Lesbian conception in the UK vs. the US

I’ve been thinking quite a bit about the ways in which the process is different for us being UK based rather than living in the US (where the vast majority or the lesbian ttc blogs I’ve found are based).

The difference which stands out most is this nifty National Health Service thing we’ve got going on. Although the Government have just passed a bill to dismantle it, the NHS which currently pretty fucking fantastic. It’s not perfect and it’s a far more clunky than a bespoke service in which you’re a customer instead of a  patient but it ensures your treatment is not based on your ability to pay.

Currently NICE guidelines (NICE is the body which makes recommendations about what the NHS should fund) recommend 3 cycles of IUI and 3 cycles of IVF to couples, including lesbian couples, who are having problems conceiving.  For lesbian couples you don’t need to show an extra problem – the lack of sperm will do it.  Not all PCTs (health authorities in different areas) follow these guidelines but luckily ours does so that’s what we’ll get for free.  The fact that the last Government ensured lesbian couples should receive the same treatment as heterosexual couples with regard to fertility treatment is something I’m very grateful for but it does seem odd that after only 3 IUIs they’ll only pay for you to have IVF – I’m pretty sure this makes treating lesbians far more expensive than it needs to be for them.  The sperm and everything to do with it (storage, shipping etc) we have to pay for – they used to cover this but it changed a couple of years ago.

In this regard it seems clear to me that I’m very lucky to live in the UK.  However, going through the NHS very much means you have to fit in with their timetable rather than they with yours (which with fertility can be particularly frustrating/tricky).  Of course, you can go right ahead and pay privately in which case I think you’d get a lot more control over timing etc, but then hardly anyone in the UK has medical insurance (why would you bother?) whereas I get the impression (perhaps totally wrongly) that this is pretty much the norm in the US – so in effect people get free treatment and the perks of being a customer so getting more control (have I got this wrong?).

The thing that can seem frustrating reading your blogs from a UK perspective is that things seem much more regulated here.  Don’t get me wrong, I’m a fan of regulation and think it’s quite right that sperm should be thoroughly tested etc etc but I’m very jealous of people getting sperm delivered to their door which is illegal in the UK (in frozen form from a clinic).  Sperm is only allowed to be sent to a registered fertility clinic and used there.  It may be that we would have ended up with a clinic anyway – but I would have liked to have a few tries at home first without endless rounds of testing first.

That’s another thing that’s frustrating about having to go through a clinic – I have to be tested a million times (may be a slight exaggeration) before the sperm is allowed anywhere near me.  Now maybe this is sensible and I’m just impatient to get going, and given the amount we’re paying for sperm it’s probably sensible to check myself out first, but it does seem a bit frustrating to be jammed into the same category as straight couples who have been trying for at least a year (which is the criteria for NHS treatment) where it makes sense to check out your tubes, ovarian reserves etc whereas there’s nothing to indicate that this would be the first step for a lesbian couple. Sigh. I’m probably just being impatient!
Also, because we’re using an anonymous donor, we have to have a mandatory counselling session.  I kind of get why.  But it feels ever so slightly insulting to be told we need this, as though we’d even think of approaching a clinic without having thought everything through really really carefully.  Now I think the fact they offer free counselling is brilliant – and we may have even taken them up on it (probably not – but may have done if we’d reached this stage a couple of years ago) but the fact it’s a legal requirement is a bit much.

The other difference is the criteria for frozen sperm.  A few years ago entirely anonymous donation was banned, so now everyone donating sperm has to be willing to be contacted at 18 – this includes imported sperm.  Now, this isn’t on the face of it a problem for L and I as we’d want ‘open to contact at 18’ anyway – but it has led to a huge sperm shortage which is why most people now have to import. Bizarrely, although this rule applies, UK sperm banks aren’t allowed to show photos (even baby photos) which seems a little inconsistent (and meant we definitely felt we had to import).  I’m really interested to hear what people think about banning the use of completely anonymous donors – which I think is still the norm in the US?

Lastly (though perhaps I’ve missed lots), and I’m VERY grateful for this one, because me and L are in a civil partnership, she’ll be on the birth certificate and will have equal parental rights as soon as the baby is born…no need for all this ludicrous adopting your own child crap.

So, overall on the basis of cost but most importantly the legal rights we get I’m grateful to be doing it in the UK however I do feel jealous of the flexibility the US system seems to offer and also the much wider choice of sperm donor (lots of US sperm banks either don’t want to or aren’t allowed to important to the UK because of how strict the regime is).

What do you guys think?

10 thoughts on “Lesbian conception in the UK vs. the US

  1. Just a quick reply as its about 1am here and I really should try and sleep…
    NHS sounds similar to Medicare here in Australia, though they only subsidise the cost of IUI and IVF. The donor sperm situation is about the same, I really wished we could have done a few cycles at home before heading to the fertility docs.

  2. Sounds similar to Canada too, though the actual IUIs and IVFs aren’t covered by healthcare (except for IVF in Quebec, only if you transfer one embryo). All the ultrasounds, etc. are covered under general healthcare, but those costs would be minimal.

    We too have to ship sperm to the clinics, which sucks, because I know we’re quite capable of doing our own insems at home. The donor situation is similar – especially as there is only THIRTY THREE active donors in Canada (forcing us to go to the two banks we’re allowed to work with in the States). They are passing a law next year that donors can no longer be anonymous, as in the UK. Something needs to change about that, and it’s really frustrating for us here. Of course we’re going to go to the States for sperm instead… but that comes at an extra cost and as I said, we’re only able to use two banks and the sperm actually has to be approved by our government (ridiculous).

    I guess the biggest difference is that, although I am legally married to my wife, she still has to adopt our future babies. Which sucks and is demeaning. I don’t understand why this is the case as gay marriage is completely legal and we are seen as “equals”.

    Interestingly enough, I have dual citizenship with the UK (born in England), so maybe we’ll just have to make a trip! Just kidding… I doubt they’d cover my costs. It does sound intriguing though.

    Anyway, I feel like I’m writing a book, so I’ll stop. But thanks for this insight – it’s really interesting!

  3. Wow – I assumed Canada would be ahead of the UK in terms of recognising the other parent (you’ve got marriage equality whereas we’re only civil partners – gives us the same rights but “seperate but equal” doesn’t really do it for me).

    33? 33? I say again 33? How on earth did that happen?

    I’d love to hear more about Canada. Do you mean the Goverment has to approve every single shipment or just the bank it comes from?

    • It’s illegal in Canada to pay someone for sperm (and eggs), so there is absolutely no incentive to donate; that’s why there is only 33 😦 It’s really backwards, and has created – at least for egg donation – a major black market.

      As for the government approving sperm… it is not bank-dependent, but only certain sperm donors (around 40%) at each bank are approved. I don’t even know how – it’s probably just a tick box asking “are you okay with your offspring being Canadian”. I should find out.

      And yeah – you’d think marriage equality would translate into parental equality, but no such luck yet!

  4. It’s similar in the UK but doesn’t seem to have created as bad as a problem. Saying that I’ve just had a check on the London Sperm Bank which says it has the largest list of donors in the UK (and I know quite a few of the private clinics use it) and it has 33 donors. Snap. They are allowed to pay expenses but this is pretty strict.

    To import to the UK it’s mainly the known at 18 thing but I think it’s also some of the more strict testing. I wonder if the standards in terms of the testing are the same between UK and Canada or one is even stricter than the other.

    (Also, just figured out how to follow blogger from wordpress so am now following your blog – that whole situation with the clinic sounds so frustrating!)

  5. Very interesting post. It’s always amazing to hear the differences between healthcare systems. I think it’s great that you get the IUIs and IVF paid for! In the US, it varies greatly between states and insurance companies. Our state does not require insurance companies to cover any portion of infertility testing or treatments, however, other states do. Some people move to different states to get this kind of coverage…it’s crossed our minds, too. I think it’s silly that you can’t have the sperm shipped to your home to do ICI. I understand your frustration in having to follow their timeline and in your situation it doesn’t make a whole lot of sense that you have to go through all the tests that infertile couples go through. Also, I think that making all donors be open to contact is great! It probably means less donors, but when you only want an open id donor it doesn’t really change much, right? In my mind, it means that the ones who wanted to be anonymous just won’t donate. Ok, I think I’ve written enough!

  6. Hi Audrey,

    Yes – I think making all donors open to contact is ultimately the right decision but has caused a shortage.. I think what should change is the banning payment – as I suspect this is what makes the real difference. The whole commodification element does make me uncomfortable, but while some men may go to all the hassle for purely altruistic reasons (and I think these men are fantastic human beings) it is an awful lot of effort to go to and I think even a small payment would make men consider it more. I’m a bit torn as I’d hate to think people did it purely for cash, but I can see why this would at least help (which is why I suspect US sperm banks have more of a certain demographic – students). They have (literally today) raised the “expenses” payable for egg donation from £250 a cycle to £750 per cycle and I really hope this helps couples who need an egg donor.

    Also,why on earth not allow photos?! Surely it’s up to the individual men whether they’re comfortable with this. Most strange.

    Some PCTs in England don’t follow the guidance and only offer one or two cycles free rather than three and we would certainly have moved if this had been the case with ours – but then we’d just have to move to a different area of London rather than another state!


  7. The UK definately sounds similar to Australia as Suzie said. We were also unimpressed by the need to attend “counseling”. On top of this we were also required to have a police and child protection check done! The state we live in also has laws preventing both the import and export of sperm so we can only chose from Victorian donors and these are few and far between again because of the laws around not being allow to “pay” for sperm and the compulsory identity release at 18. This made our options limited to say the least! I can understand you being frustrated with all the testing before they will approve the IUIs and IVF, but it’s probably worth making sure everythings good to go beforehand. It would be pretty upsetting if you used up all your free cycles and then discovered something small that could have been fixed right from the start 🙂

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