Striving For Parenthood

As more parents turn to ‘assisted reproduction’, or IVF, because they can’t have babies the ‘normal’ way, the technology evokes fear in others who think it will put us on the road to designer babies. Ron Thow reviews the issue.

Every day in New Zealand people become parents. For some it is accidental, for others part of a carefully laid-out life plan. But for a small but growing number parenthood is the end of a long, difficult and stressful medical process.

And as the average age of first-time parents continues to rise, medically assisted reproduction may become a more and more common occurrence.

The reasons that people turn to assisted reproduction are varied. Youthful indiscretions may leave long-term fertility problems. Age affects fertility as do a variety of medical and genetic conditions.

Whatever the reason, medical technology has resulted in increasing and more effective solutions for those who desire a child.

The initial consultation with both partners involves a variety of medical tests to determine the reasons behind failing to get pregnant. Male testing is far more straightforward, with production of a sperm sample the only onerous task. Sperm count, motility and sperm condition are all analysed for the sample.

For women the testing is much more invasive and often requires internal examination and ovum (egg) extraction. But it is vital to ascertain the root cause of difficulties in order to utilise the correct assisted reproduction (AR) procedure.

A low sperm count may require that the sperm be concentrated or that another donor be found. For women, hormone treatments to increase egg production may be coupled with extraction, in-vitro fertilization (IVF) and implantation. As with sperm sometimes a donor egg is used.

IVF became available in New Zealand in the early 1980s. Prior to the availability of these local programmes New Zealand women had been traveling to Australia while local puritans were initially weary of intervening in the reproductive cycle. Since that time availability and complexity of services have increased steadily and a surprising amount of these services are state-funded.

With all procedures counseling is a vital component. The procedures can take years in some cases, and the emotional and psychological stresses on the couple and their relationship can be immense. In fact, many couples find that the stresses are too great and break up.

With couples becoming parents later and later in life, it is inevitable that AR resources, never plentiful, will come under more and more pressure. In the US couples are planning ahead for parenthood and are storing sperm and eggs for later use. Only time will tell whether those options become desirable here.

What’s Luck Got To Do With It?

Brendon Smith tells the story of his friends, Scott and Karen.

It was with a sort of unknown trepidation that I interviewed my mate Scott about his IVF experience. At around 25, after having been on oral contraceptives since her late teens, Karen stopped in anticipation of commencing the family that they had always planned for.

However, when nature failed to take its course, an exploratory operation determined that Karen had a condition severely limiting her chances of falling pregnant.

Over the next three years Karen was reluctant to go shopping, declined invitations to friends’ baby showers, and only attending other friends or family outings under duress.

Scott found himself not wanting to raise the issue if he could help it. He carried on with life and tried to avoid standoffs. He knew that they could consider adopting, but wasn’t quite ready to give up on the dream of their own biological children.

After serious consideration Karen and Scott accepted an offer to join the then 3 year waiting list for one of the 40 or so state-funded IVF programmes at Fertility Associates. A change in funding criteria, focusing on success chances, reduced their waiting period to less than a year—their luck had improved slightly.

Along with a group of six other couples they were counselled, prescribed daily injections to assist egg production and all eggs were collected for freezing and storage over three months.

In the next phase Scott produced as mall cup of semen and was driven by Karen into town through heavy traffic and rain, while he held the sealed cup kept warm with a wrapped blanket.

Fertility Associates soon announced that they had successfully fertilised 11 of their eggs and within a few weeks two were selected for implantation.

Karen felt a change and wondered if it was pregnancy but soon discovered that neither egg had produced the hoped-for result. Both Scott and Karen were deeply and understandably disappointed and it seemed that their relationship was on tender-hooks most of the time.

Within a few months two more eggs were defrosted but only one was considered viable. Finally the last two fertilised eggs were defrosted although again only one survived.

With all fingers and toes crossed, realistic about their chances but still hopeful, Karen and Scott waited again and this time, fortune smiled.

After a slightly stressful term Karen and Scott were blessed with a boy whom they named Campbell, and celebrated quietly. Precious hours and days turned into weeks and months.

Scott and Karen have now added a beautiful girl to their brood, this time without IVF, and have announced that they might just try for three.

They say they will explain Campbell’s story to him when he is older, but for now they just want to enjoy family fun.

At least one of the other couples who started the process at the same time as Scott and Karen, broke up after unsuccessful attempts, and remain apart.

Derek’s Story

”We found that we, I mean I ,couldn’t have children because I was sterile. That news was pretty devastating for both of us. I felt that I had let Kelly, down and for a while I seriously thought that she would, maybe even should, leave me for someone who could do the business.

But we worked our way through that, and finally considered the AR programmes. We were very lucky as my brother acted as a sperm donor for us. I consider my son to be mine, in every way he is part of the family.

We haven’t told him about his origins as he is too young, but in time we will consider it. It just wouldn’t have been the same if we had used a donor from outside the family even if one had been available so I am eternally grateful to my brother for making Jonny possible.

Definitely the best gift one brother could give another.

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