As the number of gay couples and individuals using surrogacy to achieve biological parenthood keeps growing, there has been a transition from traditional to gestational surrogacy, involving in vitro fertilization (IVF). Through the services of egg donors and gestational carriers, it is now common to utilize IVF to maximize personal choice, security and success in the process. Indeed, statistics reveals that current IVF attempts at our clinics are 70% successful in achieving pregnancy.

The procedure is surprisingly simple, and generally involves three main steps: medically induced production of eggs by the donor, the creation and development of embryos through the harvesting and fertilizing of the eggs, and lastly the transfer and implantation of the embryos into the uterus.

Each of these steps involves crucial medical and personal choices for the intended parents and the medical team to make. These decisions will directly affect not only the success of the procedure, but also the number, health and the biological makeup of the prospective children. Even after a successful pregnancy, decisions often have to be made regarding frozen embryos that were not utilized.

Here I will focus on decisions made during the second phase of the process, the creation and development of embryos. Choices involved in selecting egg donors and those related to options for frozen embryos will be discussed in future articles.

For embryos to be created, the eggs produced by the donor are harvested, fertilized by donor sperm and developed into embryos in the IVF laboratory where highly controlled conditions exist to sustain their growth. This is performed by physicians and laboratory staff who specialize in the field of Reproductive Medicine. This medical team guides the intended parents on the choices which they will need to make regarding the fertilization processes.

One option unique to gay couples is the ability to choose and achieve “combined parenthood.” Some choose to do so by mixing their sperm before fertilization, while others direct the laboratory to fertilize half of the eggs with each sperm sample, so that the paternity of each embryo can be known, and the children can be chosen accordingly.

The second crucial decision at this stage involves the number of embryos to transfer back into your carrier. Medical experts assist prospective parents in this decision by providing statistics to help maximize your success, as well as assess their chances of a single versus twin pregnancy. The decision will also be informed by factors such as the quality of the embryos, and the egg donor’s past “track record” for pregnancies. From our experience, most parents today choose to transfer two highly developed embryos, and freeze the rest for potential future use.

Like anything, the IVF process might seem daunting, but when broken down, is really a sequence of manageable steps and decisions.