title: Counseling lesbian patients about getting pregnant.
abstract: OBJECTIVE
  To describe an approach to counseling lesbian patients about getting pregnant.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Primary care physicians can help lesbians achieve pregnancy by providing education, testing, referrals, and insemination services.
authors.affiliation: Department of Family and Community Medicine, University of Toronto.
authors.forename: L S
authors.initials: LS
authors.lastname: Steele
authors.forename: H
authors.initials: H
authors.lastname: Stratmann
mesh_terms: D000328:Adult; D003376:Counseling; D003657:Decision Making; D005194:Family Practice; D005260:Female; D018452:Homosexuality, Female; D006801:Humans; D007315:Insemination, Artificial; D016742:Preconception Care; D018570:Risk Assessment