When fertility treatment fails
After the highs and lows of an IUI, IVF or ICSI cycle, receiving the news that the cycle has not worked can be a devastating...
Sometimes a clinic will recommend treatment using donated sperm, eggs or embryos (also known as ‘gametes’) because conception would be unlikely to be successful for people using their own eggs or sperm. People may find out during initial investigations that they will need a donor, while others make the decision after having had some fertility treatment using their own gametes. Frances’s husband had had a vasectomy after having children in an earlier relationship; initially they hoped that it could be reversed through surgery.
Using donor sperm, eggs or embryos requires thinking about complex issues before starting treatment. People should be offered counselling before going ahead. In the UK, any child conceived from donated sperm, eggs or embryos is the legal child of the recipients. Once a child is 18 years old they can find out who the donor was (since April 2005 identifying information about donors is held on the Human Fertilisation & Embryology Authority (HFEA) Register). Payment for egg or sperm donation is currently illegal in the UK (although reasonable expenses are covered but set by the Human Fertilization and Embryology Authority (HFEA)). These regulations and other considerations mean that couples sometimes travel abroad for treatment to countries (e.g. Spain) where there is a more ready supply of donors.
(See HFEA, Donor Conception Network, Daisy Network, National Gamete Donation Trust).
Sally knew from the start that they would need to use donor sperm because her husband was infertile. Mike had colitis as a young man and had been on strong drugs affecting his sperm production. So when he married and wanted to start a family, he was not surprised that they needed to use donor sperm. Saskia and her partner, as a lesbian couple, knew they would need a donor and first tried with a gay couple they met through a network and then with a friend who already had his own family. (There are however possible dangers in using unscreened sperm – see Infertility Network UK and HFEA for more information).
Sometimes people did not find out until they had had many cycles of failed treatment that they might need to consider a donor. Olivia and Walter used donor sperm to conceive their two children several decades ago, after tests showed that Walter was not able to produce any sperm. Naomi and Martin started to think about using donor eggs after several cycles of IVF. Doctors had concluded that Naomi was going into an early menopause.
Susan had donor egg treatment in the UK that failed and then decided to try abroad. Although she was very impressed with the treatment she received in Spain, it did not work either and she decided to stop.
Naomi and Martin had initially planned that their treatment in Spain would be with donor eggs and Martin’s sperm. Although Naomi had come to terms with the idea of having children not genetically connected to her, she found it difficult accepting that their children would have her husband’s genetic heritage but not hers. When the clinic recommended they use donor sperm as well this came as a relief to them both.
Olivia and Walter completed their family with donor sperm treatment over twenty years ago. Their children are now grown up, so they were able to reflect on how they came to terms with using donor sperm and what it has meant for them as parents.
Using donor sperm or eggs is not something that everyone feels they can, or would want to, do. Janine and Steve had a couple of cycles of fertility treatment with donor eggs, but decided to stop and went on to adopt two boys. Sarah was concerned that it might be, ‘Storing up trouble or just weirdness’ to accept an offer of egg donation from a friend. George did not think he could look at a pregnancy the same way if it was, ‘Some other chap’s sperm’. Sandra thought she might have considered it if she had been younger but did not want to start down this route in her early 40s. Talking to children about donor conception is discussed in ‘Impact on parenting and talking to children‘.
The Human Fertilisation and Embryology Authority (HFEA) have approved the use of donated mitochondrial in fertility treatment. The UK is the first country in the world to regulate mitochondrial donation. Only people who are at a very high risk of passing a serious mitochondrial disease onto their children are eligible for treatment. Every case of mitochondrial donation treatment needs to have HFEA approval and only a small number of clinics will provide the treatment.
The treatment involves transferring nuclear genetic material from the mother’s eggs or embryos into the eggs or embryos of a donor with healthy mitochondria. Any children would still be the mother’s and father’s biologically but without the mitochondria that cause the disease. For more information see the HFEA’s website.
After the highs and lows of an IUI, IVF or ICSI cycle, receiving the news that the cycle has not worked can be a devastating...
Some people chose to travel abroad to have treatment, mostly when using donor eggs or sperm. This is often known as cross border reproductive care....