Tell me about your experiences with IVF

In My Humble Opinion
1

After 14 months of trying, and a few rounds of tests for both of us, our fertility specialist has advised that we are unlikely to be able to conceive naturally, and (following a session with an andrologist to see if we can pinpoint what is it that is causing our very low sperm count results) we’re heading for IVF. More than likely this will be the full-blown IVF, and not IUI.

I’m trying to come to terms with the fact that we may never become parents, given success rates of IVF. Also, adoption (while I’m open to it) is a very long process in Australia, and that would be by no means a cert either.

Life’s good - we live very well, and I know that would be impacted if we had kids - but there is a part of me unwilling to give up just yet - the part of me that feels pain each time a friend announces a pregnancy.

But…not sure how I feel about IVF either. I’ve read about the process (skim read, since it all sounds pretty scary…) Please let me know your experiences, successful or not, and how you have dealt with infertility?

2

No personal experience, but I observed a friend and her husband going through the process – successfully.

They found it nerve wracking, and there were all kinds of odd things that were unexpected, but kind of made sense if you thought about them. Like when they did the implantation, the room temp had to be 98.8 supposedly to make the, um, feti(?) comfortable.

They implanted 5 and two “stuck”. We called them Kang and Kodos. Eventually they aborted one – that was another unanticipated possibility they faced, and the question may come up fo you as well.

3

I can’t give you any information about my experiences with IVF yet, as my husband and I are at about the same stage as you guys, but I can talk about some of the stuff that goes has been going through my mind in the run up to realising that we might need it. I don’t know if that would help. I will certainly be interested to see what other people have to say about their experiences with IVF (both the physical and emotional side).

We have been trying for two years, and have been though probably all the tests that are necessary. I appeared to be working fine, however four months ago I had to have my left ovary and tube removed after discovering a watermelon sized, 7 lb ovarian cyst. Kind of unbelievable that it got as big as it did before I realised anything was wrong. According to the two fertility specialists we saw, though, this had no bearing on our fertility problems, which seems hard to believe. It does mean, though, that I have now half the ovarian reserve that I used to have, which might make IVF a little more tricky.

There also originally seemed to be a male factor issue, but now we’re not so sure as his results have improved a lot in the last 8 months. I think that after all of what we have been through, we have been lumped in the unexplained category, and I have found this very frustrating. I would like someone to be able to tell me why we are having problems, as now it sort of feels like we just haven’t been doing it right, as silly as that sounds.

I think one of the hardest thing about all of this has been dealing with friends’ pregnancies and the general lack of understanding as to exactly how upsetting all this has been. My best friend is currently seven months pregnant with her first baby after she got pregnant the first month they tried. As irrational as it is, it just feels so unfair. I also started off being quite open with friends, and initally upon finding out about our problems, probably relied too heavily on one friend as a sounding board. I don’t know if I have permanantly damaged the relationship because of this, but it is a little strained at the moment. I am now keeping things to myself as I feel foolish for expecting so much from a friend.

Not getting stressed about the actual trying has been difficult, particularly for my husband. We have never had so much awkward, just-plain-bad sex as in the last year or so! It’s just impossible not to know when you should be having sex, and that takes all the fun out of it. And adds a huge amount of pressure. And sometimes makes it plain impossible.

Another unexpected thing that has been hard to deal with are the questions it has raised as to exactly how much we want to have children. Some days I am so desperate that my heart aches. Other days I feel curiously ambivalent. Is this normal? I don’t know. I guess if we had got pregnant straight away, we wouldn’t have time for all the second guessing. We haven’t got as far as thinking about adoption, as we feel we need to focus on giving IVF a try first.

Like you, we would be going straight to IVF, skipping IUI. Because we live in the UK we have the option of getting IVF free on the National Health Service. We are on the waiting list, but this stands at about 2 years at the moment, and that is longer than I want to wait (I’m 32). We have been to a private clinic, and would be much happier going with them - their success rates are much better than the NHS clinic (about 56% clinical pregnancy rate per cycle (translates to about 50% live births per cycle) - which is great considering that they are only allowed to transfer two embyos per cycle in the UK) and the process will be a lot less stressful with them. We just need to save a little as this doesn’t come cheap and money is another factor that is causing us stress.

Ah, yes, money. That’s another worry. How do you put a price on getting pregnant? Is it worth £5,000? £10,000? More? What if you spend all that money and are unsuccessful? What if you are successful, and then have no money to actually raise a child? (Incidentally, I have filed that last one under the heading “Will cross that bridge if I come to it”).

We have decided, for what it’s worth, to give ourselves a break from all the infertility madness for about three months to prepare ourselves physically and mentally for going through this. I think that I am having a hard time coming to terms with the fact that we may need this and I need a bit more time. I sort of feel that when the time is right to start, I will know. I have read up a lot about the process, and physically, I am not anticipating it being too awful. It is the emotional side that I am dreading. The waiting and hoping. Are there enough follicles? Have they retrieved enough eggs (from my one ovary)? Have any fertilised? Are the embryos good quality and growing? Did they transfer okay? And then the big, important two week wait. Not looking forward to that.

So, I am not sure that helps or not. I do know that I have found it very difficult not having anyone in my life that I can really talk to this about, as no one I know has been through it. I would like to know how other people have coped - have they been open about it with friends and family, or kept everything to themselves? The process is such an intense one at times that I sometimes don’t know where to draw the line in terms of what infomation to share, as some of this stuff is pretty personal, and I have since discovered that not everyone even agrees with IVF or free funding for IVF in the UK.

4

Not silly at all - I find myself staring at people with kids, and I can’t get my head around how easy it seems for other people - because it’s been so hard for us, I am amazed at people who have actually had success. But now we’ve got a ‘reason’ for months of unsuccessful trying, at least I feel a little better; but only a little, since it’s now a tangible reason we’ll need to overcome, instead of one month, just getting lucky.

Yeah - I know this - my best friend had her second baby 2 days ago. She’s currently in New Zealand, and I feel really bad, but as much as I am looking forward to seeing her new daughter in a few weeks, I am relieved that I never actually got to see her pregnant. We’d been trying together for several months to have our babies at the same time, and I really can’t believe that she’s here now, and I’m no further ahead. I’m lucky in that my friend tried for 11 months for number 2 (after getting number 1 the first time around) - so she knows something of what I’ve been going through. But fact still remains, she’s completed her family, and we’ve not even had the chance to start.

Do you find yourself feeling less and less like talking about it? I feel like a shell is slowly growing around me about it - I now want to avoid people with kids, talking about babies, or any of my troubles. I think I’m tired of the whole thing.

I think it’s normal! (Or I hope it is…) But I do know that when, or if, this baby comes, I’ll know it was really wanted. And if it doesn’t, I know there is a good, full life to live without it. I just know I have a preference for one over the other at this point.

Luckily Australia covers much of the cost of IVF through Medicare - I haven’t been given a timeframe, but I don’t believe it’s a long waiting list. Still, I’m 33 and aware that my fertility is going to start dropping significantly within 2 years, so I’d rather just get on with it. Also since we’d consider adoption once this is done - they won’t consider you if you’re still undergoing fertility treatment, yet have maximum age limits, and at least a 2 year wait.

I will be totally amazed if it actually works. I think someone will have to hit me on the head with a giant pregnancy test to convince me.

It definately helps to hear, simply to know I’m not the only one! People don’t talk about this, only when things are successful. I take great heart from hearing that it’s not actually as easy as you’d think from other people. But I’m slowly becoming one of the ‘silent sorority’ - it’s easier not to tell people, and in fact, only my mum and 2 best friends know.

5

I know! My mind boggles sometimes at the fact that for some people, sex can actually get you pregnant! The thing is, given our (non) diagnosis, there is the possibility that if we kept trying for the next few years, then it might work for us too. I just don’t think I can take the gamble that I’m 37 or 38 and having to contemplate IVF at that point. And as you say, if it got to the point of looking into adoption, well, I would want to do that sooner rather than later.

I have had other friends have babies in the last couple of years, but this one was the first that I had to experience up close and personal, while I was going through the whole infertility thing.

In my case, my friend had seen how much trouble we were having (at about the 12 month mark) and decided not to put off starting a family herself. She also had every expectation that it would be difficult for her - her mother had had problems, she is obese and she had also been told she might have PCOS. And boom, she gets pregnant straight away. She did feel bad for me, and was dreading telling me, but once she had, I think she thought that that would be the worst of it. When she told me I felt stunned. It has got better, but to be honest it was pretty awful every time I saw her for months (not that she knew this). I have every expectation that things will go back to being pretty awful when the baby comes in November, but I am sure we will all adjust.

Reading this, I am aware that this sounds terribly self-centred of me. I have to stress that I try not to let this affect my relationship with her, and we came to an understanding that I should feel free to talk about the infertility stuff if she could talk freely about the pregnancy stuff. But let’s face it, which do you think gets talked about more? It’s probably better that way, though, as she does have a hard time understanding and has come out with a few doozies (like complaining about how I was getting to go away on (a consolation that I was not pregnant) holiday and what did she have to look forward to? Hmm…).

Definitely. I am sick of the whole thing, and I don’t want to come across as some sort of obsessed banshee that has nothing else to talk about (whether that is the case or not). When we were going through all the tests, there was a lot going on in my head that I felt I needed to talk about. Now that we have some answers and it is just a waiting game (either for free treatment, or to decide to start private treatment), I have fewer questions in my head, and less of a need to share.

Good luck with your treatment and I hope that you either get to start soon, or find out when you might be able to. The uncertainty about what is happening is very stressful in my experience.

I have to say that I am quietly hopeful. I am not sure if you can find out your clinics stats, but with ours the 50% chance per cycle seems quite good. If you can go through a number of cycles, then the odds are even better (obviously that depends on your particular circumstances). Fingers crossed.

I’m glad it’s helped a little. When we first started all the tests, I found that there were a lot of blogs out there that were very helpful (despite posting here, I really don’t go for the interactive side of things on the web, and infertility message boards were a bit much). I still read a few, but am dialing it back as I am finding it less helpful now, and it is possibly making me think about it a little too much.

My family knows (mum, dad, brother), but my husband’s does not. This is because we decided that my family would be able to be helpful and supportive, while his would not know how. I have also told most of my close friends to some degree or another, but am becoming more selective as to who I tell what to. It is too easy to get into a situation where they try to be helpful or interested, and end up saying something which makes me want to punch them! I honestly don’t blame them, but the less stress I have at the moment, the better for all concerned. I don’t want to go through this experience and end up alienating all those around me.

6

Disclaimer - I work for a U.S. company that supports Fertility MD practices.

Observation: IVF should not be considered a single treatment event. Instead, it is better approached as a course of care - planning for multiple IVF cycles. Why? Because the likelihood of success with a single cycle is ~40% on average for women aged 35 and under - meaning they are 60% likely to not get pregnant - but if they pursue 3 or more IVF cycles, their odds of taking home a baby can almost double to ~75% - 80%. Also, there are multi-cycle treatment plans available in the U.S. where for a fixed price up front you can qualify for multiple cycles. Many Fertility MD’s have either their own programs like this or access to ones like IntegraMed’s Shared Risk Refund Program (also called Attain IVF) or ARC’s various programs. Many of these programs carry the added benefit of providing a refund of some or all of the costs if you don’t end up with a take-home baby.

If you are outside the U.S., access to a multi-cycle treatment plan may be very different or not necessary - I am not sure. But the basic message remains the same - if you can, figure out a way to commit to multiple cycles to increase your chances.

Hope this helps - and please don’t take my word for it; talk with your doctor.

7

Although we are in the UK, it is a little helpful to know this. Our clinic does not operate a shared risk programme, but it does help to mentally prepare for the possibility of more than once cycle. Money will be tight, but I would rather plan for it than pin all my hopes on a one shot deal.

8

My wife and I were successful with IVF. Twins (two embryos implanted). It was a long expensive journey with a happy ending. We had a couple embryos left over and went for seconds but they didn’t take.

I can’t go into more detail because I’m at work now, but one thing I learned along the way is that I had to give myself time to digest concepts that I had a visceral reaction against before making a decision. Once it became more “normal” then it was a little easier to make a final decision. There was just a lot that I really found hard to swallow when first presented.

Also, my wife quit her job because she worked long hours (in labor and delivery. Imagine that.) and was terribly stressed out all the time. Soon after that, Bingo. But then no second income. We’re doing ok, though.

9

This is a HUGE point. When my company was surveying women who had completed multi-cycle treatment plans, we assumed that they would care most about how much money they had saved by paying up front when it turned out they needed more than one cycle of IVF to get pregnant. WRONG - it turns out that 97% of the women who got pregnant on their first cycle (meaning that by paying up front for a multi-cycle treatment plan, they paid more than for a single cycle of care) would do it again and recommend it to friends and family. Why? Because of the peace of mind - apparently knowing that they had a bunch more tries already available enabled them to approach their first attempt from a less-stressed-out place…

This ties in with later research we did - IVF is super stressful; getting the embryo(s) implanted and then waiting two. full. weeks. for a pregnancy test is apparently one of the hardest things ever. If and when the results come back and the woman is NOT pregnant, many simply don’t think they can deal with it again and stop at that point - which is awful since trying 3+ times can lead to the superior results I mention above. However, if they have locked in a multi-cycle plan they are more likely to be aware of the chances of the first cycle not working, and, if it doesn’t, to feel prepared to try again knowing they have more tries waiting for them…

Again - PLEASE talk with your doctor - I am just sharing data that has been collected…

10

I did one round of IVF and as a result I have a 4-month old daughter.

We had male-factor. My husband is low and slow (low sperm count, slow movers). He was in a car accident 10 years ago that left him in a wheelchair, which partially accounts for his underachieving swimmers.

We did IVF-ICSI last September. My protocal consisted of a Lupron shot every night, then Follistim about half way through and then finally the trigger shot 12 hours before egg retrieval. None of these shots hurt. They are all sub-q’s and once I got over the mental part about sticking myself with a needle(s) it was a breeze.

Of course, you also will have to go in to the clinic for blood draws every couple of days, as your hormone levels determine how much medication you inject that night. And there are lots of internal sonograms to count and measure your follicles. They don’t hurt, but it can be a bit uncomfortable.

The egg retrieval sucked, I’m not going to lie. I was put to sleep for it of course, but there was a lot of bloating and cramping for about 3 days after. I ended up with 13 eggs retrieved. Of the 13 retrieved, 8 fertilized. (You learn to live and die by numbers while going through IVF.)

I then started on the progesterone shots (also called PIO-progesterone in oil). You have to use a big fat needle for that, so I did all the tricks so I wouldn’t feel it-lidocain cream, ice, standing on one foot, etc. I stayed on PIO until I was 6 or 8 weeks along, I think.

I had 2 embroys transfered 5 days after egg retrieval, of which 1 implanted. I froze the other 6 embryos for possible use at a later date. My goal is to give each embryo a chance at life, so if I don’t use them I will donate them to other couples.

40 weeks and 3 days after embryo transfer-a baby girl. :slight_smile:

That’s the nuts and bolts of my experience. I know I’m leaving some stuff out, so feel free to ask specific questions and I’ll do my best to answer. All-in-all, it was a lot scarier thinking about the process than actually doing it.

You should visit the forums at www.fertilitycommunity.com. That place was a life saver for me. You can get just about any question answered and find other women who are going through the same thing you are.

11

These are two of the things I was wondering about. My clinic does something called conscious sedation for the retrieval - was this different to what you had? Yours sounds like a general anaesthetic. I think with me they will give me some sort of happy drug, but keep me awake :eek:

Also, the PIO shots sound painful (particularly for the amount of time you had to take them for) - was this difficult, or did it just get used to it, like all the other indignities (yep, I am already used to the dildo-cam)?

Did you find that you put on weight during this process? I have heard a lot of people talk of putting on 10 or 15 lbs with all the drugs (or maybe the stress?)

How did your husband cope through this? Did he play an active roll in the treatment, or take a back seat? Did it cause any friction between the two of you? I am already finding that I have stopped talking about “when” we have children, and having all those hopeful conversations, and talking more about “if”. In fact, I am mostly avoiding those sorts of conversations with him at all!

At what point did you decide that you were ready to start IVF. We have reached the 2 year mark, and are only just feeling like this might be our only option, but at the same time, we don’t want to rush in.

Thanks for the website. It’s one I haven’t visited before.

12

To the best of my understanding, most conscious sedation procedures involve a drug that has a mild and very short-term amnesiac effect. You’ll have a local anesthetic, plus a drug like Versed that will keep you mellow about what’s going on, and you won’t remember the procedure afterwards. That way with you being conscious, they can still monitor what you’re experiencing, you won’t have the extra risks of a general, and you’ll wake up faster. I had Versed for a procedure (non-fertility-related) and don’t recall it at all.

13

My sister has two sons via IVF (two years apart, no multiples for her), both conceived on the first round - but at a cost of $40k per kid. She did the multi cycle program WordMan recommends (and I would to, if such a thing is available to you) - which made it more expensive than if she would have paid per cycle and conceived like she did the first time - but who knows if she would have conceived the first time.

We have a ten year old boy adopted from Korea because we decided we would only afford one path - and the chances of a baby following the international adoption path were significantly higher than IVF - particularly since our infertility was also unexplained. We also have a surprise bio daughter - turns out we were just “sub fertile.”

The ambivalence is normal -and probably won’t go away if you do become parents - there are times when I think about how nice it was to have our own lives and our own money in the days before children ate up our time and dollars.

14

If low sperm count is your only issue, then you have a very good chance of conceiving via IVF provided you use ICSI (intra-cytoplasmic sperm injection). That’s where they inject the sperm directly into the egg thus guarenteeing fertilization. I wouldn’t waste my time with IUI if I were you.

I have been thru IVF multiple times. I now have 2 children. While the process is expensive and an emotional roller coaster, it is well worth it if you want children. It’s devastating when it doesn’t work, but when it does you feel like you’ve won the lotto. But I think you’ll need to do some soul searching to decide whether or not it is right for you.

15

No personal experience, but my neighbor had triplets via an IVF process, though as I remember the story, it was more complicated than the standard IVF. They both had fertility issues.

She had one shot at it, and they got three adorable kids out of the deal. She said it was pretty expensive.

16

Yes, I was under general. Every clinic’s procedures are different and I would guess conscious sedation is a bit cheaper than general. I would also guess that if you are really scared, nervous, etc. you could probably request general for an additional cost.

PIO shots are not the worst thing in the world, but I was a sissy and used every trick I could in order to feel the shot less. The first shot is always the hardest. My husband spent a solid hour giving me a pep talk beforehand. Once you get through the first one the rest are easier. I even started giving them to myself because my husband had to go out of town for a week. I got so used to giving them that I actually gave myself a PIO shot while on the phone to my brother and he never had a clue. After everything you’ve been through to even get to that point, you just get over it and soldier on.

I did put on about 10 pounds. Stims cause some bloating and water retention, so most of that was water weight. After I stopped the stims, a lot of the weight dropped off. (Just in time to gain 30 pounds from carrying a baby!) Also, I swear I could feel my ovaries. I read about a lot of other woman saying the same thing-there is a heaviness in your abdomen that you’ve never felt before. Could be just from the bloating, could be all in my head, but I’m conviced it was my follicle-heavy ovaries.

My husband was a real trooper. He went to all of my RE appointments (except when I was just giving blood or doing a follie count-those are super quick appointments), he watched me give myself my sub-q shots and gave me most of my PIO shots and babied me after ER (egg retrieval) when I felt like crap. I should mention that the drugs make you crazy, so we did have some fights caused by my hormone-induced insanity. But for the most part, we made it through just fine.

I found that when I decided I wanted to try IVF that I had to be very blunt with my husband and just tell him EVERYTHING that was on my mind. He couldn’t understand why I had a need to be pregnant and why I didn’t want to wait 5 years to start the adoption process. And even though I had trouble explaining what the need to have a baby felt like, he eventually got it and when he did, he was totally on board.

We had been trying to conceive for about a year when we went to our first consultation. I can’t explain how I knew this was the right path for us, I just knew it was. We did look into adoption, but because I had had cancer, every adoption agency we talked to said we had to wait 1-5 years before we could even apply. Even though what I wanted most of all was a baby, there was a huge desire in me to be pregnant. After we met our doctor, several of the nursing and lab staff, I was so completely comfortable with everyone that I knew we were on the right track.

17

I just gave birth 6 weeks ago to my daughter via ivf - icsi. It was my first try with male factor morphology being borderline normal. It was a positive experience for me and I gave myself most of the shots. I wasnt on lupron though. They tranferred 3, one took at 3 day et, 8 cell, no fragmentation. Will post more later if you have questions.

18

It’s lovely to hear the good news stories - congratulations to all of you who got that ‘take home baby’!

Sadly, having done the whole gamut of tests and treatments, we weren’t so lucky. All results for blood tests/sperm analysis/laparoscopy for tubal patency etc came back within normal limits. Being diagnosed with unexplained infertility was so frustrating - there was no discernable reason why we couldn’t conceive.

We tried Clomid (even though ovulation didn’t seem to be an issue) while we waited to go on the waiting list (the NHS offered 2 funded cycles of IVF at the time). Yes - we had a 4 month ‘wait’ to be added to the official Waiting List (which was estimated to be about 2 years).

It took nearly 4 years from our initial consultation with our GP to the 1st IVF treatment. The 1st cycle was unsuccessful, and never even made it to egg retrieval. Apparently the drug dosage wasn’t high enough. The 2nd cycle worked as anticipated but out of 16 follicles, only 4 eggs were retrieved. (I had ‘light sedation’ and pretty much remember it ALL). Out of those 4, only 2 fertilised and after the spell they spent in the ‘incubator’ neither of those were viable. That was the limit of free treatment available to us. I found the effects of the nasal spray drug to shut everything down much worse than the injectable hormones.

We decided to pay for a 3rd cycle, and to try ICSI. 14 follicles produced 8 fertilised eggs, 2 of which were transferred and 6 were frozen. We spent the next 2 weeks dreaming and hoping. Neither of the 2 transferred embryos implanted. It was devastating.

After a few months to think and recover somewhat, we decided that we would try again with some of the frozen embryos. Out of the 1st three that were thawed, only 1 made it in tact and that also failed to implant.

I can’t really explain how numb we felt. Despite what everybody tells you about keeping your expectations low, and the statistic show yadda yadda yadda, it’s impossible not to dream that you will be in the ‘lucky’ percentile. Even the awful effects of the various drug regimes, and the not insubstantial pain of injections/retrieval seemed a price worth paying, if it meant having a family of our own.

Someone once told me an analogy along the lines of this - that having a disabled child was a bit like planning a beach holiday in Greece. You pack your bags according to the climate your anticipating, but your flight is diverted to Norway. Sure, you still have a great holiday, but it’s not what you were expecting. We never even made it to the airport.

After much soul searching, we decided that we couldn’t go through it all over again - the cost was too high, mostly emotionally but also financially. The remaining embryos stayed frozen at the clinic for the next 2 years and eventually we decided to donate them for research purposes. We couldn’t bear the thought that if we donated them to another couple, there was the possibility that someone, somewhere could be raising our child(or even children!)

We never really seriously considered adoption, as for us, it wasn’t so much having A baby as having OUR baby - not to mention that here in the UK the chances of actually getting a baby are minimal. Especially considering that by the time we had opted not to pursue any further treatment, I was 36 and my husband was 44…

This turned out to be a bit of a marathon post, and there’s still lots more I could say - both good and bad, but I suppose what really really counts is that life goes on - maybe not the life you hoped for, but a good one nonetheless. We’ve been happily married for 21 years now, and although the emotional roller coaster of infertility sometimes threatened to derail us, we survived and feel blessed that we have. That which does not kill us and all that…

19

I’m sorry that you were unsuccessful after all your treatments. We are unexplained too, and I’m also finding it frustrating not having a label for what was wrong. If we did, maybe we could stop blaming ourselves. I’m aware that unexplained doesn’t necessarily mean that there is not a problem, but all the same time, it’s not a very enlightening diagnosis.

Were you not tempted to skip the NHS entirely and go straight to paying for treatment? After visiting two clinics, the NHS one, and the private one, I can’t begin to describe the differences between the two, and I now have much more faith that our time (and money) would be better spent going straight to private treatment. If nothing else, I now have only one ovary, and the NHS clinic just doesn’t seem to have the time (or interest) to monitor things as closely as I would hope in this situation.

I have experienced the opposite – everyone else seems convinced that IVF is a sure thing. They don’t seem to get why I think that it is a huge gamble. I would question whether most normal people would think is a sure thing to place a £5,000 bet on a 35% chance of winning?

It’s good to hear that even when things don’t work out as expected, life can keep going in a manner that can still be happy. If nothing else, this is really making me thing about my relationships with other people, be they family, friends or my husband. And should we be lucky enough to one day be parents, I hope that we can remember this time and appreciate things in a way that we might not have been able to had life taken a different path.

20

I’m interested in this aspect - how to go through this (success, or no success) without losing what I value most, our relationship. So far, we seem to be doing OK - it’s a partnership thing, and we talk about it in those terms. When we’ve discussed how some people get through this, and some don’t, we’ve concluded that we can see a life for ourselves without kids - instead filled with lots of cats, travel and spoilt nieces, nephews and assorted clingons. But is it really that simple?

I’m particularly interested in hints on how to deal with male infertility, since as far as we can tell (other than polycystic ovaries, but not PCOS) I’ve got no issues. Emotionally, I’m worried that IVF will have a visable physical impact on me, with little for him to do - will he feel guilty (not that he should), less manly, frustrated etc, and if so, how can I help him deal with this?