Reciprocal IVF – What Is It and What are the Phases? By Clinica Tambre

As part of Lesbian Visibility Week, we hear from one of our trusted partner fertility clinics, Tambre, in Madrid, Spain – about the ROPA Method (otherwise known as ‘Reciprocal IVF’ in the UK). Clinica Tambre explains what it is, who it is offered to, and what the phases of fertility treatment are with donor sperm.

Words by Clinica Tambre

www.clinicatambre.co.uk | @clinicatambre

What is The ROPA Method?

The ROPA method (or reception of oocytes from the partner/reciprocal IVF) is an assisted reproduction technique exclusively for female couples, in which both women actively share motherhood. This technique has been legally recognised in Spain since 2007 and it is offered to same-sex female couples.

When / why is it used?

ROPA (or ‘shared motherhood’) enables both women to be actively involved in the fertility / baby-making process. One of the women provides the eggs (she will be the egg donor) and the other is the one who carries the pregnancy (she will be the recipient).

ROPA is performed when lesbian couples want to share motherhood, and the woman who is providing the eggs has a good ovarian reserve (AMH ‘Anti-Müllerian hormone’).

Related Article – Fertility Help: How Do BMI and Age Affect IVF and Fertility?

Phases of Treatment

1. Ovarian Stimulation (Egg Donor) – The woman who donates the eggs will undergo ovarian stimulation in the same way as if she were to undergo conventional in vitro fertilisation (IVF). This begins on the second or third day of the period and an ultrasound scan is performed to confirm that everything is at rest. The administration of hormonal medication is started and ultrasound checks are carried out every 48 hours. The stimulation process lasts from eight to twelve days on average. When the follicles measure around 18 mm, the last IVF injection will be administered, which will trigger ovulation (the ‘trigger shot’). After 36 hours, the ovarian puncture will be performed under sedation.

   2. Preparation of the Endometrium AKA ‘womb lining’ (Recipient) – The woman who receives the embryo (Recipient) must prepare her uterus lining in parallel, so that it has the best conditions for implantation. This preparation is usually done with oestrogens (oral/patches) and is done at the same time as her partner undergoes IVF ovarian stimulation. From the moment the eggs are obtained (on the day of the ovarian puncture), progesterone is added (vaginally) to increase the chances of implantation.

   3. Fertilisation and Embryo Culture – The eggs are fertilised with donor sperm. The embryos are then obtained and transferred to the recipient’s uterus. In most cases, an embryo will be transferred at the blastocyst stage (Day 5 of evolution), in order to have the best pregnancy / IVF success rates and to minimise twin gestation. If more good quality embryos are obtained in addition to the one(s) transferred, they can be frozen for future pregnancies, or for another embryo transfer, if the first one doesn’t work.

   4. Embryo Transfer (fresh or frozen) – The transfer to the Recipient’s uterus is done by means of a cannula, by which the embryos are deposited in the uterus (a simple and painless fertility procedure). This is carried out under ultrasound vision and, after that, the patient will need to rest for 20 minutes in one of our private rooms.

   5. Pregnancy Test – A blood pregnancy test (BETA) is carried out ten days after the embryo transfer.

 Related Article – Lesbian IVF Story: Our Big Gay Journey

Fertility Clinic Donor Sperm Selection Process

First Selection Criteria:

• Aged < 35 years old

• Minimum Height: 1.70m

• Maximum BMI: 30

First Visit with the Andrology Team:

• Anamnesis: no medical conditions, no familial diseases

• Explanation of the sperm donor process

Interview with the Psychologist:

• This includes psychological tests

Medical Tests:

• General Health Research:

  • Complete blood count

  • Blood group + RH

  • Biochemistry

  • G6PDH

  • Serology

• Andrological Tests:

  • Sperm count

  • Sperm and urine culture

  • PCR for Chlamydia

• Karyotype + Genetics:

  • Karyotype

  • Cystic fibrosis + other basic recessive mutations

  • Carrier status tests on +300 genes performed

Reciprocal IVF (ROPA) Cost

It is hard to give an exact cost for this fertility treatment, as it depends on the couple’s needs and personalised fertility care plan. It can range between 6,000 to 15,000 euros (between £5,000 and £12,500).

If you’d like more information about why Spain is the most popular destination for fertility treatment / IVF abroad and how it helps many LGBTQ+ women, the team at Clinica Tambre would be happy to answer your questions and help you on your fertility journey.