Interview 16

Age at interview: 36

Brief Outline: Experienced recurrent miscarriage before entering an egg share IVF scheme. IVF was successful after one cycle and pregnancy was excellent. Vaginal birth.

Background: Children' 1, aged 1 at time of interview. Marital status' married. Ethnic background' White British.

After three unexplained miscarriages and treatment for low fertility with clomifene (Clomid), she...

I decided, well we decided we wanted to get pregnant January '99 shortly after we got married. So we were very fortunate and we conceived that January but unfortunately I lost that baby at 7 and a half weeks. And no reason could be given at that time for, for the miscarriage. 

And what did you do then?

We then continued trying for a baby. After a year nothing had happened so by now it was sort of March 2000 so at that point our GP sent us for routine testing to see if there, if there might be a problem. The tests showed that there wasn't really a problem with my husband so I was sent for a laparoscopy to have a look inside, have a look at my tubes, my fallopian tubes. 

And that actually showed that there was a problem with both tubes and there was a hole in one and there were adhesions on the other tube which would suggest a reduced fertility. I had, in fact, been pregnant a previous time so I had actually been pregnant twice so it, so obviously I wasn't infertile, just sub-fertile. So the decision then was taken to put me on Clomid, which is a fertility drug which, basically, increased the amount of eggs I would produce each month. So I took Clomid initially for three months, I was then reviewed, then I took it for a further three months, well I was prescribed it for a further three months, and after having taken it in total for four months I became pregnant. 

But unfortunately I lost, that pregnancy came to end at six weeks but it did, nonetheless, confirm that I was able to conceive. So I then continued to take Clomid and also was tested for having had a total of three miscarriages consecutively which was the threshold for being able to have those tests. The tests showed that, basically, the, the miscarriages were, were unexplained, they didn't fall within the categories that could be explained. So then I was sent away with more Clomid and told that I would be put on the waiting list for IVF on the NHS. At that point I decided to see an obstetrician privately who has a particularly good reputation and he told me about the IVF scheme that runs with egg donation, which would have enabled, would enable me, if I was accepted on to the scheme, which would enable me to have free treatment and treatment very quickly. 

So I duly went for the initial consultation and initially I was accepted onto the egg donation scheme. And I was put onto the programme within about three months and fortunately the first cycle of IVF was successful and I became pregnant. Then, of course, the issue was whether or not I would remain pregnant. I was given an early scan at seven weeks and there was a heartbeat at seven weeks so I knew, I was told that if there's a heartbeat, once there's a heartbeat your chances of miscarrying drop by 90%. So really, once, once we'd got to that stage we knew we were probably going to be okay. And, in fact, that pregnancy progressed without any problem whatsoever.

Harvesting the eggs for donation was painful but it was an exciting time. The effect of the drugs...

So eight eggs were harvested and four of those eggs were given to the anonymous recipient. They just do a, they tried to do a basic match with eye colour, hair colour, etcetera. And we had, we had four eggs each and I don't know how it worked out for the other lady.

What was the harvesting like?

The harvesting was, was the only part that was painful. You're, you're, well you're not aware, you're not aware of it, it's a, procedure that, I don't think it takes very long, 20 minutes, half an hour. You're just in hospital for the morning. That was the only part that was painful for me. But, but I think it was so exciting, I mean it was, that I, found it quite, I found it quite exciting in a way. And because I never had to experience going through the procedure a second time, it only ever was exciting for me. I only ever went through it that one time. Sometimes some of the injections were quite, quite difficult. Hormonally, emotionally, because, effectively, they induce the menopause over the course of about 10 days, the injections that you have and, of course, in the natural world the menopause would come about far more slowly. So that can be very difficult, certainly within a marriage that can be very difficult. You become extremely sensitive and it, it's the fact that it's brought on so quickly. 

Why do they bring on the menopause?

Well, what they do is they shut down all activity in the ovaries and, and shutting down all activity is basically inducing the menopause. They have to shut down all activity so that they can have complete control and can manipulate your system because the other issue is with the egg donation scheme, or the egg sharing scheme, the recipient's uterus needs to be, our, our bodies need to be in sync so her uterus needed to be ready to receive the harvested eggs or the embryo at the same point as mine. So, in order to manipulate both of our systems they have to shut down all form of activity. And, and then you're given another drug, a, a different type of drug which stimulates the ovaries. You need to produce a minimum of about six eggs to be able to take part in the egg sharing scheme because any less than that and there aren't enough eggs for the, for it to be worthwhile. So there, there was a moment shortly before harvesting where it was looking like I only had six eggs, which was going to be the bare minimum, which would mean I couldn't be an egg donor again. So, basically, at each point in the, the process of IVF and egg donation there are, there are points at which you might have to, to drop out and can no longer be a candidate.

The possibility of taking part in an egg donation scheme should be made more widely known, as...

I was a bit disappointed that I only was told about the egg share scheme by this particular consultant who I saw privately. I had actually contacted our IVF centre independently when it was first suggested by the NHS hospital that IVF might be the only possibility for me for success. So whilst I had contacted the IVF centre myself, I'd asked them about the, the cost of the treatment, I was, I was sent a, a price list, effectively, and I wasn't actually told that because I was under 35 I could take part in this scheme called egg sharing and it would mean free treatment. Now, fortunately, I saw a private consultant just in time to still take part in that, that scheme because I actually was 35 when I became pregnant. So had I waited another year before seeing that specialist, which if I'd been left to my own devices I probably would have, it was family members that persuaded us to see this specialist, by the time I'd seen him and found out about the egg share scheme it would have been too late because I would have been over 35. So, obviously, with everything having worked out and having been successful, it doesn't matter but had I not been successful, it would have been a very different story if I'd found out 6 months too late about this scheme. And as I say, that was with having contacted the centre itself. So I don't know what the, the politics are or the reasons are for them not publicising the fact. But I think more needs to be known, really, about egg sharing as most people who I've talked to about my treatment were unaware that such a scheme existed. 

And I think it is of particular interest because IVF treatment can be very expensive and it enables you to have three, three goes at it, basically.

After IVF, they were so anxious and excited they did the pregnancy test in the middle of the...

How did you feel when you realised you were pregnant?

Ecstatic. We had, we had to do a pregnancy test. It was very specific; it had to be 2 weeks after implantation. They implanted 2 embryos so, basically, of the 4 eggs they harvested that, that I was allowed to keep 3 of those eggs fertilised, 3 out of the 4 and there's usually a 66% fertilisation rate so 3 was good. Then they watched the way those 3 embryos grew and of the 3, 2 were, one was described as excellent and one described as very good so those 2 were put, were put back inside and that process is, takes 5 minutes and there's no anaesthetic needed for that. I found that very emotional, just having the embryos put inside because, technically, you're pregnant at that point. 

Then we had to wait 2 weeks before doing the pregnancy test and I actually did the pregnancy test at 3 o'clock in the morning because I had decided that, really, what could be the difference who, who defines at what point that 14th day begins? Does it begin at 6am; does it begin at 3am? I was unable to sleep anyway so I just sat up in bed and then eventually did the test at 3am. My husband and I sat in our beds crying until 6am when we felt it was a reasonable hour to start phoning the family, at which point they all said, 'thank goodness you phoned us, now we can go to bed.' The hospital did warn us, of course, to be, to be cautious at this point because you're still subject to the 1 in 4 miscarriage rate, 25% miscarriage rate, which in my case you could say was higher, realistically. So we had to wait a further 3 weeks to have the first scan. And that first scan showed that there was a heartbeat. It showed that what, the, the two embryos had implanted and had grown. One of them had grown properly and had a heart-beat, the second one had stopped growing and didn't have a heart-beat so it was going to be a singleton pregnancy. But again, the doctor was happier with that because there are less, less risks associated. So at that point I knew I could stop worrying, even though I was only 7 weeks pregnant there was a heartbeat so I was very happy. But I would say my husband didn't stop worrying until the baby was born. I became confident at that point, really.
 

She enjoyed pregnancy so much she did not want it to end.

Yes, I felt I was blessed with an amazing pregnancy. Whilst it had been difficult to get pregnant, actually being pregnant was wonderful and I really didn't want it to end. I felt that 9 months wasn't long enough, which does make people laugh. Every, everything was straightforward. I did have a slight hiccup when I was 5 months pregnant; I, I had a heavy cough and cold, mild 'flu, and I couldn't feel the baby moving. So I was admitted to hospital, just for a night, and I was actually dehydrated, which meant that the baby was dehydrated and so had been a bit sluggish. The baby had never been in any danger but I did find that my pregnancy was closely monitored and I had frequent scans. Once I'd got to about 30 weeks I had growth scans every 4 weeks. But I really did love being pregnant, felt very healthy and I didn't feel worried at all.
 

Investigations never found a cause for her miscarriages and the uncertainty in each pregnancy was...

Did you talk to any doctors or anyone else about your concerns about having another miscarriage?

I didn't really, because I think the, the immediate problem seemed to be the actual getting pregnant, so whilst initially after my second miscarriage that was my fear - "What if I miscarry again?" - quite quickly the becoming pregnant became the issue. And so miscarriage was something that I really needed to just put to the back of my mind and cross that bridge if and when I came to it. And when I did become pregnant on Clomid, after 4 cycles of Clomid, I really didn't imagine I would have another miscarriage. I really believed that the miscarriage had been bad luck or unexplained reason, just one of the 1 in 4 people that do have miscarriages. I knew that to have 3 miscarriages consecutively was rare. I did read a statistic that only 1% of people, 1% of women have suffered with recurrent miscarriage, which is 3 consecutive miscarriages, so I didn't really expect to form, to form part of that statistic.

So the third miscarriage was when you were on Clomid but not yet IVF?

That's right, that was the third miscarriage and so that was the, that was the trigger to then be investigated for miscarriage as opposed to fertility alone. They can investigate reasons for about 20% of miscarriages, about 20%-25% are chromosomal defect and a blood problem. So I was checked out for both of those and it showed that I didn't have a, there was no chromosomal defect and there wasn't a blood problem either. So that ruled out the reasons. It also meant that there wasn't a quick fix to a mis-, to miscarriage either because it just meant that there was no explained reason and so, obviously, I still don't know why I had 3 miscarriages.

Does it frustrate you that they weren't able to actually tell why this happens?

It did until I had a viable pregnancy. Obviously, it's still there at the back of mind because I would like to become pregnant again, I would like to have a baby again, another baby. But having had one successful pregnancy I no longer have had - my, my personal history is not that every, every pregnancy has ended in miscarriage. So, so it's, it's a frustration, but having actually had a baby puts paid to a lot of that sense of frustration.

How did you feel with the third miscarriage then, when that happened, what was your '?

I almost had a sense of expecting it. On, on one hand I didn't expect it because I thought I couldn't be that unlucky and I realised that three, three recurrent miscarriages would be unlikely, but I think also what happens is your expectations, as you go along this journey your expectations are altered and almost lowered, I suppose. You start out with the expectation that you'll get pregnant relatively easily and the pregnancy will, will be a success and obviously, your expectations alter. So on some level whilst of course it was very, very distressing to have that miscarriage, even though it was at 6 weeks, which is extremely early, but I'd known I was pregnant once I, when I was literally about 4 weeks pregnant. So whilst it was very distressing, there was almost a sense of why should I expect anything else, by then?

That's sounds quite hard, was that?

It, it was difficult because the previous miscarriage I got over relatively quickly, based on the idea that I would be pregnant again within about 6 months and still had a, a lot to look forward to. Whereas by the time I'd had the third pregnancy, which was having taken Clomid, and knowing also that both of my fallopian tubes were damaged, I realised that the

She was pleased to manage without an epidural because she wanted to be fully aware of the...

I had 50mg pethidine when I was about 5cm dilated. I did try gas and air then. I found the pethidine, it worked very well for about an hour. My plan beforehand was to just have gas and air but the problem with having been induced with a drip, because there are different ways of being induced, and being induced with a drip meant that I, I had to have bands across my belly to monitor, monitor the baby's heartbeat and that's very uncomfortable. Those, those become uncomfortable after about 20 minutes but I had to have them on throughout the labour and I wasn't able to move around as much as I'd hoped. And the contractions were being controlled completely by the midwife, who was controlling the drip so they did, they, traditionally they say they're very painful but - or more painful than natural contractions - but I'm sure that a contraction is a contraction however it's coming about and I won't know if there is a difference unless I have the opportunity to go through it again.

So, after the, the pethidine, that wore off after about an hour or two and then I did try to suck on the gas and air but I did find at that point I wasn't able to, to breathe properly, really. I was taking short, shallow breaths as you do when you're in pain. So really I used, I used the gas and air as a bit to bite on more than anything [laughing]. That was it's best use. And I did find it, I did find it all far more painful than I'd realised. I mean, incredibly painful. A pain that sends you to a different place mentally and, obviously, I'd never experienced that before.

Because in the modern world, if you're going to experience a pain like that then you'd be anaesthetised [laughing]. But I was determined that I didn't want to have an epidural because I realised that this might be my only opportunity to experience childbirth so I wanted to experience it. And by the time it came to pushing the baby out, about 5 hours had passed since I'd taken the pethidine so it had long since worn off. So I felt quite privileged to be able to feel the, to feel the whole, to feel the whole thing because I'd spoken to some friends who'd said they hadn't been completely aware of the moment of birth even, because there hadn't been enough feeling and I didn't want that to happen. So I was completely aware of, of all the movement and the moment of birth, etcetera.

Giving birth was an awe-inspiring and emotional moment. She felt privileged to experience it.

So how did you feel when they handed your daughter to you?

Oddly, considering I cried when they put the 2 little embryos inside me, I didn't cry, which seemed really strange. My husband cried, sobbed. I think I was in such a state of shock with my teeth chattering and my body shaking because I think it is an incredible thing for the human body to go through, to push out a human being. And you, you do become aware, it does become obvious why, traditionally, many women could die, could die in childbirth. All I could think of to say was, 'hello.' And it just, I was only aware of the immediate space around me. I think when it comes to the actual birth, though of course, I can only speak, speak from the experience of one birth, whether you're at home or whether you're on a floor or on a bed or, I was only aware of the immediate space around me, just myself, my husband and the baby. I wasn't really aware of anything else; I had no, I was no longer particularly aware of what room I was in or, or anything beyond a sort 2 feet area around me. And it was, without question, the most wonderful experience ever. Within about 24 hours I was, I was saying I would absolutely love to give birth again. It was awesome in the, in the true, genuine sense of the word. It was the closest I have or will ever come to a, a religious experience or spiritual experience. I think it's a privilege to have a natural birth.