Conceiving a baby can happen in many ways — planned, unplanned, through intercourse, in a fertility clinic… the truth is there’s more than one way for a pregnancy to begin. But one constant in all those ways is that a sperm fertilizes an egg.
So what happens neither partner produces sperm? Curious about how that works, exactly?
Well, it can work, but there are a few more steps to get from point A to point B. Here are answers to all your questions about whether pregnancy is possible between two people with uteruses, as well as the various routes a lesbian couple can take to achieve pregnancy.
The short answer to this question is no, not through sexual intercourse. Two cisgender women (meaning assigned female at birth) in a relationship cannot become pregnant without some form of assisted reproductive technology (ART).
The reasoning goes back to basic biology and how an embryo is formed. To create an embryo, a sperm cell and egg cell must meet in some way.
This can happen through penis-in-vagina sex, where the sperm swim up the vaginal canal, make their way up the fallopian tubes, and find an egg waiting after ovulation.
This can also happen through other routes, like intrauterine insemination (IUI), where sperm is introduced into the uterus through a tube inserted through the cervix, or in vitro fertilization (IVF), where sperm is directly injected into the egg in a lab setting and transferred to the uterus at a later time.
The bottom line is that you need both sperm and eggs to make an embryo. Just one of each will do, but pregnancy cannot happen without both in the mix.
Side note: Even if two people cannot create a baby together, they can still share other things, like sexually transmitted infections (STIs). It’s a good idea to have sex with an appropriate barrier method whether or not pregnancy is a consideration.
Again, if both partners have a uterus, fallopian tubes, and eggs, there will be no sperm to enter into the equation without a donor. However, some people who identify as women may produce sperm.
If two women want to make a baby and one is cisgender and one is transgender (meaning they were assigned male at birth), there are several ways their sperm and eggs might meet, including through penetrative intercourse or ART.
There’s really no right or wrong way to go about making a family. The option a couple chooses to build their family might be influenced by cost, availability, and personal preference.
One person may have a desire to be a biological parent — while another may not. One person may have a desire to be pregnant — while another may not.
One partner may choose to carry the pregnancy using their own egg or, alternatively, their partner’s egg, depending on personal preferences. Or a couple might opt to use a surrogate or adopt a child.
Below is some more information on the available options when a pregnancy is desired.
As previously noted, sperm is a necessary part of the baby-making equation. Donor sperm can be acquired from a donor bank or even a friend or family member (a partner’s brother, for example).
When selecting a sperm donor, you may look for someone with similarities to you or your partner. Or not. It’s really up to you.
If you chose a donor through a clinic, you’ll generally be given a catalog with information about the donor’s cultural and ethnic background, along with other details to help with your selection.
Your donor may choose to remain anonymous or have an “open identity” (open ID), which means they agree to having contact with any children after they turn 18 years old.
According to the Seattle Sperm Bank, a single vial of sperm may cost anywhere between $490 and 995 depending on where you purchase it. And shipping costs can be quite steep ($150 and up) when you consider the swimmers need to be kept cold before usage.
If two people with uteruses in a relationship wish to use donor sperm, one (or both, if additional children are desired) may opt to carry a pregnancy. There are a few ways that the donor sperm can be used in order to achieve pregnancy, including insemination and in vitro fertilization.
Artificial insemination allows couples to become pregnant by introducing sperm into the uterus without penis-in-vagina sex. Once you have secured your sperm, you may choose to inseminate in a clinic or at home.
There are a few types of insemination:
- intracervical insemination (ICI), which involves putting sperm into the vagina, near the cervix, similar to what would happen with intercourse
- intrauterine insemination (IUI), which involves putting sperm directly into the uterus by using a tube that goes through the cervix
Because of the nature of an IUI, it’s typically performed in a clinic, while an ICI can safely happen both at home or in a clinic.
Some couples prefer the less clinical aspect of trying for a pregnancy in the comfort of their own home. You can work with a clinic for some aspects of the process (like finding sperm or supplies) or opt to go it on your own.
There are also insemination kits you can purchase that include everything you’ll need and even more specific instructions. The overall cost will depend upon the source for your sperm and other supplies, but this is typically the most affordable option.
If you’d rather let the professionals take the wheel, you can also head to your doctor for an ICI or IUI. The cost of IUI will be higher than doing things at home (Planned Parenthood estimates the cost at $300 to $1,000 per cycle), but your insurance may cover some of the bill.
One older study revealed that lesbian couples had a 57 percent success rate with getting pregnant using IUI.
In vitro fertilization (IVF)
IVF is an option if one partner wants to be pregnant using the other partner’s egg (reciprocal IVF) or even a donor egg. This procedure can also be used if a transgender partner had sperm previously frozen.
IVF may be a good method to try if you’re experiencing certain fertility issues. It involves fertilizing eggs in the lab and then introducing the resulting embryo(s) directly into the uterus for implantation.
The first step is harvesting eggs from one partner (or a donor) and acquiring sperm from a donor. From there, the eggs are fertilized and you’ll decide with your doctor how many of them to transfer or save for future procedures.
Then the partner who desires to be pregnant (or a gestational carrier) is primed with various medications to prepare for the transfer of the embryo(s) and — hopefully — successful implantation.
This process is the most invasive and the most costly of all options. According to CNY Fertility, the national average cost of a complete IVF cycle is somewhere around $20,000, some of which may or may not be covered by insurance.
There are additional paths that you might consider based on your (and your partner’s) own needs and fertility status. You may opt to use a surrogate to carry the pregnancy or to build a family through adoption. Each of these options comes with unique costs, emotions, and considerations.
While a girl can’t get another girl pregnant without some assistance, the good news is that lesbian couples have many options for achieving pregnancy. The method you choose has to do with things like your (or your partner’s) desire to have a biological child, your health and fertility history, and your budget.
If you have questions, make an appointment with your doctor or perhaps a specialist at a fertility clinic. And above all else, best of luck as you navigate your own unique path to parenthood!