Abstract
Background: LGBTQIA+ people and couples increasingly pursue parenthood through assisted reproductive technologies (ART), yet the psychological, relational, and institutional processesinvolved remain dispersed across reproductive health, family studies, psychology, sociology, and LGBTQIA+ scholarship.Objective: This structured narrative review synthesizes recent literature on how LGBTQIA+ individuals and couples construct parental projects through ART, with attention to reproductiveaspirations, route selection, relational negotiation, minority stress, institutional encounters, and family narrative construction.Methods: PubMed and Scopus were searched for publications from 2016 to 2026. After deduplication, 260 unique records were screened, 126 underwent refined relevance appraisal,and 49 articles were retained as the mapped corpus. From these, 17 index studies were purposively selected for in-depth discussion as they offered particularly rich evidence onpsychosocial, relational, and institutional processes. The review followed a structured narrative synthesis approach guided by the Scale for the Assessment of Narrative Review Articles(SANRA).Results: Three family-making domains structured the synthesis: lesbian couples’ donor conception, IVF, and reciprocal IVF pathways; gay fatherhood through surrogacy and thirdparty reproduction; and transgender, gender-diverse reproductive planning, including fertility preservation and institutional barriers. Across domains, LGBTQIA+ ART family-makinginvolved six recurring psychosocial tasks: aspiration, feasibility appraisal, route selection, relational negotiation, institutional navigation, and narrative integration.Conclusion: ART is not only a set of reproductive techniques but a psychosocial and institutional context in which LGBTQIA+ parental aspirations are translated into reproductivepathways, negotiated through relationships, shaped by clinical and legal conditions, and incorporated into family narratives. These findings support cautious, pathway-sensitive, LGBTQIA+-affirmative fertility counselling.