What is reciprocal IVF?
Reciprocal IVF, also called co-IVF or partner IVF, is a way for two women to share one pregnancy biologically. One partner provides the eggs. The other partner carries the pregnancy. Both are involved, in different ways.
It works in four steps:
- Donor sperm. You choose a donor from a licensed sperm bank. Your clinic orders and stores the vials.
- Egg retrieval. The egg-providing partner takes stimulation medications for about two weeks, then has an egg retrieval.
- Embryo creation. The lab fertilizes her eggs with the donor sperm and grows the embryos, usually to the blastocyst stage. Many clinics freeze them, with or without genetic testing.
- Transfer. The carrying partner prepares her uterus with medication and receives an embryo transfer. If it works, she carries the pregnancy and gives birth.
The carrying partner is not a surrogate. She is the birth mother and an intended parent. Reciprocal IVF is the usual first choice for lesbian couples when one partner can carry safely.
Many couples swap roles for a second child. The partner who carried first provides the eggs, and the other carries. Some couples instead use embryos from the same retrieval, so their children are full genetic siblings.
When does a lesbian couple need a surrogate instead?
Gestational surrogacy means a screened surrogate carries an embryo made from one partner's eggs, or donor eggs, and donor sperm. The surrogate has no genetic link to the child.
Couples turn to surrogacy when carrying is the problem, for either partner:
- Neither partner can safely carry. For example, a heart, kidney or autoimmune condition, or a cancer treatment, that makes pregnancy unsafe.
- Repeated failed transfers. Good embryos have been transferred to one or both partners several times without a lasting pregnancy.
- An absent or damaged uterus. From birth, from a hysterectomy, or from scarring.
- Recurrent pregnancy loss that your clinic cannot treat.
Your reproductive endocrinologist decides whether surrogacy is medically indicated. Surrogacy still allows both partners a role. One partner's eggs can create the embryos, and both of you are legal parents from birth. Some couples use one partner's eggs for the first child and the other partner's for the next.
You do not have to find a surrogate through an agency. If a relative or friend offers to carry, such as one partner's sister, that is gestational surrogacy with a known surrogate. PLS offers Cycle Management for parents who bring their own surrogate.
How does legal parentage work for both mothers in each path?
Reciprocal IVF. The carrying partner is the legal mother because she gives birth. The egg-providing partner needs her own route to parentage. Depending on the state, that is the marital presumption, a parentage order, or a second-parent adoption. Many attorneys recommend a court judgment even for married couples, because every US state and every foreign country must honor a court judgment, while not all honor a birth certificate alone. Reviewed by counsel.
Gestational surrogacy. Neither mother gives birth, so both secure parentage through the surrogacy process. Under the Illinois Gestational Surrogacy Act (2005), compensated gestational surrogacy agreements are enforceable and intended parents receive pre-birth parentage. The Equality for Every Family Act, signed in December 2025, removed the requirement that an intended parent be genetically related to the child, so both mothers receive the same pre-birth parentage regardless of which partner provided the eggs. It also requires independent counsel for both sides. Statute details are reviewed by counsel.
In both paths, the law of the state where the baby is born matters most. PLS does not employ attorneys. You and your surrogate each retain your own independent reproductive-law attorney. For the full comparison of pre-birth orders and second-parent adoption, see legal parentage for LGBTQ+ parents.
How do the costs compare?
Reciprocal IVF costs one IVF cycle plus donor sperm, billed by your clinic and the sperm bank. Surrogacy adds a surrogate compensation package, the agency fee and legal work, for a typical total of $131,000 to $155,000 before IVF and clinic fees and any new surrogate health insurance.
| Reciprocal IVF | Gestational surrogacy | |
|---|---|---|
| Who provides eggs | One partner | One partner, or an egg donor |
| Who carries | The other partner | A screened gestational surrogate |
| IVF and embryo creation | Set by your clinic | Set by your clinic |
| Donor sperm | Paid to the sperm bank | Paid to the sperm bank |
| Agency fee | None | $47,500 PLS program fee |
| Surrogate compensation | None | Typically $68,000 to $78,000 total, on a $60,000 first-time base (proposed) |
| Third-party costs | Your attorney, if you seek a court judgment | $15,300 to $29,000: attorneys for both sides, escrow, psychological evaluation, background check, insurance review, travel, monitoring |
| Typical total before clinic fees | IVF cycle plus donor sperm | $131,000 to $155,000 |
| Timeline | One IVF cycle, then pregnancy | Typically 18 to 24 months from signing to birth |
| Legal steps | Parentage route for the egg-providing partner | Surrogacy agreement, then parentage for both mothers |
If you need donor eggs for a surrogacy journey, add the egg donor costs. The PLS egg donation match fee is $11,000, or $8,500 bundled with surrogacy, plus donor compensation. In surrogacy, money for the surrogate is held by an independent licensed escrow agent, never by PLS: $10,000 at match and the balance before she starts medications.
How do the timelines compare?
Reciprocal IVF moves as fast as your clinic's schedule. Stimulation and retrieval take about two weeks. The carrying partner's transfer follows, in the same cycle or a later one if the embryos are frozen. A pregnancy test follows about 9 to 11 days after transfer, then about nine months of pregnancy.
Surrogacy typically takes 18 to 24 months from signing with PLS to birth:
- Signing to surrogate introduction: about 9 months today, with a target of 6 months or fewer.
- Legal and medical foundations: 1 to 2 months.
- The surrogate's medical cycle: 2 to 3 months, ending in a frozen embryo transfer.
- Pregnancy test: 9 to 11 days after transfer.
- Pregnancy: about nine months.
Embryo creation can run while PLS searches for your surrogate, so it rarely adds time. For how IVF fits into a surrogacy journey, see IVF for surrogacy.
Can we do reciprocal IVF first and keep surrogacy as a backup?
Yes. Many couples do exactly that. Embryos created for reciprocal IVF are frozen and can later be transferred to a gestational surrogate if the carrying partner's transfers do not work or if her health changes.
Three things make the switch easier:
- Freeze extra embryos. A retrieval that banks several embryos gives you options in either path.
- Keep records together. Your transfer history and your clinic's notes help a surrogacy clinic plan the next step.
- Talk to your clinic early. Ask how many transfers it recommends before considering a gestational carrier, and whether your embryos can be shipped if the surrogate uses another clinic.
Switching paths changes the legal work. In surrogacy, both of you secure parentage through the surrogacy process, and you need a gestational carrier agreement with your surrogate before any transfer.
How does PLS work with two-mom families?
The same way it works with every family, under one published standard. A two-mom journey is not a separate program with a separate price.
A nurse runs your match. Nancy Block, RN, founded PLS in 2017 after 17 years as an OB/GYN and fertility nurse and staff educator at Northwestern Memorial Hospital's Prentice Women's Pavilion. She has run egg donation and surrogacy matching since 2000. She is a former President of SEEDS, the Society for Ethics in Egg Donation and Surrogacy.
Surrogates are asked first. Every PLS surrogate is asked at intake whether she is open to same-sex couples. You are introduced only to surrogates who have said yes.
A physician reads every surrogate's records. Mark Silverberg, DDS, MD, PLS's Executive Director, reads every surrogate candidate's prenatal and delivery records and writes a physician medical summary that goes to your fertility clinic.
Donor sperm stays with specialists. PLS refers you to licensed sperm banks, and your clinic handles the order. Sperm bank fees are paid directly.
Professionals are independent. PLS does not employ attorneys, psychologists or escrow staff. It refers you to independent licensed professionals, so each answers to the person they were hired to protect.
Your surrogate is a partner. Her case manager, Natalie Gaudio-Fricano or Jenni Symons, has been a surrogate herself. Julie Bendix, MPH, RD, LD, CLC, holds at least six nutrition consults with her across the journey.
For the full guide for LGBTQ+ intended parents, see LGBTQ+ surrogacy. If you have a question first, SurrogacyHotline.com, PLS's sister site, answers free, usually within 24 to 48 hours.
Sources
- American Society for Reproductive Medicine (ASRM), guidance on gestational carriers and gamete donation.
- Illinois Gestational Surrogacy Act (2005), Illinois General Assembly. Pending review by counsel.
- Equality for Every Family Act, signed December 2025, Illinois General Assembly. Pending review by counsel.
- SEEDS, Society for Ethics in Egg Donation and Surrogacy.