By means of in vitro fertilisation (IVF), the egg provided by one of the women is fertilised with previously selected donor sperm, and the resulting embryo is transferred to the uterus of the other woman.

The ROPA method is recommended for:

Lesbian couples who wish to have a shared maternity and actively participate in their reproductive project, either by choice and/or for medical reasons, such as:

• Illnesses that discourage pregnancy in one of them (she could provide the egg).
• Absence or alteration of the oocytes (she could provide the uterus).
• Absence or severe alterations of the uterus (she could provide the egg).
• Chromosomal or genetic alterations which could be transmitted to the offspring (she could provide the uterus).

This depends on 3 factors:

• The age of the woman who provides the eggs.
• The number of eggs available.
• The quality of the uterus which will receive the embryos and gestate.

The younger the egg provider, the greater the number of eggs she will have, and the healthier the recipient and her uterus, the higher the success rate.

A gynaecological and medical history assessment is conducted for both women. A number of tests and analysis are done that will help determine each woman’s suitability for each role.

The egg provider will be administered subcutaneous injections, and the uterus provider will be given progesterone vaginal suppositories and oestradiol tablets or patches.

A number of check-ups and ultrasounds will be necessary for both women.

Once the egg donor has been stimulated, the eggs will be extracted in the operating theatre under anaesthetic.

On the day of the ovarian puncture, the eggs are fertilised with sperm from a previously selected suitable donor. The following day, the number of fertilised eggs can be determined, and their development will be monitored over the next 3 to 5 days.

This is a painless procedure in which one or two embryos are transferred to the uterus between 3 and 5 days after the ovarian puncture.

If there are viable embryos leftover, these will be preserved by vitrification for possible future use.

Typically performed around two weeks after the embryo transfer.

According to a postliminary extension to Spain’s Assisted Reproduction Law 14/2006, legal parentage is recognised to the egg provider, and dual maternity will be recognised when the women are married and after declaring parental consent of a spouse’s child at their local Civil Registry.