Rockpool Publishing

Will our children choose IVF?

The rise and rise of test tube baby making

Parent-Infant Specialist Nichola Bedos, author of “IVF and Ever After,” heralds the future of parenting with the news that 30% of our children are likely to make their own babies in a laboratory. What help should we offer them?

When Louise Brown entered the world, crying lustily, we somehow knew life had changed. With her birth in 1978, we could now replicate the miracle of life but in our own way; in a test tube and in the laboratory. Baby making for some parents became a scientific endeavour and not simply a loving act.
From the 1980’s until the early part of this decade, In Vitro Fertilisation grew both in popularity and in the levels of success achieved. Previously, only one out of every ten cycles of treatment would produce a successful pregnancy. By 2002, we were seeing success rates around the level of 30%. Birth rates of IVF babies in Australia have been rising too, with almost 8,000 live births recorded in 2004. Our wonderful innovations in this country together with public funding that meets some of the cost of treatment, has meant Australia now has one of the highest rates of IVF births per 1000 total births in the world. This year, experts expect 4% of all babies born here will have been conceived using IVF.
IVF has not yet reached its peak. There are a number of particularly striking features of the treatment that are set to make it the method of choice for 30% of couples. The three main reasons for this rise are firstly, the drastic cuts in the cost of IVF as new, less invasive types of treatment are routinely used, secondly, the increasing age of couples trying to conceive and thirdly, the amazing potential of the technique known as Pre-Implantation Genetic Diagnosis or PGD.
IVF has been a technique used predominantly by the middle-class in most countries. In the US for example, IVF costs are high and little public assistance is available making the treatment out of reach for many American families. In the UK, one session is supposedly offered with public money making up part of the cost; however budget cuts have meant many couples have not had access to this. In Australia, a Medicare rebate is available, which makes the treatment significantly more affordable. The overall cost of IVF, however is set to drop substantially. New treatments now being developed involve lower doses of hormone stimulating drugs used in the harvesting of eggs. Other techniques involve harvesting unripened eggs, allowing them to mature in the laboratory. Fewer drugs in this so called, “Soft-IVF” will bring the treatment within the means of many more Australians.
The second reason for the rise in IVF births will be due to the increasing age at which couples begin trying to conceive. In 1979, only one out of four first-time mums was over the age of thirty. By 1999, this figure had climbed to one in two. As we have careers, enjoy the ‘couple-with-income’ lifestyle and save for a home of our own, our decisions about family life are being increasingly left well into our thirties. Since female fertility declines significantly after the age of 35, many more couples are turning to assisted conception in order to have a family of their own.
The third and possibly most dramatic reason for an explosion in IVF successes will be the increased use of PGD. This technique was developed in order to screen successful embryos after test tube fertilisation to ensure there were no known chromosomal abnormalities. Through this technique, couples that carry genes for Cystic Fibrosis or Muscular Dystrophy, for example, can ensure that the embryos chosen for implantation into the mother’s womb are those that do not carry the defective gene. These couples can achieve a pregnancy without the fear that they may have to make an agonising decision to abort an affected fetus or to deliver an affected child.
PGD has gone one step further. Children who develop certain diseases such as childhood leukaemia and who need a bone marrow donation not available from parents or existing siblings can now be treated with cord blood from a new sibling. After harvesting eggs and fertilising these through IVF, scientists can select the embryos that are a blood match to their sick sibling, implanting them into the womb so that treatment can begin after the baby is born.
PGD offers even more, however. As scientists continue to discover more about our genetic make up, parts of genes are being identified that are linked to other diseases such as cancer. As these breakthroughs continue, PGD will be able to offer couples ever more sophisticated testing. There will come a time when we may not only be able to ensure implanted embryos are free from the risk of developing certain cancers, we may also significantly reduce the risk of developing autism, schizophrenia and perhaps even the risk of becoming obese. With so much on offer to parents, may fertile couples regard IVF and PGD as the answer for risk-free parenthood as much as infertile couples do?

Much More than Science
This brave new world of healthy gene selection sounds wonderful. And it is, up to a point. The drawback to this method of conception is that, although scientifically, we are breaking amazing new ground, emotionally some IVF families are suffering.
In a groundbreaking Australian study led by researcher Dr Karin Hammarberg of the Key Centre for Women’s Health in Society, IVF families reveal the anxiety that stems from infertility and IVF treatment. “The lengthy process of relying on technology to do what their body can’t really takes its toll,” reports Hammarberg, of new mothers. Furthermore, the precious IVF baby is more often delivered by Caesarean Section than by natural means adding to both the drama of birth and the loss of control for mum. The result is three times the rate of Early Parenting Centre admissions as compared with non-IVF mums, and a drastic reduction in successful breastfeeding. Many IVF parents find themselves at the end of their babies’ first year, feeling far less confident than non-IVF parents.
Professionals who assist parents and babies are beginning to realise that IVF families bring slightly different issues to the norm. Experts are not concerned about helping mum bond with her IVF baby, instead they try desperately to help her to be a ‘good enough’ parent rather than the ‘perfect’ one she tries to be. Experts are also concerned about the level of trauma some families exhibit after multiple, failed IVF attempts. “(Parents) are still expecting it all to go wrong,” notes Infant Mental Health Specialist Judith Edwards, Manager of the Sydney based Parent-Infant Foundation of Australia, a charitable organisation helping families in need cope with early parenting.

What Parents Need
IVF brings happiness as well as stress and grief. As an IVF parent, you can enjoy the happiness far more by taking a few simple steps towards reducing your stress:

Don’t ‘go it alone’
IVF families need to be able to ask for help. A common theme that experts hear is, “I was so lucky to have my baby, how can I possibly complain that I’m not enjoying her?”
All parents need assistance with parenting at times and asking for help is not an admission of failure but a positive step towards building a happy, healthy family. There are many sources of support for IVF families including the family GP, The Australian Breastfeeding Association, Early Parenting Centres such as Tresillian in Sydney and web sites that offer IVF parents a safe haven through which to meet other IVF parents, for example

Be proud of what you have achieved
Parents who have given birth to an IVF baby need to practise feeling proud of what they have achieved rather than focusing on how they may feel their bodies let them down. “Re-framing” is a psychological tool that allows IVF parents to focus on the positives; that their egg and sperm successfully fertilised, that the embryo implanted and that the baby was delivered after a successful pregnancy.

Tell your child early
Secrecy surrounding the mode of conception, particularly if a donor is involved, serves only to create tension and mistrust within a family. Children will grow with a confident self-identity if they are told of their origins right from the beginning of life. There are wonderful children’s story books available at that introduce difficult conception discussions.

The Families’ Experience
“(IVF) was such a clinical experience,” reports a Victorian mum of twins conceived through IVF and delivered by Caesarean Section. “Most of the time, I felt like I was on ‘auto-pilot.’ All of the decisions from conception to delivery were made by the doctors, in mine and my babies’ best interests, but I had no real control.” This absence of control appears to raise anxiety levels for these couples.
IVF also had an impact on this couple’s self-esteem. “The IVF process is so far removed from natural conception, that we felt that we had failed, both ourselves and each other,” this mum notes. “I was very envious of other women who had fallen pregnant naturally and seemingly without effort or thought, and who had no real concerns or worries during their pregnancies.”
This family is very proud of their twins and despite the difficulties they encountered, are advocates of IVF treatment. “I loved every minute of taking care of (my babies). They are our ‘reward’ for years of infertility and for having to go through the emotional rollercoaster that is IVF. I would still choose to undertake IVF treatment to achieve a family.”

The Celebrity Connection
IVF parents are nine times more likely to have twins than couples conceiving naturally. Famous celebrity IVF multiple births include twins born to actress, Jane Seymour, in 1995. Seymour reports turning to IVF after several miscarriages. She initially had three embryos implant but one failed to continue and Seymour and her husband welcomed their fraternal twins into the world six weeks early. Seymour talks about her experience of raising babies in her book, “Two at a time: Having twins.”
Seymour waited some time before confirming that her babies had, indeed, been conceived through IVF. It is common for celebrities to deny their use of IVF, despite purported snaps of the concerned couple leaving a fertility clinic. This may also be the case for Desperate Housewives’ star, Marcia Cross, who gave birth to fraternal girl twins in February. Cross gave an interview before the birth, lending her support to over-40 mothers who needed to use donated eggs for IVF procedures, as their own eggs were not of the quality needed to ensure a healthy pregnancy. She has, as yet, stopped short of confirming or denying that her twins were conceived in this way.


Nichola Bedos – 04 August, 2009