Reciprocal IVF: A Lesbian Couple's Guide on the Journey to Parenthood


Life is a beautiful thing, and new life is the start of something great. Anyone that wishes to create life should be given the chance to.  At PFCLA, we welcome and embrace members of the LGBTQ community who want to begin their journey to create their own families. 

As reproductive medicine and fertility options become more advanced, the dream to have a child is even more accessible than before. Reciprocal IVF is a great family-building option for those in the LGBTQIA+ community. In this article, we will cover how reciprocal IVF works, its success rate, costs, how to decide who provides eggs and who will carry the baby to term, and alternative options.

What Is Reciprocal IVF?

Reciprocal IVF (in vitro fertilization) is a fertility treatment option for same-sex female couples that allows both partners to be intimately involved in the child creation process. Reciprocal IVF allows both individuals to play an intimate role in the biological development of the baby. The partner who provides the eggs is genetically related to the child, and the partner who carries the baby is biologically bonded to the child through pregnancy. 

How Does Reciprocal IVF Work?

In this fertility treatment, one partner provides the eggs while the other partner carries the baby to term. This is a great solution for many couples because it allows both women to be physically involved in the pregnancy, which can facilitate feelings of emotional connection and direct involvement in the pregnancy.

The partners will need to select a sperm donor to start; either an anonymous donor from a sperm bank or someone known to them. The partner donating the eggs goes through the ovarian stimulation process to produce multiple eggs. The eggs are then retrieved from her ovaries and fertilized with the donor sperm in our IVF laboratory. The embryos that are created will be frozen and later transferred to the other partner when she is hormonally prepared at a later date.  When the embryos are ready, an agreed-upon number is transferred to her uterus.

The first step of Reciprocal IVF involves reviewing medical history and undergoing a specific ultrasound and a panel of blood testing. For the partner who will provide eggs: she will go through a transvaginal ultrasound to check the ovaries and AFC (antral follicles count) and a blood test panel which will include hormonal levels including AMH (Anti-Müllerian hormone), where the results will help the IVF physician to decide the protocol of the medications. She will then take fertility medication to stimulate the ovaries to produce multiple eggs. Once the follicles containing the eggs are mature, the IVF physician will perform an egg retrieval procedure using ultrasound guidance.  These eggs will be fertilized with the donor sperm in our IVF laboratory.

Then the other partner will also go through an ultrasound to check the uterus and a panel of blood tests. If the physician finds no issues during the screening process, then hormone treatments will be given to the child-bearing partner to prepare her uterus to carry the pregnancy to term.

Which Partner Acts as the Egg Donor, and which as the Gestational Carrier?

If neither of the partners has fertility issues, either one can be the egg donor or gestational carrier. The process is the same as a regular IVF cycle, but it is divided between two women. Sometimes partners who do not have fertility issues and have had a child with Reciprocal IVF will reverse their donor and carrier roles for a second child, so that each has a biological relationship with one of the children, and each gets to experience pregnancy and childbirth.  

It is important to decide which partner will donate the egg and which partner will carry the pregnancy. Age is an important consideration. Women under the age of 35 tend to have healthier eggs and better IVF success rates. If there is an age difference, your IVF physician will likely recommend that the younger partner provide the egg. If one partner struggles with infertility, then she is probably not the ideal egg donor. However, she could still be perfectly capable of carrying the pregnancy. The decision can depend on each individual case. 

What Is the Success Rate?

The success rates of Reciprocal IVF are similar to the success rates of standard IVF cases, but with each case comes unique challenges. The success rates of Reciprocal IVF can be affected by the age of the egg source, the quality of the donor sperm, uterus condition, general fitness, and lifestyle. It is not always successful on the first attempt. In some cases, it will need multiple cycles to achieve a live birth. At PFCLA, our IVF specialist can assess the situation in the event of a failed IVF cycle. We will evaluate the cycle and advise the ideal options moving forward.

What Is the Cost of Reciprocal IVF?

The average cost for Reciprocal IVF is typically over $20,000, this cost can vary depending on medication protocols, sperm donor cost, and add-on services such as ICSI (Intracytoplasmic sperm injection) and PGT-A (preimplantation genetic testing). ICSI is when a single sperm cell is individually injected into an egg, instead of placing the sperm in a petri dish with eggs and hoping a few of the eggs will become fertilized. This method can be used to increase the fertilization rate. PGT-A is the testing of identifying each selected embryo’s number of chromosomes present. Abnormal chromosome numbers, also known as aneuploidy, are a significant source of challenges in pregnancy and birth. Having PGT-A testing done on your embryos can increase your success rate.

What Are the Alternative Options?

There are several options available for same-sex female couples who want to have a baby. Options to explore include intrauterine insemination (IUI), IVF, egg donation, and surrogacy. Connect with one of our fertility specialists today to see what options may be best for your family.

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Note: This is not intended to be a substitute for professional medical advice, diagnosis or treatment. Information provided is for general educational purposes only and is subject to change without notice. Speak to your doctor directly with any questions you may have regarding a medical condition. Any information contained herein does not replace any care plan as determined by a physician. 

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