What is reciprocal IVF?

Reciprocal IVF is an adaptation of the well-established IVF technique in which a woman’s eggs are retrieved, fertilised in the laboratory and one of the resulting embryos is transferred to her uterus. Reciprocal IVF is a method whereby a lesbian couple, or trans men who have functional female reproductive organs, can share parenthood. In essence one partner is the egg provider or ‘donor’ and therefore the genetic parent. The other partner is the gestational and birth parent.

Reciprocal IVF is also known as partner-assisted reproduction, partner IVF or co-maternity IVF. We at IVI call it the ROPA method, standing for Reception of Oocytes from the Partner. In this article we aim to explain how it works, and the issues you may want to consider when deciding if this is the right fertility treatment for you and your partner.

What are the differences between conventional and reciprocal IVF?

In conventional IVF, a woman’s ovaries are stimulated to produce multiple eggs which are retrieved and then fertilized, either through mixing with sperm or through Intracytoplasmic Sperm Injection (ICSI). The embryos are observed while developing for around five days in the laboratory. A selected embryo is then transferred to the uterus of the same woman who had the eggs retrieved.

In reciprocal IVF, or the ROPA method, one of the two partners goes through the ovarian stimulation and egg retrieval part of the IVF process. When the time comes to transfer a selected embryo, it is transferred into the uterus of the other partner who, all being well, carries the pregnancy to term, gives birth and breastfeeds the baby.

In both regular and reciprocal IVF, during the time that the embryo is developing in the laboratory, the womb of the recipient is prepared with hormonal medication to be in an optimum state of receptivity to the embryo. The only difference is that this part of the routine is carried out on the second partner, rather than the one whose eggs were retrieved.

Which partner should be the egg ‘donor’ in reciprocal IVF?

IVF with the use of donor eggs is one of the most successful fertility treatments available. This is because IVF is normally carried out when a couple is having fertility difficulties. With the use of a donor egg, from a carefully screened and medically tested donor, we are as certain as we can be that the egg is of high quality. At least one of the obstacles to conception and successful pregnancy has therefore been overcome.

It therefore makes sense in many cases that the younger of the two partners should be the one to provide the eggs. Since it is well known that the most significant fertility factor for women is age. Therefore, the quality of eggs deteriorates with the passing of time.

Naturally, the question of which potential parent will be the genetic mother is a crucial decision. It involves factors to do with your relationship, which may have nothing to do with age or fertility status, that will be important considerations. Each couple is different and patients will make their own choices, with the help of our advice.

How is a sperm donor identified?

At IVI, we have the world’s largest semen bank. The regulatory framework around donor sperm is strictly controlled, including legal requirements, a quarantine period to guard against sexually transmitted diseases, and extensive genetic and medical tests. When checks are completed and the sample is finally made available for use in fertility treatment, we then take careful account of the physical characteristics of the patients in order to achieve the best possible match between donor and recipient.

Are both partners biologically invested in their child?

We all know that there’s a lot more to parental commitment and familial ties than the mere fact of genetic inheritance. While it’s true that in the case of reciprocal IVF, the supplier of the egg has a more direct genetic connection with the future child, this is not the whole story.

• The gestational parent who goes through the entire experience of having the foetus transferred into her uterus, carrying the pregnancy, giving birth and breastfeeding, has a very real and meaningful sharing of parenthood.
• There may even be a more direct connection than this. There is some evidence that the uterine environment in which the foetus develops may have a direct effect on the expression of certain genes. A 2015 study in mice confirmed that the developing embryo is affected by microRNAs from the maternal endometrium (the womb lining) and that these may modify the embryo in terms of how certain genes are expressed. This in turn could have an impact on the immune system of the embryo and its subsequent longer-term health.
• Because we are in comparatively early days of the reciprocal IVF process, and understanding fully how the endometrium and the uterine environment affect the developing foetus, it is too early to draw definitive conclusions. However, it could well turn out that in reciprocal IVF, both parents have a more direct biological impact on the baby than we previously thought.

How do success rates compare?

Again, because this is a fairly new method compared with the well-established IVF technique, we have relatively little evidence on which to base statistical measures of success. However what we can say is that, since reciprocal IVF is essentially the same as IVF with egg donation, success rates are likely to be similar. At IVI, we have a pregnancy rate of 99% with the use of donated eggs, measured over three attempts and including the use of cryopreserved transfer.

Indeed it may be reasonable to speculate that success rates for reciprocal IVF could turn out to be even higher than for traditional IVF treatment. This is because of the chances that neither partner has any adverse fertility issues and that it is the nature of their relationship, rather than any infertility problems, that makes medical intervention beneficial and necessary.

Contacting IVI

If you and your partner would like to know more about the ROPA method, or if you have any other fertility concerns, do get in touch with us at IVI.