Struggling to conceive can be one of the most emotionally trying experiences a would-be parent can have. Whether you’re partnered or single, straight or LGBTQ+, difficulty achieving a pregnancy can be exhausting and tough on your mental health. You or your partner could be in for a long road of fertility testing and painful, expensive, or time-consuming treatments. You might have to take medications with unpleasant side effects like bloating, headaches, or nausea.
At a certain point, it may be time to try a different route toward bringing a child into your life or lives. You might consider adoption, surrogacy, or various assisted reproductive technologies. This article will describe the basics of some of the most common alternative methods for becoming a parent. With time and research, you might find the pathway to parenthood that’s right for you and your family-to-be.
1. Assisted Reproductive Technologies
Many people who want to get pregnant have perfectly functional uteruses but, for one reason or another, struggle to conceive. Diseases like polycystic ovary syndrome, in which cysts grow on the ovaries, make it much more difficult for the sufferer to get pregnant. Endometriosis, a painful condition in which uterine tissue grows outside the uterus, may also cause significant difficulties with conception.
Once a person with one of these conditions does get pregnant, however, they can typically carry a baby to term. That makes them good candidates for assisted reproductive technologies like in vitro fertilization. In IVF, eggs and sperm are collected from would-be parents and/or donors and combined in a lab, resulting in fertilization. Then, the fertilized eggs are inserted back into the uterus using a catheter.
Uterine fibroids, fallopian tube damage, and ovulation disorders are among the many reasons a person might need IVF or other ART treatments. IVF can also be performed after a patient undergoes fertility-damaging medical procedures, like cancer treatment. It may seem counterintuitive, but some people are prescribed birth control pills prior to starting IVF. This is usually to manage treatment timing, and it may have a positive impact on egg production.
Other ART treatments (there’s a long list) include gamete intrafallopian transfer and zygote intrafallopian transfer. In these procedures, the egg and sperm are inserted into the fallopian tubes instead of the uterus. These methods are usually a second course of action after unsuccessful IVF attempts, and they may work better. Because the egg is fertilized inside the fallopian tube instead of outside the body, they are more similar to natural conception processes.
2. Surrogacy
In surrogacy, an AFAB person carries and delivers a child for a couple that wishes to have a baby. It’s typically used in cases where neither parent’s body is able to carry a pregnancy to term. Some people choose surrogacy because of preexisting health issues or past histories of failed pregnancy. Some choose it because they’re older or have had a hysterectomy. Surrogacy is also a next option for people who’ve tried and haven’t seen success with ART treatments.
It’s often assumed that lesbian couples wouldn’t need a surrogate, but all kinds of LGBTQ+ folks choose surrogacy for a variety of reasons. In some lesbian couples, neither person has a uterus that can carry a pregnancy to term. Gay men may choose surrogacy so their child can have at least one partner’s DNA. Trans women may use a surrogate because their bodies can’t carry a pregnancy. Trans men may opt for surrogacy to avoid the gender dysphoria pregnancy can cause.
The first step in surrogacy is to fertilize the surrogate’s egg with the sperm of the donor or biological father-to-be. This is typically done in a doctor’s office or fertility clinic, through artificial insemination. In some cases, IVF is used to fertilize a biological mother’s egg with the biological father’s sperm. The fertilized egg is then inserted into the uterus of the surrogate, AKA gestational mother. In this case, the surrogate does not share DNA with the fertilized egg.
This second type of surrogacy, known as gestational surrogacy, has become more common in the United States, though it’s typically more expensive. Some people prefer it because, in gestational surrogacy, both would-be parents get to share DNA with the child. Gestational surrogacy is also less potentially legally challenging, because the surrogate isn’t biologically related to the child. Neither procedure is without emotional risk, as the surrogate can become attached to the child.
3. Adoption
Adoption is a process in which one or more parents become the legal guardians of a child to whom they aren’t biologically connected. The child can be a baby or closer to their teenage years, as long as they’re under 18. Some people consider adoption a last option, after they’ve tried everything else. But adoption is a perfectly valid and rewarding pathway to becoming a parent, and plenty of people would rather adopt than conceive.
Adoption procedures in the U.S. are complex and can require a great deal of patience. There’s a long list of requirements to meet for eligibility, and some can be quite strict. For instance, adoptive parents must be over the age 25 and be able to pass a criminal background check and a home study. In a home study, officials interview prospective parents and visit their home to check for clean, safe conditions. Requirements usually apply to private, public, and especially international adoptions.
Prospective parents who wish to adopt must first choose which type of agency to adopt from. In public adoptions, they typically apply to care for a child who has been placed in the foster system. There may be an associated fee (under a few thousand dollars) in some states, but in others, it is free. Public and international adoptions can cost upward of $45,000, especially when there are international travel and legal fees involved.
Same-sex adoption is legal and protected across all 50 states in the U.S., though queer parents may still experience discriminatory practices. Black prospective parents were historically denied adoption services until well into the 20th century, and some may still face difficulties or discrimination. Single parents also legally qualify to adopt in the United States, but may face more questioning about their support systems during interviews and home study procedures.
Patience is Key
Creating a human life — or bringing a preexisting one into your family — takes a lot of time no matter how you slice it. Would-be parents may spend years trying to find a successful pathway to parenthood. The emotional ups and downs can be extreme enough to wreak havoc on a partnership. There can be excitement, disappointment, grief, anger, and everything in between.
That’s why it’s incredibly important to know what you’re getting into, and make sure you and your partner are on the same page. Whether you’re parenting with a partner or solo, establish a support system of friends, family, and loved ones in your corner. Bringing a child into your life could be the most rewarding, fulfilling decision you ever make. But you’ll need to be prepared for a long, winding journey there.
