Reciprocal IVF pregnancies may have higher risk of complications

Pregnancies using donor eggs, including reciprocal IVF and surrogacy, may carry higher risks of complications than pregnancies using the woman's own eggs, according to a systematic review.

Reciprocal IVF – also known as shared motherhood IVF or co-IVF – for same-sex female couples is where one partner provides the egg, and the other partner carries the pregnancy, allowing both to have a biological connection to their child. Researchers from Anglia Ruskin University, the University of Leeds, and King's College London found increased rates of pre-eclampsia, gestational diabetes, preterm birth, and lower birthweight in donor-egg and reciprocal IVF pregnancies.

'It's important that couples going into the process are aware of potential complications that might happen because the baby is genetically unrelated to the pregnant woman,' said Professor Susan Bewley, study co-lead and emeritus professor of obstetrics and women's health at King's College London. 'All women deserve full, unbiased information ... so they can make their own decisions about whether the risk outweighs the benefit.'

The study, published in the Journal of Homosexuality, analysed over 9000 IVF cycles across five retrospective studies from the United States and Spain. The authors found that hypertensive disorders affected 24 percent of co-IVF pregnancies, compared with 13 percent in heterosexual own-egg IVF. Rates of gestational diabetes were ten percent versus two percent, respectively. Babies born through co-IVF were also more likely to have lower birthweights.

The popularity of reciprocal IVF has grown rapidly in the UK, with IVF cycles among same-sex female couples increasing almost seven-fold between 2008 and 2018, according to the Human Fertilisation and Embryology Authority. They could rise further after recent changes in UK legislation removed additional screening requirements for same-sex female couples, reducing costs by up to £1000 (see BioNews 1262).

First author Elizabeth Choong, a medical student at the University of Leeds, said: 'Numbers of same-sex female couples choosing co-IVF are increasing, so it is vitally important that the risks they face in undergoing this procedure are clearly explained from the outset.'

The authors of the review acknowledge that co-IVF may offer higher live birth rates in some contexts, but speculate that the genetic difference between the baby and gestational mother may contribute to increased complications. They called for larger-scale studies to provide evidence that can guide clinical practice and patient choice.