Fertility Treatment for Single Parents and LGBTQ+ Families

Many people who use fertility clinics are not treating infertility in the medical sense. Single people and LGBTQ+ couples often need donor sperm, donor eggs, a gestational carrier, or a combination. This guide outlines the main paths and uses CDC clinic data to show where the services are offered.^[1]

Common paths to parenthood

Which treatments are used depends on whose eggs, whose sperm and who will carry the pregnancy:

• Donor sperm with insemination (IUI) or IVF. Common for single women and for couples where one partner will carry. IUI places sperm directly in the uterus; IVF fertilizes eggs in a lab and transfers an embryo.^[2]
• Reciprocal IVF. In some female couples, one partner’s eggs are used to create embryos with donor sperm, and the other partner carries the pregnancy. The CDC data does not track this separately.
• Donor eggs and a gestational carrier. Single men and male couples typically need both an egg donor and a gestational carrier, using one partner’s sperm.
• Donated embryos. Embryos donated by other patients can be transferred to an intended parent or a carrier.
• Egg or embryo freezing before treatment that affects fertility, or to keep options open for later.^[4]

IVF itself involves ovarian stimulation, egg retrieval, fertilization in the lab and embryo transfer.^[3]

Donor sperm

Donor sperm usually comes from a regulated sperm bank or from a known donor. Sperm banks screen donors and quarantine samples. Using a known donor, such as a friend, involves extra medical screening steps and, in many cases, legal agreements about parentage. The CDC data does not cover donor-sperm services or insemination outside IVF. Ask clinics which sperm banks they work with and what their process is for known donors.

Legal parentage

Family-building with donors or a carrier raises legal questions about who the legal parents are. Rules vary by state, and they can differ for married and unmarried couples. Many clinics require independent legal counsel for donor and carrier arrangements. A reproductive-law attorney can explain the steps where you live, such as parentage orders or second-parent adoption.

Which clinics offer the key services?

Among clinics that reported to the CDC for 2022:^[1]

Service	Clinics offering it	Share of reporting clinics
Donor eggs	400	88.7%
Donated embryos	275	61%
Gestational carrier services	410	90.9%
All three	261	57.7%

The CDC data does not record whether a clinic has policies for single patients or same-sex couples, so ask each clinic directly.

Gestational carriers

A gestational carrier carries a pregnancy from an embryo that is not genetically related to them. Nationally, 4.7% of embryo transfers in 2022 used a gestational carrier.^[1] Use is concentrated: 18 clinics used a carrier in at least 20% of their transfers.^[1]

States with the most clinics reporting gestational carrier services:^[1]

State	Clinics with gestational carrier services	Reporting clinics
California	83	85
Texas	39	44
New York	38	44
Florida	25	26
Illinois	19	21
New Jersey	14	14
Virginia	11	11
Arizona	10	10
Georgia	10	10
North Carolina	10	11

In 2 states, no reporting clinic listed gestational carrier services: New Hampshire, West Virginia.

Laws on gestational surrogacy differ from state to state, and they affect contracts and parentage. Consult a lawyer who specializes in reproductive law in the relevant state before starting.

Success rates with donor eggs and donated embryos

The CDC reports donor outcomes per transfer for all recipient ages combined. In 2022, frozen embryos created from donor eggs led to a live birth in 45.1% of transfers, and donated embryos in 42.2%.^[1] More detail in donor egg IVF success rates.

If you will use your own eggs, the most relevant figures are those for your age group. See IVF success rates by age.

Questions to ask a clinic

1. Do you treat single patients and LGBTQ+ couples, and do you have a dedicated program or coordinator?
2. Do you offer reciprocal IVF?
3. Do you run your own egg-donor program or work with agencies and frozen egg banks? Which sperm banks do you work with?
4. Do you work with gestational carrier agencies, and do you require independent legal counsel for all parties?
5. Is counseling required or offered for donor and carrier arrangements?
6. What is included in the price, and what are separate costs (donor or agency fees, legal fees, medication, storage)?

Emotional and practical support

Family-building with donors or a carrier often involves more people and more decisions than standard IVF: choosing a donor, deciding how much contact there will be, and planning how to talk with a future child about their origins. Many clinics offer or require counseling with a mental-health professional experienced in third-party reproduction. Patient groups and LGBTQ+ family organizations can also connect you with others who have taken the same path.

How to use FertilityList

On each state page, open a clinic profile to see the services it reported to the CDC (donor eggs, donated embryos, gestational carrier, egg and embryo freezing), its practice patterns, and its outcomes. Services can change, so confirm current offerings with the clinic.

This guide is general information, not medical or legal advice.