“Her bun in my oven”: Motivations and experiences of two‐mother families who have used reciprocal IVF

• Published date: 01 February 2023
• Author: Kate Shaw,Susie Bower‐Brown,Anja McConnachie,Vasanti Jadva,Kamal Ahuja,Nick Macklon,Susan Golombok
• Date: 01 February 2023
• DOI: http://doi.org/10.1111/fare.12805

RESEARCH

“Her bun in my oven”: Motivations and experiences

of two-mother families who have used reciprocal IVF

Kate Shaw

1

|Susie Bower-Brown

1,2

|Anja McConnachie

1

|

Vasanti Jadva

3

|Kamal Ahuja

4

|Nick Macklon

4

|Susan Golombok

1

1

Centre for Family Research, University of

Cambridge, Cambridge, United Kingdom

2

Thomas Coram Research Unit, University

College London, London, United Kingdom

3

Institute for Women’s Health, University

College London, London, United Kingdom

4

London Women’s Clinic, London,

United Kingdom

Correspondence Susie Bower-Brown, Thomas

Coram Research Unit, Social Research Unit,

University College London, 27 Woburn

Square, London, WC1H 0AA, UK.

Email: s.bower-brown@ucl.ac.uk

Funding information

Economic and Social Research Council, Grant/

Award Number: ES/S001611/1

Abstract

Objectives: What motivates same-gender female couples to

choose reciprocal in vitro fertilization (IVF)? Do their

experiences of becoming and being a mother via reciprocal

IVF match their pre-parenthood expectations?

Background: Reciprocal IVF is a treatment route available

to cis, same-gender female couples, and other couples in

which both partners have a uterus and egg stores. One

partner’s egg is retrieved, fertilized in vitro with donor

sperm, then carried by the other partner. Existing debate

has considered the ethical implications of this treatment

route. To date, no empirical research has explored the

experiences of families who have used reciprocal IVF.

Method: Semistructured interviews were conducted with

genetic and gestational mothers in 14 families headed by

cis, same gender female couples who had conceived by

reciprocal IVF in the United Kingdom (N=28 mothers).

Data were analyzed according to the principles of reflexive

thematic analysis.

Results: Four themes were constructed: (a) becoming

mums together; (b) legitimacy: “who’s the real mum”;

(c) choices and constraints; and (d) biological connections

strengthen family connections.

Conclusion: Families had multiple and nuanced motiva-

tions for choosing reciprocal IVF, such as the desire to

share the journey of motherhood with their partner, to be

perceived as legitimate parents, to overcome practical bar-

riers, and to build strong family relationships. Mothers’

pre-parenthood expectations often mismatched the reality

of becoming and being a mother via reciprocal IVF. Most

Author note: Kate Shaw and Susie Bower-Brown are joint first authors.

Received: 9 May 2022Revised: 9 August 2022Accepted: 12 November 2022

DOI: 10.1111/fare.12805

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and

reproduction in any medium, provided the original work is properly cited.

© 2022 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.

Family Relations. 2023;72:195–214. wileyonlinelibrary.com/journal/fare 195

parents found that the significance of reciprocal IVF

diminished as their children grew up.

Implications: Findings demonstrate that reciprocal IVF

offers a fulfilling route to parenthood. Parents should have

access to routes to parenthood that meet their reproductive

needs and feel right for them as a couple.

KEYWORDS

assisted reproduction, biogenetic relationships, LGBTQ+, motherhood,

qualitative

INTRODUCTION

An increasing number of LGBTQ+individuals are pursuing parenthood (Family Equality,

2019) and cis, same-gender female couples make up the largest proportion of this group

(S. Goldberg & Conron, 2018). Same-gender female couples may become parents through vari-

ous routes, and although rates of adoptive parenthood are higher within LGBTQ+communi-

ties than non-LGBTQ+communities (S. Goldberg & Conron, 2018), many LGBTQ+

individuals desire biologically related children (Richards, 2014). This is typically achieved using

assisted reproductive technologies (ARTs). Due to technological advancements and changes in

societal attitudes and legislation, there has been rapid growth in the range of ARTs available to

same-gender female couples (Inhorn & Birenbaum-Carmeli, 2008).

One novel ART that is growing in visibility and popularity is that of reciprocal in vitro fertili-

zation (IVF), which isalso known as shared biological motherhood (Golombok et al., 2022), or

ROPA (reception of oocytes from partner; Marina et al., 2010). Through this novel procedure,

couples in which both parents have a uterus and egg stores (such as cis women, trans men and

non-binary people assigned female at birth) are able to “share”biological parenthood: One part-

ner’s egg is retrieved, fertilized in vitro with donor sperm, then carried by the other partner. One

parent has a gestational connection to their child, and the other has a genetic connection, provid-

ing many couples with the first opportunity to both be biologically connected to their child.

Although current legislation permits access to ARTs for same-gender female couples in

18 European countries (Calhaz-Jorge et al., 2020), there is a lack of information on whether

reciprocal IVF, specifically, is permitted. Bodri et al. (2018) noted that most European cases of

reciprocal IVF come from the United Kingdom and Spain, and in their clinical study of

121 couples, it was found that around 40% of mothers accessed reciprocal IVF for medical rea-

sons, including low egg count in the birth mother, advanced maternal age, and a history of

other unsuccessful treatment routes, such as intrauterine insemination or nonreciprocal IVF

(Bodri et al., 2018). In clinical studies, reciprocal IVF has been shown to be a viable route to

parenthood for these couples (Bodri et al., 2018; Marina et al., 2010).

Although there is clear justification for the use of reciprocal IVF for medical reasons, ethi-

cists have questioned the use of reciprocal IVF for nonmedical reasons because it requires clini-

cal intervention for both prospective parents without medical justification (Dondorp

et al., 2010; Zeiler & Malmquist, 2014). Reviews of the clinical literature have shown less posi-

tive pregnancy outcomes in IVF with donor eggs compared to own-gamete IVF (Keukens

et al., 2022), and this has raised ethical concerns regarding reciprocal IVF as a treatment route

of choice, rather than medical necessity. Given that over half of same-gender female couples

have been found to choose reciprocal IVF for nonmedical reasons (Bodri et al., 2018), it is

important to understand what these reasons are.

Suggested nonmedical reasons include within-couple equality, the achievement of “shared

motherhood,”and the avoidance of jealousy between mothers in the family unit (Bodri

et al., 2018; Marina et al., 2010; Pennings, 2016; Yeshua et al., 2015). However, there has been

196 FAMILY RELATIONS