3 August 2021

Lesbian Family Planning: IUI vs IVF Fertility Treatment Options

Lesbian family
By the Editorial Comitee IVI Blog

We at IVI have a strong and ongoing commitment to help all individuals and couples achieve their family dreams. We support family diversity and we welcome the European Union’s first ever EU strategy, published in 2020, to achieve equality for the LGBTIQ (lesbian, gay, bisexual, trans, non-binary, intersex and queer) community. For many people in these communities, no matter their sexual or gender diversity, there is a fertility treatment that can help achieve their dream of parenthood and a family.

In this article, we are focusing on lesbian family planning and the role of assisted fertility treatments. We compare Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF) as fertility treatment options. We are also looking at the ROPA method whereby it is possible for a lesbian couple to share parenthood in a very real and practical way.



IUI (Intrauterine Insemination) is one of the simplest assisted fertility treatments. It involves placing a sperm sample into a woman’s uterus in order to preserve the natural environment of the gametes as far as possible, while improving the chances of fertilization and conception.


IUI: who is a suitable candidate?

This method of assisted conception is an obvious choice for lesbian couples where the intended birth mother has an adequate number of good quality eggs. Of course, it is not exclusively  addressed to lesbian couples. It could also be used in the case of single women without a male partner and for women with an abnormal cervix or ovulation problems. It can also help heterosexual couples where the male partner has minor sperm quality problems.


What happens during the IUI process?

Treatment starts with ovarian stimulation to ensure the presence, at a predetermined time, of one or two mature eggs. This phase takes 10 to 12 days.

On insemination day, the sperm sample is prepared in the  Andrology laboratory, resulting in only the strongest and healthiest sperm being used.

Finally, the sperm are inserted into the uterus via a catheter. This is quick, simple and does not require any anaesthetic.


What are the success rates for IUI?

Our overall IUI success rate is 40% after three attempts. While IUI results are better than the chances of natural conception, it is not the most effective method of fertility treatment in every case. IVF has higher success rates overall. It very much depends on your individual circumstances. We can carry out fertility tests which will help us to advise, and you to decide, if this is your best option.



The well-known and well established IVF fertility treatment involves ovarian stimulation, the same as for IUI. However, in the case of IVF, the medical protocol is different. It is aimed at producing multiple mature eggs for retrieval and subsequent fertilization in the laboratory. The healthiest can then be selected from the resulting embryos before transfer to the uterus.


Who is IVF suitable for?

IVF would normally be recommended as the next step after unsuccessful IUI treatment. It would also be appropriate for women with certain fertility problems, for example lesions or the absence of fallopian tubes, endometriosis, or poor-quality eggs as a result of advanced maternal age. It is also suitable for heterosexual couples with moderate male factor infertility .


What happens during the IVF process?

IVF treatment starts with a course of ovarian stimulation to produce multiple eggs. This takes between  10-15 days. When there are enough mature eggs available, they are retrieved in a simple procedure that involves light anaesthesia.

The eggs are then fertilized in the laboratory, either through being mixed with a prepared sperm sample or if necessary by Intracytoplasmic Sperm Injection (ICSI). The resulting embryos develop in the laboratory for five to six days. During this time, our embryologists observe and evaluate their development, so that only healthy embryos are selected for transfer.


While the embryos are developing, the uterus of the intended recipient is prepared to ensure that the inner layer, the endometrium, is the right thickness for the embryo to implant and for pregnancy to result.


What are the success rates for IVF?

Overall IVF success rates are very good. Bear in mind that if one cycle is unsuccessful, any healthy unused embryos will have been frozen for future use. This means that the woman does not need to go through the whole treatment cycle again. She can however be prepared for embryo transfer when she wants another attempt. Our overall pregnancy rate for IVF, after three attempts, including the use of frozen embryos, is 95%.


Shared motherhood: Reception of Oocytes from the Partner (ROPA)

This innovative scheme uses the same techniques as IVF but with one crucial difference for lesbian family planning. It allows the couple to share parenthood in a very real way. In the ROPA method, one potential parent is the genetic mother of the child, while the other is the birth mother. Here’s how it works:

The genetic mother undergoes ovarian stimulation the same as in any IVF procedure. The eggs are retrieved, fertilized in the laboratory and the resulting embryos undergo the normal five to six days of development and observation.

During the embryo development stage, the birth mother’s uterus is prepared to receive the embryo in the same way as for every IVF procedure, even though in these circumstances she has not previously undergone the ovarian stimulation stage.

The healthiest embryo is then selected for transfer to the uterus of the birth mother who, all being well, will carry the pregnancy and give birth to the baby.


You can find in this video more information about how do we perform the ROPA Method in our clinics:


The verdict: which is the best fertility treatment for lesbian couples?

IUI, IVF or IVF plus the ROPA method: which is your best lesbian family planning option? You can see that there’s no single answer that would apply to every patient and every couple. You, or you and your partner, are the only ones who can decide on that, based on your own preferences and our advice. Our recommendations will be a result of our tests and your own medical history and circumstances.

Why not contact us at IVI to discuss the options? It could be the first step of your journey towards building a family.


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