Building a family as a lesbian couple is a deeply personal journey. One filled with questions, hopes, and decisions that hold real emotional weight. For many, reciprocal IVF offers something uniquely meaningful: the chance for both partners to take part in creating and nurturing their child. One partner provides the egg, the other carries the pregnancy. Together, they share in something extraordinary from the very beginning.
This guide was created for lesbian couples exploring that path. It’s here to gently walk you through how reciprocal IVF works, what to expect medically and emotionally, and how to make informed choices without pressure, without assumptions.
Whether you’re just starting to learn or ready to take the next step, we hope this helps you feel more grounded, more prepared, and more seen.
What we need to know about the reciprocal IVF
Reciprocal IVF (sometimes called co-maternity, partner IVF, or “shared motherhood”) is a fertility treatment that lets both partners in a lesbian couple be deeply involved in having a baby.
In reciprocal IVF, one partner provides her eggs (the genetic mother) and the other partner carries the pregnancy (the birth mother).
This means one woman’s egg is fertilized with donor sperm, and the resulting embryo is transferred into her partner’s uterus.
The result is a child who is genetically linked to one partner and carried (and given birth to) by the other.
What If One of Us Is Trans or Nonbinary?
Reciprocal IVF isn’t just for cisgender women. If one or both partners are trans men or nonbinary people, and one has eggs and the other a uterus, this process may still be possible. What matters is not your gender identity, but whether your body can participate in egg retrieval, embryo transfer, or both.
Fertility clinics with LGBTQ+ experience will support you through each step with sensitivity and respect. Hormone history, comfort levels, and personal goals can all be part of the planning. If this is part of your story, know that you’re not alone, and that family-building through reciprocal IVF can absolutely include you.
How Reciprocal IVF Works: Step-by-Step
Choosing Roles
The first step is deciding together who will provide the eggs and who will carry the pregnancy. For some couples, the answer is clear right away. For others, it takes time, conversation, and support from your care team. Often, medical factors like age or ovarian reserve play a role, but this is also about what feels right to each of you. Your clinic will help assess both partners and guide you gently through the decision. There’s no right or wrong answer, only what’s right for your family.
Finding the Right Donor
To begin the IVF process, you’ll need donor sperm – either from a sperm bank or someone you know. Some couples choose an anonymous donor whose profile feels like a good fit. Others choose someone personal.
If you go that route, your IVF clinic will make sure the donor completes all necessary health and fertility screening. Many clinics also recommend that both partners do genetic carrier screening to make sure there are no unexpected overlaps with the donor’s profile. It’s one more way to make sure you’re building from the healthiest foundation possible.
Ovarian Stimulation
The partner providing the eggs will usually take daily hormone injections for around 10–14 days. These medications gently encourage the ovaries to grow multiple eggs (instead of just one, as in a natural cycle). During this time, this parent will have regular checkups, usually bloodwork and ultrasounds to track how her body is responding.
Egg Retrieval
When the eggs are ready, this parent will have a short outpatient procedure to retrieve them. This involves light sedation and a gentle ultrasound-guided process to collect the mature eggs from the ovaries. It typically takes about 20 minutes, and most people are home resting that same day. Some cramping or bloating is normal afterward, but recovery is usually smooth.
Fertilization
Once the eggs are retrieved, they’re brought to the lab and fertilized with the donor sperm. An embryologist will carefully combine the sperm and eggs, either by placing them together in a dish or using a technique called ICSI (where one sperm is injected into each egg). Over the next few days, the embryos begin to grow and develop under close observation.
Embryo Transfer
After about 3–5 days, the strongest embryo is chosen for transfer. Meanwhile, the partner who will carry the pregnancy will have been preparing her body with hormones (like estrogen and progesterone) to make sure her uterus is ready to receive the embryo. When the time is right, the embryo is gently placed into her uterus through a thin, soft catheter. It’s a quick, simple procedure, usually no more uncomfortable than a Pap smear.
Pregnancy and Birth
About a week and a half later, the partner who received the embryo will return to the clinic for a blood test to check for pregnancy. If implantation was successful, she’ll continue with regular prenatal care, just like any other pregnancy. And when the time comes, she’ll give birth to the baby you created together. One of you carried the child, and the other passed on her genes, but both of you brought this little human into the world.
Choosing Who Provides Eggs and Who Carries
Deciding roles is an important step in reciprocal IVF. Both medical and personal factors play a role. From a clinical perspective, fertility specialists often recommend that the partner with the stronger ovarian reserve (often the younger partner) provides the eggs, while the partner with a healthy uterus carries the pregnancy.
For example, if one partner is under 35 with good egg quality and the other has previously carried a pregnancy, those roles may make medical sense.
That said, personal preference, comfort, identity, and life circumstances matter just as much. Some couples choose roles based on emotional readiness, body autonomy, or long-term family plans. Others decide to switch roles in later pregnancies so each partner has a biological connection to a child. A fertility doctor, and sometimes a fertility counselor, can help you review test results and talk through these decisions together.
Can we use eggs from both partners and mix them in one cycle?
Some couples ask whether both partners can provide eggs in the same cycle and “see which embryo implants.” In practice, embryos must always be clearly identified and tracked for medical, ethical, and legal reasons. It’s not possible to transfer embryos without knowing which partner provided the egg.
However, it is possible to create embryos using eggs from both partners and then decide together which embryo to transfer first – and which to keep frozen for a future attempt.
What If One Partner Is Taking Testosterone?
This is a common and important question. Some lesbian couples include a partner who is taking testosterone – either as part of gender-affirming care, in preparation for transition, or through self-managed hormone use.
Testosterone typically suppresses ovulation while it’s being taken, but it does not permanently eliminate fertility in many cases. Some people are able to pause testosterone under medical supervision and later retrieve eggs successfully. Egg quality and response can vary, so fertility testing is essential.
In these situations, couples may choose to:
- Have the partner on testosterone provide eggs after a planned pause, while the other partner carries
- Have the partner on testosterone carry the pregnancy if medically appropriate, while the other partner provides eggs
- Use reciprocal IVF specifically to maintain a shared biological and physical role, even when hormones are involved
Because hormone history and timing matter, it’s especially important to work with a fertility clinic experienced in caring for LGBTQ+ and gender-diverse patients.
What If We Face Fertility Challenges?
Reciprocal IVF does not require both partners to have “perfect” fertility. If one partner can’t provide eggs, they may still be able to carry. If one partner can’t carry safely, they may still be able to provide eggs. Many couples use reciprocal IVF to work around specific fertility barriers while remaining actively involved in the process.
If neither partner can safely provide eggs or carry a pregnancy, other family-building paths, such as using an egg donor or working with a gestational surrogate – are also valid options. It’s okay if your journey looks different than you first imagined. What matters most is that it reflects your reality and that you’re supported along the way.
Explore IVF & Fertility Courses & Resources
Choosing a Sperm Donor
Since reciprocal IVF requires donor sperm, choosing the right donor is key. You may use anonymous donor sperm from a sperm bank or a known donor (a friend or acquaintance). Here are some considerations:
Traits and Testing: Some couples look for a donor with desired traits (physical, educational, health history). All sperm donors must be medically screened. If you use a known donor, he must also have semen analysis and infectious disease testing.
Genetic Screening: Many clinics recommend both partners undergo a genetic carrier screen before selecting a donor. This ensures you do not both carry mutations for the same genetic condition that the donor might have.
Legal Issues: If you use a known donor, understand the legal implications in your area (e.g. donor agreements). Clinics often suggest consulting a reproductive lawyer to sort out parental rights before treatment.
Explore egg, sperm and embryo donation courses & resources
Should We Test Our Embryos?
Some couples choose to do genetic testing on their embryos, a process called Preimplantation Genetic Testing for Aneuploidy (PGT-A). It checks the number of chromosomes in each embryo, which helps identify the healthiest ones for transfer.
PGT-A doesn’t guarantee a healthy baby, but it can reduce the risk of miscarriage or failed transfers, especially if the egg provider is over 35 or has experienced past losses.
It also allows your medical team to select the embryo with the best chance of growing into a full-term pregnancy. Whether or not you choose PGT-A is up to you, your clinic will explain the benefits, limitations, and cost.
Check our course Testing for Health – The Science Behind Embryo Screening
What happens to unused embryos, and who decides?
By law in most regions, the partner who provided the eggs has legal control over the embryos. This can be important if the relationship changes or if future use is discussed. Clinics typically ask both partners to sign consent forms outlining this before treatment begins.
Thinking Ahead: Growing Your Family Over Time
If you know you want more than one child, it helps to plan ahead, even if you’re only focused on baby #1 right now.
Some couples choose to create extra embryos now, using the same sperm donor, and freeze them for future transfers. Others create embryos from both partners’ eggs and space out pregnancies over time, switching roles. If you’re using donor sperm from a bank, consider purchasing extra vials in advance, especially if you’d like your children to be biologically connected through the same donor.
It’s okay if your future plans change. But thinking about them now gives you more options later and more peace of mind today.
Benefits of Reciprocal IVF
Shared Parenthood: Both partners get to share the journey of creating their baby. One partner provides the egg (passing on her genes) and the other carries the pregnancy, so both mothers have a special connection to the child.
Emotional Bond: Carrying a pregnancy together can deepen the emotional bond of the couple. Sharing the pregnancy experience often brings partners even closer as they work toward a common goal.
Equal Involvement: Unlike options where only one partner is biologically involved, reciprocal IVF lets both of you play an active role. This can feel more equal and fulfilling for many couples.
Future Flexibility: For families planning more than one child, couples can take turns. For example, one partner might carry the first baby, and the other carries the next. Some couples have even carried each other’s embryos in back-to-back pregnancies.
Success Rates and Considerations
Success rates for reciprocal IVF are generally similar to standard IVF success rates using donor eggs. The biggest factors are the age and egg quality of the donating partner. In practice, healthy couples with younger egg providers often see high success.
However, like all IVF, it may take more than one cycle. Clinics often plan for multiple attempts if needed. The process takes time: pre-cycle tests, donor selection, ovarian stimulation (about 2 weeks), embryo culture (5–7 days), and then waiting for a pregnancy test. Overall, one IVF cycle can span a few months.
The medical risks are mostly the same as for any IVF. Fertility drugs can sometimes cause ovarian hyperstimulation syndrome (OHSS), but clinics monitor for this closely. Multiple pregnancy risk is minimized by transferring just one embryo at a time.
Importantly, pregnancies using donated eggs (including in reciprocal IVF) carry a slightly higher risk of complications like high blood pressure or pre-eclampsia than fully “own-egg” pregnancies. Your doctor will monitor you carefully during pregnancy to keep both mom and baby healthy.
Costs and Logistics
Reciprocal IVF involves two sets of medical steps (one for egg retrieval, one for pregnancy), so it tends to be more expensive than a standard single-person IVF. Costs include two IVF cycles (one for stimulation and retrieval, one for the embryo transfer), fertility medications for both partners, donor sperm fees, and any legal or counseling services.
Insurance coverage for reciprocal IVF varies widely (and is often limited), so check your local policies or financing options. Be prepared for the financial commitment as part of planning for treatment.
Legal Rights and Counseling
Legal parenthood for lesbian couples after reciprocal IVF can be complex. In many places, the partner who gives birth is automatically listed as the child’s legal parent. The other partner (the genetic mother) may need to take additional legal steps, such as a second-parent adoption or advance consent to be recognized as a parent.
Because laws differ by country and region, it is crucial to consult a family or reproductive law attorney well before IVF starts. A lawyer can help both partners secure their parental rights and draft any required consents so that on the birth certificate, both women are recognized as the child’s parents.
Emotionally, reciprocal IVF can be a rollercoaster. It’s normal to feel excited, anxious, hopeful, and overwhelmed. Make sure to lean on each other and your support network.
Many clinics recommend or provide counseling services for both partners throughout the process. Joining an LGBTQ+ fertility support group or talking with others who’ve done reciprocal IVF can also help.
Remember that both of you are partners in this journey, sharing emotions and decisions, and supporting each other at every step.
Taking Care of Each Other Through It
Reciprocal IVF is a shared experience, but it’s also an emotional one, and not always evenly. You will need to prepare your body and your mind. One of you might be giving herself daily hormone shots; the other might be waiting quietly, unsure how to help. One might be recovering from a retrieval while the other prepares her body for transfer. Both of you are doing something big, and it’s okay to feel stretched.
Talk early and often. Check in with each other about how you’re feeling, physically, emotionally, relationally. Counseling can be helpful, even if nothing’s “wrong.” And if things don’t go as planned the first time, remember: grief and hope can sit side by side. You’re not alone, and you don’t have to carry it all without support.
