The baby makers
With an increase in infertility problems, the IVF route is a common option, writes Fiona Dillon
As many as one-in-five Irish couples experience problems in having a baby, and it's a problem that is growing.
Putting off having a baby is increasingly common in this country, and it has led to an increase in the numbers seeking help for infertility.
In the second quarter of last year, the Central Statistics Office revealed that the average age of women giving birth was 31.5, which had increased by a year compared to nine years ago.
The ability to get pregnant decreases with age. The experts say it is particularly noticeable over the age of 30 and the decrease accelerates between the age of 35 and 40.
The reasons women are putting off having children is complex. Some have simply not met the right person, while some couples are striving for financial security before having children. In addition, there are increasing numbers of second marriages.
Dr David Walsh, from the Sims IVF Clinic in Dublin, believes that in the future, more women may avail of an AMH (Anti-Mullerian Hormone) test to determine how fast their biological clock is ticking. It is a marker for how many eggs a woman has. It's not routinely sought by women but would be done as part of standard infertility investigations, along with thyroid and ovarian function tests.
Walsh says knowledge is power and if a woman knows, it can inform her decisions. It could also be useful information to pass on to younger female siblings to also get themselves screened.
Despite the economic downturn, Dr Walsh says that the Sims Clinic has not seen a downturn in the number of patients. The clinic, which has been operating for 15 years, is set to move from the Dundrum Road to a bigger premises in Clonskeagh in the coming months.
The cost of IVF at the clinic is €4,400. The term in vitro fertilisation, refers to the process where a woman's eggs are fertilised outside of her body in the laboratory. The resulting embryos are then transferred back into the uterus a few days later.
Gordon Ramsay's wife Tana (35) underwent IVF treatment after they married in 1998 and became pregnant later that year.
Just 11 months after the birth of daughter Megan, they learned they were expecting twins following another course of IVF. Jack and Holly were born on New Year's Day 2000. Later the Ramsays conceived naturally and Matilda was born in 2002.
IVF is specifically recommended for women with absent, blocked or damaged fallopian tubes. It is also used in cases of unexplained infertility, and in some cases of male factor infertility.
The bulk of the costs of IVF are borne by the couple, although the State subsidises some of the drugs, and some health insurers will reimburse a portion of the infertility investigation costs.
Chances of success vary, particularly according to the age of the woman, but on average about 28pc of patients will have a baby after one attempt at standard IVF.
The Sims Clinic publishes information on its recent results for IVF at its clinic on its website.
"The average number of cycles people do is two to three," says Dr Walsh. "Usually at that stage, you will have a good idea of what is conspiring against them," he adds, although he says that some do go on to do more.
Meanwhile, the Sims Clinic has a donor sperm programme to assist couples where there is significant male factor infertility involved. And in response to the shortage of egg donors and long waiting times, the clinic developed a European donor egg programme.
"The majority of the donor sperm would come from Denmark and the majority of the eggs would come from the Ukraine," Dr Walsh says.
He says that both countries have well established legal frameworks in place in relation to these matters.
For instance, under Danish law, donors are given legal protection in relation to their anonymity.
Walsh says that for couples who are experiencing a delay in conceiving, the first port of call is their own doctor. If after a year, nothing has happened, then investigations should then be completed, and they may be given a drug such as Clomid to induce ovulation. After 18 months to two years, they will generally attend an infertility clinic for treatment.
For those in their late 30s or early 40s, the sequence stays the same, but the time scale can shorten. At that age, it is reasonable to get basic tests done at an earlier stage.