A Spanish IVF clinic has published the first clinical report of helping lesbian couples to share biological motherhood. The procedure, which they call ROPA (reception of oocytes from partner), involves one woman supplying eggs and the other gestating them in her womb. Although it is more costly than donor insemination, it is technically straightforward and has “the psychosocial advantage of allowing them to both participate in the creation of the child”, according to a commentary in the journal Human Reproduction. The clinic, CEFER Institute of Reproduction, treated 14 lesbian couples between 2007 and 2009.

CEFER is very enthusiastic about the technique. Its clinicians write: “The children that will be born through the ROPA technique are wanted children, like all children attained through ART, and this is a very positive factor for the child.”

The most difficult consideration are ethical, but these are disposed of very easily by the Spanish doctors. Benificence? “To bring a child into the world is, we believe, to do something positive for him.” Non-malificence? “The child's development does not seem to be affected by living in a family with two mothers, by the absence of a father or by maternal homosexuality.” Autonomy? “ROPA is only carried out with lesbian couples who so request it and are previously informed.”

A commentary, by Dutch IVF experts, gives a fuller description of the ethical questions raised by ROPA. The main question is whether ROPA is really to be regarded as a medical procedure since both women are healthy and there is no disease to be cured. However, they write, “in reality the practice of medicine comprises many activities that would then also have to be questioned, including sterilization, abortion, cosmetic surgery and, indeed, [donor insemination] for reproductively healthy single women and lesbian couples. More fundamentally, the concepts of ‘health’ and ‘disease’ are not as clear-cut and objective as his argument suggests. This is obviously the case in the context of reproductive medicine, certain applications of which are better understood as a treatment for involuntary childlessness than as an intervention aimed to redress a biological defect.” ~ Human Reproduction, April