Weekend Argus (Saturday Edition)
Revolution with a price: dark side of fertility treatments
FOR Justine Bold, it was only after three miscarriages, five gruelling rounds of in vitro fertilisation (IVF) and years of financial sacrifice and anguish that she finally fulfilled her dreams of motherhood.
The moment she held her twin boys, Otto and Orin, in her arms, all the difficulties of her long journey were forgotten. “When they were born, I remember just smiling a huge smile and feeling so very lucky,” says Justine, now 48.
Yet while Justine still feels lucky to have her sons, four, she also experienced a rather more unwanted side-effect of IVF.
When Otto and Orin were just 16 months old, her longterm relationship with their father broke down, partly because of the strain caused by undergoing fertility treatment. Since then Justine has found herself a single mother.
Last month marked the 40th anniversary since the first successful transplantation of an embryo grown in a test tube. Louise Brown, famously the world’s first IVF baby, was born on July 25, 1978. It’s estimated six million children globally have been born from IVF, or fertility treatments developed from it.
This gift of parenthood is surely one of the defining inventions of the 20th century. And yet there’s no denying the IVF revolution has come at a price. As Justine’s experience illustrates, it’s by no means a straightforward solution to fertility problems.
What’s often not heard about is the impact the often cripplingly expensive, not to mention physically demanding, treatment can have on the couples involved. Danish researchers, for example, estimate those who go through failed IVF are three times more likely to separate than those who go on to have a baby.
Jennifer Edwards, a relationship therapist with more than 20 years of experience, sees many couples who are trying to pick up the pieces of relationships broken by the expense and intrusion of fertility procedures.
She says: “Infertility is still a subject lots of couples do not discuss with friends and family. I still hear women and men express a sense of shame that they are not able to conceive a child.”
Men, in particular, can feel left out by female partners intent on conception. They are often more willing to accept children just won’t happen and move on, while their wives remain determined to become mothers at any cost.
Musician and former Strictly Come Dancing winner Harry Judd recently spoke of the disconnect that often occurs, after his experience with wife Izzy. “She so desperately wanted to be a mother. As soon as we realised there was a problem, it took over her life.” The couple now have Lola, one, who was born after IVF, and a three-monthold son, Kit, who was conceived naturally.
But even successful treatment is not always enough to heal the rifts, as Justine, from Worcestershire, discovered. She had wanted to be a mother since her early 30s, but suffered a miscarriage aged 32 while in a previous relationship. After meeting her partner at 37, they started trying for a baby about 10 months later. At 39, she went to her GP.
“I was told I had a good ovarian egg reserve and got pregnant naturally in 2011 but had a miscarriage.
“I then had an early miscarriage after a cycle of ICSI (where the sperm is injected directly into the egg). More tests revealed I had Hughes syndrome, which makes the placenta fail, and my immune system was attacking embryos. Finally, with a fifth cycle of IVF, the treatment worked.”
But she says: “Struggling with fertility problems and going through fertility treatment was more of a strain on our relationship than I’d expected. Having a baby was more of a focus for me. My partner started to resent it. The fertility drugs made me feel fat and emotional.
“It became harder to deal with the grief that was accumulating each time I had a miscarriage or an IVF cycle failed. I kept wanting to try, but my ex got less keen as time went on, so this was a problem that built up between us.
Then when I did get pregnant with twins, he was very apprehensive about coping with two.
“I think a lot of people believe the journey stops when you get pregnant and it’s plain sailing from there, but my experience is the journey doesn’t stop then. There can be loss and surprises on the way – like twins – that add to the pressures, particularly on relationships.
“But I think if you are lucky and you bring new life into the world, you just have to deal with whatever happens, even if it means doing it on your own, as then you have a child to think about and their needs are more important.”
Fertility treatment can also play havoc with the physical side of a relationship. A Stanford University study found that 40% of women struggling with infertility experienced low libido, even though they previously had no difficulties when it came to intimacy. It wasn’t clear whether IVF drugs or psychological issues were the main factor.
Justine, a lecturer in nutrition who has edited a book on infertility, concurs: “There are long periods where you can’t have sex after treatment or feel too sore. Years of timing sex around ovulation also takes a toll as it destroys spontaneity.”
The detrimental impact of fertility treatment on a couple’s love life is something that’s not talked about enough, says Jessica Hepburn. Now 47, she went through 11 failed cycles of IVF because of unexplained infertility before she accepted biological motherhood would not happen for her.
Jessica, who now campaigns for improved care for infertility patients, believes couples are often not prepared, emotionally or financially, for what can be a very long journey.
A single IVF cycle has an average success rate of 32.3% for those under 35, dropping to 5% for women aged 43 and 44 and only 1.9% for those 45 and older.
Jessica says: “Taking into account all the tests and three cycles of IVF that means it’s likely to be a journey of anywhere between three to six years.
“Going through IVF is definitely a catalyst for separation,” she says. “Pete (her partner) and I have had some really dark times and for a while he moved out because he was unable to cope with my violent mood swings..”
She adds: “Infertility is treated as a clinical problem. But what’s not considered is the psychological trauma which starts the moment you discover you have a problem.
Then there are the financial pressures on a couple. Jessica’s unsuccessful treatment cost a crippling £70 000 (R1.2m), while nearly eight years on from her first IVF cycle, Justine is still paying off the £50 000 bill for her treatment.
As many discover, bills for IVF can soar. A single cycle costs upwards of £5 000, and often far more.
With 60% of IVF cycles paid for privately, it’s perhaps unsurprising the fertility industry faces accusations of exploiting that desperate urge for a child.
As Jessica, a writer and arts producer, puts it: “You’ll do anything if someone says it will give you a baby.”
Yet an investigation by Panorama last year revealed some “add-on” treatments being offered by some clinics simply do not have the clinical evidence to back up the claims being made.
Over the past 40 years the landscape of motherhood has changed dramatically, with the average age of mothers climbing ever higher. Despite IVF being most effective for the under 35s, 57% of IVF cycles are undergone by women 35 or older.
To Jessica Hepburn’s mind, knowing you can have fertility treatment encourages the impression that it’s fine to delay motherhood. It’s something to get round to when all the other elements of our lives are in place.
She was 34 and successfully running a London theatre when she decided to start a family.
She sees IVF contributing, in part, to a fundamental societal disconnect from the reality of conceiving a child “that it’s just more likely when you’re young.
“People are leaving it later to have children, and they’re not having them at the biologically optimal age,” she says. “We’re told in schools how not to get pregnant, but we’re not told what we need to know about our fertility life cycle.
Jessica feels so strongly about this that she co-founded Fertility Fest, an annual festival that provides support for those going through treatment by bringing together artists and fertility experts, as well as educating teenagers about the realities of fertility.
Adam Balen, professor of reproductive medicine and surgery at Leeds Teaching Hospitals NHS Trust and chair of the British Fertility Society, which works to promote standards of fertility care and research, agrees there needs to be improved education.
Despite all these complex issues, IVF has brought joy to the lives of so many. Forty years on from that first “testtube” baby, the true legacy of IVF remains unknown. For many who have already been through the experience, it has been a mixed blessing. – Daily Mail