Times, they have changed. In the 1970s, our understanding of reproduction had advanced enough that we could start to help infertile couples conceive. Fertility clinics opened and test-tube babies became a reality. Back then, the math of fertility was simple: Egg + sperm + uterus = baby. Heterosexual couples would go to a fertility clinic and their eggs, sperm and uterus would be assessed. The fertility doctors would hopefully fix the couple's problem and sometimes a baby would follow. Fertility specialists, by their own values or institutionally imposed ones, did not treat any demographic other than straight, married couples.
Fast-forward four decades. Today, families are defined in a multitude of ways and the new math of fertility means an individual or couple does not need to have their own eggs, sperm and uterus to have a baby. Egg donation, sperm donation and surrogacy have made it possible for same-sex couples to have children.
It sounds so easy! Like a 3 a.m. infomercial: "With just three simple ingredients, you, too, can have a child of your own!" Alas, for same-sex couples it's not so easy. Couples needing eggs, sperm or a uterus to have a child undergo medical, genetic and psychological testing by fertility clinics. Legal contracts need to be drawn up between intended parents and the surrogate. Surrogates must be under 45, have had a previous uncomplicated term pregnancy and be healthy. Egg and sperm donors must not carry any serious medical, genetic or infectious diseases. Depending on the relationship, the clinic also may request a legal contract between egg or sperm donor and the intended parents. The process can take months or even years to navigate.
Same-sex female couples usually have two of the three necessary ingredients for a pregnancy: eggs and a uterus. They can use a known or anonymous sperm donor and have monthly inseminations of sperm into their uterus. The pregnancy rates are high and the treatment complexity is fairly low. The cost is approximately $1,000 per month of trying.
For same-sex male couples the process isn't as straightforward, as they only have one of the necessary ingredients: sperm. Justin Mallard, 29, and Brett Rancourt, 31, from Chilliwack, B.C., were not dissuaded by this reality.
When they first met in 2009, both declared their desire to be parents. Going from desire to healthy babies in their arms was a three-year process. They had sperm but needed eggs and a uterus (surrogate). "There are so many obstacles in the way of this working, it would have been easy to give up," Justin says. They didn't, and eventually a friend volunteered to donate eggs. Finding a surrogate proved trickier.
In Canada, surrogates must be acting voluntarily – not for compensation beyond reasonable expenses. In other words, you cannot outright pay someone to use their uterus for a pregnancy. To find a surrogate, Justin and Brett started talking. They told their friends and family about their dreams of having children. A kind-hearted co-worker and friend of Brett's eventually approached them. She had had easy pregnancies in the past and was excited to help her long-time friends achieve their dream.
Once they had their egg donor and surrogate ready, they started the in-vitro fertilization (IVF) process. During IVF the egg donor took daily injections for about two weeks to grow multiple eggs. Her eggs were retrieved from her ovaries and fertilized – 50 per cent with Justin's sperm and 50 per cent with Brett's – to make embryos. One embryo from each dad was placed into their surrogate. Both took. In June, 2014, their daughter and son, Jordyn and Sawyer, were born, happy and healthy.
Justin and Brett spent about $15,000 to have their children. This is far less than what most gay male couples will spend. Most gay male couples do not have a friend to donate eggs, so they need to purchase eggs from a bank at a cost of $18,000 or more. Surrogate reimbursement, while limited to "reasonable expenses" by federal law, can still cost hundreds or even thousands of dollars. Most gay male couples will spend more than $30,000 to have children through egg donation and surrogacy.
While the math of making a baby remains the same, how we apply it has changed. The path to parenthood isn't always straight; it can be complex and expensive. But no one would argue with Justin when he says, "In the end, it was worth it and more."
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Dr. Beth Taylor is co-founder and co-director of Olive Fertility Centre in Vancouver. She is a clinical associate professor at UBC and co-ordinates the UBC obstetrics and gynecology residency program, reproductive endocrinology and infertility, rotation. She is an active staff member at BC Women's Hospital and Vancouver General Hospital and performs surgery at both. Follow her on Facebook and Twitter.