Counseling lesbian patients about getting pregnant.

OBJECTIVE

To describe an approach to counseling lesbian patients about getting pregnant.

SOURCES OF INFORMATION: Information in this paper is based on evidence from randomized controlled trials (level I evidence), non-randomized trials (level II evidence), expert opinion (level III evidence), and government regulations.

MAIN MESSAGE: We review 5 steps that comprise an approach to counseling lesbian patients about getting pregnant safely and efficiently. These steps are preconception care (including counseling, testing, and immunization); donor choice (including explaining the risks and benefits of choosing between a known or anonymous donor and the difference between fresh and frozen semen); donor testing (including Health Canada's requirements for semen processing and recommendations for testing before home insemination); ordering the semen (including information about sperm banks and the need for "Canadian compliant" semen); and the insemination process (including techniques for monitoring ovulation and various methods of insemination).

CONCLUSION

Primary care physicians can help lesbians achieve pregnancy by providing education, testing, referrals, and insemination services.