Reciprocal IVF: What to know, from how it works to how much it costs

"Facing Fertility" Part 2: Egg freezing

Reciprocal IVF, or partner-assisted IVF, is a family planning option gaining visibility online.

On TikTok alone, there are nearly 19 million views for the abbreviated hashtag #RIVF with videos of LGBTQ couples sharing their journey with the fertility process.

"It's not that it's new, it's because we're having more open dialogue with that community and how they can become families... it's catching on," says Dr. Jessica Shepherd, OB-GYN and chief medical officer of Verywell Health, explaining why we're seeing more about RIVF. 

To better understand the process, we spoke to experts about what to know about this fertility option: 

How does reciprocal IVF work?

RIVF, which is for partners who both have uteruses, is similar to traditional IVF in that an egg is retrieved, fertilized and then placed back to develop and grow. But with RIVF, the egg is taken from one partner, fertilized with donor sperm and placed back in the other partner.

"Instead of creating the embryo and putting it back in the person that we did the egg retrieval on, we are putting it in their partner," explains Alease Daniel Barnes, an embryologist based in North Carolina.

Why do people choose RIVF?

There are a few reason same-sex couples may choose RIVF, including the emphasis on both partners having a vital role in the journey. 

"It's more of a concerted effort to ensure that both partners have a connection to the whole pregnancy process, whether they're (providing the egg) or the carrier," Shepherd explains. "You have a partner that has a genetic connection to the child and then the other one has more of a biologic bond to the to the child through carrying."

Daniel Barnes adds there are also other things to consider as physicians are counseling patients, including: 

  • who may be more suitable to undergo the egg retrieval
  • age
  • family history
  • ovarian reserve
  • anatomy  
  • personal or social considerations

For example, Daniel Barnes says a patient may not have a uterus anymore but still have ovaries, meaning "they may not be a candidate to carry but they still have ovaries left so we can do the (egg) retrieval."

In other instances, "there may be a partner who absolutely does not want to carry" but wants their eggs used, Daniel Barnes explains. "We want to make sure that they're happy with their decision and how they want to build their family."

IVF or RIVF may also be an option for same-sex couples who have already tried other methods like intrauterine insemination and were unsuccessful. 

How long does RIVF take?

"It's a similar amount of time to traditional IVF (but) it really kind of depends on their full treatment plan," Daniel Barnes says, explaining there is some prep work as well as options for different testing that can add time.

Typically, however, it can take anywhere from 6-8 weeks to 12-16 weeks, she says.

How much does it cost?

Reciprocal IVF is not cheap, experts say. 

"Thankfully, insurance is getting better, but it's still not quite where we want it to be," Daniel Barnes says, adding that it's fairly comparable to the price of an IVF cycle done by a heterosexual couple, with added costs for RIVF usually coming in the form of donor sperm.

But the total price can vary widely depending on insurance, testing opt-ins, the clinic and location.

For example, Daniel Barnes says around $20,000 is the higher end of costs she's seen, while Shepherd estimates it can be as much as $30,000-plus.

"I think roughly 25% of Americans have coverage for IVF, and usually, it's not the whole thing," Shepherd adds. "Coverage may include just the consult with the doctor or the consult and a few visits." 

Why is visibility important?

Daniel Barnes says increased visibility of options like reciprocal IVF can help make conversations easier, especially for LGBTQ people who may fear judgment or discrimination in seeking fertility information from medical professionals. 

"Unfortunately, a lot of queer couples didn't know that it was an option," Daniel Barnes says, adding social media has been a large part of bringing reciprocal IVF to the forefront.

"There's couples out there who have done reciprocal IVF... and they're able to give their personal experience, (which) can help encourage other couples who were considering it but may have been too scared to go and seek it out," she adds. "It has pushed clinics to talk about it (too)... a lot of clinics are saying we need to focus on this and talk about how we support these couples. I think that's ultimately a positive thing."

"Facing Fertility" Part 1: The reality of IVF
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