In recent years, we have witnessed an increase in the number of families who have moved away from the traditional concept of father, mother, and children. Single women and lesbian couples are some examples of these new family models.
A same-sex female couple can have a child thanks to conventional assisted reproduction techniques: artificial insemination (AI) and in vitro fertilization (IVF). In both cases, it is necessary to resort to sperm donation. Nevertheless, depending on the country, the legal framework for same-sex partners to get pregnant and become mothers may be more or less permissive.
There is also a method available to lesbian couples: reciprocal IVF, also known as co-IVF or shared motherhood since both women of the couple are able to participate actively in the pregnancy.
Provided below is an index with the 8 points we are going to expand on in this article.
Having a baby with donated sperm
There exist three main fertility options for women in a lesbian relationship to have a child, all of them obviously with donor sperm.
In many parts of the world sperm donation is a totally anonymous and altruistic process, and the donor has therefore no parental rights.
However, in the United States it is possible to use a known donor, perhaps a family member or a friend. If using a known donor it is a good a idea to seek legal counseling from a specialist in reproductive law, to ensure you do not have any problems later on with legally acknowledging both women as parents.
The following is a description of each of the reproductive options for two women to have a biological child: AID, IVF, and co-IVF method.
One of the women undergoes AI with sperm from an anonymous donor chosen by the fertility clinic based on her physical characteristics (or a known donor if preferred and legally an option).
This requires gentle stimulation so that 1 or 2 eggs mature and are released into the fallopian tubes at the time of ovulation. During this ovarian stimulation, the patient will visit the clinic periodically to monitor the growth of the ovarian follicles containing the eggs.
When follicular development has taken place, ovulation is induced and the specialist introduces the semen sample, which has been previously capacitated in the laboratory, into the woman's uterus so that fertilization can take place.
AID is a simple process that does not require anesthesia, so it is performed in the clinic itself. In addition, the patient will be able to carry out her daily routine until the time of the pregnancy test.
Read more about AI with donor sperm in the following article: IUI with Donor Sperm - Definition, Process & Success Rates.
In vitro fertilization
It may be the case that the woman who wants to carry the pregnancy to term has fertility problems and AI is not effective. The second reproductive option for these women will be IVF.
Here, the woman receiving treatment undergoes ovarian stimulation so that several eggs mature at once. These are obtained by follicular puncture and fertilized in the laboratory with the donor's sperm. The embryo or embryos obtained will be transferred to the woman's uterus on the basis of their quality criteria.
Related topic: How Does IVF with Donor Sperm Work? - Cost & Success Rates.
In the case of both AI and IVF, even if only one of the two women undergoes the treatment, both will sign an informed consent, so that both will be the legal mothers.
What is reciprocal IVF or co-IVF?
Reciprocal IVF is an exclusive IVF procedure for a same sex female couple with a reproductive desire. It allows both to participate in the process of pregnancy, one providing the eggs and the other carrying the baby.
Specifically, there are two parts of the treatment and both of the women participate in each of them:
- One woman provides the genetic load: she undergoes IVF ovarian stimulation and her eggs are extracted by follicular puncture.
- One woman carries out the pregnancy: she receives the fertilized embryos in the laboratory with donor sperm and carries the pregnancy to term.
Both women receive hormonal medication: the first for ovarian stimulation and the second for endometrial preparation.
The choice of which woman donates the eggs and which one becomes pregnant will depend on the couple's own decision, always considering medical advice. Having said this, the woman who provides the oocytes is usually the younger woman because she usually has a better oocyte reserve and better oocyte quality, thus increasing the chances of success.
Legal aspects of reciprocal IVF
The laws on assisted reproductive technology (ART) differ from country to country. In the U.K., for example, the law governing ART can be found in the Human Fertilisation and Embryology Authorisation (HFEA) Act 1990.
The law establishes that in order for both to become the legal mothers of the baby, they must be civil partners at the time of conception. The conception through IVF needs to be carried out at a licensed fertility clinic or, in cases of artificial insemination, it also can be done by a private arrangement at home.
Couples who are not in a civil partnership can still become legal parents by undergoing fertility treatment in a licensed clinic. However, should they conceive by AI in private, the mother who doesn't give birth has no legal parenthood and needs to adopt the baby in order to become the legal mother.
Patients from the U.S., on the other hand, need to consider that legislation on reciprocal IVF varies from state to state and it might be necessary for one of the mothers to legally adopt her child born through this assisted reproductive technique.
This ensures that both women become legal parents and appear together on the birth certificate.
Are you interested in undergoing Reciprocal IVF to become mothers? Then we recommend that you get your Fertility Report now. It will provide you with a selection of clinics that have passed our rigorous selection process, and subsequently we consider top clinics for our readers. We will send you a report with information on the fees and conditions of each clinic for this particular treatment option.
Video on assisted reproduction for same sex female couples
Michelle Lorraine Embleton, biochemist at inviTRA, talks to us in this video about the assisted reproductive treatments available to lesbian couples who wish to become parents and the legal aspects surrounding it.
In a same sex female couple we have two potential moms but we lack the male gamete, so they are going to use donated sperm. The three techniques available using the donated sperm are intrauterine insemination (IUI), IVF and reciprocal IVF
FAQs from users
Can a lesbian couple use the same sperm donor to do an AI for each one?
Yes, following all appropriate screening.
How does reciprocal or co-IVF work?
Reciprocal or co-IVF is a type of IVF with ICSI that has been created exclusively for lesbian couples with a desire to start a family. Moreover, both of them can participate actively in the pregnancy—one contributes the egg, while the others carries the baby until birth.
In particular, the treatment is made up of two parts, each woman participating in one:
- Woman who contributes the genetic material
- She undergoes IVF ovarian stimulation and goes through follicular puncture (egg retrieval).
- Woman who bears the pregnancy
- She receives the resulting embryos after fertilization in the lab using donor sperm, and carries the baby until birth.
Both women have to take hormonal medications: woman A for ovarian stimulation, and woman B for endometrial preparation.
What options do lesbian couples have for getting pregnant?
Couples of women should use assisted reproduction techniques with donor sperm to achieve a pregnancy. Once the sperm donor is selected, pregnancy can be achieved by in vitro fertilization (IVF), artificial insemination (AI) or through reciprocal IVF.
If we decide that we are both going to have artificial insemination, can we use sperm from the same donor?
Generally, each insemination would use a different sperm donor. Sperm donation in many countries is anonymous and the donor is assigned by the ferrtility clinic based on the immunological and physical characteristics of the patient.
However, if both women can be matched with the same donor based on these criteria, and there is sufficient sample available, theoretically it is possible, if not probable.
If in a state or country that allows free selection of the sperm donor, then yes, it is possible to use sperm from the same donor.
Do lesbian couples need a sperm donor contract?
Absolutely yes, especially in the case of same-sex couples and single women who decide to collaborate with a male friend or brother (i.e. known sperm donor). Sperm donor agreements are intended for those who do not use a sperm bank as intermediary.
The purpose of this type of contract is to make sure the donor is not the legal parent despite being the biological father of the child.
Is donor insemination for lesbian couples available on the NHS?
According to the National Institute for Health and Care Excellence (NICE), IUI is offered on the NHS if you meet one of the following conditions: 1) you are unable to have vaginal sex; 2) you have a condition that makes it impossible or very difficult for you to conceive; 3) you are in a same-sex relationship.
NHS funding for fertility treatment is limited for everyone, and varies across the UK according to the criteria set by the Clinical Commissioning Group (CCG). Until February 2013, no official guidelines existed on what NHS funding should be offered to same-sex couples.
Now, homosexual couples are mentioned on the guidelines published by the NICE, which expects lesbians to have tried to conceive up to 6 times using IUI before being considered for NHS-funded treatment.
If you would like more information about reciprocal IVF, please visit the following link: What is reciproval IVF?
You can find information about the costs involved in the various assisted reproductive options in our article: What is the price of assisted reproduction treatments?
We make a great effort to provide you with the highest quality information.
🙏 Please share this article if you liked it. 💜💜 You help us continue!
Andrade-Rocha FT (2003). Semen analysis in laboratory practice: an overview of routine test. J Clin Lab Anal 2003; 17: 247-258.
Ballesteros A, Castilla JA, Nadal J, Ruiz, M. Manifiesto de la SEF sobre la donación de gametos en España. Publicado a través de la Sociedad Española de Fertilidad (SEF).
Bos HM, Van Balen F, Van den Boom Dymphna C. Planned lesbian families: their desire and motivation to have children. Human Reprod. 2003; 18(10): 2.216-24.
Bos, H. (2013). Lesbian-mother families formed through donor insemination. En A. Goldberg y K. Allen (Eds.), LGBT-Parent families. Innovations in research and implications for practice (pp. 21-37). New York: Springer.
Chabot JM, Ames BD. «It wasn’t ‘let’s get pregnant and go do it’»: decision making in lesbian couples planning motherhood via donor insemination. Family Relations. 2004; 53(4): 348-56.
Comisión Nacional de Reproducción Humana Asistida (CNRHA) (2015). Aspectos legales y éticos de la donación. En: Registro Nacional de Donantes de Gametos y Preembriones. Ministerio de Sanidad, Consumo y Bienestar Social de España.
Donoso, S. (2013). La familia lesboparental: ¿Reinvención de la familia? (Tesis Doctoral). Barcelona: Universitat de Barcelona.
Dunne GA. Opting into motherhood: lesbians blurring the boundaries and transforming the meaning of parenthood and kinship. Gender Soc. 2000; 14(1): 11-35.
Goldberg JM, Mascha E, Falcone T, Attaran M. Comparison of intrauterine and intracervical insemination with frozen donor sperm: a meta-analysis. Fertil Steril. 1999 Nov; 72(5):792-5.
Ley 14/2006, de 26 de mayo, sobre técnicas de reproducción humana asistida. Jefatura del Estado «BOE» núm. 126, de 27 de mayo de 2006 Referencia: BOE-A-2006-9292
Machin R. Sharing motherhood in lesbian reproductive practices. BioSocieties. 2014; 9(1): 42-59.
Markus E, Weingarten A, Duplessi Y, Jones J. Lesbian couples seeking pregnancy with donor insemination. J Midwifery Women’s Health. 2010; 55(2): 124-32.
O'Brien P, Vandekerckhove P. Intra-uterine versus cervical insemination of donor sperm for subfertility (Cochrane Review). In: The Cochrane Library, Issue 1, 2001. Oxford: Update Software.
Pennings G. Having a child together in lesbian families: combining gestation and genetics. J Med Ethics. 2016; 42(4): 253-5.
Sociedad Española de la Fertilidad (SEF). Libro Blanco Sociosanitario. La Infertilidad en España Situación Actual y Perspectivas. Imago Concept & Image Development 2011.
Sociedad Española de Fertilidad (SEF) (2011). Manual de Andrología. Coordinador: Mario Brassesco. EdikaMed, S.L. ISBN: 978-84-7877.
The ESHRE Capri Workshop Group. Intrauterine insemination. Human Reproduction Update, 2009; 15 (3): 265–277.64
Wall M. Hearing the voices of lesbian women having children. Journal of GLBT Family Studies. 2011; 7(1-2): 93-108.
Wyverkens E, Provoost V, Ravelingien A, De Sutter P, Pennings G, Buysse A. Beyond sperm cells: a qualitative study on constructed meanings of the sperm donor in lesbian families. Human Reprod. 2014; 29(6): 1.248-54.
Yeshua A, Lee JA, Witkin G, Copperman AB. Female couples undergoing IVF with partner eggs (co-IVF): pathways to parenthood. LGBT Health. 2015; 2(2): 135-9.
Zeiler K, Malmquist A. Lesbian shared biological motherhood: the ethics of IVF with reception of oocytes from partner. Medicine, Health Care and Philosophy. 2014; 17(3): 347-55.
LGTB paths to parenthood. NHS. Last actualization: 4 May 2020. Link
FAQs from users: 'Can a lesbian couple use the same sperm donor to do an AI for each one?', 'How does reciprocal or co-IVF work?', 'What is AI with donor sperm in female couples?', 'How does in vitro fertilization work for lesbian woman?', 'What is reciprocal IVF?', 'What legal aspects of reciprocal IVF are there to consider?', 'What options do lesbian couples have for getting pregnant?', 'Is donor insemination available on the NHS?', 'How successful is reciprocal IVF?', 'If we decide that we are both going to have artificial insemination, can we use sperm from the same donor?', 'Do lesbian couples need a sperm donor contract?', 'Is donor insemination for lesbian couples available on the NHS?', 'Can lesbian couples choose the profile of their sperm donor?' and 'Is there any way for lesbian couples to use a sperm donor for free?'.
Authors and contributors
More information about Michelle Lorraine Embleton