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Reciprocal IVF: An Option for LGBTQ Couples

With increasing awareness of fertility treatment options, LGBTQ couples are increasingly turning to assisted reproductive technology. Reciprocal in vitro fertilization (IVF) is an option that many couples are selecting when building their family.

What is Reciprocal IVF?

Reciprocal IVF is an option available to couples desiring to have children. Specifically, one partner contributes the eggs to form the embryo and the other partner carries the pregnancy. In this way, both partners are closely involved with the pregnancy. One partner is biologically related to the baby, and the other partner carries the baby and gives birth. In some areas, reciprocal IVF is referred to as co-maternity.

Reciprocal IVF is a potential family building option for lesbian couples as well as transgender men.

How Does Reciprocal IVF Work?

During the workup process, your provider will likely evaluate both you and your partner’s health and fertility. In some cases, for example, prior issues with fertility may preclude a specific partner from being either the source of the embryo or the carrier. If your partner has a history of hysterectomy or other issues that would impact carrying a pregnancy (such as fibroids), your clinic may recommend that you carry the baby instead. Since increasing age impacts egg quality, your provider may recommend that the younger partner undergo the egg retrieval and the older partner carry the baby. If both partners are cleared for the egg retrieval and carrying the baby, the couple often determines the role that each partner will play. It is not uncommon for partners to switch roles in future pregnancies.

What Is the Reciprocal IVF Process Like?

When embarking on reciprocal IVF, a decision is made regarding which partner will carry the baby. The partner who is not carrying the pregnancy then undergoes egg retrieval. This process often involves the use of stimulation medications via injection for several days. During this time, your clinic will monitor your response to treatment and determine when a “trigger shot”, or final injection is necessary. Approximately 36 hours after the trigger injection, you will present for the egg retrieval.

The egg retrieval is a relatively straightforward outpatient procedure. Often, the couple will select a sperm donor beforehand. There are several important to decisions to make, such as whether the sperm donor will be anonymous or known. Many couples seek legal advice if selecting a known donor.

Additionally, couples undergoing reciprocal IVF will need to decide whether a fresh or frozen embryo transfer will be used. Your clinic will likely discuss the pros and cons of each option. If you decide to proceed with a fresh transfer, both partners will need to sync their menstrual cycles so that the partner carrying the baby will be physically prepared for the implantation. Often, while one partner is receiving injections for ovarian stimulation, the other partner is taking a medication regimen that will help thicken the uterine lining.

Following egg retrieval, fertilization and blastocyst development, the embryo is then implanted into the partner who will be carrying the pregnancy.

What Are the Costs of Reciprocal IVF?

The cost varies depending on the clinic and the medication regimen. The average cost can exceed $20,000, with additional costs if genetic testing is performed. For many couples, the costs can be prohibitive, especially if their insurance does not provide coverage.

What Are the Risks of Reciprocal IVF?

Reciprocal IVF has the same risks as “traditional” IVF. Specifically, there are risks involved with the use of hormones, including the risk of ovarian hyperstimulation syndrome (OHSS). Additionally, there is a slight risk of injury with the egg retrieval process. Of note, IVF is never guaranteed. There is always the potential for unexpected issues, and many couples who pursue reciprocal IVF undergo multiple treatment cycles prior to achieving pregnancy. Couples must be prepared both emotionally and financially.

Takeaway Message:

Reciprocal IVF is a newer form of assisted reproductive technology that may assist LGBTQ couples who desire to have children. Lesbians and transgender males are increasingly turning to reciprocal IVF when growing their family. Couples who are interested in pursuing reciprocal IVF should be encouraged to discuss their clinic's experience with this procedure as well as success rates.

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