In Vitro Fertilization (IVF) is a medical procedure that helps many different types of couples build their families. For same-sex female couples, the process of IVF introduces unique logistical and medical considerations. IVF offers multiple distinct pathways that allow one or both partners to participate biologically in the conception of a child. This assisted reproductive technology requires the use of donor sperm and careful planning to determine who will contribute the egg and who will carry the pregnancy. The journey involves several coordinated medical steps, from hormone therapy to embryo transfer, all tailored to the couple’s chosen path to parenthood.
Defining the Roles: Traditional vs. Reciprocal IVF
Lesbian couples typically approach IVF through two primary methods: Traditional IVF or Reciprocal IVF (RIVF). In Traditional IVF, one partner undergoes the entire medical procedure, providing the egg and carrying the resulting pregnancy. This partner undergoes ovarian stimulation and egg retrieval, and the resulting embryo is transferred into her uterus. This method results in one partner being both the genetic and the gestational mother.
Reciprocal IVF, often called shared motherhood, is a specific pathway that allows both women to be intimately involved in the biological process. In RIVF, one partner acts as the egg provider (genetic mother), and the other partner serves as the gestational carrier (birth mother). The egg provider undergoes ovarian stimulation and egg retrieval to collect her oocytes. The resulting embryo (created with donor sperm) is then transferred into the uterus of the gestational carrier. This division of roles allows one partner to have a genetic link to the child while the other establishes a biological bond through pregnancy. The decision of who takes which role often depends on factors like age, ovarian reserve, and personal preference.
Donor Sperm Selection and Screening
Regardless of whether a couple chooses Traditional or Reciprocal IVF, the use of donor sperm is required. The couple must select a donor, typically choosing between an anonymous donor from an accredited sperm bank or a known donor. Using a certified sperm bank ensures the donor has undergone rigorous medical and genetic screening protocols mandated by regulatory bodies.
The screening process for anonymous donors is comprehensive, involving a detailed medical history review and extensive testing for infectious diseases. Donated sperm is frozen and quarantined for at least six months, after which the donor is retested for communicable diseases like HIV and Hepatitis to ensure safety. This mandatory quarantine period helps mitigate the risk of transmitting infections.
Genetic carrier screening is another important part of the donor selection process. Donors undergo testing, often referred to as Extended Carrier Screening (ECS), to identify potential silent mutations for various recessive genetic conditions, such as Cystic Fibrosis. The fertility clinic recommends that the egg provider also undergo carrier screening to ensure she does not carry a matching mutation with the selected donor. Once selected, the frozen sperm is shipped to the fertility clinic, where it is prepared for the fertilization step in the lab.
The Medical Journey: From Ovarian Stimulation to Transfer
The medical journey for the partner providing the eggs begins with the ovarian stimulation phase, which typically lasts between 10 and 14 days. This involves the partner injecting herself daily with hormonal medications, primarily synthetic Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH), to encourage the ovaries to mature multiple egg-containing follicles simultaneously. The goal is to produce more than the single egg normally released in a natural cycle, which increases the chance of creating viable embryos.
During this period, the partner is closely monitored through frequent transvaginal ultrasounds and blood tests to track the growth of the follicles and measure hormone levels. Once the follicles are mature, a final hormone injection, known as the “trigger shot,” is administered to induce the final maturation of the eggs. The egg retrieval procedure is scheduled approximately 36 hours after the trigger shot.
Egg retrieval is a minor surgical procedure performed under light sedation. A thin, ultrasound-guided needle is passed through the vaginal wall into the ovaries to gently aspirate the fluid and eggs from the mature follicles. Immediately after retrieval, the collected eggs are taken to the embryology lab, where they are combined with the prepared donor sperm for fertilization, either through conventional insemination or Intracytoplasmic Sperm Injection (ICSI).
The resulting embryos are then cultured in the lab for five to seven days, during which time they are monitored for healthy development, ideally reaching the blastocyst stage. For the partner who will carry the pregnancy, her uterus is prepared to receive the embryo through a separate hormonal regimen. This often involves taking estrogen to thicken the uterine lining and progesterone to make it receptive to implantation.
The embryo transfer is a quick, minimally invasive procedure where the selected embryo is placed into the gestational carrier’s uterus using a thin, flexible catheter guided by ultrasound. Following the transfer, the gestational carrier continues hormonal support, typically with progesterone, during the “two-week wait” before a blood test confirms whether the embryo has successfully implanted.