Abstract
In recent years, advancements in assisted reproductive technologies (ART) have revolutionized family planning. For LGBTQ+ individuals and couples, this is great news because it makes parenthood more accessible. An important highlight among these advancements is that egg freezing has emerged as a vital option for preserving fertility and creating opportunities for future biological parenthood.
Family-building often involves unique considerations that traditional fertility services may not adequately address for the LGBTQ+ community. At OvoLife, we are committed to bridging this gap by offering comprehensive, LGBTQ+ friendly fertility services in Toronto. With a deep understanding of the medical, emotional, and financial aspects of fertility preservation, we provide compassionate guidance and leading-edge reproductive technology to support every individual’s path to parenthood.
While it may not be apparent to most of us, egg freezing is more than just a medical procedure. For prospective parents faced with unique challenges, it is an act of hope, planning, and self-determination. Are you considering fertility preservation before gender-affirming treatments? Do you need help planning for assisted reproduction with a current or future partner? Is it your goal to secure reproductive options for the future? Our team is here to help you with all the above!
In this guide, we’ll explore the egg freezing process, financial and legal considerations specific to LGBTQ+ individuals, and the various pathways to parenthood that become possible through fertility preservation. By prioritizing inclusivity, our expertise empowers you to take control of your reproductive future with confidence.
Let’s navigate this journey together, ensuring that everyone, regardless of gender identity or sexual orientation, has the opportunity to build the family they envision.
What if I have started gender affirming care?
Individuals who have initiated gender-affirming hormone therapy, such as testosterone, may still have the option to pursue egg freezing. Research indicates that ovarian stimulation and oocyte retrieval can be successfully performed in transgender men, even after the commencement of testosterone therapy. (Amanda J Adeleye, 2019)
However, to optimize outcomes, it is generally recommended to discontinue testosterone treatment prior to undergoing the egg retrieval process. This cessation allows for the resumption of ovarian function and the maturation of oocytes necessary for retrieval. It’s important to note that stopping hormone therapy, even temporarily, can present both physical and psychological challenges, including the return of menstruation and potential increases in gender dysphoria. Therefore, individuals considering fertility preservation after starting hormone therapy should consult with their healthcare providers to thoroughly discuss the potential benefits and challenges associated with temporarily halting treatment. (T H R Stolk, 2023)
If you have questions about the egg freezing process, family planning, or how your gender affirming treatment may impact your fertility, don’t hesitate to contact us for a consultation so you can make an informed decision about your future.
Why LGBTQ+ Couples Consider Egg Freezing
Egg freezing is becoming an increasingly popular option for LGBTQ+ individuals and couples who want to preserve their reproductive options for the future. While fertility preservation has long been associated with individuals delaying parenthood for career or medical reasons, it holds particular significance for the LGBTQ+ community. From ensuring biological parenthood after gender-affirming treatments to planning for assisted reproduction with a future partner, there are several compelling reasons why some people consider egg freezing.
- Fertility Preservation Before Gender-Affirming Treatments
For transgender and non-binary individuals who plan to undergo hormone therapy or gender-affirming surgery, egg freezing provides an opportunity to preserve their biological fertility before beginning treatment. Estrogen therapy for transgender women and testosterone therapy for transgender men can impact fertility, often reducing the chances of biological parenthood later in life. While some individuals may choose to pause hormone therapy to retrieve eggs in the future, freezing eggs before beginning treatment offers a proactive and less disruptive approach to family planning.
Research shows that transgender individuals often face barriers to fertility preservation, including a lack of affirming healthcare providers and limited financial support. (Ashni S Nadgauda, 2024) At OvoLife, we aim to eliminate these barriers by providing compassionate, gender-affirming fertility care that prioritizes the unique needs of each patient.
- Planning for IVF in Same-Sex Partnerships
For LGBTQ+ individuals and couples, egg freezing provides an opportunity to preserve fertility and look forward to future parenthood. Many choose to freeze eggs early while considering options such as sperm donation or embryo freezing for later use.
Gay couples who wish to have biological children may also consider egg freezing through egg donor programs, as part of a surrogacy journey. We provide expert guidance on donor egg options and fertility treatments tailored to same-sex male couples.
- Delaying Parenthood While Exploring Options
Many LGBTQ+ individuals and couples choose to freeze their eggs while they explore different paths to parenthood. Some may not be in a relationship but want to secure their fertility for future use, while others may be focused on career or financial stability before starting a family. Given that egg quality declines with age, freezing eggs at a younger age can significantly improve the chances of a successful pregnancy later on.
- Addressing Emotional, Financial, and Practical Considerations
Fertility decisions are deeply personal, and for LGBTQ+ individuals, they often involve additional emotional and financial considerations. Many people have concerns about reproductive healthcare access, discrimination in fertility clinics, or the affordability of treatments. By freezing eggs proactively, individuals can take control of their reproductive future while giving themselves time to explore their options without the pressure of declining fertility.
At OvoLife, we believe that everyone deserves access to fertility care that aligns with their identity, values, and future goals. By offering inclusive, expert-led fertility preservation services, we help LGBTQ+ individuals navigate their journey with confidence, knowing that their reproductive choices are supported by a clinic that prioritizes inclusivity and personalized care.
The Egg Freezing Process: A Step-by-Step Guide for LGBTQ+ Individuals
If you are a LGBTQ+ individual considering egg freezing, we highly recommend that you understand the process fully, as it is key to making informed decisions about reproductive preservation. Whether preserving fertility before gender-affirming treatments, planning for future IVF, or keeping reproductive options open, egg freezing provides a proactive approach to LGBTQ+ family planning. At OvoLife, we offer a safe, affirming, and science-backed fertility journey tailored to the unique needs of LGBTQ+ individuals.
Here’s a step-by-step breakdown of how egg freezing works, with specific considerations for transgender, non-binary, and same-sex couples.
Step 1: Initial Consultation and Personalized Fertility Planning
Every fertility journey at OvoLife begins with a consultation with a reproductive specialist. During this visit, we discuss your individual goals, medical history, and reproductive health factors that may impact egg freezing. For LGBTQ+ individuals, this includes considerations such as:
- Hormone therapy and its impact on fertility (for transgender and non-binary individuals).
- Long-term fertility storage and future reproductive pathways based on individual goals.
Blood tests and ultrasounds are conducted to assess ovarian reserve (egg quantity and quality), which helps determine how many eggs we can retrieve and store for you.
Step 2: Hormonal Stimulation
Egg freezing requires hormonal stimulation to mature multiple eggs, but the approach differs depending on the individual’s hormone profile:
- For transgender men (assigned female at birth) currently on testosterone therapy, stopping testosterone for a few weeks may be necessary to allow the ovaries to respond to fertility medications. This is a deeply personal decision, and our specialists work closely with each patient to minimize discomfort while ensuring the best possible egg yield.
- For non-binary individuals currently on hormone therapy, we make adjustments on a case-by-case basis to balance reproductive goals with gender-affirming care.
- For cisgender lesbian individuals, standard ovarian stimulation protocols are used, with the flexibility to align with a future partner’s family planning preferences.
Hormonal stimulation typically lasts 10–14 days, during which patients self-administer gonadotropin injections to encourage egg maturation. Regular monitoring ensures a safe and effective response to the medication.
Step 3: Egg Retrieval – A Safe and Quick Procedure
Once the eggs are mature, a minor surgical procedure is performed under light sedation to retrieve them. Here’s what this process involves:
- Using ultrasound guidance, a specialist retrieves eggs from the ovaries through a thin needle.
- The procedure takes 15–20 minutes and has minimal downtime, allowing most patients to resume normal activities within a day.
LGBTQ+ Considerations:
- For transgender individuals, emotional and physical discomfort related to the procedure is carefully managed with gender-affirming care and pain management strategies.
- For same-sex couples, eggs can be designated for future use in IVF or stored for later decisions.
Step 4: Cryopreservation (Freezing for Future Use)
After retrieval, the eggs are flash-frozen using vitrification, a technique that preserves them at -196°C to maintain high survival rates for future use. Eggs can be stored for years or even decades without degrading in quality.
- For transgender and non-binary individuals, this ensures reproductive options remain available post-transition.
- For LGBTQ+ couples, it offers flexibility in timing and reproductive planning.
Step 5: Future Family Planning – LGBTQ+ Pathways to Parenthood
Frozen eggs can be used whenever an individual or couple is ready to start a family. Options include:
- Sperm donation and intrauterine insemination (IUI) – Common for lesbian couples using donor sperm.
- Gestational surrogacy – Often used by same-sex male couples who require an egg donor and surrogate.
At OvoLife, we provide expert fertility counselling to help LGBTQ+ individuals navigate these options when the time comes.
For LGBTQ+ individuals and couples who have preserved their fertility through egg freezing, there are multiple paths to parenthood when they are ready to start a family. Whether through reciprocal IVF, sperm donation, or gestational surrogacy, modern reproductive technologies offer inclusive options for any person to build their family in a way that aligns with their identities and life circumstances. At OvoLife, we support every step of this journey, ensuring that LGBTQ+ individuals have the information and care they need to make empowered reproductive decisions.
- In Vitro Fertilization (IVF) with Frozen Eggs
IVF is one of the most common fertility treatments used by LGBTQ+ individuals who have frozen their eggs. When ready to pursue parenthood, a frozen egg is thawed, fertilized with donor sperm, and developed into an embryo before being transferred into the uterus for pregnancy.
- For single LGBTQ+ individuals, IVF allows them to use their own frozen eggs when they are ready to start a family.
- For same-sex female couples, one or both partners may use IVF with donor sperm to conceive.
- For transgender or non-binary individuals, IVF provides an option to use their preserved eggs in a future pregnancy, either by carrying it themselves (if applicable) or with a partner or gestational carrier.
This process gives LGBTQ+ individuals full control over their reproductive choices, allowing them to preserve fertility and start a family on their chosen timeline.
- Sperm Donation
For individuals or couples who have frozen eggs but do not have a sperm-producing partner, sperm donation offers a straightforward route to conception.
How it Works:
- A donor sperm sample is selected (either from a known or anonymous donor).
- The frozen egg is fertilized through IVF.
- Once pregnancy is achieved, standard prenatal care follows.
LGBTQ+ Considerations:
- Some individuals choose known donors (a friend or family member), while others prefer anonymous donors from sperm banks.
- Legal agreements are often recommended for those using a known donor to clarify parental rights.
- OvoLife provides guidance on sperm selection, legal considerations, and fertility treatments to help LGBTQ+ individuals make informed decisions.
- Gestational Surrogacy: A Path for Gay Couples and Transgender Individuals
For same-sex male couples or transgender individuals who cannot carry a pregnancy, gestational surrogacy is a viable path to biological parenthood.
How it Works:
- The frozen egg (either from a partner, a donor, or previously preserved eggs) is fertilized with sperm from one or both intended parents through IVF.
- The resulting embryo is transferred to a gestational surrogate—a person who carries the pregnancy but has no genetic relation to the baby.
- The surrogate carries the pregnancy to term and delivers the child, who is then legally and biologically the intended parents’ child.
LGBTQ+ Considerations:
- Many gay couples use an egg donor and surrogate to conceive.
- Legal requirements vary by region, and contracts are required to outline parental rights and financial obligations.
- In Ontario, LGBTQ+ parental rights are legally protected, making Toronto a leading city for surrogacy services.
- Using Frozen Eggs for Parenthood at a Later Stage
Egg freezing allows LGBTQ+ individuals to delay parenthood while still keeping their options open for the future. Many individuals store their eggs while they:
- Focus on career or personal growth before starting a family.
- Wait for the right time or partner to make parenthood decisions.
- Explore different reproductive options before committing to a specific pathway.
When ready, previously frozen eggs can be fertilized through IVF, offering individuals full reproductive autonomy in planning their family life.
Financial Considerations: Investing in Fertility Preservation and Parenthood
Fertility preservation, including egg retrieval, freezing, and storage, represents a significant investment in your future and your family. For LGBTQ+ individuals, particularly those pursuing fertility preservation before medical transition or while exploring family planning options, understanding the financial aspects is crucial.
The costs associated with fertility preservation include:
- Initial fertility assessment and consultation
- Medications for ovarian stimulation
- Egg retrieval procedure
- Laboratory processing and vitrification
- Long-term storage fees
Beyond preservation, those moving forward with assisted reproductive technologies also need to consider expenses for IVF or embryo transfer, along with associated medical, laboratory, and medication costs.
For same-sex male couples and transgender individuals who cannot carry a pregnancy, gestational surrogacy expenses will include medical care for both the surrogate and intended parents, legal contracts, and reimbursements for pregnancy-related expenses.
We understand that fertility care is an investment in the future. Our team of experts offers transparent guidance to help you explore options that align with your financial situation, including insurance coverage verification and financing alternatives.
Legal Considerations: Protecting LGBTQ+ Parenthood Rights
Ontario offers strong legal protections for LGBTQ+ parents under the All Families Are Equal Act, ensuring that individuals who conceive through assisted reproduction are legally recognized as parents without requiring adoption. (Government of Ontario, 2016)
Key legal considerations include:
Donor Agreements: Whether using sperm or egg donors, legal agreements clarify parental rights, financial responsibilities, and future contact terms. While anonymous donors from regulated banks have no parental claims, those opting for known donors should establish formal contracts to prevent complications.
Surrogacy Arrangements: In Canada, commercial surrogacy is prohibited, meaning surrogates can only be reimbursed for medical and pregnancy-related expenses. Legal contracts between intended parents and surrogates must be finalized before embryo transfer to ensure clarity on rights and responsibilities. (Government of Canada, 2024)
For LGBTQ+ couples planning for future parenthood, early consultation with a fertility lawyer can help streamline legal processes and prevent complications. From navigating donor agreements to surrogacy arrangements, parental rights, and more, understanding legal protections is essential for a secure path to parenthood.
Why Choose OvoLife in Toronto for LGBTQ+ Fertility Services and Family Planning
Toronto stands as one of North America’s most progressive cities for LGBTQ+ family building, offering a combination of advanced fertility treatments, strong legal protections, and a supportive community. This environment makes Toronto an ideal location for individuals seeking inclusive fertility care.
At OvoLife, we specialize in LGBTQ+ fertility care, providing personalized, affirming, and expert-led reproductive services. Our approach sets us apart through:
- Comprehensive LGBTQ+ Care: From transgender fertility preservation to family planning for same-sex couples, our services address the unique needs of the LGBTQ+ community.
- Personalized Treatment Plans: We recognize that every fertility journey is different, especially for LGBTQ+ individuals. Our specialists create customized plans that respect your identity, goals, and circumstances.
- Cutting-Edge Technology: Our state-of-the-art facility offers the latest in reproductive technologies, ensuring the highest standard of care for egg freezing and fertility treatments.
- Supportive Environment: Our team is trained in LGBTQ+ inclusive care, creating a welcoming space where you can discuss your fertility needs without judgment.
Dr. Maryam Rahbar is the founder and CEO of Ovolife Egg Freezing Clinic. With extensive academic credentials including a BSc, MSc, and PhD in reproductive medicine, Dr. Rahbar has dedicated her career to advancing fertility preservation options and providing inclusive care to diverse patient populations. When asked about her clinic’s approach to patient care, Dr. Rahbar emphasized:
“I’ve seen firsthand how deeply personal fertility decisions can be. There’s often so much emotion involved in these choices. That’s why at Ovolife, we’ve built our entire approach around respecting each person’s unique journey. Whether you’re looking into fertility preservation before gender-affirming treatment or you’re actively planning to start a family, we’re committed to walking alongside you with both compassionate support and cutting-edge medical expertise. Our team works hard to make sure your experience with us feels empowering rather than overwhelming. Whatever path brought you to our door, we’re here to help you move forward with confidence.”
If you’re ready to explore your fertility options, book a consultation today, and let’s start your journey together.
Bibliography
- Amanda J Adeleye, M. I.-L. (2019). Ovarian stimulation for fertility preservation or family building in a cohort of transgender men . J Assist Reprod Genet., 2155-2161.
- Ashni S Nadgauda, S. B. (2024). Barriers to fertility preservation access in transgender and gender diverse adolescents: a narrative review. Theraputic Advances in Reproductive Health, 18.
- Government of Canada. (2024, 02 18). Prohibitions related to Surrogacy. Retrieved from Government of Canada Website: https://www.canada.ca/en/health-canada/services/drugs-health-products/biologics-radiopharmaceuticals-genetic-therapies/legislation-guidelines/assisted-human-reproduction/prohibitions-related-surrogacy.html
- Government of Ontario. (2016, Nov 29). Ontario Passes Law Ensuring Equal Recognition for All Parents and Children. Retrieved from Government of Ontario Website: https://news.ontario.ca/en/release/42853/ontario-passes-law-ensuring-equal-recognition-for-all-parents-and-children
- T H R Stolk, E. v. (2023). Fertility counseling guide for transgender and gender diverse people. International Journal of Transgender Health, 361-367.
