Building a family can look different for every person, couple, and family structure. For LGBTQ+ individuals and couples, the path to parenthood often includes unique decisions around donor conception, reciprocal IVF, gestational carriers, adoption, and fertility preservation.

We sat down with Dr. Thalia Segal, Founder and Medical Director of Collab Fertility, and Brian Rosenberg, Founder of Gays With Kids and Executive Director of GWK Academy, to discuss LGBTQ+ family planning, common misconceptions, family-building options, and the resources available to help intended parents navigate the journey with confidence.

How does fertility planning differ for LGBTQ+ families?

What are some of the biggest misconceptions people have about LGBTQ+ family planning?

Brian Rosenberg:
"Sadly today, there are still people that we talk to who didn't realize that family building was an option for them, or think that it's possible maybe for others, but not for us.

My biggest thing is educating folks that there are so many different options for family building, and there's certainly a path that is right and best for them based on their priorities, resources, and lived experiences.

I would love to be able to talk to every single person out there who thinks that family building can't be for them because that's a real huge misconception."

How does fertility planning differ for LGBTQ+ families compared to heterosexual couples?

Dr. Thalia Segal:
"It depends on their goals. Is this a same-sex female couple? A same-sex male couple?

Are we talking about reciprocal IVF where one person in the couple provides the eggs and the other person carries the pregnancy? Are we doing donor sperm? Is it a known donor or anonymous?

For same-sex male couples, is this directed or non-directed egg donation? Are we talking about the gestational carrier process?

All of those things are available, but it's not so simple. We have to work with agencies. From the medical perspective, genetic carrier screening is really important. Knowing what diseases you inherited from mom and dad helps us make sure whichever donor we're choosing is compatible."

What are some of the unique decisions LGBTQ+ individuals and couples often face early in the process?

Brian Rosenberg:
"Our families can come in all shapes and sizes.

The very first question is: How are we going to build our family?

In an ideal scenario, I want everyone (before they start) to know they really have two journeys to consider. One is adoption-related. The other includes all the donor-conceived options.

I’m happy to chat with them about these options: we’d talk about the costs, the steps involved, the family-building professionals they'll work with, how long it's going to take, and the third parties involved—from birth families to surrogates to donors.

Once people understand all of that, they can start to think, 'Okay, this is the path that makes the most sense for me.'"

What do you wish more LGBTQ+ patients knew before they begin exploring their family-building options?

Dr. Thalia Segal:
"I think that it's a process, and it can take a little bit longer.

I think people don't realize the legal and psychological evaluations and all the other steps that are really important.

I also think the cost is a big factor for people."

What LGBTQ+ family planning options are available for individuals and couples?

Can you walk us through some of the most common family-building pathways available today?

Dr. Thalia Segal:
"For my lesbian couples, we usually talk about donor sperm and IUI insemination. That's the cheapest, the least invasive, and the least medical of all the options.

It's very successful because most of these couples are fertile.

Reciprocal IVF is becoming more common. I think it's very special because there's a shared experience where one person's eggs are used and the other person carries the pregnancy.

What I like about reciprocal IVF is that it's also preserving fertility because we have frozen embryos now."

What options do you see most frequently pursued within the GWK Academy community?

Brian Rosenberg:
"I see everything.

One option I'd like to see pursued more frequently is adoption from the foster care system.

There are over 325,000 kids in foster care right now. Twenty-five percent of them are freed for adoption, meaning there's no one waiting to take them back.

Of those children, approximately 30% identify as LGBTQ+. As a gay adult, I can’t help but feel it’s up to us to protect the most vulnerable among our community, and that’s definitely these kids! 

Adopting from foster care is not for everyone, but I think if people really understood how the foster care system works and the misconceptions fell away, more people would consider it."

How do factors like relationship status, age, fertility goals, and timeline influence which path someone chooses?

Dr. Thalia Segal:
"For female individuals and couples, age is the most important predictor of success.

We look at ovarian reserve and other fertility factors because those impact success rates.

For male couples or individuals, the good news is there's new sperm every three months until you die.

There really isn't the same physiological time clock that exists for female individuals and couples."

What would you say to someone who feels overwhelmed by all the different options available?

Brian Rosenberg:
"Get educated.

That's why we created GWK Academy.

After you get educated and understand all your options, if one path or another doesn't immediately call to you, we have coaches and mentors who have gone through those journeys who can talk to you. And I think it’s so important you talk to people you can trust, who have your best interests at heart. 

The only way around being overwhelmed is by getting informed."

What should patients know about IVF, donor sperm, and donor eggs?

How do donor sperm and donor eggs fit into LGBTQ+ family-building journeys?

Dr. Thalia Segal:
"Donor sperm is commonly used for lesbian couples and single intended parents.

For same-sex male couples, donor eggs and gestational carriers are usually part of the journey.

The questions become things like: Do we want to use the same egg donor with both partners' sperm so we have half siblings? Those are some of the decisions we help patients navigate."

What should patients consider when selecting a sperm or egg donor?

Dr. Thalia Segal:
"Genetic carrier screening is really important.

We want to know what diseases someone may carry so we can make sure the donor is compatible.

Depending on the method of conception, we may also discuss CMV status, which can be important when using donor sperm."

How do families typically approach conversations around donor conception with future children?

Brian Rosenberg:
"Be open and honest from the earliest age.

When we brought our son Levi home, my husband wrote a very short story called How We Came to Be a Family.

We read it to him every night for the first two years of his life.

When our daughters came, we had another story called How Did We Grow Our Family?

We read that story to our daughters every night too.

You talk in terms that are appropriate for the child's age, but you must be open. We must be open and proud about our family-building journeys."

What role does IVF play in family-building journeys that involve donor sperm or donor eggs?

Dr. Thalia Segal:
"IVF can create embryos that are frozen for future family building.

It can also be used in reciprocal IVF, donor egg cycles, and gestational carrier journeys.

Having embryos frozen gives people more flexibility and helps preserve future reproductive options."

What is reciprocal IVF and how does it work?

What is reciprocal IVF and how does it work?

Dr. Thalia Segal:
"Reciprocal IVF is where we collect eggs from one partner and transfer the embryo into the other partner's uterus to carry the pregnancy."

Why has reciprocal IVF become such a meaningful option for many same-sex female couples?

Brian Rosenberg:
"I think it's meaningful because both partners can participate in creating the family.

It's a way for both people to feel deeply connected to the process."

What does the reciprocal IVF process look like from start to finish?

Dr. Thalia Segal:
"We retrieve eggs from one partner, create embryos, and then transfer an embryo to the partner who will carry the pregnancy.

Many couples also choose to freeze additional embryos for future children."

Who tends to be a good candidate for reciprocal IVF?

Dr. Thalia Segal:
"Couples who want a shared biological and pregnancy experience are often excellent candidates."

What role do gestational carriers play in LGBTQ+ surrogacy?

What role do gestational carriers play in LGBTQ+ family building?

Dr. Thalia Segal:
"For many same-sex male couples, donor eggs and a gestational carrier are the most common pathway to parenthood."

What are some common misconceptions about surrogacy?

Brian Rosenberg:
"People often underestimate both the cost and complexity.

The total cost can be anywhere from $150,000 to $250,000 or more.

There are many moving pieces involved, and some of those costs are unpredictable."

How does Collab support intended parents throughout a gestational carrier journey?

Dr. Thalia Segal:
"All our patients start with a call with Angela, our third-party coordinator.

She's been doing this for 30 years.

She walks patients through agencies, the process, timelines, estimated costs, and all the logistics.

Once patients understand all of that, they'll see me and we'll go through the medical aspects.

Having an experienced team who can guide you makes all the difference."

Should you freeze sperm before starting HRT?

Should transgender individuals consider freezing sperm before starting hormone replacement therapy?

Dr. Thalia Segal:
"If preserving the option of biological children is important, it's worth having that conversation before starting hormone therapy."

How often do questions about fertility preservation come up?

Brian Rosenberg:
"They come up all the time.

People aren't always sure whether they'll want children in the future, and that's why education and planning are so important."

Why is fertility preservation important for LGBTQ+ individuals?

What fertility preservation methods are available?

Dr. Thalia Segal:
"Fertility preservation may include egg freezing, embryo freezing, or sperm freezing depending on the individual's goals and circumstances."

When should someone consider preserving eggs or freezing sperm?

Dr. Thalia Segal:
"The earlier someone starts thinking about fertility preservation, the more options they'll typically have available."

What do you wish more people understood about fertility preservation?

Brian Rosenberg:
"Even if you're not ready to have children today, preserving options can provide flexibility later.

You don't have to have all the answers right now."

What advice would you give someone just starting their family planning journey?

What's the biggest piece of advice you'd give someone beginning to explore family planning?

Brian Rosenberg:
"Get educated.

Take it slowly.

Learn about all your options before deciding which path is right for you. And it’s okay to be flexible, to change your plans as your own priorities, life experiences, and resources change."

What first steps would you recommend for someone who wants to better understand their options?

Dr. Thalia Segal:
"Talk with experienced professionals who understand LGBTQ+ family building.

The more information you have upfront, the better prepared you'll be to make decisions that align with your goals."

What message would you leave readers with who are considering parenthood but don't know where to start?

Brian Rosenberg:
"There is a path to parenthood that's right for you.

The most important thing is understanding that family building is possible and taking the first step toward learning about your options."

Explore Your Family-Building Options

Whether you're considering donor sperm, donor eggs, reciprocal IVF, gestational surrogacy, fertility preservation, or another path to parenthood, the Collab Fertility team is here to help you navigate every step of the journey.

Our dedicated third-party reproduction team works closely with intended parents to provide education, guidance, and personalized care so you can move forward with confidence as you build the family that's right for you.

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