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Riding the IV F rollercoaster

TALk to any woman who has gone through In-Vitro Fertilisation (IVF), and they'll likely tell you that the entire scenario is an emotional rollercoaster from beginning to end. Add in the not-inconsiderable financial factor -- treatment can cost up to €5,000 a cycle -- and you'd think that IVF might have become a dream that's out of reach for many.

Curiously enough, the number of women seeking IVF has remained largely unchanged in recent years.

Each year between 2,500 and 3,000 children are born in Ireland as a result of IVF or other high-tech interventions. What's more, clinics are expanding quickly, despite the economic downturn.

"There is an absolute increase but a relative decrease, meaning that more couples are needing treatment, but fewer are in a position to be able to get multiple treatments," observes Dr David Walsh of Dublin fertility specialists The Sims Clinic.

"There are fewer cycles taking place and people are waiting that little bit longer between cycles than before. But the number of people needing IVF is going up and will continue to do so."

Why the increase in Irish women needing IVF treatment?

"Women have deferred childbirth," notes Dr Walsh.

"For the last 20 years women leave it longer and longer to have children. Irish women are the oldest in Europe to have children."

The average age for a woman giving birth in Ireland has risen from 28 in 1990 to 31.7 in 2010, the oldest in the EU. In addition, the number of women in Ireland aged 45 or older having children has almost doubled.

Yet with women holding off on starting their families, the cost of this decision soon starts to add up.

"Between 35 and 40 is when the drop (in fertility) really happens," explains Walsh. "By 40 you need to compensate for almost half of your fertility. When you go over 40 years old, that compensates for another third of a drop. A US study found that in terms of cost per child, women at 35 are looking at $10,000 (¤7,600), while 40-year-olds are looking at $30,000 (¤22,800). So it really goes up sharply after a while."

Despite the cost involved, IVF is still, alas, something of a game of chance. Although there's an 85pc likelihood an embryo will form, a child will be born in only 45pc of cases.

With the stakes so dizzyingly high, little wonder that so many describe it as an emotional rollercoaster. Correspondingly, the average number of IVF cycles undertaken has dropped from 2.4 to 2.

"People are taking time out to recover financially, meaning that they're getting less treatment than they'd ideally like to have," reveals Walsh.

"In the boom most couples would undertake two cycles within six months, but there's little chance of that now."

Painfully aware that tightening finances are what stops many couples seeking IVF, Dublin mums Joanna Donnelly and Fiona McPhillips have recently launched Pomegranate, a charity that offers the cash for one IVF to those who can't afford private fertility treatment. The scheme has the backing of the Sims Fertility Clinic, which picks up the tab for all medical tests, blood work and scans, which can add hundreds to the cost.

The two mums met while trying to conceive their second children in 2005, after conceiving their respective first children naturally.

"I had lost babies and had multiple miscarriages," says Joanna.

"Both of us had had a terrible time and were devastated through the experience, and had no one in our corner. We were very lucky to both have our babies. Very shortly after, I fell pregnant naturally, and I didn't take for granted that I would get to keep this baby, so I thought, 'if I do, I want to give something back'. I realised there wasn't a charity for people like that, so we set up Pomegranate.

"We paid for a couple to have successful IVF surgery, and then managed to pay for two more. We've been contacted by 20-30 couples so far. We hope to grow and get more donations."

Referring to the cost of IVF in Ireland, Joanna says: "It's completely prohibitive. Think of how long it takes to save €5,000, and that's just for one shot, with no guarantee that it's going to be successful. It's likely that by the time you save that money you'll be out of time. I know people who are remortgaging their house so that they can have a child."

For a growing number of single Irish women, IVF may have been something of a Plan B; a means to have children even if the search for Mr Right failed to materialise. Once a resolutely single woman has passed their 'scary age', she is looking at one of three choices: First, she can shelve her dream of motherhood for good and get on with her life; second, she can find a casual playmate and get pregnant accidentally on purpose; and the third is to find a sperm donation clinic. The latter is an option that more and more Irish women are considering.

"I should think that single women make up around 5pc of our clients," says Dr Walsh. "There has certainly been a rise in business in the last few years. Many women would have gone to London to specialist clinics in recent years, but are opting to get treated at home.

"Mainly, they're women in managerial and professional jobs, aged 38-40.

"Most of them simply say they've never met Mr Right, and would have hoped to have a family within a relationship but it didn't happen that way.

"Denmark supplies most of the donor sperm used in western Europe, and that's because the Danish parliament has passed a law that guarantees anonymity for the donor," explains Walsh. "Their bloods have been checked, they have undergone genetic screening, and their family medical history has been checked. The sperm has then been frozen and checked for infections."

Donors are ordinary, physically healthy men from a broad cross-section of society whose ages range from 18-50 years. Most of them are students from institutions of higher education. They receive only small remuneration for donation and it is believed that they are genuine in their wish to help others.

At the Sims clinic, insemination using donor sperm costs upwards of €4,000, with donor semen costing €550 a cycle. Which might beg the question; why not surmount this cost by hooking up with someone for a one-night stand?

"It's a responsible way of doing things, as it's a controlled process, and the sperm is quarantined and checked for Hepatitis B, HIV. Using donor sperm, you reduce the physical risks involved."

To date, one single woman has approached Pomegranate for help: "We don't discriminate based on relationship status, race or creed," says Joanna.

Adds Dr Walsh: "It's a terrible indictment on society that these women have to face such dilemmas on their own. I've a huge amount of empathy for (single) women who decide to do this.

"Undergoing IVF with someone is hard enough, but opting to go it alone adds another layer of difficulty. IVF is never something a single woman has ever planned to consider, and it can be a horrible position for them, but they're trying to make the right decisions."

Pomegranate.ie is holding an official launch on Thursday, May 3, at the Russell Court Hotel, Dublin