My spouse and I started our path to parenthood via reciprocal IVF (my egg, her womb) in 2002—so I was surprised to find numerous places online saying that RIVF was created in 2007 or even later. For LGBTQ History Month, I dug into RIVF’s real history, going back more than 30 years.
This is a long piece, and while I hope it’s an enjoyable dive into a piece of queer history, here’s the TL;DR: Despite misinformation online that dates the creation of RIVF variously to 2007, 2009, or 2010, a 1995 lawsuit proves that same-sex couples were using it at least as early as 1995—and references to the process in 1993 strongly imply that it was being used even earlier.
I’ll also note that RIVF is also variously called ROPA (Reception of Oocytes from PArtner), co-IVF, shared IVF, shared maternity, partner-assisted reproduction, or intra-partner oocyte donation. I use the terms interchangeably below.
An Ethical Question
The earliest reference I could find to RIVF (where it is called “shared maternity”) is in a 1993 article in the journal Ethics & Behavior, where a psychologist, an OB/GYN, a Catholic theologian, and a philosopher don’t walk into a bar, but do discuss the ethical issues raised by a hypothetical lesbian couple who have “an unusual request”: they want their doctor to implant one of them with the ova of the other, fertilized with anonymous donor sperm.
I reached out to the contributor who originated the topic for the article, Timothy Murphy, then-assistant professor and now professor of philosophy in the biomedical sciences at the University of Illinois College of Medicine, to ask about its genesis. He told me in an e-mail:
A physician who worked in a Chicago hospital mentioned the instance of a couple coming forward for RIVF to me. And it caught my imagination, even if some of the language I used in the report seems dated now: “an unusual request.” Well, for 1993 it was.
I never did learn what ‘actually happened’ in the case. So, all I can say is that couples were exploring this in the early 1990s. I suspect that there were probably some people who did this without publicizing their choice. No law or policy would require disclosure of this kind of intervention to the public, or even to any health agency for that matter.
Even in the 1993 article, Murphy was optimistic about RIVF, writing:
It seems to me that the kind of relationship sought here exhibits many of the very virtues worth praising in family relations: opportunities for deepening relations between partners, shared division of parenting responsibilities, and the clear wish for a child.
Shared maternity will not, of course, render any partners’ relationship automatically blissful, but there is no reason to believe that it cannot be an important pathway to happiness for some and a model from which others may learn about their own relationships. Certainly, too, there is much to be admired in parents who may have to set aside convention in order to secure a child’s place in their midst.
Two of the article’s other contributors were also supportive of the women’s plans. Clinical psychologist Connie S. Chan said that the doctor’s ethical responsibilities “are to give the two women all the facts and to allow them to make their own decision.”
OB/GYN Janis H. Fox asserted, “Certainly there is nothing ‘unethical’ or ‘immoral’ about this couple’s dream” of raising a family together. She added that the doctor’s “first ethical responsibility is to examine his own personal opinions and prejudices regarding homosexuality” in order to provide them with the appropriate evaluation and treatment.
Only one of the four contributors felt negatively about the idea: Richard A. McCormick, SJ, a professor of Christian ethics, who called it “‘harebrained’ or ‘half-brained,'” and said, “My main problem is, how did we ever come to the point where we could treat this as anything but a freakish hoax?”
My son is not a freakish hoax. Moving on….
It’s In the Book
RIVF was also mentioned in the 1995 book, The Lesbian Parenting Book: A Guide to Creating Families and Raising Children, by D. Merilee Clunis and G. Dorsey Green (Seal Press). In it, the authors write:
There are other options besides getting pregnant for a woman who wants a child. Surrogate motherhood, in which another woman gets pregnant and bears the child, is one possibility. Ovum donation occurs when one woman’s eggs are fertilized and placed in another woman’s fallopian tubes. This may be of particular interest to lesbian couples as one woman could bear her partner’s biological child.
Again, this is not definitive proof of when RIVF first occurred, but strongly indicates it was happening by 1995 or even earlier, depending on when the manuscript was finalized.
Neither RIVF nor regular IVF was mentioned, however, in the 1993 The Lesbian and Gay Parenting Handbook: Creating and Raising Our Families, by April Martin (Harper Perennial). That is similarly not conclusive evidence that RIVF hadn’t happened yet among lesbian couples, particularly if it was still rare, but this absence, in conjunction with its mention the Ethics & Behavior article, indicates to me that we’re probably near the dawning of this method.
A Lawsuit Offers Proof
Murphy was prescient, however, when he noted in Ethics & Behavior that if same-sex partners separate:
Courts are sometimes asked to decide whether a biological mother can bar any or all continuing involvement of her former partner in the life of the child, and some partners have been excluded from relationships when such separations occur, often at great emotional cost. The kind of shared maternity occurring in this case will not solve all problems for the courts, of course, but it can demonstrate that two women did at one time intend to share their children together, which may offer courts options for recognizing partner claims that they may not recognize now.
That brings us to the first lawsuit I know of involving RIVF, which may not be the first instance of the procedure, but definitively proves it existed at least as early as 1995. Nancy Polikoff, professor of law emerita at American University Washington College of Law, and a pioneer of LGBTQ family law, who was kind enough to track down this case for me, also told me, “I remember the case well and it was certainly my impression that the practice was well established (if rare) by then.”
The lawsuit involved two women, E.G. and K.M., who were registered as domestic partners in San Francisco. E.G. was trying to get pregnant. After she tried IVF unsuccessfully several times using her own eggs, her doctor suggested using K.M.’s eggs. This worked, and K.M. gave birth to twins in December 1995. Only K.M. was put on the children’s birth certificate.
The women’s relationship ended in 2001, however, and E.G. and the twins moved to Massachusetts. K.M. brought the lawsuit in order to establish her legal parentage. Court documents attest that E.G. referred to her mother and to K.M.’s parents as the twins’ grandparents, to K.M.’s siblings as their aunts and uncles, and to her nieces as their cousins. Two school forms listed both K.M. and E.G. as the twins’ parents. The children’s nanny testified that both women “were the babies’ mother.”
E.G. countered that she (E.G.) had only wanted to be a single parent, and did not intend for K.M. to parent with her. K.M. had, indeed, signed a “Consent Form for Ovum Donor” in which she waived any rights over the donated eggs or any resulting pregnancy or offspring. However, the court documents stated, she thought that parts of the form “did not pertain to her, such as the part stating that the donor promised not to discover the identity of the recipient. She did not intend to relinquish her rights and only signed the form so that ‘we could have children.'” The form had clearly been created without RIVF in mind.
A lower court ruled in favor of E.G., but the California Supreme Court overturned that decision, drawing on its interpretation of the Uniform Parentage Act (UPA), a best-practice model law developed by the bipartisan Uniform Law Commission and adopted by many states. The court wrote (citations removed):
K.M. did not intend to simply donate her ova to E.G., but rather provided her ova to her lesbian partner with whom she was living so that E.G. could give birth to a child that would be raised in their joint home…. K.M.’s genetic relationship with the twins constitutes evidence of a mother and child relationship under the UPA…. The circumstance that E.G. gave birth to the twins also constitutes evidence of a mother and child relationship. Thus, both K.M. and E.G. are mothers of the twins under the UPA.”
(For more on how the current version of the UPA is still helping LGBTQ couples, see this post.)
The court’s ruling had no power outside of California, however, as my own experience getting a parentage order in New Jersey can attest.
A Rarity That Speaks to Queer Creativity
RIVF is a more complicated process than regular IVF (which uses the same person’s egg and womb). Two people’s cycles have to be synched and their health monitored. Both types of IVF, however, are more complicated—and often more expensive—than simple assisted insemination (loosely speaking, the “turkey baster” method). RIVF was therefore never going to be the most common path to parenthood for queer couples. While it was rare, though, it wasn’t unheard of, even in the 90s; during the 1999 PBS Frontline series “Making Babies,” in an interview with Dr. Mark Sauer, the interviewer notes, “We have a lesbian couple in our piece where one has donated the egg to the other, and they may do it the reverse next time for the second child.”
Nevertheless, back in 2002, when my partner Helen and I started our RIVF journey, I hadn’t even heard of anyone using that process (by any name) when I suggested to Helen that we could have a child with my egg and her womb. I think I just knew that egg donation was medically possible, and concluded that one of us could provide an egg to the other—not as a “donation,” but as a way to create our family together.
My suspicion is that that’s how things happened in the early 90s (or potentially even earlier); multiple lesbian couples may have realized at about the same time that RIVF was a possibility, having the same sudden insight that I did nearly a decade later (or having medical professionals who suggested it, as in the lawsuit above). We should celebrate this surge of queer creativity and courage to try something new, regardless of which single family may have been technically first.
We may never know the very first definitive instance of RIVF; as Murphy noted, there were no policies requiring that it be tracked. What we can say at this point is that it was sometime between the first instance of egg donation, in 1983 (with the child born in 1984), and the lawsuit in 1995; there is evidence that it was being sought by 1993 (although we don’t know whether the couple who precipitated the Ethics & Behavior article actually used the process), but it was rare enough that it didn’t get a mention in a 1993 lesbian parenting guide.
A Widespread Error
Despite all of the evidence above, many sources online date the first instance of RIVF to 2007, 2009, or even 2010. Many of the erroneous dates online seem to stem from people’s interpretation of a paper (PDF) presented by researchers at Spain’s CEFER Institute in 2010, describing the RIVF/ROPA process and the experiences of 14 lesbian couples treated between February 2007 and June 2009. The researchers call this “a pioneer event in Spain and among the first at a worldwide level.”
People seem to have ignored the key words “among the,” and assumed that CEFER invented the process. Wikipedia’s page on “Partner-Assisted Reproduction” says, as of this writing: “This process was first introduced in Spain in 2007 at the CEFER institute.” The same page also confusingly says: “As reciprocal IVF is a fairly new process first established in 2009….”
Other places use this or an even later date. A few instances:
- A 2025 article in the journal Bioethics cites the CEFER paper, but uses its publication date, not the dates of the RIVF procedures it describes, to assert, “ROPA was first introduced in 2010”;
- IVI, a clinic in the U.K. that is part of a global fertility network which claims to be “The world’s leading Reproductive Medicine group,” cites the CEFER paper on its website and says that RIVF “was only first pioneered in 2010”;
- Reproductive Partners Medical Group, a clinic in Beverly Hill, California, said in a Facebook post this past June, “Reciprocal IVF, otherwise known as ‘co-maternity’, was established in 2009– allowing lesbian couples to share biological motherhood for the very first time”;
- And a 2023 article in Porto Biomedical Journal aligns with the above and says that RIVF has been “used for more than a decade.” That’s technically true, but a gross underestimate, as it’s really been at least three decades.
Some sources say the process was first “described” in 2009 or 2010. Again, some examples:
- Extend Fertility, a clinic in New York, says on its website, “Because [RIVF] is a fairly new technique (the first paper describing this method was published in 2009)”;
- A 2018 article in Reproductive Biomedicine Online also cites the CEFER paper and says, “Shared motherhood IVF treatment was first described in 2010.”
Even if we take those examples to mean the date that the process was first described in print—or even just in a medical journal—they’re still wrong. In addition to the 1993 mention in Ethics & Behavior, RIVF had appeared in at least one medical and one social science journal prior to the CEFER paper:
- “Lesbian intra-partner oocyte donation: A possible shake-up in the Garden of Eden?,” Human Fertility (2006), which is entirely about RIVF;
- ‘Whose Child Is This?’: Determining Legal Status for Lesbian Parents Who Used Assisted Reproductive Technologies,” Family Relations (2008), which mentions legal considerations for same-sex couples using RIVF, among other methods.
All of the above errors have made their way into current AI systems; if you ask them: “When was the first instance of reciprocal IVF?” or variations of that question, you’ll get answers involving the dates above.
Why Does This Matter?
The 2010 CEFER paper called RIVF “a new family model.” Access to reproductive technologies for queer people was reasonably new in Spain at the time. But queer couples, at least in the U.S., were using it for at least a decade and a half before the paper’s publication.
I bring all of this up not only because I have a penchant for historical accuracy. It is vital, I believe, for queer parents and prospective parents to have a sense of their history and to know that they can look to the past for inspiration, role models, and practical advice. It saddens me to see articles and social media posts from couples who used RIVF within the past decade or so and still said they felt like they were heading into uncharted territory.
It is also important for medical professionals to know when a procedure has a long track record, so that they have a better understanding of the likely outcomes and concerns. They should know, too, that such a procedure may appeal to some of their potential clients. A 2023 study, however, found that less than half of the fertility clinics that are members of the Society for Assisted Reproductive Technology (SART), the primary organization of assisted reproductive technologies in the U.S., mentioned RIVF on their websites.
Finally, all of this is a warning about how much we still need to fact-check AI and other online information.
Present and Future
I have been unable to find statistics on the number of people born via RIVF. One 2016 study of 233 lesbian couples in Connecticut who had made preconception plans before using assisted reproduction found that 76.4% planned on having one partner conceive and carry, while 11.8% wanted to use “shared conception,” i.e., RIVF. Data in the U.K. from 2022 found that RIVF “is estimated to have accounted for 1 in 6 IVF cycles among female same-sex couples” that year.
Whether those percentages are representative elsewhere, or still hold today, is an open question; it seems likely, though, that RIVF only accounts for a small percentage of the approximately 96,000 babies born via IVF to parents of all identities in the U.S. in 2023, the latest year for which we have data. That 96,000 was itself only 2.6% of all births in the United States. And RIVF, like all forms of IVF and other assisted reproductive technologies, is caught up in matters of accessibility and affordability (and the president’s announcement last week of new IVF policies may have limited impact, as The 19th reports).
Innovations continue, however. A variation of RIVF, “reciprocal effortless in vitro fertilization,” was pioneered in 2018. That process starts like traditional IVF, by harvesting one person’s eggs. Instead of fertilizing and incubating in a dish in the lab, however, the egg and donor sperm are placed into a special device that is inserted into that person’s vagina, where they fertilize and incubate more naturally. After five days, the device is taken out and the embryos frozen until they are ready to be placed in the other person’s womb for the rest of the gestation. It’s a way for the person providing the eggs to also carry the embryo, if only for a few days, before the other person carries the pregnancy to term.
If being wanted counts for anything in the emotional security of a child, the efforts expended by these two women to share maternity may offset any psychological burden due to a child’s perceived difference of himself or herself from others.
Timothy Murphy, 1993
Here’s the key thing, though, no matter the type of RIVF. As the CEFER paper said in 2010, “The children that will be born through the ROPA technique are wanted children, like all children attained through ART, and this is a very positive factor for the child.” Hear, hear.
Professor Murphy said much the same back in 1993, when he noted, “If being wanted counts for anything in the emotional security of a child, the efforts expended by these two women to share maternity may offset any psychological burden due to a child’s perceived difference of himself or herself from others.”
It’s not that RIVF, of any type, is a better or more desirable path to family creation than anything else; it’s only one of many options for queer couples. At least one study has found that both RIVF and (non-reciprocal) donor IVF “resulted in similarly positive family relationships,” and that “Mothers in both family types showed high levels of bonding with their children and viewed their relationship with their child positively.” It is important, nonetheless, that queer couples with the requisite parts know that RIVF is a possibility, and that those who wish to pursue it find support from both their medical providers and from the accumulated wisdom and experiences of those who have used it before. All of the many decades of them.
This is not a comprehensive history of RIVF, just a correction to some of the errors about it that are floating around. As with all history, too, it is subject to change as our knowledge of the past increases. If you started your family via RIVF prior to 1995 (or your parents did), I’d love to speak with you about your experience, and invite you to please reach out if you are willing to share.