Time to tear down the wall of silence around infertility
EVERYONE thinks it will never happen to them. Unfortunately lightning not only strikes, it touches one couple in six.
I'm referring to infertility, which is one of the last taboos. People are reluctant to discuss it, even though 2pc of all births in Ireland -- 1,000 babies a year -- come about as a result of fertility treatment.
A curious wall of silence surrounds the subject. Some of the bricks in this barrier are in place because couples find it painful to be open about their condition, from a combination of grief, disappointment and shame.
Society's failure is another factor: there is a compassion shortfall and initiatives to help prevent infertility are also in short supply. When couples discover they cannot have a child, they wonder: why me? How do I cope? Where can I go for help? I know this is how they feel, because I fall into that one in six category struck by the unexpected lightning bolt.
I have to psyche myself up to talk about infertility because the pain never vanishes -- you just find coping mechanisms. However, yesterday I launched two reports on infertility by the Women's Health Council (WHC), and the reason I agreed to was because the research is valuable and their recommendations important.
We should not let them be shelved because the political will to implement them is absent for a variety of complicated reasons, although cowardice also figures.
Infertile couples are being left in the lurch. Not because childlessness happens -- it's a fact of life, however unwelcome -- but because we make it tougher on them than it ought to be. They are not a vociferous lobby group, they do not parade their wounds, and consequently we are slow to give them what they deserve. Key proposals in the twin WHC reports include a call for legislation and regulation to govern fertility treatment -- a framework for neither exists. We are among only three European countries operating in that vacuum (the other two are eastern European states).
Childless couples are vulnerable and need to be protected. Currently the system is wide open to abuse.
We have 10 clinics offering fertility services, all of them private. Those linked to maternity hospitals fall under their regulatory umbrella, but a disturbing trend is emerging with little clinics popping up, doing bits and pieces of fertility treatment. Regulation should be mandatory not coincidental.
I'm not telling the Minister for Health anything she doesn't know, because four years ago another report advised legislation and regulation. It is quietly gathering dust.
Fertility services have been available in the State for 20 years, yet successive governments have fudged the issues. Our Government appears to be waiting for the Supreme Court ruling on the frozen embryos' case, expected this term. This decision will determine whether human life begun in a petri dish in an IVF clinic is deemed to have the same rights under the Constitution as any other baby. Meanwhile, legislation is delayed yet again.
Another issue which crops up due to lack of regulation is the absence of a common standard for the way results are published. Clinics are naturally inclined to put the best gloss on their statistics. But couples have to scramble to access information, and many scratch their heads trying to interpret data.
Nor are clinics obliged to provide counselling. The HARI Unit at Dublin's Rotunda Hospital is the only one to make counselling mandatory, while other service providers say they prefer to leave it optional.
But couples in the grip of fertility treatment, and coping with the fallout from failure, can't always judge their own best interests. I know now I needed counselling, during and after three failed IVF attempts, and its absence delayed the emotional healing process.
Without counselling, clinics lay themselves open to charges of being prepared to take the money and run.
It helps couples to devise a version of life without the longed-for baby. Additionally, it allows them to negotiate an end to treatment. Sometimes it is extremely difficult to agree when they need to call a halt -- there is always the temptation to try just once more.
The silence which characterises fertility treatment means couples don't always embark on it with their eyes open. We tend to think of medical procedures as only affecting our bodies, but they also impinge on our psychological well-being.
The drugs necessary to override a patient's menstrual cycle and turbo-charge her ovaries are powerful: many women struggle to cope with see-sawing emotions during IVF cycles, as their partners look on in horror, wondering what they have let themselves in for. IVF is extraordinarily invasive and should not be a first option. I don't say this to deter people from giving it a try -- after all, some couples do strike it lucky -- but on the basis that forewarned is forearmed. If expectations can be managed, the experience becomes less traumatic.
And if we could only become more open about childlessness, its causes, repercussions and ways to minimise it, couples at the frontline of infertility might not have it so hard.
We can't wrap people in cotton wool. Negative experiences are inevitable in life. But we can stop hectoring women about waiting too long to start a family, and instead encourage couples to have their children younger. We can also persuade employers -- perhaps with tax breaks -- to put family-friendly initiatives in place.
At least these reports break the taboo and, if nothing else, that's a promising start. Read them on the council's website www.whc.ie
mdevlin@independent.ie
- Martina Devlin
