Reciprocal IVF—What You Need To Know, And Why It’s Important

Reciprocal IVF—What It Is And Why It’s Important

March 19, 2021 Updated April 15, 2021

High angle view of mother and daughter touching woman’s abdomen while leaning on sofa at home
Scary Mommy and Maskot/Getty

I not-so-secretly enjoy listening to straight, cisgender folks talk about the bumbling responses they have given to their kids when said kids ask what seems to be one of the most dreaded parenting questions: Where do babies come from? My kids have been able to answer this since they were in preschool, so I have first-hand experience and lots of chill around this subject.

First of all, your kid isn’t necessarily looking for logistical details about your experience, so let go of the idea that you have to explain that they came from the back seat of a minivan during the first date night after their older sister was born. Babies come from a sperm and an egg. How those two meet, and from what gender of the person they originate, vary in beautiful and really cool ways. One option for some people or couples is to conceive a child through reciprocal IVF.

In its most basic meaning, reciprocal means two parties share something equally. When it comes to pregnancy and childbirth, that meaning doesn’t completely hold up; the person growing the child and then delivering said child bears the bulk of the burden and unique joy in many cases. But when it comes to sharing the overall experience of family building, reciprocal IVF can give an added layer of inclusion and connection for same-sex couples with uteruses, specifically cisgender identifying lesbians and transgender men and nonbinary folks who have the ability to donate an egg and/or be a gestational carrier.

When my ex and I were ready to have children, I had a uterus and eggs that seemed capable of being fertilized but I knew I didn’t want to be pregnant or pass on my genetics. My ex-partner also had a uterus and after some tests we knew she had a good chance at conceiving via intrauterine insemination (IUI) using our anonymous and expensive donor sperm. Even though I chose to not be biologically connected to my children, I still felt a little insecure about that at times. The need to pay legal fees to be sure I had rights and protections for my kids because we were a queer couple didn’t help, but the narrative in our society consistently assumes that when couples are expecting, they are straight and cisgender and each had a role in the creation of the child—that doesn’t fit always fit the ways of baby making though. I don’t even want to get into the whole “his seed, her flower” nonsense I see too often on “we’re expecting” announcements.

But many queer couples can both contribute to their children’s conception and gestation. Sometimes both cisgender women in queer couples want to play a part in the process. Perhaps they both want to carry a child or maybe one partner doesn’t want to carry but still wants to donate her egg to the creation of her child. Reciprocal IVF is the same as IVF, except the eggs are retrieved from one person, fertilized with donor sperm, and then transferred into the other person in the relationship for implantation and gestation.

Zing Images/Getty

While some say that the carrier still doesn’t have a biological connection to the embryo and resulting child, a study in 2015 showed that the uterine lining secretes microRNAs that act as a communication system between the carrier and the fetus. This secretion, known as endometrial milk, is part of gene regulation and could influence the baby’s long-term health. This means that the carrier may be more biologically connected to the child even if the egg was from their partner.

As a reminder, transgender men can and do get pregnant. Surgery of any kind isn’t a requirement to being transgender and transgender men and nonbinary folks don’t need to surgically alter their bodies to fit into your construct of gender. Many transgender men have the ability to conceive and carry a child. Reciprocal IVF can be, and is, also used for transgender men and nonbinary folks. Gender isn’t the same as sex and there are plenty of ways to make babies as long as you have the ingredients. I know gay men who have made their babies in the backseat of a car too, Karen. One of them was a transgender man and his partner got him good and knocked up the same way your hubby did.

I also know a cisgender lesbian couple who used reciprocal IVF as their back up plan. One woman was able to get pregnant via IVF but continued to have miscarriages. They decided to use her frozen embryos to see if her partner could carry the baby and it worked. None of this was cheap and they still needed to pay for the extra layer of legal protection, even though they are married, but they were able to achieve their dream.

Because of the cost of donor sperm, legal fees, and double the amount of fertility medications, reciprocal IVF can often run close to $20,000—which is not covered by most insurance plans. Cost can be prohibitive but so can the age of the eggs being considered for the process; the younger partner is often a better candidate for egg donation. Folks can also plan to achieve pregnancy via fresh embryo transfer or frozen. It’s important for couples to find a doctor and clinic where they feel comfortable to make these decisions.

So parents, when it’s time to talk about baby making, stick to the science. I highly recommend the book called “What Makes A Baby” to help you with that. And when your kids starts to ask how the sperm and egg meet, be sure to include alternatives to the narrative.