New York Post


LGBTQ couples need a great team around them, say docs


FOR LGBTQ couples contemplat­ing starting a family, it’s an exciting time, but one that’s accompanie­d by plenty of big decisions, such as whether to use a surrogate, an egg or a sperm donor, or adopt.

Consequent­ly, assembling a good team is critically important. It’s also helpful to stay in the know about new developmen­ts in the field.

We asked Jennifer Kulp-Makarov, MD, a reproducti­ve endocrinol­ogist at New Hope Fertility, Lisa Schuman, LCSW, the founder of the NYC Center for Family Building, and Daniel E. Stein, MD, a reproducti­ve endocrinol­ogist and the director of RMA of New York’s West Side office, to weigh in on the most important things to know right now.

Pick a fertility clinic with care

The most important decision you’ll make is selecting the best fertility clinic near you. Just because there are rainbow flags on the door doesn’t necessaril­y mean it’s going to have the most optimal success rates.

Find a clinic that has the most reputable lab, great doctors and a feeling that you have right when you walk in — that the office itself is LGBTQ friendly, Dr. Schuman said. “There should be lots of informatio­n on gay family building, everyone should use the right pronouns and the staff should be educated. There’s already anxiety about the medical profession in general, particular­ly among trans patients, so this is very important.”

Ask plenty of questions

Make sure that every fertility option that’s available to a straight couple will be offered to you, Dr. Stein said.

“It’s important that every single person knows that there will be no discrimina­tion,” he said. “I encourage LGBTQ couples to look for a fertility center with a large volume of patients that welcomes everyone, not just convention­al straight individual­s and couples.”

Realize that times are changing — in a good way

For years, it was illegal to pay a gestationa­l surrogate in New York state, but all that changed in 2020 when the Child Parent Security Act passed.

This law also assures LGBTQ couples that they are the legally recognized parents from the moment of the child’s birth. In addition, couples no longer have to find a surrogate who lives in another state. It also allows for legal parents to be defined as such, even when the child is conceived via reproducti­ve technology. Another advance: More couples are doing reciprocal in-vitro fertilizat­ion where one partner provides embryos which are then placed in the other partner.

Dr. Stein said that at his West Side practice, he and his reproducti­ve endocrinol­ogist colleagues are working with trans individual­s to manage their hormones as they’re transition­ing.

“This allows them to have a successful IVF procedure,” he said.

“We’re focusing on properly informing trans individual­s about their hormones and whether they should freeze their eggs or sperm prior to the transition to make the process easier and more successful.”

Finally, more insurance companies have begun covering fertility treatments for LGBTQ individual­s, and some clinics are working to reduce the amount of synthetic hormones needed during an IVF cycle.

“We’re pushing the envelope,” said Dr. Kulp-Makarov. “We’re pioneering the use of natural hormones to grow the embryos, which make the treatments gentler, lowers the number of overall injections by 75% and, in the process, lowers the cost for couples too.”

Learn a new definition of fertility

Legislator­s in some states are currently trying to change the meaning of fertility to be more allencompa­ssing and, ultimately, factor in same-sex couples. In addition, the Biden administra­tion is weighing a requiremen­t that health plans cover fertility treatments regardless of sexual orientatio­n or gender identity. This issue is of major importance because of the current insurance company mandated definition of infertilit­y. “To qualify for fertility benefits, you have to have had a year of unprotecte­d sex [without conceiving], but, if you’re a gay couple, how can you do that?” Schuman said. “That’s been a big problem because many of the families I see don’t have insurance that will cover treatment. If the push to change the infertilit­y definition moves forward, this will be a huge advance for LGBTQ couples.”

Better call a lawyer

To help make your plan to start a family as seamless as possible, it’s critically important to work with an experience­d lawyer who will draft all of the contracts you need.

This includes the documents for co-signing with a gestationa­l carrier, adoption agency or donor sperm/egg service, or if you have someone you know who is lined up to help. “You need a contract so that everything is clear before a pregnancy — even if you’re asking a friend to help,” said Dr. KulpMakaro­v.

She also urged prospectiv­e parents to work with a mental health profession­al who can screen a surrogate or even donors for any psychologi­cal issues. “This prevents custody battles once the baby is born,” she said.

 ?? ?? Find a reputable clinic that gives you a good feeling of belonging as soon as you walk in.
Find a reputable clinic that gives you a good feeling of belonging as soon as you walk in.
 ?? ?? Dr. Jennifer Kulp-Makarov
Dr. Jennifer Kulp-Makarov
 ?? ?? Dr. Daniel E. Stein
Dr. Daniel E. Stein
 ?? ?? Lisa Schuman
Lisa Schuman

Newspapers in English

Newspapers from United States