Reciprocal IVF: A Complete Guide to Shared Motherhood
Reciprocal IVF involves collecting eggs from one partner, fertilising them in the lab with donor sperm and placing the resulting embryos in the other partner’s womb to develop. It enables both partners in a same-sex couple to have a biological connection with their child. In this article, we examine the reciprocal IVF process and explore treatment timelines, cost, success factors and legal considerations.
8 min. read
What is Reciprocal IVF?
Reciprocal IVF is an assisted reproductive technology for female same-sex couples that involves retrieving eggs from one partner, fertilising them in the lab and transferring the resulting embryos to the other partner’s uterus so they can carry the pregnancy to term. Also known as shared motherhood, shared parenthood, co-IVF, or ROPA (Reception of Oocytes from the Partner), it is a unique fertility treatment that ensures both parents share a biological connection with the child.
The reciprocal IVF procedure is similar to traditional IVF. The main difference is that both partners are part of the pregnancy - one donates the egg, and the other carries the pregnancy.
Reciprocal IVF is not allowed in all countries, with its legal status largely dependent on LGBTQ+ rights, LGBTQ+ access to fertility treatments, and egg donation legislation.
Who is reciprocal IVF for?
Reciprocal IVF is for couples in which both partners have a uterus and ovaries, and want to have a biological connection to their child and/or share in the physical experience of pregnancy. It is used by female same-sex couples, trans-masculine individuals and non-binary couples.
Reciprocal IVF step by step
A typical reciprocal IVF process involves the following steps:
Fertility assessment
Both partners undergo a comprehensive fertility assessment and health check-up. This includes ultrasounds and blood tests to assess the ovarian reserves, screen for communicable diseases and help determine whether one partner is better suited to carrying the pregnancy or providing the eggs.
Select a sperm donor
A suitable sperm donor is required for reciprocal IVF, and every couple will need to find a donor who meets their criteria. All European Sperm Bank donors are comprehensively screened and have detailed donor profiles to help you make an informed decision.
Hormone stimulation
The partner providing the eggs takes hormone medication to stimulate the ovaries and produce several eggs. Stimulation usually lasts 10 to 14 days, and the partner will be carefully monitored throughout the process to check follicular growth.
Egg retrieval
Once the eggs are mature, they are collected via a short, minor surgical procedure. The fertility specialist uses an ultrasound-guided needle to retrieve the eggs. This typically occurs under sedation or general anaesthetic.
Fertilisation
The retrieved eggs are fertilised with donor sperm in a laboratory to create embryos. In traditional IVF methods, donor sperm is mixed with the eggs and the cells have to swim and penetrate the egg to fertilise it. With ICSI, a single healthy sperm cell is injected directly into the egg.
Embryo development
The fertilised eggs are stored in an incubator for several days and carefully monitored as they develop into embryos. Throughout this process, every embryo is graded so that the fertility specialists can select the most suitable one for transfer.
Uterine preparation
Before the embryo transfer, the partner receiving the embryo takes medication to prepare the lining of the womb. These hormone medications thicken the uterine lining to improve the chances of successful implantation.
Embryo transfer
An embryo is selected and transferred into the uterus of the partner who will carry the pregnancy. In some cases, two embryos may be transferred. Any unused healthy embryos can be cryopreserved for future use.
Pregnancy test
Around two weeks later, a pregnancy blood test determines if implantation was successful. If so, the couple are transferred to standard maternity care for the remainder of the pregnancy.
How long does reciprocal IVF take?
A cycle of reciprocal IVF usually takes between 6-10 weeks from hormone stimulation to embryo transfer. This will vary depending on whether you have a frozen or fresh cycle and whether you need to synchronise your cycles.
Who provides the eggs and who carries the pregnancy?
Deciding which partner provides the eggs and which carries the pregnancy depends on medical factors, personal preferences, emotional considerations and clinical guidance.
- Medical factors – ovarian reserve and uterine health are often key considerations. If one partner has a stronger ovarian reserve, they may be the best candidate for egg retrieval. If a partner has a healthier uterus or a history of uncomplicated pregnancies, they are better placed to carry the baby.
- Personal preferences – one partner may have a particularly strong desire to experience pregnancy.
- Clinical guidance – your fertility specialists may suggest a particular distribution of roles based on their assessment of what is best for all involved.
What tests are needed before reciprocal IVF?
Medical assessments and lifestyle changes are all part of preparing for reciprocal IVF. Understanding what you can do before treatment can help you feel informed and ready for the process ahead.
Fertility testing
Couples will typically have an AMH test. This test measures the ovarian reserve to determine how many eggs remain. Ultrasound scans are also regularly used to assess the ovaries and uterus.
Genetic testing
Some couples choose to have a genetic screening to reduce the risk of having a child with a genetic disease. If you already know that you are a carrier of a specific condition, a Known Carrier Match can help find a genetically compatible donor.
Lifestyle changes and supplements for IVF
Preparing for treatment also includes taking care of yourself. A healthy, varied diet, regular exercise and avoiding smoking or excessive alcohol can have a positive effect on your fertility. It is also a good idea to take a folic acid supplement before getting pregnant.
How much does reciprocal IVF cost?
The cost of reciprocal IVF typically ranges from €5,000 to €15,000 per cycle, but costs vary considerably depending on treatment location, medications and testing. Pricing will be influenced by:
- Fertility clinic fees – clinics will have their own fee structures and treatment packages.
- Medication – costs can vary depending on the brand of medication used, the dosage required, treatment duration and an individual’s response to the hormones.
- Donor sperm – the number of straws ordered, shipping costs and storage all impact donor sperm prices.
- Testing and screening – clinics may bundle all tests together or bill individually. Aspiring parents will need to decide whether they want certain tests, such as genetic PGT-A and PGT-M tests.
- Embryo freezing and storage – will include an initial one-off freezing fee and ongoing storage fees.
- Legal advice or documentation – legal specifics are country-dependent. In some instances, couples may need to pay for additional registration and processing steps.
- Country of treatment – costs vary significantly between countries and some treatment costs may be covered by public health systems or insurance.
How successful is reciprocal IVF?
Reciprocal IVF success rates are similar to the success rates for standard IVF. However, treatment success depends on a variety of factors, such as age, fertility challenges and overall health. In general, the success rate is higher if the partner providing the egg is under 35 years.
You can use success rates when you are researching clinics, but it's important to compare the figures accurately. Consider whether the data refers to fresh or frozen IVF cycles, and make sure you're looking at success rates for the relevant age group of the egg-providing partner.
What happens to unused embryos?
In reciprocal IVF, the one or two most suitable embryos are transferred to one of the partners’ wombs to continue development. What happens to the unused embryos depends on the clinic’s policies, the partners’ wishes and local regulations. The three most common options are:
- Storage – embryos are cryopreserved for use in the future in case the couple want another child in the future or want to preserve fertility options.
- Donation – embryos may be donated to another person or family who are experiencing infertility. They may also be donated for medical research.
- Disposal – embryos can also be thawed and allowed to perish. Different clinics will use different terminology for this process, and you may hear it referred to as discarding, compassionate transfer or allowing embryos to thaw.
The options available to you will be determined by local legislation in your treatment country. Clinics should always discuss what you want to happen with unused embryos and most will require both partners to agree before treatment begins.
Who is the legal parent when having reciprocal IVF?
The partner who gives birth is the legal parent and the non-birthing partner may be recognised as the legal parent if you are married, in a civil partnership or have filled out correct forms before starting treatment.
In some countries, the non-birthing partner may need to adopt. Rules on parental rights can vary from country to country, and if you have any questions about your situation, please don’t hesitate to contact us.
Emotional and psychological aspects of shared motherhood
The journey of shared motherhood is both exciting and emotionally complex. It's natural to experience a range of emotions, from joy and anticipation to uncertainty. Communicating openly about these feelings can help both partners feel supported and connected.
Many couples also find comfort in talking to others who are on a similar journey. The European Sperm Bank website contains a range of valuable resources, including our same-sex family guide, to help you throughout your journey.
Reciprocal IVF FAQs
Yes, reciprocal IVF is often referred to as shared motherhood. You may also see or hear it referred to as Partner IVF, Co-maternity IVF or ROPA (Reception of Oocytes from Partner).
A single reciprocal IVF cycle typically takes 6-10 weeks, followed by a two-week wait until a pregnancy test can be administered. Several IVF cycles may be required to achieve a pregnancy. This means the entire reciprocal IVF process can take anywhere from three months to several years, and even then there is no guarantee of a successful outcome.
No, reciprocal IVF is not permitted in every country, and access may be restricted by LGBTQ+ and egg donation legislation. Rules surrounding same-sex parenting, egg sharing, donor sperm, embryo transfer and legal parenthood status can impact reciprocal IVF availability.
Choosing donor sperm for reciprocal IVF is simplest via a licensed sperm bank with detailed donor profiles and comprehensive donor screening. This ensures healthy, high-quality sperm, enables aspiring parents to make an informed decision about their donor, and guarantees legal parenthood status for the donor sperm recipient.
We can help you on your reciprocal IVF journey
At European Sperm Bank, we are here for you at every stage of the reciprocal IVF process. From discussing pregnancy options for lesbian couples to selecting a donor and finding a fertility clinic, our advisors are here to answer your questions.