Watch the Online Patient Meeting with Dr Anna Galindo Trias, Medical Director at Gravida Clinic, and learn more about embryo adoption and the ROPA method for same-sex female couples.
Embryo adoption and ROPA method were introduced in ART when the egg donation method was being used. A law in Spain allows using the of extra embryos (surplus embryos) that are not used by patients who no longer need them for their IVF cycles, and it’s called embryo adoption. It happens when the patients have completed their families, and they don’t want to use these embryos for themselves so they can give such embryos to others. ROPA (‘Receiving oocytes from the partner’) or Partner Oocyte Reception is a reproductive option for same-sex couples of women who wish to opt for shared motherhood. That way, both partners can be physically involved in the pregnancy, even before birth.
When a frozen embryo is created, and the patient or couple no longer need it, there are several things they can do with their embryos. As mentioned before, they can donate those embryos to other patients, another option is a donation for research or just thawing them and destroying them.
What are the requirements for these embryos to be adopted? First and foremost, this donation is voluntary, anonymous and altruistic. These requirements are the same as egg donation or gamete donation. Therefore, the egg from the donor who created the embryo needs to be between 18-35. The family history and personal risk factors must be reviewed in both males and females. They need to be in good physical and mental health, there needs to be an absence of sexually transmitted diseases, and all the embryos are tested for these. A karyotype is also checked as well as genetic testing, such as Carrier type or others. The parameters used are usually the same as when an egg donor is recruited.
If the couple donating the embryo doesn’t have all the tests that are performed on egg donors, they are asked to come back to the clinic and redo such tests. The number of offspring is limited to 6 as it is stated by Spanish law.
The patient that is adopting these embryos has to be healthy with a normal uterus or at least is capable to carry a pregnancy to the end. The recipient is matched with the embryonic phenotype. It is not a very detailed match as these embryos are already created. One embryo is usually assigned, on some rare occasions, there can be 2 assigned embryos. Most of the time, it’s recommended to adopt one embryo at a time and do a single embryo transfer.
ROPA (Shared Motherhood)
ROPA is a technique that is specifically designed for building a family for lesbian couples and same-sex female couples. The classical options for these couples are intrauterine insemination (IUI) with the donor’s sperm or IVF with the donor’s sperm. The mother who stimulates her ovaries is the one that receives these embryos that are fertilized with the donor’s sperm. However, there is another option, nowadays, that has been introduced where one of the female partners can give her eggs to the other female partner for her to carry the pregnancy. Therefore, both of them can share motherhood, one is giving the eggs, and the other mother is carrying the pregnancy.
This is a technique that requires IVF treatment, one of the female partners is going to be the donor, she is going to be stimulated in the same way as in IVF treatment, and these eggs are going to be inseminated with the donor’s sperm, then the embryo is going to be transferred to the other female partner who is getting ready at the same time, this process is called synchronized ROPA, one female is preparing for stimulation to retrieve the oocytes, the other one is prepared for the embryo transfer in a fresh cycle. There can be an asynchronous process as well where one of the partners is stimulated, the embryos are created and then frozen, and later on, the other partner, even with a natural cycle, gets ready to receive the embryo.
This technique has been already used for a few years, and it works well. Around 10 years ago, there was only IUI or IVF option for such couples, nowadays, around half of couples, ask for the ROPA method. It is completely a safe method and has high percentages of achieving a successful pregnancy.