Motherhood for lesbian Couples (ROPA)

The reciprocal IVF method is a treatment for lesbian couples. Both take part in the conception with donor sperm: one provides the eggs and the other carries the pregnancy.

New legislative information

Thanks to the provisions of the recent Law 4/2023 in Spain, whose main focus is guaranteeing the rights of the LGBTI community, the non-pregnant partner would no longer need to pursue a judicial adoption process to be legally recognized as a mother. Instead, she would simply have to express her consent in the Spanish Civil Registry upon the child’s birth. This specific development has brought equality between married and unmarried lesbian couples from Spain who are interested in pursuing fertility treatments together. Additionally, this law reinforces the argument against discrimination based on marital status or sexual orientation, when it comes to fertility treatments. There’s only one peculiarity: to ensure the integrity of the process, and to eliminate any concerns of undisclosed gamete donation between the unmarried women, both would have to declare that they share a common reproductive project, and this would be documented in their clinical history.

In what cases is the reciprocal ivf method recommended?

The reciprocal IVF method is recommended for lesbian couples in which:

• The woman who wants to provide the eggs has a good ovarian reserve.
• The woman who receives the embryos does not exhibit complex uterine pathologies.

Phases of the reciprocal ivf method

First, a visit is scheduled (in person or videoconference) in order to analyze the couple’s situation, explain the reciprocal IVF process and arrange for the necessary medical tests.

• Woman receiving the embryos:

  • Hormone analysis and screening for infectious diseases.
  • Ultrasound to see the condition of the uterus and other necessary tests depending on the case.
  • Mammography (if there is a history of breast cancer in the family or if the woman is over 39 years old).

• Woman donating the eggs

  • Hormone analysis to determine ovary function and screening for infectious diseases.
  • Ultrasound of the ovaries.
  • Mammography (if there is a history of breast cancer in the family or if the woman is over 39 years old).

Once the tests results are in, during the second visit the doctor provides a detailed report on the procedure that will be done and both parties sign the consent form.

The reciprocal ivf treatment begins:

For the woman donating the eggs:

1. Ovarian stimulation. Hormones are administered daily for about 15 days to stimulate the ovaries.
2. The egg release. Once the ovaries are properly stimulated, another hormone is administered to induce ovulation.
3. Ovarian puncture. This is done by sedation and lasts about 20 minutes. It consists of aspirating the follicular liquid and the egg using a needle connected to a vaginal ultrasound.

Woman receiving the embryos:

1. Endometrial preparation. This is a very simple process that only requires the administration of estrogen via patches (or in some cases orally) for 10-15 days. Using an ultrasound, the doctor will monitor the development of the endometrium until it grows to a thickness of between 5 to 10 millimeters and develops a trilaminar appearance.
2. Collecting the semen sample and in vitro fertilization (IVF) process. On the same day that the donor eggs are retieved, IVF is performed with the semen from the previously selected donor. This is done using the ICSI technique, which involves injecting the sperm into the egg with a very fine needle.
3. Embryo culture and selection. Over the following days, biologists observe the growth of the embryos using a time-lapse technique. This way they can see which ones are growing better and are more suited for implantation and to give birth to a healthy baby.
4. Selecting the embryos to transfer and embryo transfer. After five days of development, the most viable embryos are selected and transferred to the mother’s uterus.

What are my chances of getting pregnant?

The pregnancy rate with the reciprocal IVF method ranges from 40-70%. This percentage is only approximate, because the pregnancy success rate depends on several factors that vary with each woman, including the age of the egg donor, the quality of the ovarian reserve or if there are uterine pathologies in the woman receiving the embryos, among others. Therefore, our medical team must study your particular case to give you a more reliable percentage.

FAQ About the reciprocal ivf method

Do we have to be married?

Thanks to the provisions of the recent Law 4/2023 in Spain, whose main focus is guaranteeing the rights of the LGBTI community, the non-pregnant partner would no longer need to pursue a judicial adoption process to be legally recognized as a mother. Instead, she would simply have to express her consent in the Spanish Civil Registry upon the child’s birth. This specific development has brought equality between married and unmarried lesbian couples from Spain who are interested in pursuing fertility treatments together. Additionally, this law reinforces the argument against discrimination based on marital status or sexual orientation, when it comes to fertility treatments. There’s only one peculiarity: to ensure the integrity of the process, and in order to eliminate any concerns of undisclosed gamete donation between the unmarried women, both would have to declare that they share a common reproductive project, and this would be documented in their clinical history.

Legally, who will the biological mother be?

Both. The reciprocal IVF method allows dual or shared maternity.

Which one will the baby resemble?

The baby may share similarities with the pregnant mother, but essentially the baby will receive the genes of the egg and sperm donors. The pregnancy is the start of the baby’s life, when he/she receives the first sensory inputs. In this phase, the pregnant mother influences the baby’s mental health.

Can we choose the donor?

No, because a semen donation is totally anonymous and confidential. Though we do assure a phenotypic and immunological match between the two.

Can we use semen from an acquaintance?

No, because the Assisted Reproduction Law specifies that donations must be anonymous and confidential.

What is the best age to undergo the treatment?

For the woman who donates the eggs, it’s better if she is younger than 38 (at which age the eggs lose much of their quality). The woman receiving the embryos should be younger than 45.