An estimated one in seven couples have difficulty conceiving (see Human Fertilisation & Embryology Authority 2017). We talked to several people who had found it difficult to conceive and had tried various means of assisted conception to help. These women very much needed information about the cause of their problems and the different treatment options they had, though in some cases the reasons for their infertility remained unclear.
Where ovulation is a problem, a fertility drugs such as clomifene (Clomid) may be enough to achieve pregnancy. One woman tried acupuncture as well and found it helpful. Clomifene made her feel unwell and she found it difficult to get clear information about this. She and her husband felt that they would not have wanted further intervention such as in vitro fertilisation (IVF), and were already considering adoption as their next choice.
She had polycystic ovary syndrome and took the fertility drug clomifene (Clomid). She also found...
So I started having some acupuncture and that I think just helped me feel a lot better, and I continued with the Clomid as well, so I was doing these things in conjunction. We kind of synchronised the acupuncture with the Clomid cycle and my cycle and I had, I did two cycles of Clomid while I was having acupuncture as well, and I'd had a review at this clinic I was attending in London, in the big city [laughs] and I'd- I'd decided that we'd give it another go, just with acupuncture and Clomid before maybe seeking - there was a surgical procedure that my local hospital were offering me. And I - I felt really strange one week, as if my period was about to start at any moment, but it didn't, and I'd been away at a conference. And when I got home it was actually the night England were playing Portugal and I used to do a lot of work in Portugal, so I'd been watching the football match and texting my friends in Portugal, and I just did a pregnancy test. And I must have done about twelve or twenty tests over the last two years, and so I really wasn't expecting a positive result, and it was faintly positive, and we were frankly stunned, and terribly excited, but also terrified, to be honest.
She felt ill taking clomifene (Clomid) and could not get clear information about this. She wanted...
So is there anything you can do to alleviate the symptoms?
No. [Sigh] Not really, and they - it's to be - to be honest I think I joined various kind of email based discussion forums, like that, so I'd known from kind of other women that the side effects could be pretty grim. And the consultant kind of played them down, but when I went back the second time, she just said well, "No there's nothing else, you just" -you know. It is what it is. It does overload your system, and I think any time you try to adjust hormone levels it does kind of put everything out of sync, really.
You said it made you realise that you wouldn't be able to cope with IVF?
Tell me, did you discuss that with your husband?
Yeah, we talked about it a lot and [sigh] I suppose it, it's interesting whenever I talked to people and said, that you know IVF really wasn't on our list of options, they said, "Oh is it a religious thing that's coming through?" And, and for me it wasn't. It was, I suppose, it was nobody's ever promised me that I had a right to have children and I felt that for some people it's obviously the right decision, but I think my assessment of it was, I've really struggled doing the Clomid, and getting scanned, and, you know, having sex according to a timetable, and that's nothing compared to the kind of invasiveness of IVF, and so that, combined with the - my relatively high rate of miscarriage just made me feel that it would be another two, three, four years of heartache, really.
They felt strongly that adoption could be a good option for them, and might consider it again in...
One woman, however, who had IVF found the process less stressful than she had expected. She realised that the chances of success in each cycle were not that high. She did however say that IVF places a burden on the male partner and can create tension within the relationship.
She expected IVF to be stressful but it was not as bad as she anticipated.
I think we were rather disappointed to have to do that [laughs] and, and do the IVF treatment because, you know, we'd always hoped it would just happen naturally and we tried for several months and then, you know, realised that nothing very much was happening, and then we tried for several more months, and then went to see my GP, and she felt that because we'd been trying for almost a year that we should, we should, sort of, think about, you know, if we would take it any further. And I realised at that time that, you know, we'd be starting down this road of, you know, lots of investigations and trips to the hospital and-. But we felt that we really wanted to do it because, you know, we wanted to get pregnant so we felt it was worthwhile pursuing at that time.
Do you think that because you're a doctor you felt particularly discouraged at knowing what it might involve?
Yes, I think, as a doctor I'd seen several patients going through infertility treatment, in particular IVF and I knew it could be very stressful and I knew that the chances of success are actually not that high. They're, they're lower than people think. They're only about 25% for, for each cycle.
And as, as you get older the success rate goes down, so we- I was already in my, sort of, mid-thirties by the time we started doing it and I realised that the success rate wasn't going to be very high. So yes, it was a bit with a sinking heart but it wasn't - the whole experience of IVF wasn't as bad as I thought it would be personally.
It was, you know, the staff were very kind, and very accommodating with visits to the hospital and it was it, it wasn't as bad as I thought it might be.
What- now tell me what, what did you imagine it might be like? [laughs]
[laughing] Well, I think from, from patients I'd heard that doing IVF treatment, the hormone injections made you feel very uncomfortable, made you feel very bloated. And I'd heard some horror stories about the egg retrieval where they, when they take the eggs out with, with under sedation and take them away to be fertilised. And I'd, I'd read sort of in magazines and, and heard from several patients that that could be very uncomfortable so I wasn't looking forward to that.
In the event was it better than you expected?
I think my personal experience of, of the egg retrieval and IVF was, was probably better than I expected. I was quite lucky because I was very sensitive to the sedation, so I just tended to fall asleep and wake up when it was all over. Which I think is probably the best way to be. So yeah I think I was quite lucky, yes.
Men may find it difficult when their partner is having fertility treatment, and it can strain the...
Yes I think the IVF experience did have an impact on my husband. It's difficult for him I think, because the treatment was very much centred on, on myself. You know, obviously they have to take semen samples from, from your husband or partner but, you know, the hormone injections, the scans, it was all focussed on me and all he could do was to be supportive and, you know, come with me and stay with me; especially the day where we had the egg retrieval which was the worst bit of the whole cycle, really. And it's, yeah, I think it, it, it is very difficult for the male partner, I think.
I mean, what kind of strain does it put on couples, do you think, to go through that?
I think it can put a lot of strain on couples. I think, especially after you've been trying for a while I think you start to think, "Do we actually really want children now?" Something- you know, a decision we made several years ago and, you know, we'd hoped that it would just happen normally and suddenly it becomes this huge thing where you're spending vast amounts of time and money on treatment which isn't working, and it makes you re-evaluate, I think , you know, 'Is this really what we want to do?' So yes I, I - and, and it may be that each partner has slightly different views on that, you know and it's difficult to decide where to draw the line and do both partners want to draw the line at the same time? I think, I think that can be quite stressful.
Some women already knew they were likely to have problems conceiving, while others realised only gradually after months of trying that something might be wrong. For one woman this followed a miscarriage. Investigations showed problems with her fallopian tubes, but could not explain why she had three miscarriages. After taking clomifene, she joined an NHS waiting list for IVF, but decided to take part in an egg donation scheme so she could have free private treatment. She talked about having her eggs taken for donation and was keen that the possibility of egg donation should be better known. She felt very positive about IVF, after years of anxiety and uncertainty about whether she would ever be a parent.
After three unexplained miscarriages and treatment for low fertility with clomifene (Clomid), she...
And what did you do then?
We then continued trying for a baby. After a year nothing had happened so by now it was sort of March 2000 so at that point our GP sent us for routine testing to see if there, if there might be a problem. The tests showed that there wasn't really a problem with my husband so I was sent for a laparoscopy to have a look inside, have a look at my tubes, my fallopian tubes.
And that actually showed that there was a problem with both tubes and there was a hole in one and there were adhesions on the other tube which would suggest a reduced fertility. I had, in fact, been pregnant a previous time so I had actually been pregnant twice so it, so obviously I wasn't infertile, just sub-fertile. So the decision then was taken to put me on Clomid, which is a fertility drug which, basically, increased the amount of eggs I would produce each month. So I took Clomid initially for three months, I was then reviewed, then I took it for a further three months, well I was prescribed it for a further three months, and after having taken it in total for four months I became pregnant.
But unfortunately I lost, that pregnancy came to end at six weeks but it did, nonetheless, confirm that I was able to conceive. So I then continued to take Clomid and also was tested for having had a total of three miscarriages consecutively which was the threshold for being able to have those tests. The tests showed that, basically, the, the miscarriages were, were unexplained, they didn't fall within the categories that could be explained. So then I was sent away with more Clomid and told that I would be put on the waiting list for IVF on the NHS. At that point I decided to see an obstetrician privately who has a particularly good reputation and he told me about the IVF scheme that runs with egg donation, which would have enabled, would enable me, if I was accepted on to the scheme, which would enable me to have free treatment and treatment very quickly.
So I duly went for the initial consultation and initially I was accepted onto the egg donation scheme. And I was put onto the programme within about three months and fortunately the first cycle of IVF was successful and I became pregnant. Then, of course, the issue was whether or not I would remain pregnant. I was given an early scan at seven weeks and there was a heartbeat at seven weeks so I knew, I was told that if there's a heartbeat, once there's a heartbeat your chances of miscarrying drop by 90%. So really, once, once we'd got to that stage we knew we were probably going to be okay. And, in fact, that pregnancy progressed without any problem whatsoever.
Harvesting the eggs for donation was painful but it was an exciting time. The effect of the drugs...
What was the harvesting like?
The harvesting was, was the only part that was painful. You're, you're, well you're not aware, you're not aware of it, it's a, procedure that, I don't think it takes very long, 20 minutes, half an hour. You're just in hospital for the morning. That was the only part that was painful for me. But, but I think it was so exciting, I mean it was, that I, found it quite, I found it quite exciting in a way. And because I never had to experience going through the procedure a second time, it only ever was exciting for me. I only ever went through it that one time. Sometimes some of the injections were quite, quite difficult. Hormonally, emotionally, because, effectively, they induce the menopause over the course of about 10 days, the injections that you have and, of course, in the natural world the menopause would come about far more slowly. So that can be very difficult, certainly within a marriage that can be very difficult. You become extremely sensitive and it, it's the fact that it's brought on so quickly.
Why do they bring on the menopause?
Well, what they do is they shut down all activity in the ovaries and, and shutting down all activity is basically inducing the menopause. They have to shut down all activity so that they can have complete control and can manipulate your system because the other issue is with the egg donation scheme, or the egg sharing scheme, the recipient's uterus needs to be, our, our bodies need to be in sync so her uterus needed to be ready to receive the harvested eggs or the embryo at the same point as mine. So, in order to manipulate both of our systems they have to shut down all form of activity. And, and then you're given another drug, a, a different type of drug which stimulates the ovaries. You need to produce a minimum of about six eggs to be able to take part in the egg sharing scheme because any less than that and there aren't enough eggs for the, for it to be worthwhile. So there, there was a moment shortly before harvesting where it was looking like I only had six eggs, which was going to be the bare minimum, which would mean I couldn't be an egg donor again. So, basically, at each point in the, the process of IVF and egg donation there are, there are points at which you might have to, to drop out and can no longer be a candidate.
The possibility of taking part in an egg donation scheme should be made more widely known, as...
And I think it is of particular interest because IVF treatment can be very expensive and it enables you to have three, three goes at it, basically.
One woman with a history of miscarriages and genetic problems in pregnancy eventually used IVF to help her avoid further pregnancies with the same genetic condition. Before the embryos were put back in her womb, they were checked for the genetic condition (pre-implantation diagnosis). However, she wished she had known about this option earlier, and was angry that her local genetic counsellor advised her to get pregnant again naturally and have a termination if the baby had the condition. After two terminations the couple were offered donated eggs, but her husband particularly did not feel this was right for them. They wanted to be referred to London for IVF with pre-implantation diagnosis. There they felt staff explained the whole process clearly and were much more sympathetic. The first cycle of IVF was unsuccessful, but she became pregnant the next time. She advises other parents to accept that for a while IVF will take over your life and just allow yourself to focus on it. (See also 'When something is wrong with the baby').
After two terminations for a genetic condition they decided against egg donation. They wanted IVF...
But, the hospital were very supportive, said we could go straight to the top of the list for egg donation and we wouldn't have to wait, it would all be available on the NHS, blah, blah, blah. And my husband said, 'No, we're not doing that.' And we went back to the geneticist and we had asked at our first appointment with her, for a referral to London because we had found out that pre-implantation genetic diagnosis was available there, and she had refused our referral. Which it later transpired she's not actually meant to do but she had said, she didn't actually say, 'I refuse your referral.' She said 'No, that is not your best choice at present. I think you should do this.' And I think our experience of the NHS had been that they see everything as a very linear process. And because we wanted all the information in front of us and to make a choice from a variety of options, that was not what you were meant to do. You were meant to go from A to B to C to D, all the way through instead of maybe going from A to F and getting where you were meant to be in the first place. You weren't meant to do that, somehow you had to trot through, which must be much more expensive for them, and much less efficient in terms of everybody's time and energy and mental health. But, anyway, we went back and I can remember it being quite emotional by this point, and actually saying to her, 'Look this time can we have a referral? I want to go to London.' And, having spoken to people, other people, they said, 'Sometimes there's a reluctance to let cases go' because if she could have got a good result for us it would have, she would have wanted to get a good result for us but also it would have been good for her career-wise that she had managed to do this and it would have been a good result. But she agreed to a referral but was very negative about it and didn't feel that we would get very far and, again, felt that IVF wasn't our best option.
Staff at the specialist hospital were more sympathetic than at their local hospital. They...
So, we saw the lady in, we saw the doctor in London and she, she chatted to us, talked us through it, she said, what did we know about pre-implantation genetic diagnosis. And I'd read the booklet and showed her and she said, 'Oh well if you've read that you really know pretty much everything. Do you have any questions?' And it was one of those things, we'd read the booklets, it's actually quite straightforward. It's very high science, but the actual thinking behind it is not, it's not that complex. They, what happens is from they do a cycle of IVF the embryos will be kept outside the womb before transfer for three days. On the third day a single cell is aspirated from the embryos.
Each of those is screened using FISH technology which is like these fluorescent little, they always explain it as being like fluorescent marker pens and you can see the colours on the slides that they show you afterwards. And that will tell you whether the pregnancy has the right number of chromosomes, has the right genetic information in it. And then the embryo is transferred and at that point it's the same as any other IVF cycle as to whether the transfer is successful or not. So we knew all that, so then she said to us, 'Oh great, well the, the really important thing you need to do today, is sign the consent forms.' And we just sat there, and she, I can remember her saying to us, 'You've not had any good news for a really long time have you?'
And we said, 'No we haven't.' And she said, 'Well you can sign the consent forms now. I see no reason why we shouldn't start a cycle of treatment within the next couple of months.' And we were just absolutely stunned, I think. We had just not expected it to be available, had not expected it to be that quick. And it was the first time in a long time there actually seemed to be any hope. So we saw her and came out and just felt, you know, wow. This is kind of unbelievable, but very positive. I still didn't quite believe that they could do it. I expected the knock back. I expected the phone call, 'Oh sorry, we made a mistake, we can't do this.'
She advises other parents to accept that having IVF will take over their lives for a while and...
Well the next cycle worked.
The next cycle worked which , I'd, I'd stopped working. That was the magic question I had to ask the consultant. I had to say, 'would it help if I stopped working?' And he said if at all possible it would be, he said it was the biggest factor with an IVF cycle if you could stop working. He said you can do lots of other things but not working is the biggest factor.
Stress. And that was actually the worst piece of advice a doctor ever gave me. It was my local GP, who I, I went in to see about something completely unrelated and he just knew from my file that we'd been having this horrible time and we got onto the subject of IVF. And he said to me that the best thing I could do was to keep very, very busy and just put it to the back of my mind and not think about it. Which is rubbish, it's complete rubbish. You are never, ever going to be able to put this to the back of your mind, it is your whole focus and your whole life, it takes over everything else. And another, a, a good friend who is a doctor and I wouldn't want to be doctor bashing or anything like that, but he, he gave us the most reasonable piece of advice was, which was, to make it a project. Give yourself a time limit, you can always change your time limit, but it sets a boundary within your own mind and for, say, two years or three years or however long you want to make it, that's what you're doing. That's like your job, your job is to track down the people who will make it possible for you to have a healthy baby and you make that your focus, and you let it take over because fighting letting it take over is going to make you very unhappy. I think when you come to terms with the fact that this is your focus and you just have to get on with it because you can't not let it take over. And I think you, you would be exhausted if you tried to put it to the back of your mind all the time. So, anyway, I'd stopped teaching full-time, went to do supply, stopped at the Christmas, started the second cycle of IVF in the February and was able to tell everybody I was pregnant with twins by the Easter.
Another couple discovered the husband was a carrier for a very rare condition when the baby's 20-week scan showed a heart tumour. They reluctantly had a termination and after much discussion chose donor insemination to avoid another pregnancy with the same condition. The mother read a lot that helped her accept the idea of an anonymous sperm donor, and she tried to make her husband feel more positive about it. Nonetheless, they carefully considered how having an unknown genetic parent would affect them and their children.
After a termination for an inherited genetic condition, they considered adoption but decided to...
After that [the termination] I was sort of in depression. I mean, the doctor called it depression. It was not really that. It was more like a grieving. You know, I had about six months of not going to work and just lost faith in life, actually, for a while.
And at the same time we were having tests, to check whether one of us had the condition and, but everybody seemed to say, “Oh, you don't have the problem. You know, you're both healthy” and everything. In the end, in fact, it ended up that my husband was diagnosed with the problem. That was a sort of double shock then because of, the shock of losing your baby first, and then you go through knowing that it's one of you has something and that caused it, so it was a very, very difficult time.
And we were given sort of, well, options really, which wasn't very good. One was to try again, with maybe see if the baby's got it, but have actually no diagnosis to tell us, apart from the scan at twenty weeks, and see if, by chance, they see a tumour or two somewhere. But that was very unreliable, and I know from talking to other people that they've said that we probably may not see anything and then, you know, the baby may be born and you think it's healthy and it's not, so.
They said, “You can adopt, or you can have donor insemination.” So we sort of looked at the three different things and I said to my husband I didn't want to go for a termination again, and that twenty weeks was really too late and I didn't want that. So then we looked at adoption, but my husband was not feeling very comfortable about it.
And then we sort of decided that we'd look at donor insemination. First my husband was very, very against it. Personally I wanted to go for a known donor insemination, and I had thought about asking his brother, maybe, or you know, somebody like that we know. But he was not comfortable with it either, so we sort of talked about it and by that time I was still seeing a psychologist - since the termination I had seen a psychologist sort of almost every week. So she helped me a lot through deciding and talking about it. And then in the end in 2002 we finally decided to go ahead. So, and then, we went for it, and then the first time I tried the anonymous donor insemination, I got pregnant, so it was really good.
Reading a lot about donor insemination helped her to accept the idea. She wanted her husband to...
And the psychologist that I saw sort of every week to start with and then every month, she was telling us that maybe we should look at other ways. So I actually looked at adoption as well, even fostering, but my husband didn't want it. So in the end I thought well let's find out a little bit more about that [donor insemination].
We got some brochures, we went on some internet sites to look at it, I read lots of books, probably all the books on the market about it. And just I think probably got familiar, more and more, and sort of less scared about the issue of having an anonymous donor child. My husband was a little bit, not too sure about it, but I think in the end he probably realised that we had to do something, because we couldn't just wait and be sad for the rest of our lives, really.
And I kept saying to him, “You know, people they lose, for example, an arm or a leg in an accident, they don't stop living. They just continue with what they've got left.” And I said, “If you continue just being sad, saying, 'Oh, I've got a genetic disorder, I can't have children' and do nothing about it, then, you know, it's not going to help you.” I said, “Maybe you should just cope with whatever you have, and, you know, you are lucky at the moment, you are healthy, so...”
I was trying to sort of make him positive a bit more about the issue, and then we went to the hospital, we had several appointments, we were accepted, because you have to be accepted first. Everything was done, all the papers were done before, but I think I was just waiting for the confirmation that he was happy with it, and I would have waited a little bit more just to make him more comfortable with the idea, and then we just went ahead.
They considered carefully how having an unknown genetic parent would affect them and their...
The things that were discussed which were about donor insemination - and it was more my point of view - was that, the right for the child to know who the genetic father is. That didn't really concern my husband too much, in fact, between a known donor and an unknown donor, he wanted an unknown donor because he said to me, you know, “I don't want anybody else to come one day and say, 'Well, she's my daughter anyway' or something like that,” you know.
He wanted to be sure like he felt like he was the dad 100 per cent. And by not knowing for him it was - for me it was slightly different, and I still would like my baby to know her genetic dad. It's not possible because the law doesn't allow it, but if I could find him, or whatever, I would actually like that. But that was a scary thing for me, to think that one day she's going to say, you know, “What did you do? Why did you have me this way and, and why, you know, why can't I know who my genetic” - genitor, I would say he is, not dad, because in the end I don't think it's really a dad in that context.
Also I was worried that I was not going to like the baby or that the baby was going to have a big nose or, I don't know, something really strange that I don't recognise at all, or. I was a bit worried about other people saying, “She doesn't look at all like her dad,” which is happening sometimes, now that she's born, but well, we just cope with it. My husband usually says, “Oh well, she just looks a lot more like her mum,” and that's it. But I was worried about all the little things, you know.
Once she was there, though, everything just disappeared, all my worries, you know. I just loved her straight away from the first instant, and my husband actually fell in love with her from the first instant as well, and he said to me, “Oh she's beautiful.”
And when a couple of hours after she was born I said to him, “Did you, when you, when she was born, did you have the impression that, how did you feel? That you just said, 'Oh, she's not mine' or something?” He said, “I forgot completely about it. She's mine and that was it.” So, you know, I was very happy at the time, because I realised that we'd made the right decision.
We've still got a long way to go, and I hope that we'll be able to communicate with her, and tell her that's what happened and, you know, things like that. That we'll be open about it, because I don't want it to be a taboo, but I know sometime it's difficult for men, I think more than for women. Especially when the husband has got the problem. And also choosing the donor as well was another problem.
Because they gave us that list of five, six donors and then said, “Just pick one.” And it was like “OK” [laughs].
But I tried to get a donor which had, which was saying a lot about himself. Because some donors they just say, you know, their sort of ethnic background, their height, their weight and that's it more or less, yeah? And some of the donors they say a bit more and they say what they like, you know, like hobbies, they say the studies they've done. So when we looked at all these donors we choose somebody who was obviously close physically to my husband, but also somebody who was saying a bit more information about himself so that, you know, my daughter can have this information and know a bit more about where she comes from, genetically, than just, you know, her height and so on.
The question of biological parentage also concerned many other couples. The woman who donated her eggs to someone else (Interview 16 above) was glad it was anonymous but still felt 'curious to know if my biological child is out there somewhere.' The couple who had pre-implantation diagnosis rejected the idea of donated eggs because they did not want a non-biological child, whereas another couple (Interview 27 and Interview 28 above) were more at ease with the idea when thinking about adoption, although concerned about how grandparents would feel about a non-biological child. Each couple needs to find a solution that works for them.
This study was about experiences of pregnancy therefore all the women we talked to had successfully conceived. However it should be noted that statistics show that the success rates for IVF are low and success rates for women over forty are even lower. See the Human Fertilisation & Embryology Authority for statistics.
See our 'Infertility' section for more experiences of, and information and support on, infertility and assisted conception.
Last reviewed May 2017.
Last updated May 2017.