June 01, 2023

Having a child together is perhaps the most intimate thing a couple can do. For many couples, part of the joy of having a baby is knowing that the person they love most in the world is genetically linked to their child. Reciprocal IVF is a fertility protocol that offers both partners to be a biological part of their baby’s development.

How Does Reciprocal IVF Work?

In reciprocal IVF or co-maternity, one partner provides the egg, which is retrieved during an IVF procedure. The eggs are fertilized, and embryos are created. One of these embryos is then transferred to the other partner, who then carries the pregnancy. Because reciprocal IVF allows both parents to participate in and support the pregnancy physically, it is a beautiful option for families who place a high value on the physiology of parenthood.

Step 1: Choosing the Donor and Gestational Parent

Reciprocal IVF starts just like standard IVF, but before any procedures occur, the partners must first choose a sperm donor and work with their fertility doctor to decide which partner will provide the egg and which will carry the pregnancy. Sometimes it’s an obvious choice—if one partner wants to be pregnant and the other doesn’t, for example, or if one has health conditions that make one or the other role dangerous or impossible. More often, however, it’s a matter of having fertility assessments done and deciding who best suits each role, health-wise.

Step 2A: Egg Retrieval and Fresh Embryo Transfer

Once the partners have decided who will provide the egg, there are two ways to do reciprocal IVF: fresh embryo transfer and frozen embryo transfer.

In a fresh transfer (meaning that the embryos aren’t frozen before being transferred), both partners start by taking birth control pills on the same cycle to sync up their menstrual cycles. The partner providing the egg—let’s call them Partner A—begins a course of fertility drugs to stimulate egg production and maturation. Depending on health factors, Partner B may or may not take medications to help prep their body to receive the embryo transfer.

Once the couple’s cycles are synced up (generally taking 6-9 weeks), Partner A goes in for an egg retrieval procedure—an outpatient surgery performed in a doctor’s office or fertility clinic. The retrieved eggs are immediately fertilized with the couple’s donor sperm and grown in a lab for about a week. Then, Partner B will go in for an embryo transfer, and the couple will wait ten days to two weeks to find out if the transfer was successful.

Step 2B: Egg Retrieval and Frozen Embryo Transfer

For a frozen transfer, Partner A will start a standard IVF cycle with ovarian stimulation, medication support for egg maturation as necessary, and egg retrieval. This process takes one to two weeks. Once Partner A has undergone egg retrieval, the eggs are then fertilized with the couple’s donor sperm to create embryos (this takes about five days). Typically, embryos are then biopsied for genetic testing and frozen.

The embryos considered viable are then ready for implantation, so Partner B gets ready for a frozen embryo transfer. Sometimes this preparation includes taking fertility medications, depending on individual health circumstances, and embryo transfer occurs. Ten days to two weeks after the transfer, Partner B can take a pregnancy test to determine if the transfer was successful. 

Planning Considerations for Your Family’s Future

Partners who desire multiple children and are each physically capable of performing both roles may wish to switch roles for subsequent pregnancies so that both partners can experience every aspect of maternity.

If you’re considering reciprocal IVF, it’s worth consulting with a family law attorney to find out whether they recommend second-parent adoption for the non-gestational partner in your state.

One of the most exciting aspects of modern fertility medicine is couples’ ability to choose precisely how they want to build their families. The array of options regarding fertility treatments, donor genetic material, and non-traditional familial arrangements allows for unprecedented choice and agency. Co-maternity is one example of how science can serve and support every couple’s ability to grow their families as they wish.

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