient’s actual goals rather than a one-size-fits-all protocol. Our years of experience with a range of family structures, including same-sex couples, has shaped how we train our staff and structure our consultations.

Building Your Family With Chedid Grieco

Dr. Silvana Chedid and the Chedid Grieco team bring decades of combined experience in reproductive medicine, FDA registration and New York State tissue bank licensing, and a multilingual, judgment-free approach to every consultation. Our team has worked with individuals and couples across a wide range of family structures and has helped coordinate donor selection, gestational surrogacy, and fertility preservation for LGBTQI+ patients pursuing many different paths to parenthood.

If you are exploring your options for LGBTQI+ family building, whether that means IUI, IVF, donor eggs, gestational surrogacy, or fertility preservation ahead of medical treatment, our team can walk you through what each path involves for your specific situation. Consultations are held in Miami, with treatment provided at our facility in Brazil through our fertility tourism program. Reach out through our contact form to schedule a consultation.

Frequently Asked Questions About LGBTQI+ Family Building