Opinions Archives - Waterstone Clinic

Fertility treatment delays ‘will impact older women’

Dr John Waterstone, medical director of Waterstone Clinic, says many patients are still unclear on how to access the State-funded fertility treatment scheme.

NIAMH GRIFFIN, HEALTH CORRESPONDENT, IRISH EXAMINER

https://www.irishexaminer.com/news/arid-41242642.html

A leading fertility specialist has warned any delays in referrals to the State-funded fertility treatment scheme could further reduce older women’s chances of conceiving.

Dr John Waterstone, medical director of Waterstone Clinic, says many patients are still unclear on how to access the scheme.

And he cautioned that any potential “bottlenecks” could impact women in their late 30s or early 40s for whom fertility treatment is less likely to work.

“Patients probably still aren’t aware how the mechanism works,” he said.

“We don’t send patients to the fertility hubs, the GP has to make a referral for the patient concerned.”

There are six such hubs including in Cork University Maternity Hospital and Nenagh Hospital.

Hubs can then refer eligible couples to a private clinic of their choice, from a list of HSE-approved providers of which Waterstone Clinic is one.

“If [a woman] is 38 or 39, the passage of time means her chances are going to reduce because the chance of success is very much related to the woman’s age,” he said.

“If there is a big delay in getting through the bottleneck of the hub, it could be significant for them.”

The new scheme funds one cycle of IVF among other options, and he said while some women do get pregnant after one cycle, this is not certain.

“It’s not even guaranteed to work. Some couples will have several cycles and still not end up with a baby,” he cautioned.

Women aged up to 40 years and 364 days are eligible for funding.

Dr Waterstone said this is because “the treatment is less likely to work for women who are in their 40s. Is that fair on women in their 40s? Probably not but it is pragmatic”.

However, he is worried that the impact of age on fertility may not be fully understood.

“Some do [know], some don’t,” he said, describing a clinic where “every single patient I saw was 41, 42, 43, 44. I didn’t see anybody who was in their 30s. It was thoroughly depressing [for them].”

He explained how the chances of success vary with age.

“If you are in a good unit with good success rates and you are, say, under 35 the chance of a baby out of one IVF cycle is 50%-ish,” he said.

“Then as the woman gets older, that chance goes down.

“By the time she is 40, it’s gone down to 25% to 30%, and as a woman gets older still into her 40s, their chance gets lower still.

“By the time you get up to age 42, 43, the chances have gone to 5% or 10% maximum.”

It is not yet clear for how long the Government will involve private clinics in this system, he said.

“The fact there has been a huge over-run on the Department of Health budget this year means it all depends on how much money and how they are going to dole it out, and is IVF going to be seen as a high priority or not so high priority,” he said.

The HSE and Department of Health fertility treatment scheme opened for GP referrals on September 25 in the first phase of a process expected to include further treatment options after legislative changes.

Budget 2023: IVF Funding Announcement

Statement from the Waterstone Clinic Team, Thurs 29 Sept 2022

“We welcome the news that the Irish government intends to publicly fund IVF from late 2023. Ireland has lagged behind other European countries in its support of those who need assistance to build their families, and this announcement is long-awaited. We understand from the media that a fund of €10 Million will be available initially, with services provided through private clinics. The government has not yet communicated with IVF providers to make plans, and we have no information on who will qualify for funding, or what services will be covered.

We hope that the assistance will be universal and that it will cover the full range of services, including Pre-implantation Genetic Testing to avoid the risk of a patient’s child inheriting a monogenic disorder that runs in their family.

We hope the government will specify its plans as soon as possible and we look forward to this step of making treatment more readily available to all, without delay.”

For More Information:

Budget 2023: https://www.gov.ie/en/campaigns/budget/

RTE News: https://www.rte.ie/news/health/2022/0928/1326027-budget-2023-ivf-treatment/

‘Relaxing and private’: Dublin fertility clinic pairs holistic approach with cutting edge technology

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Newly opened in the heart of Dublin city centre, this fertility clinic bridges the gap between innovative medical care and a familial support system by welcoming couples and individuals into a warm and homely environment.

Waterstone Clinic has been providing fertility services to families across Ireland for the last twenty years.

This autumn sees the launch of their newest clinic, on Dublin’s Fitzwilliam Street Upper, which will give patients access to expert consultants and bespoke services for their fertility journeys in the capital.

Warm and welcoming

Housed in one of Fitzwilliam Street’s beautiful 18th Century Georgian buildings, a stone’s throw from Merrion Square, the clinic offers a calm, warm and welcoming space. From floor to beautifully plastered ceiling, this elegant space reflects the attention to detail Waterstone Clinic is known for in their work.

While the building’s original features have been preserved throughout, the historic period premises has been re-imagined into a cutting edge medical facility. The Waterstone Clinic consultation rooms are elegant and gracious, sitting above the state-of-the-art laboratory, one of the most advanced in Ireland.

The Dublin clinic continues Waterstone Clinic’s tradition of scientific excellence, which has driven the standards in Ireland through its track record of milestone firsts and exemplary patient care.

The clinic’s team supports their patients with honest advice and explanation of their results. If they need them, the clinic offers a full range of cutting edge treatments and fertility preservation options, giving their patients the best chance to have a family when they are ready.

Relaxing and private

“We put a great deal of thought into making this clinic right for couples and individuals seeking fertility services,” says Dr John Waterstone, director of Waterstone Clinic.

“We know fertility treatment can be stressful and sometimes it can be confusing to know who to trust. Dublin badly needs fertility clinics who will put patients’ needs first and foremost, so we wanted to extend our expertise to the capital and give patients direct access to specialists with proven experience in a setting that is relaxing and private.”

“Our clinic is welcoming and comfortable without a clinical atmosphere, which aligns perfectly with our goal to provide patients with holistic care,” explains Dr Eithne Lowe, lead consultant for the Dublin Clinic. “The feedback we have had from patients is that the design of the clinic creates a sense of calm and wellness.”

Support system

“Whether they want to explore their fertility or need advanced fertility care, patients in the care of our Dublin clinic will have the support of some of the most experienced and trusted reproductive specialists in Ireland alongside our incredible nurses and laboratory team,” notes Dr Waterstone.

The entire team is deeply committed to their work and they support their patients throughout the process, start to finish.

“We’re on the journey together,” explains Rachel, one of the team’s fertility nurse specialists. “We want to make sure they are confident and supported at every stage. We get to know them so well, everyone feels part of the family.”

“We want to help our patients achieve the best possible outcome when they take the step and trust us with their care,” Dr Waterstone notes. “Our Dublin clinic will enable our team to assist more people to achieve their goals.

“Our patients are always at the heart of everything we do and we are looking forward to this new chapter of our story, right in the heart of Dublin.”

Part of the IMAGE Talks Fertility series, published 10 Oct 2021 on IMAGE.ie[/vc_column_text][/vc_column][/vc_row]

Please stop asking me when I’m going to have a baby

“Have you any good news for us yet?” It is one of the most insensitive and irritating questions you may ever be unlucky enough to hear, but for many couples, this is a regular occurrence.

Do you choose your words carefully when speaking about pregnancy? Maybe it’s an exciting time and your friend is eager to share their own news or find out if a pal is going to join their “moms only” WhatsApp group anytime soon. But announcing a pregnancy happened “immediately” or asking what another person’s baby plans are might actually be hurtful.

While most people’s intentions are good, wanting to start a family is a private and sometimes painful matter. Being asked about it not only puts additional pressure on those experiencing fertility issues but it’s something people often deal with silently, hoping to only announce when they have good news.

After three years of marriage, Adele was still struggling to get pregnant so she decided to seek help. “For us, IVF has been the most time-consuming, invasive, expensive and emotionally painful roller coaster I have been on. You have so much invested in the process, financially and emotionally that it consumes your every thought. When you are having difficulty conceiving, it seems everyone around you is falling pregnant. It’s easy to be happy for them at first but that brave face wears thin after a while. I even started to decline going to certain get-togethers and attending baby birthdays were just painful. I became quite bitter, desperate and depressed.”

Adele says she was asked when she was going to have a baby repeatedly while going through IVF. “I’d answer with a forced smile ‘we are just enjoying being newly married’, we have some travelling we want to do first,’ or ‘I’m just focusing on my career right now’. I wasn’t always that pleasant. One day I responded with ‘it’s not that easy, you know.’ I had just gotten my period that morning… again. People would tell me that I’m not going to be young forever or that my maternal clock was ticking. And believe me, I knew it. I just didn’t need to hear it from everyone else.”

Adele is now a proud mum to two children but says she still can’t avoid the awkward questions. “We were one of the lucky ones. But many couples will be trying for years. And some may never succeed and my heart goes out to them.”

Even though we went through IVF and had such a struggle to have our son, soon after we were asked… ‘so when are you having number two?’ And now that I have two wonderful children and I feel our family is pretty complete, the question still comes.”

Sive is 36 and has just finished her sixth round of IVF. She says it has come to the stage where she has started distancing herself from friends to avoid the questions that inevitably come. “I know I’m hypersensitive to anything connected to babies and kids, but I find it too difficult to attend events where I know people are going to be asking me about my own baby plans. I don’t think people even realise how upsetting it is to have to be put on the spot like that. I’m always surprised that people aren’t more sensitive to what may be going on behind closed doors. I mean, what do they expect me to say?”

Sive is currently weighing up whether or not she and her partner will go for another cycle of IVF, but she says the experience has taken its toll. “The question for us now is if we will go for a donor egg or look into adopting. Either way, we have a long road ahead, but our desire to have a baby is still as strong as ever – I just wish I didn’t have to face other people’s questions when I’m not even sure which way is up at the moment.”

Psychologists have compared the emotions of failing to conceive similar to those associated with grief. Typical reactions include shock, grief, depression, anger, frustration as well as a loss of control and loss of self-confidence. Anyone going through a fertility cycle of hope and disappointment will tell you that well-meaning but misguided opinions and advice only add to the challenges of trying to get pregnant.

Many parents will know that it doesn’t even stop when you actually have a baby. Immediately the ‘when are you giving them a brother or sister?’ questions start, which can be equally infuriating. So no matter how burning your desire is to know when somebody else is going to reproduce (or if they are going to), think twice – your words have weight and you never know what’s really going on.

Tips for a resilient Christmas

Christmas can be a particularly tough time if you’re going through fertility issues. Seeing old friends and extended family members, seeing how much little ones have grown and the extended eye contact when you’re asked, “so, any news with you?”Even if they meant nothing by it, you can often feel so surrounded by the questions that it’s hard not to read too much into things.

Ahead of the festive season, here are a few tips from Waterstone Clinic on how to ensure you have a restful and restorative Christmas.

Know your limits
You and those close to you are the most important people to look after right now. Know your limits: you don’t have to accept every invitation (even family ones), let yourself say no – especially if you find them draining or difficult.

Share or prepare
Sharing the journey can be very helpful for some people, and their friends and family can be a huge source of support. Others prefer to keep their journey private, or private from some. Whatever you decide, knowing what you want to tell people and preparing a standard answer to probing questions can be helpful, and don’t be afraid to switch the topic of conversation to one you’re more comfortable with if you need to.

Your feelings are normal
All feelings are normal feelings. You will more than likely experience a range of them and often conflicting ones. All of them are valid. Name the emotions as they arise and notice where you feel them in your body. Take some slow breaths and acknowledge the feelings. Talking about them with someone you trust can be very helpful.

Find ways to laugh
Laughing significantly reduces stress hormones, it can boost your immune system and resilience. Look for ways to have fun: spend time with people you enjoy, watch some comedy films, read a funny book, try some dancing, be silly, have a bit of freedom. Smiling, even when you don’t feel happy, sets chemical changes off that relax you.

Treat yourself the way you treat others
Treat yourself gently and kindly, you are doing the best you can. A good friend wouldn’t force you to do things you would find too difficult, and a good friend won’t tell you that you “shouldn’t” feel the way you do. You deserve support. You deserve relaxation. You deserve a lovely Christmas.

Part of the IMAGE Talks Fertility series, published 15 Dec 2021 on IMAGE.ie

Do you know what a healthy period looks like and when you’re ovulating?

Women’s health is not prioritised in Ireland and as a result, many young women only learn about their sexual physiology when they’re trying to get pregnant. Hoping to address this, Mary McAuliffe, Head of Clinical Services at from Waterstone Clinic answers one woman’s question about identifying potential issues with your period cycle and tackles the knowledge gap around ovulation

Following on from the results from our reader survey on fertility, we asked you what you want answers to. From male fertility issues to egg donation, we get the experts’ advice on all things fertility.

We open our expert Q&A series with what should be a straightforward topic: ovulation. However, sexual education in Ireland is negligible and few women understand their ovulation cycle before they begin trying to start a family. Here, Mary McAuliffe, Head of Clinical Services at Waterstone Clinic answers our reader’s question on the topic.

Our reader’s question

Before investigating my own infertility, I didn’t know the basic facts about ovulation or conception. Women’s health is not a priority in this country, there’s so much focus on conception and not getting pregnant. What should women know about their own reproductive process before they start trying for a baby? What does a healthy period look like, what is the timeline of ovulation, how much does your egg count decrease with age and how long should be trying before seeing a doctor?

Our expert

Mary McAuliffe is the Head of Clinical Services, a general nurse and midwife. She is a founding member of the fertility specialist nursing team at Waterstone Clinic.

Mary has a vast amount of knowledge in the field of Reproductive Medicine. She has worked in Waterstone Clinic for seventeen years and is a certified fertility ultrasonographer (specialist course, University of Derby, UK). She is an active member of the Senior Infertility Nursing Group (SING, UK) and the Irish Fertility Society. She regularly mentors student midwives on female health placements at the clinic and has represented Irish fertility nurses on the steering committee of Insights and at infertility nursing conferences in the UK.

Mary McAuliffe’s advice

First of all, it’s important to know that a healthy period, above anything, is a regular one. The average cycle is 28 days, but cycles can be shorter or longer but what really matters is regularity. You should have regular, predictable cycles of about the same length (give or take a few days).

It’s always good to track your cycles and look at them over time. Do you always get periods? Are they unpredictable? Have they changed in the last six months and created a shorter or longer pattern? Do you have any irregular bleeding? If you notice any of these changes, it’s best to discuss them with your doctor.

During a regular cycle, an egg is released from the ovary. The two questions you need answers to if you want to become pregnant are: are you ovulating, and when?

Ovulation happens 14 days before your period is due. If you have a predictable cycle, it’s likely you are ovulating and that you can predict the day when it’ll happen. Knowing when you expect ovulation to occur is the first step, and knowing when to try to become pregnant is next. All you need to do to “try” is have unprotected sex, but to become pregnant, you have to try at the right time, ie during your fertile window.

If you have a monthly cycle and are ovulating, then you ovulate 12 times a year. That means there is a maximum of 12 opportunities for you to become pregnant in a year. It is easy to miss these opportunities if you are unaware of when you ovulate or if you try outside the fertile window.

Although it goes against what you might think, if you wait until you have ovulated to try, you’ll be past the fertile window and will have missed the opportunity. Trying in the days before ovulation (between four days before to the day of) is when you have the best chance to conceive. Once released from the ovary, an egg only survives in the body for about 12 hours. The possibility of conceiving after this falls to zero.

If you’re unsure when you might be ovulating, ovulation predictor kits can be useful. Once the kit turns positive, intercourse on that day and the following day should give you the best chance.

If you are unsuccessfully trying during your most fertile periods, the period regularity and your egg reserve are typically the first areas we will look into.

Some women have irregular cycles and cannot predict when they will ovulate, making it very difficult to plan a pregnancy (although they often do fall pregnant spontaneously). Finding out why this is, whether it is because you have a large number of antral follicles and polycystic type ovaries, or if it’s because of diminishing ovarian reserve will help you understand what is happening and get the assistance you need to become pregnant.

You were born with all the eggs you will ever have and they are released throughout your reproductive lifetime. The number of eggs in your ovaries is called your ovarian reserve, and this is assessed with a simple AMH blood test and an ultrasound scan. AMH results should always be interpreted alongside a transvaginal ultrasound scan by a fertility specialist to assess your ovaries.

The AMH test and scan will give you a good sense of your fertility timeline. The results will tell you if you have a high, low or average amount of eggs for your age. The number of eggs we have declines all the time and rapidly so after age 35. What is more important than the number of eggs, however, is if you are ovulating.

My biggest piece of advice is always the same: knowledge is power in fertility. If you and your partner want to conceive, have a fertility check. It will give you a wealth of information so that you have the best chance of getting where you want to be.

Part of the IMAGE Talks Fertility series, published 11 Feb 2022 on IMAGE.ie

‘The most magical thing is that it took input from the both of us in the end’: One same-sex couple’s journey to becoming parents

This Cork couple may have faced a longer journey than expected to welcome their twin girls, with failed attempts and Covid delays, but finally have the family they dreamed of.

Geraldine Rea and Niamh O’Sullivan have been together for ten years, having met playing rugby together, and they say that children were always on the cards for them. Geraldine, an Irish teacher, and Niamh, a special needs assistant, knew they would always need assistance to conceive together, but their journey ended up being different to what either of them could have predicted.

“We were very naive, Geraldine says. “We just assumed that because we were both women who didn’t have fertility issues, that it would be very straightforward.” The initial plan was for her to carry their child, and so with the help of Waterstone Clinic they tried Intrauterine insemination (IUI) and then a round of IVF, but each was unsuccessful.

Niamh then went through three cycles of IVF, one of which was unsuccessful and the others sadly ended in miscarriage.

After this, they decided that two of the remaining embryos from Niamh’s IVF cycle would be implanted in Geraldine, a treatment called Shared Motherhood or Reciprocal IVF. It was this cycle that produced their twin girls, Réidín and Aoibhín earlier this year.

A joyful outcome, but Geraldine says the process did take a toll on them. “It’s a rollercoaster and, being a same-sex couple, we didn’t anticipate it being that difficult.” The silver lining to the whole process, however, was that they both had a part to play in their successful cycle.

“The most magical thing about it is that it did take input from the both of us in the end. That’s a really nice thing to come out of it,” Geraldine says.

Getting there had the unexpected additional complication of Covid restrictions, which delayed the cycle where the embryos would be implanted in Geraldine.

“Two days before transfer, the Covid guidelines were put in place, so that was devastating,” she explains, “We had lost a pregnancy, so we had decided to take two months off, something we hadn’t done before. We had always just kept going back for more, trying, trying, trying. So we had taken that break, we were mentally ready, and then Covid happened.”

However, the clinic was able to ensure that the couple was ready to go the minute they were allowed to reopen, prescribing Geraldine’s medicine so she would be ready for the procedure as soon as it was permitted.

Geraldine believes this timing is the reason that their daughters were the first children in Ireland to benefit from the Children and Family Relationships Act (2015) being enacted in May 2020. This meant that she and Niamh were the first same-sex couple to both be registered as parents on their babies’ birth certificates.

This registration was a historic moment that was celebrated as a huge step for the LGBTQ community, although Geraldine laughs that the whole thing was a little over their heads at the time.

“When we got the news, we had two seven week old babies who had colic, and one had reflux, and we were just trying to stay afloat!”

They were incredibly thankful that they didn’t have to go through a court process to both be recognised as their children’s parents, which same-sex parents had to do before this legislation was enacted.

“Some of our friends had children only maybe a year before us, and they had a terrible ordeal to go through.” Geraldine also points out that before this legislation, the second parent had no legal guardianship over their child while this lengthy court process to be recognised as their parent was ongoing.

She also adds that she hopes the law can be changed for male same-sex couples, who are not covered under the new legislation.

And of Waterstone Clinic, who were there throughout their journey, Geraldine could not speak more highly. “Honestly, I tell everybody they were so amazing. They couldn’t have supported us more. Every time we were coming back, time and time again they were so kind to us, which meant a lot.”

She also explains that as they were the first to go through the registration process under the new legislation for the girls’ birth certificates, they were unsure about all the paperwork, but the clinic guided them through it. “They went above and beyond, I can’t praise them enough.”

The couple’s advice to others who are considering starting their family in the same way, is to surround yourself with good support.

“Fertility treatment needs to be talked about more, instead of it being hush-hush. It should be openly discussed so people can have support. We had fantastic friends around us who, when we’d gotten bad news, they’d just text and say something like, ‘I left a little parcel outside the front door’. Little things like that, a bar of chocolate, those are the things that you need.”

Part of the IMAGE Talks Fertility series, published 11 Nov 2021 on IMAGE.ie

12 frequently asked questions about undergoing IVF

How long should I wait before seeing a specialist, how much does IVF cost in Ireland, are there any supplements I should be taking? We answer the most common fertility questions

Going through fertility treatment is an important time in anyone’s life. Whether you’re just starting out on the road to parenthood or have been through it all, there is still so much to learn and understand.

IVF, or in-vitro fertilisation is one of the most common types of fertility treatment and rounded up the 12 most frequently asked questions about the treatment to help you on your way to parenthood.

When should a couple consider seeking out a fertility specialist?

This depends on the age of the female partner. If you’re under 35 with no indicator of subfertility that you know of, then it’s recommended you see a specialist after a year of trying. If you’re over 35, it’s recommended you see a specialist after six months.

However, peace of mind is really important and you can see your GP or a fertility clinic for some basic fertility tests when or even before you start trying for a little one. If there’s anything you need to do or correct to help you conceive naturally, you can then make those adjustments. Remember too that you are conceiving as a couple, so both of you should be fertility tested if you decide to go for investigations.

How much does a round of IVF cost in Ireland?

Typically in Ireland, IVF costs between €4,000 to €5,000 and this should include the treatment and aftercare of one round of IVF. It’s important to explore exactly what’s included in the costs and find out what additional costs there could be (such as fertility testing and embryo freezing) so that you can budget appropriately.

Is weight an important factor for IVF treatment?

If you are trying to conceive, it is important to be at a healthy weight. Often people put off tackling their weight until they have their treatment plan, but starting right away will put you in the best position. Being underweight or overweight can impact your fertility as this affects the normal production of hormones. For men, it can impact sperm count so it’s an important issue for both of you.

Being a healthy weight can increase your chances of becoming pregnant naturally and potentially improve the success of fertility treatment. While BMI is not the only indicator of health, it is still a useful one and a good goal. It’s important to ensure you are giving yourself every chance of success when trying to conceive or progressing with fertility treatment. Looking ahead to your pregnancy, you’ll have a healthier pregnancy and delivery if you’re nearer the ideal weight at the start of your pregnancy.

How long does it take from the initial consultation in a fertility clinic to a pregnancy test?

The first step is to get in contact with the fertility clinic. They will book you in to meet a consultant fertility specialist and advise you on any tests and information you and your partner need to have to get the most out of your consultation. At your consultation, the fertility specialist will review your medical history, perform an ultrasound scan and discuss all of your test results together as a couple. They will then give you some recommendations, which might be to have some further tests, some advice to help you conceive unassisted, or they might recommend a course of treatment.

If they recommend IVF to you, the consultant will advise a particular protocol based on your test results. Once you are ready to begin your cycle, the team will give you instructions for when and how to take your medications, and some expected dates for scans and your egg collection procedure (although these dates can change, depending on your response to the medication).

Your cycle will start when your menstrual cycle starts. The first part of the cycle focuses on daily hormone injections. to stimulate the ovaries to produce follicles (a follicle is a small bubble of fluid that contains an egg). This process usually takes about two weeks and during this time you’ll have some ultrasound scans to monitor the progress and growth of the follicles. Once the follicles reach the right size, your egg collection will take place, a procedure where the eggs are collected from the ovaries. The eggs are then brought to the lab to be fertilised and developed to embryos. A few days later, an embryo (or two – but this can result in twins or even triplets) will be transferred back into the womb. It’s then a two-week wait until you can take a pregnancy test.

Does a history of ovarian cysts affect fertility?

A history of cysts can impact fertility but not always. A specialist can assess whether you have any cysts that could interfere with your plans before and during your treatment so it’s important to flag this with your doctor from an early stage.

How should I prep my body for its first round of IVF?

The central thing to keep in your mind is that you are preparing for pregnancy, not for treatment. Keep that in sight. Getting your body ready in terms of being physically healthy for your pregnancy is so important. If you do smoke or vape, quitting will improve your chances of conceiving. A balanced diet, good water intake and a regular exercise routine are important for all aspects for health. Cook at home as much as you can, with a good supply of organic fruit and vegetables and avoid fried and fast foods.

Think about your support system and what you enjoy doing, what relaxes you, and make time for those people and things: they are your support network and will help you through from treatment to baby. There are also a number of complementary therapies that patients find helpful, such as mindfulness and acupuncture as a way to help them relax.

Are there any supplements I should take during IVF?

All women who are actively trying for a baby should take 400ug of folic acid per day and well as vitamin D, Omega 3, CoQ10 and a good source of vitamins and minerals. Generally, these can all be found in all-round supplements. For men, folic acid is also recommended, Omega 3, vitamin D, Zinc and Selenium are beneficial.

Remember that you will get most of these vitamins from a healthy, balanced diet. Eating organic fresh fruit and vegetables, particularly dark leafy vegetables will really help your intake.

Any advice on juggling IVF appointments alongside work?

Balancing the needs of your cycle with the needs of your work can cause a lot of stress for anyone undergoing IVF. If you’re comfortable, discuss your plans with your manager and with your GP. While companies in Ireland are not yet obligated to give you paid leave for reproductive healthcare treatments, the majority of managers are very supportive.

The Organisation of Working Time (Reproductive Health Related Leave) Bill 2021 is currently being discussed, which may in time allow leave for those seeking care. If you’re planning to do a cycle, once you’ve had your consultation, your IVF cycle will have 5 or 6 appointments and they are very quick appointments, usually 20-30 minutes, flexible appointments. The only day you’ll need off is the day of your egg collection.

Is there any advice on having sex while undergoing IVF?

Although you’re trying to get pregnant, it is important not to have unprotected sex during your IVF cycle since you are stimulating your ovaries to produce multiple follicles. Protected sex won’t have any impact on your treatment, but keep in mind that superovulation can be uncomfortable for some women.

What if I’m really terrible with needles?

This is a very common fear. The needles that are used for the injections are quite small and short and shouldn’t cause anything other than some mild initial discomfort. Consider having someone with you for the first or second injection just for support. After this, you’ll feel more confident and it will just become second nature.

Doing the injection for yourself is much more comfortable than having someone else administer it, and it will give you the independence to continue your regular routine – you can take injections with you – and keep your stress levels down.

What are the most common side effects of hormonal injections?

The most common side effects reported during IVF treatment are typically hormonal ones, such as headaches, tiredness and mood swings. Everybody is different but most patients report little to no side effects.

Should I have some mental health supports set up to help me through IVF?

While it is a straightforward medical process, IVF can be an emotional process: everyone needs support at times. Allow yourself to lean on your support network if you need to and give yourself space for relaxation. Don’t stop the things you enjoy during your treatment cycle.

Even if you think you don’t need it, it’s a really good idea to see a counsellor in your clinic as they will help you build resilience and good coping strategies. Most clinics offer it free of charge, so avail of it if you can and it will feel easier to see the counsellor again if you’re struggling at any point. You can also ask for help from your clinical team too: telling them if you’re finding it hard won’t affect your treatment, and it’ll give them an opportunity to reassure you and give you support and resources. There are plenty of online support groups out there too and your doctor may be able to advise other suggestions to ensure you’re in the best place going into and during treatment.

Part of the IMAGE Talks Fertility series, published 27 Jan 2022 on IMAGE.ie

What to Expect: An IVF Roadmap

Not sure what IVF treatment entails? We talk to the experts and break down the IVF process, so you know what to expect along the way.

So you’ve had your tests, met your doctor, and they’ve recommended IVF treatment. For some, this is a welcome relief and for others, it can be overwhelming news. Before you dive into the process, it’s good to have all of the information you need, that’s why we’ve broken down the process into bite-size pieces so you know what’s ahead.

By now you’ve been working to get your body ready (taking folic acid, living a healthy lifestyle, cooking at home) and get your mind ready (practising your relaxation techniques and building your team of friends and family for support). You have all the practical things done like getting your Drugs Payment Scheme card for your medications and reading all the information from your clinic. All that’s left to do is start….

So here we go, right into the map of a typical IVF cycle, drawing on expert advice to take you through each step of the process.

In IVF treatment, there are five main steps:

Stimulation Phase
Egg Collection Procedure
IVF/ICSI Procedures in the Lab
Embryo Transfer Procedure
Pregnancy Test

When Will You Have Appointments?

One thing that can cause some stress when people think about IVF treatment is appointments – how many they’ll need, when they’ll be, and how they’ll manage the appointments around work.

The team will discuss all of these with you in advance. There are different protocols for IVF, but here are typical times of when you’ll need to attend the clinic:

1. Baseline Scan: When you start your next menstrual cycle, you will inform the clinic and your treatment plan will start. You’ll have a baseline scan and you’ll get your instructions for your medication. This scan takes about 30 minutes and is important to make sure your body is ready to start.

2. Stimulation Scans: During your stimulation phase, you’ll have two or three ultrasound scans to track the development of the follicles in your ovaries. These scans take about 20 minutes. At your last scan, the fertility nurse will let you know when your egg collection procedure will be.

3. Egg Collection Procedure: A few days later, you’ll have your egg collectionprocedure. If this falls on a work day, you will need to take this day off as you will receive sedation for the procedure. Your partner will need to attend to provide a semen sample and also to accompany you after the sedation.

4. Embryo Transfer Procedure: After the egg collection, the lab will let you know how many eggs were collected, and the following day, how many have fertilised. As the embryos develop in the lab, the team will advise you on which day is the best to transfer on: Day 3, Day 5 or Day 6. The embryo transfer procedure is short; it just takes about 20 minutes.

5. Pregnancy Test: After your embryo transfer procedure, the team will give you a date to take your pregnancy test.

The IVF process takes a few weeks, but doesn’t have as many appointments as you might imagine. “If you are comfortable to talk to your manager, informing them about your treatment can be very helpful so that you can reduce any anxieties you have about leaving work for appointments,” advises Mary McAuliffe of Waterstone Clinic.

“There are also lots of resources available to help throughout the process, from relaxation resources to counselling sessions, and your team will be there to support you throughout. All of the team is behind you; we all want this to be successful for you.”

Treatment is a journey, just take it step by step.

Part of the IMAGE Talks Fertility series, published 3 Feb 2022 on IMAGE.ie

Becoming mum: Why I decided to solo parent and use a sperm donor

JANE MCNAMARA looks at the cost, legalities and choices surrounding solo parenting in Ireland, using sperm donation and talks to one Cork woman who went down that route

MORE than a year into the pandemic, everyone knows someone who is struggling.

One group whose grievance has not received much attention is single people coming to the end of their fertility window, who want to have a family.

Traditional dating has been rendered impossible for more than a year, and the chances of meeting a partner much reduced.

For some, this past year may not have been a question of life and death, but a question of life and whether they will have the opportunity to create it.

Same-sex female couples have always required sperm donation in order to become pregnant. When women become mothers without a romantic partner and through the use of sperm donation, it is called solo or single motherhood by choice.

Going it alone, regardless of sexual orientation, has its own unique set of personal considerations.

Arguably, the most straightforward way to approach this is to go through a fertility clinic. This will assess fertility, assist in sourcing sperm and draw up a treatment plan.

We don’t have any sperm banks in Ireland. Most of our sperm comes from Denmark or the U.S and women who go down this route will sift through profiles of potential donors. These profiles show things like pictures of the donor when they were a baby, their height, eye colour and medical history. In this way, it is often compared to online dating, though it is invariably very different.

Mary Butler, from Douglas and based in Ballincollig, was 40 when she first looked into solo parenting and was successful on her first attempt. Her baby Iris will be one this month.

She says: “I have always been broody, for want of a better word. As I got into my mid to late 30s I hadn’t met anyone so I just assumed it wasn’t the path for me. I kind of pushed it away. But a friend of mine mentioned using a sperm donor and I spoke to my GP about it.”

Mary says while it may be called solo motherhood, she is not doing it alone.

“If you were on the side of a mountain with no-one around, of course it would be difficult. But that’s just because we as humans need other people. I don’t feel there is a huge gap in our lives.

“My mother has been incredible through this whole thing. She came to all my appointments, holding my hand. She was in with me for the IUI procedure. I joke that she is the only grandmother in the history of the world who was present for the moment of conception. She is 78 now. Both her and my father have been so supportive. Iris is the absolute light of their life.”

In an IUI procedure, sperm is injected directly into the uterus. Fertilisation occurs inside the woman’s body.

With IVF, on the other hand, eggs are retrieved from the woman and fertilised by sperm outside of the body. A fertilised egg which is the embryo is then inserted into the womb.

There are more drugs and hormones involved with IVF and it can be a tough, exhausting process. It is also more expensive than IUI but the success rates are higher.

Often, but not always, women start by attempting IUI before moving to IVF, if the former is not successful.

Ursula Lynch is a fertility nurse specialist and donor sperm co-ordinator in Waterstones Clinic in Cork.

She says: “When we talk about sperm, we talk about it in terms of a straw. One straw of sperm tends to do one treatment cycle. Most often, women will buy two or three straws at a time. The cost per straw of sperm can be anything from €800 to €1,200.

“There is also a shipping cost, so for two straws of sperm, you are looking at €3,000. Then you pay for the treatment. IUI is about €850 while IVF, which has the higher success rate, is €4,750.”

Last year, the law changed in Ireland. Anonymous sperm is no longer allowed to be used in an Irish fertility clinic. This means that sperm donors must provide details to the Irish National Donor-Conceived Person Register so that any child conceived by their sperm can access these details, once the child turns 18.

However, there remain a great many legal grey areas when it comes to assisted reproduction in Ireland. It is hoped the Assisted Human Reproduction Bill of 2017 will give much-needed clarity when it is enacted.

Most clinics will confirm there has been an increase in the number of single women presenting for solo motherhood by choice in recent years.

While the legislation surrounding human reproduction has been disappointingly slow to advance in Ireland, the same cannot be said for societal views.

Although there are still ethical considerations for some, the stigma surrounding solo motherhood by choice is receding.

Jane Mattes, the founder of the American organisation Single Mothers by Choice, says: “We have been inundated with calls and queries since the pandemic began. Women want to know how to go about doing this. We were surprised because we thought this would be the last thing people would want to do in a pandemic, but maybe they are realising what is important.”

On reflection, Mattes agrees: perhaps the increase in interest in solo motherhood is a reaction to a changed dating landscape. If that’s the case, the increase is likely to continue.

As published on EchoLive https://www.echolive.ie/wow/arid-40287695.html on 13 May 2021

Going it Alone: Single Motherhood

An Irishwoman who became a mother through sperm donation in the early days of the pandemic has said she would make the same decision “100 times more.”

Mary Butler was coming towards her 40s when she decided that, if she wanted to become a mother, she may have to go it alone.

Her doctor put her in contact with the Waterstones Clinic in County Cork and, after getting the green light to go ahead, she gave birth to her daughter Irish in May of last year.

Solo parenting

On Newstalk Breakfast this morning, she said almost given up on the idea of motherhood before deciding to investigate sperm donation.

“I had kind of pushed it away a little bit in terms of, I didn’t really want to dream that I could have a baby on my own,” she said.

“It wasn’t even something that was really on my radar. I suppose I thought it was for celebrities or the really rich people who had nannies – I didn’t think it was for someone like me.”

She said she spoke to a lot of her friends and family about the idea before taking the plunge.

“I said look, I am thinking about doing this, do you think I would be able to do it? As in physically look after a child on my own,” she said.

“I have to say everyone was so, so supportive. A lot of my friends who have children said, well it’s hard but it is hard for everyone initially and they said you absolutely are able for it.”

Support

She said she was prepared for people to question the decision but “no one ever did.”

“I think my family were definitely worried for me in the sense of, it is a lot to take on, on your own,” she said. “But they were so, so supportive and it is something that I am always so grateful for that I had that support.

“My mother came with me to all of my appointments. When all of the tests were done, when I actually had the procedure, she was there holding my hand. I have always felt that incredible support.”

History

Ms Butler said she wants Iris to know her story as soon as she is old enough to understand.

“It is never something I am going to hide from her,” she said. “I am so proud of how we have become a family.

“What I really want to talk to her about is that there are so many different types of families and I think, in this day and age, there are so many different types of families.

“You have one mum, two mums, one dad, two dads or you know, parents who don’t live together – there are so many different types of families and I suppose, what I want her to know is that that is the norm.

“One of the reasons I am so excited to talk to you today is that I want people to be aware of the different types of families so it becomes the norm.”

“No regrets”

She said it has been hard being a new parent during lockdown – but she has no regrets about her decision.

“It is so hard to know what to expect until you are in the middle of it,” she said.

“It has been hard at times. It is hard being a single parent at times – being a solo parent and being a new parent in the middle of a pandemic but she is just amazing.

“She is just incredible and I have no regrets. I would do it 100 times more.

“I would do it 100 times to get Iris but I am happy with me and Iris as our family and I am going to stick with just the one for our family.”

As published on Newstalk.com on 18 May 2021

https://www.newstalk.com/news/mother-who-had-lockdown-baby-after-sperm-donation-would-make-same-decision-100-times-1196923