Thanks to advancements in fertility medicine, everyone has a path to parenthood today.

Whether you’re single, in a same-sex relationship, or have medical challenges that make pregnancy difficult, there are options to help you grow your family.

Keep reading to understand what third-party reproduction is, who it can help, and what to consider as you explore this option in your fertility journey.

What Is Third-Party Reproduction?

Third-party reproduction involves a “third party” (someone outside of the intended parents) to help with conception or pregnancy.

This means using donor tissue or working with a gestational carrier to have a baby. When donor tissue is used, it’s called “donor-assisted reproduction.”

Third-party reproduction options include:

Donor sperm: Used by single women, lesbian couples, or couples with male factor infertility.
Donor eggs: A common choice for single men, same-sex male couples, and women who struggle with egg quality or ovarian reserve.
Donor embryos: An option for individuals or couples unable to use their own sperm or eggs.
Gestational carriers: Recommended when carrying a pregnancy isn’t possible or safe.

Your fertility team will help you decide which approach is right for you.

Reasons to Consider Third-Party Reproduction

There are many reasons someone might explore third-party reproduction. Here are some of the most common.

Third-Party Fertility for LGBTQ+ Couples

Same-sex couples often need donor tissue to create an embryo. Depending on the couple, they may also need a gestational carrier.

Fertility Options for Lesbian Couples

For two women hoping to have a baby, donor sperm is needed to create an embryo. One option is reciprocal IVF, where one partner provides the egg and the other carries the pregnancy. This way, both partners get to play a special role in bringing their baby into the world.

A common question is, “Can you mix two female eggs with sperm?” No, it’s not possible right now for two women to have a baby with both of their genes. An embryo needs genetic material from one egg and one sperm. But science is always evolving, and researchers are exploring new possibilities.

Fertility Options for Gay Couples

For two men who want to start a family, both an egg donor and a gestational carrier are needed. The egg donor provides the egg, and the gestational carrier carries the pregnancy.

To simplify legal and emotional factors, gestational surrogacy (where the carrier is unrelated to the child) is often recommended over traditional surrogacy (where the surrogate is also the biological parent).

Some couples wonder if both of their genes can be combined into one embryo. While that’s not possible, many couples choose to each provide sperm to create embryos. From there, they can decide which embryos to transfer, sometimes using embryos from both partners. This way, both parents get to be part of the process in a meaningful way.

Single Parents

Embryos require both sperm and egg, so one person alone cannot conceive. A single parent will need donor sperm, donor eggs, a donor embryo, or a gestational carrier, depending on their circumstances.

Third-Party Reproduction for Medical Reasons

Some people need third-party reproduction due to medical challenges, such as:

Infertility in women due to age or diminished ovarian reserve
Male factor infertility, which can stem from genetic, structural, hormonal, or lifestyle factors
Failed IVF cycles where embryos didn’t implant or resulted in miscarriage. (Are you experiencing this? Learn about what causes recurrent implantation failure.)
Uterine conditions, like endometriosis, that make pregnancy difficult
Polycystic ovary syndrome (PCOS) or other hormonal conditions
Health conditions that make pregnancy unsafe, such as heart disease or autoimmune disorders

If you’re facing one of these challenges, know you’re not alone. Third-party reproduction has helped thousands of people become parents.

In fact, assisted reproductive technology — including third-party reproduction — helped bring over 86,000 babies into the world in 2021. More people are learning about these options every day, making them more and more accessible for all hopeful parents.

Overview of Third-Party Assisted Reproductive Technology Options

There are many ways to become a parent. Your fertility specialist will recommend the best approach based on your medical history and family-building goals.

Here’s an overview of the most common options for third-party reproduction:

Donor sperm: You may need or elect for donor sperm during your family-building journey. Donor sperm can be used with intrauterine insemination (IUI) or in vitro fertilization (IVF). IUI is a simpler procedure and has success rates around 10-20% per cycle, while IVF using donor sperm is thought to be more conducive to pregnancy.
Donor egg: This is an option for women with reduced egg quality, early menopause, or a history of failed IVF cycles. Donor eggs are also used by same-sex male couples. Success rates are high with high-quality eggs — about 65–80% on the first attempt.
Embryo donation: Some families choose to donate unused embryos, giving others the opportunity to carry a pregnancy.
Gestational carrier: A gestational carrier is a woman who carries a pregnancy, but is unrelated to the child. The parents’ reproductive tissue, and/or donor tissue, creates the embryo, and the embryo is implanted through IVF. This may be recommended if carrying a pregnancy isn’t safe for you or your partner.

Choosing the right path is personal. If you’re unsure, that’s completely normal. Your fertility specialist will walk you through the decision-making process. You don’t need to navigate this alone

Should You Use a Directed or Anonymous Donor?

If you’re using donor sperm, eggs, or embryos, you’ll need to decide between a directed donor (someone you know) or an anonymous donor (someone chosen from a donor bank).

Some people prefer a known donor, like a friend or family member. Others choose an anonymous donor for privacy and legal simplicity.

It’s also important to be aware of changing laws. In some states, like Colorado, donor-conceived children now have the right to access their donor’s identity at age 18. California still allows truly anonymous donations.

Your fertility team can help you understand how your state handles donor-assisted reproduction.

Does Insurance Cover Third-Party Reproduction?

Insurance coverage for third-party reproduction varies. Some states require insurers to cover fertility treatments, but third-party reproduction isn’t always included.

Unfortunately, the LGBTQ+ community and single parents often face additional barriers. Some states and insurers still define infertility in outdated ways — only covering heterosexual couples who have tried to conceive for a year without success. However, this is starting to change.

Modern Definitions of Infertility & Impact on Insurance Coverage

The American Society for Reproductive Medicine (ASRM) updated its definition of infertility to be more inclusive. Read the new definition below (note the second bullet):

‘Infertility’’ is a disease, condition, or status characterized by any of the following:

The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.
In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at 6 months when the female partner is 35 years of age or older.

Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.

Practice Committee of the American Society for Reproductive Medicine, American Society for Reproductive Medicine, Washington, DC. (2023)

This means single parents and same-sex couples may qualify for coverage in certain states. If you’re considering third-party or donor-assisted reproduction, check with your insurance provider and talk to your fertility clinic about financing options.

Moving Forward With Third-Party Reproduction

Choosing to use donor eggs, sperm, or a gestational carrier is a big decision. It’s normal to have questions — and even some big emotions — about the process.

You can lean on your fertility team to guide you through each step and help you make the best choice for your family.

If you’re ready to explore third-party reproduction, schedule a consultation with Dr. Lina Akopians. Together, we’ll find the right path forward for you.

Third-Party Reproduction: Fertility Options for All Families