By Sonja Swanson
June is Pride Month! During Pride season, we celebrate 2SLGBTQI+ peoples and their history. Pride is a time of joy and celebration of who you are and who you love, but also a time of reflection for those to have been lost too early to violence and the continuing fight again prejudice and ignorance in our society. The rights and freedoms for 2SLGBTQI+ people have been fought fiercely for and rightly won; but there is still a long way to go before everyone is free and equal under the law.
KARMA will be attending Pride festivities in the region! We will be at Guelph Pride Family Picnic on June 2nd and also Oxford Country Pride on June 15th! Come stop by our booth, get some KARMA merch, and say hi! These are family-friendly events so we hope to see lots of KARMA babies there too!
For those seeking to build or expand their family, there are many options for 2SLGBTQI+ patients of all ages, genders, sexual orientations, family structure, marital status, socioeconomic background, religion, cultural origin, and physical ability are welcome to pursue their family building journey with us.
IUI vs IVF Basics
Intra-uterine insemination (IUI) is when processed sperm is inserted into the uterus and fertilization occurs in the body. This can be done with partner sperm or donor sperm.
IVF is when eggs (oocytes) are removed from the body, they may be own or donor eggs, and inseminated in the lab with partner or donor sperm sample. Embryos are grown and any good-quality embryo(s) are either transferred to the patient or a surrogate in hopes of achieving a pregnancy; or are cryopreserved (frozen) for future use.
If using third party reproduction, the patient(s) who will be parents to any child born are called the Intended Parent(s; or IPs).
The Ontario Fertility Program
In December 2015, the province started the Ontario Fertility Program (OFP) to partially cover the cost of IUI and IVF for patients in Ontario.
The services listed below that serve the 2SLGBTQI+ community will be included in the funding and cycles will be partially covered! The OFP made a specific mission to be inclusive and coverage applies regardless of sex, gender, sexual orientation, or family status, and not restricted to those with a specifically medical diagnosis of infertility.
The OFP doesn’t cover all services so some fees will apply depending on the type of cycle. Please inquire for specific pricing of services.
Donor sperm is a widely used option for patients who do not produce sperm or if there is an issue with the quality/quantity of sperm (e.g. azoospermia).
There are three Canadian distributors that donor sperm can be purchased from. Browse profiles that match your criteria (ethnicity, eye colour, height, etc.) and once you select your donor, the frozen vials will be sent to the clinic for use. Between all the distributors, there are thousands of options to select a sperm donor!
A known donor, friend or family member, can also be the sperm provider. Canadian regulation of donor sperm is one of the strictest in the world! A known donor will be processed at a lab in Toronto then frozen vials are sent to the clinic for use.
The cost of donor sperm (or known donor sperm processing) is not covered under the OFP.
Egg donation is one of the fastest growing areas of in reproductive medicine! There are many options for patients who do not produce eggs or there if there is an issue with egg quality (e.g. premature ovarian failure). Egg donation cycles generally have a very high success rate but it does depend on many other factors.
Egg donor banks will cryopreserve (freeze) the oocytes. You can browse profiles of donors who have their eggs currently stored at the bank and select one that matches your desired criteria (e.g. ethnicity, eye colour, height, etc.), there are hundreds of donors to choose from! Then the bank will send the eggs to the clinic for use.
You can also work with an agency who will help match you with a donor and then coordinate a fresh IVF cycle. Depending on the agency, the donor may come to KARMA for the procedure or the patient will send a frozen sperm sample to the lab where the IVF is done then send back frozen embryos.
A friend or family member can also be an egg donor! They will undergo the cycle and then any eggs will be used for the Intended Parents. There are less restrictions on egg donation in Canada as compare to sperm donation but the physician will help determine if your known donor is a suitable candidate.
The cost of purchasing donor eggs or any costs incurred by the egg donor to be paid by the IPs is not covered by the OFP.
A surrogate (or the more formal term: Gestational Carrier, GC) will carry the pregnancy for a patient who is unable to do so. This may be applicable for patients who do not have a uterus or if a patient has a uterine anomaly (e.g. post-chemotherapy). There is a high demand for surrogates, especially in Ontario!
The IVF cycle can proceed with a patient’s own eggs or using donor gametes and any embryos created would be transferred to the surrogate in the hopes of a achieving a pregnancy. Any children born would then be legally declared the child of the IPs
Surrogacy agencies can help match you with a surrogate and they would assist in coordinating the journey so both you and the surrogate have the best experience possible. A lot of the management of the surrogate’s process is done through the agency and the clinic.
A friend or family member can also be a surrogate! There have been many news stories like a grandparent carrying their own grandchild! After meeting with the physician, the surrogate can be evaluated to determine if they are eligible to participate in the IVF process.
The expenses incurred by the surrogate during the cycle which is to be paid by the IPs is not covered in by OFP.
Fertility Preservation (FP) is a process by which gametes (sperm or oocytes) are cryopreserved (frozen) for future use by the individual. This is an often-neglected area of reproductive medicine; the most common reason this is done is prior to chemotherapy but it can also be done prior to gender confirmation treatment! FP can also be done for social reasons; commonly oocyte or sperm freezing prior to 35 years old to preserve gamete quality if the person isn’t ready to begin a family.
If a patient is undergoing gender confirmation treatment (hormone or surgery), this gamete preservation is covered by the Ontario Fertility Program! Then the person may be able to have genetically related children in the future if that is an important factor for them.
The Pride season is to celebrate 2SLGBTQI+ peoples; who they are and who they love! At KARMA, we want to help any 2SLGBTQI+ patients who wish to add more love to their lives by building or expanding their family! Most importantly, Pride doesn’t have to end in June, every month is an opportunity to be more inclusive and increase representation and equality for everyone!