The 9 most frequently asked questions about the ROPA method

The ROPA method is an artificial insemination procedure where both women are biological mothers to the same baby. Also known as double motherhood, it consists of retrieving the eggs from one woman, fertilising them with donor sperm and implanting them in the other woman who will carry the child.

We know that you have many questions and we will try to answer the most important ones here. If you think of other questions don’t worry just contact us!

1.Who is this treatment for?

This method is ideal for lesbian couples since you can both be biologically involved: donor mother and pregnant mother.

2.We want to have a baby. Do we need to be married?

Yes, in order to legally add your children to the civil registry, lesbian couples must be married. It is so written under law 14/2006 of Assisted Reproduction.

Since 2017 it’s not required that you show the document from the fertility clinic stating that the pregnant mother has undergone an assisted reproduction procedure.

3.Is the treatment included in the public health care plan?

The ROPA method is not included in the health care plan; you will have to go to a private clinic. Money is, of course, one of the main concerns. However, by going to a private clinic, you have the advantage of not having to wait and there are also no limits to how many times you can try.

4.What is the success rate of the ROPA method?

Usually, this method has a success rate of around 65-70 percent. The success rate can vary depending on factors such as age because from 35-37 years old the ovarian reserve declines considerably.

5.Can we pick who the donor mother and pregnant mother will be?

There are a number of tests performed before the treatment starts in order to determine which one would be more suited as a donor mother (usually the youngest of the two) and which as a pregnant mother. Some women who wish to be mothers not necessarily wish to be pregnant. Having all this in mind, it is ultimately your decision.

6.Can we choose the sperm donor?

Sperm donation is anonymous in Spain. The fertility clinic will be in charge of choosing the best match for you depending on some factors, for example, your physical characteristics or race.

If you plan on having more children with the same sperm donor it’s very important that you let your chosen clinic know this.

7.How much is the ROPA method?

The ROPA method is about the same price as a round of IVF (4000 to 8000 euros).

With us, the ROPA method is 4970€. This is the standard price; it could vary depending on the needs and characteristics of each patient. For a custom-made quote please contact our team directly. This price does not include the medications needed for each round.

8.What happens to the leftover embryos?

The leftover embryos can be kept cryogenically preserved (at a cost of 500 euros per year), anonymously donated to other couples or for research.

9.Must we undergo any treatment beforehand?

The testing is the same as an IVF procedure, the only difference being that you share it between the two mothers.

The partner who provides the egg must undergo a hormonal study to assess the quality and quantity of her oocytes, as well as blood tests, ultrasounds to assess her ovaries and various studies to rule out any chromosomal alterations.  The partner who carries the baby will also have blood tests, ultrasounds to assess the state of her uterus and various other studies to rule out any condition that might prevent the pregnancy from being carried to term.

After the preliminary tests, the donor mother will undergo ovarian stimulation and puncture in order to obtain and retrieve the best possible samples. Meanwhile, the pregnant mother will get a hormonal treatment, which will improve her endometrial lining in order to receive an embryo during the implantation process.

Remember if you have any questions all you have to do is contact us.

Endometrial preparation

The ROPA method consists of two parts: the partner that donates her eggs must go through ovarian stimulation and egg retrieval, while the other partner will undergo hormonal treatment which will improve her endometrial lining in order to receive an embryo during the implantation process.

Why prepare the endometrium?

The endometrium is the innermost layer of the uterus and it plays a fundamental part in the gestational process and during pregnancy.

Endometrial thickness varies throughout the menstrual cycle. Implantation can only occur during certain days of the cycle, this is known as the “implantation window”, generally within the 19th-21st day of the cycle. If the embryo hasn’t been implanted then the endometrium disappears in the form of menstruation.


Endometrial preparation consists of undergoing a hormonal treatment which imitates and optimises the natural cycle. This facilitates the implantation of the embryo and the chances of pregnancy.

The treatment is usually composed of progesterone and estrogen, which, depending on the type of medication may be given orally or via vaginal ovules or patches.

Endometrial preparation is key for the ROPA method. Estrogen is administered on the first days of the menstrual cycle and then progesterone is given on fertilisation day.

This medications may have some minor side effects such as bloating, fatigue and increased vaginal discharge.

Factors that contribute to a successful implantation

Optimal endometrium: when the lining is within 7 to 10 mm and contains three layers (triple-line endometrium) the chances of pregnancy are high.

Embryo quality: implantation is more likely with good quality embryos.

Endometrial receptivity: the implantation window may be too early or too late.

Also, the day the embryo develops and the endometrial receptivity must be perfectly synchronised.


Do you want more information about treatments or our clinic? Contact us!