Even with funding, infertility is a hard and lonely road

When the doctor turned to me and gently said, “I am so very sorry but I can’t find a heartbeat,” I thought for a second that mine had stopped too.

That was December 2009 and my husband and I had just completed our first cycle of IVF. I was nine weeks pregnant and attending my first antenatal appointment.

Little did I know back then that it would take another six years and four more rounds of IVF before our dream to become parents would finally come true.

Earlier this week, the Government announced that it was to provide public funding for assisted human reproduction (AHR) treatment from September to a limited number of people. Eligible patients will be entitled to one full cycle of in vitro fertilisation (IVF) or intracytoplasmic sperm injection. Up to three cycles of intrauterine insemination treatment will be funded for those clinically determined for it.

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When the news broke that for the very first time Ireland was going to provide public funding for fertility treatment, as someone who like many others had long advocated for this, my initial reaction was one of relief and excitement.

If you suffer from infertility and desperately want a child, you have a chance to become a parent if you can afford the treatment. If you can’t afford it then you don’t get that chance. That, to me, is inherently wrong

Relief that the Government was finally going to do something to loosen the financial stranglehold that the cost of private fertility treatment has on so many people; and excitement that there was now a real chance to relieve the suffering of infertility. However, when I read the details of the promised funding, my heart sank a little.

Unless you have been through fertility treatment, you will never truly understand just how devastating it can be when it fails. It does work the first time for some people and that is wonderful, but more often than not it takes several rounds before you are successful. Sadly, some people never get their happy ending after years of gruelling treatments.

Ireland is one of a very small number of EU countries that does not provide any public funding towards fertility treatment. Therefore if you suffer from infertility and desperately want a child, you have a chance to become a parent if you can afford the treatment. If you can’t afford it then you don’t get that chance. That, to me, is inherently wrong.

‘Financial hardship’

The World Health Organisation (WHO) has defined infertility as “a disease of the male or female reproductive system, defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. It can cause significant distress, stigma, and financial hardship, affecting people’s mental and psychosocial wellbeing.”

In a report published in April this year, the WHO stated that approximately “17.5 per cent of the adult population – roughly 1 in 6 worldwide – experience infertility, showing the urgent need to increase access to affordable, high-quality fertility care for those in need”.

IVF is prohibitively expensive and if it wasn’t for the credit union, the generosity of family and inheritance from my mum, who died in 2012, we would never have been able to afford it.

[ Publicly funded AHR: How will it work and how can people avail of it? ]

[ The Irish Times view on the Government’s IVF package: public provision welcome but eligibility needs to widen ]

Between 2009 and 2014, we spent €25,000 on fertility treatment. When our peers were putting down deposits to buy their first homes, we ploughed every cent we had into IVF. As a result today, at the age of 52 I am still renting and, of course, still paying back that loan.

I was 39 when I started undergoing fertility treatment. After countless tests and scans, we received a clinical diagnosis of unexplained infertility, which means that no cause was found as to why we weren’t able to conceive. At the time, my BMI was on the cuddly side of normal and I was advised to lose weight, which I did. We would therefore have qualified for government funding if the package announced this week was available back then. But we would have only received funding for one IVF cycle. It took a lot more than that for us to finally have a child.

In Britain, the NHS provides funding for up to three rounds of IVF and a small number of countries fund up to six cycles. It can take multiple cycles of IVF before you are successful, and as I learned on that cold December day in 2009, a positive pregnancy test does not always result in a much longed-for baby. That is why limiting funding to just one cycle of IVF and only to those who have had none or just one prior cycle (paid for privately) is, in my opinion, very unfair.

I understand that the health budget is limited. Nobody was expecting a blank cheque for public fertility services. I have sympathy for the experts charged with coming up with guidelines as to who can and cannot receive the funding based on a paltry budget of just €10 million. Theirs was an impossible task.

Happy ending

We finally had our happy ending in 2015 when our daughter was born. We knew it was to be our last cycle as time and money were both running out. At 43, I was advised to use a donor egg to increase our chances of success and this time, thankfully, it worked.

The miscarriage after our first IVF attempt nearly broke us, and the years that followed included some of the most distressing times of our lives

The new government funding will not cover donor sperm or eggs due to the failure to pass the long-awaited Assisted Human Reproduction (AHR) Bill. Until that legislation is passed, same-sex couples, single people and heterosexual couples who use donor eggs or sperm cannot receive publicly funded treatment. We can only hope that the future will bring more funding and a widening of the criteria so that these groups can avail of publicly funded IVF services.

The miscarriage after our first IVF attempt nearly broke us, and the years that followed included some of the most distressing times of our lives. The return of my depression and anxiety, the heartbreak of negative pregnancy tests after two more attempts which left me in tears on the bathroom floor. The phone call from the clinic the morning after my lovely mum died in November 2012 informing us that the embryos that were due to be transferred that day had failed overnight.

But we tried again and this time we struck gold. We were among the lucky ones, lucky that we could afford to take out the loans, lucky that we had financial and emotional support from family and friends and lucky that we finally got our happy ending in August 2015 when our own little miracle was born.

Infertility is a long, hard and lonely road only really understood by those who have travelled it. While the promised government funding might shorten the journey for some until the AHR Bill is passed and the eligibility criteria widened considerably, the vast majority of us will still have to go it alone.