Infertility: What Does it Mean for Lesbians?

Lesbians - Female Infertility 300 pixBecoming pregnant is the result of a process that has many steps. To fall pregnant:

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • Donor sperm must join with (fertilise) the egg along the way.
  • The fertilised egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps. And while the cause can usually be identified and solutions worked towards, occasionally a cause can remain unexplained (idiopathic infertility).

It’s important to remember anyone can be affected by infertility. For most of our lesbian patients, this is the first time they have attempted conception. This means there is a chance there could be an undiagnosed problem that only comes to light after starting the family-building process with Assisted Reproductive Technology (ART). But don’t worry, should we discover any problems, we’ll work with you to explore possible solutions.

Common Diagnoses of Female Infertility

There are numerous factors that may impact on a woman’s ability to conceive and carry a successful pregnancy.


Common female causes of infertility include:


Endometriosis occurs when menstrual bleeding (the lining of the uterus/endometrioum) flows backwards through the fallopian tubes, often attaching to the ovaries, fallopian tubes, the outer surface of the uterus, the pelvic cavity’s lining, or other parts of the lower abdomen.

Accurate diagnosis of endometriosis is important regardless of pain severity. Even mild cases of endometriosis can affect female fertility, including organ damage, embryo implantation problems, increased white blood cells within the abdominal area and stress on the immune system.

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is believed to be the most common reason for menstrual irregularities in women of reproductive age. PCOS is a complex condition in which a woman’s ovaries are generally bigger than average. Polycystic means the ovaries have many cysts, or follicles that rarely grow to maturity, or produce eggs capable of being fertilised.

PCOS is a hormonal condition involving high levels of insulin, or male hormones known as androgens, or both. The cause of this is unclear. In some cases, PCOS runs in the family, whereas for other women, the condition only occurs when they are overweight.

Fallopian Tube Structure – Tubal Blockage

For pregnancy to occur, the fallopian tubes must be open and functioning properly to allow the egg and donor sperm to meet. Blocked fallopian tubes are unable to let the egg and donor sperm meet, preventing fertilisation.


Salpingitis is an infection and inflammation in the fallopian tubes. Previously undetected or untreated infections (including sexually transmitted ones) can cause adhesions and scarring within the fallopian tubes, which can hinder a woman’s ability to conceive.

Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) occurs when bacteria move from the vagina, or cervix, into the uterus, fallopian tubes, ovaries, or pelvis. Most cases of PID are due to bacteria that cause chlamydia and gonorrhea.


A hydrosalpinx is a distally blocked fallopian tube filled with serous, or clear fluid. The blocked tube may become substantially distended, giving the tube a characteristic sausage-like, or retort-like shape. The condition is often bilateral and the affected tubes may reach several centimetres in diameter.

Ovarian Cyst

An ovarian cyst is a fluid-filled sac. Most ovarian cysts, are benign (not cancerous). They usually disappear on their own and produce no symptoms. The normal ovary can have small cysts leftover from ruptured egg follicles. Some ovarian cysts however, are associated with problems such as abdominal or pelvic pain, spotting in between menstrual periods, and/or infertility.

Fibroid Tumours

Some women have benign (non-cancerous) tumours, called myomata uteri, or fibroids, in their uterus. These myomata may be silently present and cause no problems. In some women, however, fibroids can cause excessive and frequent menstrual periods, pelvic pain, infertility, and recurrent pregnancy loss.

Advanced Maternal Age

Advanced maternal age is a major cause of infertility in women. The quality of a woman’s eggs decreases with age and can limit her ability to conceive.

Ageing of the ovaries is the most prominent factor and is part of the normal ageing changes that affect all organs and tissues.

As the woman ages, the remaining eggs in her ovaries also age, making them less capable of fertilisation and their embryos less capable of implanting.


Common Male Causes of Infertility to be Aware of (Known Sperm Donor)

As a lesbian woman you may think that male infertility doesn’t affect you. However, it’s an important thing to consider, especially if you are thinking about using a known sperm donor. There are a number of factors that can lead to fertility issues in men and these issues may hinder your ability to conceive a baby through Assisted Reproductive Technology (ART).

The six main factors that determine the ability of sperm to fertilise an egg are: the number of sperm present, sperm motility (ability to move), direction and quality of movement, sperm morphology (their size and shape), presence (or absence) of antibodies and integrity of the DNA in the sperm.

Common causes of male infertility include:

  • Structural abnormalities, where either the shape or motility of the sperm is affected, preventing it from either swimming to, or binding with, the egg.
  • Sperm production disorders. Either sperm numbers are reduced, or sperm are totally absent due to testicular failure or obstruction.
  • Ejaculatory disturbances due to ejaculatory failure, or impotence.
  • Immunological disorders.

Even if you have your heart set on using a known donor, it’s worth remembering that we have a wide range of  clinic-recruited donor sperm available should things not work out with your original choice.

Our sperm donors undertake both a semen analysis and a series of pathology tests as part of the routine screening process, ensuring the highest quality and safety for our patients. Our donors have also received advice from a qualified fertility counsellor, making sure they’re aware of their rights, responsibilities and roles as a donor. For full details, head to our Donor Program page.



While infertility can be a challenging experience, the good news is that it can often be treated, or alternative methods of conception can be explored.


At Rainbow Fertility, our specialists have extensive experience in helping create LGBTQIA+ families. Feel free to contact our friendly team to learn more about our donor program and the fertility treatment options available to you.

Call: 1300 222 623




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