HIGH-TECH PREGNANCIES.

Lesbian couples are increasingly turning to science for help in their quest to have children

On the day in 1996 that Beth gave birth to her first child through donor insemination, she looked at her partner, Jennifer, who was by her hospital bedside, and thought, Imagine giving birth to her baby. "Growing up, I always wanted to have children and produce the offspring of the person I love," she recalls. "But I never thought it was possible because I am a lesbian."

Now, if all goes well, Beth, a 36-year-old from Dallas, will give birth to Jennifer's baby in May. The pregnancy, which would have seemed unimaginable just a few years ago, is possible through an in vitro fertilization procedure in which one woman contributes her eggs, which are fertilized by a donor's sperm, and her partner carries their baby.

Arrangements like Beth and Jennifer's are still rare, but their use of technology is not. As lesbian pregnancy through donor insemination has become more common, a growing number of women have begun to take advantage of assisted reproductive technologies and other insemination methods that traditionally have been used by infertile heterosexual couples,

"I think we're seeing a quiet acknowledgment that this is not necessarily a romantic process. It's a medical procedure," says Terry Boggis, director of Center Kids, a program for children of gay and lesbian parents at the Lesbian and Gay Community Services Center of New York City. "The baby is no less wondrous. But the process of getting the baby is becoming more pragmatic and expedient, at least after the first at-home insemination."

More and more often, lesbian couples are getting pregnant through such advanced methods as intrauterine insemination and with the help of fertility medications, according to Carol Frost Vercollone, coauthor of Helping the Stork, a 1997 book about donor insemination.

"As lesbian couples are accepted into the world of reproductive medicine and as prejudice goes down, they are increasingly getting access to high-tech medical options--which is both good and bad," says Vercollone, noting that there are health risks and high costs associated with some of these procedures.

It's impossible to say how many lesbians have used these techniques. The latest statistics available from the U.S. Centers for Disease Control and Prevention reveal that 16,520 babies were born through assisted reproductive technologies in 1995. But the agency does not record how many were born to lesbian mothers.

It's similarly impossible to say how many lesbians have given birth to children--through any means--though most observers say the boom is continuing to grow. At the Berkeley-based Sperm Bank of California, for example, demand has increased about 20% in the past six months, says executive director Maura Riordan. The bank primarily serves lesbians.

The trend toward high-tech pregnancies is not a universal one, however. At least 50% of the women who use the Sperm Bank of California perform at-home inseminations, according to Riordan. In fact, the sperm bank encourages it. "We're about demedicalizing the process," says Riordan. "If someone wants to and can do it at home, what better way to go?"

There is, after all, no evidence that a woman intracervically inseminated at a doctor's office is more likely to become pregnant than a woman inseminated at home, according to Riordan. But if at-home insemination is unsuccessful after three or four attempts or if the woman is 40 or older, Riordan's staff encourages women to seek professional assistance.

In many cases a doctor or nurse will perform an intrauterine insemination, in which a catheter is passed through the cervix and into the uterus to release the sperm. In intracervical insemination the sperm is released just inside the cervix.

Intrauterine insemination has been shown to be up to three times as effective as intracervical insemination, says Vercollone. But there are no large-scale studies of at-home insemination with which to compare these results, she acknowledges.

The more complex in vitro fertilization procedure involves fertilization in the laboratory of the birth mother's own eggs or those of a donor. It is usually reserved for women with infertility problems or lesbians who want to carry their partner's babies.

Beth, a former medical social worker, spent a year being inseminated intracervically before she went to an infertility specialist and discovered she had complications that required medical assistance. The doctor conducted in vitro fertilization by retrieving her eggs, fertilizing the healthy ones with sperm, growing embryos, transferring several into her uterus, and freezing the rest for later use. Soon after, she became pregnant. One month later Jennifer had her eggs retrieved and fertilized with the same donor's sperm. And the resulting embryos were similarly frozen until Beth was ready to go through another in vitro fertilization procedure--this time, to conceive Jennifer's baby.

"It was just amazing," says Jennifer now, who is an attorney. "We had frozen sperm, a frozen embryo, and we got a baby."

Of course it wasn't quite that easy. The procedure required that Beth undergo repeated hormone injections, which caused nausea, fatigue, bruises, and mood swings. Retrieving the eggs required surgery under general anesthesia. And the couple spent about $10,000 in the process.

Couples can get more than they bargain for with in vitro fertilization. The procedure presents an increased chance of multiple births, which can cause added health risks. Yet another procedure, called blastocyst transfer, recently has been shown to be successful in countering this, Vercollone says. In this process, fertilized eggs are grown in the laboratory for a few extra days so that doctors can more clearly determine which cell configurations, known as blastocysts, will be healthy. Doctors then transfer only one or two, instead of the three or four typically used with in vitro fertilization, into the uterus, while freezing the rest for later use.

Still, for Beth and Jennifer, all the risks, complications, and expense have been well worth it. As Jennifer puts it, "This is as close as we could come in this day and age to having a child together."

Bennett is a freelance writer in New York City and a faculty member in the media studies and sociology departments at New York University.