Reciprocal IVF for Female Couples

Reciprocal IVF enables both partners to be physically involved in the conception of their baby.

Lesbian couples who do not have infertility may choose to have in vitro fertilization (IVF) using the eggs from one partner, inseminated with donor sperm, and have the resultant embryo(s) transferred into the other partner who then carries the pregnancy and gives birth. This enables both partners to be physically involved in the conception of their child. It is a very appealing concept for many lesbian couples. (Dr. Samuel Pang was the first Reproductive Endocrinologist to use the term Reciprocal IVF to identify this procedure.)

Partner Providing Eggs
Some lesbian couples may need to use donor eggs due to the absence of ovaries or the inability of the ovaries to produce viable eggs in both women. The partner who is providing the eggs for Reciprocal IVF is required to undergo preliminary screening procedures. These include review of medical records, physical examination, blood testing, screening for familial, genetic and infectious diseases, and psychosocial evaluation. When eggs from one woman are used to create embryos which are subsequently transferred into the uterus of another woman, the process falls under the jurisdiction of FDA regulations which govern tissue donation. Screening for infectious and sexually transmitted diseases include HIV, hepatitis, syphilis, gonorrhea and Chlamydia, which are required by FDA regulations.

The partner who is providing the eggs for Reciprocal IVF needs to undergo a process of controlled ovarian stimulation in which hormonal medications are used to stimulate the ovaries to induce maturation of multiple eggs. Her cycle needs to be manipulated with oral contraceptive pills and/or Lupron, after which controlled ovarian stimulation with Follicle Stimulating Hormone (FSH) may begin. When the follicles are mature, the eggs are retrieved through the vagina under ultrasound guidance and brief anesthesia. The only technical difference between standard in vitro fertilization (IVF) and Reciprocal IVF is the involvement of two women. The medical procedures are nearly identical.

Partner Carrying the Pregnancy
The uterine lining (endometrium) of the partner carrying the pregnancy must be synchronized with the stage of embryo development in order for pregnancy to be possible. When the use of fresh embryos is planned, the cycles of both partners must be synchronized. The menstrual cycle of the partner who is carrying the pregnancy is synchronized with the cycle of the partner providing eggs, using a combination of birth control pills and Lupron. Preparation of the endometrium for embryo implantation is then accomplished with estrogen and progesterone (hormones normally produced by the ovaries) in dosages intended to mimic what happens during a natural ovulation cycle. In rare situations, due to unexpected circumstances, synchronization may not be possible, in which case any embryos which are created would need to be cryopreserved, with intentions to transfer them in a subsequent cycle, referred to as a Frozen Embryo Transfer (FTE) cycle.