What is Reciprocal IVF?
Today’s posting addresses reciprocal in vitro fertilization (rIVF), an increasingly popular practice among female same-sex couples. Inspired by questions frequently asked by patients at the Center for Human Reproduction (CHR), this brief information summary is presented in Q&A format. The CHR physician answering the questions today is Sonia Gayete-Lafuente, MD. If you have additional questions regarding the subject, you can pose those directly to her (sgayete@thechr.com) or call the CHR’s main phone line at 1-212-994-4400, where you can make an appointment with one of our physicians for a more detailed discussion.
The CHR’s Editorial Staff
Questions and Answers: What is Reciprocal IVF?
With Sonia Gayete-Lafuente, MD, who is an Associate Physician-Scientist at the CHR and at The Foundation for Reproductive Medicine (FRM) and a Visiting Researcher at Rockefeller University in NYC. She is also the Director of Medical Education at the CHR and the FRM and an Associate Editor for Collaboration on the Editorial Board of the CHR. She can be reached through the CHR’s editorial office or directly at sgayete@thechr.com.
Q: In summary, what is RECIPROCAL IVF (rIVF)?
A: Reciprocal IVF (rIVF) is a family-building option that an increasing number of female same-sex couples have been choosing. It allows both partners to be part of the pregnancy in a unique way: One partner provides the eggs in an IVF cycle (which are fertilized with donor semen selected by the couple), and one or more resulting embryos are then – after proper preparation of the other partner – transferred into the other partner’s uterus. She – hopefully – conceives and carries the pregnancy to delivery. rIVF has proven to be a wonderful and very rewarding option for couples who in together creating and/or growing their families together want to share technical as well as biological experiences of motherhood.
Q: If neither partner has known fertility problems, do they still need to be medically evaluated?
A: Yes, and the main reason is that there is no test available to determine the fertility status of a woman, except for a history of repeated recent successful/unsuccessful exposure to semen, - a history partners in a female same-sex relationship usually do not have. In rIVF, therefore, it is important to assess the ability of one partner to serve as the source of “good” eggs and to assess the other partner’s ability to go normally through an embryo implantation process. If problems are found on one or both sides, this then allows the CHR’s physicians to individualize protocols to the need of each patient, as it also, of course, is the routine at the CHR in regular IVF cycles.
As rIVF practically involves an “egg-donation” from one partner to the other – and FDA egg-donor requirements in such cases mandate certain very strict - mostly infectious-disease-related – screenings, if the donor and recipient are not intimate sexually, these rules also apply to same-sex couples. They, however, of course, can be waived if the couple confirms sexual intimacy, though the general professional recommendation, even in such a circumstance, is still to undergo the testing, - mostly to protect any potential pregnancy from infections.
Since rIVF also involves the use of donor semen, this also means that the FDA’s very strict rules regarding donor semen (from a donor who is not sexually intimate with the recipient of the embryos) apply. Donor semen obtained from licensed sperm banks has already undergone required testing and quarantine periods. Use of a so-called “open” or “directed” semen donor (usually a sperm donor known to the recipient and not sexually intimate with the embryo recipient), however, requires under FDA guidelines not only the testing of the donor for infectious diseases, but also a six-month quarantine period for every semen sample before use.
Q: Who is “the mother” in rIVF pregnancies?
A: People often ask, - who’s the mom in reciprocal IVF? The answer is both partners! Both, of course, end up having varying biological relationships to the pregnancy, - with one partner - after providing the egg - being the “genetic” mother/parent, while the other partner becomes the “gestational” mother/parent by carrying the pregnancy and giving birth. Both, therefore, have a very valid claim at motherhood, parenting, and raising the child.
The legal definition of parenthood, however, does not always align automatically with these genetic and gestational roles. Depending on where the couple lives and the marital status, the partner who gives birth may be recognized as the legal parent at birth, while the egg-providing partner may sometimes require additional documentation, - such as a consent form, a parentage order, or a second-parent adoption- to secure legal recognition, especially for couples who are not married. Marital status and the use of donor sperm may also affect the requirements. Because parentage laws vary by jurisdiction, couples considering rIVF are strongly advised to review the local legal state requirements early and, when appropriate, consult an attorney specializing in reproductive and family law to ensure all documents are in place, - so all goes smoothly.
Q: Can both partners undergo rIVF and switch roles? Can they share the same sperm donor?
A: Yes. Many couples choose to complete two rIVF cycles, switching roles so that each partner has the opportunity to provide eggs and carry a pregnancy. For example, one partner may carry an embryo created from the other partner’s egg and have a first baby, and then they may reverse roles for a future second offspring.
The same sperm donor can be used to fertilize eggs from both partners, which is very often the preferred option. If each partner has a child using embryos created with that donor, the siblings would have the same genetic father, making them biological half-siblings. Couples interested in this option may wish to reserve enough sperm from the same donor in advance, as donor availability cannot always be guaranteed in the future. Medical suitability, timing, cost, and the desired number of children should all be considered when planning this approach.
Q: What does rIVF teach us about motherhood?
A: One of the beautiful things about rIVF is that it reminds us that motherhood isn’t defined by just one experience. Genetics, pregnancy, birth, caregiving, and the love and commitment you bring to your child are all part of the journey. Every path to loving parenthood deserves to be celebrated.
If you’re considering reciprocal IVF and would like to learn more about your options, our team at the CHR is here to help. Contact us to schedule a consultation and explore the path that’s right for you!