Female LGBT partners who are ready to grow their families now have many options: with the help of donor sperm, fertility treatments such as IVF and IUI have allowed thousands of lesbian couples to realise their dream of bringing home a baby with a biological link to at least one partner.

A newer innovation, reciprocal IVF, goes a step further, making it possible for both parents to have a biological connection to their child. If you are considering this option for your family, here’s what you need to know:

How does reciprocal IVF work?

The process and procedures of reciprocal IVF are the same as regular IVF, except that the eggs from one partner are used to create embryos which are then transferred to the other partner’s uterus. Generally, this means that both of you will need to sync your cycles using fertility medications. Then, the partner who is providing the eggs will go through an ovarian stimulation cycle and the egg retrieval procedure.

The eggs will then be taken to the IVF lab to be fertilized with donor sperm and incubated for three to five days. At the same time, the gestational carrier may be taking medication to prepare her uterine lining for the embryo transfer procedure. After approximately a two week wait, the carrying partner will go into the clinic again for a blood test to see if she is pregnant.

How do you decide which partner should provide eggs and which should carry the pregnancy?

Some couples arrive at the clinic with a strong sense of what they want the process to look like, but others may not have come to a decision yet. If you are uncertain, your clinic should be able to advise you about the choice with the highest chance of success. There are several factors to take into consideration when determining which partner should take on which role.

• Age: Because the quantity and quality of a woman’s eggs decline as she ages, if there is a significant difference in your ages you may have more success using the younger partner’s eggs.

• General health and medical history: Both partners should give a full medical and gynecological history at the beginning of the process. If you have a history of previous infection or surgery involving your reproductive tract, certain parts of the process may be more difficult. Overall health, fitness, and habits such as smoking should also be taken into consideration.

• Desire to experience pregnancy and childbirth: Some women look forward to the process of carrying a child, while others may have no desire to undergo pregnancy. Strong feelings in either direction should be discussed with your partner and medical team.

• Plans for future pregnancies: Some couples may plan to have more than one child through IVF, and hope to take turns carrying the pregnancies, either with leftover eggs or embryos from earlier cycles or with another cycle of reciprocal IVF using their partner’s eggs. It is also not unheard of for a couple to both undergo IVF at the same time, and sharing the experience of pregnancy together.

What are the legal considerations for reciprocal IVF?

Depending on the local laws in your state, there may be some complex legal issues to settle before you begin a reciprocal IVF process. It’s worth consulting with an experienced reproductive law professional to ensure that both partners’ rights are protected before and after a baby is born.

You want to ensure that both of you are recognized as the legal parents of any resulting children, and sometimes, just being on the birth certificate is not enough. You may also need a legal agreement regarding any frozen embryos which remain after the cycle: who has rights to these embryos and what will happen to them in the event of death, divorce or dissolution of the relationship?

Costs and insurance coverage of reciprocal IVF

Reciprocal IVF is usually a big investment, and the costs can be substantially more than traditional IVF. This is due to the requirement that both partners take fertility medications at the same time: prescription costs alone can add up to thousands of dollars. While the cost of treatment can vary widely between clinics, you can generally expect the costs of reciprocal IVF to be about the same as IVF with any known egg donor.

Is reciprocal IVF covered by insurance?

A complicating factor is the general lack of insurance coverage for fertility treatment in general. This issue is compounded when there are two patients requiring coverage at the same time. Most states do not require that insurance carriers provide IVF coverage, and in those states which do mandate some coverage, most insurance companies will not cover reciprocal IVF unless you can prove the medical necessity of the treatment.

If one or both of you have been diagnosed with medical infertility issues, you may be eligible for more coverage than you expect. For example, if the woman carrying the pregnancy has been diagnosed with premature ovarian failure before the age of 40, she may be able to receive coverage for diagnostic tests, treatment, and doctor visits. After reciprocal IVF, once pregnancy is achieved, the carrying partner should receive the same prenatal insurance coverage as any pregnant patient on her plan. 

How much does reciprocal IVF cost?

While the potential costs may seem prohibitive, don’t dismiss the possibility too quickly. When it comes to paying for IVF, there are many creative avenues to explore. Take the time to find out exactly what your insurance will cover... sometimes it takes a little digging. Look into fertility grants and scholarships. While the websites may seem geared towards heterosexual couples, some programs welcome applications from LGBT families. Programs and rebates designed to defray the cost of fertility medications may be particularly helpful when you are planning to undergo reciprocal IVF. 

If the partner who is providing eggs produces more than are needed for the cycle, you may have the option to freeze the extra eggs or embryos, which can substantially reduce the cost of future cycles.

Many families opt for IVF financing, which can divide the cost of the procedures, tests, and medications into more manageable payments. Some people finance the entire cost of the treatment, while others borrow just enough to pay for medications and pay for the rest out of pocket. Talk to your own financial planner and see what options your fertility clinic offers. You may be surprised by how affordable fertility financing can be.

When you’re visiting prospective clinics, ask them about their history with patients who fit your profile. Ask them how often they have performed reciprocal IVF and what kinds of results they have seen. As you explore your choices for building your family, it’s important to find a Los Angeles fertility clinic which understands and respects the unique needs of LGBT couples. Advances in reproductive technology have allowed families of all kinds more options, and you have the right to the best medical care available.