Sunday, 15 November 2015

Your IVF questions answered!

Since beginning our fertility treatment in 2014, we have gotten a lot of questions, via comments on our blog posts, Twitter, Instagram, and email. We seem to get questions along a similar line, so thought it would be helpful to others if we answered all those questions in one place!

The only people we have told in 'real life' (apart from parents and siblings) are close work colleagues who we see daily and would guess something was going on! (Lauren also needs to limit what she can do at work, and Sarah might need to adjust shifts around scans etc). The only questions we get from them are 'how?' - which we answered here, and if Sarah was donating her eggs to Lauren/carrying the next baby - which we answered here and here.

Here are the ten most common questions we receive:

1. Why did you choose IVF, and not IUI?

We began our baby making journey in February 2014 by visiting our GP to discuss our options for fertility treatment. She kindly referred us to the local NHS clinic, and our appointment came through for May. The Consultant we saw talked us through our options - IVF vs IUI, and reminded us that we would be paying for treatment, and it wouldn't be on the NHS. She booked our next appointment to come back and discuss what we had decided for the next available slot - November. After some online researching we found a private clinic whose prices pretty much matched the NHS clinic's, but advertised significantly shorter wait times. We booked our first appointment with them in July 2014.

After some time the waits became too long at both clinics, having been warned that our desire to egg share at the private clinic would mean we might wait longer than 6 months to be matched to a recipient. So we decided to take things onto our own hands, and try home insemination. We imported some anonymous sperm from a sperm bank in Denmark (shipping sperm to your home from a UK clinic is illegal and therefore cannot be done) and tried two rounds (two attempts each round) of home insem. One didn't work, one resulted in a chemical pregnancy that lasted a few days. We spent around £1600 on sperm and shipping, and felt afterwards that we didn't want to waste any more money on going for a method that was cheaper than IVF but had lower success rates.

We felt we would rather put our treatment in the hands of the professionals, who could time everything perfectly. So decided to continue down the route of the fertility clinic. For us, the important thing was success rates, not which option was seemingly cheaper, and so having had two failed rounds of home insemination at home (which comes with a success rate that equates to that of IUI in a clinic), we knew we wanted to go for IVF.

 IUI would have cost us about £2400 per cycle, when you add up the cost of the sperm + shipping plus the actual procedure itself, with a success rate at our clinic for women under 35 of an average of 15% per cycle. The average success rates for IVF at our clinic in women under 35 is 38% (although said to be up to 70% in women with no fertility issues i.e. single women or lesbians) and cost us approx £3000. (Our cost was reduced due to egg sharing - see questions 3 and 5)

2. How did you decide on a clinic?

Having gone to our GP to discuss the fact we wanted a baby (a good starting point to anyone wanting to know where to begin!), we originally attended the fertility unit within our local hospital. We figured that an NHS clinic would be slightly cheaper than a private clinic, but also booked an appointment at a private clinic to see if the waits were less, which they weren't due to our desire to egg share. The clinic within the NHS hospital just didn't feel quite right. We were referred to as a 'special case' as we wanted to use Sarah's eggs with Lauren carrying, and sat in a dated hospital room with peeling paint and a crowded waiting room, it just didn't appeal. Although a 45min drive away, the private clinic we went to couldn't have been more different. It was modern, well equipped, decorated in calm colours, and staff were obviously used to dealing with same sex couples as much as heterosexual ones. It just felt right, which is what we would strongly recommend when choosing between clinics, go with the one your gut tells you is right - you'll be spending a lot of time there!

3. How much is it?

It varies between clinics, but IVF is usually around £3500 not including sperm (usually around £1000-£1200) or pre treatment blood tests and scans (usually around £600), so altogether around £5100. We egg shared to an anonymous couple which bought our cost down to around £3000. The drugs you need to take once pregnant also cost £100's.

4. Can I get it free on the NHS?

This is a very frequently asked question for us, and whilst we never had any idea that our fertility treatment would be funded, I guess most people assume that just like heterosexual couples who can't conceive, you get one round on the NHS. We discussed this here - in short, the answer as the same as straight couples: if you have a proven fertility problem and you can prove you have tried to pregnant for a significant amount of time unsuccessfully (through home insem etc) then you may be able to apply for funding, for your first child only.

Otherwise, nope, you can't get it free! We believe children are a privilege, not a right, and don't really believe the NHS should pay for IVF. We recommend the way we did it - good old fashioned saving! (Plus it prepares you for how expensive children are!)

When people who had been through IVF told us how emotionally, mentally, physically, and financially hard it is, we completely underestimated this, and thought "why do people get so stressed by it?!"
Well now we know! From finding or being matched to a sperm donor, getting all your injections right, hoping every scan shows things are happening right, sudden unexpected extra costs, the discomfort of having loads of enlarged egg follicles stretching inside you, the hormone surges, the numerous internal scans, praying you have enough eggs, the worry of egg collection, the suspension of the two week wait praying this hasn't all been for nothing, then when it works - analysing every twinge, praying that things will develop as they should be. We've been told it doesn't get much easier after they are born either! It really does take strength of character, and a very stable relationship, so we recommend you don't rush into it - that also gives you time to save!

5. How does egg sharing work?

Egg sharing can be either intra-partner egg sharing, where you and your partners cycles are synced, then the eggs are collected from one partner, fertilised, and put back into the other. It does make things more complicated, and we we were told it can affect success rates, as the body is more likely to reject an egg that isn't it's own. We did look into it, but discovered due to various fertility problems, Sarah was unable to use her eggs, which really didn't matter to us. We just need an egg - it doesn't matter who's, it will still be Our Baby!

The other type is donating to an anonymous recipient who needs donor eggs to conceive. You are matched with a recipient in the same way you are matched with a sperm donor, then your cycles are synced. When your eggs are collected, half go to the recipient. If it's an odd number, she gets the extra one, as she is paying more. In return for egg sharing in this way, which is what we chose to do, you have the ability to help another couple make a family, which they wouldn't otherwise have gotten. And the costs are reduced - we didn't have to pay for the treatment as such, but we had to pay for our own drugs, plus sperm. Totalling approximately £3000 with other tests and extras etc.

6. Why did you decide to egg share?

We decided to egg share for two reasons. Firstly, because it reduces the cost of your IVF. If you egg share, your anonymous recipient pays for a proportion of your treatment. Secondly, we also just think it's an amazing thing to do. After all, our baby wouldn't have been possible without our sperm donor, so we like the idea of paying it forward, and giving someone else the chance to be a parent.

7. When you didn't have as many eggs collected as first thought, why not change your mind about egg sharing at collection?

In short, we just couldn't have done that to someone. Whoever our other eggs went to, given that she needed donor eggs, she has obviously been through a longer, harder, more expensive process than us. If you need donor eggs, this is likely to be your last shot. We know how hard IVF is even from our relatively plain sailing prospective, and watched Lauren's sister be told that she'd had no eggs to collect during her IVF and would never conceive. Our recipient must have been putting so much hope on the eggs we gave her, we couldn't never have taken that away from her at the very last moment.

8. How did you choose a donor?

People see donors in very different ways. Some people want their child to be able to meet their donor, or even have regular contact. Some are happy with an anonymous person found online, that as long as they can prove their healthy, is good enough for them. We are of the mindset that a donor has no more to do with our child than Lauren has to do with the people who receives the blood she donates at blood donor drives.

We had specified to our clinic (who have their own sperm bank) what physical qualities we wanted (basically fairly similar to us) and then went on a waiting list. The first man we were matched with refused to donate him sperm to a gay couple, and the second match was Greek Cypriot. So we decided to import from the Danish sperm bank we used for our home insemination. It had to be a non-anonymous donor (meaning the child can have their details at age 18) as anonymous donors are illegal in the UK.

We first narrowed them down to being CMV negative blood type (to match Lauren as she is CMV-) then by physical attributes - not too tall as we are 5'1 and 5'6, medium build, fair skin, brown/blonde hair etc. We then read through the other information that came with the donors and picked the one we most liked the sound of. We have our donors full family tree including what jobs everyone does, personality tests, clinic opinions, baby photos, and a huge questionnaire detailing everything from our donors favourite holidays and what food they like. We also have a letter detailing why he decided to donate.

We basically were between wanting to know as much as possible, whilst also remembering it might not impact on our child at all - Sarah's parents are short with green eyes, like her, and her brother is tall with grey eyes!

9. Are donors anonymous?

In the UK, it is illegal to ship sperm to your home, or to use an anonymous donor at a clinic.
This basically means when the child is 16 they can have some info on their donor, and at 18 can have more detailed information.

If you are using the sperm at home, you can import anonymous to your home (though it can technically be confiscated a customs, though this is rare). If you are importing the sperm from abroad, or using a UK sperm back, to use at a clinic, it has to be non anonymous.

10. How will you explain the donor to your child?

We have already considered how we will explain our donor to our child - in a nutshell - to make a baby you need an egg and a seed. We had eggs but no seed so a kind man in another country sent us his seed. Obviously this will be adapted as the child gets older. We will explain some people have two mums/two dads/one of each, a dad/a mum etc, and families are all different, but equally full of love.

So that's our ten!
If anyone has anymore questions we would be more than happy to help you out! Feel free to ask via commenting here, or via email/Twitter (links below). 
Ask away!

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