The age old costs of IVF

It might not be the same for all ‘older’ couples, but our arrival into the world of fertility clinics was met with a barrage of criticism that never relented. A commenter on this very blog was recently scathing about my level of negativity, but I remain unrepentant on that score. The fertility specialists treated us in a particularly brutal manner. 

We were told in no uncertain terms, we did not have a chance. IVF success with over 40 year old eggs was not heard unheard of. When we started out, I had just turned 43 and had an extremely low FSH level of 3.1 (somewhat under the standard range of 4.0 – 24.0) and a prolactin level of 397 (not quite middle of the 0-600 range.) I was overweight, and questioned my specialists on this issue and got no where until my third specialist. He only seemed willing to play the weight card after our fifth cycle had gone bung, and only then it was in reference to donor eggs, saying how our chance of a pregnancy went from less than 3% with our own eggs to something like 70% for donor eggs, but fell again due to weight. In the end, our file has been marked reason for infertility ‘unexplained’ with a subtext that it is because of age. 

I felt angry as a move to a new clinic location seemed to go against us, and we had reason to feel this oh so important cycle had been mismanaged. Most of all I felt humiliated, very much a second class citizen in this game that does not offer a discounted rate for economy class seating. That day due to a shortage of space, I’d been told to dress and move into the seated area very soon after receiving the ‘no eggs’ result. Wobbles and I had been separated almost as soon as we arrived, as he had to go to another building to give his ‘donation’ of little Wobbly swimmers. We were not to know that we would not be reunited until after my procedure. In a tiny recovery area I sat at close quarters with four couples trying my best to cover my distressed state – then I saw Wobbles arrive looking anxious. I assumed he had been told the results. On realising he had no clues I had to whisper him the results between my sobs I tried concealing with my hands. 

We returned to see our mostly compassionate fertility specialist two days after our last egg pick up failed to yield any eggs. That particular failure in a long list of fertility related failures, seemed particularly hard to fathom. My distress was slow to abate. Late the night before our appointment I feared I would not be able to stop my tears long enough to have a serious discussion with Dr Loverely. 

I had a few things that I wanted to say, and I said them. My words were not rehearsed, but probably sounded that way, but the first time he mentioned the age thing I jumped; 

‘I have a birth certificate, a driver’s licence. I can remember most of my birthdays. I do not need to be constantly reminded of my age….’ 

Dr Loverley seemed a little startled, but he did his best to explain; how he frequently dealt with older couples who had their own unrealistic chances of success, or who had come to him from other clinics or other specialists where they had been quoted outlandish percentages and chances of a successful outcome. So with good reason he felt it was his responsibility to bring such expectations back closer to Earth. 

No one had ever given us such a chance. We never had anything but low expectations. Frequent media reports of over 40s IVF success began to do more than grate. The popular image of the older infertile and the reality began to polarise. 

Before we had started we were told to pursue donor eggs – even when my eggs were a complete unknown. We had my age mentioned over and over again to the point where I have acquired quite a complex about it. 

We were signed up for treatment, treatment was agreed upon, treatment had begun, treatment was over – yet age remained the main topic of discussion. We never seemed to move from that point of being an older couple with zero hope. 

Even on that last cycle, a telephone conversation saw the nurse make yet another gratuitous mention of it – again – “well you are 44!” I suddenly have visions of cancer patients being told repeatedly while still pursuing treatment that their disease is terminal. I just can’t imagine they would need the reminder. 

Wobbles and I were painfully aware of my age. The issues surrounding age were made abundantly clear on a regular basis. With that knowledge we accepted the risks, and the low outcomes for success and wanted to get on with things. We were never afforded that luxury. 

The failure of our fifth cycle seemed to cause me to revisit our first cycle. 

I find memories of Professor Doofus still haunt me. A cancelled cycle and a huge ovarian cyst that he refused to address. Then the nine day wait for his promised phone call – which ended up being a brief message left on Wobbles’ mobile phone that had accidently been left at home when we went out briefly one Sunday afternoon to try and unwind after my nine days of waiting by the phone for that very call! 

We had no time to waste Prof Doofus had told us. When could we cycle again? As soon as I bleed? When will I bleed? He shrugged his shoulders. 

It took five months without a period and one visit to a new specialist to find that the cyst would stay and continue to block menstruation unless treated. Within the month following the visit to our second specialist, the cyst was history and I was bleeding once more and on the way to a much delayed second cycle. 

Soon after I read the clinic’s newsletter and saw Professor Doofus quoted, saying how he warned his daughters to be careful of their ‘biological clocks’ (oh, how I have grown to hate that expression!) and make sure they had babies well before forty. Too often since that first wretched cycle I have wondered why he bothered with older clients in the first place if they did not fit his demographic. Now my blood (now flowing cyst free – no thanks to him!) boils with weekend media reports that he is leading a move to pioneer ovarian tissue transplantation on a 47 year old. Perhaps my case was not interesting enough for him to care? It seems not all older IVF patients are created equally. 

So where does that leave us? Without a baby for one. 

Even within the land of IVF failure it leaves us kind of no where. Even my infertile colleagues appear to view the failure of a cycle pre-embryo transfer with dismissive words. It is all the same if there is a BFN at the end. Well, to me it is not. Of course I only have my own experience to go by, but from here I would have preferred to have done five IVF cycles and have done five embryo transfers. Even four transfers would have been better than one. Three would have been fine. Even two would have been good. For all that effort and energy, while I am grateful to have had that one transfer – even though I spent all but three days of the two week wait with a nasty virus – my truth is that we were only ever in this baby race once.

 Sure, to have had five negative results from five transfers would not have been fun, but at least it seems as though being in it with a chance is somewhat more of an involvement. 

What is that old expression about bacon and eggs? The one that says something about the chicken being involved, but the pig is committed. 

I would rather leave IVF behind knowing all was covered, everything was equal. Instead, I have a growing unease that very little was well planned, and that sometimes expectations can not be set low enough.