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If you are trying to conceive, you have most likely heard of IVF, or in vitro fertilization. Fewer people are aware of reciprocal IVF (RIVF), a similar treatment that provides an option for some queer couples to share the biological and gestational aspects of parenthood.
A traditional IVF cycle includes several steps: ovarian stimulation, egg retrieval, sperm preparation, egg fertilization, embryo growth, and embryo transfer. In RIVF, the labor of IVF is shared between two people. In this process, you can use eggs from one partner’s body to create an embryo that then implants, and gestates, in the other partner’s body.
One study shows that 46.6% of IVF clinics mention reciprocal IVF on their websites, but we don’t have accurate data on how common it is in practice. In my work, I’m seeing more couples exploring RIVF earlier in their family-building journey.
Is RIVF the right choice for you? Let’s dive into the details.
Who is it right for?
Many queer AFAB (assigned female at birth) couples opt to use reciprocal IVF to grow their family because it’s a way to share the biological contributions of family building.
Sometimes people choose reciprocal IVF because of medical or fertility reasons — for example, if one partner has a diminished ovarian reserve and a desire to gestate a pregnancy, and another partner has a normal ovarian reserve and doesn’t want to gestate a pregnancy, RIVF may make the most sense.
It is also commonly used by couples where one parent is trans, did fertility preservation before transitioning, and has no desire to be pregnant.
Others choose RIVF because it feels best to them as a way to blend nature and nurture in their family building.
How does it work?
The process of reciprocal IVF is very similar to autologous IVF, or IVF using your own eggs.
During IVF, a person with ovaries takes medications to stimulate their body to produce extra eggs. Those eggs are then retrieved from their body, and embryos are created in a lab by adding a partner or donor’s sperm. When those embryos mature, they can be either implanted into the person’s uterus or frozen for implantation at another time.
RIVF has one key difference: once the egg retrieval is completed, Partner A’s job is done, and they can begin the recovery process. After that, Partner B will take medications to prepare for implantation and complete the embryo transfer.
This process can happen during one IVF cycle with fresh embryos or in separate cycles with frozen embryos.
What are the success rates?
Similar to IVF, RIVF success rates vary greatly by age, mostly due to the quality of the eggs used.
However, some reassuring research shows that RIVF success rates can be slightly better than general IVF rates. This is because doctors can use a combination of fertility factors to optimize a couple’s chances of success.
What are the benefits and drawbacks?
RIVF is a way for both members of a couple to contribute to the biological formation of their child. Studies show that a fetus’s intrauterine environment profoundly influences its development in both physical and emotional ways.
Another benefit is that RIVF may be more cost-effective, depending on your family building plans. Both members of the couple can choose to go through the retrieval process and create embryos with the same sperm donor. Those embryos can then be stored and implanted in either member of the couple to create future pregnancies. That can lead to cost savings for people who suspect that they want more than one child and already need fertility interventions to make that happen.
Finally, for some couples, a major benefit of RIVF is that it allows both partners to use their body to contribute to their family formation process. This approach can counteract some of society’s messages about who the “real” parent is in queer families.
For couples who are good candidates for IUI or even at-home insemination, though, choosing to grow your family through reciprocal IVF can add high costs and medical interventions that may or may not be medically necessary.
Unfortunately, there are also some legal drawbacks to RIVF. While heterosexual families are automatically given legal protection, LGBTQ+ families need to go through a more complex process. Legal protections and the ease with which they are performed vary by state, but many queer-competent family lawyers recommend that both parents go through second-parent or confirmatory adoption in cases of RIVF to fully protect your family. Depending on your state, this may be a simple process of filing paperwork with your local clerk or going through a more complex second-parent or stepparent adoption process.
The bottom line
- Reciprocal IVF is a way for AFAB (assigned female at birth) couples to share the biological and gestational aspects of parenthood.
- In the RIVF process, two people go through the different aspects of a standard IVF cycle: egg retrieval, embryo creation, and implantation.
- Rates of success with RIVF can be slightly higher than with standard IVF, because doctors can use a combination of fertility factors to optimize a couple’s chances of success.
- It’s recommended that both parents go through the second-parent or confirmatory adoption process after the child is born to ensure both of their parental rights.
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