IVF: An Emotional Companion. Brigid Moss

by it. I usually say simply that it was fertility treatment – most people don’t ask for details.

      I’m also asked, ‘What are you going to tell the children about how they were conceived?’ But I don’t think they’re going to care about the actual mechanism of conception, especially these days. I was making dinner the other day, stirring something, and Dylan said, ‘Is that how you made us?’ He knew that he and Nathan had been in my stomach, and assumed they must have got there the same way as food! If we’d used donor sperm or eggs, I think it would be different, as then it’s a question of genetics.

      Q: WHAT WILL YOU DO WITH YOUR FROZEN EMBRYOS?

      We’ve got seven embryos frozen from our treatment. Recently, I got a letter saying that they’re about to reach their fi ve-year deadline, and we have to decide what to do with them. We’re not going to use them ourselves, as we don’t want any more children. We’re still having a debate about what to do with them. If it was just my eggs, I could donate them to someone who needs them. But I’m not comfortable doing that with embryos, as they are, theoretically, full siblings to Nathan and Dylan. If I did, I might start thinking every child I see on the street is genetically ours. I would like to give them to medical research, as for me it’s important to give back, but Adam isn’t keen as he doesn’t want them to be prodded and experimented on. He’d rather let them be destroyed. I think I’ll probably win the argument in the end, but it might take a while.

      Q: WHAT’S YOUR BEST ADVICE FOR ANYONE DOING IVF?

      You need to keep calm. I’m sure that part of the reason why IVF worked for us is that we’re quite calm people. And I made sure I stayed that way. My belief is, only worry about things when you absolutely need to.

      Also, try to be positive and don’t think about it not working. Try to go about your normal daily life and don’t let everything be about IVF. Just before I had IVF, I met a woman who’d had multiple cycles of IVF and had made some extreme life changes she thought would help it work. She was on a strict organic diet, not using foil or plastic on her food and avoiding microwaved food. But I knew that wouldn’t have suited me. I believed that the more changes I made away from my normal life, the more I would have been setting myself up for disappointment had IVF failed.

      The hard thing, when you’re having fertility problems, is when your friends are falling pregnant around you – especially, I found, when they are having their second. But you have to be positive and think: their second won’t take away my first.

      Q: WHO WAS YOUR SUPPORT SYSTEM?

      I had my best friends, my parents and, of course, my husband Adam, although, ironically, I probably spoke to him about it less, as I didn’t want it to be all-consuming for us. After a while, Adam’s attitude was sometimes, ‘Do we really need to talk about this again?’ He always believed it would happen for us. And, as a man, he wasn’t as conscious of my biological clock, so he didn’t mind if it happened straight away or in a year.

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      Difficult though it is to live with the symptoms of PCOS, the good news is that the majority of women who have it and want to get pregnant, do so. But that doesn’t mean it isn’t a hard slog to get to that point.

      For excess weight associated with PCOS, some women swear by the GI diet: ‘Many nutritionists, dietitians, and women with PCOS believe the lower sugar and lower refined carbohydrates in the GI diet really work, by reducing insulin resistance and keeping hunger pangs at bay,’ explains Colette Harris, co-author of PCOS and Your Fertility (Hay House) and The Ultimate PCOS Handbook (Thorsons). ‘The basis of the diet is more protein, more fibre and less sugar,’ she says. And while there’s no consensus on how often or how hard you should exercise, she recommends some exercise every day, even if it’s just gardening or brisk walking.

      If you are keen to explore complementary treatment for PCOS, a Swedish study from 2010,¹ where women had 16 weeks of electroacupuncture (where the needles are linked up to a minimal electric current) had more periods as a result. Fertility acupuncturist Emma Cannon (emmacannon. co.uk) says that most of her clients find their cycles return after one to two months of acupuncture.

      And there’s more good news: a study published in 2010 from the Shahid Beheshti University in Iran² compared the AMH blood levels (anti-Müllerian hormone — a marker of fertility) of women with PCOS and those without, and found that AMH declined to menopausal levels on average two years later in women with PCOS, which means they have a better chance of conceiving at a slightly older age³.

      Finally, Verity, the PCOS charity, runs conferences with expert speakers (verity-pcos.org.uk); you do need to be a member, but they can keep you up to speed on all the latest research. You can download previous conference speeches at the website of PCOS-UK, the education arm of Verity (pcos-uk.org.uk).

      My partner had no sperm

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      When a man finds out that he’s subfertile, it can be a huge knock. Thinking he might not be a father can change how he feels about himself,’ says fertility coach, Anya Sizer.

      A low or even a zero sperm count doesn’t mean a man can’t be a father, though. ‘There is a range of sperm counts in men, some have lots, some very few,’ says Dr Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield. ‘And the definition of healthy sperm count recently went down from 20 million per millilitre to 15 million. At that level, a man should be able to become a father within a year. But you can be “abnormal” by that definition and manage it in, for example, two years.’

      Male fertility treatment has seen the biggest technological advances in the past 10 years. ‘We don’t have any magic pills to stimulate men to produce more sperm. What we do have are ways of extracting sperm or doing the best we can with the sperm that we can get,’ says Dr Pacey. By using‘ intracytoplasmic sperm injection, or ICSI, embryologists can now fertilise an egg with a single sperm.

      Even if tests show zero sperm in a man’s ejaculate, there are several surgical techniques that can extract sperm, when previously a man would have had to use a donor to have a family. ‘Finding nothing in ejaculate is unfortunate,’ says Dr Pacey, ‘but it doesn’t necessarily mean that a man’s testicles aren’t producing any sperm, just that they’re not making it out in the ejaculate or they haven’t been seen in the lab. When we look at ejaculate, usually several millilitres of fluid, it’s impossible to look in every single bit of it. Theoretically, there could still be several thousand sperm in there, when we see nothing.’

      The major factors that affect sperm count and/or quality are genetics (including having undescended testicles at birth), trauma, chemotherapy and vasectomy. The surgery of choice if there’s a blockage, for example after vasectomy, is aspiration via a needle, usually taken out of the tube which carries sperm from the testes to the penis (PESA — percutaneous epididymal sperm aspiration), but sometimes from the testicle itself (TESA — testicular sperm aspiration). These are procedures that are performed every day.

      My dad had a vasectomy over 20 years ago, which meant he couldn’t have it reversed when he wanted to have a child in his 60s. So he had PESA to help conceive his now toddler daughter: ‘I had a full anaesthetic but I was only out for thirty minutes. There was no pain or bruising afterwards; the only slightly embarrassing part was that the nurse who helped with the op was so chatty!’

      ‘After a vasectomy, there’s usually a hundred per cent success rate at getting sperm surgically. These men were obviously fertile in the first place,’ says Dr Pacey. But, he explains, ‘With a man whose fertility has been affected by chemotherapy, the success rate is perhaps about forty per cent.’ These men, or those who had undescended testicles at birth, may need to have an operation called TESE (testicular sperm extraction), where tissue is removed from the testicles, then dissected to find any sperm.

      There