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Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

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Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2n, gay, bisexual, or transgender (LGBT: see Table 10.1 for definitions). Studies have found that children of lesbian or gay parents are not different

from children of heterosexual parents in terms of their emotional development or relationships with others |l|. Historically, many of these children w Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

ere conceived and born from heterosexual relationships, after which one parent (or in some cases both parents) “come out” as LGBT. More recently, LGBT

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

people are “coming out” in their youth so that they are less likely to have children from prior heterosexual relationships. Therefore, they are build

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2erm from friends, acquaintances, or family members of their partners, but the majority use donor sperm from a commercial sperm bank. For lesbian coupl

es in which one (or both) has infertility, many are able to conceive with assisted reproductive technologies (ART). Historically, gay male couples hav Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

e built their families through adoption or co-parenting arrangements with lesbian friends, but some have used surrogacy to have children. More recentl

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

y, transgender people have also been able to use ART to have genetically related children |2].After the U.S. Supreme Court Obergefell V. Hodges decisi

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2increasingly seeking to build families, which has resulted in increased demand for ART services [6|.LGBT individuals frequently experience discriminat

ion or disparities in their health care. The Ethics Committees of the American Society for Reproductive Medicine (ASRM) and the American Congress of O Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

bstetricians and Gynecologists (ACOG) have opined that ethical arguments supporting denial of access to fertility services on the basis of marital sta

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

tus, sexual orientation, or gender identity cannot be justified |7-9], Health care providers need to be informed regarding ART options available to LG

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2s is not unique to LGBT patients. All couples w ho plan to conceive w ith donor gametes (sperm or eggs) or a surrogate need to have psychoeducational

counseling IO discuss concerns and feelings that arise when family building involves the assistance of a third party. For the parent who is not contri Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

buting genetic material, there is the lack of a genetic connection to the child(ren) conceived with donor gametes. There are also practical issues suc

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

h as the challenges of choosing the appropriate gamete donor, the differences between known and recruited donors, the option of selecting donors who a

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2person's sexual, physical, romantic, and/or emotional attraction to a particular sex (male or female).Heterosexuality:Sexual, physical, romantic, and/

or emotional attraction between persons of the opposite sex or gender.Homosexuality:Sexual, physical, romantic, and/or emotional attraction between pe Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

rsons of the same sex or gender.Gay:Describes a man whose enduring sexual, physical, romantic, and/or emotional attraction is to otherLesbian:IIK.il.

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

Describes a woman whose enduring sexual, physical, romantic, and/or emotional attraction is to other women.Bisexual:An individual who is sexually, phy

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2erception of their gender.Transgender:An individual who identifies with a gender different from what society expects based on the sex the individual w

as assigned at birth. Transgender individuals can be heterosexual, lesbian, gay, or bisexual in their sexual orientation.Cisgender:An individual who i Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

dentifies with the gender that society expects based on the sex the individual was assigned at birth. Cisgender individuals can be heterosexual, lesbi

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

an, gay. or bisexual in their sexual orientation.discuss with the child(ren) conceived with donor gametes the circumstances of their conception. When

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2ctations of their relationship during and beyond thesurrogacy process. For LGBT couples, who frequently experience situations or remarks that are inap

propriate or hurtful, it is important to discuss feelings and responses to sociocultural challenges for LGBT families who are marginalized and discrim Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

inated against in subtle ways. Counseling with a professional counselor is done before proceeding with treatment.Donor SpermDonors who donate sperm to

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

a commercial sperm bank have all been tested for a standard list of infectious diseases mandated by the Food and Drug Administration (FDA), which has

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2may potentially be transmitted in semen, before collecting semen specimens intended for donation, sperm specimens are frozen and quarantined for a per

iod of 6 months, after which the donor is retested for the same list of infectious diseases. If all the repeat tests for infectious diseases result ne Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

gative, the quarantined frozen sperm specimens may then be released by the sperm bank for donation. If any test for infectious diseases is positive, t

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

he quarantined sperm specimens may not be released for donation and must be discarded.Sperm donated to a commercial sperm bank have usually been washe

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2emination (1UI) and are ready for immediate use upon thaw. If the vial of donor sperm obtained from a commercial sperm bank is labeled "1CL” it is int

ended for intracervical or intravaginal insemination and needs to be washed with special culture media fluids in the laboratory and concentrated into Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

a small volume before IUI.Occasionally, some lesbian couples choose to use sperm from a known (or directed) donor, typically a family member of the pa

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

rtner who is not conceiving, or a friend, or an acquaintance. Family building with sperm from a known donor has significant psychosocial and legal ram

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2estions of who owns the donor sperm specimens and controls their use. parental rights and obligations of the intended parents (IPs), as well as the la

ck of parental rights and108The Boston IVF Handbook of Infertilityobligations of the donor. If a lesbian couple wishes to use sperm from a known donor Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

, the most efficient process is for the designated donor to bank his sperm at a commercial sperm bank and specifically designate the banked sperm spec

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

imens for use by the recipient IPs. There are FDA regulations specifically governing use of sperm from a know n/di reeled donor if the insemination is

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2al sperm bank [10]. After initial testing for potentially transmissible infectious diseases, sperm specimens are frozen and quarantined fora period of

6 months, after which the donor is retested for the same list of infectious diseases. If all the repeal tests result negative for these infectious di Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

seases, the frozen sperm specimens may then be released by the sperm bank for use by the recipient IPs. If any lest for infectious diseases is positiv

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

e, the recipient IPs must be counseled regarding the potential risk of infection with the infectious disease, after which they may choose to use the f

10Fertility Care for the LGBT CommunitySamuel c. PangIntroductionFor many years, children have been raised in families where (heir parents are lesbian

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2ial infection from use of these donor sperm specimens.Options for Lesbian CouplesInsemination with Donor SpermDonor sperm insemination is the least in

vasive procedure and is the primary method of conception for lesbians who do not have infertility issues. One option is intravaginal insemination at h Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

ome, timed with urinary ovulation predictor kits. Alternatively, insemination performed by a clinician in a medical facility is typically 1 Ul. in whi

Ebook The boston IVF handbooknbsp;of infertility (4/E): Part 2

ch donor sperm are placed directly inside the uterus on the day that the woman is determined to be ovulating. IƯI serves to deliver the maximum number

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