Fertility 101:  a Quick Guide for Lesbians

Age and Fertility

A woman’s age is the most important indicator of her chance of conceiving. Like all organs and tissues in the human body, ovaries age over time. So do remaining eggs in the ovaries, making them less capable of fertilisation and their embryos less able to implant.

A woman’s fertility begins to decline around the age of 35. The risk of miscarriage will increase with age. For example, 10% of 25-29-year-old women miscarry, while for women aged 40-44, the rate increases to 33.8%. Unfortunately there is also a greater risk of abnormalities in children born from older women, rising from 1 in 500 (1:500) for babies carried by women aged 20, to 1 in 20 (1:20) for a woman aged 45.

Irregular Menstrual Cycles

The female menstrual cycle is determined by a complex interaction of hormones.  Any hormone imbalance can mean periods become irregular. In most cases irregular cycles aren’t dangerous (though it can be an indication ovulation isn’t happening every month), so it’s important to determine the cause.

Medical Conditions

Certain medical conditions can make it harder for a woman to conceive, including:

• Polycystic Ovarian Syndrome (PCOS)
• Endometriosis
• Blocked fallopian tubes
• Premature menopause
• Insulin resistance
• Thyroid disorders
• Genetic conditions

If you’re worried about how a medical condition may affect your chances of conception, your treating specialist will be happy to talk you through your options.

Male Fertility (Known Sperm Donor)

If you are considering using someone you know as a sperm donor, it’s important to know there are several things that can lead to fertility issues in men.

Some of the factors that can affect male fertility are:

• Quality of sperm (motility, morphology, count and vitality)
• Sexually transmitted infections
• Zinc deficiency
• Alcohol and tobacco use
• Recreational drug use
• Excessive heat
• Exposure to toxic substances
• Genetic conditions

Women

Before going ahead with fertility treatment, diagnostic fertility testing is recommended for the lesbian partner (or both, if you are planning to provide eggs to your partner – partner IVF) who plans to become pregnant. Tests include:

• Blood tests to identify common cases of ovulation dysfunction: undertaken to check estrogen, luteinising hormone (LH), follicle stimulating hormone (FSH) and thyroid stimulating hormone (TSH) levels. These blood tests are normally performed in the first week of your menstrual cycle.
• Blood tests and trans-vaginal scans to assess ovarian reserve: an Anti-Mullerian Hormone (AMH) blood test can be performed in conjunction with other blood tests and trans-vaginal scans to predict ovarian reserve. AMH is a hormone produced by small follicles in the ovary that contain eggs. The amount of AMH gives an indication of the number of eggs being produced, or ovarian reserve.
• Pelvic ultrasound/X-ray to check fallopian tubes and uterus: this can also be performed to check for blockages, ovarian cysts and determine if there are any physical changes, such as fibroids or polyps, that may affect your menstrual cycle.

Men (Known Sperm Donor)

If you are considering using someone you know as a sperm donor, fertility testing is recommended as there are several things that can lead to fertility issues in men. Tests include:

• Semen analysis to evaluate the amount and quality of semen and sperm: this is sometimes called a sperm count and tests motility (movement), morphology (sperm shape), count and vitality (ability to live and endure) of sperm.
• Blood test to examine hormone levels: assesses FSH, LH and testosterone.
• Other tests – depending on results of the initial tests, your treating doctor may require a sperm DNA fragmentation test, an immunobead test, or a testicular biopsy.

Keep in mind that we have a wide range of clinic-recruited donor sperm available to help lesbian women, or couples, in their attempt to become parents.

To ensure the highest quality and safety for our patients, all our sperm donors undertake both semen analysis and a series of pathology tests as part of the routine screening process. Our donors have also spoken with a qualified fertility counsellor. For more information, please visit our Donor Program page.

You can start the process of fertility testing with your GP, a gynaecologist, or a dedicated fertility specialist. You will need a referral from your GP to see a gynaecologist or fertility specialist. If you’ve been referred to a specialist, you’ll be able to claim some of the consultation cost back through Medicare.

Download Referral Form
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