Even though adoption remains a fantastic option for same-sex partners, IVF for gay couples offers a chance for biological fatherhood and provides more control over the process, from selecting an egg donor and gestational carrier to participating in decisions about embryo testing and prenatal care.
Still, IVF is challenging, and for same-sex couples, it involves additional medical, legal, and financial steps. In this article, we’ll walk you through what IVF for gay male couples looks like, how it works, and how to make informed decisions along the way.
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How does IVF work for gay couples?
IVF for gay male couples, with finding donor eggs and a gestational surrogate, usually takes 12–24 months from consultation to birth. Here’s what the journey looks like:
Initial consultation and testing: Meet a fertility specialist to discuss goals and medical history, complete a semen analysis, and undergo any additional testing.
Choosing an egg donor and surrogate: Since neither partner produces eggs, you’ll need to work with an egg donor. A surrogate carries an embryo created from the egg donor and one partner’s sperm. After you select a donor and a surrogate, they will both complete medical screening and sign legal contracts.
Egg retrieval preparation: Your donor takes medication to stimulate egg production. If you’re using frozen bank eggs, this step has already been completed. Meanwhile, the surrogate begins medications to prepare for embryo transfer.
Sperm collection: You and/or your partner provide a fresh or previously frozen sperm sample. Either same-sex partner can provide sperm, or both can fertilize separate eggs to create multiple embryos.
Fertilization and embryo creation: Eggs are retrieved and fertilized, often using ICSI (when a single sperm is injected directly into an egg) to maximize success.
Preimplantation genetic testing: Once embryos reach the blastocyst stage (day 5–6), you can have them genetically screened so you can select the strongest one before transfer.
Embryo transfer: A chosen embryo is transferred into your surrogate’s uterus during a carefully timed cycle. This is a minor, painless procedure that lasts about 20 minutes.
Pregnancy and monitoring: The fertility clinic monitors the early pregnancy until it’s well established. Your surrogate will then continue care with her OB/GYN.
Birth and legal finalization: At birth, you’re typically recognized as the baby’s legal parents. However, this may vary by jurisdiction, and some states will require pre- or post-birth orders and sometimes adoption for the non-genetic parent. If you live outside the U.S., your lawyer will help secure your baby’s passport and travel documents.
How to choose an egg donor
Your egg donor will contribute half of your child’s DNA, and while you may never meet her, her impact will be lifelong. When it comes to choosing the right person, there is no one-size-fits-all approach, regardless of whether you hope your child resembles you or your partner, want to minimize hereditary risks, or wish to find someone who feels like the right match.
There are four common ways to find an egg donor:
Known or directed donors: The donor can be someone you already know, like a friend, who’s willing to donate their eggs. Some parents choose this option to maintain a stronger emotional link.
Anonymous donors: In this case, you’re matched with your donor through your clinic or agency. No identifying information is shared between you and the donor, but you’ll receive detailed insights into their medical history, family background, and personality.
Agency donors: Egg donor agencies typically offer a wider pool of candidates, including greater diversity in ethnicity, background, and education. Some agencies also provide fresh eggs, which can increase your chances of IVF success and make it possible to create multiple embryos, which is especially important if you intend to grow your family in the future. However, donor agencies tend to be more expensive.
Donor egg banks: Egg banks store frozen eggs from pre-screened donors, offering faster access and often costing lower than fresh cycles. However, because frozen eggs from a specific donor are limited, it may be harder to secure more eggs from the same donor later, which is something to consider if you’re hoping for full genetic siblings.
What to look for in an egg donor
Most fertility and family-planning experts advise trying not to get stuck on finding someone ideal. Instead, streamline the process by focusing on the following factors:
Medical and genetic history: Look for a donor with no major hereditary illnesses or conditions.
Physical traits: Many couples want their child to resemble them, so they may prioritize features like skin tone, hair color, height, or eye color.
Education and personality: While education isn’t a direct proxy for intelligence, some parents value certain academic or creative strengths. Many donor profiles include personal essays or video messages to help you get a sense of their character, values, and motivation for donating.
Mental health: Donors must pass psychological evaluations, but if emotional stability or openness to future contact are important to you, ask your clinic for additional insights.
Cultural or ethnic background: You may want a donor who shares your heritage or cultural identity or one who can help you create a blended family.
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How to choose a gestational surrogate
A gestational surrogate will carry your child, and her health, values, and environment are also important. While you can use a family member or a friend as a surrogate, most couples work with a licensed agency to find a qualified candidate.
Agencies manage everything, including:
Screening surrogate candidates for infectious diseases
Drug testing
Coordinating psychological evaluations
Medical screenings, such as:
Saline sonogram
Bloodwork
General physical exam
Matching you with a surrogate who shares your values, lifestyle, and expectations
Managing communication, logistics, and potential conflict resolution throughout the pregnancy
Handling legal contracts, including a surrogacy agreement that outlines:
The surrogate’s responsibilities and compensation
Medical and lifestyle expectations
Rights related to prenatal decisions and delivery
Confidentiality and ongoing communication
Appointments and birth attendance
What to look for in a gestational surrogate
While agencies screen surrogates carefully, you’ll have input into who you choose to work with. Here are the most important criteria to consider:
Pregnancy history: A qualified surrogate must have had at least one previous healthy pregnancy with no significant complications. Ask about their experience with pregnancy and childbirth, including any C-sections, and how they recovered physically/emotionally.
Health history: Good general health is essential, with no significant chronic conditions like diabetes or hypertension.
Emotional and psychological readiness: Your surrogate must be mentally prepared for the responsibility of carrying someone else’s child. All reputable agencies conduct psychological evaluations, but you should still have open conversations about boundaries, expectations, and how she feels about the journey.
Lifestyle and support system: A healthy, stable lifestyle makes a big difference in pregnancy outcomes. You should opt for someone who avoids alcohol and smoking, eats well, and has support from family and friends.
Communication and shared values: Choose someone who communicates well, respects your role as parents, and shares your views on key issues like diet, prenatal care, or pregnancy termination in case of complications. Discuss how often you want to be in touch during the pregnancy and whether you wish to attend doctor’s appointments or be in the delivery room.
Location and legal landscape: Surrogacy laws vary by state and country, so where your surrogate lives may impact your ability to establish legal parentage, attend birth, or appear on your child’s birth certificate.
Age and BMI: Most surrogates are between 21 and 45 years old, with a healthy body mass index (BMI). BMI matters because it can affect implantation, pregnancy outcomes, and the timeline of your IVF journey. A surrogate with a very low or high BMI may face pregnancy delays or increased health risks.
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How to provide the best sperm sample
Your sperm plays an essential role in the success of IVF, and there are steps you can take to maximize sperm quality before fertilization.
The first step is semen analysis, which measures:
Sperm count
Motility
Morphology
Volume
pH of the sample
The clinic will use the results to determine which partner’s sperm is best suited for IVF or if both can be used. If necessary, your fertility doctor may recommend additional testing to check for infections, hormonal imbalances, or DNA fragmentation.
Many gay couples want to use sperm from both partners, which can be done by fertilizing half of the eggs with one partner’s sperm and the other half with the other’s, and then choosing the best graded embryos without knowing who the father is.
It’s also possible to transfer embryos from both partners, either in separate cycles or simultaneously, although single embryo transfer is typically safer.
What to do to improve sperm health
It takes about two to three months for sperm to regenerate fully, so you should start making lifestyle changes before the egg retrieval or fertilization appointment. Here’s how you can boost your chances of producing a high-quality sample:
Quit smoking and avoid all recreational drugs.
Limit alcohol intake.
Maintain a healthy weight, as being overweight or underweight can lower sperm quality.
Eat a balanced diet rich in antioxidants (leafy greens, berries, fish, and nuts).
Take fertility supplements if recommended by your doctor.
Avoid hot tubs, saunas, and tight underwear, which can overheat the testicles.
Manage stress through quality sleep, exercise, and relaxation techniques.
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To ensure optimal sperm count and motility, you should abstain for two to five days before sample collection. On the day of collection, take a shower to avoid contamination and masturbate directly into a sterile container without lubricants.
If there’s anxiety about performing in the clinic setting, some clinics allow home collection. The sample must be delivered within an hour and kept at body temperature during transport.
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How much does IVF for gay couples cost?
On average, surrogacy and IVF for gay male couples in the U.S. costs around $140,000, but this number can be higher or lower depending on location, specific services, and your preferences. Also, IVF may not work the first time, so you might have to plan for more cycles.
While many traditional policies were built with heterosexual couples in mind, a growing number of insurance providers and employer-sponsored plans now offer fertility benefits that support LGBTQ+ family building.
Contact your provider directly and check exactly what is covered. Some plans may include:
Initial consultations
Semen analysis
Bloodwork
Why do some gay couples choose IVF over adoption?
For many gay men, IVF with surrogacy offers a more direct, affirming path to parenthood than adoption. There are a few reasons why intended fathers choose this option:
Biological connection: IVF makes it possible to have a child who shares your genetics.
Challenges of the adoption system: Adoption can involve long waiting times, invasive screenings, legal uncertainties, and sometimes even bias against LGBTQ+ parents.
Control over prenatal care: With IVF for gay couples, you can play an active role in early health decisions, including prenatal genetic testing, such as NIPT, amniocentesis, cell-free DNA analysis, and sequential screening.
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For many, the desire for involvement begins at the embryo stage, and IVF allows for embryo screening to identify potential risks, increase the chances of a healthy pregnancy, and get greater insights into your child’s potential health.
With many stages involved and decisions to be made, IVF can be overwhelming. During this complex process, both gay and straight couples can benefit immensely from expert guidance.
Nucleus IVF+ is designed for parents who want clarity and the confidence that comes with smooth IV cycles and continuous support. It’s designed with genetic optimization at its core, combining cutting-edge science and genetics research with a human touch.
Nucleus IVF+ brings families greater transparency with parent-friendly reports, personalized care and testing, and a new understanding of the health and longevity of their future children.
Nucleus IVF+: Thoughtful care for modern families
Nucleus IVF+ is the first all-in-one package that integrates genetic optimization with end-to-end IVF support, helping parents grow the family they want.
Instead of focusing only on embryo viability, Nucleus IVF+ transforms complex embryo genetic data into ~2,000+ insights about each embryo’s long-term health, well-being and physical traits, and more. This can give you the clarity you need to make those deeply personal, informed decisions.
Here is what makes Nucleus different:
Made for parents to be parents: Standard IVF forces you to juggle countless medical and logistical decisions. Nucleus does the heavy lifting, so you can focus on the joy of having your baby.
Genetic optimization with a human touch: IVF+ includes access to Nucleus Embryo, an easy-to-use genetic optimization software that helps you compare and select embryos based on well-being traits and long-term health outcomes.
Judgement-free transparency: Built by clinicians and researchers who believe in the power of individual choice, Nucleus ensures every parent is an active participant in their care.
24/7 expert support: From genetic counseling to treatment decisions, specialists are with you every step of the way, making complex science approachable and your choices easier.
Nucleus can help you match with the top clinics, access compatible donors, and find tailored care throughout the IVF cycle.
Book an onboarding call with the Nucleus team to get started and learn more.
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