Reciprocal IVF – What Lesbian Couples Need to Know

Same-sex female partners, or a cisgender woman and transgender man, who want to have a baby have a number of different treatment options to help them conceive. Reciprocal IVF, sometimes called partner IVF or co-maternity IVF, is an option that allows both partners to be physically involved in their child’s conception. This is very appealing to some couples. How does it work? What are the pros and cons?

What is Reciprocal IVF?

Reciprocal IVF is increasingly popular with lesbian couples because both partners play an important role in conceiving the child. This treatment is also possible for transgender men who still have their ovaries and uterus. Some women feel it strengthens their bonds both with the child and with each other. In reciprocal IVF, one partner supplies the eggs to be used for IVF, while the other partner is the gestational carrier of the pregnancy. The menstrual cycles of both partners are synchronized so they are ready for treatment at the same time. The partners select a sperm donor, either an anonymous donor from a sperm bank or someone known to them. The partner donating the eggs goes through ovarian stimulation to produce multiple eggs. The eggs are then extracted from her ovaries and fertilized with donor sperm in the laboratory. The partner who will carry the pregnancy is prepared for embryo transfer. When the embryos are ready, an agreed-upon number are transferred to her uterus. If all goes well, an embryo will implant in her uterus and grow into a baby, which she will give birth to. Alternatively, the embryos that are created may be frozen and transferred into the partner when she is hormonally prepared at a later date. If neither of the partners have fertility issues, either one can be the egg donor or gestational carrier. The process is the same as for a regular IVF cycle, but it’s divided between two women. Sometimes partners who don’t have fertility issues and have had a child with reciprocal IVF will reverse their donor and carrier roles for a second child, so that each has a biological relationship with one of the children, and each gets to experience pregnancy and childbirth.

Reciprocal IVF Costs

Insurance coverage for IVF is not mandated in most states. In states that do require at least some coverage, insurance carriers usually do not cover the costs of reciprocal IVF unless there is a medical necessity. The costs of diagnostic tests and doctor visits for the woman carrying the pregnancy may be covered. Coverage varies greatly from state to state and carrier to carrier. In general, the costs of reciprocal IVF are similar to those of IVF with a known donor. One woman undergoes treatment to create the embryos, while the other is prepared for a fresh embryo transfer. On average, a “fresh” cycle of IVF costs about $12,000 plus the cost of fertility medications, which range from $3,000 to as much as $10,000 for each partner. The costs vary widely among IVF centers, so you should plan on a range from $18,000 to $30,000 or more for the fresh cycle. If it’s necessary to inject sperm in to the eggs to fertilize them (ICSI), the cost is an additional $1,500 to $2,000. If a second cycle is needed using frozen embryos (frozen embryo transfer or FET), the costs are somewhat lower, averaging $3,000 to $5,000 per cycle plus the cost of medication. Medication costs are lower than those of a fresh cycle as well.

Legal Issues

The legal issues with reciprocal IVF are complex and vary by state. It’s best to consult an attorney with experience in reproductive law in your state before you begin the process. Will you both have parental rights? Will the partner who doesn’t bear the child need to legally adopt the child, even though the baby is her genetic offspring? Can the non-pregnant partner participate in doctor visits and the birth? You may need to have a legal agreement with your partner.

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