Understanding the goal
Every LGBTQ+ family's path looks a little different, shaped by your relationship structure, whose biology is involved, and what matters most to each partner about the experience of conception and pregnancy. Our first job is to listen to what you want out of this process, not just medically but personally, and then map the medical options that fit.
Whether you are a female couple exploring reciprocal IVF, a male couple building your family through donor eggs and a gestational carrier, a transgender or nonbinary patient wanting to preserve fertility before beginning hormone therapy, or an individual or couple using donor sperm or eggs, we build a plan grounded in your specific biology, family-building goals, timeline, and values.
What we evaluate first
Before recommending a specific pathway, we gather the information needed to identify every viable route to parenthood available to you.
- Ovarian reserve and uterine evaluation for any partner who may provide eggs or carry a pregnancy
- Semen analysis for each intended parent or known donor who may provide sperm
- Hormone therapy history and its impact on current fertility, if applicable
- Genetic carrier screening for intended parents, including intended fathers providing sperm, and for donors
- For male couples, family-building goals regarding whether one or both intended fathers would like to contribute sperm, along with egg donor and gestational carrier considerations
- Legal parentage status and current relationship or partnership documentation
How the plan is built
Once we understand your goals and baseline fertility, we design a pathway that may combine donor gametes, reciprocal roles, gestational carrier care, or fertility preservation, depending on your circumstances.
Choosing Your Path: Reciprocal IVF, Donor Options, and Gestational Carrier Care
In reciprocal IVF, one partner's eggs are retrieved and fertilized, and the resulting embryo is transferred into the other partner's uterus, allowing both partners a biological and physical connection to the pregnancy. For couples or individuals needing donor sperm or eggs, we help you weigh known donors against accredited sperm banks or egg donor agencies, each with different legal, medical, and relational considerations that we walk through in detail. When no intended parent will carry the pregnancy, care is coordinated with a gestational carrier.
For Male Couples: Donor Eggs, IVF, and Gestational Carrier Care
For male couples, family building typically involves an egg donor, IVF, and a gestational carrier. We begin by evaluating the sperm of each intended father who may contribute genetically, reviewing carrier screening, and discussing your preferences for egg donation and future family size.
If both intended fathers would like the opportunity for a genetic connection to their children, donor eggs may be divided so that a portion is fertilized with sperm from each partner, creating separate groups of embryos. Dr. Ghadir will discuss the available options with you and develop an individualized embryo and family-building plan based on your goals.
Once embryos are created, care is coordinated with a gestational carrier for embryo transfer. Egg donor selection, medical screening, embryo creation, gestational carrier screening, and appropriate legal coordination are all important parts of this process.
Fertility preservation for transgender and nonbinary patients
For transgender and nonbinary patients, we recommend a fertility consultation before starting hormone therapy or pursuing gender-affirming surgery, since these treatments can affect future fertility. Egg or sperm freezing prior to treatment preserves the option of biological parenthood later, on your own timeline, without requiring you to pause or delay your transition.
Success factors and honest expectations
Success in any of these pathways depends primarily on the age and reserve of whoever's eggs are used, sperm quality, and uterine receptivity of whoever carries the pregnancy, the same factors that apply broadly in reproductive medicine. Using a donor does not change these fundamentals; it simply changes whose biology is being evaluated.
For male couples using donor eggs and a gestational carrier, outcomes are influenced by factors including egg donor age and egg quality, sperm parameters, embryo development, and gestational carrier considerations. Dr. Ghadir evaluates each component individually and builds the treatment plan around the intended parents' overall family-building goals.
We are transparent about probabilities at each step, including the difference between IUI and IVF success rates, so you can choose the pathway that matches both your goals and your comfort with time, cost, and complexity.
Cost, insurance, and timing
At the time of your initial consultation, a financial coordinator will meet with you to discuss the cost and your current insurance coverage to ensure that financial expectations are very clear.
Timelines range from a few months for donor sperm IUI to a year or more for pathways involving IVF, donor coordination, or surrogacy. We sequence any needed fertility preservation, especially for transgender patients, as early as possible to preserve maximum flexibility.
Emotional support and partner involvement
We actively encourage both partners to be present for consultations, monitoring visits, and major decisions, since family building is a shared experience regardless of whose body is directly involved in a given step. For known donor arrangements, we recommend involving a mental health professional experienced in third-party reproduction and LGBTQ+ family building to clarify expectations and roles.
For male couples, choosing an egg donor and gestational carrier can involve important emotional, logistical, medical, and legal decisions. Both intended fathers are included throughout the planning process so that decisions around genetic parentage, donor selection, embryo creation, and future family-building reflect the goals of the couple.
Legal parentage should never be assumed. Even with strong California protections, we recommend establishing formal parentage documentation, such as a second-parent adoption or parentage judgment, to ensure full legal recognition in every state.
Working with Dr. Ghadir
Dr. Ghadir has long served the LGBTQ+ community with individualized, judgment-free care, and has deep experience with reciprocal IVF, donor sperm and egg cycles, gestational carrier care for male couples and other intended parents, and fertility preservation for transgender and nonbinary patients. He will walk you through every option honestly, including trade-offs in cost, time, and involvement, so the pathway you choose truly reflects what you and your partner want.
What to expect
- 01
Initial consultation
Discuss your family-building goals and relationship structure, including whether one or both intended fathers hope to contribute sperm and your preferences regarding egg donation, donor sperm, and gestational carrier care.
- 02
Diagnostic evaluation
Complete semen analysis and recommended genetic and carrier screening for each intended parent who may provide sperm, and assess ovarian reserve and uterine health for anyone who may provide eggs or carry a pregnancy.
- 03
Pathway selection
Choose among reciprocal IVF, donor sperm or egg cycles, IVF with a gestational carrier, or fertility preservation, depending on findings and goals.
- 04
Donor and embryo planning
Select an appropriate egg or sperm donor, known or through an accredited bank or agency, establish an individualized plan for fertilization and embryo creation, and finalize agreements with reproductive counsel.
- 05
Gestational carrier coordination
When a carrier is part of your plan, coordinate screening, preparation, and embryo transfer with the gestational carrier and the appropriate supporting professionals.
- 06
Treatment cycle
Complete IUI, IVF, reciprocal IVF, or embryo transfer with careful monitoring and precise timing. The exact process varies based on which family-building route applies.
- 07
Parentage confirmation
Complete legal steps to establish both parents' rights before or after birth.
Frequently asked
What is reciprocal IVF?
Reciprocal IVF is a process where one partner in a couple provides the eggs, which are fertilized in the lab, and the resulting embryo is transferred into the other partner's uterus to carry the pregnancy. This allows both partners to have a direct biological and physical role in creating their child. It requires standard IVF evaluation for the partner providing eggs and a uterine receptivity assessment for the partner who will carry.
How does fertility treatment work for two men who want to have a child?
For male couples, family building typically involves IVF using donor eggs and a gestational carrier. After evaluating the sperm of each intended father who may contribute genetically, an egg donor is selected and embryos are created through IVF. A resulting embryo can then be transferred to a gestational carrier. Dr. Ghadir will create an individualized plan based on your family-building goals.
Can both intended fathers contribute sperm?
Yes. If both intended fathers would like the opportunity for a genetic connection to their children, donor eggs may be divided and fertilized separately using sperm from each partner, creating separate groups of embryos. Each individual embryo has one sperm source, but this approach can allow both intended fathers to create embryos as part of the same overall family-building plan.
Do male couples need an egg donor and a gestational carrier?
For male couples pursuing biological parenthood through IVF, an egg source and a uterus for pregnancy are needed. This generally means working with an egg donor and a gestational carrier. Dr. Ghadir and the care team will help coordinate the medical components of both parts of the process.
Should we use a known donor or a sperm/egg bank?
Both are viable options with different tradeoffs. Known donors offer a personal connection and sometimes lower cost but require careful legal agreements and typically a mental health consultation to clarify expectations around future contact and role. Accredited banks and agencies offer extensive screening, anonymity if desired, and simpler logistics. We help you weigh these based on your family's preferences and long-term wishes for donor relationships.
Can transgender patients preserve fertility before starting hormone therapy?
Yes. We strongly recommend a fertility consultation before beginning hormone therapy or gender-affirming surgery, since these treatments can reduce or eliminate future fertility. Egg or sperm freezing prior to treatment preserves your reproductive options for later, without requiring any delay to your transition timeline. Many patients find peace of mind in preserving this option even if they are unsure whether they'll use it.
Is our legal parentage automatically protected in California?
California offers strong legal protections for LGBTQ+ parents, but automatic recognition can vary depending on circumstances and is not guaranteed in every state should you relocate. We recommend working with a family law attorney to establish formal parentage, such as a parentage judgment or second-parent adoption, so both parents' rights are unambiguous everywhere.
How do we decide between IUI and IVF with donor sperm?
IUI with donor sperm is often a reasonable first step for individuals or couples with normal ovarian reserve and no other fertility factors, offering a simpler and less costly process. IVF may be recommended if there are age-related concerns, diminished ovarian reserve, or if you want the option of genetic testing or reciprocal IVF. We base this recommendation on your specific evaluation results.
What if only one partner wants to be genetically related to the child?
This is a common and completely reasonable preference. In this case, one partner's eggs or sperm are used with a donor for the other component, and the pregnancy is carried by an intended parent or a gestational carrier depending on your wishes and medical circumstances. We help you sequence future family-building, too, if you hope to have a second child with the other partner's genetics down the road.
Do you coordinate with mental health professionals during this process?
Yes, and we often recommend it, particularly for known donor arrangements, reciprocal IVF decisions, and any third-party reproduction involving egg donation or a gestational carrier. A mental health professional experienced in LGBTQ+ family building can help clarify roles, expectations, and communication plans, which contributes to smoother relationships and journeys overall.
From the podcast
Family-building stories from The Fertile Life.
October 13, 2022
Brian Kelly
Brian Kelly, The Points Guy, Shares His Fertility Journey to Parenthood
Brian Kelly joins Dr. Ghadir to talk through his path to fatherhood with an egg donor and a surrogate.
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Tom Daley
Tom Daley Talks Fatherhood, Knitting and Life
A conversation with Tom Daley on fatherhood, and how family life fits alongside everything else.
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Lance Bass & Michael Turchin
NSYNC's Lance Bass and Husband Michael Turchin Discuss Their Journey to Parenthood
Lance Bass and Michael Turchin share their path to parenthood through IVF and surrogacy.
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