What Is Reciprocal IVF and How Does It Work For LGBTQ+ Couples?

At Audubon Fertility, we understand that the journey to parenthood is filled with hope, planning, and a lot of heart. For LGBTQ+ couples, especially same-sex female couples, this journey may come with additional questions and hurdles, but it also offers powerful opportunities for connection, growth, and shared experience. More and more couples are exploring fertility options that reflect their values and identities, and reciprocal IVF has quickly become one of the most meaningful ways for both partners to participate in the process of creating life.

What makes reciprocal IVF so special isn’t just the science behind it; it’s what it represents. It allows both partners to contribute physically and emotionally to the birth of their child, turning what might otherwise be a medical procedure into a deeply personal and collaborative experience. Whether you’ve always dreamed of carrying a child, sharing genetics, or simply embarking on a family-building journey together, reciprocal IVF gives you the ability to do it as a team.

What does Reciprocal IVF actually mean?

Reciprocal IVF is a fertility treatment where both partners in a couple assigned female at birth are actively involved in the reproductive process. One partner undergoes egg retrieval and provides the eggs, while the other partner becomes pregnant by carrying the embryo. This embryo is created by fertilizing the retrieved eggs with donor sperm in our lab, and the resulting embryo is then transferred into the other partner’s uterus.

What sets reciprocal IVF apart from traditional IVF is this shared involvement. In traditional IVF, the same person usually provides the egg and carries the pregnancy. In reciprocal IVF, we split those roles between two people, creating what many couples feel is a truly shared path to parenthood. It’s also different from intrauterine insemination (IUI), which involves placing donor sperm into the uterus but doesn’t include the advanced step of fertilization outside the body or choosing the embryo with the best chance of success.

We’ve found that many couples who choose reciprocal IVF do so because they want to experience every part of this journey together. It creates a unique form of connection, one partner contributes their biology while the other nurtures that life into being. It’s a beautiful, balanced approach to family building that reflects the love and commitment both people bring to the relationship.

Who It's For, and Why Many Choose It?

Reciprocal IVF is ideal for cisgender lesbian couples, nonbinary couples assigned female at birth, or any couple where both partners have a uterus and ovaries. This method is often chosen by couples who want to share the reproductive journey in a way that includes both partners biologically. For us, it’s always inspiring to witness the depth of partnership that emerges through this process.

Before moving forward, we conduct comprehensive evaluations for both partners. We assess ovarian reserve, hormone levels, and uterine health to determine which partner is better suited to provide the eggs and which one can safely carry the pregnancy. This decision isn’t just based on medical indicators; it’s also rooted in personal preferences, emotional readiness, and long-term family goals. We have open, honest conversations with both partners to ensure you feel fully informed and supported at every step.

Couples often choose reciprocal IVF because they want to feel equally involved in the process of creating their child. One partner becomes the genetic parent while the other becomes the gestational parent. This dual involvement can make both individuals feel deeply connected to the baby from the very beginning. For some, it’s about inclusivity and balance; for others, it’s the fulfillment of lifelong dreams to carry or to share genetic ties with their child. And sometimes, medical reasons guide the decision, such as when one partner is unable to carry due to health conditions, or one has a better ovarian reserve or is younger. Whatever your story, we’ll help you write the next chapter together.

How the Reciprocal IVF Process Works?

Reciprocal IVF involves several carefully coordinated steps, each handled with precision and compassion by our team. First, we start with fertility assessments for both partners. This includes a thorough review of medical history, hormone testing, and ultrasounds to understand ovarian function and uterine health. We take the time to explain every detail, so you feel empowered in your decisions.

Once roles are determined, the partner providing the eggs begins ovarian stimulation. This involves taking hormone injections over 8–12 days to encourage the ovaries to produce multiple mature eggs. During this time, we closely monitor progress through blood work and ultrasounds. When the timing is right, we schedule an egg retrieval procedure, which is quick, safe, and done under mild sedation. It’s a major milestone and one we treat with great care.

After we retrieve the eggs, we bring them into our state-of-the-art lab for fertilization. Using donor sperm, we combine the eggs and allow them to develop into embryos over a few days. Our embryologists monitor the development carefully, selecting the healthiest embryo for transfer. If genetic testing is part of your plan, we can also test the embryos before transfer.

The next step is embryo transfer. The partner carrying the pregnancy undergoes a cycle to prepare the uterus for implantation, which may include medications to thicken the uterine lining and promote a welcoming environment. Once the uterus is ready, we gently place the embryo inside in a painless, non-surgical procedure. From there, we wait, typically about 9–11 days, before conducting a pregnancy test.

If pregnancy is confirmed, we’ll continue supporting you with ultrasounds, monitoring, and heartfelt encouragement. Our goal isn’t just conception, it’s a healthy, happy pregnancy and a smooth transition into parenthood. We're here for every heartbeat and every milestone.

Emotional and Legal Aspects to Consider

Reciprocal IVF isn’t just a medical journey; it’s a deeply emotional one. Many of the couples we work with tell us how much stronger their bond becomes through this process. When both partners are physically and emotionally involved, the sense of shared purpose and mutual contribution is incredibly powerful. It can also deepen each partner’s identity as a parent and create a lasting emotional bridge between both individuals and their baby.

That said, we know the road can have emotional complexities too. Deciding who will carry and who will provide the eggs may stir up questions around identity, expectations, or even grief for roles one partner may not be able to take. That’s why we foster an environment where you can talk about all of this openly. We encourage counseling and support groups, especially those designed for LGBTQ+ families, to help you navigate these emotions with clarity and compassion.

Legally, we also want to make sure your parental rights are protected from day one. Even if you're married, the non-birth parent may not be automatically recognized as a legal parent in every state. We recommend that all our reciprocal IVF couples consult with an LGBTQ+ family law attorney about second-parent adoption or other legal safeguards. It’s about securing your family's future and ensuring both of you are fully recognized as your child’s parents in every legal situation.

Cost, Success Rates, and Planning Ahead

We believe in transparency, especially when it comes to cost. Reciprocal IVF is an investment, and we want to make sure you're fully informed. The average cost ranges from $15,000 to $25,000 per cycle, which includes everything from ovarian stimulation to egg retrieval, embryo fertilization, transfer, and pregnancy monitoring. Medications, donor sperm, and genetic testing may add to the total. We’ll provide a detailed breakdown at the start, so you can plan with confidence.

Success rates depend on multiple factors, including the age and health of the partner providing the eggs, the quality of the donor sperm, and the uterine health of the partner carrying the pregnancy. Generally, a younger age correlates with higher success rates. On average, reciprocal IVF success rates are comparable to traditional IVF, ranging from 40% to over 60% per cycle when using high-quality eggs from a partner under 35.

Insurance coverage can be unpredictable, especially for LGBTQ+ couples. Some policies require a documented history of infertility, which may not apply to same-sex couples without male partners. That’s why we’ll help you review your benefits, explore financing options, and even guide you toward available grants or third-party lending partners if needed. We believe that everyone deserves the chance to build a family, regardless of their financial situation, and we’ll do our best to find a path that works for you.

Why Families Trust Audubon Fertility?

We’ve built more than just a clinic; we’ve built a safe space where all families are celebrated and supported. We’re proud to offer reciprocal IVF to LGBTQ+ couples, and we bring both medical expertise and heartfelt compassion to every appointment. We know that no two families look the same, and we honor that by designing customized fertility plans that meet your needs, your values, and your vision for parenthood.

We don’t just see you as patients, we see you as partners in the journey. Our team includes reproductive endocrinologists, embryologists, nurses, and coordinators who are all deeply committed to LGBTQ+ affirming care. We respect your relationship, your identity, and your dreams. From your very first consultation through to your positive test and beyond, we’re with you, offering knowledge, encouragement, and real human connection.

So if you're ready to explore reciprocal IVF or simply want to understand what’s possible, we invite you to connect with us. Let’s talk openly about what family means to you and how we can help make that dream a reality, together.