Infertility Support Forum

Many women find that their choices about when or whether to have a child are overshadowed by the fact that they haven't met the right partner. If you are aware of your biological clock ticking, and you want to have a baby before it is too late, this can start to dominate your life. Men have much more leeway and can afford to take time to make the decision to settle down, but, for some women, the fear that they may never meet the right person becomes overwhelming.

Infertility Support Forum

'I felt really desperate all the time; always thinking I wasn't going to meet someone in time. It's an awful lot of pressure. It used to consume me. I was going out on dates and meeting people, but never meeting somebody that I wanted to spend the rest of my life with" Susan, 34

Changing expectations
 
We have much more freedom than our mothers or grandmothers, and there is no longer the same pressure on couples to marry, settle down and start families. Women may not feel the need to have a male provider, and marriage is no longer an institution everyone has to buy into. However, most of us do still grow up believing that we will probably share our adult lives with someone else, but women often wonder how long they should spend waiting for Mr Right when they are getting older and less likely to conceive.

No one expects to find themselves in this situation, but when you are leading a busy life it can just seem to creep up on you. Women who have very successful careers often find that there is little time left for their personal lives, and although making the decision to have a child by yourself involves a huge shift in hopes, dreams and expectations, it may be a logical way forward for women who haven't found a partner but know they want children.
 
Not all women who opt to have children by themselves set out with the deliberate intention of doing this. Some women do have unplanned pregnancies, or get pregnant with a partner who finds he cannot commit once they are pregnant, and must then decide whether to go ahead with the pregnancy alone or to have a termination. For women who know they want to have a child, and who may be worried that they are approaching the end of their reproductive lives, this may feel like an opportunity to become a mother that they cannot miss.

The wrong relationship

Men don't have biological clocks, and although there is some evidence that they may become less fertile with age, they certainly don't have the same time pressures. Men in their thirties may feel that they would like a family one day, but have no great motivation to get on with it sooner rather than later. It can be difficult for a woman who knows she wants to be a mother, yet finds herself with a partner who is not ready for the responsibility.
 
'I was going out with somebody who was a commitment phobe. He kept making it sound as if we were going to start trying for a baby and get married at any minute, but nothing ever happened. He spent the whole time insisting that he wanted to have children, and he was very convincing. Twice he said he'd try for a baby and then changed his mind and said he couldn't do it.' Thea, 39
 
Finding yourself with a partner who doesn't want a child when you are determined you do is not only a problem for heterosexual women. Lesbian relationships can be affected in just the same way.
 
'I'd been in a long-term relationship, and it split my relationship up. I was purely interested in getting pregnant. I think she was quite angry with me because she didn't want me to be making that choice. She thought I was choosing it over being with her, being in a relationship,. Ellie, 44
 

Thinking It Through

Having a child by yourself is not a decision anyone takes lightly, and most women spend a great deal of time considering the consequences and implications of opting to become a lone parent before going ahead. There are some key areas that can cause problems, and you will want to have thought through them first. To find out more, you can check out Infertility Support Forum.
 

Only Ways To Get Pregnant

Surrogacy
 
For women who cannot carry a baby themselves, surrogacy is an option that may offer hope to those who have all but given up on the possibility of ever having a child of their own. A surrogate mother carries a baby for the couple, and hands it over to them after the birth. Surrogacy usually involves the use of the male partner's sperm, and may use an egg from the female partner, the surrogate herself or a donor.
 

Only Ways To Get Pregnant

In straight, or traditional, surrogacy, the surrogate uses her own eggs. She either inseminates herself with the male partner's sperm or goes to a clinic for insemination. This form of surrogacy is cheaper and may seem easier, but emotionally it can be more difficult for both the surrogate and the parents if she is making use of her own eggs.

With host surrogacy, the eggs of the female partner or donor eggs are fertilized in the laboratory using the male partner's sperm, and then returned to the surrogate's womb. This method is particularly helpful for women who are still producing their own eggs, but cannot carry a baby. It is more expensive and more invasive for the surrogate, but it may be less demanding emotionally for everyone concerned.
 
Whichever path is chosen, the surrogate will carry the baby and give birth, after which she will hand over the child to the intended parents who must then go through a legal process to become the official parents. Surrogate mothers do not get paid for what they do, but they are entitled to expenses. These can be substantial, and are not just the odd bill for folic acid supplements and maternity wear, but may cover for loss of earnings, travel, childcare, antenatal care, life insurance and even help around the house. During the nine months of pregnancy, these costs can mount considerably and surrogacy is not an option for couples with limited funds.
 
There have been cases in the past where a surrogate mother finds she cannot go through with the process she has started, and this is why it is absolutely vital that surrogacy arrangements are done through the proper channels. There are organizations that can help you find a surrogate mother, and who will work through the process with you. It is worth using any help of this kind you can access, as surrogacy is a complicated process and only those who have been through it themselves are really aware of all the potential pitfalls. 

'You feel so disempowered because you are so desperate for a baby, and you're very open to being exploited. Our first experience was very negative in the end, and the surrogate terminated the relationship having said she would try with inseminations for up to a year. We had been looking at traditional surrogacy, but the way we'll be doing it this time is gestational surrogacy and I think I feel a lot happier with that' Claire, 44

Adoption and fostering
 
Once we started adoption, it wasn't about having a baby to substitute the baby we couldn't have, it was all about having a family and being able to do family things like going to the beach, going to the zoo. We've been able to do all those things, which has been amazing because there was a time when we never thought we'd be able to.' Mary, 38 

Adoption is something many couples consider when fertility treatment hasn't worked, or they are told it is unlikely to succeed. It is a permanent legal way of finding a new family for children who cannot live with their birth parents. You take on responsibility for the child you have adopted, who becomes part of your family. Fostering, on the other hand, is a temporary arrangement where a child comes to live with you for a while but is likely to return to his or her family at some point.
 
The children who need adoptive families are often older children who may have brothers and sisters they want to stay with. They may have special needs or disabilities, and many have had difficult experiences in their early lives. This can make them quite challenging children to look after who may need a lot of time and attention.

Some couples prefer to try to adopt a child from overseas, where there may be more babies and younger children who need new families. If you do opt for this, you need to be aware that it can take a long time, and can be expensive. You will still need to go through the same assessments as if you were adopting at home, but there will be the additional complications of bringing a child from overseas. Many couples have adopted from overseas successfully, but you do need to have thought about the implications of taking a child away from their natural culture and heritage, and how you will deal with this as they get older.

The adoption process is fairly lengthy, as it is essential to ensure potential parents are right for children whose past experiences may have made them very vulnerable. There will be a detailed assessment carried out over some months, and once you have been approved to adopt you will then have to be matched with a child, which can take even longer.
 

'Adoption is just another roller coaster: off one and straight onto the next. There are long periods of waiting with big stresses, big highs and then the occasional crashing back down to earth with a bump,' Nic, 33

After going through years of traumatic fertility treatment, the decision to stop and go down another route to parenthood can be a relief. Most adoption agencies recommend that couples leave some time and space before they start on the adoption process if they have experienced fertility problems and treatment. It may take longer than you think to recover if you have spent some years going through treatment, or hoping to conceive, and it is important to give yourself a breathing space before leaping into adoption. Once you have decided to go down this path it can be hugely rewarding. To find out more, you can check out Only Ways To Get Pregnant.

Different Ways Of Getting Pregnant

Donor sperm 

Couples with fertility problems have been using donor sperm since the 1930s, although the pioneering doctors who first used the technique met with considersble hostility from both the medical profession and the general public. Despite this, the use of donor sperm for male fertility problems became a very common form of treatment. The advent of ICSI (intra-cytoplasmic sperm injection) in the 1990s gave new hope to men who would have had to use donor sperm in the past.

Different Ways Of Getting Pregnant

ICSI allows men with impaired fertility to use their own sperm, which are injected right into the eggs in order to fertilize them.

If you are using donated sperm, the insemination can usually be carried out in a normal cycle unless the woman has ovulation problems. ICSI, on the other hand, does involve going through the whole IVF experience with drugs and egg collection, and is more expensive. There are still some male factor fertility problems that cannot be solved by ICSI, and in these eases donor sperm may be the only way ahead. Donor sperm is also used by single women and lesbian couples.

Sperm donors are screened before they are allow to donate, and their sperm is tested for infections such as HIV, before being kept frozen for six months. As with donor eggs, counseling is a vital part of the treatment process if you are using donated sperm, and any potential problems tend to arise when couples haven't had adequate counseling.
 
'We didn't have any counseling using donor sperm. My husband didn't really want to do it until we decided that was the only way. The consultant sold it to us. He didn't suggest ICSI. He just decided donor sperm would be the best way to handle it and he said he could get donor sperm from a bank which had plenty in stock.' Sonia, 34
 
There are now shortages of donor sperm and some clinics have long waiting lists for those who will need to use it. Some women have always preferred to use known donors if they can find someone who is willing to donate, and this is an option that others may now want to consider. Using a known donor means a child can know who their biological father is, and may be able to build up a much closer relationship. Some donors want to be actively involved in the child's life, but many don't want any involvement. This is something you need to have discussed and agreed before going ahead. Women who don't have fertility problems sometimes carry out the insemination themselves at home if they are using known donors, but going through a clinic means the sperm will be screened and checked properly, and should maximize your chances of getting pregnant as your cycle will be monitored too.

Having an anonymous donor can cause difficulties for your child as they get older and you need to have considered how they will feel in the future about this if you have the option of using an anonymous donor, and what you will tell them. There are donor-conceived adults who have found it distressing not to be able to trace their genetic fathers, and although it doesn't inevitably cause problems, you do need to be aware of this. 

'There are kids who will never be able to have any contact with their donor, and will never know anything about them. I think that's quite hard for the kids. Even if my son never meets his donor, at least we know about him and I've got a picture of him, at least we have a bit of history.' Ellie, 44

Donor embryos 

If there are serious problems with both sperm and eggs, some couples may both need to use donor gametes, or to use a donated embryo from another couple. There are fewer embryos donated than either eggs or sperm, and it can involve a long wait. To find out more, you can check out Different Ways Of Getting Pregnant.

Egg Donation Infertility

Other Ways to be a Mother 

Being a mother doesn't have to involve using your own egg and your partner's sperm, it doesn't have to involve giving birth at all. Many women who cannot have children the traditional way discover that there are other routes to parenthood. Women may use eggs or sperm from a donor, or find another woman who is willing to carry their child in her womb, or they may decide to adopt. Although there is a wide variety of ways to become a mother, the job is pretty much the same no matter how you get there.

'If you are lucky enough to have a child, you just love that child. I don't ever think now that I wish my son had been from my eggs because it wouldn't have been him, and it feels so much like he was meant to be" Claire, 44

Egg Donation Infertility

Egg donation
 
Women who no longer produce their own eggs, whether due to age, an early menopause or to a medical condition, may choose to use donated eggs as a route to motherhood. Egg donation was first used successfully in the 1980s, and allows a woman who would otherwise be unable to have her own children to go through the whole experience of pregnancy, giving birth and breastfeeding her baby.
 
If you are thinking of using donated eggs, it may throw up some emotional and ethical issues you will need to grapple with. Counseling is essential, as you need to consider the consequences for you, your partner and your child. Some people start out by thinking that they wouldn't want to tell a child at all, but it is generally accepted that it is important for children to understand the truth about how they were conceived, and to appreciate how much they were wanted.
 
'Hopefully, they will understand. You are bringing them up to give them as much security and to cocoon them as much as possible. You give them your morality and values' Sophie, 43
 
One real problem with egg donation is the shortage of available donor eggs. In order to give eggs, women have to go through almost an entire IVF cycle themselves, taking drugs to stimulate the ovaries and then having the eggs collected. This is not something anyone would undertake lightly, and there is also the risk of hyperstimulation from the IVF drugs, which makes the task of recruiting egg donors a fairly difficult one. Some women find a friend or family member who is prepared to donate eggs, or they may advertise to try to find a donor.
 
'My friend inspired me. She decided to put up posters around the local town asking for somebody to donate for and I thought if she could do it, I could do it. I said I'd do some press, and l'd done a couple of interviews and put the clinic's name out. We got some people coming and donating as a result of our publicity, so they moved me up the waiting list.' Debbie, 44
 
If a woman is interested in becoming an egg donor, she will be screened to make sure she doesn't have any infectious diseases such as HIV or hepatitis. Women usually have to be under 35 to donate eggs, as older women's eggs have a greater risk of chromosomal abnormalities and are less likely to implant. Donors and recipients are matched as closely as possible to try to get similar coloring, racial, background, height and weight.
 
Once the donor has been given the all-clear, she can start taking the drugs to stimulate her ovaries. Human eggs are fragile and do not survive the freezing and thawing process very well, so egg-donation cycles use fresh eggs. The recipient is also given drugs to synchronize her cycle with her donor's so that her body will be ready for the donated egg. The egg donor has her eggs collected, and they are fertilized with the recipient's partner's sperm. Then one or two can then be returned to the recipient's womb.
 
In some countries, such as the UK, Sweden and New Zealand, egg donors no longer have anonymity, which means that any children born from a donated egg will be able to find out about the woman who donated if they wish to at some point in the future. In some other places, egg donors are anonymous, and can never be identified.

The severe shortage of donated eggs has led to more and more women seeking treatment overseas. In countries where donors are paid and maintain their anonymity, there tend to be more donated eggs available. If you decide to be treated abroad, this may mean that your child's heritage will be very different from your own. They may wish to explore this in the future, and could feel thwarted by the fact that they may not be able to identify their genetic mother. 

There may also be many practical hurdles to overcome if you are having egg donation abroad. It's not just the traveling that can be awkward, but there can be problems with language and the fact that clinics in other countries may not be subject to the same rules and regulations. They may not offer any follow-up advice or support, and probably don't provide counseling. 

You may be asked to pay in advance or even to pay in cash, while some clinics offer a 'shared risk' policy where you hand over a large lump sum, part of which will be returned if you don't get pregnant after a set number of treatment cycles. You should always ensure you have done your research thoroughly before you opt for treatment abroad.
 
Where women are paid, there may be a wide variety of donors who may choose to donate primarily because they need the money. Altruistic donors, who don't get paid, are often women who have young families and who want to help another woman experience the happiness they have found from their children.

'I'd reached the stage in our own treatment where I was grateful for everything that was in place. I appreciated the fact that it had taken a lot for me to get pregnant, and I'd relied on a lot of people to get me there. If I'd found out I needed an egg donor, I'd have wanted somebody to be there for me, so it seemed to make sense that if I'd expected somebody to be there for me, I should do it I did my first egg donation when my children were about eight months old, and then I did four more.' Doriver, 41 

Some clinics offer egg-sharing schemes where younger women who need IVF are offered cut-price treatment if they agree to donate half their eggs to another woman who needs them. This can seem an attractive offer if you need fertility treatment and can't afford to pay for it, but counseling is really important if you are considering this.
 
'I looked into egg sharing, but them is no anonymity. You could have a young adult knocking on your door because someone else had been successful with your eggs. It could work for someone else and not for us. I would have done it because it helps other women who aren't producing eggs, and it's a reduced price for IVF, but it's just the thought of the years to come ...' Gillian, 34. To find out more, you can check out Egg Donation Infertility.