The Road to Fatherhood Using Assisted Reproductive Technology: Decision Making Processes and Experiences Among Gay Male Intended Parents and Gestational Surrogates

Abstract

Background: With the progression of the gay rights movement, including increased legalization of same sex marriage and parenting options through joint adoption and Assisted Reproductive Technology (ART), there is support of access to ART regardless of marital status or sexual orientation. As an increasing number of gay men are now seeking biological parenthood through gestational surrogacy, there is limited data on the decision making processes and experiences for gay male couples and their Gestational Surrogates (GS) using ART in order to identify potential needs for programmatic improvement.
Materials and Methods: Retrospective qualitative survey was sent to 102 gay men in a committed relationship and 51 GS. Data from responses of 22 gay male intended parents and 11 GS who underwent ART was analyzed regarding their decision making processes and experiences. Statistical analysis including descriptive and Kappa correlations were completed.
Results: All gay men had considered different options for having children. Their families were more supportive of this process than when the men had disclosed their sexual orientation. When selecting GS, men prioritized surrogates’ attitudes towards gay men. All GS felt comfort able carrying for gay men. Twenty-two percent of GS reported postpartum depression despite considerable ante- and postpartum support and lack of separation difficulty from the infant(s). Sixty four percent reported they would carry for the same couple again, while only 38% of gay men expressed a desire to use the same GS. Both groups reported an overall lack of support from ART programs, attorneys, obstetricians and pediatricians.
Conclusion: There are identified areas for needed improvement for the ART process for both gay men and GS, including the need for increased sensitivity and support from those providing care/services to the intended parents and GS. Meticulous detail to pre- and post-ART treatment is essential to coordinating the medical, emotional and legal needs of gay men couples undergoing ART and their GS.