Single women and lesbian mothers often cut a unique path to parenthood. For one, many patients will need to select a sperm donor. That can be a complex subject, starting with whether one wants to use someone in her life ("known donor"), or maybe an "anonymous" or an "open" donor from a sperm bank.
Choosing a known donor creates more legal hurdles to ensure that the donor has no legal claim to the child, whereas working through a sperm bank removes most legal risk. Deciding on an open donor gives the child a chance, at the age of 18, to get in touch with that donor, whereas chosing an anonymous donor removes that option.
At the moment, purchasing sperm is still very much a "buyer's market." The banks have plenty of supply - there are three major banks, each with hundreds of donors available — but they'll readily admit that they run out of samples for very specific cases (e.g. Northern Indian or Japanese heritage).
Procuring sperm from a sperm bank typically costs anywhere from $1,000 - $5,000 and often the process of insemination requires multiples cycles. If women want to use sperm from the same donor for multiple children, they'll want to assure there is enough sperm available to begin with.
Next, patients will likely need to consider a number of medical questions. First is where to be treated. Fertility care is not a commodity, and the caregivers vary in terms of how aggressive they like to be with treatment, how the clinics themselves operate, the quality of the laboratory they use, and the prices they impose, amongst other factors. Our data shows most fertility patients ultimately end up at a second fertility clinic, and uprooting oneself to start over can be incredibly painful.
Along these lines, many women wonder whether it would just be easier to do a home insemination. Probably the most compelling reason not to go this route is if you want your partner to become a legal parent of the child. If so, it helps to have a message from the clinic that attests they oversaw insemination from a donor, so there's not another person's parental rights that need to be considered.
Many patients will be faced with the question of when to keep trying with IUI or advance on to IVF. While IVF cycles are typically 3 - 5x more likely to succeed, they are also 8 - 10x more costly. And yes, which doctor and clinic you select will influence how this decision unfolds. As you can see below, there is no standard within the field.
For lesbian couples, there are also hard choices to be made about whose eggs will be used, and who will carry the pregnancy. Regardless, work must be done to ensure that the non-carrying mother has a legal claim of parentage.
Whether you are paying for donor sperm, IUI, IVF, or all of the above, the costs stack up. Unlike many heterosexual couples, single women and lesbian couples stand virtually no chance of getting their treatment paid for. That is, unless you're diagnosed as being "clinically infertile." There are some ways to cut down on treatment costs, whether by lobbying your clinic, convincing your doctor to lobby the insurance company, or applying for grant programs, like that offered in New York State.