Reciprocal IVF — also known as shared motherhood, co-IVF, or partner egg IVF — is a treatment option for same-sex female couples where each partner has a distinct biological role in the pregnancy. One partner undergoes egg collection (the "genetic mother"); the other carries the pregnancy (the "birth mother"). Donor sperm is used to fertilise the eggs.

The result is a child who is genetically related to one partner and was carried by the other — a form of biological connection that standard IVF with one partner would not provide to both.

How Reciprocal IVF Works

The process combines elements from both standard IVF and donor egg IVF:

Partner A (egg provider): Undergoes the same stimulation protocol as a standard IVF cycle — daily hormone injections for 10–14 days, monitoring scans, and egg collection under sedation. The eggs are fertilised with donor sperm in the laboratory.

Partner B (carrier): Undergoes endometrial preparation — typically an artificial (medicated) cycle of oestrogen followed by progesterone — to prepare the uterine lining for embryo transfer. This is the same protocol as a standard frozen embryo transfer cycle. No sedation or egg collection is involved.

The resulting blastocysts are transferred to Partner B's uterus. Any surplus embryos are frozen for future use.

Parenthood at birth: Under UK law, the woman who gives birth is the legal mother. For reciprocal IVF in the UK, Partner B (the carrier) is the legal mother at birth, regardless of which partner provided the eggs.

Second parent status: If the couple is married or in a civil partnership at the time of treatment, Partner A (the egg provider) is the second legal parent automatically, without any additional legal steps — provided the treatment takes place at an HFEA-licensed clinic.

If the couple is not married or in a civil partnership, Partner A can be registered as the second legal parent by the clinic completing a "Notice of Election" before or at the time of treatment. This is a simple administrative step at the clinic, not a court process.

Important: Both partners must consent to the treatment and the parental recognition arrangements in writing at the clinic. The clinic's consent process will cover this.

HFEA Licensing

Reciprocal IVF is a licensed treatment in the UK and must be performed at an HFEA-licensed clinic. Both partners must attend the clinic for screening, counselling, and consent. The clinic will verify that both partners meet the health and screening requirements.

Who It Is Most Appropriate For

Reciprocal IVF is most straightforward when:

  • Both partners are under 38, as egg quality is a key factor (Partner A's age determines egg quality, Partner B's age matters less for IVF success)
  • Partner A has adequate ovarian reserve for stimulation
  • Partner B has a normal uterine cavity and is able to carry a pregnancy safely
  • The couple has a clear preference for shared biological involvement

If Partner A has very low ovarian reserve, the expected egg yield per cycle may make the treatment less efficient. A consultant will assess both partners' fertility profiles before recommending reciprocal IVF.

Donor Sperm Selection

Reciprocal IVF requires donor sperm, as no male genetic material is involved in the couple. The couple selects a sperm donor from an HFEA-registered donor list or from an overseas bank (with UK-compliant identifiability). The child will have the right, at age 18, to request identifying information about the sperm donor.

For full detail on sperm donor selection and the UK legal framework, see using donor sperm in the UK.

Success Rates

Reciprocal IVF success rates are determined primarily by Partner A's age (as the egg provider) and by the standard factors affecting embryo development and implantation. HFEA data does not separately report reciprocal IVF outcomes, but they follow the same age-related pattern as standard donor egg IVF:

  • If Partner A is under 35: live birth rates per transfer typically 30–40%
  • If Partner A is 35–37: 25–30%
  • If Partner A is 38–39: 18–22%
  • If Partner A is 40+: declining rates; below 10% by the mid-forties

For a full breakdown of IVF success rates by age, see HFEA success rates explained.

Costs in the UK

Reciprocal IVF involves the same cost components as standard IVF (stimulation for Partner A) plus a frozen embryo transfer cycle for Partner B:

| Item | Approximate cost | |---|---| | IVF stimulation cycle (Partner A) | £4,000–£6,500 | | Medication (Partner A) | £500–£1,500 | | Donor sperm | £900–£1,500 per vial | | FET cycle (Partner B) | £1,500–£2,500 | | FET medication | £200–£500 | | Total first cycle | £7,000–£12,000+ |

Many clinics offer reciprocal IVF packages that bundle the stimulation and FET cycles. Compare what is and isn't included.

NHS Access

NHS eligibility for reciprocal IVF varies by ICB. The Equality Act 2010 and NICE guidance (NG156) affirm that eligibility criteria should not discriminate on the basis of sexual orientation — same-sex female couples should be assessed on the same clinical criteria as heterosexual couples. However, some ICBs' historical policies pre-date NICE 2023 guidance and may need updating.

The specific question for reciprocal IVF is whether the ICB's policy covers this specific treatment modality, or only covers standard IVF with one partner's eggs and the same partner carrying the pregnancy. If your ICB's policy is unclear, ask your GP to seek clarification, and consider the Individual Funding Request (IFR) route if needed. See NHS IVF appeal.

Check current ICB policy for same-sex couples at nestie.co/nhs.

Reciprocal IVF Abroad

Reciprocal IVF is available in most European fertility destinations, including Spain, Czech Republic, and Greece. The same considerations apply as for any overseas IVF — primarily the anonymous donor sperm question and the legal position of both partners in the country of treatment. See IVF in Spain: a guide for UK patients.

Legal parenthood arrangements in overseas treatment may not automatically match UK law. If you have treatment abroad and return to the UK, the parental status of both partners should be confirmed with a specialist family law solicitor.

Frequently Asked Questions

Q: Which partner should provide the eggs and which should carry?

A: This is primarily a personal decision, though clinical factors should inform it. If one partner has significantly better ovarian reserve than the other, she is generally the more efficient egg provider. If one partner has a uterine condition or health factor that affects the ability to carry safely, the other should carry. In the absence of clinical reasons, the choice is entirely yours.

Q: Can we swap roles in a subsequent cycle?

A: Yes. If the first cycle does not succeed, or if you want a second child with the roles reversed, this is clinically possible. It involves a full new stimulation cycle for the other partner. There are no legal barriers to doing this.

Q: Do both partners need to be screened?

A: Yes. The HFEA requires that both partners undergo health screening at a licensed clinic before treatment. This typically includes infectious disease screening, reproductive history review, and a consultation with a fertility nurse and counsellor.

Q: Is there a risk that only one of us will be recognised as the legal parent?

A: As long as the treatment takes place at an HFEA-licensed clinic and both partners complete the required consent forms and Notice of Election (if not married or civilly partnered), both partners will be legal parents. It is important to complete this paperwork correctly before or at the time of treatment — it cannot be done retrospectively after the birth.

Q: Can we use a known donor for the sperm?

A: Yes. A known donor (friend or acquaintance) can be used, provided they are screened and registered through an HFEA-licensed clinic. All the standard legal provisions around donor status and child identity rights apply. The process is the same as for any other known donor arrangement in UK fertility treatment.

This article is for information only and does not constitute legal or medical advice. Legal parenthood arrangements are complex; always confirm your specific situation with your clinic and, if needed, a specialist family law solicitor.