Avalanche by Julia Leigh

I’ve just finished reading Avalanche, novelist Julia Leigh’s book about her experiences of IVF and am filled with a sense of sadness and of anger. Julia was 38 when she first went to a fertility clinic, and the book charts her journey through cycle after cycle of unsuccessful treatment in courageous and painful detail. The reader follows the highs and crashing lows of fertility problems and treatment;  the injections, the drugs, the repeated unsuccessful cycles, the low positive pregnancy test, the marriage breakdown…

My overwhelming reaction was anger that she had endured so much because no one had told her the truth about the likelihood of IVF working.  Why was she freezing her eggs at the age of 42? Why did her consultant keep telling her that there was a 40% chance of a positive outcome with IVF using her own eggs when she was in her forties? Yes, she may have had a blastocyst, but that doesn’t alter the fact that here in the UK, the chances of success for a woman of her age using her own eggs stand at around 5% – which means a 95% chance that the treatment wouldn’t work. Why did the consultant suggest she should give it one more go with her own eggs after six unsuccessful cycles when she was approaching her 45th birthday? Why didn’t anyone ever mention the risk of miscarriage for women in their mid forties? Her story story raises many questions about women’s choices and about clinician’s responsibilities.

Leigh is based in Australia, where data for individual clinics is collected, but never made public and when she begins researching clinics, she finds it impossible to compare the outcomes at different clinics. It is only at the very end of the book that she dares to asks her doctor bluntly how many women of 44 have conceived using their own eggs at the clinic where she’s having treatment in the last year, and is told that the figure is 2.8%. Some distance away from the 40% chance that had been suggested when she was having the treatment.

What makes me particularly sad about Avalanche is the lack of truth about IVF and who it can – and can’t – help. IVF is a good treatment for fertility problems, and cumulative success rates mean that a majority will conceive after treatment – but the chances of a positive outcome plummet with age. IVF is not a treatment that can reverse the biological clock and it is not a solution for reproductive ageing. If we were more honest and open about this, we could save so much heartache and pain…

Avalanche by Julia Leigh is published by Faber & Faber

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