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Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-to-Be

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Making a baby through love and science? Get the guidance you need to navigate the conception process with confidence and ease.

The only evidence-based, up-to-date fertility guide for queer people from an experienced health care provider, this is also the first to be transgender inclusive and body-positive.

Here, queer prospective parents will find sound advice for navigating complex medical, social and financial decisions. Trusted fertility midwife Kristin Kali walks you through the baby-making process: creating a timeline; fertile health for every body; preconception tests; identifying ovulation; donors, gamete banks, and surrogacy; methods of insemination including IUI, IVF and reciprocal IVF; navigating early pregnancy; and preparing for infant feeding, including lactation induction for trans women and nongestational parents.

This book is for all LGBTQ+ readers interested in creating family through pregnancy: anyone who identifies as queer, lesbians, gay men, bisexual people, trans and nonbinary people, couples, single parents by choice, poly families, and coparents. It’s an antidote to a culture and medical system that all too often centers heterosexual couples experiencing infertility while overlooking our unique needs. It also contains sidebars with guidance for reproductive healthcare professionals.

314 pages, Kindle Edition

Published May 24, 2022

70 people are currently reading
418 people want to read

About the author

Liam Kali

1 book

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5 stars
139 (70%)
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46 (23%)
3 stars
10 (5%)
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Displaying 1 - 30 of 34 reviews
Profile Image for Sam.
40 reviews5 followers
July 26, 2022
This book was so refreshing. It’s obvious that the author is deeply experienced and knowledgeable about conception, pregnancy, and birth, but I so appreciated the care with which they addressed the nuances of queer and trans family-building. There was not a moment where I winced about the language being used or felt marginalized by what was being discussed. The consideration given to the unique needs of trans and nonbinary parents, combined with the professional medical knowledge, is a special combination in this book. Highly recommended for any LGBTQ person considering building a family through pregnancy, even if they themself will not be a gestational parent.
Profile Image for Rachel Davidson.
12 reviews1 follower
December 9, 2022
So informative, and so amazing to have a book geared towards LGBT+ people
Profile Image for Chelsea Shamy-Calder.
1 review
March 19, 2025
Super helpful for understanding all of the milestones, challenges, and beautiful things that will come from ttc as a nonhet person. Will definitely be referring back throughout our journey.
Profile Image for Katrina.
107 reviews3 followers
March 30, 2025
Excellent and so affirming. Consistently blown away by how little I know about my own body.
Profile Image for Gold Dust.
320 reviews
November 25, 2023
Has some good information that other conception books don’t have, like about using sperm from donors, both frozen and from known donors. But irritatingly written because the author caters to the queer and POC community. S/he uses ‘they/them’ pronouns and makes themself look androgynous (the trendy word for it now is nonbinary), but then uses the female name Kristin. Why not go with Kris?

S/he is white and apologizes for being so (ix). Can you imagine a black person writing this book and saying “I’m sorry for being black. As a black person, I can never understand what it’s like to be white like some of you out there.” People would say, “You poor, poor person! Don’t feel bad for the color you were born as! You are not lesser than the white person!” Well, just the same, white people shouldn’t have to apologize for being white! Being born white doesn’t mean one is destined to be racist. To believe all people of one race are the same is to be racist! These hypocritical leftist are unbelievable!

The author also makes sure not to step on any fat people’s toes. She tells them that some doctors can be insensitive and fat phobic by daring to suggest that they lose weight to improve their conception chances (186). You can be as obese as you want, honey! You just get yourself a new doctor, you hear? One that tells you that you are perfect just the way you are!

The author tries to perpetuate the myth of systemic racism by saying Xytex has the largest number of black sperm donors but won’t ship vials to homes (105). I know from personal experience that Xytex ships to homes if you get your doctor to send them authorization/permission. This isn’t a secret. It’s a known policy of theirs.

The author lists risk factors for miscarriage on p. 239. Among them is “chronic stress from systemic inequities such as racism,” as if racism is the only thing a POC can get stressed about! What about just life, work, traffic, finances, relationships, family, friends, health issues, etc.? Couldn’t the author have just said “chronic stress” without making it about racism?

Tips:

If you do strenuous exercise, do it “in the first half of your cycle, when the body is primed for physical exertion” (39).

“If you have an Rh-negative blood type, it is ideal to select an Rh-negative donor. If you have type O blood, it is best to select a type O donor” (60). But all other blood types (A+, B+, AB+) can pick whichever donor they want. “If you do not have evidence of immunity to CMV, you may be required to only use a donor who is CMV negative” (65), but sperm donations from donors who have an active CMV infection are destroyed, and sperm banks only let you know whether the donor has CMV antibodies or not (either caught it and recovered or never caught it).

“Fats that are solid at room temperature, such as butter, coconut oil, and dairy products, are called saturated fats, and they contain mostly omega-6 fatty acids, which are pro-inflammatory” (37). Dairy should be consumed in moderation while pregnant or TTC. When you eat yogurt or kefir, try to get one with lactobacillus rhamnosus (50).

Eat a plant-based, whole-food diet (31). “Plant-based proteins (lentils, legumes, whole grains, nuts) and fish provide protein without increasing inflammation. Get most of your protein from these sources, adding in moderate amounts of dairy and poultry, and keeping intake of red meat to a minimum” (33). A person needs .8 grams protein per kg of body weight (divide body weight in pounds by 2.2 to get kg) (34). But the author says that a pregnant body needs up to 100 grams of protein (34).

The book provides a chart with sources of protein and amounts (34), but the foods are not all listed under the same measurement. So fish is put at the top of the chart for animal proteins (making you assume it’s the best), but the fish is measured in 4 ounces while the meat is measured in half cups. I looked up online the highest sources of protein and made sure to find a chart that would show each food in the same measurement (100 grams). (Source: healthbeet.org) The real protein winner is bacon at 37 grams protein per 100 grams weight. But each slice is only 3 grams protein each. The chart I found also includes the typical serving size of each food. When that is taken into account, the highest protein food in a typical serving is chicken breast at 36 g protein per 4 ounce serving. This exceeds the protein amount in a typical serving of tuna, which the book author placed higher above chicken. Chicken also beats tuna by 3g protein when they are both 100 gram portions. As for bacon, you’d have to eat 12 slices of it in order to get the same amount of protein in a typical serving of chicken. This is important stuff to know! Instead of the author being ashamed of being white, s/he should be ashamed of misleading her readers with a biased protein chart!

Don’t do intermittent fasting because then “your body is focussing on keeping your blood sugar stable instead of reproductive function” (31). The author recommends eating small meals every three hours to keep blood sugar stable (34). Seems counter-intuitive to me, because what about when we sleep? That’s an eight hour fast right there. So shouldn’t the body be able to handle eight hour gaps between meals while awake too? Didn’t cave women still conceive babies even though they went days without food? Don’t wild animals do it all the time?

When pregnant, maintain “your blood sugar with protein rather than high-carb foods. This is because your body will be shifting from an insulin-sensitive state to an insulin-resistant one, and if you eat too many carbs, your pancreas might not be able to keep up” (254). This results in gestational diabetes.

*Helpful information:

First trimester bleeding “occurs in 20-30% of pregnancies, but only 12% of those who bleed in the first trimester actually miscarry” (239).

“Ferritin levels are considered normal above 12, but it is ideal to start pregnancy above 20 so that you have some leeway in case you have nausea, vomiting, and food aversions in early pregnancy that keep you from being able to eat iron-rich foods or keep supplements down” (60). When TTC, A1C should be lower than 5.8% (63), AMH should be above 1 or 2 ng/mL, AFC should be 10 or higher (70), TSH should be .3-2.5 mU/L (62), and vitamin D should be 50-60 ng/mL (64).

Pregnancy and miscarriage rates by age with frozen donor sperm (23):
Age - Preg w/ unmed. ICI - Preg w/ Unmed. IUI - Miscarriage
<35 - 6% - 17-22% - 10%
35-40 - 6% - 8-14% - 19%
40+ - 6% - 3-6% - 27%

Age - IVF Live birth rate by age per cycle of egg retrieval (23)
<35 - 54.7%
35-37 - 40.6%
38-40 - 25.6%
41-42 - 12.8%
43+ - 4.4%

Normal semen values (73):
5th Percentile (Low Cutoff) - 50th Percentile (average)
Volume - 1.5 ml - 3.7 ml
Count - 39 mil - 255 mil
Concentration - 15 mil/ml - 73 mil/ml
Motility - 40% - 61%
Progressive motility - 32% - 55%
Morphology - 4% - 15%

“Sperm quality starts to decline over age 40. Chromosomal abnormalities are more common over age 45” (1).

Sperm life span - best time to inseminate (123):
Fresh - up to 3 days - 24-48 hrs before ovulation
Frozen - 12-24 hrs - within 12 hrs of ovulation

If you are doing IUI, get IUI vials with at least 20 million motile cells per ml (107).

Scientific evidence about IUI (154):
With frozen sperm, IUI doubles the success rate over ICI.
Chances of success: 17% average, but varies based on age.
Egg cells are able to be fertilized for 12-16 hours after ovulation.
Pregnancy rates are higher when IUI is performed as close to the release of the egg as possible (just before or within 10 hours after ovulation).
The time of ovulation in relation to the onset of the LH surge varies from person to person.
Detection of the LH surge in urine typically happens 12-48 hrs before ovulation; however, in some individuals it can occur after the egg is released.
The beginning of the LH surge is a more reliable predictor of ovulation than the peak.
Pregnancy rates are higher in unmedicated donor insemination cycles than with medications.
Timing inseminations with the LH surge rather than a trigger shot/hCG injection increases the pregnancy rate significantly.
At-home urine LH kits are just as effective as blood work in identifying impending ovulation.
Success is increased when you lie down for at least 10-15 minutes after IUI.

Scientific evidence for self-insemination with fresh sperm (155):
Pregnancy rates are higher with fresh than with frozen sperm
Pregnancy rates are highest with fresh sperm when insemination happens during the days of peak quality fertile fluid.
Chances of conception are highest when sperm is deposited near the cervix 1-2 days before ovulation. The day of ovulation is slightly less effective, and there is almost zero chance the day after.
Some of the sperm cells reach the fallopian tubes within 2-10 minutes of insemination near the cervix. Others are harbored within crypts alongside the cervical os.
With fresh sperm, success rates are higher when two inseminations are done instead of one.

“The best [fresh] samples occur between 24-48 hours after the previous ejaculation. After about three days without ejaculation, sperm cells start to break down” (171).

If you do self-insemination with a known donor, you are risking that the donor can call himself the father and sue for custody, because couples that conceive via sex are legally called the parents (96). To avoid this risk, you can either have a midwife or doctor present that it was just an insemination, not sex; or you can draw up a contract that the donor signs. Using a lawyer is recommended.

You can also have your donor ship samples to you overnight using a shipping kid to keep the cells alive. Donor Home Delivery charges $200 per kit including shipping. Must be mailed the day before you anticipate needing it, and use it the day it arrives (99). Time insemination the same as you would with a frozen sperm sample (172). Don’t use a turkey baster, and you don’t need to use the Mosie syringe (178).

ART resources:
Sart.org - for calculating your chance of success with ART
Fertilityiq.com for IVF grants/charities

Sincerely,
A POC

Profile Image for JTR.
83 reviews2 followers
April 2, 2024
So grateful, after two years, to be graduating from conception. 🤞 appreciate a book that is so inclusive and informative, recommend for anyone considering trying to make a baby!
Profile Image for Joseph.
182 reviews12 followers
May 26, 2025
4.5/5

Kali uses gender-neutral, educational and unbiased language that feels affirming to read, as well as relieving when taking into account that they answer so many questions about queer conception, fertility, health, and biology that I've had trouble finding online. I've learnt a lot and will definitely return to read this again once more of the information becomes relevant for my parenthood journey.
Profile Image for Clée.
3 reviews2 followers
February 21, 2023
J'ai lu le livre Queer Conception en tant que formateurice en symptothermie et je pense que c'est une ressource très complète pour soutenir les familles queer. Il parle des méthodes d’observation du cycle et propose notamment une méthode qui utilise le double contrôle, le diagramme de cycle MAIA. 


Le livre donne de nombreux conseils pour optimiser sa fertilité, utilisables pour les aussi bien pour les personnes cis que pour les personnes queer (alimentation, repos, gestion du stress, activité sportive). Il y a aussi tout un chapitre sur les fausses couches qui est utile pour tout le monde.


Le livre explique également comment les traitements hormonaux pour les personnes trans peuvent affecter la fertilité et ce qui se passe lorsqu'ils sont arrêtés pour concevoir. Il donne aussi des conseils pour faire face à la dysphorie de genre et à la dysmorphie pendant la grossesse.


Il explique comment trouver un donneur de sperme, quelles sont les informations clés à discuter ensemble pour être sécurisé d'un point de vue légal. Et aussi des informations plus pratiques sur comment transporter le sperme et faire une insémination maison par exemple.


Il explique très bien les démarches d'une procréation médicalement assistée et donne des outils pour se protéger en cas d'homophobie ou de transphobie à l'hôpital par exemple. Enfin, le livre se termine par des conseils pour la lactation induite pour pouvoir nourrir son bébé.


Je pense que c'est un livre incontournable pour accompagner les familles queer qui veulent avoir un enfant car il est très complet et il a été écrit par une sage-femme qui fait partie de la communauté queer.


Ce livre m’a beaucoup aidé à offrir un accompagnement adapté aux familles queers pendant mes accompagnements en symptothermie et je ne peux que le recommander.
This entire review has been hidden because of spoilers.
155 reviews9 followers
January 3, 2025
This book has pretty much everything you need to know to get pregnant when sperm is not readily available (like if you're queer or single). This book was indispensable to me in so many ways and I've recommended it to many people! I'm not sure there's another resource like this out there. And there's a lot of misinformation floating around about the process of trying to conceive so this book is essential. Honestly, I think everyone could benefit from the knowledge in this book, whether to better understand the human body and process of conception or to get a peek into the realities of life for others. Totally separately, I had a consultation with the author wherein they suggested maybe I should NOT try to conceive or carry a pregnancy and I was very shocked and turned off because this made no sense to me, but I guess that has nothing to do with the book! I ended up getting pregnant and having a baby anyway.
Profile Image for Kayley.
14 reviews
October 4, 2025
This is an excellent book that I think fills a huge gap for a lot of people. It's a gap in what's taught in school but also what information is readily available online and in books for people who want to conceive through any situation other than a straight, cis, couple. (For instance people who are straight and cis but not a couple.) At the end of the day, I might not be the target audience for this book, but I still learned a ton from it. It answered questions I had and questions I didn't know I had.

This book is very empowering and it's wonderful to have so much clear information about conception in one place and have none of it making assumptions about who you are or who your partner is.
1 review
August 23, 2022
Liam is your guide through unfamiliar territory, making you feel seen and held all along the way. Necessary read for anyone going through queer conception. I wish we had had this book earlier in our journey, but thankful to have it now. And grateful that anyone beginning this endeavor, or working with folks going through this endeavor, can access this invaluable resource. Thank you thank you thank you.
Profile Image for Megan.
189 reviews1 follower
March 27, 2022
ARC provided by NetGalley in exchange for an honest review.

Very helpful and informative for queer person/s trying to conceive, but the overall organization of the book was very difficult to pick through. Maybe a hard copy will be easier to navigate, but I couldn't click to each chapter and the charts were all distorted in the Kindle version.
1 review
August 23, 2022
This book is indispensable for anyone on the road to parenthood. It is comprehensive, inclusive, sensitive, compassionate, encouraging, affirming and empowering. It is loaded with information which is hard to find elsewhere: the fundamentals of conception for bodies of all kinds. A must-read for queer families everywhere.
Profile Image for Sarah Koppelkam.
559 reviews19 followers
November 9, 2025
An essential guide for LGBTQ+ people attempting to start our families. The majority of pregnancy and fertility resources remain frustratingly heteronormative, even such staples such as Taking Charge of Your Fertility. Queer Conception truly covers the variety of options, experiences, emotions, and frustrations that are part of any queer conception journey. Very grateful for this resource.
61 reviews
May 31, 2022
Queer Conception is packed full of really great information about conceiving and the different ways individuals may go about it. The formatting for the eBook was unfortunately quite difficult to navigate, especially the charts which were unreadable in the format.
2 reviews6 followers
August 24, 2022
This book is such a helpful, affirming guide for queer and trans people looking to grow their family. It breaks down processes and systems as well as offering a path to family building that honors queer legacies.
Profile Image for Larra Kelly.
38 reviews3 followers
December 29, 2022
Everything I wanted in a fertility book and couldn’t find anywhere else.

Trans inclusive, doesn’t make assumptions about the readers’ family structure, and just generally good solid information in a welcoming and judgement free tone.

I’m so glad this exists!
Profile Image for Megan Quentin .
27 reviews2 followers
January 18, 2024
This book was well written but wasn’t as useful as I would have hoped. I didn’t glean as much information for our IUI journey as we would have liked. I can see it being incredibly helpful for other folks but it was not helpful in our situation.
2 reviews
June 22, 2024
I found this book very refreshing and complementary to Taking Charge of Your Fertility by Toni Weschler. I found the section on donor conception to be lacking. It wasn't focused on the perspectives of Donor Conceived people.
Profile Image for Seoung.
38 reviews
December 24, 2022
really informative! it's nice to read a parenting book that acknowledges multi-partnered families and uses gender neutral language for bodies.
Profile Image for mathou .
34 reviews
December 11, 2023
please don't ask me why.
but it was definitely a really interesting read! deeply filled with informations and it was actually helpful.
2 reviews1 follower
September 29, 2024
I'm SO grateful this book exists!!!!! It is well-researched and affirming. Anybody considering building a family would benefit from the author's knowledge and approach.
Profile Image for Ayana.
198 reviews1 follower
February 6, 2025
This book is very informative and inclusive within the lgbtqia community.
Profile Image for Bridget.
16 reviews
February 6, 2025
Recommended by almost every queer family for a reason 🫶😌✨
1 review
September 23, 2025
So incredibly helpful as my wife and I navigate our fertility journey! The downloadable charts from MAIA are especially useful.
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