From yesterday's Indo...
IT'S NO SECRET, BUT WE DON'T WANT TO TALK ABOUT IVF...
It's a taboo subject for many couples, but presenter Miriam O'Callaghan brought it into the spotlight when she revealed that she had fertility treatment to help her conceive. Susan Daly reports
Wednesday August 05 2009
'So when are you going to make me a grandmother?" It's a flippant remark but it can be devastating for a couple struggling with infertility.
The National Infertility Support and Information Group estimate that one in six Irish couples seek outside assistance to achieve pregnancy. Observe any busy street: it's impossible to tell which passer-by is secretly nursing the heartache of childlessness but it's a guarantee that some are.
RTE Prime Time presenter Miriam O'Callaghan, for example, is not a woman one would associate with reproductive problems. She surprised many last week when she told how she sought treatment from a fertility expert in England after the birth of her first child.
"After my first child I couldn't get pregnant, so I went to a gynaecologist, a man called Peter Snow (the broadcaster Jon Snow's cousin)," she said. "I got three children in 10 months. A very effective fertility drug!"
Miriam had a daughter, and then twins 10 months later. Multiple births are a frequent consequence of fertility treatment.
Miriam, as we know, is now a mum of eight but says that she "didn't find it easy" to have children. "I am now their best success story in this fertility clinic. But, hey, I want to put it out there, because I know for some people it is hard to have babies," she added.
There are a number of fertility clinics in Ireland, some private and some linked to major maternity hospitals.
But there is still a taboo about saying you sought help to have your child says Anna (31) who had twins 10 months ago after a course of IVF (in vitro fertilisation). Anna asked for her real name to be kept out of this article. Although she has been open with family and friends about her treatment, she has just started a new business and feels that strangers might not understand.
As it was, she says, even her GP seemed wary of advising her on fertility treatments. "We got married when I was 26, and after a few years of trying, we went to the GP. All the GP would say was 'Take a break for a while, relax, it will happen'. But we were young and healthy, and it just wasn't happening. We felt we had to push the issue. In general, I feel that GPs aren't educated to the possibilities out there."
Anna was referred to HARI (Human Assisted Reproduction Ireland) in the Rotunda maternity hospital in Dublin, but says they faced a five-month wait to get a consultation. She and her husband turned to a private fertility clinic in Dublin. They had a procedure called ICSI (Intracytoplasmic Sperm Injection) where the sperm is injected into the egg outside the body -- "it's more proactive than letting them mix in a Petri dish" -- and were successful on their first cycle of IVF when the fertilised embryos were implanted in Anna's uterus.
"We were very lucky," she says. "A very good friend of mine has had three failed attempts at IVF. She feels like she's hitting a brick wall while all around her, friends are having families. She's tortured, that's the only word for it."
The treatments, and the possibility of failure, can put huge emotional strain on a couple. "Everyone has a different opinion on the hormone injections you have to give yourself, but it can be very trying. We just kept very positive in our thinking, saying 'We're giving ourselves the best possible chance'. But you are pumping yourself full of hormones and you're swaying from low to high for about 10 days a month," says Anna.
Ireland doesn't have any cohesive data on babies born as a result of fertility treatment but the latest figures from the European Society of Human Reproduction and Embryology state that around 30pc of patients who go through IVF and ICSI have successful pregnancies. Many couples begin with IUI (Intrauterine Insemination) where prepared sperm from a woman's partner is injected directly into the uterus at the time of ovulation. It's less invasive than IVF and ICSI because eggs don't have to be harvested and fertilised outside the body, but often it's not enough and women go on to those procedures.
Dr David Walsh of SIMS, one of Ireland's largest fertility clinics, says that people do not seek their help lightly. "Occasionally, we might be approached by someone who has been trying for about six months," he says. "But often that is an older woman, over 35, and it is on her mind that she has a limited time frame and just wants to check there is no major reason why she has not yet conceived."
Dr Walsh says there are three major risks associated with fertility treatment: failure to conceive, or miscarriage, and the emotional trauma that inflicts; over-stimulation of the ovaries (there has been one death in Ireland from this condition); and the possibility of multiple births.
"The incidence of twins is significant with fertility treatments and a lot of clinics are trying to reduce that, especially for younger women," says Dr Walsh. "But in the example of say a 39-year-old who is trying for her first child, twins can be very welcome."
Anna says she and her husband almost fell off their chairs with shock when they were told they were expecting twins.
They said because of our age and a 40pc chance of the treatment working, that there was a one in six chance that two eggs could take. To be honest, you are thinking the odds are against you."
On hearing the news, she says, "we wobbled out of the clinic that day!" Now they are delighted. "We count it as double luck."
The high cost of fertility treatment is another stumbling block for many couples. While units like the Merrion Fertility Clinic, which is linked to the National Maternity Hospital at Holles Street, Dublin, is a non-profit charitable organisation, private clinics can charge €4,000 and up for a cycle of IVF. Even a cycle of IUI is around €1,000 a go.
Ethical concerns revolve around what happens to the 'leftover embryos' that result when multiple eggs are fertilised in the hope of creating healthy embryos. In February of this year, Supreme Court judge Mr Justice Hugh Geoghegan described as "extraordinary" the fact that the Government has taken no steps to legislate fertility treatment here. The result is that there is still hot debate over whether an embryo has the legal protection of an "unborn" child if it is not actually implanted in a mother's womb.
Freakish stories from other countries about the possible abuse of fertility treatment add fuel to the fire.
Leading embryologists voiced their concerns that the birth of eight babies to Nadya Suleman in California, USA this year constituted "inappropriate medical therapy". The controversial Spanish woman Maria del Carmen Bousada, who gave birth to twins at the age of 66 as a result of fertility treatment, died of cancer last month. Her twin boys are now orphans at the age of two.
There are alternatives to the IVF route -- private clinics like the Galway Clinic, which offers the NaPro reproductive treatment, and the Cork Natural Fertility Clinic claim to address the issue of infertility on a more holistic level.
For Anna, having successfully had her first two children by IVF, she is hoping to try for a third child at the clinic. "I won't have to go through the harvesting of the eggs again as we have our embryos stored," she says. "That's a relief."