Dare you risk

IVF? It’s a booming £500-million industry, but at what cost to those going through it? Emma Elms speaks to women who have jeopardised their health, homes and relationships for the chance to have a baby

Claire Dower, 35, spent more than £20,000 on IVF, had eight rounds of treatment, and often travelled 600 miles in a day just so that she could go to a clinic in London.

Nothing would have got in the way. During one cycle, Claire, a laboratory technician from Cornwall, had agonising abdominal pain. Doctors continued the treatment regardless. It later emerged that she had developed ovarian hyperstimulation syndrome (OHSS), a potentially life-threatening complication of IVF, where the injected hormone produces too many eggs. ‘I was bedridden for two weeks and then found out that the treatment hadn’t worked,’ says Claire. ‘But we were so desperate for a baby, nothing would have stopped us.’

Claire recovered and, two years on, is seven months pregnant. But not every story has a happy ending. Symptoms of OHSS include weight gain, vomiting, shortness of breath and – in rare cases – death. Mild OHSS occurs in one in three IVF cycles; moderate to severe OHSS occurs in up to eight per cent of cycles. For Lee Cowden, 37, a teacher from Surrey (see below), OHSS triggered a heart attack.

It is 38 years since the birth of Louise Brown, the world’s first test-tube baby, but experts argue that the original 1990 health and safety laws surrounding IVF (updated in 2008) have failed to keep pace with new techniques and drugs.

However, many women who want a baby seem prepared to risk their health, even when there is no guarantee of success. Nearly 50,000 women in the UK have IVF each year, yet women under 35 have just a 32 per cent chance of having a baby; for women aged 40 to 42, the odds fall to 14 per cent.

Earlier this year, Siobhain McDonagh MP called on Parliament to update the Human Fertilisation & Embryology Act to protect women undergoing IVF. ‘The act contains failures that are endangering women’s lives and long-term health,’ she said. ‘It requires clinics to take into account the welfare of the child before providing IVF treatment, while the women’s welfare is not considered.’

The National Institute for Health and Care Excellence (Nice)

I was bedridden for two weeks and then found out that the treatment hadn’t worked

recommends that women under 40 who don’t already have children are offered three free cycles of IVF, while those aged 40 to 42 are given one (women over 42 are not eligible on the NHS). In practice, many couples, due to which region they live in, cannot get access to IVF on the NHS at all and must resort to private treatment. For them, regulation is even more important.

Professor Geeta Nargund, a fertility expert, calls the industry ‘the Wild West’ and believes the private sector desperately requires tighter rules. ‘First, there needs to be an explicit obligation for clinics to take into account the welfare of women undergoing fertility treatment,’ she says. ‘Second, the Human Fertilisation & Embryology Authority [HFEA] should be collecting information from all clinics relating to the doses and drugs given to women during IVF.’ This would enable the HFEA to better monitor the effectiveness and side effects of treatments.

Professor Nargund is medical director of Create Fertility, a private clinic, and a lead consultant for reproductive medicine services at St George’s NHS hospital in Southwest London. She specialises in natural and ‘mild’ IVF, which uses minimal or no drugs, and involves doctors working with a woman’s cycle to collect a naturally produced egg, which is then fertilised in a laboratory with her partner’s sperm. She is working with McDonagh to highlight the need for tighter regulation.

Professor Nargund points out that all IVF clinics must report ‘serious’ adverse effects of fertility drugs to the HFEA, but adds that they don’t have to reveal which drugs they’re using or the dose. Some clinics, she warns, could be using higher doses to generate more eggs while putting women’s lives in danger. She adds that women are at risk of being sold drugs, procedures, tests and add-ons (from immune therapy to advanced sperm selection) without understanding which ones they actually need. ‘Women going for IVF can end up paying three or four times what’s quoted,’ says Professor Nargund.

When couples arrive at a fertility clinic, they are often determined to do everything they can to ensure success. Lucy Thomas, 31, a former lawyer from Bristol, is about to undergo her eighth IVF cycle. Early on, she paid £500 for a fertility MOT from a private clinic, only to be given a sheet of bewildering numbers. ‘We had to chase them for an interpretation. It confirmed that the blood flow to my womb was fine, which we already knew.’ Another time a clinic insisted on giving Lucy a cervical dilation costing £2,000 – even though Lucy had explained that her cervix was already dilated from previous surgery.

The HFEA advises women to ask how much treatment might cost before they embark on IVF. Its website also lists questions to ask the doctor to avoid unnecessary add- ons, as well as clinics and their success rates. But this doesn’t stop women getting into crippling debt in their desperate bid for motherhood.

Claire Dower and her partner Danny sold their two-bedroom cottage in Cornwall and moved into a caravan on her father’s drive to fund their IVF treatment. Lucy and her husband have spent £40,000 – they have borrowed £20,000 from their parents, racked up £18,000 on their credit card and had to move to a cheaper home. ‘People have told us that we should give up,’ says Lucy. ‘We have agreed that we will do one more round of IVF and then consider adoption, but it’s not an easy decision.’

Such eye-watering figures are not uncommon. Sarah*, 38, a marketing manager from Sussex, and her partner have spent £51,000 on IVF. ‘We remortgaged our flat to raise £35,000, used £11,000 of savings and inheritance, and then, when the clinic suggested we try one last round, I took out a £5,000 loan from the bank and pretended it was for home improvements. I’ve spent £14,000 on fertility drugs alone.’ Sarah admits that she is reluctant to stop. ‘You feel you should try just one more time,’ she says. ‘People don’t understand what you’re going through.’

Sarah eventually went to a private clinic in Spain. ‘I compared success rates from all over the world, and those at Spanish clinics were

Claire and Danny Dower spent more than £20,000 on IVF