P-501 Sharing motherhood: same-sex female couples’ reasons for choosing shared biological motherhood
Authors: Shaw K , McConnachie A , Bower-Brown S , Jadva V , Ahuja K , Macklon N , Golombok S 
Published: June 2022

Abstract

Study question
Why do same-sex female couples choose to conceive using shared biological motherhood, where one mother uses her egg and the other gestates the pregnancy?

Summary answer
Couples consider factors within their family alongside pressures from wider society when choosing to conceive by shared biological motherhood.

What is known already
Shared biological motherhood (SBM), sometimes known as ‘reciprocal-IVF’, describes a treatment available to same-sex female couples where eggs are retrieved from one prospective mother, fertilised in-vitro with donor sperm, then carried by the other mother, meaning one partner has a gestational connection to their child, and the other has a genetic connection. SBM is growing in popularity across Europe, but it is only available in a few countries due to ongoing ethical debate. Existing research demonstrates the clinical efficacy of SBM (Bodri et al., 2017), but no research has studied the motivations and experiences of mothers who choose this treatment.

Study design, size, duration
In-depth, semi-structured interviews were carried out separately with genetic and gestational mothers in fifteen families created through shared biological motherhood (n = 30 parents). Children were aged between 0-3 years (M = 22 months). Data were collected between December 2019 and June 2021.

Participants/materials, setting, methods
Participants were recruited through the London Women’s Clinic. Of the 30 parents, 90% were working in professional or managerial occupations.
Interviews addressed a range of topics including treatment choices, experiences of treatment, thoughts and feelings about pregnancy and biological relatedness (genetic and gestational), and the nature of each mother’s relationship with their infant, and with each other. Data were analysed using qualitative content analysis and reflexive thematic analysis methods (Braun & Clarke, 2006; 2019).

Main results and the role of chance
Preliminary analysis indicates that the reasons prospective parents choose SBM are complex as couples consider factors within their family alongside pressures from wider society. Within-family factors include the desire to have a child that shares biological connections with both parents and the opportunity to protect against rejection from the child in future. Outside the family, SBM offered both parents a social and legal legitimacy that was not guaranteed with traditional IVF. A significant minority of parents understood SBM to be ‘as close as they can get’ to heterosexual reproduction.
Decisions regarding who will carry the pregnancy were mediated by parent age and the expected success rate of undergoing IVF. However, the desire to experience pregnancy and feel closeness forged through breastfeeding also shaped these decisions. Around half of families planned to, or already had, completed further round(s) of SBM with the biological roles reversed.
Both genetic and gestational mothers identified contradictions in their own feelings regarding the importance of biological relationships in their family. Parents reported that the impact of their genetic or gestational link was limited in day-to-day family life, but they were still grateful that access to SBM meant they both had a biological connection to their child.

Limitations, reasons for caution
There is a risk of selection bias, with families who have had a more positive experience of SBM being more likely to participate in research, although the diversity observed in the narratives in the sample suggests otherwise.

Wider implications of the findings
The current findings support existing clinical literature showing that SBM can be a viable and meaningful route to parenthood for same-sex female couples. The complex reasons why reciprocal-IVF appeals to prospective parents should be considered by clinicians and policy makers in the debate surrounding the regulation and practice of SBM.

Trial registration number
N/A