Reciprocal IVF, also known as Co-IVF, is a great choice for couples where two women or a cis-woman and a transgender man want to become parents together. This method lets both partners actively take part in the process of having a baby.
In this procedure, one partner provides eggs (or oocytes) taken from their ovaries, which are then mixed with donor sperm to create embryos. These embryos are later placed in the uterus of the other partner. If everything goes well, the receiving partner becomes pregnant and gives birth to the baby. Keep reading to learn more about the different aspects of reciprocal IVF.
What is Reciprocal IVF and How Does it Work?
Reciprocal IVF is similar to when a family uses an egg donor and a gestational carrier to have a child. The special thing about reciprocal IVF is that both the egg donor and the gestational carrier are the intended parents, which is different from the usual egg donor or gestational carrier IVF process.
During reciprocal IVF, one partner takes fertility medications (usually hormone injections) to make the eggs in their ovaries grow. This way, more than one egg can mature at the same time. (Usually, only one egg matures in the ovaries each month.)
The person giving their eggs also takes fertility medications to prevent the eggs from releasing on their own. (If the eggs come out on their own, they can’t be used for IVF.) The growth of the eggs is monitored with regular blood tests and ultrasounds.
Once the eggs are ready, they are collected using a special needle guided by ultrasound. The egg donor is asleep during this process. After collecting the eggs, they are combined with sperm in a dish. The sperm comes from a donor that you and your partner have chosen beforehand. If things go well, some of the eggs and sperm will join, and embryos will form.
In the days before the egg retrieval, the partner who will carry the pregnancy is given different fertility medications to prepare their uterus for the embryos. If good-quality embryos are made, one or two of them will be put into the other partner’s uterus.
Usually, the partners’ menstrual cycles are synchronized. This way, when a fertilized embryo is ready, the partner’s uterus is ready to receive it during the transfer.
However, this isn’t always possible. If syncing the cycles isn’t an option, the doctor can freeze the embryos. Freezing and thawing embryos, though, can be more expensive and might make success less likely.
Many fertility experts suggest using preimplantation genetic testing for aneuploidy (PGT-A), which used to be called preimplantation genetic screening (PGS). During PGT-A, a few cells are taken from the growing embryo on the third or fifth day of development. An expert tests these cells to check the embryo’s overall genetic makeup.
This technology helps identify embryos that have genetic issues that might lead to treatment failure or miscarriage. PGT-A used to require freezing the embryos, but that’s not the case anymore. You can have a fresh embryo transfer and still do genetic screening.
Using PGT-A might increase the chances of IVF working, but this has mostly been studied in couples with fertility problems. It’s unclear if PGT-A significantly raises the success rate for people seeking reciprocal IVF (whose fertility might be normal).
How Much Does Reciprocal IVF Cost and Does Insurance Cover It?
Reciprocal IVF is a type of fertility treatment that is slightly more expensive than regular IVF. The cost of regular IVF ranges from $10,000 to $12,000. On the other hand, reciprocal IVF typically costs over $20,000. The exact cost depends on factors such as the fertility clinic you choose, the medications used, and additional services like genetic testing.
There are several reasons why the cost of reciprocal IVF is higher. Firstly, donor sperm is required, which can be quite pricey, often close to a thousand dollars per vial. Additionally, in reciprocal IVF, both partners need fertility medications, and their ovaries and uterine linings need to be closely monitored, adding to the overall expense.
Another factor that can drive up costs is a specialized technique called intracytoplasmic sperm injection (ICSI). This technique involves individually injecting a sperm cell into an egg, which can be necessary when the sperm is not capable of fertilizing the egg on its own. ICSI can cost a few thousand dollars more.
Genetic testing of embryos is another potential cost. This testing may be done to improve the chances of success or to screen for hereditary conditions. If ICSI is used, genetic testing might be recommended to mitigate the risk of certain genetic issues. The cost for genetic testing is around $3,000 to $4,000.
It’s important to note that some fertility clinics may require ICSI if you opt for preimplantation genetic screening. This is to ensure accurate testing results by avoiding any genetic interference. However, not all experts agree on the necessity of ICSI for this purpose.
Unfortunately, insurance coverage for reciprocal IVF is rare. Most of the expenses will likely need to be paid out-of-pocket. While some monitoring or tests may be covered by insurance, the main treatment cost is often not included. Some employers’ insurance plans might cover IVF, but this is not guaranteed, and it’s best to check with your HR department. Certain states mandate coverage for IVF, but reciprocal IVF might not always qualify, especially if it’s not related to a medical or cancer-related infertility issue.
Even if your insurance doesn’t cover the entire treatment, you might be able to use Health Savings Account (HSA) or Flexible Spending Account (FSA) funds to help cover the costs.
It’s worth noting that not every treatment cycle will cost $20,000. If a cycle yields multiple healthy embryos, you can freeze some for future use, which is a more affordable option. Frozen embryo cycles cost a few thousand dollars since the initial steps of stimulation, monitoring, retrieval, and fertilization have already been completed. You can discuss these options with a healthcare provider to make the best choice for your situation.
Choosing Who Donates Eggs and Who Carries the Baby
You and your partner might already have an idea of who wants to provide the eggs and who wants to be pregnant. Alternatively, you might be thinking about taking turns if you plan to have multiple children through reciprocal IVF – for instance, one partner carries the first baby, and the other partner carries the second baby.
Sometimes people have a clear vision of how they want the process to go. However, it’s a good idea to stay open-minded and decide on roles after talking to a doctor and getting a complete fertility checkup.
Together with your doctor, you and your partner will decide who will be pregnant and who will contribute eggs based on your overall health, medical history, family medical backgrounds, and age.
If one partner is significantly younger, the chances of success might be higher with the younger partner. Still, this isn’t always the case. It’s important to do fertility tests and screenings before starting treatment to uncover any potential fertility issues.
You might be curious about whether a transgender man who takes testosterone could donate eggs. There isn’t a definitive answer since there’s limited research in this area. Many fertility doctors prefer the transgender man to pause testosterone supplements during treatment, although there have been cases of successful pregnancy when hormones continued.
It’s crucial to talk to a healthcare provider about all your choices and find a fertility doctor who listens to your concerns and offers good chances of success.
The Legal Complexities of Reciprocal IVF
Something you might not have considered yet is the legal side of reciprocal IVF. You might think that since one of you is genetically related and one will give birth, establishing legal parenthood should be straightforward. Unfortunately, it’s not always that simple.
Technology has made pathways to parenthood possible, but the law hasn’t always caught up. For instance, while the partner giving birth often automatically becomes a legal parent in most states, the partner providing the eggs might need to go through an adoption process to establish parental rights.
If you’re planning to use a known sperm donor, it’s even more important to consult a lawyer before making decisions or starting treatment. Without proper preparation and contracts, a known sperm donor might have a claim to parental rights. Speaking to a lawyer also safeguards the sperm donor, who might be held responsible for child support without proper legal steps before conception.
The specific laws depend on your location. We suggest consulting a reproductive attorney in your state to understand the rules regarding reciprocal IVF, as some states have intricate laws. It’s best to do this before beginning the treatment process.
Where Can You Get Reciprocal IVF Services?
To have reciprocal IVF, you’ll need help from a special doctor called a reproductive endocrinologist. Regular gynecologists or midwives can’t do this kind of IVF treatment.
When searching for a fertility clinic, think about two important things: how well they do IVF and if they treat LGBTQ+ people nicely. It’s better if you and your partner feel welcomed and respected at the clinic. You can tell if a clinic is LGBTQ+ friendly by looking at their website. Do they talk about helping LGBTQ+ people with fertility? Do they say they’re LGBTQ+ friendly?
You can also find LGBTQ+-friendly clinics by talking to people in your community.
Depending on where you live, you might have a lot of LGBTQ+-friendly fertility clinics nearby. Or you might have to go somewhere else for treatment.
It’s best to choose a clinic that has experience with reciprocal IVF. But if you can’t find one, a clinic that knows about gestational carrier arrangements can also work. (Gestational carrier arrangements are kind of like reciprocal IVF cycles.)
How Long Does It Take to Get Pregnant?
Getting pregnant might happen in the first try, but it’s not always certain and can often take time. Depending on factors like the health and age of the partner providing the eggs and various other fertility aspects, it’s usually a good idea to try for about three cycles to increase the chances of achieving a successful pregnancy.
However, it’s also possible that it could take up to six months or even longer without any success, especially if there are fertility challenges for either partner.
The chances of success depend on the age of the egg donor. A study showed that around 60% of pregnancies were successful when the average age of the egg donor was 32 years old. It’s important to note that the actual success rate could be higher than what’s commonly reported because many times, it’s not a biological issue but rather relationship dynamics that lead to medical intervention being helpful. In simple words, most of the fertility studies focus on couples who can’t conceive due to medical reasons. In the case of reciprocal IVF, most participants usually have good fertility.
For better odds, many fertility experts suggest testing embryos using PGT-A. This increased the chances of live birth significantly for women over 38 years old in one study – from 31.7 percent to 62.1 percent. However, this improvement wasn’t seen for younger patients. It’s important to note that this study included couples facing fertility difficulties and might not apply to those seeking reciprocal IVF, who might already have good fertility.
Keep in mind that each cycle doesn’t always require a full stimulation of the ovaries and a new sperm donation. If things go well, you might have frozen embryos from the initial cycles that can be used in a later cycle if the first attempt doesn’t succeed.
This means that the costs will vary for each cycle. Frozen embryo transfer cycles are generally more affordable – usually a few thousand dollars – compared to fresh embryo cycles, which can cost around $20,000 or even more.
A Word from BabyStepAhead
Reciprocal IVF is an exciting option for two women or a cis-gender woman and a transgender man to be involved in the biological process of having a baby together. If you’re young and have good fertility, your chances of success with IVF are better than what’s commonly studied in couples dealing with infertility.
However, it’s important to know that reciprocal IVF isn’t a guaranteed method and there are other ways to create a family. Consider options like foster care, adoption, surrogacy, insemination with a sperm donor, or co-parenting (raising a child with the help of a friend who doesn’t live with you) – they’re all wonderful alternatives.
As you embark on the remarkable journey of Reciprocal IVF, it’s crucial to understand the process, costs, and alternatives available in LGBTQ+ family planning. For more insights into conception, explore our informative ‘Conception‘ blog. As you progress on this path, anticipate the incredible transformation ahead during ‘Your 9 Months‘ blog. To ensure a smooth and well-prepared journey, delve into our comprehensive ‘Pregnancy Planning‘ blog. Together, these resources provide a holistic guide to guide you every step of the way. Embrace the adventure and create the family of your dreams.
