Let’s Talk About IVF, Baby!

The earth shattering realisation that you are unable to carry out the most basic primeval desire; to procreate afflicts couples with a lasting pain and anguish like no other.

The social stigma attached to being childless can be damaging. It is perceived as out of the norm. People assume there is something wrong. In Kenya their culture demands that for a woman to be socially acceptable she must have at least one biological child.

If you knew how many couples undergo IVF, then you’d realise how many people are suffering in silence around you right now as a result of infertility. On record, 1 in 8 couples are unable to get pregnant without medical intervention. Did you know how normal that struggle is becoming? 12.5 percent of our population (this only takes into account developed countries or those who actually go and seek out medical help) are in need of medical intervention in order to grow their families.

The first ever IVF baby was born in the UK in 1978. Since then a further 8 million babies have been born as a result of IVF globally. Approximately 180,000 births in the UK each year are IVF conceptions. It’s time to ask more, know more, be more & do more. IVF is no longer taboo, it’s no longer a far out concept associated with Dolly the sheep & test tubes. Test tubes aren’t even used anymore.

IVF has just celebrated it’s 40th birthday, it’s in our world to stay... it helps millions of couples globally achieve what nature alone for them cannot. Despite the negative attitudes that IVF couples are sadly met with, like those we saw from Serena Bergman in 2017 about her disagreeing that NHS funding should be available at all to couples suffering from infertility, or sensationalised newspaper articles that have previously claimed IVF is for couples who can’t make time for coitus, society is partly responsible for the uptrend in IVF. Society persuades couples to wait, emphasising getting degrees, encouraging career prioritisation for both men and women. Consequently, people do ‘the right thing’ and they wait.

The media contributes towards negative attitudes towards IVF. Professor Daniel Brison, director of reproductive medicine at Manchester University Hospital Trust, is currently studying the long term health prognosis for babies born through IVF as part of an EU research project. The results are yet to come out. Louise Brown is only 40 years old. So the next three decades should be telling for us all. Yet the media called it a ticking time bomb likened to eating fast food. A heartbreaking read for parents of IVF children for sure.

Schools taught us and continue to teach our children that if you have sex unprotected you will get pregnant. They fail to teach children that there are only 3-5 fertile days in a woman’s cycle. They fail to teach that fertility drops off by 30 percent at age 27. They fail to teach that the celebrities we see getting pregnant at 45 have most likely used donor eggs. That said (and this is really important for you all to know) IVF is not just for women with low egg reserves or eggs that are hiding; in need of a doctor to go in & find those eggs, IVF is for men whose sperm don’t swim (low motility), or men who have low numbers. IVF is for women whose tubes are blocked or damaged from previous miscarriages, or procedures carried out after losses, or women with PCOS who produce too much follicular fluid that then lingers in their tubes causing Hydrosalpinx, etc. IVF is for women who suffer from Endometriosis where their lining grows anywhere & everywhere but where it should! IVF is for couples who miscarry repeatedly & decide to have chromosomal testing on their embryos (PGS or PGD) to see if both the mother & the father are passing on all 23 chromosomes. IVF is for people who know they are carrying genetic diseases inherited from their parents like Huntington’s Disease, Cystic Fibrosis, etc. IVF allows the embryologist to biopsy two cells from the blended egg and sperm (the newly formed embryo) in the petri dish so that the embryos can be checked for these inherited traits prior to being returned to the mother’s womb. IVF is for lesbians who want to take the egg from one partner & fertilise it with donor sperm & grow it in the other partner so both women feel involved. IVF is for women who are born with abnormally shaped uteruses or no uterus at all allowing a surrogate to provide a couple with their own biological child. IVF is for women with lots of healthy eggs who don’t ovulate/release their eggs on schedule or at all. IVF is for men who produce next to no sperm & need their few sperm surgically removed, this is for men who remarry after a vasectomy or men who have had undescended testes or men who have low testosterone or men who are exposed to heat in their jobs or who suffer radiation damage post-cancer treatment. IVF is for female cancer patients who are advised to freeze their eggs before chemotherapy & radiotherapy to protect them from the radiation. IVF is for women who have experienced premature ovarian failure (early menopause) as young as 19. As you can see, the MEDICAL need for IVF is often multifactoral, meaning there is often more than one singular cause. IVF IS NOT a means of choosing the gender, having twins or for busy couples unable to have sex. IVF IS NOT for rich people who can’t be bothered trying naturally who want to get there faster. You can’t choose the hair colour, eye colour or even choose that your IVF baby will be healthy! IVF pregnancies unfortunately carry a higher risk of miscarriage. You have to have tried for a set amount of time (which changes in duration in the UK based on age) and have to have one of more of the aforementioned medical reasons to qualify for IVF. Most couples beginning IVF have tried other medical procedures prior to IVF like ‘the turkey-baster method’, formally known as IUI: intra-uterine insemination. This bypasses the females’ hostile cervical mucous and places the sperm directly into the uterus. Often, injections are used at this stage. IVF is very much a last resort. It’s a decision made by a doctor. Couples in the U.K. are asked to sign HFEA forms allowing their GPs to do background checks on them. Couples are scrutinised prior to starting IVF. IVF isn’t a quick process. It takes between 60 and 30 days to complete an IVF cycle.

During an IVF cycle the woman takes drugs (that can cost anything from £200-£3000, on top of the cost of IVF itself) to make her ovaries hyper-produce lots of eggs when ordinarily she would only produce one follicle containing one egg a month. The doctors see this as an efficient way to maximise the couple’s chances of achieving a healthy pregnancy sooner.

The gynaecologists then surgically remove multiple eggs in a procedure called ‘egg collection’. Then the eggs (oocytes) go to the lab in a petri-dish to be assessed by an embryologist who will determine how many are mature (fully cooked and fit for fertilisation). The embryologist then puts the sperm into the dish & nature takes it’s course. Some eggs fertilise, some eggs don’t. In the event of sperm not moving (having low motility) a procedure called ICSI can be carried out. Sperm is randomly selected and injected into the centre of the egg. Some controversy still surrounds this technique as not enough babies have been born from ICSI to study it’s long term effects on physical development. Other more specialised techniques for sperm issues are coming into play as scientists more readily acknowledge that DNA fragmentation of the sperm can lead to miscarriage. I LOATHE the term miscarriage, as it implies that the mother carried the pregnancy badly. As if she MISS-CARRIED it. I refer to my own as ‘pregnancy losses’. The science is now acknowledging that the genetic matter delivered to the embryo from the sperm can impact on the development of the embryo significantly. You could have a perfect egg, a perfect womb but a poor quality sperm which can stop the embryos from continuing to grow in the lab up to transfer or can lead to an early miscarriage. IMSI & PICSI are a more developed means of ICSI whereby the embryologist can use a medium to attract the best sperm allowing selection of the best quality sperm cells. This of course costs more money but it permits a reduction in the chance of miscarriage or embryo arrest. This ‘in vitro’ (in the lab) time is a tense 2-6 day wait for the parents to be. Prospective parents are lucky to receive 2 phone calls in this time. Imagine your 1-6 day old baby being with a stranger you’ve only spoken to briefly with minimal contact!

New medical advances are coming into play (but they cost more) like time-lapse imaging of the embryos. A machine incubates the precious cargo and photographs the changes in the cells every ten minutes. The benefits of time-lapse imaging is that the embryos are not taken out of the incubator and exposed to chemicals, bacteria, and viruses in our natural environment. Embryologists practice the utmost hygiene; however, it’s still not as sanitary as it would be if the embryo were to remain inside the mother during this phase. Believe me when I say IVF failure is multi-factorial too. It is never just the fault of the mother, although it is instinctive for the prospective parents to feel this way.

The sense of responsibility for your offspring is strong even when they are only a ball of cells.

If natural fertilisation has happened or ICSI has been performed, some of the (now) embryos will grow; they are invisible to the naked eye but seen clearly under a microscope. The medical team consult and decide to then TRANSFER one or two embryos back to the womb. They do not IMPLANT them (God, I hate that word & misunderstanding). The embryos are suctioned out of the petri-dish into a syringe/catheter also containing a liquid that mimics the insides of a woman’s tubes (different qualities of solution are used by different clinics this is often reflected in the differing prices paid between clinics) & are squirted back into the womb in this liquid. Nature is very much at play & nature ultimately decides if the embryos are accepted into the lining. This is why IVF is not fool proof. Damage can even occur to the embryos in the catheter at transfer. It is NOT the woman’s fault when IVF doesn’t work. Sometimes it is pure chance/nature. Sometime the embryo has been transferred on the wrong day. Sometimes natural fertilisation took place but a DNA fragmented sperm go in. Sometimes the embryos are aneuploid (chromosomal abnormal). Out of every 10 eggs collected it is believed that one 1 egg is ever intended to become a live birth. At the end of the day IVF is a science; a constant learning curve for all involved. The techniques are constantly evolving. The success rates are slowly increasing meaning couples who historically would never have had the opportunity to overcome their fertility diagnoses now have the chance to. I’m grateful it exists & I’m fortunate to have access to it. It bleeds our bank account dry every month, but don’t all kids, no matter how small?

IVF failure is as painful for the prospective parents as miscarriage and loss. This is mainly down to the fact that we see our living offspring on a screen, knowing it gets placed into us having only been seen alive in the laboratory 90 seconds earlier. Once the two week wait (the time clinics ask patients to wait until doing a home pregnancy test after transfer) is up, if there aren’t two lines on that home pregnancy test then the sense of loss is all consuming & often suffered in total silence by the couple. The silence engulfs people going through this private trauma. Some poor women get their periods before the two week wait finishes. Goodbye money, good bye baby.

My personal coping mechanism is to go out and do all of the things I couldn’t do it if was pregnant. I have a nice medium rare steak, blue cheese, pâté... maybe a glass of red wine followed by a hot bath. We allow ourselves to grieve and we look to the next cycle. We put ourselves in a bubble & ignore all of the uneducated comments that inevitably come our way. With each failed transfer it gets harder and harder. Emotionally it’s getting slightly easier oddly, financially it’s becoming impossible. We’re just not ready to let go of our perceived future that consists of a home full of love, laughter, toys that we stand on in the middle of the night and our children. We haven’t yet divorced the idea of being parents together. It’s something most couples would take for granted as a given. For most it’s a standard part of life, to get married, then have kids, watch them grow and then grow old yourself to then look after grandchildren. Infertility affects prospective grandparents too. I’m hearing increasing stories where grandparents are stepping in to foot the bill of IVF.

On a positive note, not all IVF ends in failure; in fact, many couples are successful on their first try and go on to have siblings for their first born through IVF too. IVF on average has a 30 percent success rate; therefore just like normal means of reproduction, it is a numbers game.

There is widespread debate in the UK right now about the ‘IVF postcode lottery’ whereby different NHS trusts in different regions offer no NHS IVF cycles or up to three IVF cycles on the NHS. In American different companies offer different health insurance packages, some are better than other at covering infertility and IVF.

If like us you’re a couple paying for all of the investigative tests prior to IVF and then the IVF itself you might be tempted to look overseas. The cheapest country appears to be Hungary offering IVF for €1500 a cycle. We chose clinics based on our medical need. We chose clinics who specialised in treating our own personal causes of infertility.

Not every couple ‘graduates’ from the school of IVF and goes on to have a family of their own. Jessica Hepburn is the UK-based blogger and Author of The Pursuit of Motherhood and 21 Miles detailing her long journey with IVF. Jessica said that doing IVF 11 times made her feel ‘ashamed, delusional and lonely.’ These are certainly emotions that the women I speak to endure. Money & the support you have around you from friends, family and work ultimately dictates how long you can withstand the journey. Health plays a huge role too. It’s important to acknowledge the physical and mental toll IVF has on a woman.

If you’ve been affected by ‘Secondary Infertilty’ whereby you have one child but have been unsuccessful at conceiving and delivering subsequent children that can also be an isolating and painful experience. Getting support in this instance is even harder. ‘Appreciate the one you have,' or ‘You’re lucky to have one,’ are common throwaway comments. Helen Davies, a fellow IVF sister from Hull who has written an excellent book called More Love To Give, accurately details the daily strain of IVF. Her IVF resulted in her twins, thankfully. So every couple has their own story to tell.

The UK will treat women up to age 42. Countries like Greece extend the offering of help with reproductive treatments up to the age of 50. In 2016 Daljinder Kaur gave birth to her first baby, a boy, at the age of 72 in India.

Knowing all of these facts, IVF isn’t the problem. IVF is a cure. IVF doesn’t upset couples or bring them sadness. Yes it’s a tough going and often expensive process but it’s the infertility itself, the being forced to suffer in silence & people having lack of understanding, or worse judging, that causes the sadness. It’s time to talk about infertility. It’s time to support the vast numbers of people who are going through IVF. It’s time to understand what it is. It’s time to embrace the science and be grateful that Jean Purdy (the world’s first embryologist responsible for Louise Brown), Patrick Steptoe and Robert Edwards took the risk and trialled this intriguing medical gamble! Robert Edwards was awarded the 2010 ‘Nobel Prize in Physiology or Medicine’.

The World Health Organisation recognises infertility as a disease. Once embryo transfer has taken place a woman should be regarded as pregnant in the workplace and all maternity employment law applies during the two week wait here in the UK. Unfortunately not all employers recognise IVF as an illness and some contracts categorise IVF as a voluntary medical treatment like plastic surgery; failing to note the infertility is not voluntary. The world has a long way to go in developing it’s attitude towards infertility and IVF. Let’s start by shattering the stigma around infertility. Let’s talk about IVF. Let’s be open about all of the different causes of infertility. Future generations with thank you for it.

My First Ever Stimulation Drug Injection

I was supposed to take my stimulation drugs at 9 PM; by 10 PM my husband was chasing me around the house, nagging me not to put it off any longer. I chose to do this so at night so that it didn’t affect me at work, and so that I could sleep through the intense symptoms. After the first few needles I got very good at it. Everyone develops their own technique. Safe to say, don’t go aggressively hugging your friends and family who are going through IVF; they might be bruised, it might hurt them.

Have you seen the size of these needles 😰 If this isn’t commitment to the cause, I don’t know what is...

Another day, another stirrup... This is our life!

The side to IVF you don’t see: This is what 29 follicles growing inside of you before egg collection looks like.

In 2005 Temilola Akinbolage, 33, from South London, died after collapsing at a bus stop after developing OHSS. This potentially fatal condition affects one percent of women doing IVF while the mild or moderate form affects 20 percent of women undergoing hyper stimulation of the ovarian follicles.

Risk aside, this is cause enough for women to hide away during their IVF. They noticeably aren’t drinking alcohol and are sporting a sudden protruding belly. Infertility is so harrowing that being asked if you are pregnant when that’s all you want feels like a smoking hot meteorite has just hit you. It makes social situations trickier, which in turns makes those undergoing IVF who play social dodgeball look more miserable than they already are, which unfortunately doesn’t recruit support from friends and family—which is actually the very thing that is needed.

The Contents of Our Fridge...

And so we dust ourselves off and carry on...

The Sun Before the Rain...

And so the two week wait commenced. This was our first ever IVF cycle. Statistically, it all looked good. An earthquake happened inside of me when my period came three days before my official test date, only 11 days after our embryos had been transferred.

IVF can be lonely & isolating. I choose to try to minimise those feelings by organising IVF Meet Ups, bringing ladies in the same boat together...

Why pineapples, I hear you ask? Pineapples contain an enzyme called bromelian that is supposed to make the uterine lining more receptive to embryos after transfer. Also there is a cute quote flying around: ‘Be a pineapple: stand tall, wear your crown, and be sweet on the inside.’ Unfortunately, infertility has the potential to make a couple bitter. It takes a lot of self assessment and mindfulness along the way to fight the feelings that creep in. IVF meet ups do help. We are #ivfstrongertogether.