A Systematic Review of Reproductive Technologies for Shared Conception in Same Sex Female Couples

Reciprocal in vitro fertilization (IVF) and intravaginal culture (IVC) are two technologies that allow same sex female couples to jointly contribute biologically to a pregnancy. This systematic review aimed to synthesize clinical outcomes of each method including live birth rate, clinical pregnancy rate, embryo quality, and perinatal complications. A dual reviewer protocol identified eight studies on reciprocal IVF and ten studies on IVC. In retrospective studies reporting on a total of 1405 reciprocal IVF cycles, reciprocal IVF has demonstrated similar cycle and pregnancy outcomes to autologous IVF. The one study that reported on pregnancy complications found a comparable rate of hypertensive disease of pregnancy between patients undergoing reciprocal IVF and intrauterine insemination. However, a lack of prospective studies on reciprocal IVF limit the generalizability of these results. Overall, small prospective and retrospective studies reporting on a total of 776 IVC cycles show that IVC offers good cycle and pregnancy outcomes, comparable to IVF. However, randomized prospective studies reported that the rate of quality embryo creation in IVC may be lower than in IVF. While both reciprocal IVF and IVC show promise for same sex female couples and the larger LGBTQIA+ (lesbian, gay, bisexual, transgender, intersex, asexual, and other sexual or gender minorities) community, this review has highlighted the need for larger, prospective, more diverse studies on methods of shared biological contribution for family building.