Two women can have a baby using donor sperm combined with one of several conception methods, ranging from at-home insemination to in vitro fertilization. The path you choose depends on your budget, how involved each partner wants to be biologically, and your fertility health. Here’s how each option works in practice.
Choosing a Sperm Donor
Every path to pregnancy for two women starts with donor sperm. You have three main options: an anonymous donor, an identity-disclosure donor, or a known donor (someone you already know personally).
Anonymous donors from a sperm bank remain unidentified permanently. Identity-disclosure donors (sometimes called “open” donors) agree to have their name, date of birth, and last known address released to any offspring once that child turns 18. The child can then decide whether to initiate contact. A known donor is typically a friend or acquaintance willing to provide sperm directly.
Sperm bank vials typically cost between $25 and $1,500 each, depending on the bank and how much background information is included in the donor profile. You’ll usually need multiple vials across several cycles, so most couples purchase several upfront. If you go the known-donor route, a legal agreement is essential. It should clearly state that the donor has no parental rights or financial responsibilities, and that the intended parents hold exclusive parental rights. Without this contract, a known donor could later claim custody, or be pursued for child support, depending on your state’s laws.
At-Home Insemination
Home insemination is the simplest and least expensive starting point. It involves placing donor sperm near the cervix using a syringe or cervical cap, without any medical assistance. It’s commonly used, cost-effective, and considered safe, though success rates are lower than clinical insemination. Many couples try this first and move to clinic-based options if it doesn’t work after several cycles.
If you use a known donor’s fresh sperm, you skip the cost of a sperm bank. If you order frozen vials from a cryobank, you’ll thaw them at home according to the bank’s instructions. The key limitation is that frozen sperm loses some motility during the freeze-thaw process, and home insemination doesn’t place sperm as close to the egg as clinical methods do.
ICI: Intracervical Insemination
Intracervical insemination (ICI) is essentially the clinical version of home insemination. A provider places unprocessed (unwashed) donor sperm at the cervix using a cap or syringe. Because the sperm doesn’t need to be specially prepared, ICI is cheaper than other clinic-based options.
In a randomized controlled trial published in Human Reproduction, ICI with frozen donor sperm produced a live birth in about 24% of women over eight months of trying. That’s a meaningful success rate, but it trailed behind intrauterine insemination by a significant margin.
IUI: Intrauterine Insemination
Intrauterine insemination (IUI) is the most popular clinic-based method for lesbian couples. A provider processes the donor sperm (washing and concentrating it) and then places it directly inside the uterus through a thin catheter. This bypasses the cervix entirely, putting sperm closer to the egg and compensating for the reduced motility that comes with frozen sperm.
In the same trial, IUI produced a live birth in about 39% of women over eight months. That’s roughly 15 percentage points higher than ICI. Age matters considerably: women 35 or younger have about a 20% chance of pregnancy per cycle, which drops to around 12% for women 35 to 40, and 6% for women over 40. Over seven cycles, the cumulative pregnancy rate for women 35 and under reaches roughly 88%, compared to 65% for ages 35 to 40 and 42% for those over 40.
A typical IUI cycle costs a few hundred dollars for the procedure itself, plus the price of the sperm vial. Some providers add ovulation-monitoring ultrasounds or medication to stimulate egg production, which increases the cost but can improve timing and odds.
Reciprocal IVF
Reciprocal IVF is designed specifically so both partners play a biological role in creating their child. One partner provides her eggs, and the other carries the pregnancy. The egg provider is genetically related to the baby, while the gestational partner experiences pregnancy and birth.
The process follows standard IVF steps. The egg provider takes hormone medications for about 10 to 12 days to stimulate multiple eggs to mature at once. Those eggs are retrieved in a short outpatient procedure using a needle guided by ultrasound. The eggs are then fertilized with donor sperm in a lab and cultured for about five days until they reach the blastocyst stage.
Meanwhile, the partner who will carry the pregnancy takes medications to prepare her uterine lining. In a fresh cycle, both partners take medications at the same time to synchronize their cycles. The embryo is then transferred into the gestational partner’s uterus through a soft catheter. Optional genetic testing on the embryos can be done before transfer to screen for chromosomal issues.
Reciprocal IVF is the most expensive option. A single cycle typically runs $20,000 to $35,000, covering the base procedure, medications for both partners, lab fees, and monitoring. When you factor in sperm donor fees, genetic testing, and the possibility of needing a frozen embryo transfer if the first attempt doesn’t succeed, most couples budget $50,000 to $70,000 for a realistic path to a baby.
Standard IVF
Standard IVF follows the same process as reciprocal IVF, except one partner both provides the eggs and carries the pregnancy. This is typically chosen when one partner has stronger fertility markers, or when couples prefer a simpler medical process involving only one person’s body. It’s also the route for situations where only one partner wants to undergo treatment. Costs are somewhat lower than reciprocal IVF because only one partner needs hormonal medications and monitoring.
Fertility Testing Before You Start
Before beginning any conception method, both partners typically undergo basic fertility screening. This helps your provider recommend the right approach and avoid wasted time and money on a method unlikely to work for your situation.
Common tests include a transvaginal ultrasound to evaluate the uterus and count ovarian follicles (a marker of how many eggs remain), and a blood test for anti-Mullerian hormone (AMH), which gives a snapshot of overall ovarian reserve. If the partner who will carry the pregnancy has any risk factors, a provider may also recommend a hysterosalpingogram, which checks whether the fallopian tubes are open. Genetic carrier screening is often recommended for both partners and the sperm donor to flag any inherited conditions.
These tests help answer a practical question: should you start with a lower-cost method like IUI, or does your fertility picture suggest going straight to IVF?
Legal Steps for the Non-Biological Parent
Establishing legal parentage for the partner who isn’t biologically related to the baby is one of the most important steps in the process, and one that’s easy to overlook in the excitement of conception planning.
In some states, signing an acknowledgment of parentage (sometimes called a voluntary acknowledgment) carries the same legal weight as a court determination of parentage and eliminates the need for adoption. In other states, the non-biological mother may need to complete a second-parent adoption to secure her legal rights. The rules vary significantly by state, and even by county in some cases.
Regardless of where you live, getting legal counsel before conception is far simpler and cheaper than resolving a custody dispute later. A family attorney experienced with LGBTQ+ family building can tell you exactly which documents you need, whether that’s a parentage acknowledgment, a second-parent adoption, or both. If you’re using a known donor, that attorney should also draft or review your donor agreement to ensure it holds up in your state.