Two Moms, One Family

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"The first thing they need to check with each other about is if they both want children...Have they both always wanted to have children?"

— Sherron Mills, a nurse practitioner and founder of Pacific Reproductive Services, a San Francisco sperm bank.

Are Both of You Ready for a Family?

Couples should ask themselves if they're prepared for a family and how they plan to pursue that goal. Before even deciding what method you'll employ to bring a child into your life, talk about how you'll handle every aspect of parenthood once your bundle of joy arrives.

Discussions should include everything from what school you'll send your child to and how you plan to handle discipline to whether you want to raise the child within a certain religion and if you have the means to bring up kids.

"Children are really expensive," said Sherron Mills, a nurse practitioner and founder of Pacific Reproductive Services, a San Francisco lesbian-owned sperm bank.

Once you've determined you're both ready to add to your family, you must consider how best to bring a child into your life. Will you adopt, and if so, what type of agency will you use? Will you foster a child with the goal of adopting? Will you seek a sperm donor and have one of you carry the baby or find a surrogate to do so? Other choices include in vitro fertilization and intrauterine insemination.

Using a Sperm Bank

Using a sperm bank is one option for building your family. If that's the plan, there's a few questions you should ask and have answered, Mills said.

Has the sperm bank fulfilled the required registration with the U.S. Food and Drug Administration? Does it meet FDA standards? Does it follow guidelines set by the American Society for Reproductive Medicine and the American Association of Tissue Banks? Some reputable sperm banks aren't accredited by the tissue bank association but still follow their guidelines, Mills points out.

Of course you want the sperm bank to have high marks from the FDA and to follow the standards set by the reproductive medicine society and tissue bank association since both issue important guidelines, she said.

The extent of family medical history a sperm donor must provide, the type of genetic testing, limits on the offspring donor sperm yield and even the amount of sperm in the vial to be used can vary, so it's best to check into that as well, Mills said.

For example, Pacific Reproductive Services guarantees 20 million motile sperm in its vials, boosting the chances of conceiving. But some banks have dropped the volume to 10 million motile sperm, Mills said.

In the case of medical testing and history, the more the better. It's why more banks are testing for Fragile X syndrome, a leading cause of mental retardation, and even giving donors EKGs to determine the possibility of hypertrophic cardiomyopathy, a condition that's caused young and seemingly healthy athletes to collapse and die during heavy exercise, she said.

Even if you have a potential sperm donor in mind, such as a friend, experts recommend all involved seek medical and legal advice. Case law involving children conceived using a known sperm donor includes claims of paternity rights, child support and other legal issues, even when an agreement was made among friends. Also, sperm banks offer the benefit of rigorous medical screening and preparation of the sperm for conception.

When considering getting pregnant, age does matter.

Fertility starts to decline about 10 years before a woman goes into menopause. So by the time a woman reaches her late 30s she's not necessarily infertile, but getting pregnant might take some intervention, Mills said.

"If they can, try to start before their mid-30s," she said. "I know that doesn't always fit with what's going on."

Like heterosexual and gay couples, lesbian couples who need help conceiving and bearing a child are also turning to surrogacy. This could range from using a donor egg and sperm to a gestational surrogate. According to the National Center for Lesbian Rights, in some states where same-sex couples use a medical procedure or surrogacy to have a child, the intended parents can petition the court to declare the non-biological parent to be the child's legal parent.

Building a Family Through Adoption

Adoption is another option for many couples. However, laws and regulations regarding fostering and adoption by unmarried or same-sex couples are a patchwork, said Emily Hecht-McGowan, director of public policy for Family Equality Council, which advocates for lesbian, gay, bisexual and transgender families.

The District of Columbia, California, Colorado, Connecticut, Illinois, Indiana, Iowa, Maine, Massachusetts, Nevada, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Vermont and Washington explicitly allow same-sex couples to adopt, notes the National Center for Lesbian Rights.Judges in some jurisdictions in Alabama, Alaska, Delaware, Hawaii, Louisiana, Maryland, Michigan, Minnesota, New Mexico, Rhode Island, Texas, and West Virginia have granted second-parent adoptions, NCLR said. That legal effort lets gays and lesbians adopt their partner's children without the parent terminating parental rights.

"Many states are silent on the issue of sexual orientation, adoption, foster care," Hecht-McGowan said. "In practice they prohibit unmarried couples, whether explicitly written in regulation. Oftentimes what happens in practice is that couples are not permitted by caseworkers or judges to adopt."

That means a couple's ability to adopt can be left up to the interpretation and the individual biases of caseworkers or judges. Even within the same state, one judge in a progressive city might allow it while another in a conservative part of the state could give the same couple a "no" on adoption, Hecht-McGowan said.

Establishing a Legal Relationship

Whether the child is the biological offspring of one of you or adopted by one, it's important for the other parent to establish a legal relationship too.

In states with marriage equality, each partner is presumed to be the parent of children born within the marriage. In states that don't recognize same-sex marriages, only one partner will be considered the child's parent. Also, couples should take into account that not all states have a mechanism for the nonbiological parent to create a legal relationship to the child, Hecht-McGowan said.

"A lawyer will recommend a second parent adoption for the nonbiological parent," she said. "So the recognition of the child relationship isn't dependent on the marriage."

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