For the last installment of our Let’s Have a Baby series, we’ll be talking about Assisted Reproductive Technology (ART). Assisted Reproductive Technology as we know it was first successful in 1978, when Dr. Patrick Steptoe and Dr. Robert Edwards implanted a fertilized egg into Leslie Brown, impregnating her and allowing her to have a child after almost a decade of infertility. 

Fertility treatments were originally the answer to the infertility of a heterosexual couple, but have since become a mainstay in LGBTQ family planning. Being able to become pregnant without heterosexual sex means queer individuals and couples have the agency to grow their own biological families.

Read More: Queer Family Planning: An Introductory Guide

Fertility Treatments for LGBTQ Folks

Of course, as with other methods of LGBTQ Family Planning, ART is not without its politically charged hurdles. The biggest issue is with what insurance companies define as “infertility” that qualifies for coverage. Most carriers don’t cover surrogacy, but will potentially cover egg donation and fertilization if a couple can show they’ve been unable to conceive through sexual intercourse for at least a year. In the case of same-sex Chicago couple Adam Motz and Amadou “Tee” Lam, that method would be completely impossible. In fact, male sex-same couples are often the ones left out of any kind of reproductive coverage and therefore tend to pay the most to grow their family. 

Another issue can be the fertility clinics’ lack of knowledge when working with queer families. Some fertility clinics don’t understand or support reciprocal IVF, where one partner donates the egg while the other carries it to term. Many others don’t have the proper training to work with trans people, making the experience uncomfortable and invalidating. Currently, a movement for “fertility equality” has been gaining ground for the past decade, with a recent win regarding the legalization of surrogacy in New York. Ultimately, activists want fertility and family planning to be accessible to everyone regardless of wealth, sexuality, gender or biology. 

While the news isn’t particularly encouraging, we want to assure you that many LGBTQ families have found a way to bring new family members into their life through IUI or IVF. There is a supportive LGBTQ community of parents and parents-to-be out there sharing stories, tips, and recommendations as well a ton of great LGBTQ family podcasts that will make the future a bit brighter. With that being said, let’s move on to the nitty-gritty, i.e. the finances!

Types of Fertility Treatments (and Costs)

First, let’s break down the two primary types of Assisted Reproductive Technology used for Family Planning. 

Intrauterine Insemination (IUI) or Artificial Insemination: Intrauterine Insemination is the process through which donor sperm are inserted into the uterus. IUI is the simplest way for female same-sex couples to have a baby. The cost includes donor sperm and the procedure itself and averages about $300 to $1,000 on average per cycle (but could be up to $4k) plus the donor sperm. You should typically plan for three cycles of IUI or more. If you’re able to use insurance, you’ll want to ask if there’s a minimum amount of IUI cycles required before insurance will cover IVF in case the embryos do not implant or there are miscarriages. The price range for IUI could be somewhere from $1,000 to $15,000 to get pregnant. 

In-Vitro Fertilization (IVF):  IVF is the process of creating an embryo in a laboratory and then transferring it to the carrier. The most common fertility option for same-sex parents who are both males is in vitro fertilization (IVF) with a surrogate or gestational carrier. This is a more expensive and lengthy process. The average cost of an IVF cycle is $20,000. But there are potentially additional costs including donor sperm or if there needs to be more than one attempt. 

For more helpful definitions about family formation via pregnancy, check out this comprehensive glossary from Family Equality. 

Financial Considerations of Assisted Reproductive Technology 

• Budget Considerations: When planning a budget for ART, come up with a total end-to-end budget of what is likely. Plan for the high and low ends of your budget range. Do you understand what your options are and the cost of seeing the entire process through? Make sure you think about multiple attempts at getting pregnant. See what you’re willing and able to financially (and emotionally) accommodate. 
• Insurance Considerations: As we talked about above, typically insurance won’t cover fertility treatments unless you’re diagnosed with infertility, which for same-sex couples is not the cause. When you have to foot the bill on your own, you’ll have to create an optimal plan ahead of time to pay for fertility treatments. Also, look into whether or not switching to an HSA plan makes sense for you. 
• Tax Considerations: Unlike fertility treatments for surrogacy, costs of fertility treatments are deductible medical expenses. Talk to your financial advisor about how you can take advantage of this benefit. 

Surprisingly, even though LGBTQ families use fertility treatments to grow their families, they still make up the minority. LGBTQ people make up 5 to 10% of fertility clinic patients, while queer couples are only a third of donor-sperm users. But even though the current culture and numbers aren’t exactly uplifting, we are seeing progress. More options than ever before exist for LGBTQ individuals and couples to use fertility treatments for family planning. As with any family planning avenue, choose well-vetted, LGBTQ-friendly organizations, agencies, clinics, attorneys, and advisors who will help you realize your dream of a family while validating your lifestyle.