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Reciprocal IVF / ROPA | Countries | Laws | Programs | Costs | Clinics

Reciprocal IVF / ROPA | Countries | Laws | Programs | Costs | Clinics

Reciprocal IVF (reception of oocytes from a partner, ROPA method), also known as “Shared Motherhood” lesbian shared IVF, or just shared IVF, is a multi–step in vitro fertilization process designed for female couples, enabling both women to be involved in a pregnancy. One of them provides the oocytes to create the embryos (genetic mother) and the other receives the embryo, hosts/gestates (gestational mother), and gives the birth to the baby.

As for in vitro fertilization (IVF) with donated semen, both women will be legal mothers, but only one partner who conceived via this method will be involved in the process unless both women undergo an IVF.

Unlike traditional IVF rounds, the ROPA method allows both women to take an active role in the conception of the newborn and share the motherhood experience with its hurdles, nuances, and milestones. Furthermore, shared IVF promotes feelings of legitimacy and security within the couple. It is worth noting that there is a great difference between non–ROPA in vitro fertilization cycles and ROPA as female couples undergoing reciprocal IVF may have and may not have fertility disorders, the semen is always donated by an anonymous/open identity/known donor, and the pregnant partner is not the one providing the oocytes.

Why Couples Choose Shared IVF?

There are two main reasons why female couples may undergo a ROPA treatment — the first is to share biological motherhood, and the second one — is for medical indications, including cases of advanced age (38 years old or older), when most couples have some condition that could affect the fertility of one or both partners.

Medical indications may include low ovarian reserve, poor oocyte quality, ovulation disorder, polycystic ovary syndrome, or a genetic disease of the gestational mother when she cannot use her oocytes. On the other hand, the genetic mother may have endometriosis, uterine disorders, or any medical issue contraindicating pregnancy and can provide viable and healthy oocytes but will need someone to host her baby.

When medically indicated, ROPA can potentially improve chances of positive outcomes for lesbian couples through the possibility of selecting the woman who can provide healthy oocytes (oocyte provider) and the woman who will be the gestational carrier between two gestational mothers, considering that both women wish to participate in the pregnancy.

In nonmedical cases, sharing the motherhood experience enables both women to be equally involved in the clinical process, as they both have to do injections and ultrasound scans; that is why it is very much like they are in this process together, and it feels like they are making a baby. For some same–gender female couples, being equally involved in the clinical process did provide feelings of equality after their child was born, as reciprocal IVF is a much closer shared journey that wasn’t previously available to same–sex female couples.

One more reason to opt for shared IVF is legitimacy. Being legitimate in the eyes of others when they ask: “Who is the real mom?” is essential for many same–gender female couples. Many two–mother families described being motivated to use reciprocal IVF instead of traditional IVF with the donor’s sperm so that others would accept that they are both mothers. After coming home with a newborn, they can say that they are both mothers as one of them is a gestational mother because she gave birth, and the other partner is the genetic mother as her DNA has been used in the baby–making process. So, no one can doubt that both women are parents, eliminating doubts about their family roles.

The ROPA Process for Lesbian Couples

The reciprocal IVF process is identical to standard IVF. The only difference is that reciprocal IVF allows couples to share the experience of pregnancy as both partners participate in the process. One partner undergoes fertility testing to ensure a healthy uterus and optimal hormone levels. If all is clear, they select a sperm donor. While the partner who will be implanted with an embryo receives the treatment to prepare her uterus to pregnancy (gestational mother), the other partner (biological mother) has to undergo ovarian stimulation cycle with hormonal medication to mature multiple eggs, which are then retrieved surgically. After fertilization with donor sperm, the resulting embryos can be genetically tested before one or more are transferred to the partner chosen to carry the pregnancy. A positive pregnancy test two weeks later confirms success.

Understanding the Cost of Reciprocal IVF & Affecting Factors

The cost of reciprocal IVF is incredibly variable and depends on: 

  • The Location (This includes country, state, and even the specific clinic the couple choose).
  • Legal Fees: Legislation around reciprocal IVF vary from country to country and from state to state within the same country, which is why the couples are suggested to seek legal counsel and have legal paperwork filed with the court that ensures both partners are recognized as legal parents, as well as the legal rights to the resulting embryos). 
  •  Program Type: The Live Birth Guarantee, Multi Cycle with multiple transfers (DuoStim/ MultiStim), medication protocols, additional screenings and procedures, additional consultations and services, which can influence the price.
  • Sperm Donation: Sperm source (anonymous vs. known donor), non–premium vs. premium donor, local vs. traveling donor (premium donation packages are more expensive, and premium donors receive a higher compensation per donation including travel fees, accommodation, the donor’s insurance, expenses in case of canceled donation), fresh vs. frozen donor’s sperm (legal fees, shipping fees, export and import fees, fertility clinic fees for storing and using frozen sperm) impacts the cost.
  • Number of Cycles Initiated to Achieve a Viable Pregnancy: Multiple egg retrieval cycles, embryo transfers, or additional procedures like vitrification of the embryos will add to the cost.
  • Add–on Services: Assisted hatching, mock transfer, genetic testing, and sex selection are optional services with additional fees).

In most cases, reciprocal IVF winds up costing around the same amount as traditional IVF with donor eggs, averaging about $25,000 including legal fees in the United States and Canada and under $11,000 across the Europe. This rate is variable based on any additional services or treatments required, such as whether the couple adds preimplantation genetic testing and additional cryotransfers (for example, some clinics offer one fresh transfer and two cryotransfers in case the fresh transfer fails). Some clinics may have higher fees for a double blastocyst transfer when two embryos are transferred per cycle. Also, unmarried couples participating in reciprocal IVF will need to seek legal counsel to ensure that they have equal parenting rights and that they establish their legal rights for the resulting embryos.

While it is difficult to provide precise figures, expect to pay up to $30,000 in the United States and Canada and under $11,000 in European countries. However, this is an estimate, and the actual cost can be higher or lower depending on your specific needs and location. Reliable cost comparisons across continents can be challenging due to variations in healthcare systems and currency exchange rates. Consulting with local fertility clinics and legal professionals is crucial for obtaining the most accurate cost estimates for your specific situation.

Considering Regional Variations:

While the factors mentioned above significantly influence the overall cost, reciprocal IVF costs can also vary depending on the specific country you choose for treatment.

Shared IVF in Canada 

Legal status: Lesbian couples in Canada have access to fertility treatments with supportive legislation. The key piece of legislation is the Assisted Human Reproduction (AHR) Act, which prohibits discrimination based on sexual orientation for accessing AHR services. This means lesbian couples can undergo fertility treatments like IVF and reciprocal IVF with equal rights as heterosexual couples.

However, it is important to note that the AHR Act doesn’t regulate the specifics of parentage in these situations. Some provinces might have additional legislation regarding parental recognition for children born through AHR for non–biological mothers. Consulting with a lawyer specializing in family law can ensure a smooth process and establish legal parenthood for both partners in your specific province.

The Cost of ROPA in Canada

Reciprocal IVF in Canada carries a variable price tag, typically ranging from $10,000 to $20,000 per cycle. This cost can fluctuate depending on several factors:

  • Clinic fees: Individual clinics set their own base prices for procedures and services included in a reciprocal IVF cycle.
  • Medications: The amount and type of fertility medications required for both partners can significantly impact the overall cost.
  • Additional procedures: Some cycles might require additional procedures like intracytoplasmic sperm injection (ICSI), mock transfer or genetic testing, which add to the final bill.
  • Province of residence: Government funding for fertility treatments varies across provinces. Some provinces offer partial coverage for specific procedures, while others don’t offer any financial assistance.

Fertility Clinics with Reciprocal IVF Programs in Canada 

With more than 50 IVF clinics across its territory, Canada offers lesbian couples a variety of options for pursuing parenthood through reciprocal IVF. However, it is essential to understand that government funding for fertility treatments varies by province. While some provinces offer partial coverage for specific procedures, others don’t. Here are 10 reputable clinics with established ROPA programs:

ROPA in the United States 

Legal status: There are no federal restrictions on lesbian couples accessing standard IVF procedures including shared IVF (reciprocal IVF) in the United States. Clinics may have their own policies, but sexual orientation cannot be a legal reason to deny treatment. However, some states have specific laws regarding parentage establishment for children conceived through assisted reproductive technologies (ART), like reciprocal IVF. In these cases, legal steps might be necessary for the non–gestational partner (egg donor) to secure parental rights.

The Cost of Shared IVF in the United States

Reciprocal IVF in the United States can be a significant financial investment, with costs ranging anywhere from $10,000 to over $30,000 per cycle. On average, couples can expect to pay around $19,500, which is comparable to traditional IVF using donor eggs. Medication is a major cost factor, typically adding $3,000 to $8,000 per cycle on top of the base procedure fees. The location also plays a role, with clinics setting their own prices.

Several factors can influence the total cost:

  • Insurance Coverage: Some insurance plans might offer coverage for reciprocal IVF, potentially reducing the overall cost.
  • Medications: The amount of medication needed for both partners can significantly impact the final bill.
  • Clinic Location: Geographical location can affect clinic pricing.
  • Number of Cycles: Success rates for pregnancy vary, and additional cycles may be required, adding to the total cost. Each additional embryo transfer can range from $3,000 to $5,000.
  • Sperm Donation: If sperm donation is needed, sperm bank vials typically cost around $1,000 each, with clinics often recommending purchasing multiple vials.

Fertility Clinics with ROPA Programs in the United States 

The United States hosts an impressive network of over 500 fertility clinics offering various assisted reproductive technologies, including reciprocal IVF. Almost all American clinics have dedicated coordinators for IVF cycles, financial counseling options, and inclusive support groups for intended parents. For lesbian couples considering the ROPA method, thorough research is key to finding the right clinic. Here are 15 top–rated clinics with established ROPA programs:

Reciprocal IVF in Mexico 

Legal status: Lesbian couples in Mexico have access to In Vitro Fertilization (IVF) itself, as there are no national restrictions on the procedure. Instead of a routine IVF with donated sperm when only one partner is involved in the process, female couples may explore alternative options such as reciprocal IVF, where one partner provides the oocytes and the other one carries the pregnancy.

The Cost of Co–IVF in Mexico 

In Mexico, IVF cycles for lesbian couples typically range from $7,000 for the basic procedure to over $9,000 for all–inclusive packages with medications and monitoring.

Premium programs with two or three IVF cycles, preimplantation genetic testing (to assess for chromosomal abnormalities or screen for gene disorders in embryos), gender selection option, multiple blastocyst transfers (a more developed embryo stage for potentially higher implantation rates), frozen embryo transfers (thawed embryos used for implantation if the initial fresh transfer fails), and vitrification (freezing) of any remaining embryos for future use are available at a higher cost vs. basic ones, starting at $11,900.

Fertility Clinics with ROPA Programs in Mexico

Mexico has nearly 75 fertility clinics, some of which are the branches of the large networks. While not all IVF centers in Mexico offer Co–IVF (ROPA), several well–regarded clinics specialize in this treatment for lesbian couples. Here are a few examples:

ROPA in Panama

Legal status: In Panama, the legal landscape regarding fertility treatments for lesbian couples offers some possibilities but lacks full clarity. While same–sex marriage and adoption by same–sex couples are not currently legal, there is no legal barrier for lesbian couples to access In Vitro Fertilization (IVF). This means both traditional IVF and reciprocal IVF, where one partner provides the eggs and the other carries the pregnancy, are technically possible.

However, there are some uncertainties. Panamanian law doesn’t explicitly address parentage establishment for children born through ART procedures for non–biological mothers in same–sex couples. To ensure legal parenthood for both partners, consulting with a lawyer specializing in family law is highly recommended.

Reciprocal IVF Cost in Panama 

Reciprocal IVF in Panama presents a generally more affordable option than in the United States or Canada. Costs typically range from $9,000 to $15,000 per cycle, making it a financially attractive destination for some couples. However, it is important to consider several factors that can influence the final price tag:

  • Clinic fees: Individual clinic pricing structures can vary. Be sure to get a detailed breakdown of all costs included in their ROPA program.
  • Medications: The medications required for both partners can significantly impact the overall cost. Fertility medications can fluctuate in price depending on dosage and brand.
  • Sperm donation: Sperm donation adds to the cost, with sperm bank vials typically ranging from $500 to $1000 each.
  • Additional procedures: Certain situations might require additional procedures, such as Intracytoplasmic Sperm Injection (ICSI) or genetic testing, which would add to the final bill.

Consulting with chosen clinics in Panama for personalized quotes and exploring any potential payment plans they offer will help to get a more accurate total cost.

Fertility Clinic with Shared IVF Program in Panama

  • Panama Fertility

Reciprocal IVF in Colombia

Legal status: The Colombian Constitution itself prohibits discrimination, allowing all couples, heterosexual and same–sex, to access fertility care. Lesbian couples have access to a wide range of fertility treatments to help them build their families. This includes intrauterine insemination (IUI), in vitro fertilization (IVF) with donor sperm, and reciprocal IVF.

The Cost of ROPA in Colombia 

In Colombia, reciprocal IVF cost generally ranges from $10,000 to $20,000. Additionally, fertility clinics may have specific packages adjusting for different cases like reciprocal IVF with one fresh and one cryotransfer, ROPA with preimplantation genetic testing, shared IVF with transfer of two blastocysts and vitrification of the remaining embryos, the cycles with DuoStim protocols and vitrification of all resulting embryos for future use, or pricing structures for Premium packages (depending on the services included), so contacting clinics directly would be the best way to get a more accurate estimate.

Top IVF Clinics in Colombia:

ROPA in Argentina 

Legal status: Since 2013, lesbian couples have equal access as hetero couples to IVF treatment. This legislation was passed with overwhelming support in the House of Deputies, reflecting Argentina’s strong stance on LGBTQ+ rights.

The Cost of Shared IVF in Argentina 

The estimated cost of basic reciprocal IVF varies from $4,900 to $6,900 depending on the protocol (Single Stim or Duo Stim), the number of egg retrievals (one or two), the type of sperm donation (fresh or frozen) and associated costs, the type of fertilization (conventional or ICSI), and other services involved. The basic cost doesn’t include medications, genetic testing, sex selection, vitrification of embryos, or additional transfer attempts. 

Premium packages are available for a higher starting price (around $7,900). Basically, such programs cover intracytoplasmic sperm injection (ICSI), at least two vials of cryopreserved donor’s sperm or fresh sperm donation, blastocyst transfer, vitrification of extra embryos, one or two cryotransfers (if fresh transfer failed), and re–vitrification of embryos (if necessary).

Fertility Clinics with ROPA Programs in Argentina

Argentina hosts more than 60 fertility clinics, with some specializing in shared motherhood programs. Lesbian couples seeking ROPA can explore their options at several clinics, including:

Shared Motherhood in Brazil 

Legal Status: Brazil has emerged as a frontrunner in LGBTQ+ rights, and this extends to fertility treatments for lesbian couples. Since 2011, lesbian couples, along with single women, have enjoyed full access to fertility treatments, including In Vitro Fertilization (IVF) with donor sperm. Additionally, Brazil recognizes reciprocal IVF (ROPA) as a legal option. There are no additional legal hurdles for the non–gestational partner to be recognized as a legal parent, as long as the couple is in a stable union.

ROPA IVF Cost in Brazil 

In Brazil, each IVF cycle, which includes medications, procedures, and embryo transfer, can cost an average of $5,000. This cost may vary depending on the specific clinic, medications used, and additional procedures needed. However,  health insurance coverage for fertility treatments is uncommon in Brazil. Therefore, lesbian couples considering ROPA should factor in the potential for multiple cycles and the associated financial burden.

Top IVF Clinics in Brazil:

ROPA IVF in Portugal 

Legal Status: Portugal has adopted inclusive legislation for same–gender female couples that gives them the same access to medically assisted procreation (MAP) as heterosexual couples. When conceiving through MAP, lesbian couples have equal parental rights according to current law. Regardless of the source of oocytes or who carries the pregnancy, both partners have identical legal rights over their children and are recognized as legal mothers.

The marital status does not impact the ability to access assisted reproductive technologies. Unlike Spain, where marriage is required, in Portugal, ART is available for unmarried and married couples without any change in the rights that each member of the couple has over the embryos that are created.

The Cost of Reciprocal IVF in Portugal 

Typically, the basic ROPA treatment in Portugal costs between €4,950–€5,000 and €5,200, including embryo transfer procedure. Most of basic bundles do not cover medication, clinical analysis, vitrification and storage of embryos, preimplantation genetic diagnosis (if necessary), additional cryopreserved embryo transfers or donor’s sperm associated costs. Some clinics may also charge between €100 and €190 for the first fertility consultation, while most fertility centers have a complimentary initial consult to discuss the options and review the medical history. 

Fertility Clinics with Shared Motherhood Programs in Portugal

While Portugal has numerous IVF clinics, only a select few offer Reciprocal IVF (ROPA) programs. Here is a list of some clinics known to provide ROPA services:

ROPA IVF in Span 

Legal Status: The legal framework governing ROPA in Spain (The Spanish Assisted Reproduction Law 14/2006) is inclusive, allowing female couples to access a range of assisted reproductive technologies (ART) while maintaining a strong commitment to safety and ethics. Unlike Portugal, where marriage is not required, and unmarried couples may access IUI and IVF services, in Spain, only married lesbian couples are eligible for fertility treatment. Like in Portugal, both partners will have the same obligations and legal rights of the future child conceived via IVF. Babies who are born using a ROPA method can be legally registered in Spain as having two mothers.

The Cost of Reciprocal IVF in Spain 

In Spain, the basic ROPA IVF program cost ranges from €5,990 to €6,990. ROPA in Spain typically costs between €5,990 and €6,990 for the basic program. This covers most essential steps, including initial and follow–up consultations/appointments, ultrasound scans, bloodwork during the stimulation cycle, egg retrieval, conventional fertilization or ICSI with donor’s sperm (some bundles include one or two vials of frozen donor’s sperm), blastocyst transfer, embryo vitrification and storage for 12 months, pregnancy test, pregnancy confirmation ultrasound, and final appointment. Medications, genetic testing, additional cycles, and frozen embryo transfers are usually extra.

Premium programs may include pre–ROPA screening, genetic compatibility test, one fresh and up to three frozen transfers of embryos, and series of pregnancy tests and ultrasound scans. A few premiums may also include two or three fresh cycles, preimplantation genetic testing, and a mock transfer. Such programs are usually more expensive, starting at €7,900.

Fertility Clinics with Shared Motherhood Programs in Spain:

Shared Motherhood in France

Legal Status: France legalized gay marriage in 2013. However, access to fertility treatments like IVF remained restricted to heterosexual couples until 2021. In 2021, the French parliament approved a bill that gives lesbian couples and single women access to fertility care and treatments for the first time. This overturned previous restrictions that limited access to fertility care, making medically assisted reproduction accessible to all women regardless of sexual orientation or relationship status. The new law allows all women under 43 to undergo IVF with donor sperm, eliminating the need for French women to travel abroad for these fertility treatments.

The Cost of ROPA Treatment in France 

Lesbian couples in France considering reciprocal IVF are encouraged to research and compare costs at different fertility clinics. This includes inquiring about pregnancy options, available programs, any success guarantees offered, and the specific breakdown of treatment costs.

Top French Fertility Clinics

France hosts a network of renowned fertility clinics dedicated to assisting two–mom couples on their journey to parenthood. Here are some of the leading facilities:

  • Procrealis 
  • Nataliance
  • Centre d’Assistance Médicale à la Procréation NatiFiv
  • Centre de Fertilité Bayonne Belharra 
  • Le centre d’Assistance Médicale à la Procréation du Blanc Mesnil

ROPA Treatment in Norway 

Legality: While lesbian couples can legally undergo IVF with donor sperm in Norway, the legal status of Reciprocal IVF (ROPA) remains unclear. This lack of clear legal guidelines can create uncertainty. It is advisable for lesbian couples in Norway considering ROPA to consult with a lawyer specializing in family law and fertility rights. They can provide the latest advice on the feasibility and potential legal implications of pursuing ROPA in Norway.

The Cost of Shared IVF Treatment in Norway

Female couples should expect to pay between €4,400 and €5,000 for the basic program, including fertility tests and initial consultations. Some clinics may charge higher fees, especially for programs with backup options like additional attempt using a frozen blastocyst or preimplantation genetic screening. Premium packages with multi–cycle IVF and add–ons, such as endometrial receptivity test(s) before embryo transfer, mock transfer, EmbryoGlue (a special culture medium), preimplantation genetic testing and other services price tag starts at €6,000 excluding medications.

Top IVF Clinics in Norway: 

  • Klinikk Hausken
  • Livio 
  • Fertilitetssenteret

Reciprocal IVF in Denmark 

Legal Status: In Denmark, lesbian couples and single women can access Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) using donor sperm, including the ROPA method.

Medically Assisted Reproduction (MAR) treatments in Denmark are regulated by several laws. The primary law is number 460 of June 1997 on artificial fertilization in connection with medical treatment, diagnosis, and research. This law was amended in 2006 (law number 535 of June 8, 2006) to allow unmarried women and lesbian couples to access MAR and extend the storage period for frozen eggs from 2 to 5 years. Most significantly, in January 2018, the Danish Parliament further amended the law, permitting double donation. This means both the egg and sperm cells used in IVF can come from anonymous donors.

The Cost of Shared IVF in Denmark

Shared IVF, also known as ROPA, can be an attractive option for female couples in Denmark. However, the exact cost can vary depending on the specific clinic and any additional services required. To get a more accurate estimate, female couples considering shared IVF in Denmark should contact fertility clinics directly.

Top Denmark’s IVF Clinics

Here are some of the leading fertility clinics in Denmark, known for their expertise and success rates:

  • Aagard clinic 
  • Trianglen Fertility Clinic 
  • Fertility clinic IVF–SYD

Shared IVF in Austria

Legal Status: Lesbian couples, married, in a registered partnership or civil community can access fertility treatments, including reciprocal IVF, under a Fortpflanzungsmedizinrechts–Änderungsgesetz (FMedRÄG) 2015 law. In this process, both women become legal parents of the child. The woman who provides the eggs (genetic mother) and the woman who carries the pregnancy (gestational mother) are both listed as legal parents of the newborn.

The Austrian IVF Fund helps cover 70% of the cost for eligible couples (Austrian/EU citizens or residents with a medical diagnosis of at least one partner such as blocked fallopian tubes, endometriosis, or polycystic ovary syndrome (PCOS)). The fund covers a maximum of 4 treatment cycles (including medication) per couple, per pregnancy achieved, but couples need to pay 30% upfront before embryo transfer.

The Cost of Reciprocal In Vitro Fertilization in Austria 

The cost of Reciprocal In Vitro Fertilization in Austria can vary depending on the specific clinic and individual circumstances. However, the couples can expect a range of €2,900 to €7,000. This cost may not include additional fertility medications or procedures, so consulting directly with a clinic is important to get a personalized quote for the situation.

Top Fertility Centers in Austria 

Before choosing a fertility center, it is essential to research and compare the options. Consider factors like success rates, available treatments, patient reviews, and cost. Here are four of the leading fertility centers in Austria, known for their expertise and success rates in helping female couples achieve pregnancy:

  • Kinderwunschzentrum an der Wien
  • Döbling Outpatient Clinic – Fertility Center
  • Kinderwunschklinik Graz – Dr. Došen
  • Tiny Feet

Reciprocal IVF in Cyprus 

Legality: Lesbian couples can access IVF in Cyprus with no legal restrictions. This welcoming environment is reflected by many Cypriot fertility clinics openly advertising their services to lesbian couples, including experience with ROPA (Reciprocal Ovulation and Partner Assisted Reproduction). While there isn’t specific legislation addressing ROPA itself, the general legal framework regarding fertility treatments is positive for same–sex couples.

ROPA Сost in Cyprus 

The cost of ROPA IVF in Cyprus can vary depending on the specific clinic, additional medications or procedures needed, and the chosen sperm source (own sperm or donor sperm). However, it generally falls within a range of €4,000 to €5,750. Here is a breakdown:

  • Base Cost: Some clinics offer a base package for ROPA itself, typically around €4,000.
  • Sperm Source: Using donor sperm incurs an additional cost, raising the total to around €5,250–5,750.
  • Additional Costs: Fertility medications and other procedures like embryo freezing may incur separate charges.

It is important to consult directly with Cypriot fertility clinics to get a personalized quote that reflects your specific needs.

Top Cypriot IVF Clinics 

Cyprus hosts nearly 50 fertility clinics, offering a wide range of services to Cypriot and international patients. This abundance of options allows couples to find a clinic that aligns with their specific needs and budget. Here are some of the leading Cypriot IVF clinics known for their expertise and experience in working with lesbian couples seeking IVF, including ROPA procedures:

ROPA IVF in the UK 

Legal Status: The United Kingdom recently introduced significant changes to its IVF legislation, making the process more accessible and equitable for couples with fertility issues. This reform eliminates an outdated law that required same–sex female couples undergoing reciprocal IVF to pay up to £1,000 for screening for infectious diseases such as hepatitis B, hepatitis C, or rubella which is not mandated for heterosexual couples. This change removes a financial barrier and promotes equal access to fertility treatments. Additionally, the new legislation allows same–sex couples where one or both partners have an undetectable HIV viral load to pursue IVF, along with known sperm or egg donation to friends or relatives. This update expands access to IVF for a wider range of couples facing infertility.

Reciprocal IVF cost in the UK

While the recent legal changes in the UK make reciprocal IVF more accessible, the overall cost can still be a significant factor for couples. The price can vary depending on the clinic, medication needs, and additional procedures. Typically, medication for the partner who provides her eggs can range from £975 to £2,600 per cycle, while the recipient partner’s medication costs less, around £250 to £500. There are also pre–treatment tests and potential add–on procedures that can add to the total cost. The cost of shared IVF varies between £6,250 and £7,000 per cycle. For treatments involving the import of donor’s sperm, expect to pay between £150 and £200 (for domestic) between£600 and £750 (for international). Additionally, storing frozen embryos incurs annual fees. It is important for couples to consult with clinics and understand the full financial picture before embarking on a reciprocal IVF journey.

Top Fertility Clinics in the UK:

  • Harley Street Fertility Clinic
  • Care Fertility 
  • The Centre for Reproductive & Genetic Health 
  • Salisbury Fertility Centre
  • Create Fertility
  • London Women’s Clinic
  • The Fertility & Gynecology Academy

Shared Motherhood in Ireland

Legal Status: Ireland doesn’t have specific legislation for reciprocal IVF, also known as shared motherhood. While the Children & Family Relationships Act (2015) covers egg donation, it doesn’t directly address this process. However, since May 2020, there seems to be a legal pathway. If both partners undergo the procedure in an Irish clinic and meet certain criteria, they can be recognized as legal parents without needing additional legislation. Still, the lack of specific regulations creates some uncertainty, and the Health (Assisted Human Reproduction) Bill 2022, currently in development, could provide more clarity on this aspect of fertility treatments in Ireland.

Cost of ROPA IVF in Ireland

The estimated cost of ROPA IVF in Ireland ranges from €7,500 to €8,500. It is worth noting that this is just a starting price, and the final cost may vary depending on the specific clinic, medications needed, and the number of embryo transfers required. Additional expenses like genetic testing and sperm donor fees might also apply.

Top IVF Clinics in Ireland:

  • ReproMed Fertility Clinic
  • Thérapie Fertility
  • Waterstone Clinic 

Fertility Options for Lesbian Couples (Non–ROPA IVF)


Legality: Reciprocal IVF is legal in Finland. The country’s fertility law allows lesbian couples to undergo IVF with donor sperm, and there are no legal barriers to the ROPA process (one partner providing eggs, the other carrying the pregnancy).

Although shared IVF is allowed, most Finnish clinics offer intrauterine insemination and IVF with donor’s sperm.

Among the top fertility centers in Finland, there are: 

  • Ovumia 
  • Gynova Klinikka
  • Felicitas Mehiläinen 


Legality: Sweden allows lesbian couples to access IVF with donor sperm. Currently, there is no specific legislation directly addressing ROPA in Sweden. A key hurdle is the Genetic Integrity Act, which restricts egg donation to heterosexual couples with the biological sperm of the male partner. This effectively prevents lesbian couples from using eggs from one partner within a ROPA procedure.

Instead of reciprocal IVF, women–only couples opting for assisted reproduction may access IUI and IVF with donated sperm.

Top fertility clinics in Sweden: 

  • Nordic IVF 
  • FertilitetPlus
  • Livio


Legal Status: Lesbian couples in the Netherlands have access to fertility treatments, including reciprocal IVF, also known as ROPA (Reception of Oocytes from Partner). This method allows them to share the experience of pregnancy and parenthood. One partner provides the eggs, undergoing ovarian stimulation and retrieval. The fertilized eggs are then implanted in the other partner’s uterus, who carries the pregnancy and delivers the baby. Dutch law recognizes both partners as legal parents of the child without the need for adoption, as long as they are in a registered partnership or married. This legal clarity and access to advanced fertility treatments make the Netherlands a welcoming option for lesbian couples looking to build a family.

Top fertility clinics in the Netherlands: 

  • Amsterdam UMC
  • Isala Kampen 


Legal Status: In Belgium, IUI and IVF with donor sperm have been accessible to lesbian couples and single women since 2007, with full coverage.

In Belgium, since 2007, lesbian couples and single women have full coverage for fertility treatments, including Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) with donor sperm. This progressive legislation extends to reciprocal IVF (Reception of Oocytes from Partner). Unlike some countries, Belgium doesn’t require additional legal procedures like adoption for the non–gestational partner to be recognized as a legal parent. This streamlined process and financial support make Belgium a very attractive option for lesbian couples seeking to build a family through assisted reproduction.

Top fertility clinics in Belgium:

  • Fertility Clinic Brussels
  • Brussels IVF


Legal Status: As of July 2022, following the legalization of same–sex marriage, Switzerland allows lesbian couples to access some fertility treatments with donor sperm. This includes Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI). However, the legislation currently does not explicitly address reciprocal IVF (ROPA). While some clinics might offer it on a case–by–case basis, there шs no clear legal framework for establishing parental rights for the non–gestational partner. This lack of clarity can be a hurdle for lesbian couples seeking a more shared experience of parenthood through ROPA. Advocacy efforts are ongoing to push for legislation that grants full access to reciprocal IVF and simplifies the legal process for lesbian couples to become parents.

Top fertility clinics in Switzerland:

  • Fertility Medicine and Gynecological Endocrinology CHUV Maternity Unit
  • OVA IVF Clinic Zurich
  • Kopelli Klinik
  • Kinderwunsch Zentrum Zürich


Legal Status: Lesbian couples in Latvia have access to In Vitro Fertilization (IVF) using donor sperm. However, the legislation regarding reciprocal IVF, also known as ROPA (Reception of Oocytes from Partner), is less clear. While the law doesn’t explicitly prohibit it, lesbian couples are currently treated as single women when undergoing IVF. This means the intended gestational carrier would need to adopt the child after birth, which can be a lengthy and bureaucratic process. There is growing interest in establishing clear legal pathways for ROPA in Latvia, but for now, the process lacks the legal certainty some couples may desire.

Top fertility clinics in Latvia:


Legal Status: While there is no clear information on the legal status of fertility treatments for lesbian couples in Estonia, some sources suggest access to sperm donation for IVF might be possible. However, the legal framework surrounding reciprocal IVF (ROPA) remains unclear. This lack of clarity creates uncertainty for lesbian couples seeking to build a family through assisted reproduction. Further research into Estonian legislation or contacting fertility clinics directly would be necessary to get a more definitive picture.

Top fertility clinics in Estonia:


Legal Status: Albania has an open–access policy for In Vitro Fertilization (IVF) and other assisted reproductive technologies, extending this access to unmarried couples, single individuals, and lesbian couples. While there isn’t any specific mention of reciprocal IVF (ROPA) in legislation, Albania’s openness to various fertility treatments suggests it might be a possibility. For lesbian couples considering ROPA, consulting a local fertility clinic is advisable to understand the legalities involved.

Top fertility clinics in Albania:

  • American Hospital


Legal Status: Bulgaria offers a welcoming environment for lesbian couples seeking fertility treatments. The law permits assisted reproduction for unmarried couples, single women, and lesbian couples alike. This means lesbian couples can access IVF with donor sperm without any legal hurdles. Additionally, Bulgaria takes a progressive approach by allowing reciprocal IVF (ROPA).

Top fertility clinics in Bulgaria:

  • NOVA Radost
  • Nova Clinic
  • Mother’s Home
  • ReproBioMed
  • Medical Center Afrodita
  • Adella Clinic


Legal Status: Lesbian couples in Romania have access to fertility treatments, including In Vitro Fertilization (IVF), thanks to a 2005 Constitutional Court ruling. This decision declared it unconstitutional to deny medically assisted reproduction based on marital status or sexual orientation. Therefore, lesbian couples can legally pursue parenthood through IVF using donor sperm.

Top fertility clinics in Romania:

  • IASI – Origyn Fertility Center
  • Genesis Athens
  • Clinica Fertilia Medical

Countries with Restrictions on Lesbian Fertility Treatments

While many countries offer lesbian couples access to fertility treatments, some still have restrictions. He is a list of countries where lesbian couples currently face limitations:

  • Central Europe: Czech Republic, Slovakia, Hungary (allows for single women but not couples), Slovenia (referendum rejected access for lesbian couples in 2001)
  • Eastern Europe: Poland, Lithuania, Belarus, Moldova, Ukraine
  • Southeast Europe: Bosnia and Herzegovina, Montenegro, North Macedonia, Serbia
  • Western Europe: Germany (exceptions may exist)
  • Southern Europe: Italy (no access to fertility treatment or legal recognition of same–sex parenthood)
  • Other: Croatia (limited to married heterosexual couples and single women)

Note: Information for some countries may be limited.

Additional Considerations:

This list focuses primarily on legal restrictions for lesbian couples. Some countries might have social or cultural barriers that make accessing fertility treatments difficult.

Laws and regulations can change. It is advisable to research the latest information for your specific situation.

Reciprocal IVF: A Path to Shared Motherhood

Reciprocal IVF offers lesbian couples a unique opportunity to share the experience of motherhood biologically and create a unique bond between both partners and baby or babies in case of multiples, unlike traditional IVF or adoption. It allows both partners to contribute directly to the creation of their child, fostering a sense of equality and shared parenthood. While legal hurdles and societal biases persist, reciprocal IVF empowers female couples to build their dream families on their own.

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