Opinion

Suspension of fertility treatment having a devastating effect

Two weeks ago I was due to have my fourth embryo transferred

It is estimated that 5,000-6,000 women undergo fertility treatments in Ireland each year. Photograph: Alan Betson

Sarah K
Mon Apr 20 2020 - 02:00

Sir,

I’m writing this letter to raise awareness of the countless women and men whose hopes of having a family are currently on hold due to the cancellation of all fertility treatments.

All fertility clinics in Ireland have ceased providing any treatment that could result in pregnancy. This is in line with recommendations from the European Society of Human Reproduction and Embryology (ESHRE), and with fertility treatments not being deemed an “essential service”.

Two main reasons have been given. Firstly, clinics have said they are taking a precautionary approach given the limited data on how the coronavirus could affect women and babies in early pregnancy; and secondly, treatments have been stopped in an effort to prevent any additional burden fertility patients may place on the healthcare system.

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I’m 42 years of age, and more than two years ago, I started down the precarious road of fertility treatment. After three rounds of IVF, countless diagnostic tests, and three early miscarriages, two weeks ago I was due to have my fourth embryo transferred.

In Ireland, fertility clinics are run as private entities and therefore operate outside the realm of public health

A few days before the procedure, I got a call from my fertility clinic to say it was cancelled indefinitely. My hopes of having a baby in 2020 shattered, and with all treatments stopped, there is no sight of when I will get to try again.

People speak about fertility treatments as elective procedures, much like they would of breast implant surgery or a face lift, yet fertility treatment is anything but. The World Health Organization recognises infertility as a disease and fertility procedures as a treatment.

The American College of Reproductive Medicine in one of its recent Covid-19 updates “continues to emphasise that infertility is a disease and infertility care is not elective”. Elective procedures generally refer to “surgery that can be delayed for a period of time without undue risk to the patient”, and this is not the case with fertility treatment.

We know a woman’s age is the single most important factor when it comes to fertility. Any delay, even a month, can mean the difference between success and failure.

Frustrating

For me, one of the hardest and most frustrating parts of the IVF process has been my inability to translate into words the sheer desperation and sense of urgency I feel. If I was drowning, someone would throw me a life line. If I was starving, someone would find me food.

For me, the longing and desire to have a child is just as strong and instinctual as wanting to survive or eat, yet when it comes to infertility, it is somehow okay to say, sorry your treatment has been cancelled indefinitely. Would we tell a person with depression that their treatment has been put on hold?

While the reason for cancellation of taking a precautionary approach is a noble one, surely if this was being taken seriously as a real threat, like the Zika virus, our radio and TV screens would be filled with experts advising all women to avoid pregnancy, not just women undergoing fertility treatment.

This is not the case.

As the powers that be get to grips with the situation, I am pleading with them to strongly consider the time-sensitive nature of this treatment

Currently, to my knowledge, there is not one governing body advising fertile women to avoid pregnancy. Only women requiring assistance are being asked to avoid pregnancy. As a fertility patient reliant on treatment, the talk of a baby boom in nine months’ time is agonising.

As regards to the intent of reducing any unnecessary burden on the healthcare system: in Ireland, fertility clinics are run as private entities and therefore operate outside the realm of public health. It is estimated that 5,000-6,000 women undergo fertility treatments in Ireland each year.

Many of these women will not interact with the public system until they are 12 weeks pregnant. Early pregnancy complications are a concern in both fertility patients and women who conceive naturally.

However, is it really equitable to say to fertility patients, we are not providing treatments as we don’t want you to be a burden, yet we accept we will be treating the complications of fertile women?

Time sensitive

As a someone who works in healthcare, I am acutely aware of the current situation and truly sorry for the tragedy that will befall so many. I know our Government is fighting fires and doing the best it can during this very uncertain time.

However, as the powers that be get to grips with the situation, I am pleading with them to strongly consider the time-sensitive nature of this treatment.

It is well published and widely accepted that a women’s fertility begins to decline after the age of 35. At 42, fertility takes a nosedive. Women my age have about a 6 per cent chance of success per IVF treatment. Just one month could determine if I become a parent, one of the most natural miracles of our existence, or live for the rest of my life wondering.

As a nation we have made great strides to acknowledge and address mental health issues, and so I would ask ESHRE, the National Public Health Emergency Team, our Government, the Medical Council and the clinics to take into consideration the massive unintended psychological distress this action has already caused, and will continue to have, if fertility treatments are not resumed.

Fertility Network UK has reported a 50 per cent increase in the use of its counselling helpline, and psychologists in the UK have said the shutdown is having a devastating impact on IVF patients. The Hippocratic Oath says, “first, do no harm”. Are we doing more harm by doing nothing?

Sarah K is not the writer's real name. It has been changed to protect her privacy

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