In Vitro Fertilization (IVF) challenges our conventional ideas around families and fertility. Modern medicine can achieve extraordinary feats in many ways, but the creation of life holds special status. Ethical implications aside, any mention of IVF treatment speaks to our assumptions of heterosexual couples wanting to conceive. So what about same-sex couples who also want a family? Two women tell their stories of infertility, heartbreak, IVF miracles, and life with two wombs.
What is IVF?
IVF is a fertility treatment where fertilization takes place outside of the body. The eggs and sperm are collected and placed together in a tube or dish, hence the term “in vitro,” which means “in glass.”
The IVF process begins with a course of hormone therapy to suppress ovulation so that any eggs can be retrieved direct from the follicle. Further hormone therapy then stimulates the ovaries to produce more eggs. Only one egg is matured and ovulated each month without IVF hormones, and more eggs technically means more potential embryos.
Once matured and retrieved, each egg is placed together with approximately 100,000 sperm. If this volume isn’t available, or their motility is reduced, a single sperm is injected directly into the egg (known as intracytoplasmic injection).
The resulting embryos are incubated for up to six days before being transferred into the woman’s uterus where it’s hoped that implantation will take place, and pregnancy will begin. Not all embryos will implant, which is why a surplus can be frozen for later use.
An IVF Success Story
Kiran is 41 and married to Lia. Their daughter is 10 months old. “I always wanted a baby,” said Kiran. “But being gay I didn’t know how, and doing IVF on my own wasn’t an option. So when I met Lia I told her very early on in the relationship that I wanted a baby, especially as she’s much younger than me.”
“We started dating in March and by August we were looking for a known donor. We thought it would be good for our baby to know their biological dad. But while our friends said yes, none of them really wanted to commit. Next we discovered that if Lia and I weren’t married at the time of conception, she wouldn’t be considered a legal parent. So that was it. We were married three months later.”
In January 2016 the couple chose a clinic and an unknown donor. “My fertility was really low. My Anti-Mullerian Hormone (AMH), which tells you how many eggs you’ve got, was at 3.1, less than half the average at my age. But the clinic was really negative and unsupportive. They said, “you’ve hardly got any eggs so what’s the point, take your wife’s eggs instead,” it was so depressing.”
While the clinic tried to dissuade Kiran, she persisted, continuing with the daily injections to stimulate her follicles. “They kept reiterating that I was practically infertile, but that’s the whole point of IVF! And when my eggs matured, they were really surprised. I had two at retrieval but they were poor quality because of my age, so they were fertilized by intracytoplasmic injections.”
Even after this process the consultant told her it was never going to happen. “The whole thing was so emotionally devastating. Considering the cost—and I’ve since found out that they ripped us off—it was an entirely negative experience. I had to wait for egg collection in a small cubicle, as if I was in the emergency room, and Lia wasn’t allowed to stay with me.”
When Kiran’s eggs didn’t take, she tried again at another clinic. “It was an entirely different experience. They were so supportive in comparison. When I told them that my AMH was low they said, “You still have eggs!” The clinic itself was a pleasure to visit each time. It was like staying in the Holiday Inn with your own room and a TV, and Lia could stay too.”
This time Kiran had three follicles and three eggs. “One egg was fertilized so they put the embryo back in. A week later the nurse wanted to check my iron levels, and that’s when she noticed a small trace of the pregnancy hormone, at least a week too early!” Despite virtual infertility at the outset, Kiran’s second experience of IVF was a success.
What If IVF Fails?
Sarah is 39 and married to Louise, and they already have a four-year-old son. “My partner conceived via intrauterine insemination (IUI),” she explained. “IUI is low cost and low-tech in comparison to IVF. They basically track your cycle and place sperm inside you when you’re most fertile.”
They’d been together for a few years before they discussed having children. “We both wanted to have a biological child, so my partner went first as she’s three years older.” After three rounds of IUI their son was born. Nine months later they began the process again with Sarah, not knowing how long it would take.
“I had three rounds of IUI too,” she said. “And three times it didn’t work, so the consultant suggested we try IVF instead.” Sarah is now on her sixth cycle. “I abandoned the fifth round as there weren’t enough follicles. I thought it was best to start again than go through the process knowing the chances were low.”
At the time of writing Sarah was waiting for the embryo to implant. “The egg was fertilized by intracytoplasmic injections, which is considered to be more successful for older women whose eggs aren’t so viable. The clinic called to organize the embryo transfer early to give it a greater chance of success, but I’m not hopeful, I’ve been through this enough times to know.”
The barrier to pregnancy for Sarah lies in the quality of her eggs. “Initially the clinic thought I had problems with my uterus since I’ve had four miscarriages over the course of five IVF cycles. But embryo development is driven by the quality of the egg on days one to three after fertilization, and considering I’ve had problems on the first two days, it’s my eggs that aren’t up to scratch.”
“If this cycle is unsuccessful we will try again using my partner’s eggs and my uterus. But before I do that I’ll get counseling to make sure I’m really ready. I know I’ll be staring over the cliff of never having my own biological child, and I don’t want to end up resenting my partner in the future because she has one and I don’t—she’s lived this with me and I want to be completely accepting of it all.”
Throughout the interview Sarah remained measured while telling her story of repeated heartbreak. “I would rather go through it, and throw everything at it, and know that I really tried,” she said.” I don’t want to wake up one day thinking, what if…
How Do You Choose a Sperm Donor?
Sarah and Louise got a good feeling for theirs straightaway. “You tell the clinic what you’re looking for—everything from height and eye color. We were really big on education and we wanted him to be active. We also wanted him to look similar to us. You then get the suggested donor’s vital statistics plus a personal statement, so you’re basically choosing DNA input based on one piece of paper!”
The couple switched donors after the first two rounds of IUI before their son was born. “We’d moved location and I think he’d reached his family limit.” Donors can contribute to up to 10 families only. “But we’ve maintained the same donor since, meaning our children will have the same paternal DNA.”
Kiran and Lia have decided to do the same. “It’s like online dating,” said Kiran. “We wanted an Indian donor because I’m Indian, and we’ve reserved sperm from the same donor for when Lia goes through IVF next year. It wasn’t all about the looks though, we wanted brains too.”
Do You Have Advice for Anyone Considering IVF?
“Research the clinic,” said Kiran. “There was such a massive difference between the two I went to. And do wider research around IVF too. Make sure you absolutely know what you’re going in for so you’re emotionally prepared (both of you). It also helps not to compare your situation to anyone else’s. Some women may have 15-20 eggs, but they could all be dud. One quality egg is all you need.”
Despite the journey Sarah’s been on, she’s adamant that it was the only choice. “I spoke to someone at work who wanted IVF but was too worried about putting herself through it. I don’t understand that mindset to be honest. I was afraid of blood tests before I began and now I’m like a pincushion. If you want it, you have to face your fears, you have to just do it.”