The IVF lottery of joy and sorrow

Beaten the odds ... Collette Dinnigan, shown here with partner Bradley Cocks, was "really fortunate" to fall pregnant ...
Beaten the odds ... Collette Dinnigan, shown here with partner Bradley Cocks, was "really fortunate" to fall pregnant naturally at 46. 

When I heard the news that fashion designer Collette Dinnigan is pregnant with her second child at 46, my first reaction was elation, because I wish her and new husband Bradley only happiness. The second was harder to accept. Guilt always is.

I thought of my dear friend "Louisa" (she doesn't want her real name used in this story) and how only weeks before I begged her to give up on IVF and, therefore, on her fiercely held dream of being a mother.

You see, Louisa was a mess. After enduring nine IVF cycles in less than a year, she was so obsessed with trying "just one more time" for a baby that she hid her last two attempts from her closest friends and family - even her husband.

Her abdomen was a blast of angry pinpricks from hormone injections; she had put on eight hated kilos, was clinically depressed and had forgotten a time when sex was fun.

She was also broke, having re-mortgaged to keep up with the expensive procedures (minus the government rebate, the average cost for a cycle is $3000). Her relationship was suffering and career neglected.

Here lies the big emotional hurdle with IVF: it's a numbers game. It's like buying lottery tickets - not such a silly idea if you win

But perhaps the saddest fact is that Louisa entered into every cycle of IVF aware that at her age - 46 - her chance of conceiving was a fraction of 1 per cent. Not great odds when compounded with her history of endometriosis and the fact she had never become pregnant naturally.

And it wouldn't have been much better had she met her partner years earlier and started trying then. Despite the remarkable advances in assisted reproductive technology, the statistics are as irrefutable as they are dismal for women over 40: about 10-15 percent chance per first cycle for those aged between 40 and 43, 1-2 percent for 44 and 45-year-olds and a fraction of a percent beyond.

The odds of conceiving at 46 naturally like Ms Dinnigan are practically immeasurable - "tougher than winning lotto", according to one doctor.

Having watched several other girlfriends over 40 go through numerous cycles of IVF in past years, I thought that after nine efforts it was only right to suggest that Louisa have a time-out to reassess and recoup.


Now, I'm not sure. And I know that after hearing Ms Dinnigan's happy news, Louisa will be doubting my advice too, wondering once more that if Ms Dinnigan can fall pregnant naturally at the same age, then surely she's in with a fighting chance with IVF on her side.

And here lies the big emotional hurdle with IVF: it's a numbers game. It's like buying lottery tickets - not such a silly idea if you win.

But the sad fact is money, success, status and desire cannot compensate for old eggs. And while I don't want Louisa to view herself as a statistic, I also don't want her to become a victim.

In the assisted reproduction business, those who get older women pregnant achieve holy grail status. Which means there is great pressure on them to put over-40s women through as many cycles as possible to get the success rates up.

As it stands there's no limit to how many IVF cycles a woman can undergo in Australia, and hence no shortage of doctors willing to perform the procedure.

Yet what has really bothered me is that, as with so many of my girlfriends on IVF, no one seemed to be monitoring Louisa's mental health. And Blind Freddy could see she was not well in that department. At all.

"Counselling? What use was that?" Louisa told me. "I wasn't going to tell them anything was wrong in case they rejected me for treatment. I wasn't going to admit I cry all day, every day. Of course I was depressed. I wanted a baby and couldn't have one. I was there for them to give me hope, not point out the obvious."

I understand why I have become a sounding board for friends like Louisa who are still hoping for children - it's because I don't have them myself and have resigned myself to the fact I never will.

It's as if by speaking to someone who has resolved her childlessness, my friends gain the hope that they too may survive life without biological children - something they simply can't or won't contemplate while there is still any hope.

Ask any woman over 40 why she doesn't have children and there'll be a back-story, often a painful one. I'm no different. But I have a deeply felt opinion that children are not a given in life - they are a gift. And that sadly, despite how much a child is desired, it is simply not every woman's lot or luck in life to reproduce.

But I also realise not all women feel the same. Many believe a child is their right. And that with IVF, there is a chance to set things right. And I'm not about to judge those who hold this opinion - we have come way too far to start debating anyone's right to assisted reproduction.

But I do thank Ms Dinnigan for being gracious in using the announcement of her pregnancy to urge women to not put off having a child, to not believe that luck and chance may be on their side as it was so happily for her.

"You really need to start a lot earlier if you want to start a family, and I think there are a lot of misconceptions that it's easy to have a career and then start a family at 40," she said. "We consider ourselves really fortunate."

I must admit that when I heard Ms Dinnigan's news I felt that stab in the pit of my soul that harbours a tear of unfulfilled potential. I doubt that this feeling will ever disappear altogether, but I do want other women struggling with fertility to know that it does get better, that the yearning does abate, that it won't plague your every waking moment as it does now.


Wendy Squires is on twitter.

Talk to other women who are trying to conceive, or who are undergoing assisted conception, in the Essential Baby forum.