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ROPA: Shared motherhood for female same-sex couples

Blog post written in collaboration with our partners Reproclinic
ROPA is a fertility treatment method, also called reciprocal IVF. This treatment allows both women in a same-sex relationship to be active participants in the conception of the child: one woman provides the eggs, a sperm donor is used to fertilise them, and the other woman carries the pregnancy. In this blog, we spoke with Reproclinic, specialists in ROPA treatment to learn about this treatment.

Who is ROPA for?

The reciprocal IVF method is recommended for lesbian couples in which:

• The woman who wants to provide the eggs has a good ovarian reserve.
• The woman who receives the embryos does not have complex uterus problems.

At Reproclinic, we specialise on ROPA treatment and provide personalised care. Each patient is cared for one team.

How does ROPA work?

At Reproclinic, we start by doing some tests to make sure both women are eligible for this procedure:

Woman receiving the embryos

o Hormone checks and screening for infectious diseases.
o Ultrasound to check the uterus.
o Mammography (if there is a history of breast cancer in the family or if the woman is over 39 years old).

Woman donating the eggs

o Hormone checks to determine ovary function and screening for infectious diseases.
o Ultrasound of the ovaries.
o Mammography (if there is a history of breast cancer in the family or if the woman is over 39 years old).

If everything is ok, the ROPA treatment may begin.

For the woman donating the eggs

1. Ovarian stimulation. Hormones are administered daily for about 15 days to stimulate the ovaries.
2. The egg release. Once the ovaries are properly stimulated, another hormone is administered to induce ovulation.
3. Ovarian puncture. This is done by sedation and lasts about 20 minutes. It consists of aspirating the follicular liquid and the egg using a needle connected to a vaginal ultrasound.

For the woman receiving the embryos

1. Endometrial preparation. This is a very simple process that only requires the administration of estrogen via patches (or in some cases orally) for 10-15 days. Using an ultrasound, the doctor will monitor the development of the endometrium until it grows to a thickness of between 5 to 10 millimeters and develops a trilaminar appearance.
2. Collecting the semen sample and in vitro fertilization (IVF) process. On the same day that the donor eggs are retieved, IVF is performed with the semen from the previously selected donor. This is done using the ICSI technique, which involves injecting the sperm into the egg with a very fine needle.
3. Embryo culture and selection. Over the following days, biologists observe the growth of the embryos using a time-lapse technique. This way they can see which ones are growing better and are more suited for implantation and to give birth to a healthy baby.
4. Selecting the embryos to transfer and embryo transfer. After five days of development, the most viable embryos are selected and transferred to the mother’s uterus.

What are the success rates with ROPA?

At Reproclinic, the pregnancy rate with the reciprocal IVF method ranges from 40-70%. This percentage is only approximate, because the pregnancy success rate depends on several factors that vary with each woman, including the age of the egg donor, the quality of the ovarian reserve or if there are uterine problems in the woman receiving the embryos, among others. Therefore, our medical team must study your particular case to give you a more reliable percentage. By having ROPA treatment at Reproclinic, you will be cared for by a specialist team who will be with you every step of the way.

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