Some people might need third-party reproduction to build their families. This could include:

• Same-sex couples
• Single parents by choice
• People who unable to produce sperm
• People who are unable to produce eggs
• People who cannot carry a pregnancy

For patients interested in third-party reproduction, we suggest they begin by consulting with their primary care provider and ask for a referral to Mount Sinai Fertility. The initial phase of a  third-party reproduction process typically follows the following 3 steps:

Donor sperm may be an option if you:

• Are single and choose to have a child
• Biologically cannot produce sperm
• Have severe infertility issues related to sperm production or quality

Testing: Begin with tests to understand your chances of success with donor sperm.

Choosing a Donor: Select a known or unknown (anonymous) donor based on your needs.

Known sperm donor

• Could be a friend or family member.
• Donor must complete assessment and testing for infectious and genetic risks which can include medical questionnaires, physical examination and blood and urine testing
• Requires counselling and independent legal advice for both parties.

Unknown sperm donor

• Chosen through Health Canada approved sperm banks.
• Sperm banks screen donors for medical, psychological, and genetic issues.
• Provide details like donor’s background, education, and health.

At present, MSF currently uses only three sperm banks. The sperm banks listed below are Canadian compliant.

When choosing a donor you many also wantot consider whether you would prefer a donor who has chosen to remain closed or open to identity release.

• Closed: information will not be released to the offspring in the future
• Identity release: information can be released to the offspring in the future

Sperm Straws/Vials: For IUI, we recommend ordering at least three vials. For IVF, one vial may be enough.

Sibling Planning: If you conceive, consider purchasing extra vials to allow for future siblings.

CMV Status: If you are CMV-negative, we recommend to choose a CMV-negative donor to protect your pregnancy.

Delivery and storage

• Donor sperm must arrive at Mount Sinai Fertility at least two weeks before your treatment.
• Extra vials are stored securely with a grace period of six months before storage fees apply.

Any additional vials will be stored at Mount Sinai Fertility until we instructed to dispose of them. We are happy to offer a 6-month grace period for donor sperm storage fees. If there are any vials in storage after 6 months, the patient will be billed for 1 year of storage ($480). If the remaining vials are used before the end of the year, the patient will be refunded the cost of the unused months.

Donor eggs might be an option if you:

• Have a low egg count or quality
• Experienced ovarian damage (e.g., from cancer treatment)
• Are over 43 years old
• Biologically cannot produce eggs

When selecting an egg donor, patients can choose to use a known egg donor or an unknown egg donor. Before proceeding with egg donation, The donor recipient(s) will meet with a counsellor for implications counselling.

Steps to using donor eggs

Testing: Start with assessments to evaluate success.

Counselling: Counselling sessions will help you understand the process.

Known egg donor

• Could be a friend or family member.
• Donor must complete assessment and testing for infectious and genetic risks which can include medical questionnaires, physical examination and blood and urine testing
• Requires counselling and independent legal advice for both parties.
• Donor must undergo ovarian stimulation and egg retrieva

Unknown egg donor

• Mount Sinai Fertility partners with Donor Egg Bank USA to provide a variety of options. You can review donor profiles and details to choose the best match. Learn more.

Embryo transfer process

1. Eggs are thawed and fertilized with sperm using ICSI.
2. Embryos develop for three to five days before transfer. To learn more about what happens in our lab click here.
3. Your doctor will help decide how many embryos to transfer.
4. Extra embryos can be frozen for future use.

The procedure takes about 15 minutes.

The Process of Using a Gestational Carrier at Mount Sinai Fertility

When using a gestational carrier (GC) is the right choice for your family-building journey, Mount Sinai Fertility is here to guide you through every step. This process involves medical, psychological, and legal preparation to ensure everyone is supported and protected.

Step 1: Find a gestational carrier

Identify a suitable GC. At MSF, we only work with known GC and will not work directly with an agency.

Step 2: Consultations and screening

The GC will undergo assessment and screening with one of our fertility physicians. We also require the GC undergo an assessment and counseling on obstetrical risks with an obstetrician.

The intended parents and GC must complete implications separate and joint counseling with a third-party reproduction counselor.

Step 3: Legal agreements

Both parties must meet with separate lawyers for independent legal advice.

A signed gestational carrier agreement is required before treatment begins.

Mount Sinai Fertility must receive a legal clearance letter confirming this agreement.

 Preliminary Assessment

• The GC undergoes: A full medical history review and physical exam to ensure pregnancy is safe. Infectious disease testing, including HIV, hepatitis B and C, gonorrhea, chlamydia, and more, as recommended by the Canadian Fertility and Andrology Society (CFAS).
• A medical assessment including lab work, a transvaginal ultrasound, and a uterine cavity evaluation.
• The intended parents will also be screened for infectious diseases through questionnaires, exams, and blood tests, as required by Health Canada.

Cycle Monitoring

• For intended parents contributing eggs via IVF: Embryos are first created and frozen using the intended parents gametes or donor gametes.
• The GC’s uterine lining is monitored to ensure it’s ready for embryo transfer.
• For the GC, hormones may be naturally produced or supported with medication to prepare the lining.
• Once the lining is optimal, progesterone medication is added, and the embryo transfer is scheduled.

To learn more about IVF, the egg retrieval process and egg fertilization, please click here.

Embryo Transfer

• During the transfer: A speculum is used to access the cervix, and an ultrasound guides the procedure.
• A thin catheter is inserted into the uterus to place the embryo(s). The procedure takes about 15 minutes and is painless.

Pregnancy Test

• Approximately 1.5 weeks after the embryo transfer, the GC will take a beta-hCG blood test to confirm pregnancy.
• Testing can be done in-clinic or at an outside lab with a requisition provided by our team.

*Please note: The Assisted Human Reproduction Act (AHR Act 2004) prohibits several surrogacy-related activities. Surrogacy itself is not banned, but payment of consideration or the offer of payment to a surrogate are prohibited acts. Therefore, Mount Sinai Fertility does not facilitate finding a GC and we do not work with surrogacy agencies

We offer expert guidance, compassionate care, and specialized support to help you navigate the third-party process with confidence.

Mount Sinai Fertility is committed to providing expert care and compassionate support. From your first consultation to the final steps of treatment, our team will ensure you feel confident and informed every step of the way.