The routes, in the order they are usually considered

Intrauterine insemination with donor sperm

The HFEA describes IUI, also called donor insemination, as often used by people in female same-sex relationships. Donor sperm is prepared in the laboratory and placed directly into the uterus around the time of ovulation, with or without fertility drugs, and the procedure itself is relatively quick.

IVF with donor sperm

IVF may be appropriate where there are fertility problems, and it is increasingly used as a first treatment rather than after IUI. The HFEA reports that single patients and patients in female same-sex couples were previously more likely to have donor insemination first, but in recent years an increasing number opt for IVF with donor sperm as their first treatment.

Reciprocal IVF

Also called shared motherhood or shared parenthood: eggs are collected from one partner and fertilised with donor sperm, and the resulting embryo is transferred to the other partner, who carries the pregnancy and gives birth. The HFEA notes couples choose it for various reasons, including where both want to take part in conception and pregnancy.

What the national data shows

The HFEA's 2024 figures give useful context, with the population and denominator stated. Female same-sex IVF patients increased from around 1,000 in 2014 to 2,800 in 2024. In donor insemination, single patients accounted for the largest share of patients at 51% and female same-sex couples 42% in 2024. The average age at the start of IVF was 33.4 for female same-sex couples, compared with 34.8 for opposite-sex couples and 35.4 for single patients.

On outcomes, the HFEA reports that among patients aged 18 to 37 in 2022–24, the average birth rate per embryo transferred was 42% for patients in female same-sex couples, 39% for single patients and 35% for patients in opposite-sex couples. Two cautions belong with that figure. It is a rate per embryo transferred, not per cycle started, so a cycle producing several transferable embryos gives more than one attempt at it. And the difference largely reflects who is being treated — a younger group, often without a diagnosed fertility problem — rather than anything about the treatment.

Legal parenthood: the forms that decide it

This is the part that causes the most avoidable harm, and it is entirely administrative.

In the UK, the person who gives birth is always the child's legal mother and legal parent. If you are married or in a civil partnership before treatment with donated sperm or embryos, your partner will also automatically be the other legal parent, unless they do not consent to the treatment.

If you are not married or in a civil partnership, your partner will not automatically be a legal parent. For that to happen, both of you must give written consent before treatment takes place — before the sperm is inseminated or the embryo transferred. The HFEA states this applies even in a female same-sex relationship where one partner is donating her eggs for the other's treatment. The birth mother completes the WP form; the partner completes the PP form. They cannot be completed afterwards.

The consequences of getting this wrong are not theoretical. The HFEA records that problems with legal parenthood consent have led to couples going to court after their child was born so that legal parenthood could be declared, and lists the errors that cause it: forms not completed before treatment, mistakes on forms, missing information, the clinic not providing the right information, and forms getting lost. Ask for copies of both completed forms and keep them.

Legal parenthood affects nationality, inheritance, financial responsibility and the right to make decisions about schooling, medical treatment and religious upbringing. A partner should only be registered on the birth certificate if they are the child's legal parent.

Why the clinic route matters legally

Where treatment takes place at a licensed UK clinic, the donor has no legal rights or responsibilities to the child. The HFEA warns that if you use a private sperm donor outside a licensed clinic and you are not married or in a civil partnership, the donor could be considered the legal parent of your child, with the rights and responsibilities that follow.

Clinic treatment also means the donor has had rigorous health testing and counselling, and it means your child can access information about their donor: non-identifying information at 16, and identifying information including contact details at 18, with the possibility of contacting genetic siblings where both parties wish. In the UK one donor's sperm, eggs or embryos can be used to create up to 10 families.

Funding, and a rule worth knowing before you start

The HFEA sets out the position plainly: same-sex couples and single women without a known fertility problem may be asked to have a certain number of self-funded IUI cycles before qualifying for fertility testing, and NHS-funded treatment depends on where you live. It advises talking to your GP about the process in your area.

NICE's access criteria for IVF include a route that reflects this: IVF should be offered to those who have not conceived after 12 cycles of artificial insemination, where 6 or more cycles are by IUI. Ask your Integrated Care Board or equivalent for its written policy, including whether self-funded cycles count towards the total, and keep records of every cycle you pay for.

Practical steps

Choose an HFEA-licensed clinic and check its inspection and patient ratings, waiting times for donor sperm, and counselling provision.
Decide together whose eggs and whose uterus, and if considering reciprocal IVF, understand that the partner who provided the eggs has the final say over any stored embryos.
Confirm ovulation first. NICE recommends confirming ovulation before donor insemination, and offering tubal assessment if the history suggests tubal damage.
Complete the WP and PP forms before treatment if you are not married or in a civil partnership, and take copies away.
Take up the offer of counselling. Every licensed clinic is required by law to make it available.

Getting Pregnant as a Same-Sex Female Couple: Your Options