All paths.
All families.
All welcome.

No referral is required. Anyone can book an initial Family Building Consult directly online. Your first consult is covered by OHIP in Ontario and MSP in BC.

Both partners come to the first consult, if possible. We review your family-building goals together, discuss the paths that fit your situation (IUI, IVF, reciprocal IVF, donor or carrier cycles), and lay out a personalized plan.

There are three common paths. IUI with donor sperm: one partner carries the pregnancy using their own eggs and donor sperm. IVF with donor sperm: one partner carries the pregnancy using their own eggs and donor sperm, with higher success rates and the option to test or freeze embryos. Reciprocal IVF: one partner provides the eggs; the other carries the pregnancy, so both partners are biologically and physically connected. Your care team will help you choose a path that fits your goals, your medical history, and your family-building plan.

Building a family as two men involves three steps. Donor eggs: sourced through a Twig partner egg bank or known donor. Sperm from one or both partners: some couples use one partner's sperm; others create embryos using both partners' sperm. A gestational carrier (surrogate): undergoes an embryo transfer cycle and carries the pregnancy until birth. Embryos are created through IVF using donor eggs and your sperm, then transferred to the gestational carrier. This pathway involves close coordination between clinical care, an egg donor source, a gestational surrogate, and fertility lawyers. We coordinate the clinical side and work alongside your other experts.

Reciprocal IVF (sometimes called shared motherhood) is an IVF cycle where one partner provides the eggs and the other partner carries the pregnancy. It's a way for both partners to be biologically and physically connected to the pregnancy. Twig offers reciprocal IVF as a standard pathway.

Twig is a trans-affirming space. The intake process captures your legal name, chosen name, and pronouns. Forms ask about your anatomy, not your gender. We coordinate fertility preservation alongside hormone or surgical pathways, and we refer to and work with trans-competent OB/GYNs and mental health providers.

Yes. Twig welcomes HIV-positive patients and has experience supporting same-sex couples and other patients living with HIV through their family-building journey. Before starting fertility treatment, we work closely with your infectious disease specialist to ensure your viral load is suppressed. Per Canadian Fertility and Andrology Society (CFAS) guidelines, this typically means: being on combination antiretroviral therapy for at least three months; two undetectable viral load results taken at least one month apart; the most recent result within six months of your cycle start. For HIV-positive patients with sperm, we offer sperm washing onsite, a procedure that significantly reduces the risk of transmission. Your care team will coordinate counselling on transmission risk and walk you through every step of the pathway alongside your specialist. Note: the CHLOE™ AI Embryo Quality (EQ) Report is not available for HIV, Hepatitis B, or Hepatitis C-positive cycles. Embryos are cultured in a separate dedicated incubator. Your care team and embryology team will walk you through how this affects your cycle.

Third-party reproduction is a term that refers to family building that involves the use of donor eggs, donor sperm and/or a gestational surrogate.

A gestational surrogate is a person who carries and gives birth to a baby for another person or couple. The gestational surrogate is not genetically related to the baby because the embryo is created using the intended parents' eggs and/or sperm, or donor eggs and/or sperm.

Twig provides the clinical care related to gestational carrier cycles, including intake, screening, cycle coordination, and embryo transfer. The legal agreement is handled by a fertility lawyer.

A known donor is someone who is known to the intended parent(s) and who agrees to donate their eggs or sperm to them so that they can build their family.

Yes. Known donors are welcome at Twig. Legal counselling, genetic counselling, and clinical screening are part of the known-donor pathway and we coordinate the whole process with you.

Health Canada regulates the screening of donor sperm and eggs, including both anonymous and directed donors. When anonymous sperm or eggs are obtained through a bank, that bank has already screened the donor. When using a known donor through Twig, we are required to screen that donor through the same rigorous process. These steps are designed to protect everyone involved and give you confidence in what you're doing.

Building your family with a known donor involves more steps than using an anonymous donor because the donor has not yet gone through the required Health Canada screening process. Additionally, a legal agreement is required in these cases.

Yes. We work with major International and US sperm banks and donor egg banks, as well as Canadian importers and distributors to give you access to a wide range of Health Canada screened donors to select from.

Choosing a sperm donor is a personal decision, and there is no single right answer. Most patients consider factors like the donor's medical and family history, physical characteristics, education, personal essays, and whether the donor is open to future contact from any children conceived (known as an "open" or "ID release" donor). Your care team can help you think through what matters most to you. Reproductive counselling is available throughout the process to help you and your partner work through these decisions together.

Co-parenting is a family-building arrangement where two or more people, who are not in a romantic relationship, decide to raise a child together. This might be a gay man and a lesbian woman, two friends, or another configuration that works for you. Twig supports co-parent family building, and our care team has experience walking patients through the clinical pathway. Because co-parenting involves multiple intended parents and often donor materials, independent legal advice and reproductive counselling are essential and required parts of the process.

Twig requires that all people planning to build their families through third party reproduction, or who are planning to act as a donor or gestational surrogate, meet with a reproductive counsellor. A reproductive counsellor can help you navigate decisions, learn more about your options, and provides a space to talk through the process, your expectations and boundaries, and any emotional or logistical difficulties you may be experiencing. We want to ensure everyone is informed and prepared for the process.

If you are using a known donor or a gestational surrogate, or if you are acting as a known donor or gestational surrogate, Twig Fertility requires that you have independent legal advice and a legal agreement between all parties. Legal agreements protect the rights and define the responsibilities of all parties.

Donor sperm and donor eggs from banks are not covered by OHIP or MSP. The clinical procedures (IUI, IVF, embryo transfer) follow the same funding rules as those not using donor eggs or sperm. In Ontario, eligible patients under 43 may use the Ontario Fertility Program for one funded IVF or egg thaw cycle, and this cycle can include donor sperm or donor eggs.

The known donor assessment fee at Twig covers case coordination, a financial consult, and diagnostic testing (such as blood work, ultrasounds, ovarian reserve testing and semen analysis). It also covers Health Canada-required medical history and screening, infectious disease testing, physical examination, genetic counselling and testing, and required reproductive counselling for all involved parties.

In addition to the known donor assessment fee, you can expect costs for treatment, medication, shipping of samples, and cryostorage.

Procedure pricing (IUI, IVF, reciprocal IVF) is the same for LGBTQ2S+ patients as for any patient. Donor sperm or eggs, gestational carrier costs, and legal costs are billed separately. Your care team confirms every cost with you before you commit.