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Deciding to start a family is a huge, life-altering decision, and for couples who need to use in vitro fertilization, that decision all too often comes with a huge, life-altering price tag.

As a same-sex couple, Texans Ashleigh and Bliss Coulter knew they would need to turn to IVF to start a family, and thanks to some new developments in reproductive technology, they were not only able to both carry their baby at different stages of pregnancy, but also save money and time in the IVF process.

The Coulters made international headlines this fall when news broke that they had both carried their son, Stetson (now 4 months old) thanks to a procedure called effortless IVF, and the INVOcell device, a small medical device that basically uses a woman's vagina as an incubator.

"I wanted to have a child that was biologically mine, but I didn't want to carry the child," Bliss tells Motherly. Her wife, Ashleigh (seen above holding Stetson), did want to be pregnant.

It's common for same-sex couples to turn to reciprocal IVF (also called "shared motherhood") when one woman wants a biological child but her partner wants to be the one to be pregnant. Reciprocal IVF sees one partner's eggs fertilized and then implanted in her spouse's body.

It doesn't come cheap (costs per IVF cycle range between $16,000 and $30,000, according to WinFertility), but for some couples, it is the perfect way to start a family.

The Coulters knew that's what they wanted, but when they heard about the work Drs. Kathy and Kevin Doody of the Center for Assisted Reproduction (CARE Fertility) were doing, they wondered if the method the Doodys pioneered, effortless IVF, could allow them to add a layer to their reciprocal IVF plan—and remove the need for a laboratory incubator by using Bliss' own body.

When the couple met with Dr. Kathy Doody to inquire about whether effortless IVF with the INVOcell device could be used in reciprocal IVF, they were thrilled to hear the doctor say she couldn't see why not. "We've done close to 200 effortless IVF cycles with heterosexual couples," Dr. Doody tells Motherly. "But this is a special opportunity that same-sex couples can share in."

Dr. Doody and her husband are passionate about helping more couples (both same-sex and heterosexual) access IVF by reducing the costs associated with the procedure. The effortless IVF method makes things more affordable by reducing sonogram and monitoring appointments and by using the patient's health, age, and weight to determine the dosage of medication (which reduces the costs of the medication and eliminates the need for appointments for medication adjustments).

"I think the onus rests on us as physicians, it is our obligation to figure out ways to help as many patients as we can rather than just stick to a very confined model of what we think IVF should be," Dr. Doody says.

"The way the cost is less is just not with the device. There are fewer visits, there's no blood work during their IVF cycle, [and] they have a fixed dosing protocol," she explains.

For the Coulters, having fewer costly appointments than are required with traditional IVF was a great bonus, but the fact that Bliss got to carry the embryo that would be implanted in Ashleigh was even better, and actually easier than they expected.

Regarding the INVOcell device, Bliss tells Motherly "there was no side effects, it didn't hurt at all. I continued to ride my horses like I do, and so that was pretty cool. That kind of took me by surprise in a good way."

After the embryo that would become Stetson was done incubating in Bliss and moved to Ashleigh, another welcome surprise came along. Although Dr. Doody seemed super confident about the likelihood of success, somewhere in the back of her mind Ashleigh has worried that it wouldn't work. "It was something that had never been done, honestly," she tells Motherly. "I was so shocked that it happened on the first try. I think that was the biggest thing for me."

The first time she felt Stetson kick, it all became more real. Finally, she and Bliss were going to be parents. A shared conception experience followed by an uncomplicated pregnancy and the birth of a healthy baby boy. It was an absolute dream come true.

Both the Coulters and Dr. Doody tell Motherly they hope the story of Stetson's conception not only helps same-sex couples share in the IVF experience, but that it also makes IVF more accessible to all couples who are working within a budget or live far from an IVF clinic.

As Dr. Doody points out, there are places in America where there isn't an IVF clinic in the entire state, and Bliss says that with the minimal appointments she and Ashleigh experienced, she could see effortless IVF being a good option for people who live far from a clinic and need to keep out-of-state appointments to a minimum.

"The concept of effortless IVF is to make IVF more accessible to more patients," says Dr. Doody. Whether that means making reciprocal IVF a more shared experience for two mamas or reducing the burden of the investment on couples in general, she's keen to help more families experience the life-altering results of IVF with a less life-altering price tag.

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