Therapeutic donor insemination for LGBTQ+ families: a systematic review

Importance

Lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) families deserve evidence-based care within environments designed for their unique needs; however, care provided in fertility clinics has been reported to fall short, most notably for assigned female at birth recipients of therapeutic donor insemination (TDI).

Objective

To identify the aspects of routine infertility care that are clinically appropriate for this unique patient population, specifically those seeking pregnancy with donor sperm. The research question was posed, “What screening and treatment protocols are supported by the evidence regarding TDI care for LGBTQ+ families?”

Evidence Review

High quality, prospective studies specific to and/or inclusive of this patient population in assisted reproductive care contexts is limited, however evidence regarding age-informed prognosis, screening guidelines, treatment outcomes, insemination timing, number of inseminations per cycle, when to refer, and safety of the procedure were found.

Findings

Findings indicate that compared with routine infertility care protocols, a low-tech, low-intervention model of care for ovulatory LGBTQ+ individuals renders equal or higher success rates without increasing risk.

Conclusion

Given the current evidence, TDI for LGBTQ+ families can, with support and training, be provided appropriately in a variety of contexts, including community-based and primary care settings as well as in fertility clinics.

Relevance

This review establishes the current state of the evidence supporting TDI for LGBTQ+ families, expanding access to care for recipients as well as their care providers and outlining areas for further study.