Reciprocal IVF (ROPA) Abroad: A Guide for Lesbian Couples
Last updated: March 2026
ROPA stands for Reception of Oocytes from Partner. One woman provides the eggs (genetic mother). They’re fertilised with donor sperm and the resulting embryo is transferred to the other woman (gestational mother). Both partners participate biologically in creating their child. It costs EUR 5,500-8,000 in Spain and is legal in six European countries.
For lesbian couples who want shared biological involvement rather than just one partner going through IVF, ROPA is the procedure. Here’s where you can do it and what to expect.
Where It’s Legal
| Country | Legal since | Marriage required? | Notes |
|---|---|---|---|
| Spain | 2007 | Yes (for automatic dual parentage) | Ley 14/2006. Both partners recognised as legal mothers. |
| Portugal | 2016 | Marriage or registered partnership | MAR Law 32/2006 amendment. |
| Austria | 2015 | Marriage, partnership, or cohabitation | FMedRÄG 2015. Constitutional Court forced the change. |
| Denmark | Jan 2025 (expanded) | No | Previously required medical indication in one partner. Now available to all lesbian couples (The Local DK, 2024). |
| Netherlands | Available | Marriage or partnership | |
| UK | Available | Through HFEA-licensed clinics | Parental Order process may be needed for non-birth mother. |
Sources: IVF Spain (2025), Reproclinic (2025), Cryos International (2025), The Local DK (2024).
Where It’s Not Legal
Germany: Egg donation is banned entirely (ESchG 1990). Since ROPA involves one partner donating eggs to the other, it falls under the egg donation prohibition.
France: Same reason. France legalised IVF for lesbian couples in 2021 but did not legalise egg donation between partners.
Italy: Same-sex couples cannot access any fertility treatment (Legge 40/2004).
Greece: Same-sex couples cannot access fertility treatment despite the 2024 marriage equality law.
Czech Republic: Fertility treatment restricted to heterosexual couples.
North Cyprus: IVF available to lesbian couples, but ROPA specifically is not permitted.
The pattern: countries that ban egg donation also ban ROPA. Countries that restrict IVF to heterosexual couples also ban ROPA. You need both egg donation legality and same-sex IVF access for ROPA to work.
How It Works
Step 1: Deciding Roles
One partner will be the egg provider (undergoes ovarian stimulation and egg retrieval). The other will be the gestational carrier (receives the embryo and carries the pregnancy). The decision usually comes down to age (younger partner often provides eggs for better quality), ovarian reserve (AMH levels), medical history, and personal preference about which experience matters more to each partner.
Step 2: Choosing Donor Sperm
You’ll need donor sperm. Options depend on your treatment country:
- Anonymous donor (available in Spain, where the clinic selects based on phenotype matching)
- Open-ID donor (available in Denmark, UK, Portugal, via sperm banks like Cryos International or European Sperm Bank)
- Known donor (available in some countries with specific legal requirements)
Sperm cost: EUR 500-1,500 per straw from an international bank. Spanish clinics typically include donor sperm selection in the ROPA package price.
Step 3: Synchronisation
Both partners undergo preparation simultaneously. The egg provider starts ovarian stimulation (hormone injections for 10-14 days). The gestational carrier prepares her uterine lining with estrogen and progesterone. Timing is coordinated so the embryo is ready when the lining is optimal.
Step 4: Egg Retrieval and Fertilisation
The egg provider undergoes egg retrieval under sedation. Eggs are fertilised with donor sperm via ICSI. Embryos are cultured for 3-6 days.
Step 5: Embryo Transfer
The best embryo is transferred to the gestational carrier. Surplus embryos can be frozen for future siblings. A pregnancy test follows 10-14 days later.
The entire process takes about 4-6 weeks from the start of stimulation, with 2 visits to the clinic (one for monitoring and retrieval, one for transfer if not on the same trip).
Costs
| Country | ROPA cost | What’s typically included | What’s extra |
|---|---|---|---|
| Spain | EUR 5,500-8,000 | Consultation, stimulation monitoring, egg retrieval, ICSI, embryo culture, transfer, donor sperm | Medication (EUR 800-2,000), embryo freezing, PGT-A |
| Denmark | EUR 4,000-6,000 | Similar to above | Medication, donor sperm if using external bank |
| Belgium | EUR 4,000-6,500 | Varies by clinic | Medication |
| UK | GBP 5,000-8,000 | Varies by clinic | Medication, donor sperm (GBP 500-1,500) |
Add medication cost for both partners: the egg provider needs stimulation drugs (EUR 800-2,000), and the gestational carrier needs endometrial preparation (EUR 200-500). Total medication: approximately EUR 1,000-2,500.
Realistic all-in cost in Spain: EUR 7,000-10,500 including medication and donor sperm.
Why Spain Dominates ROPA
Spain has the largest ROPA market in Europe for four reasons:
- Legal since 2007. Spanish clinics have nearly 20 years of ROPA experience. The procedure is routine, not experimental.
- Anonymous donors. The clinic handles sperm donor selection. No bank browsing, no shipping logistics. Walk in, start treatment.
- Automatic dual parentage. Both partners are recognised as legal mothers from birth in Spain. No adoption process, no court orders. Marriage is required for automatic recognition.
- Clinic infrastructure. Barcelona and Madrid have multiple clinics offering ROPA with dedicated LGBTQ patient programmes. IVI, Eugin, Institut Marques, Reproclinic, and Tambre all advertise ROPA specifically.
Denmark’s January 2025 expansion makes it a strong alternative, especially for Northern European couples. Shorter flight from Scandinavia and Germany, and no medical indication requirement (previously, one partner needed a medical reason to justify using the other’s eggs).
Legal Parentage
This varies by country and is worth checking with a lawyer before treatment:
- Spain: Both mothers on the birth certificate. Marriage required for automatic dual recognition. Civil partnership may not suffice for parentage purposes in all Spanish registries.
- Denmark: Both mothers recognised. No marriage requirement since 2025 expansion.
- UK: The birth mother is the legal mother. The non-birth mother may need a Parental Order (similar to surrogacy pathway) or must be listed on the birth certificate if conception occurred at an HFEA-licensed clinic and both consented.
- Portugal: Both partners recognised as legal parents from birth (marriage or registered partnership required).
Cross-border recognition: A Spanish birth certificate listing two mothers is generally recognised across the EU under the principle of mutual recognition. But “generally” does a lot of heavy lifting. Some countries (Italy, Poland) have refused to recognise same-sex parental rights established abroad. If you live in a country that doesn’t recognise same-sex parentage, get legal advice before starting.
Before You Start
- Both partners need medical workup. Ovarian reserve (AMH, antral follicle count) for the egg provider. Uterine assessment for the gestational carrier. Some conditions (fibroids, endometriosis) affect which role each partner should take.
- Age matters for the egg provider. The egg provider’s age determines egg quality and success rates. If one partner is 35 and the other is 40, the younger partner usually provides eggs.
- Discuss future siblings. If you want more children with the same donor, freeze extra embryos or reserve additional donor sperm straws. Consider whether you’ll switch roles for a second child (the gestational carrier becomes the egg provider and vice versa).
- Marriage may be required. In Spain, marriage is needed for automatic dual parentage. If you’re in a civil partnership, check whether it’s sufficient in your treatment country.
LGBTQ fertility laws → | IVF for single women → | Browse Spain clinics → | Find your clinic →
Sources
- Spanish Ley 14/2006 on Assisted Human Reproduction.
- IVF Spain. ROPA for same-sex couples: https://www.ivf-spain.com/en/blog/assisted-reproduction-same-sex-couples/
- Reproclinic. ROPA method: https://reproclinic.com/news/what-is-ropa-method
- Cryos International. Reciprocal IVF in Denmark: https://www.cryosinternational.com/en-gb/dk-shop/private/treatments/treatment-at-cryos-in-denmark/reciprocal-ivf-ropa/
- The Local DK. Key law changes in Denmark 2025: https://www.thelocal.dk/20241230/key-law-changes-in-denmark-in-2025-that-you-need-to-know-about
- FMedRÄG 2015 (Austria). PMC analysis: https://pmc.ncbi.nlm.nih.gov/articles/PMC5952810/
- Diers Klinik UK. Reciprocal IVF: https://diersklinik.co.uk/donor-egg-ivf/reciprocal-ivf/