In Vitro Fertilization (IVF) is an assisted reproductive technology that provides a pathway to parenthood for same-sex female couples. This process involves combining an egg and sperm outside the body in a laboratory setting before transferring the resulting embryo into a uterus. For couples who share no male partner, the process requires the use of donor sperm to achieve conception. Same-sex female couples have two primary options for biological involvement. These options allow for one partner to contribute the genetic material, or for the roles of genetic provider and gestational carrier to be shared between both partners.
Sourcing Genetic Material: Donor Sperm
The first step for same-sex female couples pursuing IVF is securing a viable sperm sample, which can be obtained through an anonymous sperm bank or from a known donor. Most couples choose to work with certified sperm banks, which offer cryopreserved samples from rigorously screened donors. These donors undergo an extensive screening process, including a comprehensive review of their medical and family history to identify potential hereditary disorders. Potential donors are also subject to infectious disease screening, with testing for conditions such as HIV, Hepatitis B, and Hepatitis C, adhering to regulations set by the Food and Drug Administration (FDA). After collection, the donor sperm sample is typically quarantined for a minimum of six months, after which the donor is retested for infectious diseases to ensure the sample is safe for use. Once a couple has selected a donor, the cryopreserved vial is shipped to the fertility clinic, where it is thawed and prepared just before the fertilization procedure.
The Reciprocal IVF Path: Egg Retrieval and Fertilization
Reciprocal IVF allows both partners to participate directly in the biological process, beginning with the partner designated as the egg provider. This partner undergoes controlled ovarian hyperstimulation, where injectable hormone medications are taken for approximately one to two weeks. These hormones stimulate the ovaries to mature multiple egg-containing follicles simultaneously. The egg provider’s response is tracked closely through frequent transvaginal ultrasounds and blood tests to monitor hormone levels, ensuring the eggs are progressing toward optimal maturity. Once the follicles reach an appropriate size, a final injection, referred to as the “trigger shot,” is administered to induce the final maturation phase of the eggs.
Egg Retrieval and Fertilization
The egg retrieval procedure takes place about 36 hours after the trigger shot and is a minor outpatient surgery performed under light sedation. Using ultrasound guidance, a thin needle is passed through the vaginal wall into the ovaries to aspirate the fluid and eggs from the mature follicles. Following retrieval, the eggs are transported to the laboratory, where they are combined with the thawed donor sperm. Fertilization may occur spontaneously (conventional IVF) or via Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected directly into the egg. The resulting embryos are then cultured for five to six days, allowing them to develop into the blastocyst stage before being prepared for transfer or cryopreservation.
The Reciprocal IVF Path: Endometrial Preparation and Transfer
Endometrial Preparation
The second phase of Reciprocal IVF focuses on preparing the gestational carrier to receive the embryo. This preparation involves a hormonal regimen designed to optimize the uterine lining, known as the endometrium, for implantation. Estrogen is administered first, typically starting near the beginning of the menstrual cycle, to encourage the thickening of the endometrium. The lining is monitored via ultrasound to confirm it has reached a receptive thickness, generally between 7 to 10 millimeters. Once the lining is sufficiently thick, progesterone is introduced to create the ideal “window of implantation” for the embryo.
Embryo Transfer
The actual embryo transfer is a non-surgical procedure performed once the endometrium is ready and the embryo has developed. The selected embryo, which may have been freshly cultured or thawed, is gently placed into the uterus using a thin, flexible catheter guided by ultrasound. Following the transfer, the gestational carrier continues to take progesterone to support the uterine lining and enhance the chances of successful implantation.
The Standard IVF Path: Single Partner Conception
The Standard IVF Path involves a single partner taking on both the role of providing the eggs and carrying the pregnancy. This option consolidates the medical steps, making the synchronization of two separate cycles unnecessary. This path is often chosen when only one partner is medically cleared to carry a pregnancy, or when a couple prefers that one individual maintain both the genetic and gestational connection. This individual undergoes the same rigorous process of ovarian stimulation, monitoring, and egg retrieval as described in the reciprocal method. The retrieved eggs are then fertilized with donor sperm to create embryos, which are transferred back into the same partner’s uterus, either immediately in a “fresh” transfer, or in a subsequent frozen cycle.