“Being gay doesn’t turn off the biological desire to have children”: our journey through IUI, miscarriage and IVF

I always knew that I was going to need some form of fertility treatment one day. I came out as gay when I was a teenager and so did my now wife, Lucie. It was around that time that the tide was turning when it came to both laws and social attitudes surrounding same-sex marriage, and by extension, families. It was never a case of ‘if’ for us, but ‘when’.

But before we even started the process we recognised how fortunate we were to be in a position to create a family of our own. Just one generation above us and the picture was very different. While there always have been and always will be gay and queer parents, as Lucie and I waded into the realm of prospective parenthood, we looked around to find that we didn’t have any examples of older queer parents in our lives to emulate or guide us. That’s not because they don’t exist, of course, but because the services, cultural attitudes and indeed laws did not freely allow for these reproductive tools to be used by people like us, so they are in the extreme minority.

Some of the assumptions around queer people having children persist today. Plenty have assumed that Lucie and I wouldn’t have children at all, or that we’d adopt. And while some queer people do indeed choose not to have kids — as do heterosexual people — the reality is that nowadays, queer folk can and do have biological children. And while some queer families do choose to adopt — as do heterosexual families — assuming adoption as the obvious path is a legacy of the idea that it’s impossible for us to have children. The reality is that adoption is extremely time-consuming, emotional and challenging, and should not be regarded as an easy or default option for any individual or family struggling to have a child.

Being gay doesn’t turn off the biological desire to have children. It doesn’t just go away, nor does it go away for straight people who struggle to conceive. Both my wife and I crave parenthood and long to raise a family.

Despite these assumptions, Lucie and I have been fortunate enough to imagine for most of our adult lives that we would each have the opportunity to carry a child. In fact, living in London has provided us with a false sense of security. London is mostly progressive and people tend not to bat an eyelid as we walk down the street hand in hand, or when we say we have a wife and not a husband. Like our straight friends of the same age, we talk about settling down, moving to the suburbs and just getting on with life. We hardly have to think or care about our sexuality at all, and we know just how lucky we are to live in a society that allows for that to be the case.

When we went to the GP back in early July 2019 to start the process, we knew of two other lesbian couples our age who had been through it. One couple had given birth after two rounds of IUI (intra-uterine insemination), and another was heading into their fifth year of treatment as they struggled with unexplained infertility. We were going to be treated in one of the most progressive and funding-friendly places in the country, and so, as we excitedly approached our family doctor in July 2019, we felt we’d hit a sort of jackpot.

Olivia with her wife Lucie

But the journey to starting our family has brought our sexuality back into the spotlight as we realise that we’re actually blazing trails for future queer parents. During our initial conversation with our family doctor, we were blindsided when we realised he had no idea what to do with us. This doctor was in his sixties and so we had wrongly assumed that he would have treated dozens of patients in our situation. But we could see him struggling to make sense of us. He nodded slowly as we explained we were married, that I would like to carry the pregnancy on this occasion, that we would use donor sperm from a bank, and needed to be referred to an NHS hospital with a fertility clinic.

Going through the NHS rather than a private clinic seemed like the more appropriate option for us at the time as some of the standard tests, scans, consultations and medications would be much cheaper. The policy surrounding funding is largely dependent on location. We knew right out the gate that we were going to be paying and that it wasn’t going to be cheap. As it happens, there is no funding available for lesbians on the NHS who haven’t received a diagnosis of sub-fertility. In order to qualify for any kind of financial assistance, we’d need to demonstrate we’d failed six rounds of self-funded IUI. But at that point in time, I was only 27. While we were keen to get the ball rolling, we weren’t in a desperate rush.

We reiterated this all to the doctor who just sort of stared blankly and made some notes. Needless to say if we hadn’t shown up with the questions to ask from our friends who had just been through it, we’d have had no clue either. The information available online was geared towards straight couples struggling to conceive, not lesbians with no known fertility issues, so we’d learned everything from our friends and forums.

The doctor said we’d need to have some blood tests but beyond that he’d need to confirm what to do. Lucie and I left the GP deflated and with a big question mark over our heads. We had wrongly assumed that we’d be able to walk in and have a doctor map out a timeline for us and give us very clear steps to follow. We’ve since learned, had we gone to a private clinic, that may well have been the case. But the knowledge that there could be funded IVF if there were indeed issues with either of us was too much to pass up. After a lot of confusing conversations with our GP (and being referred to the wrong hospital) we were finally given our first consultation with an NHS hospital with a fertility clinic in January 2020.

During this time, Lucie and I deep dived into the internet. Our search for knowledge was two-fold: finding fertility statistics that related purely to gay women, and then — arguably the much more difficult part — actually raising children not just as parents, but as gay ones. We wanted to understand the laws and how they would affect us. We wanted to read stories about donor-conceived children from both their perspective as well as their parents’ to help make decisions. Along this journey, we were painfully reminded, over and over, that it was impossible for Lucie and I to procreate together. Something that we both thought we’d processed long ago came to the surface and made us quite upset at times. We didn’t want to have to go through these long-winded processes that seemed highly medicalised, expensive and impersonal. A fact, of course, but something inescapable for us.

Soon however, our concerns about our sexuality shrunk into insignificance. Since our initial fertility consultation Lucie and I have had almost two years of disappointments, delays, frustrations and heartbreak. And after six rounds of IUI, dozens of internal scans, multiple invasive tests, a pandemic, two abandoned cycles, one miscarriage, and over £10,000 later, I am about to start IVF. To say it has been challenging is an understatement. The administrative side of the process has been beyond frustrating, but along the way Lucie and I have learned so much about our own bodies, fertility and what it means to be resilient.

What’s more, we’ve found comfort and solace in other couples who have faced or are facing infertility. As we sit in the waiting rooms, our question is the same as everyone else’s: will we get pregnant? We’ve been surprised by how many are in the same boat as us. Endometriosis, early menopause, low ovarian reserve, blocked fallopian tubes, low or no sperm count, or — as in my case — simply unexplained. In fact, after my failed rounds of IUI, I had to receive a sub-fertility diagnosis. A heterosexual couple trying for up to two years under the age of 25 are still regarded as “normal”. But in order for us to qualify for the funding, that distinction is what matters, and so slapped with the label of sub-fertility I have been.

It is important to note that while leaps and bounds have taken place socially and legally, there is one hurdle that gay and queer people trying to start families must still overcome: the financial. We started out by purchasing a package of three IUI cycles (£2,000) as well as four vials of donor sperm (£4,000). We had already decided Lucie would go straight to IVF when it was her turn to carry a pregnancy — by that point we wouldn’t be eligible for any funding anyway — so the fourth vial was intended to be for her so that our biological children would be genetically related.

After checking out the different banks, we opted for a donor from the European Sperm Bank because of the quality, the amount of detail given about the donor, and because we got a good feel for it. The man we went for is an exemplary human, and if our future children decide to contact him when they turn 18 — in the UK, anonymous donation is illegal — then we will fully support them in doing so. Sperm donation is one of the more hotly debated topics in queer spaces surrounding parenthood. People tend to have strong opinions about what is fair, right, or accepted. Lucie and I made sure we understood the literature around donor-conceived children and firmly believe that we have made the right decision to choose a donor from a bank. We have a deep gratitude for the people who decide to become donors. Our donor has made our family possible, and we will find creative and age-appropriate ways to honour both genetic sides of our future kids.

We also feel protected by the law, knowing that both mine and Lucie’s names will be listed on the birth certifications automatically as we’re having treatment within a licensed HFEA (The Human Fertilisation and Embryology Authority) clinic. In the UK, if you have a friend or known donor who provides sperm outside of an HFEA clinic, that person will have automatic parental rights. This can present challenging legal issues that can make it very difficult for all parties involved, particularly if feelings change. But, with fertility treatments being so expensive, it is easy to see why some do opt for more traditional methods (the at-home turkey baster we’ve all heard about). For some families this approach works for them and is their first choice. For others, it becomes a necessity as the costs of fertility treatments are simply out of reach. But the legal risks involved are just that: risks.

“We were painfully reminded, over and over, that it was impossible for Lucie and I to procreate together. We didn’t want to have to go through these long-winded processes that seemed highly medicalised, expensive and impersonal.”

Before I started my treatment, I was informed that IUI was like having a smear test and would be quick and painless. In my case it wasn’t. I have a retroverted cervix (as do 1 in 4 women) which makes it much harder to insert the catheter. I found each IUI to be a varying degree of hell and, with multiple people in the room at the time, sometimes a bit embarrassing. A far cry from the children conceived in the throes of passion and heat… My conception story, had the IUI worked, would have involved a fluorescent light being pointed between my legs, four doctors and nurses trying to help feed a catheter through my cervix, while my poor wife stood by helplessly jammed up against a sharps bin.

Sadly, none of those first three cycles worked. Lucie and I were really disappointed. We’d had treatment suspended for six months already because of Covid-19, and each month felt like a small eternity. But the doctors remained optimistic. They said it was a numbers game and there was “no reason” why it wouldn’t work.

With each failure I dug deeper into the statistics and science of IUI, and indeed, reproduction in general. While the doctors had been optimistic the actual figures showed anywhere between 5–20% success for any given IUI attempt. Essentially, the same likelihood a heterosexual couple has each month of conceiving. But we only had one opportunity each month and it had to be timed with military precision. An egg will survive for up to 24 hours. Thawed sperm will live for up to the same. That’s a very narrow window, and even if egg and sperm do meet, there are so many delicate and essential processes that need to take place flawlessly, and are very much out of the control of a clinic. On more than one occasion I ovulated on the wrong day and had cycles cancelled. The NHS clinic is not open at weekends, a frustrating fact we learned too late.

After the failed third attempt, Lucie and I discussed our options. Did we throw in the towel and go for IVF, which we now understood to be much, much more effective? If we switched to private IVF, would we regret it later if that too didn’t work? In the end, we decided on three more cycles of IUI and another four vials of sperm. Three for my IUIs and one for Lucie’s future IVF. That promise of three funded rounds of IVF was too big to ignore and we decided it was worth it, despite the money we’d already spent. Besides. The doctors were very optimistic.

Then we were thrown a curveball. After my fourth cycle of IUI I found out my beautiful mother back in New Zealand had been diagnosed with Cholangiocarcinoma — bile duct cancer. Rare and, in her case, incurable. While she was otherwise healthy and the cancer has been found as an incidental, it suddenly placed upon us a new desperation for the treatments to work. While I was ready to jump on a plane and race home, it was impossible because of CoVID-19 and, of course, Lucie and I were right in the middle of treatment. Mum convinced us to just wait a little bit and see out the treatment, and hopefully return to New Zealand with a baby on board. We want her to have as much time with her first grandchild as possible.

Finally, after my fifth cycle of IUI, we found out I was pregnant. It was an extraordinary feeling after learning such devastating news about Mum, and after so much disappointment across the failed cycles. I booked flights and managed to get a slot in the New Zealand quarantine. Mum was over the moon. We all were. She bought a little baby outfit while away for a weekend in Taupo.

But it was short lived. I started miscarrying only 72 hours later. It was impossible to process that this beautiful light on the horizon had been extinguished so quickly.

At that point, I pleaded with the hospital to just stop the IUIs and let us go straight through to the IVF before wasting anymore time. But policy is policy, and we had to see out that last round. Cycle six didn’t work either.

And now here I am, embarking on IVF. A different ballgame altogether. In fact, the difference between the fertility drugs for IUI and IVF is the difference between a game of footy in the park and the Olympic games. Piles of boxes of drugs are stacked in the wardrobe, waiting. I’m nervous. Afraid of how my body will react to the drugs. Of whether it’ll work. Will I be going back to New Zealand pregnant, or with some embryos in the freezer to transfer later on? Or will we to get any viable eggs at all? Regardless of what happens with this cycle, I’ve got to go home and be with my mother.

Nobody could have prepared Lucie and I for this journey. Looking back, my biggest regret is that we didn’t go privately in the first place. Learning about the different experiences our friends who have gone privately have had, I wish we’d done the same. While the NHS is excellent in many regards it has a little way to go in making fertility treatment more accessible and inclusive for queer people. Lucie and I cringed more than once when she was referred to as my husband. A lot of forms we had to fill out were written in a way that addressed only married heterosexual women with infertility pathologies. What about single women? Trans folk? Women needing fertility preservation treatment? I can only hope that Lucie and I choosing this service will build a better future experience for queer families.

My advice to other people out there who are looking to carry a pregnancy in the future is that it’s worth having a blood test that measures your AMH (Anti-Mullerian Hormone), and an internal ultrasound that shows your AFC (Antral Follicle Count). Having this information can help make informed decisions about how you plan your future family. If you already know you’re going to need to have assisted reproductive treatments, weigh up costs that don’t just relate to money because your time is valuable too. It’s worth noting that across my IUI treatments I had to go to the hospital more than forty times. If I hadn’t been furloughed and working from home due to the pandemic, this would have been almost impossible to negotiate with work.

There are going to be people out there who believe that if we can’t naturally have kids, then we shouldn’t be doing it. Well, everyone’s entitled to their own opinion. But being gay doesn’t turn off the biological desire to have children. It doesn’t just go away, nor does it go away for straight people who struggle to conceive. Both my wife and I crave parenthood and long to raise a family. The effect of not being deeply marginalised and oppressed by our society has meant that Lucie and I can strive for this traditional ideal for the first time without persecution, and so in many ways, we see our role as future parents as an absolute win for equality.

To all the people out there who are struggling with building a family, you are not alone. It will all be worth it in the end.

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