ROPA is a treatment for lesbian couples that allows both women to play an active role in the achievement of pregnancy. It is and In vitro Fertilization treatment in which one woman will provide the egg, that will give rise to the embryo, and the other will provide the uterus, in which the embryo will be implanted.

ROPA method consists in:

1. Uterine preparation of the recipient: the uterus of the recipient is prepared with an estradiol treatment (pills or patches) in order to thicken the endometrium. A transvaginal ultrasound scan and an estradiol blood test will check that the endometrium is ready before embryo transfer. This phase of endometrial preparation is carried out simultaneously with the ovarian stimulation of the partner.

2. Obtaining oocytes from the donor: the partner who provides the oocytes undergoes an ovarian stimulation treatment, during 7-10 days, with the aim of achieving a good development of several follicles. Once the follicles have the adequate size, the egg retrieval is performed with transvaginal ultrasound and under sedation.

3. Insemination of oocytes: the oocytes are inseminated with an anonymous donor sperm.

4. Embryo transfer: 1 or 2 embryos are transferred into the recipient´s uterus between day 2 and 5 after oocyte retrieval. This transfer is carried out introducing, through the uterine cervix, a thin cannula loaded with the embryos. The transfer lasts a few minutes and does not require any analgesia. When the transfer is concluded, the patient rests for a few minutes. After the transfer a hormonal medical treatment is indicated (pills) to facilitate the implantation of the embryos.

5. The pregnancy test is carried out in blood approximately 10-12 days after embryo transfer and the results are available in a few hours.

Freezing or vitrification of embryos

If the day of embryo transfer there are surplus embryos, these are left in culture for up to seven days after the follicle aspiration and those who have a normal evolution are vitrified, with the consent of the couple. These embryos can be thawed in the future and transferred to the uterus, to try for a pregnancy again.

Legal aspects of IVF with ROPA

In Spain, since 2005, marriage and adoption are allowed to all couples, regardless of their gender and sexual orientation. Gamete donation is anonymous by law in our country. The Assisted Reproduction law of 14/2006 was modified to make a legal exception in the case of lesbian couples, recognizing that both mothers are progenitors of the children born through assisted reproduction techniques, whether they have undergone treatment for medical reasons or by choice. This modification makes the non-anonymous egg donation a legal exception in the case of lesbian couples that are married.

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