Diamonds and Daisychains reader, Samantha O’Donnell, shares her journey through IVF, from the moment she decided she’d better get on with it to the moment she realised it might not happen.
I never expected I would be pursuing fertility treatment on my own in my 40’s. It never occurred to me that I would be that desperate for a child…
Every woman’s personal circumstances are different. I was waiting for the right time, right bloke, when I would have the funds and patience to take on motherhood. I spent my 20’s preventing pregnancy and my 30’s with a partner who couldn’t have children. I thought if I worked hard, played hard and importantly got some money under my belt everything would fall into place. Unfortunately little did I realise my biological clock was ticking.
I was about 38 years old when I first mentioned to my GP in Scotland that I wanted to have children but my partner was infertile. I remember the GP saying that we would have to pay privately for treatment at a specialty fertility clinic. Deep in my heart I knew that it wouldn’t happen: My partner was never going to pay for fertility treatment and I had no savings and was surviving month to month with a new business. It wasn’t even worth bringing the subject up. So I shelved my desire to have a family and concentrated on working harder.
Five years later, I mentioned my desire to have children to another GP. I was now 41 years old. That was two years ago. I was informed that NHS funding for IVF stopped at 39 years of age, (although this may be extended to 42 in 2014) but was given a quick referral to a private fertility clinic.
My consultant was sympathetic to my situation and explained to me that I could be treated together with my partner. If he was willing to attend the clinic he would need to have a sperm analysis, then we would have counselling together and separately, and sign all the legal paperwork before moving forward with treatment.
Alternatively, I could decide to be treated as a single woman. Both options involved me paying for treatment privately.
Unfortunately my partner did not wish to join me in going forward with any fertility treatment. He had made his peace with not having children and he thought we were too old (me over 40, him nearing 50). He had undergone fertility treatment during a previous relationship and the experience had completely and permanently put him off the idea. In his words it was “meddling with nature”. Further, adoption was ruled out as he “didn’t want to bring up someone else’s kid”.
He wished I had addressed this five years earlier. His arguments were sound. I felt awful for bringing up “his” infertility. I was sad they he didn’t want to try and have a child with me, despite having been prepared to do it with someone else.
I did a lot of thinking about how I would lose my relationship if I pursued my desire to have children. I never wanted to trap a man with a child he didn’t want.
I spoke to a doctor friend who advised me that at 41 my best chance of falling pregnant with intra-cytoplasmic sperm injection (ICSI) using my partner’s sperm or failing that with donor sperm. She urged me time was not on my side.
Going it alone
Looking back, the most stressful decision was to proceed alone. I had thought only desperate, lonely women would have IVF without a partner. Was that me? I found it hard to make the decision to move forward and use donor sperm. Was I being selfish?
I was offered free counselling with the fertility clinic. The first session didn’t go so well. The counsellor started the session by telling me she was writing a report that would go to the fertility team regarding whether I was suitable to have treatment. Great. So I had to talk about my concerns while simultaneously being judged? I was too emotional and – to be honest – I knew that to move forward with fertility treatment I had to give up my 10-year relationship. At the end of the session she said she wasn’t prepared to write a report for approval yet. I would have to come back and see her, either with my partner or as a single woman.
In the meantime I went back to my fertility consultant and choose to go forward with a laproscopy to check for any problems. I didn’t want to give up my relationship and later find out I couldn’t biologically have children anyway. Everything came back clear.
I remembering my partner picking me up from my parents’ house after the operation and telling him the doctor hadn’t found any problems with my reproductive system. I had tears in my eyes. I knew it was the end for us. I look back now and wonder whether I would have been able to accept not having children if they had found some sort of physical problem.
It took me six months to pluck up the courage to go back and see the counsellor. When I finally did, I kept my emotions to myself and said very little. I needed her approval to go forward with treatment, but after my previous experience had decided that the less said the better!
Right from the start of my fertility journey I knew I wouldn’t qualify for any free NHS treatment. Some may argue at 41 years of age I had left it too late to start thinking about getting pregnant, and sadly they may be right. I naively thought I would fall pregnant quickly with a little expert help. I had never tried to get pregnant before and had no diagnosed problems. I was fit and healthy and thought all I needed was a little male help.
How far would I go to have a child?
At each step of the fertility journey you peel back another layer, make another decision, take another step forward. After getting the approval for fertility treatment, my next step was choosing a sperm donor. Checking out men’s profiles online, should be fun, right? Possibly, if you are Internet dating. Personally, I couldn’t get my head around choosing the genetic father of any potential child on line. I was still struggling, thinking myself selfish to bring a child into the world without a father, but pushing ahead all the same.
It came as a bit of a shock to me to discover that generally, when being treated privately as a single female you choose your donor from a registered sperm donor clinic. These clinics have done all the required health checks on the donor and store the sperm for at least six months before it is re-checked and released.
In Scotland, donors are required to be open, which means that at 18 years of age the child can obtain information on the donor if they wish. My clinic gave me two names: the European Sperm Bank in Denmark and Xytex in the USA. Initially my feeling was to go with the European clinic as it was closer if any child wanted to trace their biological father at 18 years of age but in the end it was much easier dealing with an English speaking clinic, so I choose Xytex in the US.
Xytex has a good website and you start by searching basic physical descriptions of potential donors. In the meantime I had some blood tests required by my clinic. One of these tests confirmed my Cytomegalovirus (CMV) status as negative. This meant I needed to find a donor who was also CMV negative as a first exposure to the virus during pregnancy can damage the fetus.
Searching for a Caucasion donor who was willing to donate to the UK and was CMV negative narrowed my search from 1000′s of potential men to just six.
Of those six, I made my choice by height, weight, hair and eye colour. Because the shipping cost was so much more than the insemination vial itself, I decided to buy three insemination vials (three potential chances) instead of shipping each one individually if the it didn’t work straight away. Including the shipping cost I spent about £1500.00.
Initially I thought all I wanted to know about the donor was his basic physical statistics, but after I had purchased the sperm I wanted to check out his whole donor profile, and keep it for any potential offspring. His profile was a big shock!
Without realising it, I had built my own picture of what the donor would look like. Although he was 26 years old and met my physical criteria, when I saw his picture staring back at me the first thing I thought was that I probably wouldn’t have dated him. Also, there was a letter from him to any potential child, and something bothered me about it: it just sounded a bit flat.
But I had chosen my donor and purchased my sperm, and my “precious cargo” was being shipped by the sperm bank to my fertility clinic.
My early attempts at getting pregnant
I felt like I had my head around the process and was excited to start with my first insemination. I would undergo intrauterine insemination (IUI), which costs around £1500.00. This basically involves injecting a small amount of hormones every day, from after your period and attending the clinic for vaginal scans to monitor follicle growth. I have since nick-named this part of the treatment “my date with the dildo camera”.
Usually these scans are on day 1, day 8 and possibly day 10. The nurses checked both my ovaries for any potential follicles and measured their growth. With an IUI you are only growing 1 –3 follicles, no more are allowed as they may result in multiple pregnancies (which have high risks and lower success rates). Once there was a lead follicle (around day 12 –14) I was given another hormone to stimulate my ovaries to release the eggs and then about 36 hours later I went into the clinic for insemination.
This was probably the most uncomfortable part of the treatment: my legs were in stirrups while the frozen sperm was transferred via a catheter into my uterus. It lasted less than 20 minutes, then after a little lie down on a hospital bed it was all over and I could go home. It literally can be done in your lunch break.
Then came the very long two week wait, where I was plagued with pregnancy symptoms from all the hormones I had been treated with. I think after injecting myself every day, the two week wait with nothing to do seemed unimaginably slow. Normally, after two weeks you do a pregnancy test but I never made it to test day. After all three IUI treatments I got my period on day twelve.
I thought having spent over 20 years trying not to get pregnant that I would get pregnant, first time. Nope. And not after the second or third insemination. Each time I called the clinic with the bad news.
Getting on to the IVF roller coaster
After the third IUI it was mid February 2013 and I was about to turn 43. I called the clinic to book another insemination and was told I needed to see to my consultant. I knew that meant I had to move on to IVF. The insemination treatments had each cost around £1000.00, and moving on to IVF would cost £5400.00 with the additional expense of ordering more sperm. So far, I had managed the payments myself but I had to ask my parents for financial help to cover most of the IVF.
This time when ordering the sperm I paid to look at all ten of the potential donor’s profiles which met my criteria. It was easier the second time, maybe because I was more familiar with the process but also, reading the profiles and seeing the pictures first helped me choose. I was much happier with my second choice of donor. I liked his letter to the child that said, “Remember your parent/s have gone through a lot to bring you into this world”. I felt like he has put thought into his letter and what he was doing.
I was prescribed long protocol IVF where for the first three weeks you use a nasal spray to put you in a menopausal state so your body doesn’t grow any follicles. You stay on this nasal spray right through until you give yourself the final injection to release the eggs before egg collection (about six weeks).
My IVF cycle then followed the same pattern as my previous inseminations, dates with the dildo camera on day 1, 8 and 10 but just a lot more drugs and more hormones! At each scan my follicles were measured and once again I was given an injection for my follicles to release the eggs.
The major difference is that the egg collection is done under anesthetic, so just like an operation you need a day off work: no food or drink from midnight the night before, into the clinic at 8am, into the operating room and lights out. When I came around after the operation, the embryologist told me they had collected 16 eggs – yippee! – and after a few hours in recovery I went home. They recommended no being alone, no work, no operating machinery, no making important decisions and no driving for 24 hours.
The next day I was a little bit sore but otherwise I went back to work at lunchtime. In the morning I had a call from the embryologist to update me on the progress of my eggs: of the 12 fertilised, six were going strong and they wanted me to go back to the clinic a couple of days later for a three-day transfer. On the day of transfer I was told that because I was over 42 years of age I was allowed to transfer two embryos instead of just one if I wanted.
The embryo transfer was exactly like an insemination but instead of sperm being transferred through a catheter my precious fertilised embryos were transferred back inside me. It was a truly emotional moment. I got to a picture of each of my three-day eight-cell embryos.
In less than an hour, with two precious embryos on board, I was sent home with a pregnancy test to do in two weeks time. A couple of days later I got the call from the embryologist that none of my other embryos had survived. If they had, they would have frozen them for my future use.
I had a wobble. If the two inside me didn’t make it, it was going to be another around of IVF. If I had been lucky enough to have anything frozen I could have just had a Frozen Embryo Transfer (FET) treatment, meaning not so many drugs and no need for egg collection.
Thirteen days later, just like after my inseminations I got my period! I was truly gutted!! Once again I didn’t even get to day 14 to test. Of course I did test, the next day and the next but nada, just one line on a pregnancy test.
The evil thing about injecting yourself for IVF is that the hormones make you feel pregnant when you are not. I just hadn’t prepared myself for it not too work. For the fourth time I made the call to the fertility clinic telling them I wasn’t pregnant. But having experienced the feeling of having a precious cargo on board I found it impossible to walk away from trying again.
As far as I could see, the only thing to do was to pick myself up and have another go. I had been saving to pay my parents back for the initial round of IVF, but they said I could use it for another go. One more chance I thought, then I will give up.
I sold my car and put the money together with what I had saved and got back on the IVF rollercoaster. I went through the same long protocol: again I down regulated my hormones with the nasal spray for three weeks and then injected for two, going for dildo scans and another egg collection.
This time they collected 18 eggs, of which 8 fertilised and made it to a five-day transfer. I got my hopes up: a five-day transfer meant better quality embryos. Again during the two week wait I had lots of different pregnancy symptoms including nausea and bloating. Finally I made it to day 14 and actually thought I might be pregnant and I was! Two lines on a pregnancy test! I was stunned, but happy. Finally this is it!
It was short
I phoned the clinic with my jubilant news. “That’s great,” said one of the nurses, “you need to come in for a scan in just over three weeks”. I thought there would be a blood test but was told that the clinic would scan me at just over six weeks after which I would be moved over to NHS care.
If I thought the two-week wait for a pregnancy test was hard, waiting three weeks and two days for a scan drove me insane! I had only told one person that I was pregnant. I was desperate to tell my parents, but something stopped me. I knew they would be happy but I wanted to be sure!
I had been pumped full of drugs and for some reason I decided to wait it out. I literally skipped into the clinic for my scan. There were two nurses present in the room and I should have guessed by their silence that there was bad news. I had just thought if I got pregnant everything would be okay.
So the good news was that there were two fetal sacs but the bad news was that there heart beats. They told me not to panic, because it might have been be too early to detect the heartbeats but referred me to the early pregnancy unit at the hospital the following day.
As I sat waiting for some details to take with me to the hospital the following day I quietly shed a tear. I realised that something was wrong. I didn’t exactly panic but I went straight to the hospital, where it was confirmed by another scan, there were no heartbeats. I was told to come back a week later.
Unfortunately or fortunately for me, I was on holiday for the next five days. I was told to rest, not do exercise, or drink alcohol and to look after myself in case the next week they found a heart beat… but I was also warned I was likely to miscarry.
After the slowest, most miserable holiday ever, one week on, another scan confirmed a missed miscarriage of twins. I was advised that it was probably best to wait to naturally miscarry but after another two weeks of waiting and no bleeding I finally went in for the surgical management of miscarriage (SMM).
It was heart breaking.
There are no words…. When you have IVF one of the things you can work out is the exact day when your baby is due and you can work out when your 20-week scan will be (because surely it would be safe to tell people by then!). Mine would be coming up next week. My due date would have been May 5th 2014.
Where I go from here, I don’t know
When I started on this journey I had so much hope. I didn’t realise there were no guarantees. When do I stop? How much is too much? At what point do I walk away? Third time lucky?
The only thing that has helped me move on emotionally is securing another vial of my donor’s sperm. I probably have one more shot at this with my own eggs before my 44th birthday, or so I thought.
My recent clinical review was depressing. I was expecting the consultant to say, “Well, you got pregnant once, you can do it again”. Instead I was greeted with, “You have given it a really good shot do you want to give up?” Are you mad I got pregnant? “Your chance of pregnancy is less than 8%, after your next birthday it will drop to 1%, plus you have to get through all the prenatal checks.
I asked whether my chances would increase if I used younger donor eggs. My consultant replied that at my clinic single women aren’t offered donor eggs, as there would be no genetic connection to the child. (Donor egg treatment is available at their clinic for couples using the husband’s sperm.) I was shocked as I had researched that using a younger egg would have doubled my chances. I wasn’t sure how I felt about it. My consultant said if I wanted to give it one more shot, he would use the same protocol with a bit more drugs and I could start as soon as I felt ready….
My advice: if you want a baby, don’t leave it too late
The last year has been a real turmoil of emotion, energy, time and money which I have invested into trying to get pregnant: five treatments in 12 months. How and when do I give up? Surely, third time lucky. I have started looking at other clinics that specialise in treating women in my age group, both here in Scotland and abroad in Greece and Spain. I like my current clinic, but they don’t seem to have a live birth statistic for a 43 year old.
Wouldn’t you want to spend your next £5-6k at the whichever clinic gives you the greatest odds for success?
I will have to travel and pay a premium for a shot at pregnancy with the most experienced clinic in my age group. They treat over 200 women and only about 40 actually get pregnant and less than 40 women actually have a live birth.
At some point and hopefully not too late you need to decide if you are happy to live your life without children. Will that be me? I don’t know, at least I can say I tried. I have met women that are happy to move on and have a childfree life. Maybe I should have made different choices ten years ago.
My advice is don’t leave it too late. If you reach 37 years of age and you haven’t had kids, visit your GP ask for a fertility MOT, just to find out what your options are…