Why do people go overseas for IVF?

A new survey of fertility patients looking at overseas treatment carried out for Fertility Network UK and the website Fertility Clinics Abroad has unsurprisingly found that cost is the major reason why people travel for treatment.  Of those who responded to the survey, nearly 80% said fertility treatment in the UK cost twice as much as they were willing or able to pay and 68% said that they would travel for treatment because IVF overseas was generally cheaper.

When people first started travelling overseas for fertility treatment, it was often to access donor eggs but according to this survey most of the respondents were using their own eggs for IVF treatment abroad. The survey found that people believe that treatment can often be offered more quickly abroad. There was also a perception that the standard of care was better overseas with clinics offering a more personalised approach.

Interestingly many were also attracted by the apparently high success rates overseas, but some respondents had noticed that these rates could be confusing and misleading. A majority had said a centralised database of all overseas clinic success rates would be welcome but it would be very hard to verify these rates. Some overseas clinics claim success rates of more than 80% for women using their own eggs for IVF, and it is important to be clear that these rates are not comparable with the figures you will get from a UK clinic as they are using different criteria, are not always including all the patients treated at the clinic and may be giving rates for positive pregnancy tests rather than for live births.

Almost a quarter of respondents wanted to go overseas because they would have access to anonymous donors and it would have been very interesting to find out why they felt this was an advantage – did they feel it was linked to a larger pool of available donors or was it the anonymity itself which was attractive, and if so why. So, a survey which provides some interesting information – and also raises many questions! You can read more details about it here 

Low ovarian reserve

If you’re trying to conceive, you will be aware of your ovarian reserve but when you are starting out on your fertility journey, this isn’t something you will have come across before. Our potential to produce eggs declines as we get older, but the rate at which this happens is different for everyone – so some women may be diagnosed with a low ovarian reserve in their thirties or even twenties, which often comes as a real surprise as there may be no other signs of any decline in fertility at all.

If you want to know about your ovarian reserve, I was interviewed about the emotional impact by Allie Anderson for an article for NetDoctor the other day which you can read online here.  It is important that we talk about this issue more often and more openly. Fertility specialists may suggest using donor eggs if they feel the ovarian reserve is so low that IVF is unlikely to be successful, but for women this may seem a huge and unexpected step and is certainly one which needs thought and counselling.

Anyone who is using donor eggs or sperm will find it useful to contact the Donor Conception Network who can provide information, help and support.

How old is too old to be a parent?

Do you think there should be a cut-off age after which people shouldn’t have children? Or is it fine at any age at which it is remotely feasible? And is it right that we ponder this subject so much when it comes to women having children later in life, and yet barely raise an eyebrow when Mick Jagger has a baby at the ripe old age of 73?

The subject has been back in the news again after Dame Julia Peyton-Jones, former director of the Serpentine Galleries, became a mother at 64. It isn’t clear how she had her daughter, although we can be sure she didn’t use her eggs and that she may well have paid for a surrogate to carry the baby too.  I know we all feel and act younger than our grandparents may have done at the same age, but she will be 80 by the time her daughter is 16 – and I can’t help wondering what it would be like for a 16 year old to have an 80 year old mother? Or what it would be like to be responsible for a teenager when you were 80?

Of course, the other problem with news stories like this is that they muddy the waters when it comes to NHS funding for fertility treatment, as many people seem to assume that it is the NHS which is footing the bill for older women to try to have babies. In fact, in most areas there is limited funding for women up to the age of 39, and often nothing at all beyond that. At most women of 40-42 will get one cycle, but if you are older, there is no likelihood of funded treatment.

Getting pregnant at 49 – how it really happens…

120px-Pregnancy_test_resultWe’ve all seen the stories about babies born to celebrities in their late forties – or even fifties – with no mention of how they got pregnant. It can make it seem as if having a baby at an age when most women are on the verge of the menopause is effortless when in fact the celebrities concerned will almost certainly have used donor eggs in order to conceive.

Now Sonia Kruger has spoken out about this – and I admit, I hadn’t heard of her, but apparently she is an Australian television presenter who hosts Big Brother and is described by the Mail as a ” fashionable 49-year-old” (because of course not many 49 year olds are “fashionable”….). Responding to a magazine headline which referred to her “miracle pregnancy”, she has gone public about her history of fertility problems, miscarriage and the fact that she was told by doctors that for any woman over the age of 45 the chance of IVF success using their own eggs was zero. She says her pregnancy is  “science, not a miracle” and has been open about the fact that she needed donor eggs in order to get pregnant.

You can read more here and here

 

Would you like to work for the National Gamete Donation Trust?

3049_ngdt_logo_rgb_2016_05_24_11_07_41_am-190x78.jpgThe National Gamete Donation Trust is looking for a new National Coordinator who will be responsible for the day to day management of the charity. It sounds a fascinating job for anyone interested in the fertility field, and you would be the first port of call for many different people and organisations and discussions are often of a sensitive and confidential nature.

It is a part-time role (30 hours a week) working from home, and involves flexible working and attending some meetings with trustees and stakeholders. The meetings are mostly in central London, Birmingham and the South East, so you should ideally be located within easy reach of these. You can find more details about the job and how to apply here 

Should patients be able to travel abroad for treatment?

104px-GEO_GlobeThere’s a really interesting article here asking whether patients should be allowed to travel overseas for fertility treatment to a country which has different rules and regulations from those at home. We just assume that patients have the right to go wherever they want and do whatever they want, but this article is based on a  report in European Journal of Obstetrics and Gynaecology and Reproductive Biology which considers the idea that there are moral issues for doctors in supporting patients who want to travel abroad to avoid the laws in their own countries.

Apparently in 2012 the French Health Ministry sent out a warning to doctors that informing patients about egg donation overseas would carry a risk of five years in prison and a fine of 75,000 Euros because of concerns about human eggs being bought and sold – and in Germany and Turkey they have also had penalties for doctors referring patients overseas for certain treatments.

You can find the report itself, from the European Journal of Obstetrics and Gynaecology and Reproductive Biology here, which argues that governments should be tolerant to patients who wish to travel for treatment and suggests that their doctors who refer them are trying to act in their best interests. However, the article from Fox News quotes a Japanese health researcher from  Kanazawa University in Japan called Yuri Hibino who says that in Japan some hospitals are so worried by the risks of egg donation abroad, which can include multiple pregnancies and older mothers, that they won’t deliver babies conceived by egg donation.

 

What do you think? Should there be restrictions on treatment overseas? Or would that be a step too far and an interference with personal liberties? And what about doctors who refer patients overseas? It’s certainly an interesting issue…

New advice to women of 44 and over doing IVF

eggFor women who are going into IVF in their mid-forties, the chances of success are not good and now new research from  Dr Marta Devesa from Barcelona has led her to suggest that women who are 44 and over should be advised against trying IVF with their own eggs.

What does the research conclude when it comes to IVF  for older women ?

Her study, which has taken 12 years to complete, looks at birth rates following IVF at her clinic and shows that the cumulative rate for women aged 44 and over using their own eggs is just 1.3%. The success rates for women using donor eggs do not decline with age in the same way – leading to the conclusion that it is the age and quality of the egg which is the key factor rather than the age of the woman herself.

Dr Devesa explained that the most likely biological reason for a decline in live birth with female age was chromosomal abnormalities in the embryo.

You can read more about her research and her findings here 

When IVF isn’t the right thing…

What a terribly sad story of the woman of 65 in Germany who has given birth to quadruplets after fertility treatment. The babies were born very prematurely and will need a lot of medical support just in order to survive. When I saw the headlines, I’d assumed that she hadn’t ever had children – but in fact she already has 13 children aged from 10 to 44…

Ethical issues 

It raises the inevitable questions about sensible age limits for fertility treatment. Most clinics in the UK will not treat anyone who is above the age of menopause or over 50, but that’s not the case in all countries. Is it ever right to offer fertility treatment to someone who will be 80 by the time their children reach 15?

Of course, in this case, it’s not just the mother’s age which is an issue, but also the question of the multiple pregnancy. Why would a medical professional allow a woman to become pregnant with quadruplets leading to huge risks for both the babies and herself?

In Germany, where she lives, IVF with donated eggs is not permitted at all, and she had apparently travelled to Ukraine in order to have the treatment…

You can read more about this here

Researcher wants to interview successful egg donor recipients

egg Another research request – this time the researcher is looking to talk to people who have conceived using donor eggs and is part of a doctorate in Counselling Psychology. It will involve an interview of about an hour and you will be asked to discuss your experiences throughout the process of conception, including their experiences of the actual donation, the support that they received and how they could have been better supported, their views and experiences about their pregnancy, their sense of self as a woman, mother and partner, their view on their mother/child attachment, and views about their egg donors.

If you think you might be interested and want to know more, you can contact Simone by email at Simone.Roggenkamp.1@city.ac.uk

Travelling for treatment

There was an interesting piece in the Telegraph at the weekend about people travelling overseas for fertility treatment, but sadly it fell short on when it came to the suggestion that the number of egg donors in the UK has gone into decline since  the change to the law on anonymity.  In fact the number of new registered egg donors has risen steadily in recent years, but you’d never know this from reading most articles on the subject which accept the urban myth of the rapid decline in donors following the law change.

The article implies that new technologies used in Spain, such as time-lapse imaging, may not be available in the UK which is not the case. It also quotes a pregnancy rate of 90% after four embryo transfers for one Spanish clinic. Figures given here in the UK are not usually pregnancy rates but live birth rates, as we know that more than 50% of pregnancies will miscarry once a woman is in her forties and so the live birth rate is considered more meaningful. The 90% pregnancy rate can be compared with data released at the Fertility Fairness event last week from one UK clinic showing an 80% live birth rate rather than pregnancy rate after just three cycles of fully funded NHS treatment.

What I found most odd about the article was the claim that the desire for an anonymous donor is the key reason for couples to travel for treatment. In fact, when we did a survey at Infertility Network UK on why people choose to go abroad for treatment we discovered that this was not something that the vast majority wanted – some said that they’d accepted it because at the time it was the only way to get an egg donor. It was cost which was usually the main driving factor, along with donor availability.

Now, there are many clinics in the UK which don’t have long waiting lists for donors – and it is always worth looking at all your options before making a decision.