Advances in fertility science now allow same-sex female couples to become parents with the help of reciprocal IVF. The idea is to give both moms a chance to play a biological role in creating and carrying their child.
Understanding reciprocal IVF treatment for lesbian couples can help you navigate the emotional and logistical aspects of the process, set realistic expectations, and make informed decisions. This guide explains how IVF works with two women, how long it takes, and what to consider before getting started.
What is reciprocal IVF?
Reciprocal IVF is a fertility treatment that enables both partners in a same-sex female couple, or a couple where one partner is a trans man, to physically and emotionally participate in the pregnancy. The process is also called co-IVF, shared motherhood, shared parenthood, or partner-assisted IVF.
Unlike traditional IVF, where one woman undergoes the full cycle of egg retrieval and embryo transfer, reciprocal IVF splits these roles. This dual participation is why moms choose reciprocal IVF. One partner provides the eggs, becoming a genetic parent, while the other carries the pregnancy, becoming a birth parent. Sharing the journey also makes both partners equally connected to the baby from the beginning.
Source: Pavel Danilyuk
For couples with no fertility issues, the process offers various options. For instance, if you want twins but without the risk of carrying multiples, you can go through this journey together at the same time.
Navigating IVF for lesbian couples: 5 key phases
The process of IVF for same sex parents follows the same core steps as the standard IVF, with one important difference: the embryo(s) are placed into your partner’s womb. Here’s how it typically works:
Step 1: Medical evaluation and planning for same sex IVF
Before starting reciprocal IVF, both partners go through a series of consultations and medical assessments. Your care team will evaluate your reproductive health and identify potential challenges to create a tailored IVF plan.
At this stage, you will discuss your roles (providing the egg vs. carrying the pregnancy) in the process and decide on the sperm donor, either from a sperm bank or someone you know.
You’ll also talk about embryo transfer options:
A fresh transfer, which requires cycle synchronization for both mothers
A frozen transfer, which offers flexibility for scheduling and preimplantation testing
Once the roles are set, the mothers go through relevant baseline tests, including:
Bloodwork to check key hormones like AMH, FSH, LH, and estradiol, assess ovarian reserve, and decide on the medication protocol
Ovarian ultrasound to check the ovaries and AFC (antral follicle count) and get a clearer picture of your egg supply
Uterine evaluation to check the uterus for any physical issues (fibroids or polyps) and ensure the lining is healthy and able to support implantation
Saline sonogram or hysteroscopy to get a closer look at the uterine cavity
For many mothers, genetic carrier screening is an essential step at this stage. It’s a DNA test that can reveal if you or your partner carry inherited conditions, such as cystic fibrosis, muscular dystrophy, or hemophilia, that can be passed down to the baby.
Carrier screening helps guide complex conversations about preimplantation genetic testing, embryo selection, and even surrogacy.
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If you’re considering genetic screening, opt for Nucleus Family. It’s a whole-genome carrier screening test that checks for over 2,000 genetic conditions, including rare variants often missed by traditional panels. You can get lifetime access to comprehensive reports and actionable tips for managing your long-term health risks.
Order your at-home test kit to get started.
Step 2: Syncing cycles
If you are planning a fresh embryo transfer, your fertility clinic will use hormone therapy or birth control pills to synchronize your and your partner’s cycles. The alignment is necessary so that when the egg is retrieved and fertilized, the uterus of the partner who will carry the pregnancy is hormonally ready for implantation.
In a natural cycle, fertilization usually happens around day 14–16, and the embryo travels to the uterus to implant around day 20, when the uterine lining is thick and prepared for pregnancy.
Reciprocal IVF for same sex couples replicates that natural window. The embryo must reach the uterus at the same stage that it would in a typical pregnancy, when it’s five days old.
Syncing is not required for frozen embryo transfers, since the embryos can be preserved until the optimal time for implantation. Still, many couples try a fresh transfer first because it’s often more cost-effective and has similar success to frozen transfers.
Step 3: Ovarian stimulation
At this stage, the medical procedures of IVF for lesbian couples begin. The egg donor goes through ovarian stimulation, usually daily hormone injections, to help the ovaries produce more than one mature egg.
Having multiple eggs is important as not every egg will fertilize or grow into an embryo. With many healthy embryos, you have the option to select the healthiest ones for transfer or freeze extras for future family-building.
Ovarian stimulation begins on day 2–4 of the menstrual cycle, after routine ultrasound and bloodwork are done to assess hormone levels and follicle count. During this time, you’ll attend monitoring appointments every few days. Regular testing will help track follicle growth and hormone levels, so your team can adjust medications if necessary and perfectly time egg retrieval.
Step 4: Egg retrieval and embryo development
Once the follicles have matured, it’s time for egg retrieval, which is a minor outpatient procedure performed under light sedation. It lasts about 20–30 minutes, with quick recovery. Some mild cramping or spotting is normal afterward.
Guided by ultrasound, your fertility doctor inserts a thin, hollow needle through the vaginal wall and into the ovaries to collect the fluid from the follicles, each containing a developed egg.
The number of eggs retrieved varies depending on:
Age
Hormone levels
Response to medication
Overall reproductive health
Source: Edward Jenner
After retrieval, the eggs are sent to an embryology lab, where they are combined with the donor sperm. Fertilization can happen in two ways:
By placing the sperm and eggs in a petri dish
Through intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into each egg
The fertilized eggs, now embryos, are then cultured in a nutrient-rich environment that mimics the fallopian tubes. Over the next 3–5 days, the embryology team monitors their development, looking for healthy signs of growth and progression to the blastocyst stage, when an embryo is ready for transfer or freezing.
This is also when embryo genetic testing is performed to evaluate its health.
What embryo genetic testing options do you have?
You can go for standard tests, such as PGT-A (aneuploidy), PGT-M (monogenic disorders), and PGT-SR (structural rearrangements), to screen for chromosomal abnormalities and inherited disorders. More advanced analyses, such as PGT-P (screening for disorders influenced by multiple genes interacting together), can provide additional insights into potential risks for late-onset, chronic conditions, such as:
Heart disease
Certain types of cancer
Diabetes
Neurological disorders
While you wait for genetic testing results, your embryos are safely frozen and stored.
PGT has many benefits and even reduces the risk of miscarriage or failed implantation. It can also offer the possibility of choosing your baby’s sex with higher accuracy. Still, you should consult your doctor to understand what testing options are suitable for your condition.
Step 5: Uterine preparation and embryo transfer
When transferring a fresh embryo, the partner who will carry the pregnancy begins uterine preparation at the same time as the egg donor goes through ovarian stimulation. Frozen embryo transfers allow for uterine preparation to begin when convenient.
To create the most supportive environment for implantation, the carrier partner typically takes estrogen followed by progesterone to help the uterine lining become receptive, so the embryo has the best possible chance to attach and grow.
While it’s possible to attempt a transfer using a natural, unmedicated cycle, most fertility clinics recommend hormone support as it enables precise timing. In most cases, the carrier mother attends a few monitoring appointments to ensure her body is responding well and the uterine lining is developing as expected.
Embryo transfer is quick and painless, taking a few minutes and requiring no anesthesia. Using ultrasound guidance, the doctor places one or more embryos into the uterus using a thin, flexible catheter. Most couples opt for single embryo transfer to reduce the risks associated with multiple pregnancies.
How long does reciprocal IVF take?
IVF for lesbian couples can take anywhere from two to six months from start to embryo transfer. The IVF timeline ultimately depends on personal and logistical factors, including:
How quickly fertility testing is completed
Whether you do a preconception genetic screening
Whether you go for the fresh or frozen embryo transfer
Here is a general timeline:
Stage | Estimated time |
|---|---|
Initial testing and evaluation | 1–2 months |
IVF cycle (stimulation to retrieval) | 2–3 weeks |
Genetic testing | 1–2 weeks |
Uterine preparation | 2–4 weeks (if frozen transfer) |
A fresh embryo transfer can shorten the total timeline by a few weeks since uterine preparation happens alongside ovarian stimulation. That said, many variables, such as addressing uterine polyps surgically or waiting on lab results, can also stretch the timeline.
Source: Tiger Lily
What to consider before choosing IVF for same sex couples
Like any fertility treatment, same sex IVF comes with emotional, medical, and financial decisions. Here are some areas to discuss as a couple before moving forward:
Who will donate eggs and who will carry the baby? If you are both healthy and have no fertility issues, either can take either role, but age and medical assessment should help guide the decision.
Who will donate sperm? You can choose someone you know, or you can find an anonymous donor through an agency or sperm bank. Platforms like Nucleus can help you access trusted donors or agencies.
What is your family size and plan for the future? Some couples alternate roles for future children so both can experience pregnancy and have a genetic link to at least one child. You can discuss if you want the same sperm donor in the future or if you want to use sibling embryos from the same cycle.
Are you emotionally ready for IVF? IVF for lesbian couples (and all parents, in general) is an emotional rollercoaster. Many couples don't succeed on the first try, and those with genetic conditions face additional worries. Open communication, mutual support, and professional counseling can make this journey easier to navigate.
Have you explored the legal aspects of IVF for same sex couples? By default, the birth certificate typically names the gestational mother. The egg donor may need a second-parent adoption or a pre-birth parentage order to secure legal rights. Laws vary by jurisdiction, so it’s best to consult with a family lawyer.
Are you financially ready? Reciprocal IVF costs $15,000–$25,000, excluding add-ons like donor sperm, embryo testing, freezing, and storage. Many insurance plans don't cover reciprocal IVF unless there’s a medical infertility diagnosis, although some couples report partial coverage.
What are the success rates of IVF treatment for lesbian couples?
Success rates of reciprocal IVF for lesbian couples are comparable to traditional IVF. The biggest factor affecting success rates is the age and egg quality of the partner providing the eggs. According to CDC data, the live birth rate for IVF cycles using eggs from women under 35 is around 55%.
Other ways to improve your chances include:
Choosing the younger partner as the egg donor
Maintaining a healthy lifestyle during treatment
Choosing a fertility clinic experienced in LGBTQ+ family building
Screening embryos for chromosomal abnormalities
Parental carrier screening
Selecting donor sperm genetically compatible with your eggs
Reciprocal IVF demands a lot of logistical maneuvering, so having professional guidance through the entire process can make all the difference. You can explore the Nucleus IVF+ platform for an all-inclusive IVF experience.
Nucleus IVF+ is designed to help families undergo IVF smoothly with minimal logistical friction. The platform simplifies your journey with comprehensive options, including genetic insights, access to pre-vetted clinics, embryo testing and optimization, and a network of trusted donors.
Nucleus IVF+ is the all-in-one support you can trust
Nucleus IVF+ is for parents who dream of healthy children and value transparency, personalized guidance, and active participation in shaping a healthy future for their children. You get one-stop support for all stages of IVF, with:
24/7 expert guidance from genetic counselors
Nucleus Family for parental carrier screening
Access to top clinics, physicians, and proven testing protocols tailored to your journey
One IVF cycle
Medications
STD and AMH testing
ICSI (included with cycle)
Curated network of sperm and egg donors
Nucleus Embryo for advanced embryo screening
All consultations during treatment — and more
You can access all of the above at a single price point with the Nucleus IVF+ package. Complete a simple form to get started.
If you’ve already started IVF, you may still benefit from Nucleus’ standalone products and services: Nucleus Family and Nucleus Embryo.
Particularly, Nucleus Embryo is a genetic optimization tool that helps parents compare embryo data before implantation. It can screen your embryos for 2,000+ conditions, including:
Common diseases like type 2 diabetes, heart disease, and obesity
Rare hereditary conditions
Well-being and mental health traits like ADHD, migraine, and insomnia
Nucleus offers a parent-friendly interface with an interactive dashboard to compare and filter up to 20 embryos, which gives you more agency over fertility decisions.
Schedule a call today to tailor your IVF journey.
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Featured image source: Pavel Danilyuk
