Alex Jones - Fertility & Me

She's a little pumpkin, my God.

Super-cute.

We'd just got married

and then, inevitably, the questions start,

literally a week later -

"When are we going to hear the pitter-patter of tiny feet?

"Are you trying? Do you want children?"

Now that Charlie and I are married, we do want to try and have a family.

You know, it's really funny, because you spend your entire life

trying not to become pregnant

and, suddenly, everything changes.

Settling down in our late 30s

means that falling pregnant isn't something we can take for granted.

Around 3.5 million people in the UK have difficulty conceiving a child

and, as I'm 38, I'm concerned that I might, too.

My main fear is realising too far down the line

that it's actually not working.

So I'm on a mission to find out more about fertility.

It can be an issue for people of all ages, but these days,

more women over 40 are having babies than those under 20.

And that's possible

because the science of fertility is keeping pace.

This is where the magic happens.

So I'm going to investigate

what pioneering science is doing to help.

This is personalised medicine.

'I'll find out how cutting-edge techniques

'are giving everyone new hope of having children...'

Essentially, this is where life is created, in this room.

Pretty much.

'..even transplants for those born without a womb...'

I think it's going to be a routine procedure

in five to ten years.

'..and how we can all keep our eggs and sperm healthy.'

Let's get some tests done.

'I'm even going to take the plunge to find out how fertile I am.'

Oh, wow!

-20 seconds.

-Cheers.

'Today, we make a lot of choices -

'choices about our career, our partner

'and when we feel ready to have a baby.'

Shadow, the black Labrador...

'And often, that means starting a family later in life.'

At 38, I'm leaving it later than many

and I'm beginning to wonder about my biological clock.

'So, where better to start than by asking my mother and sister

'about their experiences of having a family?

'So I've popped back to Jen's house in Cardiff

'for a chat and a slice of cake.'

Most people got married very early 20s -

even at 23, people gave me funny looks, as if...

"Oh, she's not getting married until she's 23."

-Things have changed.

-I know, they have changed.

They have changed.

-23 is so young, though, isn't it?

-Yeah.

But obviously you can't do anything

until you meet the right man, can you?

No, and it just took me absolutely ages.

-Yeah, yeah.

-Fussy.

-Fussy!

SHE LAUGHS

We had you at 25 and I was considered an old mum then.

-Were you?!

-Yes, at 25.

-Wow.

But I'd always planned to have my children before I was 30.

Oh, right. What about you, then, Jen?

-So you were 31 when you fell pregnant with Dash.

-Yeah.

What about conceiving Indy, then? Was that planned? Was it a choice?

-It happened very quickly.

-That happened quite easily, then.

Easy-peasy.

Yes, but for all sorts of reasons, you haven't got time to hang around.

You've got to consider,

I was quite early having the menopause,

I started the menopause at 44.

-That's really young.

-That is young.

-Gosh - I mean, that's six years away.

-Yes, so...

Quick!

'I had no idea my mother was so young

'when she went through the menopause.

'I don't suppose it's something you talk about, normally.'

At 44, the number of eggs left in her ovaries had run so low

that any chance of a natural pregnancy had virtually gone.

If I take after her, it could mean that I have just six years

to have a family of my own.

For some reason, I just thought I was invincible, really,

and didn't think that there was a cut-off point,

but that really hit home.

And I just suppose it goes to show that, you know,

some people's biological clock ticks for a lot longer than others,

and I'm just crossing my fingers

that mine ticks for as long as we need it to tick!

Most of us know that as we get older,

the number of eggs in our ovaries decreases,

but I want to find out exactly how age affects my chances

of having a baby.

So I'm meeting Professor Tim Child,

a consultant in reproductive medicine.

Now, somebody told me, and it scared the living daylights out of me,

they said, "Alex, do you know that your fertility

-"will literally fall off a cliff after 35?"

-Yeah.

-Tell me it's not true.

-It's not true.

During someone's 20s,

About 90%, 95% of people will get pregnant after a year of trying,

during early 30s, 85% to 90%,

-late 30s, 75% to 80% chance of getting pregnant...

-Oh.

..but the risk of miscarriage does go up.

Early 40s, you may be heading down

towards a 50% chance of getting pregnant over a year.

Mum recently told me

that she started going through the menopause at 44,

which was a huge shock to me,

because that's really early, isn't it?

In the UK, the average age is about 51.

Women are born with 2 million or 3 million eggs in their ovaries.

The numbers of eggs are actually not used up by ovulating them.

Most of those eggs just die off -

so they're not being used, they just die off.

Once women get down to a few thousand eggs,

then the menopause happens.

The big question for me, Tim - is menopause hereditary?

As with many things, if there's something in the family history,

it can increase the chances of it happening to close relatives.

Certainly, it can be a risk factor

if someone has had a premature menopause,

it could increase the chances for a daughter.

But it does not mean they WILL have an earlier menopause.

There's no way of knowing if I will follow in my mum's footsteps,

but there is a chance I could have an early menopause.

So I'm on my way to Hammersmith Hospital

to find out how healthy my ovaries are.

There are tests available to anyone, no matter what your age -

just ask your GP for them if you're having problems conceiving.

And the examination I'm having today

could reveal my chances of becoming pregnant.

Here goes.

Well, first of all, we do two basic tests.

One's a blood test,

which looks at your ovarian health in several different ways.

The second is an ultrasound scan which, first of all,

looks at the general gynaecological health of the pelvis

to see whether there's any ovarian cysts or fibroids present,

but also, specifically on the fertility side,

it looks at what's called the antral follicle count.

That tells us if the reserve of eggs is good.

So, between what we see with the ultrasound and the blood test,

that's probably the most powerful predictor

of the health of the ovaries that we've got at this stage.

Well, let's start at the beginning, then, and get some tests done.

Hi there, come in.

Hello. Hi.

'A blood test will help work out

'whether or not I'm close to the menopause,

'by checking whether I have a healthy reserve of eggs left.'

Do you want to look to the side and think of something nice?

-Yes, OK, I will think of something nice.

-OK.

-All done here.

-Thank you very much.

The more eggs that remain inside a woman's ovaries,

the further the woman is from the menopause.

The eggs develop within cells which produce a hormone called AMH,

and it's this hormone that's being tested,

to see if I have a healthy level.

I'm also going to have a more intrusive ultrasound,

to scan my womb lining and check my ovaries.

Come through.

'It should be able to tell me

'if I'm still maturing a healthy number

'of between 10 and 30 eggs a month

'but could also reveal whether there are any other problems.'

Over one in three women develop fibroids,

benign growths in the womb,

while around one in seven have polycystic ovary syndrome,

a hormonal condition that affects how the ovaries produce eggs.

Conditions like these can make becoming pregnant more difficult...

or impossible.

But they can respond to treatment.

I'll have to wait a few days for my results.

In the meantime, I want to find out what else I can do

to improve my chances of conceiving.

-Hello, Zita.

-Hi, Alex, lovely to meet you.

Lovely to meet you.

-Well, what a nice office you have, Zita!

-I know.

Midwife Zita West advises couples,

especially those in their 30s and 40s,

who want to have a baby.

So, if Charlie and I came in to see you,

what sort of areas would be the first areas we'd be looking at?

Age is the biggest factor

and I think, for today's women, they look absolutely fantastic.

I mean, you're 38 - you don't look 38.

Oh, thank you, Zita!

But it's understanding that your body and your eggs are still older.

How can we maximise our chances?

Have as much sex as you can.

-Lovely.

-Really, really important.

But also, everybody's got a weak area in their lives,

so look at your stress levels -

you seem very relaxed and laid-back to me.

You also seem very optimistic, which is a good thing.

Alcohol, cigarettes, really cleaning up your lifestyle.

Look at your diet and look at the weak areas there.

One of the things we do here is we test everybody for vitamin D.

You know, vitamin D now is linked to fertility

and many women and men are deficient in vitamin D.

So making sure you're getting key nutrients

from a wide range of food is really, really important.

It's about building your reserves up.

To get pregnant, it does require energy.

I'm amazed at some of the couples I see

that work really long hours, absolutely running on empty,

and they're exhausted.

'An initial consultation at Zita's clinic costs £240

'and is very comprehensive.'

Yeah...

'But this kind of information is also available through your GP.'

OK, great.

'Luckily, I've always had a pretty healthy diet and enjoyed exercise,

'although there's always more you can do

'to improve your overall health.'

But having a baby is a double act,

so I want to discover all I can about male fertility, too.

My husband, Charlie, is 37.

So is age as important for men as it is for women?

And what effect could a man's lifestyle have on his fertility?

Charlie does the cooking.

He used to be a chef, so he's...he's a very good cook.

It's the only reason I married him.

No, it's not.

I've read that working in intense heat

can actually affect your sperm count.

I mean, that was a long time ago and he's worked in an office

for, I suppose...

Well, since I've known him, for about six or seven years, now.

So it might not be relevant.

But it might be, who knows?

It would just be good to get the lowdown on sperm.

I've come to the University of Sheffield

to meet Professor Allan Pacey.

That actually is really nice.

He investigates what can have an impact on sperm quality

and he reckons that age is a crucial factor,

which is a new one on me.

Age does affect male fertility,

but not quite in the same way that it does in women.

So men don't have the equivalent of a menopause.

-Right.

-But we know that men above the age of 40

are about half as fertile as men under the age of 25.

-Really?

-They may have the same numbers of sperm,

but the quality of the sperm in the 40-or-above-year-olds

may be less good at the genetic level,

compared to the younger chap.

We can see this in many ways.

We do detect more miscarriages in women who become pregnant

through older men's sperm,

in comparison to younger men's sperm.

See, that's interesting,

because we tend to think of a miscarriage

as being the female's problem.

-Indeed.

-That's the first time I've heard somebody say that.

But there's a lot of evidence now

to show that the quality of the sperm has a bearing

on how likely a miscarriage is to happen.

There are many factors that affect a man's fertility.

One of the important things

that defines whether a man is fertile or not,

or whether he produces lots of sperm or not so many sperm,

are the size of his testicles.

-Right.

-To illustrate the point,

I've actually brought a set of testicle-sizing beads.

-It's like a necklace!

-It is a bit like a necklace, isn't it?

-OK.

-We call this an orchidometer

and this allows a doctor to assess how big a man's testicles are,

by simply holding it next to the chap's testicles.

That must be a lovely job!

This is the testicle size you'd expect a young boy to have,

but then, as he goes through puberty,

the size of his testicles will increase

and we would expect that the bigger testicle

would be producing more sperm than the little testicle.

So if a man's testicles grow to this kind of size,

he'll have a much higher sperm production rate

than if his testicles grow to this size.

And that, really, is predetermined by his genes

and by factors that happened when he was put together

as a foetus inside his mother's womb.

It's common sense, really, I suppose, isn't it?

Think about it in terms...

How big are they and how much can you get in them?

Absolutely, it's like car factories -

if you've got a bigger car factory,

you'll make more cars per unit of time

than if you've got a small car factory.

Allan also investigates

how a man's sperm can be affected by his lifestyle.

And for certain men, changing it could be critical.

There will be some men who have big testicles

who produce lots of sperm,

where lifestyle will have a small effect.

But there will obviously be some men

whose sperm production isn't as good as it could be,

and what they then do is damage it further...

-Right, OK.

-..by doing unhealthy things

or being in an occupation which is at risk.

To study risk factors linked to lifestyle,

Allan is running a series of experiments.

-Jacob.

-Hi.

-Nice to see you.

-How's it going?

-Come this way.

-Take a seat.

-Thank you.

Every day, his lab welcomes volunteers

who are willing to provide

the raw material he needs for his work.

Ten microlitres on the slide, cover slip, have a look.

Allan has studied sperm samples from over 2,000 men.

He judges the health of the sperm by how far and fast they swim.

I'm going to move it along cos they've been zipping up here.

He puts some of each volunteer's sperm into a glass tube

and measures how many reach the top in 30 minutes.

These sperm are much more meandery.

Oh, that's lovely as well.

So far, he's discovered that being exposed to certain chemicals,

as painters and decorators

or those working in the printing industry can be,

could harm sperm quality.

Other factors, such as wearing tight underwear,

sitting down a lot, or working in a hot environment

can also have a detrimental effect on sperm,

because they raise the temperature of the testicles.

My husband, Charlie, used to be a chef.

-Mm-hm.

-Is that going to cause problems, do you think?

For the duration of time you're working in that environment,

it's possible your sperm quality or your sperm production

will be impaired.

In fact, the ideal temperature for sperm production

is around 35 Celsius -

a couple of degrees below body temperature.

That's why a man's testicles are on the outside.

Anything that increases their temperature harms the sperm.

The good news is risk factors like heat are very reversible.

So if you stop the exposure, if you go to another job,

then the likelihood is that your sperm production will increase

to the point that then is natural for you.

A man keeps producing new sperm throughout his life

and the good news is that anything that harms it

only really affects the existing batch.

Once that problem's resolved,

it should take about two or three months

for the sperm quality to recover.

BABY LAUGHS

So there are some pretty simple things you can do

to increase your chances of conceiving,

both as a man and a woman.

But what if it's not enough?

Millions of people in the UK who struggle with fertility

turn to science for help

and try a technique like in vitro fertilisation, or IVF.

The first IVF baby was born in 1978,

after more than 100 attempts with the new technology.

Since then, over 6 million IVF babies

have been born worldwide.

Your chance of having IVF on the NHS

depends on how old you are and where you live.

It's very variable.

If you're under 40,

the NHS can provide from none up to three cycles

and for those in their early 40s, it could be one or none.

If you choose to go private,

IVF could set you back around £5,000 per cycle.

OK, Alex, come on through.

-This is where the magic happens.

-Oh, wow!

'Dr Cristina Hickman creates under a microscope

'what usually happens inside a woman's body.'

We have a dish like this

where we would have the eggs and the sperm inside.

She's working to push IVF science forward.

The important thing is we are helping the sperm and these eggs

get together when they wouldn't naturally be able to do that.

Essentially, this is where life is created, in this room.

Pretty much, yes.

In the early '80s, IVF success rates averaged 10%.

Today, it's well over 30% for women under 35,

although rates fall as you get older

to about one in ten for women in their early 40s.

IVF success rates have been rising constantly,

as new techniques have been introduced and improved.

With ICSI, intracytoplasmic sperm injection,

sperm can now be injected straight into the egg

using a tube the thickness of a hair.

OK, so this is how the IVF happens.

This helps when sperm quality is poor

and they don't easily penetrate the egg.

And the egg still needs to go through the process

of accepting the sperm inside.

But we have improved the odds of it happening

by putting them together in the same place.

If the egg is fertilised, the cells will begin to divide

and the egg becomes an embryo.

However, not every embryo created in the lab

will lead on to a successful pregnancy.

There may be faults in the embryo's genes,

problems with the way it develops,

or it may fail at the next stage,

which is implanting into the woman's womb.

But a recent breakthrough has helped increase chances

of picking a healthy embryo to transfer into the womb.

A time-lapse camera inside the incubator

monitors the embryo while it's growing.

Because it takes pictures every ten minutes,

you can put a video together and you can see the embryo going on

from one, to two...

-Oh, wow!

-..to three cells to four cells

and it continues, the embryo development.

This allows the team to check constantly

whether the embryos are developing correctly

and which ones look like the best bet.

But, in this lab, it's also possible

to see some of the reasons it's more difficult

to become pregnant as you get older.

As you age, it's not just the egg quantity that drops -

it also the egg quality.

Some eggs collapse as soon as the sperm is injected,

because their membrane is too soft...

..while others develop a tougher membrane over time,

making it difficult to be fertilised,

as it's harder for the sperm to get in.

It's not bursting, so this membrane on the top and the bottom,

it's not letting go.

This one comes from a woman about my age.

So would this egg, then, be unlikely to fertilise?

This one's less likely to fertilise

and less likely to lead on to a baby.

Today, it's hit home how fragile our little eggs are

and how they do age.

This is the ironic thing - we all feel ten years younger.

You know, 40 is the new 25 or the new 30.

But, inside, we're all still the same as we were 100 years ago.

The trend to have babies later

means more women are leaving it too late.

Their eggs are just unable to be fertilised

and, for some, their eggs have virtually run out.

But another form of IVF is giving them a real chance to carry a child

and it's now being used to help over 2,000 women in the UK every year.

"Mommy and Daddy tried for a long time to have a baby,

"but when no baby started to grow,

"we went to the doctor for help."

Sarah was a sales director at a global company

and didn't start trying for a family until she married in her 40s.

But she always wanted children.

"The doctor said that we couldn't use Mommy's eggs..."

By then, the condition of her eggs

meant she couldn't conceive naturally,

so she turned to an IVF technique

that doesn't rely on using your own eggs.

"The doctor said there are some women who are so kind,

"they want to give one of their eggs to another woman who needs them."

Sarah used eggs donated by a younger woman

and it allowed her to have the child she always wanted.

Hello.

Hi, you!

Have you gone shy?

-No!

-No?

-How old are you?

-This is Alex, Andre.

Hello, Andre. Shall we shake hands?

-How old are you, Andre?

-Three.

-Three!

Wow! You're a big boy.

'Sarah didn't meet her husband until she was 43.'

We tried to have a baby naturally,

until I then needed to go to the doctor

and get a read what my fertility was like at that age.

I had the test done and it was very clear

that I had a 2% chance...

-Oh, gosh.

-..of using my own eggs.

And with a donor egg, you have a 60% chance.

And for me, it was a bit of a no-brainer,

that I can maybe get pregnant and have a baby and become a mother.

-There's something kind of magical about that.

-Yeah, I bet.

So when you decided that you were going to go for egg donation,

how does the process start?

I mean, what does it entail?

So what happens is they identify the donor.

You know, they create the embryos with my husband's sperm

and then they tell you how many embryos you have

and then you get prepared for those embryos to be placed back.

-And because...

-Mummy?

-Yes.

-There's a bee.

No, that's just a little fly, it's fine.

Does it feel strange at all to be carrying an embryo,

a baby, essentially,

that genetically wasn't created by yourself?

I guess...

because science even allowed me to carry a baby,

I was just - and continue to be -

just amazed that I was able to do that.

'Sarah needed five attempts

'before an embryo of her husband's sperm and a donor egg

'was successfully transferred into her womb and implanted there.'

How did you feel initially when you had the news

and they said, "It's worked"?

I had just turned 50, like, two weeks before.

So I kind of knew, just naturally,

that it was coming to its natural conclusion.

And, um...they said, "It's positive", and I...

Yeah, I just didn't believe it. I just didn't believe it.

I still don't believe it.

SHE LAUGHS

-No!

-SARAH LAUGHS

I'm delighted that, at 50,

science has enabled Sarah to have the child she always wanted.

The success rate of IVF with donated eggs average about 40%.

They largely depend on the age of the egg donor

and, in the UK, all donors have to be under 35.

But it comes at a cost.

In some areas, the NHS does pay for egg donation, but if not,

going private means adding around £2,000 per IVF cycle

and it took Sarah several attempts.

It's been an eye-opener, really,

because my friends and I used to say,

"Well, if nothing works, we'll just do IVF".

We thought it was just a quick-fix solution, really.

But what I've learned is that it's really difficult,

both emotionally and physically.

And, actually, the odds are really stacked against you.

The success of IVF, with your own or a donor egg,

depends heavily upon choosing a healthy embryo

to transfer into the womb.

If the embryo isn't healthy, it won't implant successfully.

But an ongoing trial aims to make that critical decision much easier.

In Oxford, Professor Tim Child is part of this international trial

which involves screening embryos

to check they are genetically healthy

and carry the correct number of chromosomes.

When we do a normal IVF cycle,

we just look and see which embryos look best,

but we've no idea what the genetics are like inside.

So the embryologist will choose which embryos look best

to put back into the woman's womb.

How many on average for, say, a 35-year-old woman would be viable?

Incredibly, only around half of embryos that couples make

when a woman's in her mid-30s

will have the right numbers of chromosomes in.

As humans, we are fairly inefficient, actually,

at making healthy embryos.

I'm flabbergasted that you've just said, you know...

-50%.

-Half, yeah.

That's the reason why the success rate drops off.

We know as women get older,

the miscarriage rate goes up significantly.

That's really linked to this,

it's linked to these embryos having the wrong numbers of chromosomes.

So what we can do is actually test the genetics of the embryo.

It's called pre-implantation genetic screening

and the latest technique is called next-generation sequencing, or NGS.

So what we do is actually take away

between two and five of the cells of the embryo from the outside -

this is what Danielle is doing now.

So she's sucking them into this tube here?

There's a pipette that she's sucking a few cells into -

you can see here, a laser is being used to separate the cells.

Wow!

What will happen now is those cells will be passed over

to the genetics laboratory and they'll undertake

the next-generation sequencing of those cells

to see that those cells have the right numbers of chromosomes

or don't have the right numbers of chromosomes.

The embryos are frozen while Tim waits to find out

which ones are normal and do have the correct number of chromosomes.

Then he and the embryologist will decide which of those

to transfer into the woman's womb.

This test is already available privately

and costs at least £2,000 on top of the IVF cycle.

But it may be offered by the NHS

if the trial shows it to be cost-effective.

So, Tim, is it foolproof?

In terms of, if you've had the screening done,

is your embryo definitely healthy and will definitely implant?

Or, sometimes, does it just not work for however many other reasons?

We know that if we find an embryo

that's got the right numbers of chromosomes in

and is an otherwise healthy-looking embryo,

when we put that back, the chance of it implanting

is between 60 and 70%.

So it's not 100%, but it's certainly much higher

than just a random embryo.

And the reasons why it's not 100% would be there are many other things

that could affect why embryos implant or not.

So even if doctors select

a genetically viable embryo to transfer,

there's still over a 30% chance

that it won't implant successfully in the womb.

But in the Spanish city of Valencia,

a team has made a discovery about the timing of the transfer.

'Dr Carlos Simon hopes it will help

'transform implantation success rates.'

We have calculated that one in four patients with implantation failure -

the reason is because we are not doing the transfer of the embryos

at the right time for the patient.

One couple he's helping are Maite and Julio.

They're both in their early 40s

and have spent over five years having IVF.

But Maite's womb keeps rejecting the embryos.

IN SPANISH:

Carlos believes there is just one optimum chance

for the embryo to be transferred into the womb.

This is a window of opportunity, just a few hours, in every woman

and this is not the same time in each patient.

-And synchronisation is crucial.

-Right.

If we transferred the embryos at the wrong time,

they will not be able to attach to the mother's womb.

Carlos gives each woman a bespoke combination of hormones

to help prepare her womb.

He then takes a tiny tissue sample from the womb

to make sure that it's at its most receptive

by testing the individual characteristics of the cells

that make up the womb lining.

This is personalised medicine

and by transferring the embryos at the right time,

this patient implants and has a healthy child.

Four months ago, Carlos used this technique

to choose the right time to transfer an embryo into Maite's womb.

HEART PULSES ON SPEAKERS

This treatment is currently only available

in a handful of clinics around the world,

but Carlos hopes it'll one day be available to everyone,

improving the chances of having a baby for women of all ages.

Science is constantly pushing the boundaries of what's possible.

But for a few women, the odds are so stacked against them,

they're told they will never carry a baby of their own,

like Jenny.

So, when did you first think

that there might be a problem, then, Jen?

I think I was probably about 15, 16,

and I had to go and have an ultrasound

because I was having some abdominal pain

and I was called in to see one of the consultants,

who sort of sat in front of me and looked at me in a certain way

and I thought, "Oh, there's really something wrong, here,"

and you get that feeling in your stomach.

-Yeah.

-And then she said,

"I don't really know what to tell you.

"You have a condition called MRKH and you were born without a womb."

I remember saying to her,

"So does that mean I can't have children?"

And she shrugged, and said,

"I really don't know what I can say."

And that was it? No further support, no advice?

No.

I felt like the world had dropped out

and I went and locked myself in the bathroom

and sat on the floor and just cried and cried.

-And how do you feel now, then, nearly 30...?

-Yeah.

Is a family something you want?

Mm...eventually.

Have you thought about the options that are open to you, then?

Women with MRKH actually are quite lucky, in a way,

because we're born with ovaries and eggs

-and some women don't have that.

-No.

So we are able to have our own biological children,

-we just can't carry them.

-No.

So there's agencies in the UK that can link you up

with women that are interested in being surrogates.

I'm lucky enough that I have two older sisters

who have both said that they'd love to do it.

So let's start over here.

Four years ago, Swedish surgeon Mats Brannstrom

made an extraordinary breakthrough

that could transform the lives of people like Jenny.

He became the first person in the world

to successfully transplant a womb from one woman to another.

A 61-year-old woman gave her womb to a family friend.

That pioneering operation has led to six more transplants

and five healthy babies so far.

Jenny now runs a support group for women without wombs,

and she's come to Sweden to find out more about this new technique.

So this is the actually the story about the first baby,

and I delivered the baby myself.

-This was a very special moment.

-Yeah.

-And...

To hear the first cry and so on.

-And so, of course, that's something I will always remember.

-Yeah.

Today, he is one-and-a-half years, almost,

-and he walks and is a very happy baby.

-Aw.

-That's amazing.

-Yeah.

So, obviously, there's lots of women back home

that are really excited about this step forward in treatment.

So if I go home and the women and the girls say to me,

"Is this something that's going to be an option for me in the future?",

what would you recommend that I say?

If it comes into clinic, which I'm sure it's going to be,

I think it's going to be a routine procedure in five to ten years

in many, many countries around the world

and, of course, including UK. because...

you have done a lot of research in the UK

and you're now starting your first trials, so definitely.

-Hello.

-Hi.

Mats has arranged for Jenny to meet Cash,

his fourth womb transplant baby, along with Cash's father, Patrick.

Hi, Cash!

You're beautiful, aren't you?

Womb transplants could help thousands of British women

in the future.

Do you want a cuddle?

'Even though I know that's not going to be the road that I'll go down,

'it's the girls in my support group

'that will potentially be able to benefit from it, which is fantastic'

because...they might get this and that's amazing,

because I don't want them to have to go through what I've been through.

He is solid.

THEY LAUGH

'To be able to see someone else

'who has gone through what I've gone through'

and yet have the magic wand that I wanted...

SHE SNIFFS

It's amazing.

Aw, you're so soft and warm.

Jenny's story makes me all too aware

that carrying a child is still not something

anyone can take for granted,

despite the extraordinary research happening right across the globe.

It occurred to me that I never considered the possibility

that I wouldn't have children one day,

which is really naive, especially knowing what we know now.

But that's changed.

I do now realise it's something I might have to face.

'Today, I'm going to hear the results of my fertility tests,

'to find out how my ovaries are doing

'and whether I've got a healthy reserve of eggs left.'

-Good afternoon. How are you?

-Very well.

So starting, first of all, on the ultrasound side,

the ultrasound shows there's no significant cysts

in the ovaries at all,

which, straight away, is very reassuring.

Well, that's...phew! Yes.

-We then come onto the fertility aspect.

-Yeah.

So the ultrasound measurement, the antral follicle count,

that came out to be a total of 12.

That means that about 12 eggs

were maturing in my ovaries when I had the scan.

So, for your age, that is absolutely fine,

with no concerns at all.

We then look at the blood test - yours has come out at 14.8.

This is the level of the AMH hormone in my blood

that indicates how many eggs I have left in my ovaries

and whether or not I'm close to the menopause.

-You're in the very healthy range, there.

-Oh, great.

I'd be reassured, not worried, about the health of the ovaries.

That's very good news.

Well, I'm really relieved.

It was really unnerving to be faced with it suddenly,

and therefore, I've got every sympathy

with any couple or individual

who are having a difficult time of it.

Yeah, it's a big thing.

I know now there are no guarantees when it comes to getting pregnant -

there are so many things at play,

and the tests I've had have only shown me a few of those.

I mean, Dr Trew said everything was OK,

but I know that is for a woman of my age.

And my eggs really aren't getting any younger.

This process has been brilliant, though, because I've learned so much

and I now feel that I've got the right information

to maximise my chances,

so I really hope that we can start our own family pretty soon.

It just so happens

that my husband and I, Charlie and I,

are having a baby...

CHEERING AND APPLAUSE

Lots and lots of you had guessed, and I was trying to breathe in,

and eventually, I can breathe out, which is just lovely.

'Fantastic news. We've got a new One Show baby on the way

'and we are so thrilled for you.'

'Thank you very much.'

When I started filming this documentary,

I had no idea how things would turn out for us

but, luckily, it was a straightforward process

and of course, we are thrilled to be having a baby.

But what I've learned is how precarious conception can be.

It can be a heartbreaking process, both emotionally and financially.

But we've met some really inspiring people

and it's been amazing to see what science can do

and I really hope it can help everybody,

no matter what their circumstances, to have a family.