Enjoying parenting

Your attachment to and love for your baby keep growing as your baby grows and increasingly your baby really feels like she's your baby. And as she develops you get more and more in return for your efforts she smiles, laughs, looks for you and becomes ever-more responsive. Don't feel guilty if you don't find motherhood fatherhood totally gratifying and pleasurable all the time. Caring for a baby can be extremely demanding, particularly if your baby is unsettled and cries a lot. As your baby gets...

Feeling Better Three Months On

For the first three months after your baby's born, you and baby spend time getting to know each other and you may not be totally confident in your role as a parent. But a few months down the track when you know your baby better, have a handle on what makes her happy and settled and colic is a thing of the past, you start to feel more confident about what you're doing and find you're back in something resembling control again. A daily routine emerges that makes life more predictable and allows...

Getting fewer eggs than expected

Ideally, you have eight to twelve eggs and you and your partner are mightily relieved, because the more eggs that are collected, the greater your chance of having a baby. But what happens when you have only a couple of eggs or worse, none at all Obviously, if you expect to get ten eggs and get only two, you may be disappointed. But this doesn't mean the end of the cycle you can still progress to the next stage. Finding no eggs is a devastating outcome that very rarely happens, but when it does...

Asking someone you know to be a donor

If you need an egg donor, your best bet is to BYO (bring your own). You may have a sister, cousin or friend who you feel comfortable approaching. If you're very lucky, someone close to you who knows you need donor eggs may offer to be a donor for you. If you ask someone you know to be an egg donor for you, don't feel bad if she says no. Being an egg donor isn't for everyone and some women just can't bring themselves to do it even if they'd love to be able to help you. The physical process of...

Stimulation response

The more eggs you get, the greater your chances of having a baby with IVF. Although age is the most important factor affecting the number of follicles that develop and the number of eggs you get, the fact is some women respond well to hormone stimulation and others don't, and these differences aren't just age-related. For example, some women in their late thirties get 20 eggs while some women in their late twenties struggle to get a few eggs. MER If you get only a few eggs in a stimulated...

Jumping For Joy Baby On the

Reaching the end of one journey and the beginning of another Moving from team to team Undergoing antenatal care and screening Waiting to finally meet your baby Getting ready for the birth Signing up helpers for when baby arrives A fter all the trials and tribulations of infertility and IVF treatment you've W finally reached your goal You're pregnant The end of your infertility journey marks the beginning of a new and exciting phase in your life. The transition to parenthood begins with...

Getting on your bike

Being physically fit benefits your general health as it helps you to fend off nasties like heart disease, high blood pressure, diabetes and osteoporosis. Regular exercise and a healthy diet are the cornerstones for maintaining good health and optimising physical and emotional wellbeing. Making time for physical activity is important, but when you're trying to get pregnant you mustn't overdo things Marathons and other extreme sports are out for now, as they can adversely affect ovulation.

Talking about your feelings often helps her hinders him

Studies show that among couples who go through IVF treatment, both women and men get the majority of their emotional support from their partner. Mostly this works well, because there's give and take on both sides of the relationship and when one partner feels down the other steps up to the plate, and vice versa. But what happens when both partners feel down and have trouble coping with the demands of IVF As a general rule and it's certainly not true for everyone women feel better having a good...

Dealing With Dashed Hopes

Part of the process of coming to terms with the fact that IVF hasn't worked for you is dealing with your disappointment and the disappointment of those close to you. IVF isn't just about hoping to have a baby it's about hoping to experience parenthood and sharing this unique experience with your partner, hoping to extend the family tree and give your parents grandchildren, hoping to enjoy raising children together with your friends (who all already have children, of course) and looking forward...

Finding Out That It May Take Three or Four to Tango

You may need donated gametes or embryos to conceive for any number of medical reasons. You'll probably try to have a baby with your own gametes first and then if that path is unsuccessful consider the option of using a donor. But you may know from the outset that the only way you can have a baby is by using donor gametes. If you're a single or lesbian woman, you may want to use donor sperm for social reasons. In Chapter 4, I outline which Australian states allow the use of donor sperm for...

Advertising for a donor

Many couples advertise to find an egg donor. This method relies on women reading the ad and deciding to respond, not because they expect payment or some other compensation, but because they want to help someone in need. If you're lucky enough to get a response and both of you and the donor feel right about going ahead after you've met, this way of finding an egg donor can work really well. Some states have legislation in place regulating advertising for donors, so talk to your clinic counsellor...

Maturing the eggs

You may undergo additional ultrasound examinations or blood tests over the next few days to determine when the eggs are ready to be fertilised. When the largest follicles reach a diameter of 18 mm or more, the lining in your uterus is thickening well and your oestradiol levels are still rising, the time to collect your eggs is getting close. Before eggs and sperm can finally meet, the eggs have to be matured and for this you have an injection of human chorionic gonadotrophin (hCG), which acts...

Reaping the Rewards of Parenthood

If you're overwhelmed by the demands of caring for your newborn and wonder when life is going to feel 'normal' again, don't despair. After the first crazy few months of new parenthood the dust usually settles and things start to look up. You may get the odd night of decent sleep, your baby has some sort of a routine, you know what your baby wants when she 'calls', you feel confident about caring for her, and you get plenty of rewards for your efforts when your baby giggles and shows her...

Sleeping through the night sometimes

Babies vary a lot regarding when they start to sleep through the night and even when they do start, they can easily go back to night-time waking during their first two years. In a large Australian study of more than 3,000 children's sleep patterns, researchers found that I At age three months about 70 per cent sleep through the night occasionally. I Among babies who start to sleep through the night, many relapse into waking at night during their first year. I Frequent night-time waking is...

Checking on progress

The morning after egg collection the embryologist checks the eggs carefully under a microscope for signs of fertilisation. The embryologist hopes to see two pronuclei (PN) inside each egg one containing the genetic material from the egg and the other containing material from the sperm because this indicates that the egg has been fertilised normally. About 5 per cent of fertilised eggs are abnormal, in most cases because more than one sperm has been 'let in' so that there are three or more...

Taking the rough with the smooth

You may find some downsides of being an IVF parent. One is that your friends may be a few steps ahead of you You're still at home with a new baby while they're sending their kids off to school. Because a lot of parents' daily activities are tied in with the life stages of their children, you may no longer see so much of your 'old' friends when you become a new parent. Another slight drawback, related to being an 'older' parent, is that your own and your partner's parents may be less able to...

Taking folic acid

Folic acid is essential for healthy cell growth and reproduction. Evidence abounds that getting enough folic acid before conception and during the early stages of pregnancy greatly reduces the risk of the baby having neural tube defects such as spina bifida. So where can you find folic acid Foods like leafy green vegetables, fruits, dried beans, peas, wholegrain cereals and nuts are rich in folic acid, but the best option when you're planning to fall pregnant is a daily supplement, which you...

A positive pregnancy test

If your test is positive, you, your partner and the nurse who gives you the result will be jumping for joy you've cleared the final hurdle of the IVF obstacle course Some women already have an inkling that they're pregnant, but others find it hard to believe because they don't feel different in any way. And you may find that just as you breathe a sigh of relief that the worry of your treatment outcome is finally behind you, a new worry creeps in Will the baby be okay Such worries are quite...

Having a birthing experience that isnt quite what you expected

Several years ago some colleagues and I undertook a study of women's experiences post-IVF (see Chapter 18). About one-third of the IVF mums in our study weren't so thrilled with their childbirth experience but were very happy with the baby, of course These were predominantly the women who had a caesarean delivery, as shown in Table 19-1. Some possible explanations why these women felt less satisfied include 1 When you have trouble conceiving and need IVF to have a baby, you may want to at least...

Long protocol

The long protocol is also called the down-regulation protocol and as you probably guess this protocol takes a while to get through. The reason for this is that you actually start this protocol in the second half of the cycle before your planned treatment cycle. You begin the protocol by taking a GnRH agonist every day, as either an injection or a nasal spray. This drug shuts down your body's own production of follicle-stimulating and luteinising hormones (hence the term down-regulation). Such...

Wondering whether your baby will be okay

From time to time every woman thinks about the wellbeing of her unborn baby and hopes that her baby will be born healthy. After IVF treatment, you may be even more preoccupied thinking about whether your baby is developing normally and will be okay. For some women who conceive with IVF, worry about the welfare of their baby stops them from fully enjoying the fact that they're pregnant especially in the first few weeks of their pregnancy. However, these feelings don't usually last and in the...

Completing your first treatment cycle

Every time you try to conceive with IVF there's a chance the treatment will work. If you're lucky, it may work the very first time for you. In one study of 200 women who were pregnant as a result of IVF, 26 per cent were fortunate enough to conceive on their first go. If it's bingo for you first time, you'll think IVF is pretty easy and that all the talk about how hard it can be to conceive with IVF is nonsense You have a 100 per cent personal success rate. If you're unsuccessful on your first...

Having more than one baby

The number of couples who have a multiple birth after IVF treatment has been steadily decreasing over the last few years, mainly because more and more women are having only one embryo transferred. But twins are still more common among IVF parents In 2007, about 10 per cent of IVF parents had twins compared with a rate of 1.7 per cent for parents in general. Even if the pregnancy goes well, carrying twins is hard work and takes its toll on your physical and emotional health. As a result, if...

Introduction

T My hen you're ready to start a family you're full of anticipation about taking on the joys and responsibilities of parenthood. However, if month after month goes by without you falling pregnant, you may get a sinking feeling that something is wrong. Most people take fertility for granted and that's why infertility usually comes as a shock to couples who face it. Having no doubt spent many years trying to avoid falling pregnant, it's quite ironic to discover that when you really want a baby...

Dodging the blame game

When things go wrong you may look for someone to blame. The blaming that sometimes happens when IVF fails includes The fertile partner in a couple blames the partner with the fertility problem A woman who had an abortion as a teenager that resulted in an infection and blocked fallopian tubes blames herself A couple blame each other for waiting too long before trying for a family The doctor is blamed for not giving the right stimulation protocol or for not getting enough eggs The embryologist is...

Deciding What to Do With Your Surplus Embryos

Tens of thousands of embryos are stored in freezers in IVF labs around Australia. Initially you freeze your embryos to improve your chances of having a baby. After several years, however, you may have all the babies you want and don't need the rest of your frozen embryos. Occasionally there are sadder reasons why couples don't use their frozen embryos for example, separation or chronic illness may prevent you from having your embryos transferred. Irrespective of why you don't use all your...

Planning the birth Have your say

About 50 per cent of women who conceive as a result of IVF have a caesarean birth, which is about twice the rate for women in general. Some of the reasons for this high rate are 1 About 70 per cent of twin pregnancies are delivered by caesarean section and since IVF mums are more likely to have twins than other mums, this adds to the high proportion of babies delivered by caesarean section after IVF. 1 More caesarean sections are performed in private than public hospitals, and most IVF mums...

IVF Beyond

42 McDougall Street Milton, Qld 4064 Copyright 2010 Wiley Publishing Australia Pty Ltd The moral rights of the author have been asserted. National Library of Australia Cataloguing-in-Publication data Title IVF & Beyond For Dummies Karin Hammarberg. Subjects Fertilisation in vitro, Human. All rights reserved. No part of this book, including interior design, cover design and icons, may be reproduced or transmitted in any form, by any means (electronic, photocopying, recording or otherwise)...

Realising you may be sad but youre not mad

Many studies use measures of mood and anxiety to gauge how infertile couples feel throughout their IVF journey. The research clearly shows that keeping your spirits up through the turmoil of IVF is very hard, and couples commonly feel sad and worried while they're on the IVF program. When you feel really sad about something, it's very hard to enjoy anything in life. If you have trouble getting pleasure out of things you normally enjoy, you need to spend time dealing with your feelings and...

Beating the Clock Age Counts So Get Started

Most people know that a woman's chance of having a baby decreases with age, but few are sure at what age this starts to happen. Many also believe that men's reproductive capacity is unaffected by age just look at Charlie Chaplin fathering children into his seventies The reality is that fertility declines with age for both women and men For women, the sad fact is that fertility starts to decline from about age 25. In addition, as you get older, the risk of having a child with birth defects...

Deciding to stop treatment

Most couples find that being on the IVF program has some negative effects on their sex life, job, career and financial situation. In spite of this many couples keep trying, sometimes over a period of years. Others find the process of IVF too demanding and decide to not pursue treatment if they experience treatment failure. The most common reason why couples stop treatment is that they're pregnant a very good reason to stop But for those who aren't so fortunate, the emotional demands of IVF are...

Going natural

Some women prefer to use the one egg that they ovulate naturally every month rather than having hormone stimulation to produce multiple eggs. Their reason may be that they've suffered bad side effects from the drugs before or have tried various stimulations without success. If you opt to go natural, you'll have ultrasound and blood tests to try to pinpoint the optimum time for egg collection. Performing natural cycle IVF is very tricky because there's no margin for error If the one and only egg...

Finding Virtual Support

You'll find an array of websites dedicated to infertility and IVF treatment, and many have facilities for people to chat and share their experiences. From the comfort of your home you can connect with people who really understand what you're going through because they've had similar experiences to yours even though you don't know them or live on the same continent. If you like the idea of talking about your feelings and sharing your experiences of infertility and IVF while remaining anonymous,...

Feeling on top of the World

IVF is a numbers game and as you play the game you always look at the crucial numbers. These are The number of follicles that develop The number of eggs recovered The number of eggs that fertilise normally and divide The number of embryos available for transfer and freezing And all along it's a case of 'the more, the merrier'. When you get your progress reports, you hope for something like this Your scan shows that you have 12 to 15 large follicles Your hormone levels are 'just right' You get...

Stimulating egg production

Ovulation induction may be an option for you if the only problem you have is that you don't ovulate regularly. Sometimes, a course of clomiphene citrate (CC), a synthetic anti-oestrogen, is all that you need to fall pregnant. You take CC in tablet form for five days, starting during your period. The drug 'tricks' the pituitary into thinking that your levels of oestrogen are low. In response, the pituitary starts to produce more follicle-stimulating hormone (FSH), which and there are no points...

Feeling ready to take your baby home

After your short stay in hospital it's time to gather your belongings, take your baby home and embark on a new phase in your life. You may suddenly wonder whether you're ready for this challenge, but there's no going back. Many new parents feel quite anxious about taking their baby home from hospital. It's perfectly normal to feel worried about looking after a newborn when you've never done it before. But you can rest assured that no one will do a better job of caring for your baby than you and...

Recognising your families disappointment

Many of the people close to you will be disappointed that IVF hasn't worked for you. They've been keeping their fingers crossed hoping that your extraordinary effort would pay off and feel sad for you that it didn't. But they may also feel a bit sorry for themselves for example, your mother may be disappointed that she won't become a grandparent or your sister may be sad that she won't be an aunt. If you already have children who were looking forward to having a sibling, they may feel that...

Putting Your Embryos on

If you agree to embryo freezing and have embryos that are judged good enough for freezing, the freezing process embryo cryopreservation usually happens on the same day as embryo transfer, although some clinics leave the extra embryos to grow for a bit longer before they freeze them. The freezing and thawing processes are pretty harsh and only the toughest embryos are candidates for freezing. The embryologist will rate your embryos' chances of getting through such a cold spell. So, even if you...

Identifying the Most Viable Embryos

The majority of embryos created in IVF labs and indeed many of the embryos that come into being as a result of good old-fashioned sex don't survive to develop into babies. Embryologists grade embryos based on their appearance (see Chapter 7) and good-looking embryos have a greater chance of developing into babies than not so good-looking embryos. But there's more to it than looks alone because even the best looking embryos don't always result in pregnancies and sometimes embryos that don't look...

Thinking About Your Baby

As they approach the birth, most pregnant women become more and more emotionally attached to their unborn baby and spend increasing amounts of time thinking about their baby. While pregnant women in general form an emotional attachment to their baby that increases substantially when they can feel the baby moving inside them, IVF mothers form a very strong and protective bond with their baby from the very beginning of their pregnancy and spend a lot of time thinking about their baby right from...

Telling others

So, when is the right time to tell the world (or those close to you, at least) that you're pregnant It depends on what feels right for you. Some couples tell everyone as soon as they get the result of the pregnancy test, while others prefer to wait until their pregnancy is well under way. If you don't have any bleeding and see a foetus with a heartbeat in your uterus at your six-week scan, you can feel pretty confident that things are going according to plan, and so this may be a good time to...

Folliclestimulating hormone

Follicle-stimulating hormone (FSH) promotes follicle growth. Follicles are the fluid-filled cysts in the ovaries where the eggs develop and mature. You take the drug in the form of a daily injection for as few as six days to possibly up to two weeks (and rarely more) if the dose has to be increased. The dose required to grow between 10 and 15 follicles varies between women Your doctor calculates your dose and then may increase or decrease this amount depending on how your body responds. The...

Discovering that things dont always go to plan

In IVF, bad news can come out of the blue Sometimes a progress report is much worse than you expect and your dream of a baby seems to float out of reach. The kind of news you hope never to get includes 1 Your scan shows only one or two large follicles 1 Your hormone levels aren't 'right' i You have nine large follicles but only two eggs are recovered 1 You have 11 eggs but only two fertilise normally and only one divides 1 You have six embryos but they're all poor quality i You have seven...

Clomiphene citrate

If you don't respond well to other stimulation protocols, a course of clomiphene citrate (to which your doctor may add FSH injections) can stimulate growth of a few follicles. You usually take CC for five consecutive days, starting early in the cycle. When the largest follicle reaches about 16 mm in diameter, your blood is tested daily to check the level of luteinising hormone and ensure that you aren't about to ovulate before the eggs are retrieved. All being well, the level indicates that you...

Having So Much to Worry About

As a new parent, you may find yourself worrying about your baby's wellbeing How do you know that she's had enough milk Is she too cold or too warm Is she getting a cold Much of this worry stems from being new in the job and not having any experience to fall back on. After a few months when you know your baby better, you start to feel more confident in your parenting role. As part of the study my colleagues and I carried out about mothering post-IVF (see Chapter 18), we were interested to know...

Interpreting the NPSU report

When you're trying to get your head around the NPSU's IVF statistics, it's important to remember that the data reflect the average of what happens to all couples undergoing IVF treatment. The data include the young and the old, couples on their first treatment cycle and those on their tenth cycle, couples who have lots of eggs and those who have only a few and so on. The report thus provides a global view of the workings of IVF. Note All statistics in the following sections relate to the year...

Busting Some Motherhood Myths

The birth of a baby is usually a joyful event and after you give birth to a healthy baby (especially post-IVF) you're expected to be extremely happy. But being happy about having a healthy baby doesn't make caring for him any easier. The ideas that women just know how to look after a baby, that motherhood is the most rewarding job a woman can ever do and that being a stay-at-home mum is easy are myths about mothering or fathering, if dad's the primary carer that I hereby declare busted. i...

Curing Chronic Diseases

Many years of IVF-related research led to the discovery of embryonic stem cells about a decade ago. Embryonic stem cells, which are produced by embryos, have the potential to develop into any type of cell in the body for example liver, brain or skin and scientists all over the world are working very hard to find ways of using these cells to repair and regenerate tissue that's affected by chronic disease. Many believe that in time diseases like diabetes, Parkinson's and Alzheimer's will be cured...

Taking it tike a man

Men can easily become a bit marginalised during IVF treatment because all attention is on the woman until the crucial moment when the sperm sample is to be delivered and then it's expected pronto But, of course, whatever ups and downs a woman goes through during the IVF cycle affect her partner too. Naturally, men worry about whether the treatment is going to work, but sometimes they don't show their feelings because they think they need to be strong for their partner. It's hard for you as a...

Understanding What the Law Says About Donor Conception

People contemplating donor procedures have to provide a lot of information about themselves so that in the future any child born as a result of a donation can find out about his or her origins. Federal law is silent on the issue of donor conception, and the amount and type of information required in relation to donor conception varies between the states and territories. Rules sometimes change, so if you're considering using donor gametes or embryos, you need to find out what the current...

Graduating from sleep school

In some areas you can access hands-on practical advice about baby feeding, settling and sleeping by being referred to one of the existing private or public day-stay or residential mother-baby programs. These programs help you work on solutions to your baby-care problems. l Day-stay programs You and your baby spend the day with other mums and a team of health-care professionals who offer education about baby care, individualised practical help, and advice and strategies on how to deal with the...

Needing a sperm donor

You may need or prefer to use donor sperm for the following reasons Azoospermia Very few sperm are needed for the embryologist to be able to create embryos with the intracytoplasmic sperm injection (ICSI) procedure (see Chapter 7), but if you have azoospermia and so have no sperm at all, you need donor sperm. Genetic condition If you know that you are a carrier of a severe genetic condition and don't want to risk passing this condition onto your child or children, you may prefer to use donor...

Seeing Further Down the Track

Several studies have followed couples who had IVF for a period of time after their treatment. The good news is that within a few years of ending treatment, there are very few differences in terms of emotional wellbeing between those who had a baby as a result of treatment and those who didn't. Here are a few more results from these studies i Infertility doesn't go away, even if you have a baby Interestingly, despite having a baby with IVF, many couples still think of themselves as infertile It...

Feeling out of your depth

As a competent adult who managed a demanding job, travelled the world and successfully negotiated plenty of life challenges, you may be totally surprised that a tiny baby can make you feel so out of your depth. Many new parents feel this way, but the feeling can hit even harder when you've had IVF. After you've experienced a lot of trouble having a baby, your confidence in yourself can take a dive, and this dip can cause you to doubt your ability to keep your precious baby alive. Maternal and...

Getting off the merrygoround

Deciding to stop IVF treatment can be difficult, because it may mean giving up on your dreams of becoming parents or having another child. That's why some couples just keep going with IVF, even if the chance of the treatment working is virtually zero. If this happens to you, you need someone to stop the merry-go-round so that you can both get off. Interestingly, in one study about IVF experience a whopping 79 per cent of women thought that couples should be counselled about the option to stop...

Undergoing the egg collection procedure

After weeks of injections, the big day for you and your partner finally arrives. You're bound to feel nervous. In fact, probably all sorts of emotions are churning around inside you. You receive a light general anaesthetic for your egg collection procedure, and the trusted ultrasound machine is used for collection. The ultrasound probe is covered with a sterile plastic cover and fitted with a needle guide, along which a long metal needle slides. The surgery proceeds as follows (see also Figure...

Getting Eggs Without Stimulating the Ovaries

Hormone stimulation is one of the cornerstones of modern IVF, but for women with polycystic ovaries or polycystic ovarian syndrome who have many tiny follicles in their ovaries, the stimulation protocol can be difficult to manage and they risk over-responding to the drugs and developing ovarian hyperstimulation syndrome (OHSS) (see Chapter 10). Embryologists are currently perfecting a technique known as in-vitro maturation (IVM) to allow such women to have IVF without hormone stimulation. Using...

Flare protocol

During the first couple of days of taking GnRH agonists they cause a flare of follicle-stimulating and luteinising hormones to be released from the brain, but afterwards these hormones are inhibited by the GnRH. The flare protocol takes advantage of this temporary increase in FSH, which helps many little follicles to start their growth from the very start of the cycle. After the follicles have started to grow the FSH injections keep them growing when the largest follicles reach at least 18 mm...

Using a Donor

Adding a donor to your family tree Transferring the donor material Considering the legal side of donor conception Making sure donor conception is right for you Locating the right donor Working out how to tell your child o-called third-party reproduction is an option you may want to consider if you can't use your own sperm or eggs (or both). The most recent data available from the Australian Institute of Health and Welfare show that about 650 babies are born annually in Australia and New...

Putting up with nosy family and friends

Some people are good at putting their foot in it and frequently they're the ones closest to you. Your mother or mother-in-law may be impatient for grandchildren, putting her foot in it when she asks 'And when are you two going to stop thinking about yourselves and start having a family ' The best man at your wedding may put his foot in it when he says 'About time you got her pregnant, mate' (nudge-nudge, wink-wink). And your best friend may put her foot in it when she says 'Now that I'm...

Beyond IVF

'With a bit of scientific help, the miracle of life just got even more miraculous.' Congratulations IVF treatment worked for you and you're pregnant Beyond IVF is a whole new world, one you've wanted to be part of for a long time. But you may find that the blissful state of pregnancy isn't so blissful after all and that caring for a baby can in fact be a bit of a nightmare. In this part, I talk about pregnancy, birth and parenting after IVF, and how you can prepare yourself for this new phase...

During pregnancy and childbirth

Generally speaking, pregnancy and childbirth are very safe events in countries like Australia with a good healthcare system and most babies are born healthy. But, irrespective of how you conceive, you may have unexpected complications during pregnancy or at the time of birth. Some of these complications are more common with IVF than with spontaneous conception. This is because 1 When more than one embryo is transferred, there's always a chance that you'll have twins (and occasionally triplets)...

Knowing When to Stop Treatment

If you have multiple treatment cycles without success, how do you get off the treadmill Some couples feel that they can't stop treatment because that spells the end of their baby dreams. And sometimes one partner wants to keep going with treatment while the other wants to move on. There's no right or wrong time to stop treatment, but you and your partner need to think carefully at what point you'll bring your efforts to have a baby to a close and move on with your lives. Talking to your IVF...

Getting Prodded and Probed

Antenatal care is all about monitoring the health of mother and baby so that any problems with the pregnancy are detected early and managed effectively. Women who conceive with the help of IVF often have more antenatal visits than women who conceive spontaneously. Partly this is because IVF mums are older and therefore are more likely to have pregnancy complications (see Chapter 10), to carry twins and to be first-time mums. But I think a few extra visits are often scheduled in for 'peace of...

Donor eggs

If you use donor eggs, the egg donor completes the first two parts of the IVF cycle and you complete the third, meaning that the donor undergoes hormone stimulation and egg collection (refer to Chapter 5 for more on these procedures). When the eggs have been recovered, your partner's sperm is added to the eggs and two to five days later, when the embryos are formed, you undergo embryo transfer. In preparation for embryo transfer you need to take a course of oestrogen tablets and progesterone,...

Coping when lifes not as fun as it used to be

Enjoying life as much as you normally do can be hard when you're undergoing IVF treatment, especially when the treatment isn't working. The physical and emotional demands of treatment tend to be a bit of a dampener on your spirits. You may feel that your life has lost its gloss and become bleak and gloomy. As far as possible, try to keep doing the activities you really enjoy while you're on the IVF program such as playing a sport, reading, seeing friends or going to the movies. These activities...

Managing your disappointment

When IVF comes to nothing, you may have overwhelming feelings of disappointment. This is to be expected after all, you've invested a lot of time, money, and physical and emotional capital without any return. It can take time to get over the disappointment and come to terms with not having a child or having fewer children than you want. Over time, some of these negative feelings fade. In one study of women's IVF experience several years after treatment, only 12 per cent of the women who didn't...

Feeding Breast is best but

No doubt about it Breast milk is the best form of nutrition for babies. But sometimes breastfeeding proves extraordinarily difficult or mothers don't feel able to do it for example, if your baby is very sick, premature or can't suck, or if you have a health problem, you may not be able to establish breastfeeding. Even if you can't supply all the milk your baby needs, anything is better than nothing. Whatever amount of breast milk you can provide will have plenty of goodness to help your baby...

Figuring Out the Intricacies of Baby Feeding

Even if you have every intention of breastfeeding your baby, you may have problems and find this 'natural' process harder than you thought. Unfortunately, the advice about breastfeeding you receive can be conflicting and sometimes bad. If you have a strong wish to breastfeed your baby, don't give up, and remember that some breast milk is better than no breast milk your baby will benefit even if he's partially breastfed and topped up with formula. I talk more about establishing breastfeeding in...

Counting your losses

Your reactions to your (hopefully temporary) loss of fertility are really responses to a whole raft of losses, including loss of A dream, because you always planned to have children Control, as you can't do what others seem to do so easily Identity, because you always imagined being a parent one day Genetic continuation in the family tree, which may be short of a limb if you can't have children Social inclusion with all your friends and family who have children If you've had the misfortune of...

Looking for signs

You've no doubt heard how pregnant women have all sorts of signs and symptoms as soon as they conceive and how they just know that they're pregnant. These signs may be anything from tender breasts, nausea, tiredness and dizziness to needing to go to the toilet ten times every night. So, after transfer, you're looking for all these and other 'sure' signs of pregnancy. But, trust me, you can have all sorts of sure signs and not be pregnant, and you can be pregnant with no signs at all. You may be...

Feeding can be tricky

Whether you breastfeed or bottle-feed your baby, feeding can be difficult and problems are common with newborns. Almost half of the IVF mums in our study reported having feeding problems such as not producing enough breast milk, producing too much milk and the baby refusing to take the breast or bottle. Both you and baby are beginners at breast bottle feeding and you need time to learn the ins and outs of the feeding routine. Don't despair if you have some teething problems at first feeding...

Realising How IVF Can Affect Your Mental Health 143

Understanding How IVF Knocks You About Realising you may be sad, but you're not Feeling good for Coping when life's not as fun as it used to Hanging In There Talking about your feelings often helps her, hinders him 147 Dodging the blame Losing a Waiting and Putting your life on Getting Deciding to stop Seeing Further Down the Chapter 12 Moving On When IVF Doesn't Work 153 Taking Reviewing your Getting off the Letting Dealing With Dashed Managing your Handling your partner's Recognising your...

Getting Ready for IVF

Perhaps you've been trying for a baby for many months and nothing has happened. If you think you've waited long enough and want to start doing something to help you conceive, I suggest that you start reading here. In this part, I talk about the steps you can take to find out why you can't conceive and the possible treatment options. I devote a whole chapter to discussing how you may feel when you discover that you're infertile and how to handle the emotional aspects of infertility. I also talk...

Finding Out Why You Dont Get Pregnant

As soon as you suspect that you have a fertility problem, you need to confirm your suspicions and find out what sort of problem you have, because this determines your treatment. Some detective work is needed here and you may have to see several doctors before you discover the cause of your infertility. A fertility problem is a challenge that you and your partner should tackle together. Whenever possible, make sure that you can both attend the required medical appointments. Don't waste precious...

Finding an infertility specialist

There are several types of specialist that you may see for an infertility problem 1 Andrologists are specialists in matters relating to the male reproductive organs. 1 Gynaecologists specialise in matters relating to the female reproductive organs. 1 Infertility specialists are gynaecologists who specialise in the treatment of infertility. If such a specialist practises in the area where you live, ask your family doctor for a referral straight to the top If you live in an urban area, you may...

Moving On to IVF The Hightech Way to Get Pregnant

Whether you've already tried other forms of infertility treatment or are told that IVF is the only way for you to have a baby, making the decision to start IVF treatment is a big one. Nonetheless, many couples at this stage also feel a sense of relief that they're finally going to be actively doing something that gives them a chance of having a family. To help make your decision, you need to find out as much as you can about IVF before you start treatment. This includes what the law says about...

Who can have IVF in Australia

There are laws and regulations governing IVF in many Australian states relating to who can access IVF treatment, what kinds of records clinics need to keep, what clinics need to do to make sure that couples can make an informed decision, how long eggs sperm embryos can be frozen, the rules for donation of eggs sperm embryos and other matters. These laws and regulations change from time to time and vary between the states. For example, in the past only legally married heterosexual couples were...

Reacting to Your Infertility Diagnosis

Even if you've long suspected that you have an infertility problem, the actual diagnosis of infertility can come as a shock. Like many people, your initial reaction to the news may be disbelief 'There must be a mistake here Maybe the test results are wrong, or they've been mixed up ' After it all sinks in you may feel angry 'Why us What have we done to deserve this This is so unfair ' You may also feel guilty, blaming your infertility on something you did in the past 'It's probably because I...

Improving Your Chances of IVF Success

The success rate for IVF treatment has greatly improved since the late 1970s when the technique was first introduced. Although your chance of having a baby with IVF depends largely on factors beyond your control such as how many eggs you produce in response to your drug protocol and whether your eggs and sperm turn into healthy embryos recent research shows that getting into shape before starting IVF treatment can influence the odds in your favour. This mostly involves things you should be...

Choosing an IVF Clinic

About 75 clinics around Australia provide IVF services. Your family doctor or the doctor looking after your infertility investigation may routinely refer his or her patients to a particular clinic, but you may prefer to choose the clinic yourself. If you live in a city you may have several IVF clinics within a ten-kilometre radius of your home or workplace. So how do you know which clinic's right for you Researching the clinics helps you make an informed decision. Start by gathering as much...

Legally Speaking Understanding How IVF Services Are Regulated

In Australia, assisted reproductive technologies such as IVF are heavily regulated by federal and state government legislation as well as professional bodies. Overall, such regulation is beneficial for couples seeking IVF treatment because you can be sure that clinics have high standards of care. All IVF programs have to abide by the following rules and regulations l Research Involving Human Embryos Act 2002 (Cwlth) and Prohibition of Human Cloning for Reproduction Act 2002 (Cwlth), both of...

Coming to Grips with All the IVF Acronyms and What They Mean

Several forms of treatment have evolved from the original IVF technique developed in the late 1970s. These treatments all go by their short names, or acronyms, with which you soon become familiar. Here's an explanation of what these acronyms mean and the treatments involved 1 IVF, in-vitro fertilisation In-vitro fertilisation literally means 'fertilisation in glass' and the term was coined because in the early days the eggs and sperm were placed in glass test tubes where fertilisation and early...

Finding out exactly what happens in an IVF cycle

At most clinics, the nurses make sure that you know what to do throughout the course of your IVF cycle. So, before you start your cycle, you have a scheduled appointment with a nurse to find out what to expect and what you need to do at each step. This meeting is likely to cover 1 The drugs used to stimulate egg production and when and how you take them i The potential side effects of these drugs i How your response to the drugs is monitored 1 Why these drugs sometimes don't work so well i What...

Type of fertility problem

Your chance of having a baby varies slightly depending on the type of infertility you have. Male factor infertility Couples with male factor infertility have the best odds of having a baby with IVF technology and in 2006 had a live birth rate of almost 22 per cent per started stimulated cycle and almost 17 per cent per frozen embryo transfer. Female factor infertility Couples with female factor infertility have slightly lower odds of having a baby with IVF technology and in 2006 had a live...

Riding the Emotional Roller Coaster of the IVF Cycle

Preparing for the roller-coaster by knowing what to expect Dealing with good news and bad news Sending out an SOS when things get on top of you A n IVF cycle is often described as an emotional roller-coaster ride during which you sometimes feel hopeful and optimistic and at other times sad and low-spirited. In this chapter, I describe the events that can make your emotions swing during an IVF cycle and give you some strategies for dealing with your feelings and staying in control while you're...

Understanding the Risks of IVF

'The twins are doing fine, but the doctor thought you may need this for the next few years.' rn n the hands of experts, IVF procedures are safe and medical complications are rare. But your emotional health can take a beating when you have IVF and sometimes, no matter how hard you try, the treatment doesn't work. In this part, I explain the potential risks involved with IVF to your physical and mental health and discuss how you can move on and get your life back on track if IVF doesn't work for...

Understanding the Risks of IVF to Your Physical Health

Weighing up the risks involved for the female partner Checking out the risks involved for the male partner Considering the health of IVF children A s with all medical procedures, IVF involves some potential risks that you should be aware of before you decide to embark on treatment. You need to consider firstly the risks that relate directly to the IVF procedure and secondly health problems that may develop down the track because you've undergone IVF. But the most burning question for couples...

Realising How IVF Can Affect Your Mental Health

Realising how IVF plays havoc with your emotions Being there for your partner Coping with pregnancy loss Avoiding letting treatment run your life Healing over time A lthough IVF doesn't pose a great risk to your physical health (see Chapter 10), the possible risks to your mental health and general wellbeing from IVF are probably greater than from most other medical procedures. As well as your immediate reactions to the ups and downs of each step in the treatment process (which I describe in...

Understanding How IVF Knocks You About Emotionally

Of course, people are different and the way you feel about being infertile and having IVF treatment depends on several factors, such as 1 How much support you have You can cope more easily with difficult patches in your life if you have a good support network and don't feel that you're alone. If you want to broaden your support network, refer to Chapter 2, where I talk more about finding various sources of support. 1 How you usually deal with difficult situations There are many different ways...

Moving On When IVF Doesnt Work

Closing the IVF door Managing your disappointment Getting back into life A lthough the chances of having a baby with IVF have increased dramatically over recent years, the sad fact is that treatment still doesn't work for everyone. IVF clinics provide plenty of information about their 'success' rates, but you need to remember on the flip side that they also have a 'no success' rate. Some couples fluke it first time around, but many couples need to try a few times before they strike it lucky...

Offering Lowcost IVF in Developing Countries

IVF and other assisted reproductive technologies are very high-tech and expensive forms of treatment that are available almost exclusively in developed countries. However, the personal tragedy of childlessness is no different for men and women in developing countries. In fact, in some cultures women who can't have children may risk public humiliation, divorce, abandonment or withdrawal of food and financial support even if their infertility is due to a sperm problem. As a result, the Low Cost...

Cutting the Ties With Your IVF Team

When you undergo IVF treatment you're in constant contact with the members of your IVF team. But after your six-week scan confirms your pregnancy, you have to say goodbye to your team and move onto the obstetric team for antenatal care. However, the obstetric team members usually don't want to see you until several weeks after your first scan and during this wait some couples describe feeling a bit abandoned, unsure who to turn to with questions they have. If you're worried about something...

Ten Tips for Surviving IVF

Keeping yourself informed Being there for your partner Enrolling supporters m VF is a very high-tech way of getting pregnant and you have to get your head around all sorts of medical jargon and complicated instructions, not to mention putting up with the inconvenience of numerous clinic visits and all that poking, probing and prodding of your body along the way. But that's the easy part The trickiest aspect of IVF for any couple is hanging on to each other and your sanity during the ups and...

Ten Tips for New IVF Parents

Waiting for baby Getting to know your baby Growing confident and getting baby care down pat m ongratulations You've cleared all the IVF hurdles and you're pregnant As you close the door on your IVF treatment and enter the world of antenatal care, you can start to count the days until you finally meet your baby. The transition to parenthood is an amazing and joyous period that starts in pregnancy. But becoming a parent for the first time can be pretty daunting and unsettling, even if you've...

Fplus

More complex forms of treatment have evolved from the 'original' IVF treatment, some of which you may need in your quest to start a family i Third-party reproduction Today, some 10 per cent of IVF treatment cycles involve using donor gametes (eggs and sperm) or embryos to have a baby. The big question that arises in such cases is whether a child born as a result of the donation should be able to find out who the donor is. I discuss the arguments for and against in Chapter 13. 1 Use of a...

Age and IVF success

A common misconception (no pun intended ) is that IVF can help you have a baby if you put off starting a family until later in life. After all, movie stars seem to have no problems having babies in their forties. Well, in many cases these women use eggs donated by younger women to conceive, although such a fact isn't usually publicised. (I cover donor conception in Chapter 13.) Age is one of the most important factors in determining your chance of having a baby with IVF. In Chapter 8 I show you...

Starting IVF again

If you know that you have to undergo IVF to conceive again, you need to bite the bullet and get on with it. Ask your family doctor for a new referral to your infertility clinic and then make an appointment to see the IVF doctor. Your IVF doctor will arrange for you to have any tests that need updating, then you can see the IVF nurse and get your instructions to start another IVF cycle (refer to Chapter 5 for a refresher on what the cycle entails). Having been there and done that already, you...

Authors Acknowledgements

Over the many years that I've been involved in the areas of infertility and IVF I've had the good fortune of working with, and being mentored by, many extraordinary people. The knowledge and experience I gained from these people has allowed me to write this book and I'm deeply indebted to them. In chronological order they are Professor Lars Hamberger, who pioneered IVF in Scandinavia Drs Matts Wikland and Lennart Enk, who established one of the first private IVF clinics in Sweden the late Ian...

Why Us Going Through the Emotions

Of Being Reacting to Your Infertility Diagnosis 26 But everyone else can have a baby 27 Talking about infertility How, and to whom 29 Treating yourself and each other 32 Having sex on demand where did the fun go 32 Chapter 3 Setting the Perfect Scene 35 Beating the Clock Age Counts, So Get 42 Part 11 All You Need to Know About 1VF 51 Chapter 4 The Law and the Legally Speaking Understanding How IVF Services Chapter 5 Taking IVF One Step at a Time 65 Coming to Grips with All the IVF Acronyms and...