Finding a path through infertility
The high cost of treatments here and lack of donor egg options are driving the growth of ‘fertility tourism’
Siobhan and Jim Boucher and their daughter, Rachael (7), at home at Castleknock, Co Dublin. Photograph: Eric Luke
Cliff and Anne had been going out for only two months when he discovered through medical investigations at the age of 30 that he was probably infertile.
“That was a difficult time,” he says. He felt he had to let his girlfriend know right away but their relationship continued and they were married in 2006.
After learning he was definitely infertile, as a result of being born with undescended testes which was not picked up in childhood, they knew they would have to use donor sperm to have children.
“We tried with two IUI [intrauterine insemination] procedures first and then we were told the only option was IVF [in vitro fertilisation].” After several cycles of IVF in the Sims clinic in Dublin, they were advised in February 2012 to go for “double donor” conception – using donated eggs as well as sperm.
The fact that any resulting child would not have a genetic link to either of them did not put them off, although he acknowledges this choice is not for everybody.
“All we wanted was to have a baby and we had been through so much and so many failed attempts, it just seemed the natural way to go. You would go to any lengths.”
The series of failed IVF attempts had eaten into their time, with each one taking three to six months to get over before gearing up for another.
It is hard to convey, he says, how “gruelling” the whole thing is. It is very tough to go into work each day as if nothing is happening, while dealing with the injections, medication and doctor’s appointments, and keeping it all secret.
The couple went to Spain towards the end of last year for double-donor treatment, from which they got five good embryos. Two were transferred but Anne had a miscarriage after six weeks.
“We had three embryos left and we went back in July of this year to have another two embryos transferred – one didn’t survive the thawing. The good news is that it has actually worked,” says Cliff, who sounds as if he still doesn’t quite dare believe it.
But as Anne (40) is just 10 weeks pregnant with twins as we speak, it is still a very anxious time. He had none of the elation he had anticipated after the positive pregnancy test.
“You think your life is going to be completely different and you’ll be jumping around. But it hasn’t got any easier,” he explains. “It still feels like we’re in the two-week wait [the period between embryo transfer and the pregnancy test].” He hopes that after 12 weeks, they will be able to relax a bit more.
It has cost them roughly €45,000 to get to this point. “They say it is like a rollercoaster you can’t get off – it is very difficult to know when to stop.”
Although they couldn’t really afford the second visit to Spain, “there was no way we couldn’t go when we still had embryos left”.
“Fertility tourism” is a growing phenomenon, with Irish couples travelling to clinics in various countries such as Spain, the Czech Republic and the Ukraine.
“There are loads of people going abroad,” agrees the director of Sims clinic in Dublin, Dr David Walsh.
“It used to be primarily for donor eggs, now it’s for economic reasons. When they can get treatment for half the cost outside the euro zone – in the Czech Republic in particular – why wouldn’t they?
“At least they have the choice and it puts the onus on providers in the high-cost euro zone, including Ireland, to see how we can bring costs down,” he says.
Couples can expect to pay up to €5,000 for one IVF cycle here, while the same amount of money could cover two cycles abroad.
The only problem about going abroad is the continuity of care, he points out. “Personally I think doctors, and indeed politicians, have a duty of care to citizens to provide as much as we can provide within these boundaries, within reason, that should be our orientation and intent.”
There is still no legal framework to deal with issues arising from infertility treatments. The National Infertility Support and Information Group (NISIG), which will host a conference in Limerick on September 14th, has long been calling for action on the report of the Commission on Assisted Human Reproduction that was published in 2005.
It has been gathering dust, while reproductive medicine has forged ahead.