Fertility treatment options for the LGBTQ+ community 

The Assisted Conception Unit (ACU) at Guy’s Hospital is known internationally as a leading provider of fertility treatments. With options ranging from fertility preservation to embryo implantation, our specialists are committed to providing evidence-based care to patients on all routes to parenthood. Dr Julia Kopeika, consultant gynaecologist and head of the service, and Dr Orestis Tsonis, reproductive specialist, explain more. 

Fertility treatment for transgender patients 

Dr Julia Kopeika and Dr Orestis Tsonis work closely with transgender patients at the ACU to facilitate a fertility journey tailored specifically to their needs. Dr Tsonis is known in the transgender community for his commitment to provision of specialised care to an underserved population. 

“In 2024 so far, we’ve seen a large number of transgender fertility patients,” says Dr Tsonis. “We realised a couple of years ago that, while we do offer all forms of fertility preservation, there were no patient information materials to specifically address the needs of transgender patients.” To this end, Dr Tsonis embarked on developing new patient resources and training to offer a better, more inclusive experience specifically for transgender patients. 

We offer holistic support for all ACU patients and are proud to have received a rating of 5/5 from our patients and the Human Fertilisation and Embryology Authority (HFEA), the UK’s fertility regulator. 

Fertility and gender-affirming hormones 

Primarily, transgender patients come to our unit seeking fertility preservation to preserve their gametes prior to medically transitioning with gender-affirming hormones (including oestrogen, testosterone blockers, progesterone, and testosterone). “We highlight to our patients that they are under no pressure to make a decision about parenthood now, but preserving their fertility at this stage gives them more options in the future, should they wish to have biological children,” explains Dr Kopeika. 

We can carry out preservation of eggs or sperm prior to gender-affirming hormones being taken. However, if a patient has taken these hormones, which tend to suppress their fertility, then they can stop taking the hormones for at least 3 months ahead of preservation treatment, after which time their fertility should recover enough to retrieve gametes. 

Fertility treatment for same-sex couples 

We offer a comprehensive range of fertility investigations and treatments, including support for those using both known and unknown donors. We collaborate with a variety of UK-based and international sperm banks to meet our patients’ needs. For couples or single parents requiring donor eggs, we can assist in connecting them with agencies that specialise in finding matching anonymous donors.  

“Once our patients have selected their donors, we will see the potential donors in our unit to assess their medical history, family history of genetic conditions, and egg reserve,” explains Dr Kopeika. “Most patients choose to use agencies to find a donor, however some also make their own arrangements with friends or family members, who will be assessed by our medical team in the same way.” 

Same-sex male couples seeking fertility treatment visit us for IVF, ICSI or IUI once they have connected with a surrogate and/or found an egg donor. We also see single patients looking to start their solo parenting journey once they have identified an egg or sperm donor, and a surrogate if required.  

For same-sex biologically female couples, a popular option is reciprocal motherhood (also called shared motherhood). This is a process whereby one partner’s eggs are fertilised with donor sperm, before the embryo is implanted into the second partner’s uterus. This allows both mothers to experience biological connection with the baby. 

Supporting patients’ emotional wellbeing 

As well as the fertility treatment itself, we offer patients up to 6 counselling sessions, as we understand the toll fertility treatment can take on patients, both mentally and physically. The counselling is with our specialist fertility counsellors who specialise in supporting patients going through any type of fertility journey, helping patients to prepare to embark on their journey to parenthood. 

Patients also have access to fertility coaching with an embryologist, to help them learn more about the scientific process of fertility treatment. Our embryologist has completed a specific coaching qualification in order to offer this service, and is one of very few embryologists in the UK who is qualified to coach patients in this way. 

Further to this, and more specific to the LGBTQ+ community, we provide counselling on donor gametes, legal parenthood and surrogacy for all parties when surrogacy is used, with guidance on the process, as well as understanding the practicalities of birth certificates and other paperwork. 

We’re committed to educating our patients and ensuring that they fully understand the processes of fertility treatment, surrogacy and donor eggs and sperm. We regularly hold patient information events so that our patients from the LGBTQ+ community are well informed before beginning their fertility treatment with us. 

When to refer to us 

All patients can be referred to our fertility specialists in the ACU, regardless of whether they are taking gender-affirming hormones. Our specialists pride themselves on providing the evidence-based inclusive care and information needed to help any member of the LGBTQ+ community on their journey to parenthood. 

Our service covers patients seeking to preserve their fertility now to give themselves options for starting a family in the future, as well as patients seeking IVF, IUI, or advice about donor and surrogacy routes to parenthood. 

Dr Julia Kopeika

Consultant gynaecologist and subspecialist in reproductive medicine and surgery 

Dr Kopeika is the clinical lead of the ACU and specialises in reproductive medicine and surgery including IVF, ICSI, IUI, fertility preservation and more. She has a PhD in cryobiology and now works as the UK lead for fertility preservation, leading a national training module for Fertility Preservation of the British Fertility Society. 

Dr Orestis Tsonis

Obstetrician, gynaecologist and reproductive specialist 

Dr Tsonis is a specialty doctor at the ACU and has contributed significantly to developing the fertility preservation service for transgender patients at the unit. He holds a master’s degree in human reproduction and a PhD in office hysteroscopy. He is an advocate for women’s and LGBTQ+ reproductive health and shares his knowledge with regular webinars and charity talks for patients. 

Get in touch 

Contact our ACU customer services team to learn more about our fertility treatment options and how to start your journey with us. Contact us via our form or email ACUPersonalisedCare@gstt.nhs.uk.