Article written by Suzanne Zuppello and medically reviewed by Dr. Aimee Eyvazzadeh, host of the Egg Whisperer Show.
What is Reciprocal IVF and Who Usually Uses It?
There are a variety of ways to go through the IVF process, including using a sperm or egg donor, using a gestational carrier, and reciprocal IVF, which to some degree encompasses the first two methods. The process of reciprocal IVF allows two partners — typically a lesbian couple or trans-men with functioning ovaries — to both play an active role. One partner provides the egg (and therefore, the genetic material) for the embryo that is later implanted in the other partner, who carries the baby until it’s birth.
Who is the Mother?
The question “who is the mother?” is complex, and also why reciprocal IVF is such an amazing option for trans or lesbian couples. While one partner is the genetic parent to the child, involving both partners in the process, which is often referred to as shared or co-maternity, allows both partners to truly feel like their child’s parent. Both are lending their bodies to the conception and birth of a child so the experience is shared (or reciprocal). Ultimately, families can decide how they want to refer to each other however there may be legal implications, which should be taken into account.
And, of course, the last thing a couple wants to consider if what happens if the parental relationship doesn’t work out, for same-sex couples, this is an important question. Depending on your state’s laws, a couple might want a legal agreement stating that both the biological and non-biological parents have equal rights.
The other side of this question is which parent wants to provide their eggs and which wants to carry. This might be an easy decision for some couples and for others might take longer. When deciding, it’s also important to speak with your doctor because one partner may have more or healthier eggs than another, or a history of endometriosis, previous childbirths or miscarriages, and other reproductive health considerations that will need to be evaluated.
How Much Does Reciprocal IVF Cost?
Similar to what we might call “traditional” IVF, the process can cost between $10,000 and $50,000 and the medication between $1,500 and $6,000 without insurance. Now, because reciprocal IVF involves extracting eggs from one person and implanting in another, there may be additional costs as there are now two patients when there would normally be one.
While many companies are expanding their health insurance options to include fertility treatments, as well as support for LGBTQ+ employees, some insurance companies have not caught up on making inclusivity a focus of their offerings. If insurance coverage is limited or unavailable, Family Equality offers grants and other financial support to LGBTQ+ couples.
What's the success rate of reciprocal IVF
There are a variety of factors that affect the success rate of IVF — and reciprocal IVF is no different. On average, the rate of live births among those under 35 is 41-43% and this percentage lowers with age. People over 40 have a live birth rate of 13-18%. So, while age is a clear factor for success, there are other considerations as well.
With reciprocal IVF, doctors will consider the health of both the parent providing the eggs and the parent carrying the embryo. As you read above, a physical examination of both parents can be done to determine the roles of each parent and improve the chance of success.
Am I likely to have twins?
The likelihood of having twins when using IVF is dramatically higher than when conceived without assistance. In fact, one-third of all twins in the United States are both through assisted fertility treatments, including IVF, and 75% of triplets and larger multiple births are conceived using fertility treatments. However, your doctor can help reduce this probability by implanting fewer embryos at once, though this can increase the costs incurred if embryos fail to mature once implanted.
Alternatives to reciprocal IVF
There are options beyond reciprocal IVF for couples wanting to conceive. One parent could choose to provide the egg and carry the baby, using donor sperm. With this, parents have three options for insemination: IVF, Intracervical insemination (ICI) and Intrauterine Insemination (IUI). With ICI, the sperm is delivered directly into an anatomically female reproductive tract, at or near the cervical opening and can be done in a doctor’s office or at home using a specialized syringe. With IUI, the procedure must be done in a doctor’s office, where the sperm is inserted directly into the uterus.
It’s also possible for couples to use both of their eggs and involve a third-party gestational carrier (commonly referred to as a surrogate) and sperm donor. Other couples may prefer to follow concurrent IVF, in which both partners go through the IVF process at the same time and carry the other partner’s embryo.
Where does the sperm come from?
Couples that need a sperm donor when conceiving have two options: an anonymous or a known donor. Known donors might be a family member, friend, and someone you found through a sperm donor app. Using a known donor can be easier insofar as the person is more familiar and, therefore, you’re more comfortable with them. But when using a known donor, it’s important for couples to create a donor agreement or contract, to outline their role — or lack thereof — in the child’s life and their parental rights.
In using an anonymous donor from a cryobank (sperm bank), the need for a donor contract is null because the cryobank handles this part. Depending on what you’re looking for in an anonymous donor, the process of finding one can be fairly quick or might require a more in-depth search. However, there are plenty of resources that can help couples in choosing their donor.
Ultimately, the choice of how to conceive a child is a deeply personal one. There are many options available and a multitude of factors beyond egg and sperm health to consider. Whatever route you choose, we are here for you. Should any questions remain after reading this, please feel welcome to reach out. We are wishing you the best!
If you're hoping for additional resources, check out our full digital course with Connecting Rainbows on growing your family with donor sperm here.