More often, gay and lesbian individuals and couples are using egg donation, sperm donation and surrogacy to help them have a biological family. 

For gay men with no fertility issues, the road to biological parenthood will lead them to a surrogate: A surrogate is a woman, sometimes called a carrier, who carries  and gives birth to a baby for another individual or couple. In traditional surrogacy the carrier's eggs are used; in gestational surrogacy donor eggs are used. Most  surrogacy arrangements today are gestational surrogacy.

For lesbians with no infertility issues, biological parenthood is achieved with donor insemination. Donor sperm can be obtained from a sperm bank or from a "known  donor" such as a friend. There are a few different insemination options: vaginal insemination, which can be done at home, or intracervical or intrauterine insemination (IUI), which is typically done in a doctor's office.

Not all physicians, fertility clinics, attorneys or agencies work with same-sex couples or singles. It's important to find professionals who are knowledgeable and  sensitive to your specific situation or needs. 

The Surrogacy Process for Gay Couples

The process that you will go through to have a surrogate child is extensive. But once you hold your baby in your arms for the first time, you will know it was  completely worth every headache, doubt, fear or hoops you had to jump through! 

1. You may start by finding either an in vitro fertilization (IVF) clinic or a surrogacy agency that you like and works with gay men/couples. IVF clinics and surrogacy  agencies work closely together and will often be able to refer you back and forth to each other. However, many people start with surrogacy agencies. Either way,  make sure your questions and concerns are adequately addressed.
2. Review the overall timeline and processes of in vitro fertilization (IVF) and surrogacy, as well as your agency's or clinic's costs, policies and procedures. 
3. If you are a couple, decide who will provide the sperm. One partner may provide all the sperm or a couple may choose to divide the eggs and have half fertilized  by each partner. In this case, one embryo from each partner would be implanted into the gestational carrier. Anyone providing sperm will need a physical exam,  medical history and sperm analysis.
4. Find a surrogate through your surrogacy agency or fertility clinic. Or, the surrogate may be someone you know.
5. Find an egg donor. Some people choose to use family members or friends as egg donors; other people choose to work through their agency or fertility clinic, which  usually can pair an egg donor with you and your surrogate. You may choose traditional surrogacy, where the woman is both egg donor and surrogate and artificial  insemination (as opposed to IVF) is used. The egg donor may be anonymous. In that case, all communication would be through the agency or clinic. In gestational  surrogacy a donor egg is used.
6. Once you select a surrogate, you will meet with an attorney and draw up a contract. Once the contract has been signed, funds are provided to the surrogate for  her expenses and fees, often through a trust account. It is critical that you choose an attorney with experience with surrogacy. Most surrogacy agencies will be able  to assist you with this. You should also draw up legal contracts with the egg donor, whether she is a known donor or anonymous donor.
7. If you have not already, select an IVF clinic to work with.
8. Collect the egg donor's and gestational surrogate's medical records and provide them to the IVF clinic. Again, most surrogacy agencies will help facilitate this type of information transfer.
9. Prior to IVF, you and the surrogate as well as any other relevant parties (such as the surrogate's partner) will undergo some type of counseling, often through the  surrogacy agency or IVF clinic, as well as sign consent forms and review the process as a group.
10. The egg donor and the surrogate will take oral contraceptives followed by hormones to synchronize their menstrual cycles and prepare their bodies for egg  donation/embryo implantation.
11. Six to nine weeks later the eggs will be retrieved from the egg donor, fertilized in the laboratory and implanted in the surrogate.
12. Fifteen days after egg retrieval, the surrogate will have a blood test to check for pregnancy.
13. Three weeks after the first positive blood test, a pregnancy ultrasound to confirm pregnancy will be done. If the surrogate is not receiving care at the clinic, the  surrogate will sign a consent form so her records can be transferred to her obstetrician, where her care will continue.
14. The surrogate will have ongoing prenatal care at her own obstetrician. You can negotiate with the surrogate how much you will participate in this. 
15. Birth of the baby!
    
    

Surrogacy Tips for Gay Men or Gay Couples

Surrogacy is an option for gay men who wish to have a biological connection to their child. In a gestational surrogacy arrangement, one or more embryos would be  created in an IVF cycle using donor eggs and the individual's or couple's sperm. 

If you are planning on having more than one child, you may decide that one partner is the biological parent in the first pregnancy and the other partner is in the next  pregnancy. Some couples choose to fertilize donor eggs with sperm from both partners, and embryos from both partners are implanted. A genetic test can determine  the biological father. Other couples use donor eggs from the relative of one partner and sperm from the other partner, so each has a biological connection to the child.

It's important to work with an agency or attorney who is well versed in surrogacy laws and has experience and knowledge in working with gay couples. State laws  regarding surrogacy vary, and 11 states and the District of Columbia prohibit surrogacy in one form or another. 

To find out more about state surrogacy laws, check www.creativefamilyconnections.com. If you are a couple, decide who will provide the sperm. One partner may provide all the sperm or a couple may choose to divide the eggs and have half fertilized by each partner. In this case, one embryo from each partner would be  implanted into the gestational carrier. Anyone providing the sperm will need a physical exam, medical history and sperm analysis. 

Donor Insemination for Lesbians or Lesbian Couples

Donor insemination is an option for lesbian women or couples who wish to have a biological connection to their child. You may use an anonymous sperm donor  through a sperm bank or fertility center, or a known donor who may be a friend or relative.

The type of insemination you'll use will be based on a number of factors, including personal preference, cost, and fertility potential. Types of insemination include:

• Intravaginal insemination (IVI). Unwashed sperm is placed into the vagina around the time of ovulation using a syringe or cervical cap. IVI can be done in a  physician's office or at home.
• Intracervical insemination (ICI). Washed or unwashed sperm is placed in the cervix using a thin catheter and a syringe which pushes the sperm through the  catheter. ICI is done in a physician's office.
• Intrauterine insemination (IUI). Washed sperm is placed in the uterus with a thin catheter that is passed through the cervix. IUI is performed in a physician's  office.

Your physician will recommend that you have a medical screening prior to trying to conceive. If you have a partner, the decision of who will carry the pregnancy may  be based on age and medical conditions. 

A consultation with an attorney specializing in reproductive matters, preferably one who has experience and knowledge working with same sex parents, is  recommended. She/he can help with any necessary documentation regarding legal status as parents or define the role of a known sperm donor.