Baby Makers: The Fertility Clinic

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0:00:02 > 0:00:04What do we do when we want to procreate?

0:00:04 > 0:00:09We put the candles on, the lights, get Engelbert Humperdinck

0:00:09 > 0:00:14on the record player, and we have missionary sex lying down on the

0:00:14 > 0:00:18silk sheets, and then the female puts her legs up in the air, puts a pillow

0:00:18 > 0:00:22under her bottom, because one of the questions that she wants to ask me,

0:00:22 > 0:00:26and never dares, is that, "Why is it that the sperm all dribbles out?"

0:00:30 > 0:00:33Britain is in the grip of a fertility crisis.

0:00:34 > 0:00:39Our lifestyle is affecting our chances of having babies.

0:00:39 > 0:00:42Women are leaving it later to have children,

0:00:42 > 0:00:45and men's sperm counts are falling.

0:00:45 > 0:00:47That's quite a small sample.

0:00:47 > 0:00:50Volume-wise, that's quite a regular amount.

0:00:50 > 0:00:53Reproductive treatment is one of the fastest-growing

0:00:53 > 0:00:57areas of medicine, with over 200,000 babies born in Britain to date.

0:00:57 > 0:00:58Big cough.

0:00:58 > 0:00:59WOMAN COUGHS

0:01:01 > 0:01:04More and more desperate couples are seeking high-tech and sometimes

0:01:04 > 0:01:09very expensive procedures to give them that elusive dream baby.

0:01:09 > 0:01:12When you think you can't potentially have a family,

0:01:12 > 0:01:15and then to have him, it's a little miracle!

0:01:15 > 0:01:19But what's it like to work on the front line of fertility treatment?

0:01:19 > 0:01:21You sound lovely!

0:01:21 > 0:01:22How does it feel to be a scientist,

0:01:22 > 0:01:26nurse or doctor involved in the very creation of a new life?

0:01:26 > 0:01:28Of course it makes all of us anxious,

0:01:28 > 0:01:32because it's an incredibly high-responsibility job.

0:01:32 > 0:01:35Does anyone come closer to playing God?

0:01:41 > 0:01:44This is Liverpool Women's Hospital.

0:01:44 > 0:01:47It's home to the Hewitt Fertility Centre,

0:01:47 > 0:01:50one of the largest and most modern fertility clinics in the country,

0:01:50 > 0:01:53offering both NHS and private treatment.

0:01:54 > 0:01:57I'm spending three months here to find out what it's like

0:01:57 > 0:02:00to be one of the doctors or nurses who treat the patients.

0:02:02 > 0:02:05Or the scientists who actually create life in the lab.

0:02:07 > 0:02:12The clinic is run by Prof Charles Kingsland.

0:02:12 > 0:02:17In his long career, Charles has helped conceive thousands of babies.

0:02:17 > 0:02:18Your eggs are 40 years old.

0:02:18 > 0:02:21Fertility treatment is still a source of great controversy

0:02:21 > 0:02:26in this country, but Charles feels it should be available to everyone.

0:02:26 > 0:02:29It's just a question of getting the right egg.

0:02:29 > 0:02:34To have or not to have children is a lifestyle choice.

0:02:34 > 0:02:39When you decide you want children but can't have them,

0:02:39 > 0:02:41that is when the problem arises.

0:02:41 > 0:02:44If you look at the definition of disease,

0:02:44 > 0:02:46it is an abnormality of easiness.

0:02:46 > 0:02:49And one thing you notice about men and women who want to have children,

0:02:49 > 0:02:54and who can't have children, they are diseased.

0:02:54 > 0:02:57And any disease is worthy of treatment,

0:02:57 > 0:03:01and ideally, in this country, I believe diseases should be

0:03:01 > 0:03:05treated free at the point of access within the National Health Service.

0:03:06 > 0:03:09Charles believes fertility treatment is a human right,

0:03:09 > 0:03:12and most people are allowed two free goes on the NHS.

0:03:15 > 0:03:19But those fail, they will have to pay for the next treatment.

0:03:19 > 0:03:22The first medication that you are going to start taking...

0:03:22 > 0:03:23The whole process takes around two months.

0:03:23 > 0:03:27It's geared towards creating as many eggs as possible by artificially

0:03:27 > 0:03:30stimulating a woman's ovaries with drugs,

0:03:30 > 0:03:33which she has to inject every day for five weeks.

0:03:34 > 0:03:37Each one of those is one of your follicles...

0:03:37 > 0:03:40The ovaries create lots of follicles,

0:03:40 > 0:03:42each one hopefully containing an egg.

0:03:42 > 0:03:44You are ready for planning egg collection.

0:03:44 > 0:03:48At this point, the woman is booked in to have her eggs collected.

0:03:52 > 0:03:56This morning, Prof Kingsland is about to start a daily round of egg collections.

0:04:00 > 0:04:03- Morning.- Good morning. - Pleased to meet you.

0:04:03 > 0:04:06His first patient is 38-year-old Deborah Dickin.

0:04:06 > 0:04:09I've been awake since five.

0:04:09 > 0:04:11- Worrying!- Nervous.

0:04:12 > 0:04:15- You won't feel a thing. - This is the easy bit.

0:04:15 > 0:04:19Once Deborah's eggs are collected, they will be introduced

0:04:19 > 0:04:23to her husband's sperm, and if they fertilise, they will become embryos.

0:04:28 > 0:04:32This procedure requires the patient be under general anaesthetic,

0:04:32 > 0:04:34'and takes about ten minutes.

0:04:34 > 0:04:37'On average, a woman produces around six eggs.'

0:04:39 > 0:04:43These are any indication of what this lady might get out?

0:04:43 > 0:04:47I'm hoping that she will get about three or four eggs today, so what

0:04:47 > 0:04:52we do now is we put the needle through the vaginal skin

0:04:52 > 0:04:55and then straight into the ovary,

0:04:55 > 0:04:59missing all the vital organs that might get in the way.

0:05:00 > 0:05:04So what I'm doing now is just having a quick scan around, looking at the end of my atrium,

0:05:04 > 0:05:07and making sure there is nothing at the end of the ovary

0:05:07 > 0:05:12and the follicle, and then just pop the needle straight in,

0:05:12 > 0:05:14and you can actually see the needle

0:05:14 > 0:05:17is right in the middle of the follicle.

0:05:17 > 0:05:19Put my foot on the pump,

0:05:19 > 0:05:23and the fluid is now dribbling into that test tube.

0:05:23 > 0:05:27And then you can actually see that follicle shrinking away.

0:05:27 > 0:05:32Deborah and her husband Matt have been trying for a baby for three years.

0:05:32 > 0:05:35This is their first time trying IVF.

0:05:35 > 0:05:37Having children is a biological drive.

0:05:37 > 0:05:41It's like moving, growing, breathing, eating...

0:05:43 > 0:05:46It's a drive, and if you have an inability to conceive,

0:05:46 > 0:05:51all you think about all day long is babies.

0:05:51 > 0:05:54Having babies, your inability.

0:05:54 > 0:05:57The first thing in the morning, you think about it,

0:05:57 > 0:05:59the last thing at night.

0:05:59 > 0:06:02And then, of course, you get so stressed,

0:06:02 > 0:06:04your mind starts playing tricks on you.

0:06:04 > 0:06:06Why is it that every shop on the high Street is Mothercare?

0:06:06 > 0:06:08Everybody is pushing a pram.

0:06:08 > 0:06:11Why is it that every time I nip into a supermarket,

0:06:11 > 0:06:13I always walk down the aisle with the nappies?

0:06:13 > 0:06:16Of course, that's not true, but that's what you perceive.

0:06:16 > 0:06:19And then somebody comes along and says, "Just relax."

0:06:19 > 0:06:22How can you relax? It's a very stressful situation.

0:06:23 > 0:06:26That's it. It's all over.

0:06:26 > 0:06:29- Coo-ee!- All right? Are you OK?

0:06:29 > 0:06:32After the procedure, Deborah is taken to the recovery area,

0:06:32 > 0:06:34and given a cup of tea.

0:06:35 > 0:06:39- I don't feel any pains. Is that likely to come?- You may do.

0:06:39 > 0:06:43- I don't feel like anyone's been down below.- Good. Good!

0:06:43 > 0:06:47Do you find women fascinating?

0:06:49 > 0:06:52I think women are great!

0:06:52 > 0:06:58I think they are...eternally fascinating, and challenging.

0:06:58 > 0:07:04Difficult to understand, but the beauty of being a gynaecologist

0:07:04 > 0:07:08is that it is like being a mechanic in a Mercedes garage.

0:07:08 > 0:07:09Women are built to last.

0:07:09 > 0:07:14They live longer than men, they have more fortitude than men,

0:07:14 > 0:07:17they are built better.

0:07:17 > 0:07:18We're Ford Escorts.

0:07:18 > 0:07:22We race around for 60,000 miles and our big ends blow,

0:07:22 > 0:07:25our heart blows, and you drop dead in the street.

0:07:25 > 0:07:31Women are built to have babies, so their physiology is so much stronger.

0:07:31 > 0:07:34- You all right?- Yes!

0:07:34 > 0:07:36- Deborah Dickin?- It is.

0:07:36 > 0:07:38- You got five eggs.- Ooh!

0:07:38 > 0:07:41- So well done.- Lovely! Brilliant.

0:07:41 > 0:07:46- Fingers crossed! - I was worried there wasn't any!

0:07:46 > 0:07:49- Well done.- She was very nervous. - Five is a good number.

0:07:49 > 0:07:52- Is it about the average, is it?- Yeah.- Is it?

0:07:52 > 0:07:55- Good sizes? - We don't know the quality yet.

0:07:56 > 0:07:58We only know the number.

0:07:58 > 0:08:01So worried. Thank you.

0:08:03 > 0:08:06There you go. See? Nothing to worry about.

0:08:09 > 0:08:12Deborah Dickin and Matthew Dickin...

0:08:12 > 0:08:15Deborah Dickin's eggs and her husband Matt's sperm

0:08:15 > 0:08:18are brought together here in the embryology lab.

0:08:20 > 0:08:24Here, the embryologists can take in up to 70 eggs a day,

0:08:24 > 0:08:29and millions of sperm, in what is a finely-tuned human production line.

0:08:39 > 0:08:41- You can see them swimming.- Yeah.

0:08:41 > 0:08:45You can see these are swimming quite fast.

0:08:45 > 0:08:47What I am going to try and do is try and catch them.

0:08:47 > 0:08:50The head of embryology, Rachel,

0:08:50 > 0:08:52is carrying out a procedure called ICSI for the Dickins.

0:08:52 > 0:08:57She must select what she thinks is the best sperm.

0:08:59 > 0:09:03This is then injected directly into the egg.

0:09:03 > 0:09:06ICSI is used in cases where men have low sperm counts,

0:09:06 > 0:09:10or sperm that doesn't move around much.

0:09:14 > 0:09:17That's it. We start the hunt for the next sperm.

0:09:19 > 0:09:22- Are sperm tricky buggers to catch? - Yes.

0:09:22 > 0:09:25It's the hardest part of the ICSI process, really.

0:09:25 > 0:09:27What we're doing is we're selecting the sperm.

0:09:27 > 0:09:30We're not letting the best sperm enter the egg itself.

0:09:30 > 0:09:33You're swimming beautifully! Right.

0:09:33 > 0:09:34Going to see if I can get him.

0:09:34 > 0:09:36Just sort of...

0:09:36 > 0:09:40Running my needle over the tail.

0:09:40 > 0:09:44- Oh! His head's come off!- Oh!

0:09:44 > 0:09:46SHE LAUGHS

0:09:46 > 0:09:48I knew that would happen!

0:09:48 > 0:09:50He's stuck to the bottom.

0:09:50 > 0:09:53'Rachel injects sperm into five Deborah's eggs.

0:09:53 > 0:09:58'On an average week, Rachel carries out around 50 of these procedures.'

0:09:58 > 0:10:02Will you think about this particular procedure later tonight...

0:10:02 > 0:10:04Oh, God, yeah, yeah. Absolutely.

0:10:07 > 0:10:09No matter how many ICSIs you do,

0:10:09 > 0:10:11you still think about it when you get home,

0:10:11 > 0:10:15and you just you think, "Oh, my God, I hope it's all right."

0:10:15 > 0:10:17You know, you hope they get good fertilisation.

0:10:18 > 0:10:23'Rachel is in charge of a team of 14 women.'

0:10:23 > 0:10:25So do you think working here made you a bit more anxious

0:10:25 > 0:10:27to make sure you could have children?

0:10:27 > 0:10:29Yes.

0:10:29 > 0:10:32Yeah, I do.

0:10:32 > 0:10:37It makes you more aware how old you are.

0:10:37 > 0:10:41There's a few of us who have talked about should we have our hormone levels checked?

0:10:41 > 0:10:45We're all worried, I think. We're all worried.

0:10:45 > 0:10:47- You're all worried? - Yeah. And I'm only 24!

0:10:47 > 0:10:49All right! Don't show off!

0:10:49 > 0:10:54- I've been told I look 35. - I'm 29, that's worse!

0:10:54 > 0:10:58'Amy is the youngest embryologist at the Hewitt Fertility Centre,

0:10:58 > 0:11:00'aged just 24.'

0:11:00 > 0:11:03- Do you go on at your boyfriend about it?- No.

0:11:03 > 0:11:05- About having kids?- No.

0:11:05 > 0:11:08- So he doesn't know that you're anxious about it?- Erm...

0:11:11 > 0:11:14Well... I suppose I've said it.

0:11:14 > 0:11:16But I'm not...

0:11:18 > 0:11:22I'm not, you know, badgering him to have children!

0:11:26 > 0:11:31You don't sit there on an evening saying, "Oh, the clock's ticking!"

0:11:31 > 0:11:33No. No, I don't!

0:11:37 > 0:11:40Cos I also think what will be will be,

0:11:40 > 0:11:44and I'm not sure I'd have fertility treatment if I needed it.

0:11:44 > 0:11:47- Why?- I don't know if I could go through it myself,

0:11:47 > 0:11:51and obviously, I've never done it, but when you see it every day,

0:11:51 > 0:11:54and you see what the women go through,

0:11:54 > 0:11:56and it's very difficult for them, I think.

0:11:58 > 0:12:01- And I don't think I've got that strength.- Really?

0:12:03 > 0:12:08I don't know. I still think I'm still too young to decide,

0:12:08 > 0:12:10but then at the same time...

0:12:11 > 0:12:14I'm getting older! I'm only getting older!

0:12:18 > 0:12:21There is another part of the treatment process

0:12:21 > 0:12:26at the Hewitt Centre, which has no time for science and technology.

0:12:26 > 0:12:29It's a procedure that is as old as time itself.

0:12:30 > 0:12:35This is back to the nerve centre of the unit.

0:12:35 > 0:12:40Across the way, that's where all the ladies go for their eggs collected,

0:12:40 > 0:12:43and at the same time, the gentlemen will come in here

0:12:43 > 0:12:46to our masturbatorium and produce their sample.

0:12:46 > 0:12:50This used to be called the room 21.

0:12:50 > 0:12:53Ten fingers, ten toes,

0:12:53 > 0:12:56I'll leave you to think where the extra digit comes from!

0:12:56 > 0:13:00We have a comfortable chair,

0:13:00 > 0:13:04we have earphones for music or videos,

0:13:04 > 0:13:06and we have a touch screen here

0:13:06 > 0:13:12which displays a choice of appropriate stimulatory material,

0:13:12 > 0:13:17as opposed to a few tatty old magazines

0:13:17 > 0:13:20that are strewn around on a coffee table.

0:13:24 > 0:13:27'Each of these newly refurbished "masturbatoriums",

0:13:27 > 0:13:29'as Charles likes to call them,

0:13:29 > 0:13:32'comes equipped with its own selection of pornographic films.

0:13:34 > 0:13:38'Today, a couple who are on their second cycle of treatment

0:13:38 > 0:13:41'are in to have their eggs collected.

0:13:41 > 0:13:47'Lisa Henney's husband Gareth has just been into the masturbatorium.'

0:13:47 > 0:13:49It's a funny thing, isn't it, because most wives would not

0:13:49 > 0:13:51be that happy about their partners watching porn.

0:13:51 > 0:13:54- Yeah.- And yet, how do you feel about it in this situation?

0:13:54 > 0:13:56- It doesn't bother me at all. - It doesn't bother you?- No.

0:13:56 > 0:14:00Could you not have told me that four years ago?

0:14:00 > 0:14:02No! It doesn't bother me.

0:14:02 > 0:14:06- Hi!- I'm looking for a Lisa Henney. - That's me.- Is that you?- Yes. - Pleased to meet you.

0:14:06 > 0:14:09'Charles's team do up to 12 egg collections every day.'

0:14:09 > 0:14:11- Pleased to meet you.- Bye!

0:14:13 > 0:14:16'Like many couples, there is no apparent reason why Lisa

0:14:16 > 0:14:19'and Gareth Henney have not been able to get pregnant.'

0:14:20 > 0:14:22You sound lovely.

0:14:26 > 0:14:28Are you asleep yet?

0:14:28 > 0:14:30Ooh, right.

0:14:38 > 0:14:40You must have done this procedure many times?

0:14:40 > 0:14:42The first 10,000 were a bit difficult.

0:14:42 > 0:14:44After that, it gets a bit routine!

0:14:44 > 0:14:46Usually takes about five minutes.

0:14:48 > 0:14:50This lady's got a fair number of follicles.

0:14:50 > 0:14:52Her ovaries have responded quite well.

0:14:58 > 0:15:00That's it.

0:15:00 > 0:15:02LISA SIGHS

0:15:02 > 0:15:05- How are you feeling?- Thank you so much.- It's quite all right.

0:15:05 > 0:15:09You're so lovely. You are lovely with people.

0:15:09 > 0:15:12I must say that to you. You really are.

0:15:12 > 0:15:14How many eggs?

0:15:14 > 0:15:18Haven't finished counting them! Just counting them now!

0:15:18 > 0:15:21- Go now! Find out! - THEY LAUGH

0:15:21 > 0:15:25- Right, I'll go now then! Immediately! - I couldn't feel anything.

0:15:25 > 0:15:27We've got six so far.

0:15:27 > 0:15:30- It's good.- Oh, thank you.

0:15:31 > 0:15:35- Is it time for a cup of tea?- Oh, I could have stayed for a bit longer!

0:15:41 > 0:15:44Lisa Henney, 29, three, seven...

0:15:44 > 0:15:48Lisa and Gareth's fertilisation is being carried out by Rachel,

0:15:48 > 0:15:51using the most common method of treatment,

0:15:51 > 0:15:54in vitro fertilisation - IVF.

0:15:55 > 0:15:57So I just pick up my sperm,

0:15:57 > 0:16:01and I just drop it onto the well...

0:16:04 > 0:16:05..containing the eggs.

0:16:05 > 0:16:09The Petri dish imitates the environment of the womb,

0:16:09 > 0:16:13and the process of natural selection is allowed to unfold.

0:16:15 > 0:16:19I can see motile sperm in there, I can just see them swimming now.

0:16:19 > 0:16:22And they need to get towards that egg now.

0:16:22 > 0:16:26So I'll leave it up to them. It's out of our hands.

0:16:26 > 0:16:31There you go. See if that can find the egg itself.

0:16:31 > 0:16:32There's an egg.

0:16:35 > 0:16:38You can see the eggs here.

0:16:38 > 0:16:43There's a lot of cells around it, so you can't really get a good focus on the cell. The egg itself.

0:16:43 > 0:16:45These are all its cumulus cells,

0:16:45 > 0:16:49and you can just see the sperm starting to swim towards it now.

0:16:49 > 0:16:51- Oh, yes.- You can just see them swimming around.

0:16:51 > 0:16:54- You can just about see them, can't you?- Yeah.

0:16:54 > 0:16:57- There's a lot to get through, isn't it?- Yeah, loads. And they're tiny.

0:16:57 > 0:17:00Look at the tiny sperm compared to the size of the egg.

0:17:00 > 0:17:03Both the Henneys' and the Dickins' eggs will hopefully

0:17:03 > 0:17:06develop into embryos over the next few days.

0:17:06 > 0:17:08During that time, they will be checked regularly,

0:17:08 > 0:17:13along with the several hundred other embryos stored in the lab.

0:17:13 > 0:17:16- BOTH:- Gemma Jonesfield, 11, 4, 8...

0:17:16 > 0:17:19Gemma Jonesfield, 11, 4, 8.

0:17:19 > 0:17:21Gemma Jonesfield, 11, 4, 8.

0:17:21 > 0:17:24'Embryologists are trained on the job for three years,

0:17:24 > 0:17:27'and need a degree in a life science like biology.

0:17:27 > 0:17:30'But working with such microscopic human cells,

0:17:30 > 0:17:33'they need to be incredibly well-organised too.'

0:17:33 > 0:17:38Do you feel that there's a certain sort of mindset that suits an embryologist?

0:17:38 > 0:17:43- I'm a bit of an obsessive-compulsive paranoid person, I would say!- Really?

0:17:43 > 0:17:45It makes you good at your job.

0:17:45 > 0:17:48Do you think that you acquire that sort of mentality

0:17:48 > 0:17:50once you come here and work for while?

0:17:50 > 0:17:52Do you think you come here with it?

0:17:52 > 0:17:54I think you make a good embryologist

0:17:54 > 0:17:56if you have a little bit of it inside of you anyway.

0:17:56 > 0:18:01I think it breeds it a little more inside of you. It makes you worse.

0:18:01 > 0:18:04I don't think that I have got those tendencies by working here,

0:18:04 > 0:18:07I think this place suits my natural tendencies,

0:18:07 > 0:18:12and I am, I'm a bit of a control freak, clean freak,

0:18:12 > 0:18:15all of those things in my whole life, never mind in here.

0:18:15 > 0:18:19I can't think of any other business anywhere where the consequences could be so great.

0:18:19 > 0:18:22- For that detail.- Exactly. You are expected...

0:18:22 > 0:18:25it is one of the only jobs where you are expected to be absolutely

0:18:25 > 0:18:30100% perfect, and there is no room for human error whatsoever.

0:18:30 > 0:18:35Which... Is that an impossible situation? Maybe it is. Exactly.

0:18:35 > 0:18:37Cos we are all human, after all.

0:18:37 > 0:18:42But you have to be perfect, or as close to perfection, as we are!

0:18:42 > 0:18:45Really? So it's gone so far so good?

0:18:52 > 0:18:54After my first week at the centre,

0:18:54 > 0:18:59I'd got a sense of just how normal fertility treatment has become.

0:18:59 > 0:19:02But I was intrigued to learn that despite all of the very

0:19:02 > 0:19:06expensive high-tech science, Charles's advice to many couples

0:19:06 > 0:19:09is simply to try getting back to basics.

0:19:10 > 0:19:15OK. Say seven million years ago, this couple, the only two

0:19:15 > 0:19:20people on the planet, and it's their job to populate the planet.

0:19:20 > 0:19:22- Like Adam and Eve? - Yeah. Like Adam and Eve.

0:19:22 > 0:19:26And they have got to compete with all of the other animals,

0:19:26 > 0:19:31with bloody hairy sabre-tooth tigers and mammoths and dinosaurs.

0:19:32 > 0:19:35Do they have... And they've got to survive, right?

0:19:35 > 0:19:39Do they have sexual intercourse quickly or slowly?

0:19:39 > 0:19:42DOCUMENTARIAN CHUCKLES

0:19:42 > 0:19:44Go on!

0:19:44 > 0:19:47I'd say they do it...quickly.

0:19:47 > 0:19:49- Why?- To get away from a predator. - Exactly!

0:19:49 > 0:19:52- Lying down or standing up? - Standing up.

0:19:52 > 0:19:57Should the male be relaxed or anxious?

0:19:57 > 0:19:59- I think he should be anxious. - Should be anxious?- Yes.

0:19:59 > 0:20:00Of course you'll be anxious.

0:20:00 > 0:20:05So what I say to patients, imitate the jungle. Just go for it.

0:20:05 > 0:20:08Wham, bam, thank you, ma'am. And they say, what will we do?

0:20:08 > 0:20:10Well, next time you are around at your mother-in-law's,

0:20:10 > 0:20:13sit there at Sunday lunch, when you're ovulating,

0:20:13 > 0:20:18and say to your husband, "I'm ovulating.

0:20:18 > 0:20:22"We've got to have to have sexual intercourse in this house before we go home,

0:20:22 > 0:20:25"and by the way, I'm not wearing any knickers!"

0:20:25 > 0:20:29And I guarantee you, he will have the best sperm count ever!

0:20:30 > 0:20:34Difficulties with fertility don't just lie with the woman.

0:20:34 > 0:20:36The man is part of the equation.

0:20:36 > 0:20:39And in particular, the quality of his sperm

0:20:39 > 0:20:41can be the root of the problem.

0:20:41 > 0:20:43Lock the door behind you.

0:20:43 > 0:20:47And the Hewitt Fertility Centre has a whole department dedicated

0:20:47 > 0:20:48to the analysis of sperm.

0:20:48 > 0:20:53Oh, it's so sticky! Urrgh, it's on my glove!

0:20:53 > 0:20:57The andrology department gets all its samples from the masturbatoriums.

0:20:57 > 0:21:01Each one is connected to the laboratory by a special hatch.

0:21:01 > 0:21:05- ALARM BEEPS - So when the sample is placed in the hatch, the alarm goes,

0:21:05 > 0:21:08so we know it's there, and it's ready to take.

0:21:08 > 0:21:12And we just have a look, just check the details,

0:21:12 > 0:21:16and we'll sign for the sample, to say it's been received.

0:21:16 > 0:21:18Amanda is one of the andrologists.

0:21:19 > 0:21:23The best sperm moves around fast, with a sense of purpose.

0:21:23 > 0:21:26These healthy sperm are described as motile.

0:21:26 > 0:21:31This sample is in a raw state. It is quite unprepared.

0:21:31 > 0:21:36So before we use this for any sort of treatment,

0:21:36 > 0:21:42a lot of the non-motile sperm will be washed out of the sample

0:21:42 > 0:21:44in the preparation process.

0:21:44 > 0:21:48This sample is actually concentrated down, so the sample that we use

0:21:48 > 0:21:52has a lot more of these motile, freely-swimming sperm.

0:21:53 > 0:21:55Hello?

0:21:55 > 0:21:59When Charles needs to speak to a man about the quality of his sperm,

0:21:59 > 0:22:01he tries to get onto the man's level.

0:22:01 > 0:22:05I'll say, "Do you follow football?", and they will say, "Yes."

0:22:05 > 0:22:09I'll say, "Your sperm is Fulham. Your sperm is Wigan."

0:22:09 > 0:22:11And they'll say, "What does that mean?"

0:22:11 > 0:22:14And I will say, "You'll probably stay up this year,

0:22:14 > 0:22:16"but it will be a tough fight!"

0:22:16 > 0:22:19Rarely are they Manchester United or Manchester city.

0:22:19 > 0:22:23Most of us are Stoke or West Brom,

0:22:23 > 0:22:26although West Brom are doing particularly well this year,

0:22:26 > 0:22:29and some unfortunately might be Southampton.

0:22:29 > 0:22:33In the andrology lab, there is also hope for infertile men,

0:22:33 > 0:22:37in the form of sperm donors, like 21-year-old Nathan.

0:22:38 > 0:22:42Donors like Nathan can also help same-sex couples

0:22:42 > 0:22:44or single women who want a baby.

0:22:44 > 0:22:48But the Hewitt Centre has a shortage of donors.

0:22:48 > 0:22:50I have a stepfather who now acts as my father.

0:22:51 > 0:22:54And I love him more for that,

0:22:54 > 0:22:57because I know he's chosen to be my father,

0:22:57 > 0:23:00and so I think I have a unique perspective.

0:23:00 > 0:23:02It helps me do this.

0:23:02 > 0:23:05It helps me think that there's going to be someone else out there

0:23:05 > 0:23:07that has chosen to be a dad.

0:23:07 > 0:23:08That's quite a small sample?

0:23:08 > 0:23:12No, actually 2ml is about the regular volume.

0:23:12 > 0:23:13That's bang on the dot.

0:23:15 > 0:23:18That's a question we get asked quite often.

0:23:18 > 0:23:22Can you do it on that? Is there enough in there? Yes.

0:23:22 > 0:23:27How often do you... into a pot and measure it?!

0:23:27 > 0:23:30So people assume that there is a lot more of it than there is.

0:23:30 > 0:23:35- Is not as if they could do anything about it if they wanted, anyway? - No. Probably not.

0:23:35 > 0:23:39'Nathan's sample is ready for analysis.'

0:23:39 > 0:23:43It's a lovely sample. There's some good morphology in the sperm.

0:23:43 > 0:23:44They're swimming really well.

0:23:44 > 0:23:49The concentration's quite nice as well. That's some nice sperm.

0:23:49 > 0:23:52There's no denying it. If you are a man and you've had a test done on your sperm,

0:23:52 > 0:23:55there'd be an extra spring in your step, wouldn't there,

0:23:55 > 0:23:57if you found out that you had very good sperm?

0:23:57 > 0:23:59Definitely. Men try to hide...

0:23:59 > 0:24:04they always want to be the stalwart in the relationship,

0:24:04 > 0:24:08and to lend the...

0:24:08 > 0:24:11you know, the arm of comfort to their female mate.

0:24:11 > 0:24:15I've seen men absolutely break down in tears,

0:24:15 > 0:24:19and the woman be the stronger of the two.

0:24:19 > 0:24:21That's rare. It's usually the other way round.

0:24:21 > 0:24:27But even though men are stalwarts, stoical, stiff upper lip,

0:24:27 > 0:24:31when I tell them that they've got good sperm,

0:24:31 > 0:24:36there is definitely a sort of an aura comes about them,

0:24:36 > 0:24:39one of, sort of...well-being.

0:24:50 > 0:24:54- So those are risks that you do need to be aware of.- Yeah.

0:24:54 > 0:24:56And obviously as you're going through your treatment,

0:24:56 > 0:24:59- we will talk you through all this again.- OK.

0:25:00 > 0:25:04When a couple begin the process of fertility treatment,

0:25:04 > 0:25:08the first thing they need to do is have a meeting with Sister Diane Ford,

0:25:08 > 0:25:12where she interrogates them about their lifestyle.

0:25:12 > 0:25:16In this case, it's Kerri and Mike Fraser.

0:25:16 > 0:25:18- Do you smoke at all?- No.

0:25:18 > 0:25:21- What about alcohol?- Occasionally.

0:25:21 > 0:25:24Would you say each day you have a drink? Or just a couple?

0:25:24 > 0:25:28- No, because I stopped. I've cut down. I've been good.- OK.

0:25:28 > 0:25:30- Drink alcohol?- Yeah. - How much would you say?

0:25:32 > 0:25:35About ten pints a week, something like that.

0:25:35 > 0:25:39- No, you don't! Ten pints a week?! - At the weekend...

0:25:41 > 0:25:44- So you'd say about ten? - About ten.

0:25:44 > 0:25:47I would advise that you do reduce that, because alcohol

0:25:47 > 0:25:49can affect both the quality of eggs and the quality of sperm.

0:25:49 > 0:25:51- Yes.- OK.

0:25:51 > 0:25:54'These two are in their early 30s.

0:25:54 > 0:25:56'They've been trying for a baby for three years.

0:25:56 > 0:25:59'This is their first cycle of IVF treatment.'

0:25:59 > 0:26:05- Because what we want is for you to go home with one healthy single baby.- Yes.

0:26:05 > 0:26:08But we cannot guarantee fertilisation,

0:26:08 > 0:26:12and we cannot guarantee pregnancy.

0:26:12 > 0:26:15- Are you clear?- Yes. I'm so excited.

0:26:15 > 0:26:21I'm happy with everything you said. Ready to get going now.

0:26:21 > 0:26:22Well, good luck. Take care,

0:26:22 > 0:26:25don't forget, any queries, just give us a ring.

0:26:25 > 0:26:28- Brilliant.- All right? - Thanks very much.- No problem.

0:26:33 > 0:26:34- Bye!- Bye!

0:26:34 > 0:26:37- All right, then, see you later. - OK, see you. Bye.

0:26:37 > 0:26:40'I arrange to meet up with Kerri and Mike in a few weeks' time,

0:26:40 > 0:26:43'when they return for the next stage of their treatment.

0:26:47 > 0:26:51'So far in my time in the Hewitt Centre, I had noticed that patients

0:26:51 > 0:26:54'might have different reasons why they can't get pregnant,

0:26:54 > 0:26:59'but they all share a deep-seated biological desire to have a baby.

0:26:59 > 0:27:05'But one person stands out in demonstrating just how deep this desire runs.'

0:27:05 > 0:27:07My name is Hannah. I'm one of the embryologists.

0:27:07 > 0:27:10And I've just come to speak to you before your egg collection.

0:27:10 > 0:27:11'Anne-Marie Brotherstone.

0:27:11 > 0:27:15'She is 31, but has had two heart attacks in her short life.'

0:27:15 > 0:27:18Just before you go home, we'll see how many eggs have been collected.

0:27:18 > 0:27:20'Because of this untreatable heart condition,

0:27:20 > 0:27:23'a pregnancy could put her life at risk.

0:27:23 > 0:27:25'But even so, she wants a child so much,

0:27:25 > 0:27:28'she is prepared to go against the advice of doctors.'

0:27:28 > 0:27:31Have you got any questions you'd like to ask us?

0:27:31 > 0:27:34My mind's gone blank! No, I don't think so.

0:27:34 > 0:27:38Anne-Marie does have significant medical issues.

0:27:38 > 0:27:42She has this cardiomyopathy, which people thought was serious enough

0:27:42 > 0:27:48for her to be sterilised a number of years ago, and of course, obstetrics

0:27:48 > 0:27:52changes and new technological advances, but nevertheless,

0:27:52 > 0:27:56her pregnancy, if she were to get pregnant, would still be risky.

0:27:56 > 0:27:58Do you feel very nervous?

0:27:58 > 0:27:59Yeah.

0:27:59 > 0:28:01Very nervous.

0:28:01 > 0:28:05You've been waiting a long time, haven't you, for this?

0:28:05 > 0:28:07Yeah.

0:28:09 > 0:28:13Are you nervous about your health, or the eggs?

0:28:13 > 0:28:16The eggs. Not my health!

0:28:16 > 0:28:19- Really?- She's always been like that.

0:28:20 > 0:28:24Have the doctors expressed to you the risks associated with it?

0:28:24 > 0:28:26Yeah, yeah.

0:28:26 > 0:28:30Just the risk to Anne-Marie, it's the risk...

0:28:30 > 0:28:34there's a chance the baby might have the same heart condition as well.

0:28:34 > 0:28:39We were told that. But, I mean, we still think it's worth it, don't we?

0:28:39 > 0:28:45Yeah. I think the way we look at it is we don't want to get 40, 45,

0:28:45 > 0:28:47and have any regrets and look back

0:28:47 > 0:28:52and think we never done everything we possibly could, isn't it?

0:28:52 > 0:28:59If it doesn't work out, at least we can say we did try everything.

0:29:01 > 0:29:03And hopefully not have any regrets.

0:29:07 > 0:29:10Today, her eggs are being collected.

0:29:10 > 0:29:13But due to the risks, the procedure is being carried out

0:29:13 > 0:29:17in a full operating theatre, and we aren't allowed to film.

0:29:21 > 0:29:24The drained fluid from Anne-Marie's follicles is rushed

0:29:24 > 0:29:28back into the embryology lab, where the search begins to find her eggs.

0:29:30 > 0:29:33There are 21 test tubes of follicular fluid.

0:29:33 > 0:29:36Hannah is already halfway through them.

0:29:43 > 0:29:45Still no eggs so far.

0:29:56 > 0:29:58Egg number one.

0:29:59 > 0:30:02- We've got our first egg? - Yeah. Really happy!

0:30:02 > 0:30:06Because there was... I didn't expect there to be eggs in every single one,

0:30:06 > 0:30:09but obviously, you do get a bit scared as you go through them,

0:30:09 > 0:30:11and you haven't seen a single one.

0:30:11 > 0:30:15But that egg looks really nice, so hopefully we will get a few more now.

0:30:16 > 0:30:20She continues to search through the remaining test tubes.

0:30:20 > 0:30:22The more eggs produced,

0:30:22 > 0:30:25the better the chance of creating a viable embryo.

0:30:27 > 0:30:29Last tube.

0:30:36 > 0:30:38No.

0:30:38 > 0:30:40One it is.

0:30:40 > 0:30:42Although she found one egg,

0:30:42 > 0:30:46Hannah is concerned it may not be mature enough to fertilise.

0:30:46 > 0:30:51If the egg doesn't fertilise, then that's the end of the line, but...

0:30:53 > 0:30:55We have one, and it does look nice.

0:30:55 > 0:30:57The procedure itself went well.

0:30:57 > 0:31:01The lining of the womb... I know that they scanned you previously...

0:31:01 > 0:31:07Anne-Marie Brotherstone's procedure was carried out by Dr Lucy Coyne.

0:31:07 > 0:31:11When we gave you the injections to help to stimulate the ovaries,

0:31:11 > 0:31:13in the hope of producing eggs,

0:31:13 > 0:31:17Your response wasn't as good as we might have hoped for,

0:31:17 > 0:31:23so I think the fact that we've got an egg today is good news, really.

0:31:23 > 0:31:26The difficulty is obviously, if we create a nice embryo,

0:31:26 > 0:31:28we will have to freeze it,

0:31:28 > 0:31:32because of the fact the lining of the womb hasn't thickened up as we hoped it might have done.

0:31:32 > 0:31:35- Right.- If you think of anything before we go, just let us know.

0:31:35 > 0:31:38- Yeah, OK.- Thanks very much.

0:31:38 > 0:31:41That was quite a difficult moment for Dr Coyne,

0:31:41 > 0:31:43because she's actually pregnant.

0:31:43 > 0:31:47Before I was pregnant, I did actually wear normal clothes for clinics and things like that.

0:31:47 > 0:31:49I started wearing scrubs quite early on,

0:31:49 > 0:31:52to try and hide the fact I was pregnant for as long as I could,

0:31:52 > 0:31:55- cos I found that a little bit awkward.- Did you?

0:31:55 > 0:31:57- With the patients?- Yeah.

0:31:57 > 0:32:00I'd rather not be pregnant in this environment,

0:32:00 > 0:32:03unless I get to the stage I'm at now,

0:32:03 > 0:32:06where the last patient has seen me has just said,

0:32:06 > 0:32:09"Pass on your good vibes," cos she could tell I was pregnant.

0:32:13 > 0:32:16'One egg was enough for Anne-Marie Brotherstone.'

0:32:17 > 0:32:20Really good news, cos the embryo's fertilised!

0:32:20 > 0:32:23So it carried on maturing, then?

0:32:23 > 0:32:25Yeah, it carried on maturing last night,

0:32:25 > 0:32:29so it was injected a couple of hours late and it has fertilised.

0:32:29 > 0:32:34'Embryologist Hannah successfully got Anne-Marie's egg to fertilise.

0:32:35 > 0:32:38'But as an embryo, it needs to be frozen for a few weeks

0:32:38 > 0:32:41'until the lining of her womb is ready.'

0:32:41 > 0:32:45- Hello?- 'Hi, is that Michael Brotherstone?'- Yeah, it is, yeah.

0:32:45 > 0:32:48- 'Well, I've got brilliant news for you guys.'- Thank God.

0:32:48 > 0:32:52'The egg you have collected was mature, and it has fertilised.'

0:32:52 > 0:32:56- Oh, brilliant. Absolutely fantastic. - 'OK?'- Thank you!

0:33:03 > 0:33:06- Lisa Henney?- Yes, thanks.

0:33:08 > 0:33:11It's nearly a week since Lisa Henney had her eggs collected,

0:33:11 > 0:33:14and five of them have fertilised into embryos.

0:33:14 > 0:33:19Today, one of those embryos will be transferred to her womb.

0:33:19 > 0:33:22This is a key moment in their fertility journey,

0:33:22 > 0:33:25but it's also a critical moment for the staff,

0:33:25 > 0:33:27after weeks of careful treatment.

0:33:27 > 0:33:30It is a culmination of the embryologists' work,

0:33:30 > 0:33:32it's a culmination of the doctors and nurses' work,

0:33:32 > 0:33:35and it's also that crunch time for the patient.

0:33:35 > 0:33:39Patients' awareness throughout infertility is high,

0:33:39 > 0:33:44but at the embryo transfer moment, it's really, really quite electric.

0:33:44 > 0:33:46OK, so we'll leave you to get changed.

0:33:46 > 0:33:49'Hilary will be carrying out the transfer.'

0:33:49 > 0:33:51I'll come back. All right?

0:33:51 > 0:33:54- Do you like doing the embryo transfers?- Yeah, very much.

0:33:54 > 0:33:59- Is that a good job?- Yes, it is a very good job. I really like it.

0:33:59 > 0:34:01Yeah.

0:34:01 > 0:34:03It's always a bit...

0:34:05 > 0:34:08..it always fills your stomach with trepidation,

0:34:08 > 0:34:10because it is something that's really important,

0:34:10 > 0:34:12so it is scary to some degree,

0:34:12 > 0:34:15but I think it's always good to be like that,

0:34:15 > 0:34:19- because it is good to respect what you're doing, and not be blase.- No.

0:34:21 > 0:34:24- It's a key moment in their lives. - It is.

0:34:24 > 0:34:26Never to be taken lightly.

0:34:34 > 0:34:37But first, in the lab,

0:34:37 > 0:34:40Amy must decide which is the best of the five embryos.

0:34:44 > 0:34:48So, that one is looking all right.

0:34:48 > 0:34:52The cells are differentiating, that's probably what's going to become the inner cell mass,

0:34:52 > 0:34:55which is what becomes the baby.

0:34:55 > 0:34:59This one, you can see the difference between this one and the last one.

0:34:59 > 0:35:02Dark cells there, where it's maybe deteriorating a bit.

0:35:04 > 0:35:07OK. Cluster of cells in the middle.

0:35:07 > 0:35:12Big undifferentiated one there, couple there, and it's quite dark,

0:35:12 > 0:35:16so four out of her five embryos

0:35:16 > 0:35:20haven't managed to continue through the culture.

0:35:20 > 0:35:23They've started deteriorating.

0:35:23 > 0:35:25But that first one is looking good.

0:35:25 > 0:35:27That will definitely be the one that I transfer.

0:35:27 > 0:35:30On this occasion, it's a clear-cut decision,

0:35:30 > 0:35:33but it still carries massive responsibility.

0:35:33 > 0:35:36In the patient's eyes, they're all their babies.

0:35:36 > 0:35:38All the embryos are their babies.

0:35:38 > 0:35:41And they have to stand to one side and watch

0:35:41 > 0:35:44while we do all the choosing,

0:35:44 > 0:35:48and while we have them all in the lab away from their bodies.

0:35:48 > 0:35:51So the responsibility is immense, with all of it,

0:35:51 > 0:35:54not just with the choosing of the embryos.

0:35:54 > 0:35:56Especially, with the choosing of the embryos,

0:35:56 > 0:36:01it's a high responsibility, but it is all very intense.

0:36:01 > 0:36:04Still can't believe we're here.

0:36:04 > 0:36:06That's scary.

0:36:06 > 0:36:09Do you think of it as a little person?

0:36:09 > 0:36:11Um...yeah.

0:36:11 > 0:36:15If it all works out, do you think we could keep the dish it was made in?!

0:36:17 > 0:36:20As a little souvenir? Imagine that, though.

0:36:20 > 0:36:24- There's your dish you were made in! - Aye, it would be good, that.

0:36:24 > 0:36:27- Would you like to do that? Keep the Petri dish?- Yeah!

0:36:27 > 0:36:31Yeah, you would, wouldn't you? you'd wear it round your neck on a chain.

0:36:31 > 0:36:35- Put some nuts in it! - When people come round!

0:36:36 > 0:36:39"My sperm was in that dish!"

0:36:41 > 0:36:44So, I've decided that I'm going to transfer that one in 05.

0:36:49 > 0:36:51I'm going to double-check everything,

0:36:51 > 0:36:54so I'm checking that there's definitely one in there for transfer.

0:36:54 > 0:36:58Then it needs to go back in the incubator until it's transferred.

0:37:00 > 0:37:03- Hi!- Hi, I'm Amy. We've met before.

0:37:03 > 0:37:05- Yes, we have.- In the last cycle.

0:37:05 > 0:37:10So out of your five embryos, one of them is actually really nice,

0:37:10 > 0:37:13it looks like it's doing everything spot-on.

0:37:13 > 0:37:17- OK. Happy?- Yeah. - It's weird, isn't it?

0:37:19 > 0:37:21- SHE SOBS - Sorry!

0:37:21 > 0:37:25You don't need to get upset, kid. Eh? It's fine.

0:37:25 > 0:37:30- It's a good thing. Isn't it? - They're happy tears?

0:37:30 > 0:37:33- Yeah, thank you. - Good. You're very welcome.

0:37:33 > 0:37:34You changed your mind?!

0:37:34 > 0:37:37THEY LAUGH

0:37:38 > 0:37:39- You OK?- Yeah.

0:37:39 > 0:37:41I'm going to give the nurses a call.

0:37:41 > 0:37:44- I'll be back in a couple of minutes. - OK, thank you.

0:37:47 > 0:37:48You can look into it loads.

0:37:48 > 0:37:51It's amazing how you try and put all of your emotions away,

0:37:51 > 0:37:55and deal with it, and think you're really strong, and...

0:37:58 > 0:38:02You build up a rapport with some patients, and you don't with others,

0:38:02 > 0:38:05so certainly if you've seen them all the way through,

0:38:05 > 0:38:09so you've seen them at egg collection and you've seen them at transfer,

0:38:09 > 0:38:12and you've spoken to them on the phone, and you've tracked

0:38:12 > 0:38:15the progress of the embryos, then yeah, I think you do get attached.

0:38:15 > 0:38:18And especially when it's a good...

0:38:18 > 0:38:21probably the extremes of the scale, when it's extremely good

0:38:21 > 0:38:25and when it's extremely bad, you feel strong emotions for them.

0:38:27 > 0:38:28Point your knees.

0:38:28 > 0:38:31I know it goes against the grain, but point your knees out.

0:38:31 > 0:38:33So now I need to get you into position, please.

0:38:33 > 0:38:37- So I'm not just staring underneath. - It's all right.

0:38:38 > 0:38:41Thanks for that!

0:38:42 > 0:38:46Can you go back a little bit, please? About an inch.

0:38:46 > 0:38:49That's grand. I think a little bit more.

0:38:49 > 0:38:52OK? And now come into the middle a little bit.

0:38:52 > 0:38:55A bit like the Golden Shot. Did you ever watch the Golden Shot years ago?

0:38:55 > 0:38:59- I think you'd probably be too young! - The Golden what?

0:38:59 > 0:39:03The Golden shot, and it would be up a bit, down a bit. Bernie the Bolt!

0:39:04 > 0:39:07- I remember that. What was the bit? - Yeah, you would!

0:39:09 > 0:39:11What did you get if you hit it?

0:39:11 > 0:39:17You'd get a prize, or you would go on to the next round.

0:39:17 > 0:39:19A lot of cash came out, didn't it?

0:39:19 > 0:39:23Oh, yes, I remember now, yeah! I remember that!

0:39:23 > 0:39:28That's right. I was, gosh... I just remember Bernie the Bolt.

0:39:29 > 0:39:33- Would you like to see your embryo? - Yeah.

0:39:33 > 0:39:36OK, so if you just want to look up at the screen for me,

0:39:36 > 0:39:38I can show you both the embryos.

0:39:38 > 0:39:40OK. So there's your embryos there.

0:39:40 > 0:39:43Doing everything they should for today. Well done.

0:39:43 > 0:39:46- GARETH: Where's it going? - Camera shy!

0:39:48 > 0:39:52HANNAH: So that mass of cells at the top, that's the inner cell mass.

0:39:52 > 0:39:55- GARETH: Ah!- Gosh!

0:40:03 > 0:40:05You'll feel a little bit of pressure as I open up

0:40:05 > 0:40:07and look at the neck of the womb. OK?

0:40:18 > 0:40:20- You all right now?- Yeah, I'm fine.

0:40:20 > 0:40:22- Is it hurting you?- I'm OK.

0:40:36 > 0:40:40- I'm putting your embryo back now. Good luck to you both.- Thank you.

0:40:45 > 0:40:46HANNAH: Thank you.

0:40:46 > 0:40:48I'm just going to check now

0:40:48 > 0:40:50and make sure the embryo has left the catheter, OK?

0:40:53 > 0:40:56- Yeah, that's lovely and clear. The embryo's in.- Fantastic.

0:40:56 > 0:40:59- All the best, guys. - Thank you very much. Thank you.

0:41:04 > 0:41:07- Have you performed lots of those, Hilary?- Yes. Yes.

0:41:07 > 0:41:09GARETH: First one today!

0:41:09 > 0:41:13It's a funny one though, because sometimes when I'm doing embryo transfers,

0:41:13 > 0:41:16I think, I'd just love to sing at this present time.

0:41:16 > 0:41:18I don't know. I usually...

0:41:19 > 0:41:21it usually does comes in a feeling.

0:41:21 > 0:41:23I'd love to sing.

0:41:23 > 0:41:27And I really think that most people would find that very inappropriate

0:41:27 > 0:41:29if you just burst out singing!

0:41:29 > 0:41:31They'd go... what on earth!

0:41:31 > 0:41:35While you're down there between the women's legs?

0:41:35 > 0:41:37Yes.

0:41:37 > 0:41:41Yeah. Because it's a lovely thing, isn't it,

0:41:41 > 0:41:44putting someone's embryos in you. It's a lovely thing.

0:41:44 > 0:41:46If you'd like to look at the monitor,

0:41:46 > 0:41:49- I'll just show you your embryo now. - It's dying to get to me!

0:41:51 > 0:41:54Now it's the turn of Deborah Dickin,

0:41:54 > 0:41:56whose husband Matt had a low sperm count.

0:41:58 > 0:42:00- Who are you?- Deborah Dickin.

0:42:00 > 0:42:02Very good. You haven't been placed...

0:42:15 > 0:42:18Becky's just going to check that the embryos have gone.

0:42:18 > 0:42:21- That's fine, it's in. - That's it. It's all over.

0:42:23 > 0:42:26- Good luck, guys. - Thank you very much.

0:42:28 > 0:42:31- OK, then, all the very best. - Thank you.- Cheers.

0:42:33 > 0:42:37- I wish you the best of luck with it. - Thank you very much, Richard.

0:42:37 > 0:42:41- Time will tell, now! - Yes, time will tell.

0:42:41 > 0:42:45'On average, couples who go through fertility treatment

0:42:45 > 0:42:48'have a 30 to 40% chance of success.'

0:42:48 > 0:42:51I've seen it in patients' eyes when they come and see you,

0:42:51 > 0:42:55not overstating it, to see you as someone who performs miracles.

0:42:55 > 0:42:57No, well...

0:42:58 > 0:43:05Technically, in vitro fertilisation

0:43:05 > 0:43:07is a routine procedure.

0:43:07 > 0:43:11It's how we manage the patients which is the difficult thing.

0:43:11 > 0:43:14The laboratory bit often is the easy bit.

0:43:14 > 0:43:18It's how we manage the patient's expectations.

0:43:18 > 0:43:20Our contract to the patient is to say,

0:43:20 > 0:43:25"Well, we can't guarantee you babies, but we'll do our very best,"

0:43:25 > 0:43:28so that we try and avoid the scenario

0:43:28 > 0:43:36that I think is the one we should all be striving to avoid,

0:43:36 > 0:43:39and that is the patient who hasn't got any children,

0:43:39 > 0:43:42but is left in the situation where she says, or he says,

0:43:42 > 0:43:47"If only. If only I'd had the funding to have this treatment.

0:43:47 > 0:43:49"If only we should have done that."

0:43:49 > 0:43:51And that is what we've got to try and avoid.

0:43:51 > 0:43:55And that's what we try and do here.

0:44:04 > 0:44:07Ten days have passed, and it's time for the Henneys

0:44:07 > 0:44:11and the Dickins to take their home pregnancy tests.

0:44:11 > 0:44:15For Gareth and Lisa, it's not good news.

0:44:15 > 0:44:17I don't know what to think, what to do next,

0:44:17 > 0:44:19so I don't think I want to do IVF again.

0:44:20 > 0:44:24But you said that, didn't you? But...it's early, isn't it?

0:44:24 > 0:44:30- We're going to relax, aren't we, and take things...- Yeah. 38 this month.

0:44:30 > 0:44:32- Are you?- Yeah!

0:44:34 > 0:44:36You know I am.

0:44:36 > 0:44:43- So we'll make other plans now, and get over it.- We've got a good life.

0:44:43 > 0:44:46No. We've got lots of pets, as you can see!

0:44:46 > 0:44:49But no, we'll be OK.

0:44:49 > 0:44:51I think my mum and dad have avoided me this week,

0:44:51 > 0:44:54because I think they're stressed and upset, aren't they?

0:44:54 > 0:44:58- Do you feel disappointed for them? - Yeah, I do.

0:44:58 > 0:45:03Because all they do is say what great parents we'll make, don't they?

0:45:03 > 0:45:06We've got so many lovely kids in the family, haven't we?

0:45:06 > 0:45:09Our nephews are just... They're all so lovely.

0:45:09 > 0:45:12Our time will come. I promise you.

0:45:12 > 0:45:15All the kids are great.

0:45:15 > 0:45:17They all love us to bits, don't they?

0:45:17 > 0:45:21We've got good people around us. Everywhere we go, it's good people.

0:45:21 > 0:45:26Yeah. We're so lucky. We've got lots of lovely people in our lives.

0:45:26 > 0:45:28We have. Mm-hmm.

0:45:30 > 0:45:32So we said we'd get a pram for the cat!

0:45:35 > 0:45:39At Deborah and Matt's home, it's also sad news.

0:45:45 > 0:45:49It's hard for me, because I feel like I might never be a mum.

0:45:52 > 0:45:55I just want to have our own flesh and blood.

0:46:00 > 0:46:03- Hard to deal with.- Hmm. It is.

0:46:03 > 0:46:09When you have the embryo transfer, you see the egg, the embryo,

0:46:09 > 0:46:10you fertilise that.

0:46:10 > 0:46:14It's still me and Matthew, it's still been fertilised,

0:46:14 > 0:46:17and you think, well...

0:46:17 > 0:46:19- You're creating a life, here. - Yeah, you're creating a life,

0:46:19 > 0:46:23and then you feel like it has been pulled from under you.

0:46:23 > 0:46:26- Nature's way, I suppose. - Cruel way.- Yeah.

0:46:26 > 0:46:30- A very cruel way, sometimes.- But...

0:46:30 > 0:46:33I just want to have our own flesh and blood.

0:46:33 > 0:46:36Something that we've produced,

0:46:36 > 0:46:39and we can bring up our way.

0:46:42 > 0:46:44- And we will.- We will. We will.

0:46:44 > 0:46:48We've still got to be positive, because we've still got another go.

0:46:49 > 0:46:54- And it's just a waiting game again now.- Yeah.

0:46:59 > 0:47:04It's very difficult not to take it personally, but of course, sometimes

0:47:04 > 0:47:08you have to try and distance yourself from those sort of emotions,

0:47:08 > 0:47:13because it can be quite detrimental

0:47:13 > 0:47:17to your own health and well-being.

0:47:19 > 0:47:20Isn't it?

0:47:20 > 0:47:22I came in halfway through that!

0:47:22 > 0:47:25- Stress.- Oh, yes. Yes.

0:47:25 > 0:47:28Upset. Disappointed.

0:47:28 > 0:47:31Probably the same sort of feelings that they were feeling,

0:47:31 > 0:47:33but not to the same extent. Because it's their treatment.

0:47:33 > 0:47:35But we do that with all the patients.

0:47:35 > 0:47:38You feel elation when someone gets pregnant,

0:47:38 > 0:47:40and you feel disappointment when they don't.

0:47:40 > 0:47:42Because our job is to get them pregnant,

0:47:42 > 0:47:44and if we haven't done that for them,

0:47:44 > 0:47:46then in our eyes, we've...failed, really.

0:47:46 > 0:47:51But also, talking about being happy or being sad, then these have

0:47:51 > 0:47:55got to be fleeting emotions for us, because we see so many people.

0:47:55 > 0:47:57If you got too attached...

0:47:57 > 0:48:01and too emotionally involved with all of them, you would be...

0:48:01 > 0:48:05- an emotional wreck coming to work! You'd be crying all the time!- Yeah.

0:48:05 > 0:48:07And that hardness comes with time.

0:48:07 > 0:48:11Because when I started here, I found everything really difficult,

0:48:11 > 0:48:13and everything was like, why isn't it working? And...

0:48:13 > 0:48:18But now, like Hannah says, you just have to feel the emotions,

0:48:18 > 0:48:21but you do have to remember what you're doing, and why you're here,

0:48:21 > 0:48:23and the other patients matter as well.

0:48:26 > 0:48:27Anne-Marie Brotherstone?

0:48:31 > 0:48:36'All the patients I had met at the Hewitt Fertility Centre are desperate to have a baby,

0:48:36 > 0:48:39'but none more so than Anne-Marie Brotherstone,

0:48:39 > 0:48:41'who has a rare heart condition.'

0:48:41 > 0:48:44- All right?- Hmm.

0:48:44 > 0:48:46- Nearly there.- Yeah.

0:48:46 > 0:48:48'She had just one egg.

0:48:48 > 0:48:51'It fertilised, but the embryo had to be frozen

0:48:51 > 0:48:53'because her womb wasn't ready.

0:48:53 > 0:48:56'Now, two months later, she is back to have the embryo transferred.

0:48:58 > 0:49:02'The procedure is going to be performed by Jill.'

0:49:02 > 0:49:04You've not got children, have you?

0:49:04 > 0:49:07- No. Got a cat! - You've got a cat?- Yes.

0:49:07 > 0:49:10How do you find working in this environment with people

0:49:10 > 0:49:12who are all on the search for children?

0:49:15 > 0:49:17It's a difficult one to answer really.

0:49:17 > 0:49:19I've never wanted children.

0:49:19 > 0:49:22There was never that deep yearning to have them.

0:49:22 > 0:49:26Yeah, but you might have thought, "I'm different to most women."

0:49:26 > 0:49:28No! I'm not!

0:49:29 > 0:49:32Well, are you not different to most women?

0:49:32 > 0:49:36- I might be different and special! - Yeah, I'm sorry!

0:49:36 > 0:49:39- It's all right. It's fine. - I did not mean to sound like...

0:49:39 > 0:49:43I know, and to be fair, I haven't actually faced a lot of

0:49:43 > 0:49:47the kind of questions you'd expect, like, "Couldn't you have children?"

0:49:47 > 0:49:50There are quite a few of us who are not in that situation, now, are we?

0:49:50 > 0:49:51How many have you got?

0:49:51 > 0:49:54Three, and I've got a little granddaughter as well.

0:49:54 > 0:49:56So that's lovely.

0:49:56 > 0:49:59And hopefully I'll have some more grandchildren!

0:49:59 > 0:50:02No, I...

0:50:02 > 0:50:04always wanted children.

0:50:06 > 0:50:08I still have my career, and I love my job,

0:50:08 > 0:50:11and I always think I'm very lucky, because I've, you know,

0:50:11 > 0:50:18through the years of my nursing, I've seen some really sad scenarios.

0:50:22 > 0:50:25You all right, Michael? you can sit down if you want.

0:50:25 > 0:50:28Hannah is the embryologist who has been at every stage

0:50:28 > 0:50:30of the Brotherstones' journey.

0:50:30 > 0:50:34- And here's your embryo. Can you see that on the screen?- Yeah, perfect.

0:50:34 > 0:50:37That's magnified a few hundred times.

0:50:37 > 0:50:41The Brotherstones don't have any frozen embryos to fall back on.

0:50:41 > 0:50:46All their hopes are contained in this one catheter that Hannah carries.

0:50:49 > 0:50:51Thank you. Thanks.

0:50:58 > 0:51:02It's sad. It's sad when they've only got one, and to them,

0:51:02 > 0:51:03that's their potential child.

0:51:05 > 0:51:06That's sad.

0:51:09 > 0:51:12OK, Anne-Marie, the catheter's in place.

0:51:12 > 0:51:14Has that caused you any pains at all?

0:51:16 > 0:51:17No? Good.

0:51:22 > 0:51:25Thank you. OK.

0:51:25 > 0:51:27Now, Hannah's going to take the catheter and flush it,

0:51:27 > 0:51:30just to make sure the embryo has left, OK?

0:51:30 > 0:51:31HANNAH: That's fine. The embryo's in.

0:51:31 > 0:51:33OK. Can you pop your legs down now?

0:51:33 > 0:51:37HANNAH: Well done. Very best of luck. MICHAEL: Thank you.

0:51:40 > 0:51:44- Hello! Here we are again! How are you?- My mind's blank at the minute.

0:51:44 > 0:51:48- I'm just in shock, I think!- What, about the fact that it survived?

0:51:49 > 0:51:52- I've got this far!- We've got to keep our fingers crossed now.

0:51:52 > 0:51:57See what happens. OK. Well, you've got my mobile if you need me.

0:51:57 > 0:52:00- OK. All the very best. MICHAEL:- Thanks very much for your help.

0:52:00 > 0:52:02See you soon. Bye. Cheers.

0:52:06 > 0:52:09How much hope do you have for them?

0:52:09 > 0:52:10Well, I'm Scorpio.

0:52:10 > 0:52:15My cup is always half empty, so I'm a natural-born pessimist.

0:52:15 > 0:52:18Not a great deal. Not a great deal.

0:52:18 > 0:52:23She's got a lot of problems to face,

0:52:23 > 0:52:26with her cardiomyopathy as well.

0:52:27 > 0:52:30So I'd like to think...

0:52:30 > 0:52:34we've certainly given her a chance, but how things will turn out,

0:52:34 > 0:52:37we'll find out in the fullness of time.

0:52:37 > 0:52:41None of us would be here doing this if we didn't think it was going to work some of the time.

0:52:41 > 0:52:44And every cycle you start, it's with hope, isn't it?

0:52:44 > 0:52:48At least they can say, "I've done everything we can,"

0:52:48 > 0:52:52and what we have to say is, we've done everything we can,

0:52:52 > 0:52:57and certainly for the Brotherstones, on this particular cycle, we have.

0:52:57 > 0:52:59So it's out of our hands now.

0:53:00 > 0:53:02'In ten days' time,

0:53:02 > 0:53:06'the Brotherstones will carry out a home pregnancy test.'

0:53:06 > 0:53:08We'll say goodbye to you then.

0:53:08 > 0:53:11- We'll be in touch?- Yeah.- All right.

0:53:13 > 0:53:15I'll give you a text when we're coming back in.

0:53:15 > 0:53:19- If we do come back in.- Yeah. - All right then. Best of luck.

0:53:19 > 0:53:23- Thanks very much for that. Speak to you soon.- Speak to you soon.- Bye.

0:53:28 > 0:53:32'There is one other couple I had met at my time at the Hewitt Centre

0:53:32 > 0:53:34'who were desperate to have a baby.'

0:53:34 > 0:53:37Big cough. SHE COUGHS

0:53:37 > 0:53:39- Lovely. Are you guys ready?- Yeah.

0:53:39 > 0:53:43I'd first met Kerri and Mike Fraser a few weeks ago when they were

0:53:43 > 0:53:46being quizzed by a nurse over their alcohol consumption.

0:53:48 > 0:53:52Today, they too are back to have their embryo transferred.

0:53:52 > 0:53:55The embryo's here. We're ready to put it in.

0:53:55 > 0:53:57Here we go.

0:53:57 > 0:54:00- Have you read your white booklet of all your dos and don'ts?- Yes.

0:54:00 > 0:54:02Is there anything in that that doesn't make sense?

0:54:02 > 0:54:05I really like chorizo sausage. Am I still OK to eat it?

0:54:05 > 0:54:09- You really like what?! - Chorizo sausage! Am I OK to eat it?

0:54:09 > 0:54:11Cos it says about like Parma ham and all that.

0:54:11 > 0:54:14You know, I have never been asked that before! I don't know!

0:54:14 > 0:54:16I would imagine it's fine.

0:54:16 > 0:54:18Because I have it, like, twice a week!

0:54:24 > 0:54:30- All right, it's in. Good luck, guys. - Thank you.- Don't move your legs yet.

0:54:30 > 0:54:31I had to ask about the chorizo sausage,

0:54:31 > 0:54:33cos it's been playing on my mind!

0:54:33 > 0:54:36- It's been bugging you, that, hasn't it?- They said don't have it.

0:54:36 > 0:54:40- But I cook it, though, don't I?- I'm not risking it.- I'll have it then!

0:54:40 > 0:54:44My time was coming to an end at the Hewitt Fertility Centre.

0:54:44 > 0:54:47Good luck, love. With everything.

0:54:47 > 0:54:48Shortly before I leave,

0:54:48 > 0:54:53Dr Lucy Coyne has a buffet before she goes on maternity leave.

0:54:53 > 0:54:57I remember... Yeah, I remember...

0:54:57 > 0:54:59I remember the interview.

0:54:59 > 0:55:03The first question was, who would you like to dinner?

0:55:03 > 0:55:05Who would you invite to dinner?

0:55:05 > 0:55:08Anybody you could invite ever, living or dead.

0:55:08 > 0:55:13The previous guy said, I think I'd invite Wolfgang Amadeus Mozart,

0:55:13 > 0:55:17because he was a genius of the 19th century or whatever.

0:55:17 > 0:55:20So we asked the same to Dr Coyne, and I said,

0:55:20 > 0:55:25"Who would you invite you to your dinner party, anybody, living or dead."

0:55:25 > 0:55:28She said, "I'd like Simon Cowell!"

0:55:28 > 0:55:31- And she got the job?- That's my girl!

0:55:31 > 0:55:35LAUGHING AND CHEERING

0:55:40 > 0:55:44A few days later, I join Anne-Marie and Michael Brotherstone at home

0:55:44 > 0:55:46for their pregnancy test.

0:55:48 > 0:55:49All right?

0:55:59 > 0:56:03- You've got tissue all over your face.- I can't look at it.

0:56:03 > 0:56:06You're very good at offering Anne-Marie support, aren't you?

0:56:06 > 0:56:08You have to be. It's...

0:56:08 > 0:56:11There's not much we've been through really.

0:56:11 > 0:56:14The waiting, the appointments,

0:56:14 > 0:56:18we've both been quite upset times, haven't we?

0:56:18 > 0:56:21Just hard to take at the minute.

0:56:21 > 0:56:23- But we'll be all right, won't we? - Yeah.

0:56:37 > 0:56:41I had spent three months looking at the extraordinary work

0:56:41 > 0:56:45that goes on here, and I had seen it through the eyes of the staff.

0:56:45 > 0:56:49I had learned that by intervening, these scientists and doctors

0:56:49 > 0:56:52can profoundly change the course of people's lives.

0:56:52 > 0:56:54But at the same time,

0:56:54 > 0:56:58I had seen that nature ultimately will have its way.

0:56:58 > 0:56:59While at the Hewitt Centre,

0:56:59 > 0:57:03I had met couples who did not have positive outcomes.

0:57:03 > 0:57:06But I think Charles Kingsland and his team

0:57:06 > 0:57:09did give these unlucky patients something.

0:57:09 > 0:57:12He gave them hope.

0:57:12 > 0:57:17And in the case of Kerri and Mike Fraser...

0:57:17 > 0:57:18Even more.

0:57:18 > 0:57:20Yes! Yes!

0:57:24 > 0:57:26Oh, God!

0:57:27 > 0:57:29Oh, brilliant!

0:57:31 > 0:57:33SHE SOBS

0:58:05 > 0:58:09Subtitles by Red Bee Media Ltd