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Disclaimer: This post was written in San Francisco, the LGBTQ mecca of the world. We Bay Area locals are uniquely positioned to champion the legal and medical advances that bring our gay, bisexual, queer, trans, brothers and sisters closer to the full realization of their civil rights. We recognize that much of the country has some catching up to do in this respect, and that assisted reproductive technologies (ART) and options described in this post have yet to be extended to many who may seek them. We’re optimistic about the progress made, and the direction in which we’re headed.

What Is Reciprocal IVF?

Reciprocal IVF is an iteration of the in vitro fertilization (IVF) process whereby one partner assumes the role of the egg donor, and the other the role of the gestational carrier. Partner #1 undergoes the egg retrieval process and those eggs are then fertilized using donor sperm. An embryo(s) is selected and transferred into the uterus of partner #2, who will carry the pregnancy should the embryo successfully implant. The treatment protocol is routine in cases where an egg donor is involved, and only recently extended its reaches into this socially progressive function.

Who Should Consider It?

Reciprocal IVF, aka co-maternity or shared maternity, has opened new procreative doors for lesbian couples and pre-transition trans men.

Splitting the IVF process into two distinct parts allows both women to participate in the conception and birth of a child, alongside a known or anonymous sperm donor. It also allows trans men to participate in the procreative process should they elect to undergo the IVF process prior to beginning hormone replacement therapy and gender reassignment surgery, and utilize the resulting embryos for treatment with a female partner.

Reciprocal IVF is a great option for prospective parents, but isn’t for everyone. Other alternatives include Intrauterine Insemination (IUI) which is more cost-effective, and traditional IVF with sperm donation. When working with a clinic that offers Reciprocal IVF (like Spring Fertility!), be sure to explore all of your options, asking your doctor about the process and seeking professional, financial, and legal advice. Be open to your wants, needs, and concerns. It’s imperative that both partners feel comfortable with their role in the treatment process and feel able to prepare for any psychological and emotional effects that may come up.

Where Is Reciprocal IVF Offered (and How Accessible Is It)?

Alarmingly, some fertility clinics in the U.S. still refuse service to same-sex couples. (Insert irate rant here). Fortunately, Spring Fertility and many of our colleagues serve patients of all sexual orientations, races and religions.

Next steps: Once you’ve determined that your clinic of choice offers Reciprocal IVF, it’s time to crunch the numbers. Due to restrictive guidelines surrounding insurance coverage for fertility treatments, Reciprocal IVF is by and large an out-of-pocket venture and a costly one at that. Many insurance companies require that a woman attempt natural conception for 6-12 months prior to seeking treatment, clearly neglecting the biology of same-sex couples. Others insist on multiple failed IUI cycles before IVF coverage is made available. Either way, coverage for women seeking Reciprocal IVF – driven by a mutual desire to participate in the family building process – is non-existent unless one or both partners present with a medical indication of infertility.

IVF, including injectable medications, generally ranges between $15,000 and $20,000 per cycle and often requires multiple cycles to achieve a successful pregnancy. Once you’ve got embryos frozen, transfer cycles are a bit more affordable ($3,000-$5,000 per cycle). Each vial of donor sperm ranges between $500-$800, and most doctors require you to purchase at least two vials. For most, embarking on this expensive journey requires a great deal of consideration and planning.

Enter: Benefit companies like Progyny, that promote unrestrictive employer benefit offerings. While it may seem like the tech behemoths are the only ones doling out generous fertility benefits to their employees who wish to grow their families or preserve their fertility, a wide array of industries are following suit and becoming increasingly progressive with benefits packages. In addition to traditional fertility treatments, many companies have expanded options for LGBTQ employees with benefits or reimbursements for treatments incorporating egg donation, gestational carriers, and adoption.

When Should You Decide About Reciprocal IVF?

Only once you’ve considered all of the financial, legal, and emotional implications of embarking on the Reciprocal IVF journey.

The choice could be a simple one, or it could require weeks, months, or even years of deliberation. A couple must take into consideration the fate of any frozen embryos that remain once a pregnancy is established in the event of a death or divorce, which can prove an uncomfortable topic of discussion. It may feel as though you’re signing a biological pre-nuptial agreement, which can be stressful for a relationship. Reciprocal IVF is also a taxing physical undertaking for both partners, not just the one choosing to carry the pregnancy. Both partners will be subject to a series of tests, injections, and procedures. Bottom line: The process requires the full buy-in of both partners, so make sure you’re all-in before you take the leap.

Why it Matters

Reproductive choice, reproductive choice, (we’ll say it again) reproductive choice.

The advent of Reciprocal IVF offers up a new avenue of reproductive choice for lesbian couples and trans men interested in contributing to the miracle that is bringing a child into the world. As advocates and activists, we’re constantly looking for ways to increase access to quality care, promote equality, and fight for reproductive choice for all. Reciprocal IVF is a remarkable achievement in that respect and a triumph for the LGBTQ community.

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