In vitro fertilisation - The birth of miracle babies

Walking into Mary’s* home it is clear that family is a number one priority in this household. A very pregnant Mary waddles into the kitchen littered with crayons, tricycles and other children’s toys. Two-year-old Marcus runs around at her feet. This was not always the reality, as Mary and her husband were unable to have children naturally.

Mary was 32 when she decided to go ahead with fertility treatment, after a year of trying to get pregnant naturally.

“Before we started any sort of fertility treatment we both got tested to try to find out where the problem was. When the tests came back revealing that everything was normal we weren’t sure whether to be relieved or more worried.

“If the tests identified where the problem was, then there would be something to work with, as it is was it just intensified the fear that no matter what we did we might not ever have children.”

In-vitro fertilisation (IVF) is not a matter taken lightly by doctors. There are a number of treatments that are tried before embarking on the costly procedure.

“After a number of tests, we were given dates when to try to conceive naturally, when I was most fertile and conception was most likely to occur. Failing that we tried intratubular insemination (ITI) where sperm is injected into the fallopian tubes, so that the sperm does not have to travel up the cervix to fertilise the egg.”

When none of the procedures worked they embarked on an IVF treatment. Before the procedure could be done Mary had to take a course of hormone pills every day and a daily injection of the hormone gonadotrophin to encourage multiple ovulation.

The eggs were then gathered and placed together with the sperm. In their case intra-cytoplasmic sperm injection (ICSI) was not used and sperm and egg were just left together to fertilise. Three embryos were eventually graded well enough to be implanted into the uterus.

Following the procedure there is a 10-day bed rest period during which the only thing to do was worry whether any of the embryos implanted.

Mary does not describe her pregnancy as normal. Hormone supplementation had to be continued throughout the pregnancy and every little twinge resulted in huge panic that she might miscarry.

Nine months later Marcus was born.

“We were very lucky that the first IVF treatment was successful. There is a huge number of couples that try again and again and are not successful straight away.”

Mary is now pregnant for the second time by IVF, and is carrying twins. Multiple births are often the consequence of IVF as a number of embryos are implanted to increase the chances of carrying at least on foetus to term.

Another issue involved in IVF treatment is the expense. The procedure in itself costs between €3,000 and €4,000 including hospital visits and the birth of the child. However medication prior and during the pregnancy are quite high.

“We feel privileged that we could afford to undergo the treatments. I know it is not affordable to everyone.”

Mary and her husband feel that the church is wrong to criticise IVF ferlilisation. The issue of aborting embryos she says is null because nature aborts embryos all the time.

“During my first pregnancy, three embryos were implanted and nature only allowed one to be carried to term. Only three to four embryos are created so there is no unnecessary destruction.”

The issue of ‘wasted’ empbryos is among the reasons for controversy surrounding the procedure. The Catholic Church is against IVF, and even criticized the decision to award the Nobel prize for Science to its inventor, Dr Robert Edwards.

Mary’s husband, Paul, feels strongly about this saying that the Church cannot criticize something it does not fully understand. He says: “Nobody can understand the situation we’ve been through unless they’ve been through a similar situation themselves. I don’t think its fair of them to criticize something they don’t know.”

Dr Josie Muscat, CEO of the St James Hospital Group, said 10% of people who try to bear children encounter problems and need some sort of fertility treatment.

“Only 4% of those actually seek help in the form of IVF, ICSI, PESA, TESA… Age is an important factor. Women who seek careers are putting off having children until later on in life, often to find that this is difficult at their age,” Muscat says.

“At 35, fertility begins to decrease. By 42–43 it becomes difficult to conceive, and by 47 it’s almost impossible.”

Dr Muscat says the success rate of IVF in Malta is 58%-60%, which is one of the highest in the world. “People come to Malta for fertility treatment from England, US.Africa, Nigeria. Services are not advertised. On the other hand gynaes in Malta don’t even know about the services offered here and will send their patients abroad for treatment.”

Dr Muscat says he is not against regulation, though care must be taken not to go over the top. “The more rules and regulations there are the more the expensive it will be for couples. At the moment it costs in the region of €4,000 for one IVF including medication.” * Names have been changed to protect identity