LGBTQ+ Family Building

Reciprocal IVF for Women in Same Sex Relationships

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As reproductive medicine gets more advanced and more fertility options become available, same sex couples have more choices than ever if they want to have a family. One increasingly popular route for women with female partners wishing to have a child is reciprocal in vitro fertilization (IVF), sometimes called co-IVF or reception of oocytes from partner (ROPA).

For co-IVF, one partner provides the eggs and the other partner carries the pregnancy. This is attractive to many couples because it allows both women to be physically involved in the pregnancy, which can heighten the emotional connection to the pregnancy.

How Does Co-IVF Work?

Once a couple decides to use co-IVF, they begin a process almost identical to standard IVF. Like other forms of reproductive assistance for same-sex female couples, one of the first things to consider is sperm donation. Once a couple chooses a sperm donor, they can begin the treatment cycle.

There are two different ways that co-IVF can take place, with a fresh or frozen transfer.

A frozen transfer is used when the couple elects to have Preimplantation Genetic Testing for Aneuploidy (PGT-A) performed on their resultant embryos. In this process:

  • Partner A undergoes an IVF freeze-all cycle.
  • Using medications to stimulate the maturation of multiple eggs, she will undergo an egg retrieval or follicular aspiration once her follicles have reached a certain size and her hormones have reached a certain level (usually 10-14 days after the start of medications).
  • The eggs are then fertilized in the lab using donor sperm.
  • The resultant embryos are allowed to grow for 5 days before being biopsied and then cryopreserved.
  • Then Partner B, who is attempting to become pregnant, will undergo a frozen embryo transfer cycle once the results of the PGT-A are known.
  • She may or may not take any medications prior to transferring one of the embryos from her partner’s cycle.
  • She will return to the clinic 10-14 days after the transfer for her first beta hCG (pregnancy) test. If pregnancy is achieved, prenatal care can begin.

If the couple elects to have a fresh transfer:

  • They will begin a process of synchronizing their menstrual cycles by taking oral contraceptive pills.
  • The partner whose eggs are being retrieved will also take medications to stimulate the maturation of multiple eggs.
  • The partner who will have the embryo transferred may take medications to help prepare the uterus for implantation.
  • After 6 to 9 weeks, depending on how long it takes to synchronize the cycles, the eggs will be retrieved from one partner using ultrasound guidance and fertilized with the donor sperm in the laboratory.
  • After about one week, an embryo will be transferred using a small catheter into the uterus of the partner who will carry the pregnancy. She will return to the clinic 10-14 days after the transfer for her first beta hCG (pregnancy) test. If pregnancy is achieved, prenatal care can begin.

What Should We Consider with Co-IVF?

The same considerations that apply to standard IVF also apply to co-IVF. Talk with your doctor to make sure you understand the process and its success rates.

You may also want to inquire about insurance coverage for your treatment. You should speak with your insurance provider before starting to avoid any large, unexpected out-of-pocket costs.

You will also need to carefully consider the role each of you will play, and your expectations for the pregnancy. It is not uncommon for a couple to use co-IVF for a second child, with their original donor and carrier roles reversed so that each woman gets to experience both pregnancy and having a genetic connection to a child.

If you have the Progyny benefit, reciprocal IVF is covered. Contact Progyny to speak with a Patient Care Advocate.

Dr. Taraneh Gharib Nazem is Senior Fellow in Reproductive Endocrinology and Infertility at the Icahn School of Medicine at Mount Sinai/Reproductive Medicine Associates of New York. She is a board-certified Obstetrician Gynecologist. Dr. Nazem completed her residency in Obstetrics and Gynecology at the New York University School of Medicine, where she was elected administrative chief resident and graduated with the Robert F. Porges Honor Resident Award, for outstanding performance. 

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