Infertility and Miscarriage – The Facts What is infertility?
Infertility is defined as no pregnancy after having unprotected, regular intercourse for one year. Within the first year of having unprotected intercourse 80% of couples will conceive, increasing to 90% in the second year.
Women over 35 are usually advised to approach their GP after six months of unprotected regular intercourse for further investigations.
All patients have the right to be referred to the NHS for the first infertility investigation, but treatment is not widely available on the NHS and can be very expensive privately.
If you want to get private treatment for infertility make sure you choose a clinic which is licensed by the Human Fertilisation and Embryology Authority (HFEA), which regulates and inspects all clinics.
Each year around 24,000 couples in the UK opt for IVF treatment, and about 8000 babies are conceived this way.
More than one in five pregnancies ends in miscarriage – around a quarter of a million in the UK each year.
A quarter of women who become pregnant will experience at least one miscarriage.
Most miscarriages happen in the first three months of pregnancy – but they can happen up to the 24th week. Pregnancy loss after 24 weeks is known as stillbirth.
Recurrent miscarriage is usually defined as the loss of three or more consecutive pregnancies, and fortunately only 1% of couples fall into this group
Even after several miscarriages, most women have a good chance of a successful pregnancy.
One in 100 pregnancies are ectopic. This is where the embryo starts growing outside the womb, posing a risk to the mother’s life and making the pregnancy unviable.
Infertility and Miscarriage – Real Life ‘My friends getting pregnant breaks my heart’
Milla Johnson*, 32, has been happily married for five years and for the last two has been trying for a baby.
‘ “So when are you going to have children?” A perfectly straightforward and reasonable question, especially when asked of a 32-year-old who loves children and has been happily married for five years. But if only the enquirers knew what torture these eight words are to me. I’ve learnt to lie politely that “We’re thinking about starting sometime next year.’ But the angry, hurt and irrational side of me wants to smash their smug face with my fist.
‘I’ve been told I’m infertile, but there’s nothing physically wrong with me or my husband. We’ve had all the tests, and they’ve all come back AOK; we just haven’t conceived yet.
‘But how can I tell these apparently super-fertile people about my inability to conceive? I know they are super-fertile, because people delight in telling others how quickly they fell pregnant. I find myself drifting from my friends as they embark on a new phase of their lives that I can’t follow.
‘How can I tell them about The Waiting. That every month for over a year, two weeks of each month are torture for me as I wait to see if perhaps this month, things have worked. And just in case they have, staying off soft cheese, rare steak, smoked salmon and red wine. But the double line on the pregnancy test never appears and I am left with a bitter taste in my mouth.
‘Now I face IVF and I’m petrified. What if it doesn’t work? Where do we go from here?
‘And the worst of all of this? I don’t even know why I want children. I can only describe it as a desperate longing inside me, a physical ache. And each, “So, when are you going to have children?” hurts so much I can barely breathe for the pain. But I smile, reply, turn away and carry on desperately hoping that maybe, just maybe, this cycle will be the one.’
* Names have been changed for privacy.
‘We grieved for the children we did not conceive’
Nicola, 36, and Robin Ball, 41, were trying for six years before becoming pregnant through IVF. They now have two daughters – one is adopted.
‘You know you’re not having a good day when you’re sitting in a traffic jam and the car in front is smugly advertising they belong to an amazingly exclusive club which you can’t join – the ‘Baby On Board’ club! You want to place your hand on the horn and not let go.
‘It was when we’d been trying to conceive for five years that Robin and I talked to our GP about fertility treatment. Initial talks were followed by six months of taking temperatures before getting out of bed, mountains of vitamins and zinc for him, while we waited for our hospital appointment. Then followed intrusion, prodding, pulling, injecting and questions. Finally we were scheduled for IUI and, three weeks later, we were looking at a positive pregnancy stick.
‘Emily was a large baby, born by caesarean. But after her birth, her weight kept dropping as I couldn’t produce enough milk. There’s nothing like a proud mother crying hysterically in front of the baby formula shelves in the supermarket, a screaming child desperate for nourishment, and a husband diplomatically comparing the virtues of brands. I was supposed to be a woman, yet I couldn’t conceive ‘naturally’, give birth ‘naturally’ or even feed ‘naturally’.
‘Fast-forward a couple of years and many of my friends were onto their second pregnancies, and Emily kept asking when her brother and sister were coming along. So we decided to give fertility treatment another go. But two tries and our expectations were shattered. We grieved for the children we did not conceive. Then, with sadness and excitement, we applied for adoption.
‘It was just as intrusive as fertility treatment – questionnaires, graining courses, special videos…
‘But 15 months after our first enquiry, we were told about an eight-month-old girl, Katie*. Six months later, we went to court and she became legally ours. She slept through the night, was responsive, started eating solids and played with Emily.
‘Adopting is probably the most rewarding thing we’ve ever done. Children adapt to whatever life throws at them, and somehow so do the adults. We’ve been given two spectacular daughters who have made our lives and family complete.’
* Names have been changed for privacy.
‘We’re realistic – if it’s not meant to be, it’s not meant to be’
Miranda Boyer Luck, 39, and husband Guillaume have been trying for a baby for the last two-and-a-half years, during which time she has had four miscarriages.
‘At eleven weeks pregnant, I had a scan which revealed that this pregnancy may not be viable. I didn’t feel pregnant any more: all the symptoms have subsided so I expected to start miscarrying physically within the next few days – and did.
‘There’s a sort of secrecy about miscarriage and yet it is happening to thousands of women all the time. When I got pregnant the first time we were very excited, not imagining anything would go wrong, so it was quite a shock when I did miscarry. We were told that it was very common and I remember thinking it was odd that they were telling me how common it was, but that I’d never been warned about it.
‘All the pregnancy books refer from the very outset to ‘your baby’ even when it’s only the size of a broad bean and I wonder if that makes it all the more difficult when the baby is no longer there.
‘I do find it difficult when I first learn about other women who are pregnant. But luckily, my husband and I have always been able to discuss things openly and each time it has happened we have a cry, a cuddle, a few quiet days then we think about the next pregnancy, or Plan B or C. It’s not that we don’t talk about it, but we try to focus on the future rather than dwell on the past. I really believe that when bad things happen you can become depressed or you can use the experience to empower yourself.
‘The specialist tells me that if this pregnancy proves to be unviable, there are new tests, new treatments and we could investigate if we are suitable. But we are realistic: if it doesn’t happen we will have lots of animals and borrow our nieces and nephews for the day. If it’s not meant to be, it’s not meant to be.’
‘You don’t expect to be told something is unfixable’
Sue Broadway, 46, and husband Mike conceived their first child within eight weeks of trying. Then they suffered three years of secondary infertility.
‘When our gorgeous little boy was 18-months-old we decided to do it all over again. For the next three years, our life became an emotional rollercoaster. We conceived in a month, reached twelve weeks and were starting to tell people when a week later it was the horror story of waking up in a pool of blood: the baby had gone.
‘Fourteen months later we were at the infertility clinic because we’d been unable to conceive. Finally, I got pregnant again but it only lasted seven weeks. We were desperate to find out what was wrong but when tests revealed that both my husband and I were carrying rare chromosomal abnormalities it was a terrible shock. Six weeks later I had a third miscarriage. We were facing the double whammy of fertility problems and a genetic predisposition to miscarriage. You think you want to find out what the problem is, but you have to be prepared for what the results might reveal. You don’t expect to be told something is unfixable.
‘Of course we’re so grateful for Jack and we adore him, but that doesn’t take away the grief for a child lost, nor the longing for another child. Who’s to say which is worse: knowing the joys having a child can bring but not being able to experience them again or never having known what you’re missing?
‘We never gave up hope and six months on I became pregnant again – and this time stayed pregnant! There’s not a day goes by when I don’t look at Kate and think ‘Thank God I have you.’
For more info*Infertility Network UK has advice, help-lines, local groups, fact sheets (www.infertilitynetworkuk.com)
*British Infertility Counselling Association (BICA) has details of counsellors specialising in infertility (0114 263 1448; www.bica.net)
*CHILD (The National Infertility Support Network) provides support and the exchange of information to infertility sufferers (01424 732361; www.child.org.uk)
*Fertility Connect offers impartial information regarding fertility, infertility and treatments available in the U.K (www.FertilityConnect.com)
*Fertility Friends is an online community aimed at helping people through the difficult process of assisted conception by sharing thoughts, experiences and knowledge with others (www.fertilityfriends.co.uk)
*HFEA (Human Fertilisation and Embryology Authority) is the Government body that regulates and inspects all UK fertility clinics (020 7539 3308; www.hfea.gov.uk)
*The Miscarriage Association (01924 200799; 0131 334 8883 in Scotland; www.miscarriageassociation.org.uk)
*The Ectopic Pregnancy Trust (01895 238 025; www.ectopic.org)
*Babyloss provides information and support online for anyone affected by the death of a baby during pregnancy, at birth, or shortly afterwards (www.babyloss.com)
*The Recurrent Miscarriage Clinic at St Mary’s Hospital, London (www.st-marys.nhs.uk/specialist/ miscarriage_clinic/index_miscarriage.htm)
For more information, advice and real life experiences about trying to conceive and pregnancy, check out Practical Parenting each month.