Episode 3 The Baby Makers

In the UK, an estimated one in seven couples

suffer fertility problems of some kind.

Every year, thousands of these will seek help

in the form of fertility treatment.

For some, this will be a success,

resulting in a much longed-for child.

I suppose it's a different type of stress

when you're pregnant through IVF

because you just want it to work out so much

and it was just the best day of our lives, I would say, to have our son.

For others, it will be an uphill struggle.

Society puts all of us under a massive amount of pressure

and for those people who are struggling to have a family,

or those people who choose not to have a family,

I think people need to be more aware of that.

This is the story of the arduous journey faced by many couples

and individuals as they strive for their ultimate goal -

a newborn baby.

Ali and Andrew have been together for five years,

and, after experiencing one unsuccessful IVF cycle,

they are now embarking on the journey for the second time.

'Well, we're going to meet the consultant that's going to be doing'

our treatment and to basically make a plan as to where we go from here.

So, did they do, at any stage,

a blood test called AMH blood test,

or anti-Mullerian hormone, do you remember that?

I don't remember that as such, no.

OK. Then I think the first thing I would want is your AMH level,

to know exactly what sort of protocol we're going to use,

and then the results are usually ready within a week.

-OK, yep.

-Great.

By testing Ali's AMH, or anti-Mullerian hormone,

the clinic will be able to determine the function of Ali's ovaries,

and how she is likely to respond to fertility treatment.

'I mean, the blood test that we had done'

is something that we hadn't heard about before,

and I think could answer so many questions for us.

'You want to be excited but yet the disappointment and devastation

'when it didn't work before

'and you know there's a chance that might happen again, that's tough.'

It's hard. It's not easy.

The appointments are the easy bit.

It's the bits in between that aren't the easy bits.

When you've got time to think about things.

Too much time to think about things! Yes, that's my problem!

For many couples, the battle with infertility can last several years.

This was the case for Sharon Davidson

and her husband Gary who got married in 1997.

'With infertility, it's a journey.

You're waiting on tests, you're waiting on test results,

'you're waiting on treatments - if the treatment doesn't work,'

you sort of have to pull yourself out of that

and go through the tests and treatments again,

so it's a bit of a roller coaster ride, to be honest.

After five years on this roller coaster ride,

we went through a treatment cycle - it was a frozen embryo transfer -

and it was successful.

We were quite lucky because that was kind of the last throw of the dice.

We're very blessed to have our son.

Somebody was looking down on us that day, that's all I can say!

Really, at that time, I think we just said, "That's enough.

"Draw the line under fertility treatment."

We decided to look at alternative routes to have a family.

We embarked on this journey to go to an orphanage in Russia

and that wasn't straightforward either.

In some respects, that was more stressful than the IVF.

In the spring of 2008, Sharon and Gary were finally able to bring

their newly adopted daughter home, from Russia to Northern Ireland.

We are very, very lucky to have two wonderful children and every day that

goes by, you really pinch yourself to realise how lucky you are.

PHONE RINGS

Sharon's experience led her to become involved with

infertility Network UK

and she is now the regional organiser for Northern Ireland.

Do you want to know about the support groups?

So there's plenty of support and information out there if you want it.

'I think that there is a bit of a culture in Northern Ireland

'where people don't ask for help as readily,

'and I think that that needs to be challenged a wee bit,

'so that people will feel comfortable to ask for help

'and to go along to support groups,'

and they can gain support from each other, really,

that kind of peer support.

Ali and Andrew are at the clinic,

and are anxiously awaiting the results of Ali's blood test.

'The thought of getting those results today

'and getting bad news is just sickening me to my stomach.'

I don't even know how to put into words.

OK, so from the last time that we met,

-you had your blood test done on for the anti-Mullerian hormone.

-Mm-hm.

So we've got the reports back on that and that seems absolutely fine.

They basically say that that's normal for your age,

so the implication of this is that, A, it's highly unlikely that

if we put you onto IVF hormonal medications,

you would not produce eggs.

'If I'm completely honest, I should be ecstatic because my results worked

'to my favour and everything seems to be moving along, but I'm nervous.

'I am nervous,'

and I've three weeks now to get my head around,

that when I start the treatment,

it's in a positive frame of mind, so, quite nerve-racking.

-And then we'll take it from there.

-OK.

-Good luck. Hope it works for you.

-Thank you.

-Thank you.

'If it doesn't work eventually, then we deal with it afterwards'

'but in the short term,'

we have to think that it will work and that we'll get our twins.

After marrying in 2009,

Emma and Ben moved from London to Emma's hometown of Belfast.

One of the reasons we moved back to Belfast was

cos we'd like to bring up a family

and we didn't think we could really do it in London,

so we've been trying pretty much as soon as we got back.

'We had a minor success about this time last year.'

Found out I was pregnant but then miscarried at the start of January.

After recovering from the miscarriage,

Emma and Ben decided to seek medical help with their efforts to conceive.

'We've had our tests,

'so Ben's had his sperm tested and I've had my blood tested.

'For the woman, they just test for your hormone levels'

and mine were fine. The only one that was a bit low was oestrogen,

but not enough to be too worried.

'My sperm tests weren't 100%. There were two areas.

'One of them, I think, was motility,

'which is kind of the amount of movement of the sperm,'

and then morphology was actually just below the normal range,

which suggests that there's a higher number of ones with two heads,

and double tails and, you know, freak sperm, basically.

-Monster sperm!

-Yeah.

Which I thought was quite funny,

but then I should probably be a bit more serious about it.

Emma and Ben are now waiting to be called for treatment on the NHS,

but in the meantime they are trying to conceive naturally.

I've been keeping track of my cycles and everything, just in case,

and we've been very good, and having regular sex.

'And I haven't really thought about

if it does or doesn't happen on this treatment.

I don't want to play too many scenarios in the future in my head.

No, we can't really afford to think about

-the other options at the moment, so one day at a time.

-Yeah, exactly.

At home, Ali has begun administering her own injections,

with the help of her husband Andrew.

I have to be honest. I don't...

SHE LAUGHS

I don't fill them up or anything.

I tried one day and completely freaked out

because I couldn't work out what I was doing.

Andrew's quite good at it. It's quite fiddly.

These injections are designed to allow Ali's cycle to be artificially

controlled and to stimulate her ovaries to produce more eggs.

Many of Ali's friends and family are pregnant,

or already have children,

a situation which can be difficult to cope with.

I currently have a sister-in-law and two very good friends pregnant.

My cousin just had a baby this morning,

and a very good friend of mine's daughter is seven weeks old,

and then you've other people who you know want children,

or have one already, and are starting to try again for a second,

or things like that, so...

You know, everybody's different, mind you.

I'll just take one if I can get it!

'I can't pinpoint a reason.

'I just know that the last few days for me have been difficult,

'but for Andrew especially when I go into my little downtimes,

'that I can't really explain to him.'

You know, when a woman wants to be a mother,

it's quite hard to explain the feeling when you can't.

In an effort to gain more insight into the way Ali is feeling,

Andrew is accompanying her to a counselling session.

'We're going tonight to a counselling lady

'that's being provided by the IVF clinic.'

I think it's important for me to go to the counselling so that

I can understand, as we go through this process,

exactly how she's feeling.

'I have had a rough couple of days the last couple of days,

'just very emotional,'

and almost angry feelings,

towards having to do this again, and I've struggled to deal with that

and, unfortunately, Andrew's borne the brunt of that.

I've tried to train myself to ignore the bad bits

and just focus on the positive.

I don't want to look at this process as there being a possibility

of negative, whereas Ali obviously has much more of that

roller coaster emotional ride, and I'm blocking that part completely,

and trying to focus on the positive, and look at that as our outcome.

Maybe I don't realise that Ali's getting upset

and then her way of dealing with that is...

I wouldn't go so far as to say pick a fight, but something...

I'm sitting upset and I feel to myself,

"Why hasn't he come looking for me? He should know I'm upset,"

and then, eventually, I'll come down the stairs

and Andrew will talk to me like nothing's happened,

and I'll feel quite angry that perhaps he hasn't...

..noticed and, because of that, will lash out.

So maybe there's some other way of showing that you

would like Andrew to acknowledge

and step into your space.

Going through treatment - it's not the normal kind of situation and,

therefore, maybe it requires slightly different ways of doing things.

A hand gesture, maybe there's something to move, physically,

from one place to the other,

to let the other person know, "Yes, I need something different here."

-I quite like that idea, actually.

-Moving something?

Yeah, cos it's something that you moved or

something physical that you did that I could understand and go,

"OK, I need to take some time out for,"

even if it's only 15 or 20 minutes or half an hour,

and to put aside what I'm doing

and come back to it again at a later time.

Maybe that is a good idea.

You need to do something that is different and obvious,

so that you can actually come together.

I think that's probably something that's workable

and not even just in the IVF.

I think probably going forward,

cos we haven't had anything before that we would have

necessarily done and because you are so emotional, and you get...

I'm not that emotional! I cry at movies and X Factor, but that's OK.

Most birds do.

SHE CHUCKLES

It's what we do!

And our hearts aren't made of stone.

-OK.

-OK.

Emma and Ben have been for an initial consultation

at the Regional Fertility Centre, but before any treatment starts,

the doctor has advised them to keep trying to conceive naturally.

The fact that we've already been pregnant briefly before,

and that I've had positive ovulation tests, is a really good sign,

and he kind of even said himself, "You know, the best outcome for us

"would be that you wouldn't even have to have that much intervention."

So, we're crossing our fingers and uncrossing our legs!

Emma is a photographer

and is currently working towards a master's degree.

Well, for my master's, I've begun a project about

women's access to reproductive rights in Northern Ireland.

I think it makes me feel quite strongly.

For instance, when I found out that in Northern Ireland,

we only get one cycle of fertility,

it's somebody else forcing their moral or other opinions

onto a woman legally.

I feel very strongly that the moral or, I don't know,

financial opinions of an MOA shouldn't affect at all

whether a woman wants to have a child or not.

Five weeks after her drugs regime began,

Ali is at the clinic for her egg collection.

Although she has been regularly scanned, it is not yet known

how many eggs she will produce.

Once the anaesthetist gives you the drugs to make you feel dizzy,

I'm going to locate the ovary, give a single jab

and start draining the fluid from the follicles.

Try not to be nervous, try to listen to my instructions in theatre, OK,

and everything will go smoothly, OK?

Although she remains awake, Ali is sedated for the procedure,

which involves draining the fluid from the follicles in her ovaries.

That is the follicle,

so the fluid goes on that tube and that follicle is drained slowly.

The fluid is then taken to the adjoining lab where

it is examined under a microscope to check for the presence of eggs.

As the procedure concludes, the result is a positive one for Ali.

Everything went smoothly, straightforward,

and we hit nine eggs, which is slightly above the average.

On average, we expect eight eggs per patient so we are pleased with that.

A few hours later, Ali and Andrew meet embryologist Richard,

who wants to discuss whether they are treated with conventional IVF

or ICSI, which involves injecting an individual egg with a single sperm.

The one issue this morning is when I first looked at the sperm sample,

it was worse than your previous, OK.

I think in the past, you'd had about 70% motile in your initial.

Today, it was about 20, 30, so that was a bit of a concern initially.

I've done the preparation now and that's prepared much better, OK,

so the motile percentage is about 55% now.

So there's plenty of sperm swimming there.

The initial analysis raised a few question marks for me,

as to whether we should be doing ICSI.

The other options are we could always do a split,

where we do half IVF, half ICSI, but I think the fact you've

had this IVF before, I think we should stick to IVF.

Wherever possible,

we use the least invasive technique which is conventional IVF.

-Are you all right?

-Yeah, I just...

-The whole sperm thing just kind of threw me a little bit.

-Oh, sorry.

I just... I wanted to put you in the picture, obviously,

of what's going on there.

I think there's plenty of sperm there, it's just more the percent.

The question initially was, was there enough there,

or enough to do conventional IVF?

That's why we wanted to check, so we've just got to wait to see

tomorrow how many fertilise and we'll go from there.

-OK? I'm sorry to upset you today.

-No, no, no.

I just... I think it just threw me a little bit.

I'll call tomorrow to tell you how things have gone on

and we'll go from there. Best of luck. All right? Good to meet you.

-Thanks.

-Thank you.

-Thanks.

Yeah, I think you're always hoping that you're going to hear that

everything's perfect and it's clearly not perfect today, but...

..I think at the end of that, we probably got from that

that he was happy enough to proceed.

I don't know, it's just one of those things.

You spend so long focusing on your eggs, I think that you

forget that there's another side to it, you know, and... I don't know.

You expect everything to be normal and perfect,

as it has been all along,

and when it's not, it kind of throws you a little bit.

The next 24 hours are going to be pretty tough.

But...we just have to wait and see.

Fertility problems can put a huge strain on a relationship,

and Ben and his wife Emma are no exception to this.

'We have a very strong relationship

'but the whole process has put some pressure on us,

'whether we'd like to admit it or not.

'It gets really hard.'

I mean, we felt a lot of pressure

and have kind of fallen out with each other unnecessarily.

I don't think I would happen if...

Well, put it this way - if Emma was pregnant,

we'd have something to focus on that is very real, and very big,

and scary and stressful, but at the same time,

this is our challenge together and it's, like, we're having a family!

After reading all the advice on the pregnancy websites,

it suggests you have sex every other day and, after a few months of that,

it started to get really difficult for us.

I felt I was actually struggling to perform and then, thankfully,

the two of us sat down and talked about it, realised what was going on -

it was just the pressure of the situation -

and did exactly what the pregnancy websites advise you to do,

which is just enjoy it!

We have busy lives as it is.

We both do freelance work and we would obviously try

and squeeze in our sex lives into that anyway,

but when you realise that you have to do it on that particular day,

it actually suddenly changes the whole kind of pressure you're under.

It's quite... It's quite weird, actually,

experiencing it for the first time

and trying to fit that into our lives.

Back at the clinic, a decision has been made to proceed with

conventional IVF for Ali and Andrew.

Today, embryologist Steve is carrying out the process.

Four eggs, plus those five, so we've got nine eggs.

We have the sperm prepared in the incubator

and we're going to inseminate a small fraction of that

directly into the eggs and that will give us

a concentration of around about 200,000 sperm per insemination.

And...inseminate around the eggs.

This process involves the mixing of sperm and eggs in a Petri dish.

Hopefully, the strongest sperm will enter an egg

and fertilisation will occur.

So that's the egg and the sperm...

..are swimming around the egg there.

All nine of Ali's eggs are treated in this way

before being left to incubate.

So we'll leave those to incubate overnight

and then we'll check them for fertilisation in the morning.

The following morning, Ali and Andrew are anxiously awaiting

news from the clinic of how many eggs have fertilised.

PHONE RINGS

Hello?

Yes, yes.

Hi, there.

OK, that's great. That's a big relief.

OK, that's great. Thank you very much. Bye.

All nine fertilised.

HE CHUCKLES

So they'll go back either Thursday or Saturday, definitely not tomorrow.

That's really good news. Oh, my God, I feel sick.

Oh, your wee swimmers were really strong!

HE LAUGHS

Ah!

-Brilliant.

-Such a relief.

SHE EXHALES LOUDLY

Oh, bless them, we've got nine little embies.

THEY CHUCKLE

-Yeah, that's good.

-At least I'm not for the high jump.

I was concerned if they didn't,

if they didn't get fertilised today, I'd be for the high jump.

I know people who have broken up after ongoing efforts, but...

..thankfully for us, and hopefully for us,

this is it, we're back on track and...

..it's our time.

Again.

Four days have passed

and the moment has finally arrived for Ali and Andrew.

Today, the embryos will be placed back into Ali's uterus.

This is the biggest day of my life to date.

Apart from our wedding day.

THEY CHUCKLE Well.

At least I got to wear a pretty dress that day!

Ali has six embryos which have reached an advanced stage.

Today, she will have two embryos transferred back into her uterus.

The other four will be frozen for use in the future.

We are going to be putting back two blastocysts.

They've got to blastocyst stage,

which means that the embryos are dividing well.

Before the procedure begins, Ali is shown one of the embryos in the lab.

-Now that will develop into the baby.

-OK.

That's a lovely grade.

So when that develops into the baby, does this go away, the outer bit?

Well, these are all cell lines,

-so that they'll all proliferate and go their own separate way.

-OK.

-All right?

-Yeah.

-I'll get those ready for you.

I had no idea what they did.

This painless procedure involves

placing the embryos into a catheter for transfer into Ali's uterus.

The catheter is then checked to ensure the transfer is complete.

They're fine.

OK. That's that over, then.

'She's had a strong group of embryos from the beginning

'and she's got more than average number of blastocysts

'from that group of embryos,'

so, you know, I'm very hopeful.

This is the late-stage embryo,

so implantation, if it's going to occur,

is going to occur in the next 24 to 48 hours, right?

If that does, your chances of getting pregnant are very good,

because we've selected the embryos which are able to get that far.

-OK, thank you very much.

-All right. So all the best, all the best.

-Thank you.

-Thanks, Steve.

-Take care.

-Thank you.

It's as good as it could be, so I think...

I think we're in as good a position as we can be and...

..the next 48 hours are restful.

From what he said, that's just about as good as it gets, yeah.

Emma and Ben are no longer trying for a baby.

Since we spoke last, Ben and I aren't together any more,

so obviously that means we're not trying for a baby any more.

Yeah, so months later,

and I've...sort of stabilised quite a bit

and am mostly thinking about the future,

and trying to make the most of the situation,

not feeling too regretful or anything like that.

If I didn't have children in my life ever,

that would just be the way things were,

but having got close to that, it sort of...

It's very much on my mind, I think, as something that's there,

and I have to... Well, we'll see, we'll see who comes along.

If I find the right kind of person.

Otherwise, we'll just go with what's going, really.

I still want children but I don't want children now,

and I don't think, um...

Yeah, I don't think I'm in the right kind of place mentally,

or in terms of work and everything.

Erm, but, yeah, I would like to look after children,

or have my own children at some point in the future.

Two weeks after her embryo transfer, Ali's pregnancy test was negative.

Unfortunately, we are sitting here today which means

that your treatment didn't work, so...

It is taking time, but they are beginning

to come to terms with the outcome.

'Emotions are back intact as such,'

but it's been a rocky road since it didn't work.

In that moment, and at that time, it's a loss. It's grief.

It's traumatic. Very, very traumatic.

'Because we found ourselves in the situation where'

we had the bonus of extra embryos that we didn't expect to have,

that's given us an opportunity to have another go,

in the springtime, I think.

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