Why Are the Proportions of In-Vitro Fertilisation Interventions for Same Sex Female Couples Increasing?

Same-sex female couples who wish to become pregnant can choose donor insemination or in-vitro fertilization (IVF)—a technique intended for infertile women. In general, women in same-sex female partnerships are no more likely to be infertile than those in opposite sex partnerships. This article investigates data available from the Government Regulator of UK fertility clinics—the Human Fertilization and Embryology Authority, which is the only data available worldwide on same-sex female couples and their fertility choices. IVF is increasing both in absolute numbers and relative proportions year on year in the UK, compared to licensed donor insemination for same-sex female couples. As IVF has greater human and financial costs than donor insemination, policies should not encourage it as the first choice for fertile women requiring sperm. Commercial transactions are taking place where fertile lesbians receive cut price, and arguably unnecessary, IVF intervention in exchange for selling their eggs to be used for other infertile customers. If women are not told about the efficacy of fresh vs. frozen semen, and the risks of egg ‘sharing’ or intra-couple donation, exploitation becomes possible.

Live birth after additional tubal flushing with oil-based contrast versus no additional flushing: a randomised, multicentre, parallel-group pragmatic trial in infertile women with at least one patent tube at hysterosalpingo-foam sonography (HYFOIL study)

IntroductionTubal patency testing is an essential part in the fertility workup of many subfertile women. Hysterosalpingography (HSG) has long been the test of choice in many clinics. There is evidence from a large randomised multicentre trial and from a recent meta-analysis that women who had HSG using oil soluble contrast medium (OSCM) had higher rates of ongoing pregnancy compared with women who underwent this procedure using water contrast. However, the field is moving away from HSG and nowadays hysterosalpingo-foam sonography (Hyfosy) using ultrasound guidance is considered as the first line office tubal patency test. Therefore, a large multicentre randomised clinical trial (RCT) will be initiated to evaluate if flushing the fallopian tubes with OSCM after a normal Hyfosy showing at least one patent fallopian tube will increase the live birth rate as compared with no flushing.Methods and analysisWe plan a multicentre two arm, 1:1 randomised, open-label pragmatic comparative trial in 12 Belgian centres. After informed consent, we will randomise infertile women between 18 and 40 years of age, undergoing Hyfosy as part of the fertility workup to Hyfosy with additional tubal flushing with OSCM versus Hyfosy without additional flushing. Infertility is defined as lack of conception despite 12 months of unprotected intercourse, or three cycles of donor insemination without pregnancy or three ovulatory ovulation induction cycles without pregnancy, all three in combination with at least one patent tube on Hyfosy. Primary endpoint will be live birth with conception within 6 months after randomisation.Ethics and disseminationApproval on 11 May 2021 by the Ethics Committee from ZNA Hospital Antwerp who was the central Ethics Committee for the Clinical Trial Regulation Pilot (Pilot 412) in the 12 centres. The findings from this RCT will be disseminated in peer-reviewed publications and presentations at scientific international meetings.Trial registration numbersEudraCT number: 2020-002135-30 and NCT04379973.

Obstacles to transsexuals becoming parents : a preliminary investigation

Transsexuals can become parents through a variety of biological and social means both pre and post-transition. This exploratory study looked at the obstacles transsexuals may face in trying to access parenting through donor insemination, surrogacy and/or adoption post-transition. Qualitative interviews were conducted with two professionals who work with transsexuals trying to access parenting and one transsexual parent/activist. Key informants highlighted a number of obstacles faced by transsexuals trying to access parenting including discrimination from social services, fear of the medical system, lack of information and knowledge biology, cost, lack of support and sense of entitlement. In addition key informants also highlighted the reasons why transsexuals want to become parents, the impact these obstacles can have on children of transsexuals and the changes that need to be made to eliminate these obstacles both at social and governmental levels. It should be noted that because of the small sample size, use of non-probability sampling and uniqueness of each case that the results of this research cannot be generalized to all transsexuals seeking to access parenthood.

Obstacles to transsexuals becoming parents : a preliminary investigation

Transsexuals can become parents through a variety of biological and social means both pre and post-transition. This exploratory study looked at the obstacles transsexuals may face in trying to access parenting through donor insemination, surrogacy and/or adoption post-transition. Qualitative interviews were conducted with two professionals who work with transsexuals trying to access parenting and one transsexual parent/activist. Key informants highlighted a number of obstacles faced by transsexuals trying to access parenting including discrimination from social services, fear of the medical system, lack of information and knowledge biology, cost, lack of support and sense of entitlement. In addition key informants also highlighted the reasons why transsexuals want to become parents, the impact these obstacles can have on children of transsexuals and the changes that need to be made to eliminate these obstacles both at social and governmental levels. It should be noted that because of the small sample size, use of non-probability sampling and uniqueness of each case that the results of this research cannot be generalized to all transsexuals seeking to access parenthood.