The infertility work-up: a guide for lesbians

When couples decide that yes, it's time to have a baby, many excitedly set the stage for that first, heady, baby-making sexual encounter with a candle-lit dinner, soft, romantic music, and fingers crossed. For hopeful moms who are lesbians however, that scene might look a little different.

According to the U.S. Census Bureau, same-sex households have increased by more than 80% over the last decade, and gay women are contemplating parenthood in far greater numbers than ever before. Many of these women will start this process by pouring over sperm donor profiles, assuming that all they need to get pregnant is a sample and a turkey baster. But is this really the best place to start?

Somewhere around 5% of all women in the United States today identify as gay, although the numbers are not conclusive and might be much higher. When you take into consideration that over 6 million women of reproductive age are infertile, it stands to reason that some gay women will fall into this statistic. And for lesbians who are infertile, the introduction of sperm to cervix will simply not be enough for pregnancy to take place.

endometriosis. Advanced maternal age also plays a role.

Many lesbians discount the possibility that they are vulnerable to sexually transmitted infections which can affect health and fertility, however, this is not the case. Herpes, bacterial vaginosis and the HPV virus, as well as other STI's, can be passed from woman to woman. Smoking and obesity are also negative factors to fertility potential.

It is understandable to want the baby-making experience to be romantic and loving, so many lesbian couples opt to try it at home without first consulting a medical specialist. However, prior to attempting conception, it may make sense to get an infertility work-up done in order to determine if any unknown obstacles to pregnancy exist, particularly when you factor in the cost of each sperm vial at $500-$700.

Look for an LGBT-friendly provider, and be prepared to discuss your health history, exercise and lifestyle habits, as well as your age. Infertility tests including blood draws, a sonogram and hysterosalpingogram will be done. After testing is completed, your doctor will discuss options including at-home insemination, intrauterine insemination, and . While it may feel overwhelming, your physician will also recommend an assisted reproduction attorney for you to consult with, in order to protect both yourselves and your children.

As a couple becoming a family, you have many issues to discuss, including where you will live, your financial future, and your goals together. Looking at your fertility potential and how you will have your children is simply another issue you need to talk through and map out. It may not sound romantic, but getting information about your health and fertility prior to attempting pregnancy can save you time, emotional stress, and money.

Your baby-making moment might include soft candles and beautiful music, or it might take place under the slightly-harsh lights of a doctor's office. Whatever route to motherhood you decide is best for you, make sure it is based on knowledge and information, as well as on love and excitement for the future.

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