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Purpose Assisted reproductive technology (ART) treatments with donor sperm have been allowed for women in lesbian relationships (WLR) since 2005 in Sweden, but for single women (SW), these became approved only recently in 2016. This study was conducted to compare the outcomes of ART treatments in SW vs. WLR. Methods This is a prospective controlled cohort study of 251 women undergoing intrauterine insemination (D-IUI) or in vitro fertilization (D-IVF) using donor sperm between 2017 and 2019 at the department of Reproductive Medicine, Karolinska University Hospital. The cohort comprised 139 SW and 112 WLR. The main outcomes included differences in live birth rate (LBR) and cumulative live birth rate (cLBR) between the groups. The SW underwent 66 D-IUI and 193 D-IVF treatments and WLR underwent 255 D-IUI and 69 D-IVF treatments. Data on clinical characteristics, treatment protocols and clinical outcomes were extracted from the clinic’s electronic database. The outcomes of D-IUI and D-IVF were separately assessed. Results The cohort of SW was significantly older than WLR (37.6 vs. 32.4 years, P P P P = 0.019), respectively. There was no statistically significant difference in the main outcome LBR between the two groups, or between the two different types of treatment, when adjusted for age. Perinatal outcomes and cLBR were also similar among the groups. Conclusions SW were, on average, older than WLR undergoing treatment with donor sperm. No significant differences were seen in the LBR and cLBR when adjusted for age between the two groups and between the two types of treatment (D-IVF vs. D-IUI). Trial registration ClinicalTrials.gov NTC04602962.

This is the first study evaluating the desire to marry and attitudes toward same-sex family legalization in an Italian sample of lesbians and gay males from 18 to 35 years of age. Even though the majority of participants reported a positive attitude toward same-sex family legalization, gay men expressed a lower desire to marry than lesbian participants. Participants with a high level of internalized sexual stigma were less likely to want to marry and to recognize the positive effects of the legal recognition of the same-sex family. Regression analyses showed the relevance of internalized sexual stigma, self-disclosure to family, political progressivism, and higher education to predict a desire to marry and a more positive attitude toward same-sex family legalization. The results point to the necessity of social policy reform to eliminate social and structural inequalities surrounding the pursuit of intimacy to reduce disparities in intimacy-related stressors of lesbians and gay men.