The infertility diaries

“Have you tried running less?” It’s October 2019 and my partner and I are in a meeting with a fertility consultant.

After a string of baseline assessments at an NHS hospital, doctors can’t find anything wrong with us. We’re both in our late twenties, we’re a healthy weight and don’t smoke, but after almost two years of trying to conceive, we have never seen a positive pregnancy test.

The consultant looks bored. She talks quickly. We’ve waited weeks for this appointment but, sitting in her office, we’re made to feel like we’ve just interrupted her lunch break.

“What about the cysts on my ovaries?” I ask. The sonographer told me she’d spotted the cysts at an internal ultrasound. I’d left the appointment buoyed by the news, thinking we finally had an answer, but now, with the written reports from our scans in front of her, the consultant shrugs it off.

“One of your ovaries is a bit polycystic,” she says. “But that doesn’t mean you can’t get pregnant.”

She tells us the next step is IVF. I feel my stomach drop. In my search for answers about our infertility I have put in hours of research about fertility treatment. I’ve read about lifestyle changes, supplements and medication that can treat hormone imbalances. In vitro fertilisation (IVF) – the process of removing a woman’s eggs and fertilising them with sperm in a laboratory before transferring an embryo back into the woman’s womb to grow – just seems a bit extreme.

The thought of going through IVF terrifies me. And I’ve done enough research to know that IVF isn’t a magic cure. In 2019, the NHS reported the percentage of IVF treatments that resulted in a live birth was 32 per cent for women under 35, 25 per cent for women aged 35 to 37, declining to 4 per cent for women aged over 44.

The National Institute for Health and Care Excellence (NICE) fertility guidelines make recommendations about who should have access to IVF treatment on the NHS in England and Wales. The guidelines recommend that IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years. Because of the relatively low success rates NICE recommends three full rounds should be offered to women under the age of 40, with the research showing that the cumulative effect of three full cycles of IVF increases the chances of a successful pregnancy to 45-53 per cent.

But despite NICE’s recommendations, not everyone has access to three full rounds of NHS-funded IVF. The decision to fund fertility treatment cycles lies with clinical commissioning groups (CCGs), and access to funded treatment is a postcode lottery, with eligibility varying from one region to the next.

Research by the British Pregnancy Advisory Service in 2020 found that only 23 out of 135 CCGs in England offer the full three cycles that NICE recommends. Some do not offer any at all. Same sex couples do not qualify for funded treatment, nor do most couples who already have children, including children from previous relationships.

The consultant tells us we qualify for one round of IVF on the NHS – covering one fresh transfer and one frozen. We can be added to the waiting list now, which is six months long. But the consultant recommends we wait. We’re young, we have no diagnosed fertility issues – well, until now. We’re given the unhelpful diagnosis of “unexplained infertility”, advised to keep trying, and then if nothing happens to get back in touch when we are ready to start treatment.

“IVF isn’t nice,” the consultant says, looking at my partner earnestly. “You both won’t like it.”

How reassuring. We leave the appointment with our heads spinning. We stop at a café. I order moussaka.

“Did she say something about running?” I ask my partner. I do a quick Google search. I can’t find any research about the effects of moderate – and it really is moderate – exercise on fertility.

We arrive home with more questions than answers. But following the consultant’s advice, we decide to wait a little while longer.