Fertility Treatment for Female Couples and Single Women: IUI, IVF, Reciprocal IVF and the Law

Female couples and single women usually build a family through a licensed clinic using donor sperm, with either intrauterine insemination (IUI) or IVF, and for couples there is a third route, reciprocal IVF, in which one partner’s eggs become the other partner’s pregnancy. Our own road was a different one, but some of the women who have written to me while I built this site were on this one, and their questions were rarely about the medicine. They were about the forms, the money, and who would be on the birth certificate. This guide answers those, alongside the treatment choices.

Who this route is for, and how common it is

Treatment with donor sperm is now an everyday part of UK fertility care, and single patients and female couples are its fastest growing groups. The HFEA reports that between 2012 and 2022 the number of single patients having IVF or donor insemination rose from about 1,400 to 4,800, and the number of female same-sex couples from about 1,300 to 3,300¹. Together they accounted for around one in six IVF and donor insemination treatments in 2022.

That matters for two reasons. You will not be unusual in a clinic waiting room, and clinics are used to the specific questions you will have. It also means there is good data. The same HFEA report found that in 2022 single patients and female couples had birth rates per embryo transferred of 40 percent or more, compared with 35 percent for opposite-sex couples aged 18 to 34¹, which partly reflects that many are not dealing with a fertility problem at all, simply the absence of sperm. How to read figures like these is explained in IVF success rates.

Option one: IUI with donor sperm

IUI places washed, prepared donor sperm directly into the womb around the time of ovulation, and it is often the first treatment for people who have no known fertility problem. The NHS describes how the sperm is first washed and the fastest moving selected, then passed into the womb through a thin tube via the cervix². The HFEA notes that IUI is often used by female same-sex couples, with or without fertility drugs, and is relatively quick and painless³.

IUI is less intensive and less expensive per cycle than IVF, but it also has lower success per cycle, and it relies on open fallopian tubes and regular ovulation, so clinics usually check both first. Age matters a great deal, because egg quality falls with age whatever the treatment. The trade-offs between the two treatments are set out in IVF vs IUI.

Option two: IVF with donor sperm

IVF with donor sperm is the usual route when there is also an egg, tubal or age-related factor, or after several unsuccessful IUI cycles. The steps are exactly the same as any other IVF cycle, from stimulation injections to egg collection and transfer, and are explained in IVF explained. An advantage worth knowing about is that a single IVF cycle can produce several embryos, and spare good quality ones can be frozen, which some single women and couples use to try for siblings from the same donor later.

Option three: reciprocal IVF (shared motherhood)

Reciprocal IVF lets both partners in a female couple take a biological part: one provides the eggs and the other carries the pregnancy. The HFEA describes it as eggs from one partner being fertilised with donor sperm, with the embryo transferred to the other partner, who carries the baby³. In practice it is a full IVF cycle for the egg provider, with stimulation and egg collection, and a frozen or synchronised transfer cycle for the birth partner.

Couples often choose who does what on medical grounds, such as which partner is younger or has better ovarian reserve, and sometimes on personal ones, such as who has always wanted to be pregnant. The two can be separated: some couples swap roles for a second child. Because reciprocal IVF is a full IVF cycle, it costs more than IUI, and it is less likely to be NHS funded. The cost picture is in how much IVF costs.

Choosing a donor

Most people use sperm from a donor recruited and screened by a licensed clinic or a UK sperm bank, and that brings important legal protections. A donor through a licensed UK clinic is not the legal parent of the child and has no legal rights or responsibilities, and donation is not anonymous: anyone conceived from donation after April 2005 can apply to the HFEA for identifying information about their donor at 18, and for non-identifying details from 16⁴. One donor can help create children in no more than 10 families in the UK⁴.

Known donors, such as a friend, are possible through a clinic too, with screening and the same legal framework. Arrangements made informally at home carry very different legal and health risks, so take specialist legal advice before going down that route. The wider picture, including the counselling clinics offer, is in donor eggs, sperm and embryos.

Legal parenthood: the forms to sign before treatment

In the UK the woman who gives birth is always the legal mother, and whether her partner is automatically the second legal parent depends on whether they are married or in a civil partnership. The HFEA explains that a spouse or civil partner is generally the legal parent provided they consented to the treatment, while an unmarried partner will not automatically be the legal parent unless you both consent before treatment⁵.

That consent is given on two HFEA forms: the WP form, completed by the woman having treatment, and the PP form, completed by her partner. Both must be completed before the insemination or embryo transfer, and the HFEA is explicit that they cannot be completed after treatment has taken place⁵. If the forms are missing or wrong, the partner may need to go to court for a declaration of parentage, which the HFEA warns can be extremely time consuming and expensive³.

This is the single most important practical step in the whole process for unmarried couples, and it is worth asking your clinic directly, at the consultation, to walk you through the forms and confirm they are on file before every cycle. In reciprocal IVF, the partner who gives birth is the legal mother even though the eggs are her partner’s, which surprises many couples; the same consent rules decide the egg provider’s status.

NHS funding and paying privately

NHS funding is available to female couples and single women in some areas, but it is harder to get than for opposite-sex couples, and the rules vary by where you live. The HFEA notes that female same-sex couples are often required to pay for six cycles of IUI before they become eligible for NHS funding, with availability depending on the local area³. Its 2024 report found that 52 percent of opposite-sex couples aged 18 to 39 had their first IVF cycle NHS funded, compared with 18 percent of single patients and 16 percent of female couples¹.

Check your local commissioning policy early, ideally before you start paying for anything, because some areas count self-funded cycles towards eligibility and others do not, and some do not fund single patients at all. Your GP or clinic can usually tell you where to find the policy.

The emotional side

The questions people bring to this route are often less about treatment and more about identity, family and other people’s reactions. How will we tell our child about the donor. How do I explain to my parents that I am doing this on my own. Will my partner feel like a parent if she is not the one carrying. These are real, and the counselling that UK clinics offer for donor treatment is a good place to start working through them, ideally before the first cycle rather than after. Fertility Network UK also runs support groups⁶, and many clinics can put you in touch with others who have taken the same route.

Treatment with donor sperm can still involve the same waits and disappointments as any other fertility treatment. Much of what is written elsewhere on this site, from the two-week wait to coping with a failed cycle, applies just as much here.

This is general information and not medical or legal advice. Which treatment suits you depends on your age and tests, and questions about legal parenthood, consent forms and known donors should be checked with your clinic and, where needed, a specialist family lawyer.