Tuesday 21 November 2017

Going IVF alone: Increase in Irish single women looking to have a child via donor sperm

The Irish single women who take on the emotional and financial burden

The rollercoaster of IVF can take an unpredictable toll on a woman's body, mind and savings
The rollercoaster of IVF can take an unpredictable toll on a woman's body, mind and savings
Mother and baby posed by models.

Chrissie Russell

I'm looking at buying sperm online. It's actually not unlike searching for a property - tick the options you want, only in this case it's racial background, hair colour and eye colour up for selection rather than number of bedrooms, bathrooms and a postcode.

I opt for the same race as myself but carte-blanch on the hair and eye colours, bringing up a potential 471 donors. Then it gets more tricky, do I care about their height? Weight? Educational background? Do I want my donor to be anonymous or not?

For €12,000 I can have exclusive rights to a top-notch donor. I'm not sure quite how much of the product that buys me, but at 12 grand I'd wonder if it's not saffron but sperm that is the most valuable commodity per gram.

After just five minutes online researching prospective donors, my head is already spinning. Prices range from €63 to the €12k donor depending on motility, standard, type and profile. Do I want to pay €219 to have stems of the sample transported in a nitrogen tank or save €45 and get it delivered in dry ice?

I'm looking from the detached point of view of a researcher (although I might clear my internet history just in case my husband gets concerned). But when you're spending thousands of euro and trying to pick the best possible parent for your unborn child - how do you know where to start?

"It can be a minefield, particularly after reading through pages and pages of options" agrees Jenny (not her real name). "In the end I just looked for similar characteristics to my features and tried not to get too bogged down on things like degrees. But it's quite daunting and overwhelming to choose the possible father of my child."

If all goes well - and there's no reason to suggest it won't - later this year Jenny (now 41) will become one of the first women in Ireland to give birth after having her eggs frozen. She's one of a growing number of single women in the country taking advantage of the ever-evolving fertility treatments available in the hopes of fulfilling her dreams of becoming a mother without a man.

At the ReproMed Ireland clinic, where Jenny is a client, they've seen the number of women accessing egg freezing increase four fold in the first three months of this year compared to the same period last year.

"In addition to this, we've seen a 20pc increase in the number of single women looking to access IUI using donor sperm," reveals Caitriona McPartlin, general manager at ReproMed Ireland.

"The statistics support what we're hearing on the ground at the clinic, which is that an increasing number of women are taking control of their own fertility by either having children 'on ice' by freezing their eggs, or by using donor sperm instead of waiting for the right partner.

"It's a progressive attitude and one that's reflective of today's society in Ireland."

Mary McAuliffe, fertility nurse and head of clinical services at Cork Fertility Clinic, agrees there's been an increase in single females looking to have a child via donor sperm, though she's keen to add that the majority of clients are still heterosexual couples.

"People are more independent now and more driven to succeed in their personal goals," she explains. "The ladies we see coming through tend to be very solid in where they are; they've their own house and a steady income. They're pretty happy with most areas of their life except for one or two elements.

"The majority would love to have met the perfect person to have a family with but at the same time they know that they still want to have a child even if they've not met the right person."

Jenny was single and 36 when she decided to take action. "I felt time was ticking so wanted to see what my options were in order to have a baby by myself," she explains.

She started with three rounds of Intra-Uterine Insemination (IUI) where sperm is inserted into the uterus at the time of ovulation, but all failed. A fourth attempt with a new donor also failed.

Jenny requested an egg reserve test (something she would urge all women to do at the start of the process) which revealed she had a low egg reserve, prompting her to begin egg collection and freezing to increase her chances of a viable embryo.

Egg collection, freezing and IVF (where fertilisation occurs outside the body) began in August 2015, then again in October with all eggs defrosted in November and added to those collected that month, making 12 in total. Three were viable and implanted - one resulted in a pregnancy.

It's not a cheap option. Three stems of donor sperm cost €1,150, the original three IUI were €850 per round and two or three scans at around €100 each as well as fertility medicine (covered under drug scheme) at €144. The fourth IUI, €850 per round and three new stems of donor sperm costing €650.

Intra-cytoplasmic sperm injection (ICSI), when the sperm is injected directly into the egg, and IVF cost a further €10,000.

"The total cost has been in and around €20,000 which included diagnostic testing in hospitals too," says Jenny. "A lot of money for someone on their own but obviously worth it to end up pregnant."

But therein lies the rub, not everyone is successful. At Cork Fertility Centre the cumulative live birth rate for women less than 40-years-old, using donor sperm with fertility treatment, is 40pc. Often fertility clinics advertise their success rates citing 'clinical pregnancies' but the number that make it to live births is generally lower.

You might be paying for it, but fertility treatment does not come with a baby guaranteed.

Miriam (not her real name) was single and 37 when she started trying to have a baby through donor sperm. "I did four IUI before I accepted I needed not just a donor, but fertility treatment too," she explains.

She started IVF and on the second cycle had three good embryos implanted.

"At seven weeks I had a scan and discovered I was expecting triplets. It felt amazing and, although I was super anxious about raising triplets as a single mother, I was very excited and friends and family were very supportive," says Miriam.

Aside from being a little tired and hungry, her pregnancy seemed to be going well. "The day of my 12-week scan I was so excited to be out of the big danger zone for miscarriages," she recalls.

"But when I went for my scan they discovered all three babies had died. I was completely devastated, bereaved and heartbroken. I grieved for about three months non-stop."

To date, her quest to be a mum has cost Miriam €30,000 plus additional costs in unpaid leave.

"I feel that I'm still privileged to be able to afford it and to have the emotional support to get through it," she explains. "I think it's tragic that some couples who can't have children and can't afford IVF don't have the opportunity I've had."

One area that does raise concern is with regard to the regulation of the fertility industry in Ireland. In many ways the technology has evolved faster than legislation. There are no sperm banks in Ireland so clinics here use donors from banks in Denmark and the USA.

A popular one is Cryos International in Denmark (the website I'm doing my window shopping on), which is governed by the Health Products Regulatory Authority (HPRA) and, like all sperm banks, sets its own quotas for how often a donor can be used.

Once you've done your search, they'll tell you whether the donor is available in your country.

The Irish clinics also have an informal method of regulation, whereby a database is shared between fertility clinics enabling them to let each other know when a donor has resulted in a pregnancy. The object being to ensure, that in a small population like ours, the same donor isn't being used by multiple Irish women.

But there's no way of knowing how many women might be buying sperm online and attempting self-insemination at home.

"We self-regulate to only allow the same donor to be used three times," explains Declan. "So if there have been three pregnancies in Ireland from that donor, then it can't be used again." 

But that raises challenges if a donor has been purchased and treatment already started with one woman before a viable pregnancy is announced on the shared excel sheet.

"The last government began work on introducing legislation for the field of Assisted Human Reproduction in Ireland, including the use of donor gametes, but this legislation was drafted and is still, I believe, at the consultation phase," reveals Caitriona.

"Currently Irish clinics adhere to the guidelines set out by the EU Tissues and Cells Directive, and are regulated by the HPRA, but it would give Irish fertility clinics and their patients a real sense of security and support knowing that there's a dynamic and dedicated regulatory body for the field of AHR in Ireland."

The industry looks set to get even more complex in the near future when anonymous donors, for both sperm and eggs, will be banned from use in Ireland and all donor treatments will have to be recorded onto a State register.

"This will severely restrict donor availability, which may well create waiting lists for donors and will most likely lead to increased costs to patients requiring this service," says Graham from SIMs.

"Currently with a free choice, just over 50pc of our patients choose an anonymous donor. These patients will either be forced to choose an identifiable donor or travel overseas for anonymous treatment."

"Certainly it will reduce choice," agrees Mary at Cork Fertility. "But it'll become normal to us in time. Change can be difficult but hopefully it will get easier."

There's no denying that the family unit is changing in Ireland, and its many variations will no doubt become 'normal' to all of us in time. Jenny would not have been a single mother by choice.

"It's not the route I thought I would do down, circumstances dictated it," she admits. "But considering everything, I would not hesitate in recommending it. Even now, at 27 weeks pregnant, I still can't quite believe it's real.

"It's irrelevant whether it's coming into a one-parent family because this baby will have enough love for two."

Irish Independent

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