In reciprocal IVF, one partner provides the eggs and the other carries the pregnancy. It is standard IVF with the roles split between two people, and it is used mainly by female couples and couples where one partner is transgender.
The method goes by several names. ROPA (Reception of Oocytes from Partner) comes from the Spanish Recepción de Ovocitos de la Pareja, coined by the Barcelona group that first published on it. Co-IVF and reciprocal IVF came from a US group emphasizing that both partners contribute. UK literature tends to use shared motherhood IVF. And partner-assisted reproduction appears as a broader term. They all describe the same procedure.
Who does what
Both partners are patients at the same time, on protocols that have to line up. Many clinics sidestep the scheduling problem by freezing all embryos and transferring in a later cycle, which separates the two timelines entirely.
| Partner providing eggs | Partner carrying | |
|---|---|---|
| Before | Ovarian reserve testing, baseline bloodwork | Uterine assessment, baseline bloodwork |
| Weeks 1–2 | Stimulation injections, monitored by ultrasound and bloodwork | Medication to prepare the uterine lining |
| Retrieval day | Egg retrieval under sedation | — |
| In the lab | Eggs fertilized with donor sperm, embryos cultured 5–6 days | — |
| Transfer | — | Embryo transfer, then pregnancy and birth |
How both partners are connected to the child
The partner providing the eggs contributes the genome, which is genetic and straightforward.
The partner carrying the pregnancy contributes gestation. Her body actively shapes the environment the embryo develops in. Research has shown that days before implantation, the uterine lining releases tiny molecules that the embryo absorbs, and those molecules change which of the embryo’s genes switch on. Much of this work is still in animal models, but it consistently points the same way: gestation actively shapes the embryo rather than simply housing it.
Both roles are biologically substantial, which is the reason many couples choose this route over insemination.
Success rates
Outcomes are comparable to conventional IVF, possibly slightly better by a few percentage points, though not because of the procedure itself. Couples pursuing reciprocal IVF are generally younger on average, and in most cases neither partner has an infertility diagnosis, so the eggs and the uterus are usually both in good shape.
Success is more tied to the age of the person who provided the eggs, not the age of the person carrying. We cover that more in depth in IVF Success Rates by Age.
Deciding who takes which role
Age and ovarian reserve should be considered when deciding who provides the eggs. Uterine anatomy and pregnancy history should be considered when deciding who will carry. Sometimes the same person is the better candidate for both roles, and the couple has to weigh the medical advantage against the arrangement they might’ve pictured.
Some clinics suggest deciding after testing rather than before, since results often change the picture.
Donor sperm
Reciprocal IVF requires donor sperm, and where it comes from affects the timeline more than the cost.
Sperm from a bank is ready to use. With a donor the couple knows, the donor gets screened and tested for infectious disease first. Many clinics then hold the sample for 1-6 months and then retest before releasing it. The reason is that a newly acquired infection can go undetected for weeks, so a test run soon after exposure can come back negative on someone who is actually infected. Retesting later closes that gap.
There is no federally required waiting period here, so the hold varies from clinic to clinic. Worth asking about early so you can plan around it.
Legal parentage
The partner who gives birth is generally recognized as a legal parent at birth. The partner who provided the eggs may not be, and a genetic connection does not settle it.
A birth certificate is an administrative record, not a court order, and it can be questioned in another state or country. There are a few ways to get a court order that confirms both partners as the child’s legal parents: a judgment of parentage, a confirmatory adoption, or a second-parent adoption. Which is available depends on the state. But once a court issues one, every other state has to honor it. Many attorneys recommend this even if the couple is married and both are listed on the birth certificate.
Bottom line
Medically, reciprocal IVF is “regular” IVF with the work divided. One person goes through egg retrieval. The other goes through pregnancy. The decisions that matter most are outside the lab: which partner takes which role and what the state requires to recognize both parents. The last of those is worth settling first.
Related reading
Sources
- American Society for Reproductive Medicine, “Guidance regarding gamete and embryo donation (2024)”
- Fertility and Sterility, “A systematic review of reproductive technologies for shared conception in same-sex female couples”
- Reproductive BioMedicine Online, “Shared motherhood IVF: high delivery rates in a large study of treatments for lesbian couples using partner-donated eggs”
- Development, “Hsa-miR-30d, secreted by the human endometrium, is taken up by the pre-implantation embryo and might modify its transcriptome”
- eCFR, “21 CFR 1271.85: What donor testing is required for different types of cells and tissues?”
- Movement Advancement Project, “Equality Maps: Parental Recognition Laws”