Want a baby but no sign of Mr Right?

Irish Examiner

By Catherine Shanahan

BY the time we hit 30, most women have been bitten by the baby bug.

For those who have met Mr Right, there is opportunity to try for that child. For those who have not, motherhood may look like a long shot. Certainly, in the past, singledom equalled a life consigned to childlessness.

But the world has moved on. Giant strides in the fertility industry, particularly in the last decade, make having a baby far more attainable, regardless of marriage or relationship status.

With her biological clock ticking loudly and no suitable partner on the horizon, Spanish actress and model Monica Cruz, pictured right, sister to Penelope, took matters into her own hands to “fulfil the dream of a lifetime”. In May, the 36-year-old delivered a healthy baby girl conceived through anonymous donor sperm.

She decided to go public on her decision to prevent endless speculation about the father of the child. “… my thanks to all those anonymous men that help to give many women like me, the dream of their lives,” she said to El Pais in January.

The industry has come a long way from the first known case of a child by donor insemination in 1884 when an American professor chloroformed the wife of a sterile quaker, then let his medical students vote who among them was “best looking”. The winner provided the donor sperm and the merchant’s wife gave birth to a son.

While the science behind fertility treatment has improved hugely since then, women have still been dependent on men to provide that much longed-for child — until now. Suddenly, medical advances have opened up a whole new vista. Fertility clinics in Ireland (with the exception of the HARI unit at the Rotunda Hospital which does not offer donor sperm) are reporting a steady increase in the number of single women opting to go it alone.

At the Galway Fertility Clinic (GFC), laboratory manager Jenny Cloherty says since 2009, four babies have been born to women using donor sperm, in addition to two ongoing pregnancies. They have treated 27 single women, 10 of whom only started treatment in the last few months.

The Waterstone Clinic (CFC), which has offered donor sperm since 2009, says demand for this treatment is “small and steady”. It has treated 28 women using donor sperm, nine of whom have either had a baby or have an advanced successful pregnancy.

At the Kilkenny Clinic, which established a donor sperm service in 1999, medical director Dr Martine Millet-Johnston says they are seeing about 20 single women a year and the numbers are increasing among older women.

In Dublin’s Sims Clinic, patient co-ordination manager Dr Lyuda Shkrobot says of the women without a male partner that they treated in 2011, about two-thirds were “same sex couples”, the remainder — single women.

Annabel*, an American business woman living near Dublin, is one such woman.

“Around the age of 40, after several long-term relationships, and having built a career, I decided to look into it. I had thought about it in the past, but at around 40, it seemed more important,” she says.

She heard an interview on the radio with Dr David Walsh of the Sims Clinic and was impressed. A few months later, she decided to go ahead with treatment.

Sims, like most of the Irish clinics, sources sperm mainly from Denmark, home to Cryos International, the world’s biggest sperm bank.

While previously its clients were predominantly couples affected by infertility, 40% of demand is now coming from single women.

Restrictions are in place to limit the number of children produced by any one donor. Dr Tim Dineen, lab manager at the Waterstone Clinic, says limits are imposed by the clinic, the Government and the sperm bank. “These limits are aimed at minimising the small possibility of consanguinity, ie a man and a woman, both children of the same sperm donor, but unaware of that fact, marrying,” he says.

CFC’s policy is that a particular donor can only be used by one recipient female. All pregnancies achieved are also reported to the donor bank as it has a maximum limit to the number of families that each donor can produce.

In addition to informing the donor bank, Dr Millet-Johnston says there’s a centralised database in Ireland where each clinic registers usage of a given sperm donor. She says the clinics abide by the “three-family rule” — donations from one donor cannot be used by more than three Irish families.

The client fills in a donor characteristic form and the embryologist tries to match it to available sperm donors.

Dr Dineen explains that the characteristics always specified are physical: hair colour, eye colour, height, weight, ethnicity and skin colour.

Annabel sought a donor with physical characteristics similar to her father. She estimates it took about two months for the sperm to arrive. Initially, she opted for ICSI (Intracytoplasmic Sperm Injection), where a single sperm is picked up with a fine glass needle and injected directly into the egg.

After three failed rounds of ICSI, she decided to try IVF, a process where the woman’s egg is fertilised outside the body and then replaced in the uterus.

At Sims, prices for sperm vary according to type of treatment. An IVF cycle using donor sperm at Sims is priced at €4,500. At CFC, the cost is €3,750 for IVF. Neither price includes the cost of sperm.

The cost of donor sperm depends on what is specified by the woman, Dr Dineen says.

“She may choose to import a larger amount in case she needs a number of treatment cycles and to cover the possibility of trying for a second baby with the same donor. The cost also depends whether the donor is anonymous (versus open to identification) and the characteristics profile (basic versus extended). At CFC we recommend allocating approximately €1,500 to €2,000 for importation of sufficient donor sperm straws to allow for a sibling,” says Dr Dineen.

Unfortunately for Annabel, three rounds of IVF failed. By now, she had spent about €16,000 on trying to get pregnant. After a trip to Italy, she decided to take stock. Treatment had put her body under stress. The cost was draining her financially.

It was at this stage that her doctor suggested dual donation (sperm and egg), a treatment she had initially ruled out because she felt there would be no biological link with the child. But she was encouraged by the live birth rates — donors are young women and generally produce more and better quality eggs. By now, Annabel was approaching 44 and was afraid that by using her own eggs, she would give birth to a child with special needs.

Because egg donation treatment is not available in Ireland, Annabel travelled to the Ukraine. The egg donor treatment cost €5,000, excluding travel costs and fertility medication from Sims, which between them added approximately another €2,000 to her bill, she says.

The doctor implanted two eggs — one subsequently miscarried — and Annabel says she “knew immediately” that she was pregnant.

Annabel, now 46, is the proud mum of an eight-month-old baby girl, born last November by emergency C-section, weighing 9lbs 7oz. She recalls how she burst into tears when she first heard the baby’s heartbeat at her seven-week scan.

Family, including Annabel’s mother, flew from America for the birth. “My parents were delighted, really supportive. I was really surprised. I thought their generation would think it was bizarre,” she says.

Annabel says she’s not concerned about telling her daughter about her genesis. “I think she has a really unique story, she’s one of a kind. People talk about adoption being special, but this is a whole new level. I created this,” she says.

Annabel’s donors were anonymous, something she is happy about — she didn’t want anyone “laying claim” to her child in the future, she says.

Angela O’Mahony, fertility counsellor and psychotherapist at the CFC, feels it’s important for single women who opt for donor sperm to consider the issues and challenges involved for mother and child now and into the future.

“Most women have made their decision to proceed with treatment prior to our session. They generally come from a mid socio-economic bracket, with their own homes and secure employment. The common theme tends to be the need to fulfil a deep desire to have a child.”

Counselling offers an opportunity to explore feelings around the challenges of single parenting and identifying where the woman will obtain practical, emotional and psychological supports.

“While single parenting is a common feature of our world today, donation brings the unique challenge around telling a child about his/her birth origins,” O’Mahony says.

For instance, it raises issues around the identity of father. The woman can choose a ‘known anonymous donor’ which means the child can opt to make contact through the sperm bank at the age of 18.

“Ideally I would like to see the availability of non-identifying information on the donor, so that mum can share it with the child as he/she grows. It is understood that the more information a child has about his/her beginnings, the more it supports the child’s sense of self.”

O’Mahony points out that there is considerable research done on the importance of a father or father figure in a child’s development.

“A dad plays a significantly different role to mum, often helping a child to individuate and separate from mum at the appropriate developmental stage. Many women identify a close male friend, granddad or brother as having offered to provide a positive male role in the child’s life.”

O’Mahony says it is her experience that the majority of women she sees “continue to hold the possibility for a relationship at some point in the future”.

Annabel is a case in point. “I haven’t given up on the idea of getting married and finding a husband,” she says. “Having a baby may even increase my chances. Your network expands.” she says.

*Name has been changed