Britt Kernen is the Nurse Team Lead and Third Party Coordinator at Twig Fertility, and has worked in fertility for over 7 years. In her role as the team lead, she organizes and oversees the nursing team, working behind the scenes to ensure seamless day-to-day operations. Britt is also the third party coordinator, and works exclusively with those who require donor eggs, donor sperm and/or a surrogate. She is a member of the queer community and is passionate about providing care for queer couples in their journey to parenthood. 

To queer folks starting to consider their journey to parenthood, what advice would you give?

We know that the journey to parenthood is long for queer people and it can feel even longer when there are so many extra steps due to Health Canada guidelines and regulations. For that reason, it’s so important to try to be patient with the process and lean on those around you for support. The journey to parenthood can be isolating for anyone but even more so for the queer community. If you know of any support groups or friends who are going through the process it may be beneficial to reach out and feel connected to others during your journey. 

What options are available for queer couples to become parents and what does the process look like for each option?

There are different options depending on if the couple requires donor sperm or donor eggs: 

For queer couples that require sperm

A decision needs to be made between using sperm from a bank or a known donor. If using a known donor then the donor will need to do diagnostic testing and Health Canada testing/assessments. Once all testing is complete and the donor has been approved, then typically they freeze their sample for later use. If using a sperm bank, then they need to decide on the donor and purchase vials from a sperm bank. Once purchased, the vials would be shipped to the clinic and stored for use. 

The couple would then need to decide on their treatment plan. This depends greatly on their own diagnostic testing results and goals as parents. There are options of using the sperm samples for an Intrauterine Insemination (IUI) or IVF cycle to create embryos. 

For queer couples requiring eggs

Similar decisions need to be made on whether a known donor or donor egg bank is used. If using a known egg donor, then similar to a sperm donor, they would have to do diagnostic testing and proceed with any Health Canada testing/assessments. Then the donor would need to proceed with the treatment to retrieve eggs. 

Typically in these cases embryos are created either with the intended parents sperm or sperm from a bank. If using eggs from an egg bank, the bank would have done the Health Canada testing.  It is important to know that if the intended parent/parents are the sperm providers, they still have to undergo Health Canada testing/assessments prior to being able to use their sperm to create embryos and in order to be used with a surrogate.

With a few different avenues to decide between, what considerations should folks be aware of when considering what option is best for them?

One of the main considerations is their timeline of when they hope to be a parent and their goals as parents. Are they wanting to use their own gametes (sperm or eggs)? Are they wanting to carry the pregnancy? Which partner is carrying the pregnancy? Which partner is using their gametes? 

Choosing to use a known donor can be a longer process given the Health Canada testing required for both the donor and intended parent. Choosing to use a bank does speed up the process slightly as the banks have already complied with Health Canada regulations. 

Another consideration are the costs involved as testing for a known donor is not covered and thus intended parents need to pay for this testing. 

Inherently this journey for queer people is longer and more financially burdensome, and both factors are important to consider when choosing which options work best for them. 

Are fertility treatments, cost of surrogates etc. covered by Canadian healthcare? What sort of out-of-pocket expense can people expect?

There is funding available for IVF treatments which is offered by some clinics. This funding does allow for IVF cycles to be covered with subsequent FET (transfer) cycles as well. It is wonderful this is an option for people however there are normally waitlists involved and waitlists vary depending on the clinic. 

If a person or couple are not using funding then they would have to pay for treatment/procedure costs. Typically, IVF cycles cost anywhere from $10,000 – $15,000. They could cost more depending on the number of transfers that would be needed and if any genetic testing is being done on the embryos (PGT-A). In addition there would be associated medication costs for the cycles. 

Medication costs vary slightly as well, as it depends on how much medication is needed, however generally it can be anywhere between $5,000-$8,000 per IVF cycle. It’s important to note that many folks may need to undergo multiple IVF cycles in order to conceive. 

For those using known donors they would have to pay for the known donor assessment/testing, and for those purchasing either eggs or sperm from a bank there are the associated fees for these as well. Egg banks have several different options and pricing varies depending on what avenue  is chosen. 

For those using a surrogate they may need to use a surrogacy agency to help with connecting with a surrogate, which do have costs associated with this process. It is not legal in Canada to pay someone to be a surrogate, however it is legal to reimburse for some expenses. This amount ranges depending on the needs of the surrogate during treatment and during pregnancy. 

What do you wish more people knew about the queer journey to parenthood?

I wish more people were aware of the added obstacles that queer couples face in their journey to parenthood. Health Canada guidelines have made the process longer for queer people, while also making it more financially burdensome. It can take several months to a year or so for a queer person/couple to be able to even begin treatment due to the regulations in place. 

In addition, they have to be prepared financially to deal with the added costs of treatment. It is a long journey and like every fertility journey, there is no guarantee that a pregnancy will occur. 

What advice would you give to those going through the process of becoming parents right now?

Whether you are queer or not, it can be a very isolating experience. Reaching out to others that are also on their journey can help, and even speaking to a professional may be recommended to support you during the journey. 

Try your best to take care of yourself and alleviate stress levels. This is definitely easier said than done! 

Any parting thoughts?

I hope that queer individuals/couples know that we as fertility professionals understand that this process can be very challenging and frustrating. As a member of the queer community myself it is my goal to make the process as seamless as possible and be someone that the queer community can trust with their care during their journey to parenthood. At Twig we strive for all patients who walk through our doors to feel welcomed and cared for, and I’m happy to be a part of providing that care.