Baby Makers: The Fertility Clinic

What do we do when we want to procreate?

We put the candles on, the lights, get Engelbert Humperdinck

on the record player, and we have missionary sex lying down on the

silk sheets, and then the female puts her legs up in the air, puts a pillow

under her bottom, because one of the questions that she wants to ask me,

and never dares, is that, "Why is it that the sperm all dribbles out?"

Britain is in the grip of a fertility crisis.

Our lifestyle is affecting our chances of having babies.

Women are leaving it later to have children,

and men's sperm counts are falling.

That's quite a small sample.

Volume-wise, that's quite a regular amount.

Reproductive treatment is one of the fastest-growing

areas of medicine, with over 200,000 babies born in Britain to date.

Big cough.

WOMAN COUGHS

More and more desperate couples are seeking high-tech and sometimes

very expensive procedures to give them that elusive dream baby.

When you think you can't potentially have a family,

and then to have him, it's a little miracle!

But what's it like to work on the front line of fertility treatment?

You sound lovely!

How does it feel to be a scientist,

nurse or doctor involved in the very creation of a new life?

Of course it makes all of us anxious,

because it's an incredibly high-responsibility job.

Does anyone come closer to playing God?

This is Liverpool Women's Hospital.

It's home to the Hewitt Fertility Centre,

one of the largest and most modern fertility clinics in the country,

offering both NHS and private treatment.

I'm spending three months here to find out what it's like

to be one of the doctors or nurses who treat the patients.

Or the scientists who actually create life in the lab.

The clinic is run by Prof Charles Kingsland.

In his long career, Charles has helped conceive thousands of babies.

Your eggs are 40 years old.

Fertility treatment is still a source of great controversy

in this country, but Charles feels it should be available to everyone.

It's just a question of getting the right egg.

To have or not to have children is a lifestyle choice.

When you decide you want children but can't have them,

that is when the problem arises.

If you look at the definition of disease,

it is an abnormality of easiness.

And one thing you notice about men and women who want to have children,

and who can't have children, they are diseased.

And any disease is worthy of treatment,

and ideally, in this country, I believe diseases should be

treated free at the point of access within the National Health Service.

Charles believes fertility treatment is a human right,

and most people are allowed two free goes on the NHS.

But those fail, they will have to pay for the next treatment.

The first medication that you are going to start taking...

The whole process takes around two months.

It's geared towards creating as many eggs as possible by artificially

stimulating a woman's ovaries with drugs,

which she has to inject every day for five weeks.

Each one of those is one of your follicles...

The ovaries create lots of follicles,

each one hopefully containing an egg.

You are ready for planning egg collection.

At this point, the woman is booked in to have her eggs collected.

This morning, Prof Kingsland is about to start a daily round of egg collections.

-Morning.

-Good morning.

-Pleased to meet you.

His first patient is 38-year-old Deborah Dickin.

I've been awake since five.

-Worrying!

-Nervous.

-You won't feel a thing.

-This is the easy bit.

Once Deborah's eggs are collected, they will be introduced

to her husband's sperm, and if they fertilise, they will become embryos.

This procedure requires the patient be under general anaesthetic,

'and takes about ten minutes.

'On average, a woman produces around six eggs.'

These are any indication of what this lady might get out?

I'm hoping that she will get about three or four eggs today, so what

we do now is we put the needle through the vaginal skin

and then straight into the ovary,

missing all the vital organs that might get in the way.

So what I'm doing now is just having a quick scan around, looking at the end of my atrium,

and making sure there is nothing at the end of the ovary

and the follicle, and then just pop the needle straight in,

and you can actually see the needle

is right in the middle of the follicle.

Put my foot on the pump,

and the fluid is now dribbling into that test tube.

And then you can actually see that follicle shrinking away.

Deborah and her husband Matt have been trying for a baby for three years.

This is their first time trying IVF.

Having children is a biological drive.

It's like moving, growing, breathing, eating...

It's a drive, and if you have an inability to conceive,

all you think about all day long is babies.

Having babies, your inability.

The first thing in the morning, you think about it,

the last thing at night.

And then, of course, you get so stressed,

your mind starts playing tricks on you.

Why is it that every shop on the high Street is Mothercare?

Everybody is pushing a pram.

Why is it that every time I nip into a supermarket,

I always walk down the aisle with the nappies?

Of course, that's not true, but that's what you perceive.

And then somebody comes along and says, "Just relax."

How can you relax? It's a very stressful situation.

That's it. It's all over.

-Coo-ee!

-All right? Are you OK?

After the procedure, Deborah is taken to the recovery area,

and given a cup of tea.

-I don't feel any pains. Is that likely to come?

-You may do.

-I don't feel like anyone's been down below.

-Good. Good!

Do you find women fascinating?

I think women are great!

I think they are...eternally fascinating, and challenging.

Difficult to understand, but the beauty of being a gynaecologist

is that it is like being a mechanic in a Mercedes garage.

Women are built to last.

They live longer than men, they have more fortitude than men,

they are built better.

We're Ford Escorts.

We race around for 60,000 miles and our big ends blow,

our heart blows, and you drop dead in the street.

Women are built to have babies, so their physiology is so much stronger.

-You all right?

-Yes!

-Deborah Dickin?

-It is.

-You got five eggs.

-Ooh!

-So well done.

-Lovely! Brilliant.

-Fingers crossed!

-I was worried there wasn't any!

-Well done.

-She was very nervous.

-Five is a good number.

-Is it about the average, is it?

-Yeah.

-Is it?

-Good sizes?

-We don't know the quality yet.

We only know the number.

So worried. Thank you.

There you go. See? Nothing to worry about.

Deborah Dickin and Matthew Dickin...

Deborah Dickin's eggs and her husband Matt's sperm

are brought together here in the embryology lab.

Here, the embryologists can take in up to 70 eggs a day,

and millions of sperm, in what is a finely-tuned human production line.

-You can see them swimming.

-Yeah.

You can see these are swimming quite fast.

What I am going to try and do is try and catch them.

The head of embryology, Rachel,

is carrying out a procedure called ICSI for the Dickins.

She must select what she thinks is the best sperm.

This is then injected directly into the egg.

ICSI is used in cases where men have low sperm counts,

or sperm that doesn't move around much.

That's it. We start the hunt for the next sperm.

-Are sperm tricky buggers to catch?

-Yes.

It's the hardest part of the ICSI process, really.

What we're doing is we're selecting the sperm.

We're not letting the best sperm enter the egg itself.

You're swimming beautifully! Right.

Going to see if I can get him.

Just sort of...

Running my needle over the tail.

-Oh! His head's come off!

-Oh!

SHE LAUGHS

I knew that would happen!

He's stuck to the bottom.

'Rachel injects sperm into five Deborah's eggs.

'On an average week, Rachel carries out around 50 of these procedures.'

Will you think about this particular procedure later tonight...

Oh, God, yeah, yeah. Absolutely.

No matter how many ICSIs you do,

you still think about it when you get home,

and you just you think, "Oh, my God, I hope it's all right."

You know, you hope they get good fertilisation.

'Rachel is in charge of a team of 14 women.'

So do you think working here made you a bit more anxious

to make sure you could have children?

Yes.

Yeah, I do.

It makes you more aware how old you are.

There's a few of us who have talked about should we have our hormone levels checked?

We're all worried, I think. We're all worried.

-You're all worried?

-Yeah. And I'm only 24!

All right! Don't show off!

-I've been told I look 35.

-I'm 29, that's worse!

'Amy is the youngest embryologist at the Hewitt Fertility Centre,

'aged just 24.'

-Do you go on at your boyfriend about it?

-No.

-About having kids?

-No.

-So he doesn't know that you're anxious about it?

-Erm...

Well... I suppose I've said it.

But I'm not...

I'm not, you know, badgering him to have children!

You don't sit there on an evening saying, "Oh, the clock's ticking!"

No. No, I don't!

Cos I also think what will be will be,

and I'm not sure I'd have fertility treatment if I needed it.

-Why?

-I don't know if I could go through it myself,

and obviously, I've never done it, but when you see it every day,

and you see what the women go through,

and it's very difficult for them, I think.

-And I don't think I've got that strength.

-Really?

I don't know. I still think I'm still too young to decide,

but then at the same time...

I'm getting older! I'm only getting older!

There is another part of the treatment process

at the Hewitt Centre, which has no time for science and technology.

It's a procedure that is as old as time itself.

This is back to the nerve centre of the unit.

Across the way, that's where all the ladies go for their eggs collected,

and at the same time, the gentlemen will come in here

to our masturbatorium and produce their sample.

This used to be called the room 21.

Ten fingers, ten toes,

I'll leave you to think where the extra digit comes from!

We have a comfortable chair,

we have earphones for music or videos,

and we have a touch screen here

which displays a choice of appropriate stimulatory material,

as opposed to a few tatty old magazines

that are strewn around on a coffee table.

'Each of these newly refurbished "masturbatoriums",

'as Charles likes to call them,

'comes equipped with its own selection of pornographic films.

'Today, a couple who are on their second cycle of treatment

'are in to have their eggs collected.

'Lisa Henney's husband Gareth has just been into the masturbatorium.'

It's a funny thing, isn't it, because most wives would not

be that happy about their partners watching porn.

-Yeah.

-And yet, how do you feel about it in this situation?

-It doesn't bother me at all.

-It doesn't bother you?

-No.

Could you not have told me that four years ago?

No! It doesn't bother me.

-Hi!

-I'm looking for a Lisa Henney.

-That's me.

-Is that you?

-Yes.

-Pleased to meet you.

'Charles's team do up to 12 egg collections every day.'

-Pleased to meet you.

-Bye!

'Like many couples, there is no apparent reason why Lisa

'and Gareth Henney have not been able to get pregnant.'

You sound lovely.

Are you asleep yet?

Ooh, right.

You must have done this procedure many times?

The first 10,000 were a bit difficult.

After that, it gets a bit routine!

Usually takes about five minutes.

This lady's got a fair number of follicles.

Her ovaries have responded quite well.

That's it.

LISA SIGHS

-How are you feeling?

-Thank you so much.

-It's quite all right.

You're so lovely. You are lovely with people.

I must say that to you. You really are.

How many eggs?

Haven't finished counting them! Just counting them now!

-Go now! Find out!

-THEY LAUGH

-Right, I'll go now then! Immediately!

-I couldn't feel anything.

We've got six so far.

-It's good.

-Oh, thank you.

-Is it time for a cup of tea?

-Oh, I could have stayed for a bit longer!

Lisa Henney, 29, three, seven...

Lisa and Gareth's fertilisation is being carried out by Rachel,

using the most common method of treatment,

in vitro fertilisation - IVF.

So I just pick up my sperm,

and I just drop it onto the well...

..containing the eggs.

The Petri dish imitates the environment of the womb,

and the process of natural selection is allowed to unfold.

I can see motile sperm in there, I can just see them swimming now.

And they need to get towards that egg now.

So I'll leave it up to them. It's out of our hands.

There you go. See if that can find the egg itself.

There's an egg.

You can see the eggs here.

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

These are all its cumulus cells,

and you can just see the sperm starting to swim towards it now.

-Oh, yes.

-You can just see them swimming around.

-You can just about see them, can't you?

-Yeah.

-There's a lot to get through, isn't it?

-Yeah, loads. And they're tiny.

Look at the tiny sperm compared to the size of the egg.

Both the Henneys' and the Dickins' eggs will hopefully

develop into embryos over the next few days.

During that time, they will be checked regularly,

along with the several hundred other embryos stored in the lab.

-BOTH:

-Gemma Jonesfield, 11, 4, 8...

Gemma Jonesfield, 11, 4, 8.

Gemma Jonesfield, 11, 4, 8.

'Embryologists are trained on the job for three years,

'and need a degree in a life science like biology.

'But working with such microscopic human cells,

'they need to be incredibly well-organised too.'

Do you feel that there's a certain sort of mindset that suits an embryologist?

-I'm a bit of an obsessive-compulsive paranoid person, I would say!

-Really?

It makes you good at your job.

Do you think that you acquire that sort of mentality

once you come here and work for while?

Do you think you come here with it?

I think you make a good embryologist

if you have a little bit of it inside of you anyway.

I think it breeds it a little more inside of you. It makes you worse.

I don't think that I have got those tendencies by working here,

I think this place suits my natural tendencies,

and I am, I'm a bit of a control freak, clean freak,

all of those things in my whole life, never mind in here.

I can't think of any other business anywhere where the consequences could be so great.

-For that detail.

-Exactly. You are expected...

it is one of the only jobs where you are expected to be absolutely

100% perfect, and there is no room for human error whatsoever.

Which... Is that an impossible situation? Maybe it is. Exactly.

Cos we are all human, after all.

But you have to be perfect, or as close to perfection, as we are!

Really? So it's gone so far so good?

After my first week at the centre,

I'd got a sense of just how normal fertility treatment has become.

But I was intrigued to learn that despite all of the very

expensive high-tech science, Charles's advice to many couples

is simply to try getting back to basics.

OK. Say seven million years ago, this couple, the only two

people on the planet, and it's their job to populate the planet.

-Like Adam and Eve?

-Yeah. Like Adam and Eve.

And they have got to compete with all of the other animals,

with bloody hairy sabre-tooth tigers and mammoths and dinosaurs.

Do they have... And they've got to survive, right?

Do they have sexual intercourse quickly or slowly?

DOCUMENTARIAN CHUCKLES

Go on!

I'd say they do it...quickly.

-Why?

-To get away from a predator.

-Exactly!

-Lying down or standing up?

-Standing up.

Should the male be relaxed or anxious?

-I think he should be anxious.

-Should be anxious?

-Yes.

Of course you'll be anxious.

So what I say to patients, imitate the jungle. Just go for it.

Wham, bam, thank you, ma'am. And they say, what will we do?

Well, next time you are around at your mother-in-law's,

sit there at Sunday lunch, when you're ovulating,

and say to your husband, "I'm ovulating.

"We've got to have to have sexual intercourse in this house before we go home,

"and by the way, I'm not wearing any knickers!"

And I guarantee you, he will have the best sperm count ever!

Difficulties with fertility don't just lie with the woman.

The man is part of the equation.

And in particular, the quality of his sperm

can be the root of the problem.

Lock the door behind you.

And the Hewitt Fertility Centre has a whole department dedicated

to the analysis of sperm.

Oh, it's so sticky! Urrgh, it's on my glove!

The andrology department gets all its samples from the masturbatoriums.

Each one is connected to the laboratory by a special hatch.

-ALARM BEEPS

-So when the sample is placed in the hatch, the alarm goes,

so we know it's there, and it's ready to take.

And we just have a look, just check the details,

and we'll sign for the sample, to say it's been received.

Amanda is one of the andrologists.

The best sperm moves around fast, with a sense of purpose.

These healthy sperm are described as motile.

This sample is in a raw state. It is quite unprepared.

So before we use this for any sort of treatment,

a lot of the non-motile sperm will be washed out of the sample

in the preparation process.

This sample is actually concentrated down, so the sample that we use

has a lot more of these motile, freely-swimming sperm.

Hello?

When Charles needs to speak to a man about the quality of his sperm,

he tries to get onto the man's level.

I'll say, "Do you follow football?", and they will say, "Yes."

I'll say, "Your sperm is Fulham. Your sperm is Wigan."

And they'll say, "What does that mean?"

And I will say, "You'll probably stay up this year,

"but it will be a tough fight!"

Rarely are they Manchester United or Manchester city.

Most of us are Stoke or West Brom,

although West Brom are doing particularly well this year,

and some unfortunately might be Southampton.

In the andrology lab, there is also hope for infertile men,

in the form of sperm donors, like 21-year-old Nathan.

Donors like Nathan can also help same-sex couples

or single women who want a baby.

But the Hewitt Centre has a shortage of donors.

I have a stepfather who now acts as my father.

And I love him more for that,

because I know he's chosen to be my father,

and so I think I have a unique perspective.

It helps me do this.

It helps me think that there's going to be someone else out there

that has chosen to be a dad.

That's quite a small sample?

No, actually 2ml is about the regular volume.

That's bang on the dot.

That's a question we get asked quite often.

Can you do it on that? Is there enough in there? Yes.

How often do you... into a pot and measure it?!

So people assume that there is a lot more of it than there is.

-Is not as if they could do anything about it if they wanted, anyway?

-No. Probably not.

'Nathan's sample is ready for analysis.'

It's a lovely sample. There's some good morphology in the sperm.

They're swimming really well.

The concentration's quite nice as well. That's some nice sperm.

There's no denying it. If you are a man and you've had a test done on your sperm,

there'd be an extra spring in your step, wouldn't there,

if you found out that you had very good sperm?

Definitely. Men try to hide...

they always want to be the stalwart in the relationship,

and to lend the...

you know, the arm of comfort to their female mate.

I've seen men absolutely break down in tears,

and the woman be the stronger of the two.

That's rare. It's usually the other way round.

But even though men are stalwarts, stoical, stiff upper lip,

when I tell them that they've got good sperm,

there is definitely a sort of an aura comes about them,

one of, sort of...well-being.

-So those are risks that you do need to be aware of.

-Yeah.

And obviously as you're going through your treatment,

-we will talk you through all this again.

-OK.

When a couple begin the process of fertility treatment,

the first thing they need to do is have a meeting with Sister Diane Ford,

where she interrogates them about their lifestyle.

In this case, it's Kerri and Mike Fraser.

-Do you smoke at all?

-No.

-What about alcohol?

-Occasionally.

Would you say each day you have a drink? Or just a couple?

-No, because I stopped. I've cut down. I've been good.

-OK.

-Drink alcohol?

-Yeah.

-How much would you say?

About ten pints a week, something like that.

-No, you don't! Ten pints a week?!

-At the weekend...

-So you'd say about ten?

-About ten.

I would advise that you do reduce that, because alcohol

can affect both the quality of eggs and the quality of sperm.

-Yes.

-OK.

'These two are in their early 30s.

'They've been trying for a baby for three years.

'This is their first cycle of IVF treatment.'

-Because what we want is for you to go home with one healthy single baby.

-Yes.

But we cannot guarantee fertilisation,

and we cannot guarantee pregnancy.

-Are you clear?

-Yes. I'm so excited.

I'm happy with everything you said. Ready to get going now.

Well, good luck. Take care,

don't forget, any queries, just give us a ring.

-Brilliant.

-All right?

-Thanks very much.

-No problem.

-Bye!

-Bye!

-All right, then, see you later.

-OK, see you. Bye.

'I arrange to meet up with Kerri and Mike in a few weeks' time,

'when they return for the next stage of their treatment.

'So far in my time in the Hewitt Centre, I had noticed that patients

'might have different reasons why they can't get pregnant,

'but they all share a deep-seated biological desire to have a baby.

'But one person stands out in demonstrating just how deep this desire runs.'

My name is Hannah. I'm one of the embryologists.

And I've just come to speak to you before your egg collection.

'Anne-Marie Brotherstone.

'She is 31, but has had two heart attacks in her short life.'

Just before you go home, we'll see how many eggs have been collected.

'Because of this untreatable heart condition,

'a pregnancy could put her life at risk.

'But even so, she wants a child so much,

'she is prepared to go against the advice of doctors.'

Have you got any questions you'd like to ask us?

My mind's gone blank! No, I don't think so.

Anne-Marie does have significant medical issues.

She has this cardiomyopathy, which people thought was serious enough

for her to be sterilised a number of years ago, and of course, obstetrics

changes and new technological advances, but nevertheless,

her pregnancy, if she were to get pregnant, would still be risky.

Do you feel very nervous?

Yeah.

Very nervous.

You've been waiting a long time, haven't you, for this?

Yeah.

Are you nervous about your health, or the eggs?

The eggs. Not my health!

-Really?

-She's always been like that.

Have the doctors expressed to you the risks associated with it?

Yeah, yeah.

Just the risk to Anne-Marie, it's the risk...

there's a chance the baby might have the same heart condition as well.

We were told that. But, I mean, we still think it's worth it, don't we?

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

and have any regrets and look back

and think we never done everything we possibly could, isn't it?

If it doesn't work out, at least we can say we did try everything.

And hopefully not have any regrets.

Today, her eggs are being collected.

But due to the risks, the procedure is being carried out

in a full operating theatre, and we aren't allowed to film.

The drained fluid from Anne-Marie's follicles is rushed

back into the embryology lab, where the search begins to find her eggs.

There are 21 test tubes of follicular fluid.

Hannah is already halfway through them.

Still no eggs so far.

Egg number one.

-We've got our first egg?

-Yeah. Really happy!

Because there was... I didn't expect there to be eggs in every single one,

but obviously, you do get a bit scared as you go through them,

and you haven't seen a single one.

But that egg looks really nice, so hopefully we will get a few more now.

She continues to search through the remaining test tubes.

The more eggs produced,

the better the chance of creating a viable embryo.

Last tube.

No.

One it is.

Although she found one egg,

Hannah is concerned it may not be mature enough to fertilise.

If the egg doesn't fertilise, then that's the end of the line, but...

We have one, and it does look nice.

The procedure itself went well.

The lining of the womb... I know that they scanned you previously...

Anne-Marie Brotherstone's procedure was carried out by Dr Lucy Coyne.

When we gave you the injections to help to stimulate the ovaries,

in the hope of producing eggs,

Your response wasn't as good as we might have hoped for,

so I think the fact that we've got an egg today is good news, really.

The difficulty is obviously, if we create a nice embryo,

we will have to freeze it,

because of the fact the lining of the womb hasn't thickened up as we hoped it might have done.

-Right.

-If you think of anything before we go, just let us know.

-Yeah, OK.

-Thanks very much.

That was quite a difficult moment for Dr Coyne,

because she's actually pregnant.

Before I was pregnant, I did actually wear normal clothes for clinics and things like that.

I started wearing scrubs quite early on,

to try and hide the fact I was pregnant for as long as I could,

-cos I found that a little bit awkward.

-Did you?

-With the patients?

-Yeah.

I'd rather not be pregnant in this environment,

unless I get to the stage I'm at now,

where the last patient has seen me has just said,

"Pass on your good vibes," cos she could tell I was pregnant.

'One egg was enough for Anne-Marie Brotherstone.'

Really good news, cos the embryo's fertilised!

So it carried on maturing, then?

Yeah, it carried on maturing last night,

so it was injected a couple of hours late and it has fertilised.

'Embryologist Hannah successfully got Anne-Marie's egg to fertilise.

'But as an embryo, it needs to be frozen for a few weeks

'until the lining of her womb is ready.'

-Hello?

-'Hi, is that Michael Brotherstone?'

-Yeah, it is, yeah.

-'Well, I've got brilliant news for you guys.'

-Thank God.

'The egg you have collected was mature, and it has fertilised.'

-Oh, brilliant. Absolutely fantastic.

-'OK?'

-Thank you!

-Lisa Henney?

-Yes, thanks.

It's nearly a week since Lisa Henney had her eggs collected,

and five of them have fertilised into embryos.

Today, one of those embryos will be transferred to her womb.

This is a key moment in their fertility journey,

but it's also a critical moment for the staff,

after weeks of careful treatment.

It is a culmination of the embryologists' work,

it's a culmination of the doctors and nurses' work,

and it's also that crunch time for the patient.

Patients' awareness throughout infertility is high,

but at the embryo transfer moment, it's really, really quite electric.

OK, so we'll leave you to get changed.

'Hilary will be carrying out the transfer.'

I'll come back. All right?

-Do you like doing the embryo transfers?

-Yeah, very much.

-Is that a good job?

-Yes, it is a very good job. I really like it.

Yeah.

It's always a bit...

..it always fills your stomach with trepidation,

because it is something that's really important,

so it is scary to some degree,

but I think it's always good to be like that,

-because it is good to respect what you're doing, and not be blase.

-No.

-It's a key moment in their lives.

-It is.

Never to be taken lightly.

But first, in the lab,

Amy must decide which is the best of the five embryos.

So, that one is looking all right.

The cells are differentiating, that's probably what's going to become the inner cell mass,

which is what becomes the baby.

This one, you can see the difference between this one and the last one.

Dark cells there, where it's maybe deteriorating a bit.

OK. Cluster of cells in the middle.

Big undifferentiated one there, couple there, and it's quite dark,

so four out of her five embryos

haven't managed to continue through the culture.

They've started deteriorating.

But that first one is looking good.

That will definitely be the one that I transfer.

On this occasion, it's a clear-cut decision,

but it still carries massive responsibility.

In the patient's eyes, they're all their babies.

All the embryos are their babies.

And they have to stand to one side and watch

while we do all the choosing,

and while we have them all in the lab away from their bodies.

So the responsibility is immense, with all of it,

not just with the choosing of the embryos.

Especially, with the choosing of the embryos,

it's a high responsibility, but it is all very intense.

Still can't believe we're here.

That's scary.

Do you think of it as a little person?

Um...yeah.

If it all works out, do you think we could keep the dish it was made in?!

As a little souvenir? Imagine that, though.

-There's your dish you were made in!

-Aye, it would be good, that.

-Would you like to do that? Keep the Petri dish?

-Yeah!

Yeah, you would, wouldn't you? you'd wear it round your neck on a chain.

-Put some nuts in it!

-When people come round!

"My sperm was in that dish!"

So, I've decided that I'm going to transfer that one in 05.

I'm going to double-check everything,

so I'm checking that there's definitely one in there for transfer.

Then it needs to go back in the incubator until it's transferred.

-Hi!

-Hi, I'm Amy. We've met before.

-Yes, we have.

-In the last cycle.

So out of your five embryos, one of them is actually really nice,

it looks like it's doing everything spot-on.

-OK. Happy?

-Yeah.

-It's weird, isn't it?

-SHE SOBS

-Sorry!

You don't need to get upset, kid. Eh? It's fine.

-It's a good thing. Isn't it?

-They're happy tears?

-Yeah, thank you.

-Good. You're very welcome.

You changed your mind?!

THEY LAUGH

-You OK?

-Yeah.

I'm going to give the nurses a call.

-I'll be back in a couple of minutes.

-OK, thank you.

You can look into it loads.

It's amazing how you try and put all of your emotions away,

and deal with it, and think you're really strong, and...

You build up a rapport with some patients, and you don't with others,

so certainly if you've seen them all the way through,

so you've seen them at egg collection and you've seen them at transfer,

and you've spoken to them on the phone, and you've tracked

the progress of the embryos, then yeah, I think you do get attached.

And especially when it's a good...

probably the extremes of the scale, when it's extremely good

and when it's extremely bad, you feel strong emotions for them.

Point your knees.

I know it goes against the grain, but point your knees out.

So now I need to get you into position, please.

-So I'm not just staring underneath.

-It's all right.

Thanks for that!

Can you go back a little bit, please? About an inch.

That's grand. I think a little bit more.

OK? And now come into the middle a little bit.

A bit like the Golden Shot. Did you ever watch the Golden Shot years ago?

-I think you'd probably be too young!

-The Golden what?

The Golden shot, and it would be up a bit, down a bit. Bernie the Bolt!

-I remember that. What was the bit?

-Yeah, you would!

What did you get if you hit it?

You'd get a prize, or you would go on to the next round.

A lot of cash came out, didn't it?

Oh, yes, I remember now, yeah! I remember that!

That's right. I was, gosh... I just remember Bernie the Bolt.

-Would you like to see your embryo?

-Yeah.

OK, so if you just want to look up at the screen for me,

I can show you both the embryos.

OK. So there's your embryos there.

Doing everything they should for today. Well done.

-GARETH: Where's it going?

-Camera shy!

HANNAH: So that mass of cells at the top, that's the inner cell mass.

-GARETH: Ah!

-Gosh!

You'll feel a little bit of pressure as I open up

and look at the neck of the womb. OK?

-You all right now?

-Yeah, I'm fine.

-Is it hurting you?

-I'm OK.

-I'm putting your embryo back now. Good luck to you both.

-Thank you.

HANNAH: Thank you.

I'm just going to check now

and make sure the embryo has left the catheter, OK?

-Yeah, that's lovely and clear. The embryo's in.

-Fantastic.

-All the best, guys.

-Thank you very much. Thank you.

-Have you performed lots of those, Hilary?

-Yes. Yes.

GARETH: First one today!

It's a funny one though, because sometimes when I'm doing embryo transfers,

I think, I'd just love to sing at this present time.

I don't know. I usually...

it usually does comes in a feeling.

I'd love to sing.

And I really think that most people would find that very inappropriate

if you just burst out singing!

They'd go... what on earth!

While you're down there between the women's legs?

Yes.

Yeah. Because it's a lovely thing, isn't it,

putting someone's embryos in you. It's a lovely thing.

If you'd like to look at the monitor,

-I'll just show you your embryo now.

-It's dying to get to me!

Now it's the turn of Deborah Dickin,

whose husband Matt had a low sperm count.

-Who are you?

-Deborah Dickin.

Very good. You haven't been placed...

Becky's just going to check that the embryos have gone.

-That's fine, it's in.

-That's it. It's all over.

-Good luck, guys.

-Thank you very much.

-OK, then, all the very best.

-Thank you.

-Cheers.

-I wish you the best of luck with it.

-Thank you very much, Richard.

-Time will tell, now!

-Yes, time will tell.

'On average, couples who go through fertility treatment

'have a 30 to 40% chance of success.'

I've seen it in patients' eyes when they come and see you,

not overstating it, to see you as someone who performs miracles.

No, well...

Technically, in vitro fertilisation

is a routine procedure.

It's how we manage the patients which is the difficult thing.

The laboratory bit often is the easy bit.

It's how we manage the patient's expectations.

Our contract to the patient is to say,

"Well, we can't guarantee you babies, but we'll do our very best,"

so that we try and avoid the scenario

that I think is the one we should all be striving to avoid,

and that is the patient who hasn't got any children,

but is left in the situation where she says, or he says,

"If only. If only I'd had the funding to have this treatment.

"If only we should have done that."

And that is what we've got to try and avoid.

And that's what we try and do here.

Ten days have passed, and it's time for the Henneys

and the Dickins to take their home pregnancy tests.

For Gareth and Lisa, it's not good news.

I don't know what to think, what to do next,

so I don't think I want to do IVF again.

But you said that, didn't you? But...it's early, isn't it?

-We're going to relax, aren't we, and take things...

-Yeah. 38 this month.

-Are you?

-Yeah!

You know I am.

-So we'll make other plans now, and get over it.

-We've got a good life.

No. We've got lots of pets, as you can see!

But no, we'll be OK.

I think my mum and dad have avoided me this week,

because I think they're stressed and upset, aren't they?

-Do you feel disappointed for them?

-Yeah, I do.

Because all they do is say what great parents we'll make, don't they?

We've got so many lovely kids in the family, haven't we?

Our nephews are just... They're all so lovely.

Our time will come. I promise you.

All the kids are great.

They all love us to bits, don't they?

We've got good people around us. Everywhere we go, it's good people.

Yeah. We're so lucky. We've got lots of lovely people in our lives.

We have. Mm-hmm.

So we said we'd get a pram for the cat!

At Deborah and Matt's home, it's also sad news.

It's hard for me, because I feel like I might never be a mum.

I just want to have our own flesh and blood.

-Hard to deal with.

-Hmm. It is.

When you have the embryo transfer, you see the egg, the embryo,

you fertilise that.

It's still me and Matthew, it's still been fertilised,

and you think, well...

-You're creating a life, here.

-Yeah, you're creating a life,

and then you feel like it has been pulled from under you.

-Nature's way, I suppose.

-Cruel way.

-Yeah.

-A very cruel way, sometimes.

-But...

I just want to have our own flesh and blood.

Something that we've produced,

and we can bring up our way.

-And we will.

-We will. We will.

We've still got to be positive, because we've still got another go.

-And it's just a waiting game again now.

-Yeah.

It's very difficult not to take it personally, but of course, sometimes

you have to try and distance yourself from those sort of emotions,

because it can be quite detrimental

to your own health and well-being.

Isn't it?

I came in halfway through that!

-Stress.

-Oh, yes. Yes.

Upset. Disappointed.

Probably the same sort of feelings that they were feeling,

but not to the same extent. Because it's their treatment.

But we do that with all the patients.

You feel elation when someone gets pregnant,

and you feel disappointment when they don't.

Because our job is to get them pregnant,

and if we haven't done that for them,

then in our eyes, we've...failed, really.

But also, talking about being happy or being sad, then these have

got to be fleeting emotions for us, because we see so many people.

If you got too attached...

and too emotionally involved with all of them, you would be...

-an emotional wreck coming to work! You'd be crying all the time!

-Yeah.

And that hardness comes with time.

Because when I started here, I found everything really difficult,

and everything was like, why isn't it working? And...

But now, like Hannah says, you just have to feel the emotions,

but you do have to remember what you're doing, and why you're here,

and the other patients matter as well.

Anne-Marie Brotherstone?

'All the patients I had met at the Hewitt Fertility Centre are desperate to have a baby,

'but none more so than Anne-Marie Brotherstone,

'who has a rare heart condition.'

-All right?

-Hmm.

-Nearly there.

-Yeah.

'She had just one egg.

'It fertilised, but the embryo had to be frozen

'because her womb wasn't ready.

'Now, two months later, she is back to have the embryo transferred.

'The procedure is going to be performed by Jill.'

You've not got children, have you?

-No. Got a cat!

-You've got a cat?

-Yes.

How do you find working in this environment with people

who are all on the search for children?

It's a difficult one to answer really.

I've never wanted children.

There was never that deep yearning to have them.

Yeah, but you might have thought, "I'm different to most women."

No! I'm not!

Well, are you not different to most women?

-I might be different and special!

-Yeah, I'm sorry!

-It's all right. It's fine.

-I did not mean to sound like...

I know, and to be fair, I haven't actually faced a lot of

the kind of questions you'd expect, like, "Couldn't you have children?"

There are quite a few of us who are not in that situation, now, are we?

How many have you got?

Three, and I've got a little granddaughter as well.

So that's lovely.

And hopefully I'll have some more grandchildren!

No, I...

always wanted children.

I still have my career, and I love my job,

and I always think I'm very lucky, because I've, you know,

through the years of my nursing, I've seen some really sad scenarios.

You all right, Michael? you can sit down if you want.

Hannah is the embryologist who has been at every stage

of the Brotherstones' journey.

-And here's your embryo. Can you see that on the screen?

-Yeah, perfect.

That's magnified a few hundred times.

The Brotherstones don't have any frozen embryos to fall back on.

All their hopes are contained in this one catheter that Hannah carries.

Thank you. Thanks.

It's sad. It's sad when they've only got one, and to them,

that's their potential child.

That's sad.

OK, Anne-Marie, the catheter's in place.

Has that caused you any pains at all?

No? Good.

Thank you. OK.

Now, Hannah's going to take the catheter and flush it,

just to make sure the embryo has left, OK?

HANNAH: That's fine. The embryo's in.

OK. Can you pop your legs down now?

HANNAH: Well done. Very best of luck. MICHAEL: Thank you.

-Hello! Here we are again! How are you?

-My mind's blank at the minute.

-I'm just in shock, I think!

-What, about the fact that it survived?

-I've got this far!

-We've got to keep our fingers crossed now.

See what happens. OK. Well, you've got my mobile if you need me.

-OK. All the very best. MICHAEL:

-Thanks very much for your help.

See you soon. Bye. Cheers.

How much hope do you have for them?

Well, I'm Scorpio.

My cup is always half empty, so I'm a natural-born pessimist.

Not a great deal. Not a great deal.

She's got a lot of problems to face,

with her cardiomyopathy as well.

So I'd like to think...

we've certainly given her a chance, but how things will turn out,

we'll find out in the fullness of time.

None of us would be here doing this if we didn't think it was going to work some of the time.

And every cycle you start, it's with hope, isn't it?

At least they can say, "I've done everything we can,"

and what we have to say is, we've done everything we can,

and certainly for the Brotherstones, on this particular cycle, we have.

So it's out of our hands now.

'In ten days' time,

'the Brotherstones will carry out a home pregnancy test.'

We'll say goodbye to you then.

-We'll be in touch?

-Yeah.

-All right.

I'll give you a text when we're coming back in.

-If we do come back in.

-Yeah.

-All right then. Best of luck.

-Thanks very much for that. Speak to you soon.

-Speak to you soon.

-Bye.

'There is one other couple I had met at my time at the Hewitt Centre

'who were desperate to have a baby.'

Big cough. SHE COUGHS

-Lovely. Are you guys ready?

-Yeah.

I'd first met Kerri and Mike Fraser a few weeks ago when they were

being quizzed by a nurse over their alcohol consumption.

Today, they too are back to have their embryo transferred.

The embryo's here. We're ready to put it in.

Here we go.

-Have you read your white booklet of all your dos and don'ts?

-Yes.

Is there anything in that that doesn't make sense?

I really like chorizo sausage. Am I still OK to eat it?

-You really like what?!

-Chorizo sausage! Am I OK to eat it?

Cos it says about like Parma ham and all that.

You know, I have never been asked that before! I don't know!

I would imagine it's fine.

Because I have it, like, twice a week!

-All right, it's in. Good luck, guys.

-Thank you.

-Don't move your legs yet.

I had to ask about the chorizo sausage,

cos it's been playing on my mind!

-It's been bugging you, that, hasn't it?

-They said don't have it.

-But I cook it, though, don't I?

-I'm not risking it.

-I'll have it then!

My time was coming to an end at the Hewitt Fertility Centre.

Good luck, love. With everything.

Shortly before I leave,

Dr Lucy Coyne has a buffet before she goes on maternity leave.

I remember... Yeah, I remember...

I remember the interview.

The first question was, who would you like to dinner?

Who would you invite to dinner?

Anybody you could invite ever, living or dead.

The previous guy said, I think I'd invite Wolfgang Amadeus Mozart,

because he was a genius of the 19th century or whatever.

So we asked the same to Dr Coyne, and I said,

"Who would you invite you to your dinner party, anybody, living or dead."

She said, "I'd like Simon Cowell!"

-And she got the job?

-That's my girl!

LAUGHING AND CHEERING

A few days later, I join Anne-Marie and Michael Brotherstone at home

for their pregnancy test.

All right?

-You've got tissue all over your face.

-I can't look at it.

You're very good at offering Anne-Marie support, aren't you?

You have to be. It's...

There's not much we've been through really.

The waiting, the appointments,

we've both been quite upset times, haven't we?

Just hard to take at the minute.

-But we'll be all right, won't we?

-Yeah.

I had spent three months looking at the extraordinary work

that goes on here, and I had seen it through the eyes of the staff.

I had learned that by intervening, these scientists and doctors

can profoundly change the course of people's lives.

But at the same time,

I had seen that nature ultimately will have its way.

While at the Hewitt Centre,

I had met couples who did not have positive outcomes.

But I think Charles Kingsland and his team

did give these unlucky patients something.

He gave them hope.

And in the case of Kerri and Mike Fraser...

Even more.

Yes! Yes!

Oh, God!

Oh, brilliant!

SHE SOBS

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