your book on infertility, and I went out and bought it. It made me realise we had to do something, and quickly. So that’s why we’re here. To see why it isn’t happening.’
‘I see from your notes that you are forty-three,’ Niall said gently.
‘That’s not too old, is it?’ replied Patricia anxiously. ‘I mean, I don’t feel old. I’m fit, I exercise regularly. I feel as good as I did in my twenties. Anyway, don’t they say your forties are the new thirties?’
‘Yeah, she even drags me to the gym,’ Luke added. ‘I don’t know where she gets her energy from.’ He smiled fondly at his wife. ‘She’ll be a great mother. We’re even looking forward to the sleepless nights.’
Robina felt a pang of envy. Whatever difficulties these couples were experiencing, it was obvious they loved and supported one another.
‘Unfortunately, people don’t realise that a woman’s fertility begins to tail off once they are thirty-five,’ Niall said quietly. He passed the couple a chart illustrating his point. ‘And once they get to forty, their fertility is dramatically reduced. It doesn’t really matter how fit and healthy they are, although for younger women, being a reasonable weight does help.’
‘What are you saying?’ Luke was frowning. ‘Are you telling us you can’t do anything for us, that you won’t treat us?’
‘Not at all,’ Niall said. ‘But I do have the results of your fertility tests here; the semen analysis from you, Luke, and the blood test we did on you, Patricia, at your first visit.’
Patricia grabbed Luke’s hand. It was clear to Robina that she was beginning to realise that she wasn’t going to like whatever it was that Niall had to tell her.
‘Go on,’ Patricia said quietly. Robina could hear the tremor in her voice.
‘Luke’s tests came back normal, but I’m afraid, Patricia, that your ovarian reserve is so low as to make the possibility of you falling pregnant, even with IVF, just about zero.’
Robina could tell he was choosing his words carefully, and that he knew he was giving the couple the worst possible news.
‘Just about zero?’ Patricia echoed, clearly shocked. ‘Are you sure?’ Her voice cracked. ‘No chance at all?’ Her eyes shimmered.
‘I’m sorry,’ Niall said. ‘There really is no point in going down the IVF route. It’s not just the number of eggs you have left, it’s the quality. In my opinion, even if we did manage to collect some eggs from you, and I think that is extremely unlikely, there is every chance that they won’t fertilise. And even if they do, the chance of you miscarrying is about sixty per cent. And lastly, even if a pregnancy were to continue, there is the much increased risk of foetal abnormality. I’m sorry if all this sounds harsh, but you need to know the truth.’
Patricia started crying in earnest, deep, racking sobs as if her heart was being shattered, which it very probably was, Robina thought sadly. Luke placed an arm around his wife’s shoulders. ‘Is that it then?’ he said. ‘We have to give up? Never have a family?’
Robina ached for them. She felt a lump the size of a pebble form in her throat. She knew only too well how the couple would be feeling, especially Patricia. It was a devastating blow to their hopes and dreams. She gripped her hands together tightly, not wanting to let Niall see how much she was affected.
‘I think it’s only fair to be brutally honest with you, no matter how difficult it is for you to hear. But there are other options.’
Patricia looked up and Robina shied away from the naked hope in her eyes. ‘But I’m warning you—what I am about to suggest is not for everyone. You would need to think about it very carefully, and before we went ahead, you would have to talk it through with a counsellor.’
‘Please, tell us.’ Luke spoke for his wife.
‘The only way your wife could get pregnant is by using donor eggs. That’s where we use the healthy eggs of another woman, fertilise them with your sperm, Luke, and then place one of the embryos back in you, Patricia.’
Patricia glanced at her husband and then back at Niall. ‘But it wouldn’t be my baby.’
‘Not genetically, no. It would, of course, have half of Luke’s genes, but, no, none of yours. The positive thing about using donor eggs is that the chances of achieving and maintaining a pregnancy are the same as if you were the donor’s age. And since we don’t accept donors over thirty-five, there is a greater than fifty per cent chance of you falling pregnant on your first cycle.’
‘I don’t know,’ Patricia said slowly. ‘It’s all so much to take in. I never imagined for one moment that I wasn’t going to be able to have children of my own. I guess I knew it wouldn’t happen naturally, but I wasn’t prepared to find out that it wouldn’t happen at all except with another woman’s eggs.’
‘I don’t expect you to make a decision right away,’ Niall said. ‘In fact, I would actively encourage you to have a long hard think about it. As I said, it’s not for everyone. But if you think it is something you might consider, I suggest you put your name on our waiting list. I’m afraid it’s about a year’s wait at the moment.’
‘A year! As long as that?’ Patricia’s face fell. Then she looked curious. ‘Do these women sell their eggs? Is that how it works? Maybe if we paid someone more…’
Niall shook his head. ‘I’m afraid that’s illegal. There is no money involved. The women either donate their eggs because they have had their families and want to help someone else achieve their dream, or they are women who donate a proportion of their eggs in order to help fund their treatment. There are very strict regulations around all of this. No clinic in the country can try and get around them without running the risk of losing its licence. The regulations are there to prevent women, who are often pretty desperate, from exploiting or being exploited.’
Robina was conscious of leaning forward in her chair. Of course she knew that couples could use donated eggs or donated sperm, she had written about it in her book after all, but that had been before…before she had known that there was every possibility she had joined their ranks. Listening to Niall talk to the couple was almost as if he was talking to her.
‘There is one other option, and I am not necessarily recommending it either, but I think you have the right to know. There are other clinics, overseas, that have more donated eggs than we do in this country. Not all of these clinics are above board, but there is one which I’d be happy to refer you to, if you want. You need to think about it. Speak to the nursing staff who will be able to put you in touch with others who are going through the same thing. Most people find that it helps. Then, if you think you may want to go forward, make an appointment to chat things over with the counsellor. She’ll help you decide whether it’s the right thing for you.’
After answering several other questions from the shaken couple, Niall showed them out to where one of the nurses was waiting to talk to them.
By the time he returned, Robina had managed to get her trembling hands under control. How on earth was she going to manage another couple of months of this? When every patient’s story left her feeling like a wrung-out rag. But over the last couple of weeks Robina had known that something was shifting inside her. Seeing the way couples were able to deal with their grief and move on with their lives—together—was planting the tiniest seed of optimism inside her. Maybe, in time, she too could come to terms with
