#33: The Turkey Baster Of It All
COMMUNITY VOICE: Tiffany Cook | HEALTHCARE EXPERTS: Brent Monseur MD, ScM; Patrina Sexton Topper PhD, MS, RN | COMMUNITY REVIEWER: Olivia Hall
SHOW NOTES
Quick Recap from Part 1
Who's carrying? Whose eggs? Where will sperm come from? In Part 2, we're covering sperm selection, costs, and the different fertility procedures available.
The Cost Reality
What's typically NOT covered:
Purchasing sperm (often $1,000+ per vial)
Storage fees
Ways to manage costs:
Health Savings Accounts (HSAs)
Fertility benefits through employers
Third-party storage facilities (cheaper for long-term storage)
How Much Sperm Do You Need?
For IUI: 1 vial per attempt. Success rate is 15-20% per try, so plan for 4-5 vials per child.
For IVF: 1 vial per cycle (some clinics require 2—ask upfront!)
Planning for multiple children: Buy extra vials upfront. Popular donors sell out quickly. Some banks offer priority purchasing for existing customers or buyback options.
Picking a Donor
Sperm bank profiles include background info, voice recordings, and baby photos. It can feel overwhelming.. Common considerations include:
Family resemblance
Physical attraction and gut feelings
Voice recordings
For Black families: limited inventory means considering potential "diblings" (donor siblings)
Know that the process is personal: Some keep it private, others consult close friends. There's no single right way.
Three Paths to Conception
Home-Based Insemination
The "turkey baster" method.
Pros: Most affordable, private
Challenges: Lower success rates, requires careful timing
Can involve a midwife for ~$250/attempt
IUI (Intrauterine Insemination): sperm placed directly into uterus at a clinic. Similar to a pap smear.
Unmedicated: Works well with no infertility risk factors
Medicated: Includes hormones, monitoring, and trigger shot. Increases multiple pregnancy risk by 4-5x.
IVF and Egg Freezing
Both start with egg retrieval:
Egg freezing: Preserves eggs, gives flexibility
IVF: Creates embryos for immediate or future transfer
The process:
Injectable medications for ~2 weeks
Frequent ultrasound monitoring
Retrieval under anesthesia
Side effects: mood swings, bloating, tenderness (temporary)
Avoid vigorous activity during stimulation
Recovery: 3-5 days
One Decision at a Time
This is a lot—but you don't have to figure everything out at once. Focus on what's in front of you now. Each family's journey is unique, and different pregnancies may involve different approaches.
TRANSCRIPT
Gaby: Welcome back to Queer Health Pod. I'm Gaby, that's Sam, and that's Richard. And you're listening to part two of our series on fertility and family planning for Queer Women. Now, if you didn't catch part one, we highly recommend it, but here's your 20 ish second recap: in the first part, we talked about why people with uteruses-- face a unique set of decisions when it comes to building a family. And then we sort of laid out this roadmap of questions that people often answer along the way to parenthood. These are questions like: who's carrying? Whose eggs are being used? And then whether the sperm is gonna come from somebody you know, or something like a sperm bank. In this episode, we're picking up right where we left off and moving forward on that roadmap, we're gonna start by talking about the real-world details of picking sperm from a bank. That means talking about what it actually takes to find sperm, navigating the donor selection pool, and then thinking through costs, logistics, and the emotional layers that can come with all of these decisions. And then we're gonna talk a little bit about the different kinds of fertility procedures that somebody with a uterus might undergo to get pregnant. And because some of the language is really technical, we're gonna define it upfront.
Sam: IUI is essentially medically timed or assisted insemination while IVF is a process where eggs are fertilized outside the body and then transferred into a uterus. We'll explain both in more detail , but wanted to give you a heads up because our acronym fetish has arrived.
Gaby: Besides the number of acronyms, one of the things that surprises people the most about the sperm banking and the fertility process is the cost.
Tiffany: I think we were also lucky to, and fortunate to have the money available to us to do so. And I know that that's not always the case. And it was still expensive for us. It wasn't like an inexpensive process.
Gaby: As a reminder that's Tiffany Cook, who is our community voice for this episode series.
Sam: Dr. Monseur breaks down what these costs can look like in some ways to manage them.
Dr. Monseur: Purchasing of sperm is often not covered and storage is often not covered. Some thing that, of my patients do is if they have access to their employer through like a health savings account, you can often use those funds, like you can get it approved to use that, and sometimes employers will match like your health savings account fund. I work in Silicon Valley, so my experience may be a little biased, but a lot of the tech companies are now partnering with these benefit packages that are more inclusive, And they actually do allow you to use their benefits to purchase donor gametes. So I'm hoping that more employers will move to that. And then it will also kind of pressure insurance companies to do the same.
Gaby: All right, so it sounds like the first cost to consider is just the cost of sperm itself. Now, sometimes that can be covered by health insurance benefits like health savings accounts or through special fertility insurance benefits that are often acquired through someone's employer. But just know that this is really individual to your insurance situation, and so it's definitely worth checking it out before assuming that it's covered. Here is another cost to consider, which is storage. So if you buy sperm from a bank, they will give you a few different options of upfront storage plans and these will have different time intervals that range from months to years. But it's important to consider that this is not your only storage cost down the line, once you've done either egg or embryo freezing, you're gonna have to pay for storage for that as well. So the actual total storage cost depends on a couple of different variables, including: when are you doing your sperm selection relative to when you're conceiving and if you're doing egg freezing and storage along the way.
Dr. Monseur: For folks who are doing long-term storage, so for example, let's say you're freezing your eggs, but you're not planning to use them for five or 10 years, it's often cheaper to actually ship them to a third party storage facility than paying the clinic. ' And there might be different facilities and different private storage places in your local area, but you can always ask your clinic or even do a Google search to find places that offer those services. And a lot of times they'll even set up a courier for you. So you'll just tell them you want your stuff transported and they'll go to the clinic, get the material, and take it for you.
Sam: If you're wondering, how will I know how much sperm is enough, Dr. Monseur has some guidance.
Dr. Monseur: So in general, when we think about the number of vials, you need one vial for each time you try an insemination. An insemination typically in this population is probably successful 15 to 20% of the time. So on average, folks should be planning to do four to five inseminations to be successful, right? So that would be four to five vials for one child through IUI.
Richard: Because IVF is much more precise, the math there is a bit different.
Dr. Monseur: On the flip side, if you're planning to do IVF, you only need one vial per IVF cycle. And in an IVF cycle, obviously, again, lots of factors here, but - a normal fertility assessment, you might expect to get anywhere from 10 to 15, maybe 15 to 20 eggs in a cycle. And so you might only need one vial for one IVF cycle, which then might translate into one child.
Gaby: Dr. Monseur did remind us to not take these numbers as hard or fast rules. Everybody's body is a little bit different, and some clinics have slightly different policies. So for example, our community reviewer pointed out that her clinic required two vials on the day of egg retrieval, which is higher than that one vial for one round of IVF rule that Dr. Monseur just told us about. It's very much something that's worth asking about upfront.
Dr. Monseur: it is challenging because it's very,specific to the ideal family size. It's also specific to what your treatment plan is, so it really depends and I think it's important, to have a conversation with your clinician upfront about what your goals are and what your plans are.
Richard: Like, for example, the picture can be a little more complicated and require a little more sperm if a couple wants to have, say, multiple kids with different egg sources each from a different parent, and have those kids be genetically related.
Dr. Monseur: I often tell parents: if you are planning to have the children be half siblings and it's a couple and you're both wanting to use the same sperm source, it's often better to buy more so that you kind of don't find yourself not having it available later. Now, having said that, sometimes sperm banks will let you, if you already have a child with a certain donor, they'll give you priority for additional purchase and some banks will also allow you to sell it back to the bank if you are finished. So asking these questions up front are really important. 'Cause, you know, it can be like a thousand dollars a vial.
Richard: So it's helpful to think about how many cycles you might try your overall family plan, and how that influences the number of vials you'll need. Planning ahead can help avoid surprises and make the process feel a little bit more manageable.
Sam: And this is coming from some New Yorkers here. But do not forget storage logistics, especially if you're thinking long term or planning for multiple one bed, I mean multiple children.
Gaby: And when you put all of that together, costs, cycles, storage, you start to see that sperm and donor selection really isn't a one and done decision for most people.
Tiffany: I guess one of the things that I would challenge people to think about is to not think about sperm donor selection as a one-time process. It's hard to say that because when you fall in love with a donor, you don't wanna give them up. But at the same time, it may be a process you have to do a couple times over. When you are considering like, okay, this is the donor I like, you're gonna consider how much sperm can we afford to purchase right now? How many cycles like are we thinking we're going to do? You know, maybe before we take a pause or a break, if we wanna fund past that, or if we wanna just fund until that point.
'cause I think what often happens is like there's a new donor, you're like, "Ooh, I like this donor." And then suddenly everyone else likes this donor too. And so everybody's buying as much as they can at that point and very quickly they're out.
Richard: Once you've thought through cycles, vials and storage logistics, the next big step is actually picking a donor, and that's where the process can start to feel really personal and honestly a little bit overwhelming.
Sam: The classic saying "You can't pick your donor's nose, but you have already by definitions picked their sperm."
Richard: Yes, a classic. It's one of my dad's favorites.
Sam: (Laughing) I should hope so. Cryobank have huge libraries of donor profiles that contain a lot of information about the donor and also, yes, a lot of sperm.
Tiffany: Everything from like background to like answers to certain questions. Like I said, a voice file, some baby photos.
Gaby: If this sounds like a lot of information, it is.
Dr. Sexton Topper: Thinking about how you go through the library of possibilities through a cryobank could be really overwhelming.
Sam: Which is why we'd like to market our gay man who's used to going through sexual attributes on an app, a service that most people probably don't need at this juncture anyway,
Yeah. Overwhelmed by everyone's attributes on an app and need to find one that actually guides your desire to be with them? Do we have some sluts for you! Anyway: for Tiffany, one guiding principle was not a gay man helping her go through the apps, but family resemblance.
Tiffany: So we were kind of looking under specific parameters and looking for somebody who looked at law like Morgan as much as possible. And I was looking at photos, looking at not only people who looked specifically like Morgan, but also like his either siblings or like kind of close relatives. And I think for us it wasn't just about looking like Morgan, but it also was about looking like family because we wanted to make sure our kids could kind of see themselves in their cousins and their siblings.
Richard: Family resemblance can be a common thing that people look for. Though of course, not everyone necessarily wants to prioritize that. Dr. Sexton Topper notes that this choice is more complicated for Black families, for example.
Dr. Sexton Topper: For Black folks who are trying to conceive, it can feel all kinds of ways, and I'm not gonna speak for others, but it has, has to do with the limited inventory across the country. Therefore the implications are how many diblings there are out there for your potential children. And so it's a consideration, right? And I think it's worth considering all these possible fact patterns.
Sam: We asked Tiffany if there were other things she looked for when she was picking between donor profiles.
Tiffany: I equate it to like online dating a little bit. Like you're just like kind of sifting through profiles. The thing that's so interesting is, I was like in my head about all of my biases all the time as I was like sifting through these profiles. You know, I'm like, you know, it's like the, my initial instinct of like, do I think this person's attractive or not? And then in I'm in my head like, why do I think you're not attractive? You know, like, what is that about? And like, does this really matter? For me, what I wound up being okay with in my own head. And I think you just kind of have to decide your own version of things for yourself was: I wanted to be somebody that I personally find to be attractive because there's some interesting data out there that shows like if you're attracted to somebody, that you're probably more biologically like inclined towards each other. And so that was something that I was thinking about in terms of like, you know, actually being able to get pregnant. Similarly for me, one of the weird things that I cared a lot about was voice. So they have these little, like, voice files and I would either have an initial like incline or disincline, like kind of feeling like either yes or no, thumbs up, thumbs down to their voice. And if I didn't like their voice, I was like, Nope. Out, you know, next person. If I was really like, really like you in somebody's overall profile, which included all kinds of stuff, then I would send it on to Morgan for reinforcement. If Morgan liked them, then okay, that was the number one. Then we would like gather a couple of those and then we would send them to our closest friends to weigh in on. And so a couple of friends had like my login and they would go in and look at the favorites. We're like, okay, "which one do you think, which one do you think we should choose?" And so we did have a couple of close friends kind of weigh in. the vote, yes, vote no. All of those friends were queer, which I think also speaks to like the comfortability to look at that kind of stuff.
Gaby: And just to give you a counterpoint, I know some queer couples for whom the donor voice wasn't really a thing they were considering. But they might've been considering, for example, only donors that included adult photos as part of their photo portfolio, which is not a given. And then I know other queer couples who were extremely private about the decision and didn't want anyone's input as they were taking their sperm. The reason that I'm bringing this up is just to say that there isn't a single right way to do this, and really the process is quite individual in terms of how you go about it.
Sam: When it finally comes to picking a donor, it's less about numbers and storage and more about sorting through profiles, values, and the things that matter most to someone.
Richard: Some people zero in on one guiding principle, like a family resemblance, while others juggle a whole list of traits, cultural considerations, or just that gut feeling.
Sam: Two points. You don't need to use a gay guy who's a slut on the apps and there isn't really one right way to choose. Each couple or individual works through the process differently, and that is okay.
Gaby: At the end of the day, selecting a donor is both practical and deeply personal. It's a mix of research, reflection, and intuition about the family that you're building.
Tiffany: [ music]
Sam: In this final section, we're moving from choosing a donor to what happens next: the actual ways queer families try to conceive. We're going to talk about three main methods going from least invasive or medicalized to the most. We'll start with home-based insemination, which Tiffany is describing here.
Tiffany: I always think of like the classic, L Word scene of like, you know, the turkey baster-style situation. Like that for me is like the epitome of what trying at home is like, right? Like, you've got the sperm, you've got the syringe, you're gonna just put it inside and put your legs up and hope that something takes, right? Like, that's essentially what you're doing.
Gaby: What Tiffany just talked about, that Turkey baster style insemination, that can actually take a couple of different forms depending on where exactly the sperm is placed. Intravaginal insemination is at the entrance of the vagina, whereas intra cervical puts a sperm just inside the cervix, which gives it a bit of a headstart when it comes to conception. And both of these approaches are meant to approximate the kinds of conception that can happen through penis and vagina sex.
Richard: That's going on a QHP pillow with a little ghostbuster sign over it.
Sam: QHP Clue it was the penis in the vagina.
Gaby: I just really didn't know how else to phrase it, and I think that gets across the point.
Sam: You're not wrong. You're not wrong.
Richard: I mean, that's what straight people do. For Tiffany's first pregnancy. They went the home insemination, turkey baster route. The reason was simple.
Tiffany: So it was definitely cheaper.
Richard: The downside? Lower success rates.
Tiffany: So for us it was like, "Okay, let's try to do this at home for the sake of the cost saving measure." But simultaneously, it's a pretty small window that you're trying to kind of capitalize on. There's this very small window of when that live egg has been released and you're trying to inject this previously frozen sperm that has a very short lifespan and hoping that they will connect.
Richard: As Dr. Monseur points out, home-based being less likely to be successful is not always a hard and fast rule.
Dr. Monseur: It is true that if you are doing a home-based intracervical or intravaginal insemination, we do expect those to be less successful than an intrauterine insemination. Having said that, there are certified midwives depending on the state that you live in, who may be able to provide at home intrauterine insemination. And so if you are able to do that with a midwife and have an intrauterine insemination at home, and you prefer kind of less medicalized not going to a clinic, it's my strong opinion that there's no reason that the success rates would be different between those two. But I think there's a bias in the reproductive endocrinology community 'cause when we hear home insemination, we automatically think intravaginal or intra cervical. Now it's not to say you can't do that but it will have reduced success just because physiologically, that's just kind of the case.
Sam: In Tiffany's case, home insemination meant doing a ton of research about her own cycle in order to maximize her chances.
Tiffany: And so I did a lot of work ahead of time to figure out what my cycle looked like, kind of pre pre-planning for when. I would be ovulating.
Gaby: I think it's also worth reminding everybody what Tiffany shared in the first part of the series, which is that she's a person who is really interested in reproductive health, and so if the kinds of stuff that she's describing sounds uninteresting and overwhelming, then you can definitely Turkey baster with professional help.
Sam: Tiffany did have a midwife play a role in her home insemination, but this does add to the bill.
Tiffany: So I spent $250 on a friend who was a midwife to come over and do it one time each time we were trying, right? So that's a pretty significant additional cost on top of the sperm.
Gaby: Dr. Monseur describes what it looks like when you wanna move away from DIY Turkey basting, and towards options that have a bit more support.
Dr. Monseur: So I think there's kind of three levels. Think that you can call a midwife to come to your house to go at home. Then I think there's going to kind of a midwife or another OB GYN type provider in the clinic. And then there's actually going to an REI a reproductive endocrinologist at an IVF fertility center.
Gaby: Once you're in an OBGYN's office, you're often Turkey bastering through a procedure called IUI or intrauterine insemination. This is where sperm is placed directly into the uterus rather than into the vaginal canal or just inside the cervix, which as we said earlier, is really what you're doing when you're doing at-home turkey, bastering. At the end of the day, whether you're doing IUI in an OBGYN's office or with a fertility specialist, the process is pretty similar.
Dr. Monseur: In the clinic, we're usually talking about transvaginal ultrasounds, kind of a probe that's placed vaginally to take pictures with an ultrasound. And then for the actual IUI itself, it is very, actually similar to a pap smear. We were just talking about that. So a speculum is placed and then a small catheter is placed through the cervix.
Richard: We asked Dr. Monseur what one could expect as side effects of an IUI insemination.
Dr. Monseur: Usually very minimal to no cramping beyond the pressure of the speculum for that, but obviously sensitive to different people have different levels of tolerance and even the transvaginal ultrasound could cause some discomfort. So I would say patients should just feel comfortable speaking up for themselves, being empowered to say things like, " I might have discomfort with this," or "I prefer you to do a transabdominal ultrasound picture," or "do you mind if I place the vaginal probe myself?" One thing that I often do with my patients, if they're motivated to do transvaginal approach, I'll kind of recommend that they try out vaginal dilators on their own at home when there's no pressure and they're not in a busy clinic space.
Gaby: I really just wanna shout out the fact that Dr. Monseur mentioned dilation. I think it's just so important to talk about this more for all kinds of OB GYN procedures for people who have pelvic floor issues.
Richard: Absolutely, and for some people, what Dr. Monseur describes is the entirety of it. Yes, a speculum exam, but no medications.
Gaby: If I have a patient who I don't think has any risk factors for infertility, I offer unmonitored, unmedicated, IUI cycles at my clinic. We know that if you're just using donor sperm and you're not infertile, using one of those medications doesn't increase your chance of success, but it does increase the risk of multiples by about four to five times. Multiples means more than one baby in a pregnancy. So think twins or triplets. and What Dr. Monseur is saying is that the risk of that goes up when fertility medications are in the mix.
But I wanna get back to why Dr. Mansour offers unmedicated IUI. It ties back to basically how fertility guidelines were originally written. Those guidelines were designed for people coming in after trying "viable" conception methods. And viable conception methods really just means, and I'm gonna say it again, penis-and-vagina sex. For those couples in that category, an unmedicated IUI procedure is probably less likely to work. And so moving on to a process with hormones makes sense. But for a lot of queer couples, you're not coming in after a year of unsuccessful attempts. You're coming in at the very beginning because you need medical help to conceive. And so it's reasonable to offer somebody an unmedicated procedure because they may actually be able to conceive using unmedicated IUI.
Richard: For Tiffany's second pregnancy, this wasn't the case. So at-home insemination wasn't working and she stepped up to medication assisted IUI at her fertility clinic with a few extra bells and whistles compared to home insemination.
Tiffany: I think what was cool about that was that REI was able to do a lot of things that I couldn't do. So they basically maximized my possibility of getting pregnant each cycle in a different way. So like, they immediately were like, "okay, we know you can get pregnant. We know this is a timing thing. We're using frozen sperm. Let's like do all the things we can to potentially get you pregnant." So they had me on clomid which makes sure that you're gonna release multiple eggs to make sure that you're getting like the most possibility of getting pregnant. That they're, they were watching me on an ultrasound so that way they could see that the follicles were growing to be the size that they should be. Once I hit a certain point, then I was given a trigger shot so that we could time the exactness of the sperm placement so that when the sperm was placed, I had a live egg in my uterus. And so I think that's the kind of stuff that's super hard to plan for when you're at home.
Sam: Now that we've covered home insemination. And IUI, let's turn to some of the more advanced procedures IVF and egg freezing, which Tiffany did not do. Conceptually, IVF and egg freezing. Start the same way, retrieving eggs from the From there, the paths diverge. Egg freezing preserves the eggs for future use while IVF fertilizes the eggs in a lab, meaning combines them with sperm to create embryos, which can then be transferred to a uterus or frozen for later use.
Richard: Dr. Monseur gave us his opinion on whether to freeze embryos versus eggs.
Dr. Monseur: So there's a lot of information on the internet that embryos are better than eggs, and that really comes from a pre vitrification era. So vitrification is a different newer technology that we use to freeze that we've been doing since roughly 2012. And we really don't see a drastic difference in success rates now with eggs versus embryos. So I actually very heavily encourage folks to do eggs, especially if there's any chance that they might wanna change their mind on a sperm source, if there's any chance of any relationship instability, if there's any chance that maybe they're single and they might be wanting to be in a relationship in the future, the pendulum has swung a little bit more, and now we're kind of saying eggs are probably a better option unless there's a really strong reason why you really need to do embryos up front. The main pro of doing embryos upfront is you get more information sooner. So: if you freeze eggs and then you come back five years later to fertilize them and none of them fertilize, which would be a catastrophic thing, but it can happen, you would've known that five years earlier. It doesn't change the fact. It would've happened either, either time, but it, you would've had that sooner. So that's one benefit.
Sam: Once someone decides whether to freeze eggs or create embryos, the next step is the actual egg collection. This is where the process becomes more hands on and medicalized with monitoring and medications to prepare the ovaries for retrieval.
Dr. Monseur: For IVF, which would include things like egg freezing, embryo creation, or reciprocal IVF. When we talk about the egg collection stage, you usually come in for a baseline ultrasound and basically they're making sure that nothing looks out of the ordinary. So they just wanna make sure that your ovaries are ready to go. It involves sometimes an oral medication like a birth control type pill for a period of time. Then taking injectable medications, usually two to three different injectable medications, and you'll take injectable medications for about two weeks.
Richard: These medications, and we'll spare you all the scientific details, are basically made to ramp up hormones like estrogen and progesterone, which in turn stimulate the ovaries, causing them to mature and drop a bunch of eggs.
Gaby: We asked Dr. Monseur what patients might feel like taking these medications because as we discussed a million times on this podcast, hormones come with symptoms.
Dr. Monseur: So it is very high levels of estrogen. And you really can have a wide range of symptoms because of that: mood swings, you can have breast or chest tenderness depending on your terminology. It's really individual specific. And so for some folks, they really don't notice a difference and others notice a more severe difference. I do kind of say though, you know, it is short-lived. That elevation is only gonna be in that two week window, and then there will be kind of a quick return back to the baseline.
Gaby: So bloating and abdominal discomfort can also be common symptoms. And there are a few reasons for this. One of the main reasons is that the ovaries get really big as they get stimulated by the hormones in the procedure. And because of that size increase, fertility doctors often recommend holding off on any kind of physical activity.
Dr. Monseur: So typically we say that you should avoid kind of vigorous activity particularly towards the end of the stimulation and then right thereafter. Torsion is a risk a lot of times these ovaries like if someone has a large cyst on their ovary, and then it might kind of flip.
Gaby: I know that this sounds kind of scary, but Dr. Monseur explains that this is really more about keeping people safe than a significant risk. I,
Dr. Monseur: The interesting thing about ovarian stimulation is that both of your ovaries get so enlarged that actually there's not as much space in the pelvis for them actually to move once they're that enlarged. Short of doing like gymnastics or horseback riding, probably not a super elevated risk, but certainly potentially more than baseline. So just kind of avoiding vigorous activities is the main thing.
Richard: Okay, so when on hormones, you can expect maybe some mood swings, breast or chest tenderness, bloating, and no gymnastics or horseback riding.
Sam: And to some listeners on this podcast, vigorous activity may also include a tarot card reading.
Gaby: And for me it does. Anyway, once the hormones have had time to do their thing, doctors like Dr. Monseur will monitor the growth of the ovaries to figure out the optimal time to retrieve eggs. And this kind of monitoring is done with transvaginal ultrasounds. And just to say out loud, these are pretty frequent. You're typically getting checked on once every like one to three days.
Dr. Monseur: Different clinics will have a different policy, but in general they want a small group of really large follicles. And then once you meet their criteria, that's when they set you up for the retrieval.
Gaby: At that point, you're gonna have something called a trigger shot, which causes the eggs to release, and then you come in about a day or two later for the egg harvesting procedure, which Dr. Monseur describes for us.
Dr. Monseur: You'll have a procedure that's done under anesthesia. You won't feel or remember anything. And then recovery is usually pretty quick within the next three to five days. Some folks, if they have a really robust response, it could be up to a week.
Richard: To be clear, what Dr. Monseur is describing is egg retrieval, which is the first step for egg preservation and for IVF.
Sam: So you can freeze your eggs, or If you're using donor sperm to make embryos, you freeze the embryos.
Gaby: If you're hoping to conceive in the shorter term, then just know that there's a separate procedure for that, and that's called an embryo transfer.
Dr. Monseur: And then an embryo transfer would actually happen at another point, either into the same uterus of the body that the eggs came from, or a different one if you're doing reciprocal IVF.
Gaby: I wanna say that again to make sure we didn't lose anybody. So in many cases, the embryo is gonna be reimplanted into the uterus of the person whose egg was used to make the embryo. But in some cases, another partner with the uterus wants to carry, and so the egg is transferred to that person. This is what Dr. Monseur just described as reciprocal IVF, but in either case, the medicine around the process is exactly the same.
Dr. Monseur: And that typically just involves maybe an oral pill. Maybe a vaginal pill. And then sometimes would also involve one injection depending on the protocol. The embryo transfer piece is a lot less invasive than the IVF portion. And the transfer piece is kind of similar to an IUI cycle in that way.
Richard: So: across at-home insemination, IUI and IVF, you can see a clear ladder of options from the lower frills approach at home to the more medicalized, closely monitored procedures in a clinic or fertility center. Each step comes with its own trade-off in terms of cost, convenience, success rates, and level of medical support needed. Some families might start at home to save money or feel more comfortable in a private setting, while others may prefer IUI or IVF to maximize their chances with professional guidance. The right choice depends on your personal circumstances, your reproductive goals, and what you're willing and able to invest both financially and emotionally. And as we've seen even within one family, different pregnancies may involve different approaches showing just how individualized the journey to parenthood can be.
Gaby: No matter what path you take, whether it's at home insemination or IUI or IVF -or other paths like adopting, fostering, and gestational carriers that we haven't mentioned on this episode- we've covered a lot of ground and there's a lot of ground to cover in queer fertility in general. Between timing, procedures, all of the logistical and cost details, It's a lot to take in, but as Dr. Sexton Topper reminds us, it really can just be one decision at a time.
Dr. Sexton Topper: Having a framework is helpful , for, for people to manage the possibilities. Eventually you have to think about the logistics of what postpartum is gonna look like. And so there are all these decisions we make and there's all this like a lot of focus on the antipartum prenatal period and postpartum. There are lots of decisions and dynamics that play out also. And so it might be for some worth considering and for others it might be too overwhelming. And so let's, let's make a decision that's in front of us now.
[QHP THEME MUSIC STARTS]
Richard: QHP is a power sharing project that puts community stories in conversation with healthcare expertise to expand autonomy for sexual and gender minority folks.
Sam: Thank you to our community voice, Eli Oberman, and our healthcare experts, Dr. Hazen and Dr. Deutsch. We would also like to thank our community reviewer, Preston Allen.
Richard: For more information on this episode's topic, check out our website, www.queerhealthpod.com.
Gaby: Help others find this information by leaving a review and subscribing on Spotify or Apple.
Sam: On Twitter and Instagram, you can find us – meaning Gaby will respond to you - at @QueerHealthPod. So reach out to us. I mean her. I mean us.
Richard: And as always, thank you to Lonnie Ginsburg who composed our theme music.
[QHP THEME MUSIC ENDS]
Gaby: Opinions in this podcast are our own and do not represent the opinions of any of our affiliated institutions. And even though we are doctors, don't use this. podcast alone as medical advice. Instead, consult with your own healthcare provider.
Gaby: Back to sperm. My other fetish we're gonna talk about, we're gonna talk about what it. Yeah, I'm coming out as a spermophiliac. I hate myself.
Sam: There's an app or three or four for that.
Gaby: I don't wanna know anymore. I'm back to being gay.