LGBTQ+ Family-Building at FSAC: Pathways, Options, and Where to Begin

Building a family doesn’t look the same for everyone, and at Fertility & Surgical Associates of California (FSAC), it doesn’t need to. Whether you’re a same-sex couple, a single parent by choice, or transitioning and thinking ahead, there’s a pathway built around your specific situation.

This article will explore an overview of the main options FSAC offers and where to start looking.

What Is Reciprocal IVF, and Who Is It For?

Reciprocal IVF, also called partner IVF or reception of oocytes from partner (ROPA), is an in vitro fertilization (IVF) pathway designed for couples where both partners want to participate biologically in the pregnancy. One partner undergoes ovarian stimulation and egg retrieval, and those eggs are fertilized with donor sperm in the lab.

The resulting embryos are transferred to the other partner’s uterus, so one partner contributes the genetic material and the other carries the pregnancy.

Reciprocal IVF is most commonly chosen by same-sex female couples. It may also be an option for some transgender and nonbinary individuals depending on anatomy and fertility status, and FSAC’s team can advise on what’s possible for your specific situation.

It’s one meaningful option among several, not the default path for every couple, and plenty of people choose differently for reasons that are entirely their own.

How Reciprocal IVF Works Step by Step

The process moves through several stages, each building on the last:

• Initial consultation and fertility evaluation for both partners, including ovarian reserve testing for the partner providing eggs and uterine evaluation for the partner who will carry.
• Choosing a sperm donor, whether a known donor or an anonymous donor through a sperm bank.
• Ovarian stimulation, where the egg-providing partner takes fertility medications over one to two weeks to develop multiple eggs.
• Egg retrieval, a brief outpatient procedure performed under sedation.
• Fertilization, where the retrieved eggs are combined with donor sperm in FSAC’s IVF lab.
• Embryo development, with optional preimplantation genetic testing (PGT) to screen embryos before transfer.
• Uterine preparation for the carrying partner, using medications to ready the uterine lining.
• Embryo transfer, where one embryo is placed into the carrying partner’s uterus.
• A pregnancy test roughly two weeks later.

Other LGBTQ+ Family-Building Pathways at FSAC

Reciprocal IVF is one pathway among several, and FSAC’s LGBTQ+ family-building team can walk through which one fits your specific goals.

Donor Sperm IVF and IUI

For individuals or same-sex female couples where only one partner will be genetically and gestationally involved, IVF or intrauterine insemination (IUI) with donor sperm is a common starting point. IUI is a lower-intervention, less expensive option than IVF, and it may be the right first step depending on age, ovarian reserve, and other clinical factors.

When IUI isn’t recommended or hasn’t led to pregnancy, IVF with donor sperm is typically the next option. Donor sperm can come from an anonymous donor through a sperm bank or from a known donor, and FSAC can provide input and resources on the legal and medical requirements that come with either path.

Donor Egg IVF

For same-sex male couples, single men, and others who need a donor egg, IVF using donated eggs is the standard pathway. One or both partners can provide sperm to fertilize the donor eggs, and the resulting embryos can be transferred using a gestational carrier.

FSAC supports this pathway, including coordination with a gestational carrier when that’s part of the plan.

Options for Transgender and Nonbinary Individuals

Fertility preservation before hormone therapy or gender-affirming surgery is an important option for transgender and nonbinary individuals who may want biological children in the future. FSAC works with CryoFuture, a long-term storage partner, for egg, sperm, and embryo freezing, so both egg freezing and sperm freezing are available depending on what you’re preserving.

Transgender men who retain their uterus and ovaries may be able to carry a pregnancy, and transgender women may have sperm available for use with a donor egg and gestational carrier.

Every situation is individual, and FSAC’s team can walk through what’s possible based on your specific anatomy and goals.

How Much Does Reciprocal IVF Cost at FSAC?

Reciprocal IVF generally costs more than standard IVF because it involves fertility evaluation, and sometimes medications, for both partners, plus donor sperm. Costs vary further based on your specific protocol and any add-ons like PGT or embryo freezing, so the clearest next step is getting a personalized cost estimate directly from FSAC rather than relying on a general figure.

This is genuinely great news for a lot of families. California’s SB 729 requires qualifying large group health plans to cover IVF, and the law explicitly broadened the legal definition of infertility to include people who need medical intervention to achieve pregnancy, including many LGBTQ+ individuals and couples, single parents by choice, and others who rely on donor gametes or donor embryos.

That means many people building a family through reciprocal IVF, donor sperm, donor eggs, or a gestational carrier may have coverage through a qualifying employer-sponsored plan that simply wasn’t available before. FSAC’s financial counseling team can verify your specific benefits and walk you through actual costs before treatment begins.

Learn more about financing and insurance options on FSAC’s financing and insurance page.

Choosing a Sperm Donor

For many LGBTQ+ individuals and couples, choosing a sperm donor is one of the most personal decisions in the process. A few key considerations shape that decision:

• Anonymous versus known donor, which affects both the emotional experience and the legal steps involved.
• Open-identity, or ID-release, donors who agree to be contactable once the child turns 18.
• Donor health and genetic screening, including infectious disease testing.
• Physical characteristics, donor profiles, and family medical history.

FSAC can guide you through donor selection and the legal requirements for known donors. Known donor sperm typically involves a shorter quarantine and testing period than anonymous donor sperm, and FSAC’s team can walk you through the specific steps for your situation, consistent with ASRM’s gamete and embryo donation guidance.

Starting Your Journey at FSAC

Your first appointment at FSAC starts with a conversation, not a treatment plan. You’ll meet with a reproductive endocrinologist who will ask about your goals, your timeline, and your specific situation, whether that means discussing donor options, reviewing fertility preservation before transition, or exploring what a gestational carrier arrangement would involve. You’re the one steering this journey, and FSAC’s team is there to support every step of it, so no question is too basic or too complicated to bring to the table.

From there, the team may recommend specific evaluations based on what you’re working toward.

Explore more about LGBTQ+ family-building options on FSAC’s LGBTQ+ fertility page.

Every Family-Building Journey Is Different. Let’s Talk About Yours

You now have a clearer picture of the pathways available, but the right one for you depends on details only a conversation can surface. Request a consultation at FSAC to start with listening, not a commitment to treatment. Your family is worth building exactly the way you envision it, and FSAC is honored to help you get there.