Wednesday, September 30, 2009

Women are risking their lives to have IVF babies


Women are risking death and bankruptcy in their desperation to become mothers, according to Professor Sammy Lee, one of the country's leading experts on infertility.

Some couples going through fertility treatment are driven by an urge "stronger than addiction and more powerful than obsession", said Lee, who pioneered egg donation in the UK when he was chief scientist of the IVF programme at Wellington Hospital, London.

"The quest to have children can become a vortex that gets faster and faster and sucks people in. Women will sell everything and anything to have the treatment if they are short of funds. They will risk their lives, there's no doubt about it," said Lee, who will discuss the issue on Friday when he chairs a major conference, Motherhood in the 21st Century, at University College, London.

"I have treated young women with cancer who have refused to have treatment for their illness until they have got pregnant and given birth, knowing they are risking their lives," added Lee, who has helped some couples through 12 cycles of IVF. The maximum number of treatments provided on the NHS is three. "Some of these women do, indeed, go on to die [from the cancer], but they die happy, feeling that they have achieved something greater than their own continued existence."

He admitted that the determination of couples to have children can lead to clinicians continuing treatment when they know there is little chance of success. "Everyone involved in these scenarios is trying to do the right thing, but the extraordinary energy of a couple's determination creates a vicious circle.

"The advances of science seem to promise women everlasting hope, which means they put ever more trust and hope in the doctors.

"Clinicians, such as myself, should refuse to treat these couples because further treatment is highly unlikely to work, but after helping that couple through three IVF attempts, you can get too pulled in to insist that enough is enough. This is how couples become implicit in their own abuse. Even if you do tell them you will no longer help them, they often just go and get treatment across the street," Lee added. "Then when they get too old to be treated in this country, they go abroad. That makes them vulnerable to yet more abuse, although again, it is abuse in which they are complicit.

"These are often professional, streetwise women who know the physical, mental and financial dangers, but who are prepared to take any risk if it offers even a sliver of hope they might end up with a baby."

Infertility affects about one in seven couples – approximately 3.5 million people. Most of the women will eventually become pregnant naturally, but a significant minority will not. At least 44,000 a year undergo IVF treatment , with about 11,000 IVF babies born every year.

Rebecca Frayn, a film-maker, screenwriter and novelist, has spoken of her fears when she chose to go through IVF. "Couples undergoing IVF are set on achieving a baby at any cost, often developing a kind of wilful moral myopia about the risks in order to avoid being deflected from their goal. I know, because it happened to me," she said. "I had questions about the cancer scares associated with all the hormones I would be required to ingest.

"Liz Tilberis and Ruth Picardie, both journalists who died respectively of ovarian and breast cancer after many rounds of IVF, believed their treatment had caused and accelerated their cancers, respectively," she added. "To attempt to achieve life at the potential expense of one's own [health] is self-evidently sobering. Yet, even then, I somehow squared what I was contemplating doing with my conscience. I was in the iron grip of procreation fever."

Dr Mark Hamilton, consultant gynaecologist at Aberdeen Maternity Hospital, has treated couples who insisted on having up to 10 attempts. "The number of cycles people are prepared to have has increased in the last few years," he said.

But Dr Tony Rutherford, chairman of the British Fertility Society, said that for some patients it was necessary to exhaust all possible options. "I have patients who undergo treatment even though I've counselled them that their chance of success is less than 5%," he said.

"I also counsel couples for whom the chance of experiencing complications through IVF is equal to their chance of success, or for whom being pregnant would be very dangerous. But for many couples having the treatment becomes key in their ability to reach closure."