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Article| Volume 42, ISSUE 5, P1033-1047, May 2021

Same-sex male couples and single men having children using assisted reproductive technology: a quantitative analysis

  • Shilini Hemalal
    Affiliations
    Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto Ontario M5G1N8, Canada

    Institute of Medical Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto Ontario M5S 1A8, Canada
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  • Samantha Yee
    Affiliations
    Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto Ontario M5G1N8, Canada
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  • Lori Ross
    Affiliations
    Institute of Medical Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto Ontario M5S 1A8, Canada

    Department of Psychiatry, University of Toronto, 250 College Street, Toronto Ontario M5T 1R8, Canada

    Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto Ontario M5T 3M6, Canada

    Centre for Addiction and Mental Health, 250 College Street, Toronto Ontario M5T 1R8, Canada
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  • Mona Loutfy
    Affiliations
    Department of Medicine, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto Ontario M5S 1A8, Canada

    Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto Ontario M5T 3M6, Canada

    Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto Ontario M5G 1N8, Canada

    Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto Ontario M4N 3M5, Canada
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  • Clifford Librach
    Correspondence
    Corresponding author.
    Affiliations
    Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto Ontario M5G1N8, Canada

    Institute of Medical Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto Ontario M5S 1A8, Canada

    Department of Obstetrics and Gynecology, University of Toronto, 123 Edward Street, Suite 1200, Toronto Ontario M5G 1E2, Canada

    Department of Physiology, University of Toronto, 27 King's College Circle, Toronto Ontario M5S 3K1, Canada

    Department of Gynecology, Women's College Hospital, 76 Grenville Street, Toronto Ontario M5G 1N8, Canada
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Published:August 28, 2020DOI:https://doi.org/10.1016/j.rbmo.2020.08.032

      Abstract

      Research question

      How do same-sex male couples (SSMC) and single men perceive their experience of using assisted reproductive technology (ART) in Canada; what factors contribute to their experience and the decisions made throughout the ART process?

      Design

      This cross-sectional study used an anonymous online survey to gather exploratory data (between August 2018 and August 2019) about participant experience and decision-making considerations, for SSMC and single men internationally who had undergone ART in Canada. The survey was accessed by 145 individuals; 98 participants were included in the final analysis. Statistical Package for the Social Sciences (SPSS) was used for quantitative analysis.

      Results

      Four out of five participants had a positive overall experience of using ART in Canada. Having the social support of knowing others who had previously pursued ART, and needing to work with multiple egg donors, were found to affect overall experience significantly. Agencies were the most common way for intended parents to connect with third parties. Major factors men considered when choosing an egg donor included medical history, physical attributes, personality and temperament, ethnicity, and education; they tended to select gestational surrogates who had similar lifestyle values to themselves. Most coupled survey respondents created embryos using each partner's spermatozoa (73.6%).

      Conclusions

      This exploratory study expands on limited knowledge of the current topic, identifying key areas for future research. Most SSMC and single men, domestic and internationally, had a positive experience pursuing ART in Canada to have children. Research on the experiences of SSMC and single men and decision-making considerations should continue.

      KEYWORDS

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      References

        • ACAPS
        Qualitative and Quantitative Research Techniques. 2012
        • Bergman K.
        • Rubio R.J.
        • Green R.-J.
        • Padrón E.
        Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood.
        Journal of GLBT Family Studies. 2010; 6 (https://doi.org/): 111-141https://doi.org/10.1080/15504281003704942
        • Berkowitz D.
        • Marsiglio W.
        Gay Men: Negotiating Procreative, Father, and Family Identities.
        Journal of Marriage and Family. 2007; 69 (JSTOR): 366-381
        • Better Outcomes Registry & Network Ontario
        (September)Canadian Assisted Reproductive Technologies Registry (CARTR) Plus. Preliminary treatment cycle data for 2017. 2018
        • Blake L.
        • Carone N.
        • Raffanello E.
        • Slutsky J.
        • Ehrhardt A.A.
        • Golombok S.
        Gay fathers’ motivations for and feelings about surrogacy as a path to parenthood.
        Human Reproduction. 2017; 32 (https://doi.org/): 860-867https://doi.org/10.1093/humrep/dex026
        • Blake Lucy
        • Carone N.
        • Slutsky J.
        • Raffanello E.
        • Ehrhardt A.A.
        • Golombok S.
        Gay father surrogacy families: Relationships with surrogates and egg donors and parental disclosure of children's origins.
        Fertility and Sterility. 2016; 106 (https://doi.org/): 1503-1509https://doi.org/10.1016/j.fertnstert.2016.08.013
        • Brown Launcelot
        • Shank G.D.
        Exploring educational research literacy.
        Routledge, 2007 (ACCESS ONLINE)
        • Carone N.
        • Baiocco R.
        • Lingiardi V.
        Italian gay fathers’ experiences of transnational surrogacy and their relationship with the surrogate pre- and post-birth.
        Reproductive BioMedicine Online. 2017; 34 (https://doi.org/): 181-190https://doi.org/10.1016/j.rbmo.2016.10.010
        • Crockin S.L.
        Growing families in a shrinking world: Legal and ethical challenges in cross-border surrogacy.
        Reproductive Biomedicine Online. 2013; 27
        • Daar J.
        • Benward J.
        • Collins L.
        • Davis J.
        • Davis O.
        • Francis L.
        • Gates E.
        • Ginsburg E.
        • Gitlin S.
        • Klipstein S.
        • Koenig B.
        • La Barbera A.
        • McCullough L.
        • Reindollar R.
        • Ryan G.
        • Sauer M.
        • Sokol R.
        • Tipton S.
        • Westphal L.
        Child-rearing ability and the provision of fertility services: An Ethics Committee opinion.
        Fertility and Sterility. 2017; 108 (https://doi.org/): 944-947https://doi.org/10.1016/j.fertnstert.2017.10.006
        • Dar S.
        • Lazer T.
        • Swanson S.
        • Silverman J.
        • Wasser C.
        • Moskovtsev S.I.
        • Sojecki A.
        • Librach C.L.
        Assisted reproduction involving gestational surrogacy: An analysis of the medical, psychosocial and legal issues: Experience from a large surrogacy program.
        Human Reproduction. 2014; 30 (https://doi.org/): 345-352https://doi.org/10.1093/humrep/deu333
        • Dempsey D.
        Surrogacy, gay male couples and the significance of biogenetic paternity.
        New Genetics and Society. 2013; 32 (https://doi.org/): 37-53https://doi.org/10.1080/14636778.2012.735859
        • Dempsey D.
        Relating across international borders. Gay men forming families through overseas surrogacy.
        in: Inhorn M.C. Chavkin W. Navarro J.-A. Globalized Fatherhood. InGlobalized Fatherhood. Berghahn Books, 2015
        • Denscombe M.
        The Good Research Guide (5th edition). 2014
        • Fantus S.
        • Newman P.A.
        Motivations to pursue surrogacy for gay fathers in Canada: A qualitative investigation.
        Journal of GLBT Family Studies. 2019; (https://doi.org/): 1-15https://doi.org/10.1080/1550428X.2018.1546156
        • Frost D.M.
        • Meyer I.H.
        Measuring Community Connectedness among Diverse Sexual Minority Populations.
        Journal of Sex Research. 2012; 49 (https://doi.org/): 36-49https://doi.org/10.1080/00224499.2011.565427
        • Golombok S.
        • Blake L.
        • Slutsky J.
        • Raffanello E.
        • Roman G.D.
        • Ehrhardt A.
        Parenting and the Adjustment of Children Born to Gay Fathers Through Surrogacy.
        Child Development. 2018; 89 (https://doi.org/): 1223-1233https://doi.org/10.1111/cdev.12728
        • Greenfeld D.A.
        Effects and outcomes of third-party reproduction: Parents.
        Fertility and Sterility. 2015; 104 (https://doi.org/): 520-524https://doi.org/10.1016/j.fertnstert.2015.07.1128
        • Greenfeld D.A.
        • Seli E.
        Gay men choosing parenthood through assisted reproduction: Medical and psychosocial considerations.
        Fertility and Sterility. 2011; 95 (https://doi.org/): 225-229https://doi.org/10.1016/j.fertnstert.2010.05.053
        • Grover S.A.
        • Shmorgun Z.
        • Moskovtsev S.I.
        • Baratz A.
        • Librach C.L.
        Assisted reproduction in a cohort of same-sex male couples and single men.
        Reproductive Biomedicine Online. 2013; 27
        • Leibetseder D.
        • Griffin G.
        Introduction: Queer and Trans Reproduction with Assisted Reproductive Technologies (ART), in Europe.
        Journal of International Women's Studies. 2018; 20: 1-9
        • Mitchell V.
        • Green R.-J.
        Different Storks for Different Folks.
        Journal of GLBT Family Studies. 2007; 3 (https://doi.org/): 81-104https://doi.org/10.1300/J461v03n02_04
        • Murphy D.A.
        The Desire for Parenthood: Gay Men Choosing to Become Parents Through Surrogacy.
        Journal of Family Issues. 2013; 34 (https://doi.org/): 1104-1124https://doi.org/10.1177/0192513X13484272
        • Norton W.
        • Hudson N.
        • Culley L.
        Gay men seeking surrogacy to achieve parenthood.
        Reproductive BioMedicine Online. 2013; 27 (https://doi.org/): 271-279https://doi.org/10.1016/j.rbmo.2013.03.016
        • Smietana M.
        • Jennings S.
        • Herbrand C.
        • Golombok S.
        Family relationships in gay father families with young children in Belgium, Spain and the United Kingdom.
        in: Ebtehaj F. Richards M. Graham S. Freeman T. Relatedness in Assisted Reproduction: Families, Origins and Identities. Cambridge University Press, Cambridge Core2014: 192-211https://doi.org/10.1017/CBO9781139814737.014 (https://doi.org/)
        • Statistics Canada
        2016 Canadian Census. 2016 (www12.statcan.gc.ca/census-recensement/2016/as-sa/index-eng.cfm)
        • Tefteller D.H.
        Fatherhood in transition: Masculinity, identity, and everyday life. London, UK: Palgrave Macmillan, 238 pp., $84.99.
        Journal of Marital and Family Therapy. 2018; 44 (https://doi.org/): 741-742https://doi.org/10.1111/jmft.12341
        • Thibeaud M.
        Same-Sex Families Challenging Norms and the Law in France.
        in: Digoix M. Same-Sex Families and Legal Recognition in Europe. Springer International Publishing, 2020: 95-115https://doi.org/10.1007/978-3-030-37054-1_5 (https://doi.org/)
      1. United Nations Development Programme. (2014).Being Lgbt in Asia: Thailand Country Report.

        • Van Rijn-van Gelderen L.
        • Bos H.W.M.
        • Jorgensen T.D.
        • Ellis-Davies K.
        • Winstanley A.
        • Golombok S.
        • Rubio B.
        • Gross M.
        • Vecho O.
        • Lamb M.E.
        Wellbeing of gay fathers with children born through surrogacy: A comparison with lesbian-mother families and heterosexual IVF parent families.
        Human Reproduction. 2017; 33 (https://doi.org/): 101-108https://doi.org/10.1093/humrep/dex339
        • Yauch C.A.
        • Steudel H.J.
        Complementary Use of Qualitative and Quantitative Cultural Assessment Methods. 2003
        • Yee S.
        • Goodman C.
        • Librach C.L.
        Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases.
        Reproductive BioMedicine Online. 2019; 39 (https://doi.org/): 249-261https://doi.org/10.1016/j.rbmo.2019.04.001
        • Yee S.
        • Hemalal S.
        • Librach C.L.
        “Not my child to give away”: A qualitative analysis of gestational surrogates’ experiences.
        Women and Birth. 2019; (https://doi.org/)https://doi.org/10.1016/j.wombi.2019.02.003
        • Ziv I.
        • Freund-Eschar Y.
        The Pregnancy Experience of Gay Couples Expecting a Child Through Overseas Surrogacy.
        The Family Journal. 2014; 23 (https://doi.org/): 158-166https://doi.org/10.1177/1066480714565107

      Biography

      Shilini Hemalal completed her Bachelor of Arts and Science in 2017 at the University of Guelph, and her Master of Science in 2019 at the University of Toronto. She completed her thesis at CReATe Fertility Centre with Dr Librach. She is now studying in Australia to complete her Medical Doctorate.
      Key message
      Same-sex male couples and single men accessing assisted reproductive technology (ART) in Canada report a positive experience. Social support of men who pursued ART and worked with multiple egg donors significantly affected overall experience. Understanding the experiences of unique groups using ART can result in informed, inclusive reproductive healthcare practices.