News Features
Dealing with post IVF-stress
28Jul07
Specific support for IVF parents usually ends at conception but a new handbook by an Allambie Heights parent-infant counsellor gives couples advice to help them cope when the baby arrives, writes MARJ BELESSIS
NEXT year marks the 30th anniversary of the world's first IVF birth. Since 1978, three million babies, conceived outside the mother's womb through in vitro fertilisation, have been born worldwide.
In Australia, 10,000 IVF babies - 4 per cent of all babies - will be born this year.
IVF treatment doesn't work for all couples affected by infertility who go down that path in their quest to have a child. With 41,000 IVF cycles beginning each year in Australia, the overall success rate of IVF is nudging 25 per cent, but this is double the success rate of 20 years ago.
Advances like pre-implantation genetic testing are expected to double the current success rate of IVF over the next decade. This, combined with other factors like the older age of couples trying for a baby and the decreasing fertility rate, is set to change the face of human reproduction to the point where, within 20 years or so, 3 out of every 10 babies will be conceived by IVF.
IVF offers hope to the one in six Australian couples who are unable to conceive a child by normal means. But it is a stressful procedure, involving an exhausting series of medical tests and fertility treatments leading up to the combination of sperm and eggs ``in vitro'' and the implantation of one or more viable embryos within the mother's womb.
Couples participating in the IVF program receive counselling before and throughout the treatment process. However once a pregnancy is confirmed the IVF mothers-to-be pass into the pregnancy mainstream where, according to Dr Karin Hammarberg of the University of Melbourne, there is little support and information available to meet their needs.
In a recent study, Dr Hammarberg found that women who conceive through IVF are more likely to doubt their abilities as mothers and experience difficulties with parenting. They are also three times more likely to attend early parenting centres for help.
To help fill the information void, specialist parent-infant counsellor Nichola Bedos has written a book, IVF and Ever After, which looks at in vitro fertilisation, the treatment's impact on families and relationships and how to manage the stress it causes.
English-born Ms Bedos, who now lives at Allambie Heights with her sons, Callum, 14, and Andrew, 11, has worked with 150 families over the past eight years. About 30 per cent of her current caseload are IVF families.
``I work with couples trying to make a decision, going through the process, during pregnancy and after the child is born,'' she said. ``There is great stress and anxiety involved in all these steps, stress which is not necessarily eased once pregnancy is achieved.
``Because of all the intervention involved and because they have not been able to conceive naturally, there is a lot of feeling that this is not natural, that it's too good to be true and that it will not last.
ƒMs Bedos said there was evidence that stress levels were substantially lower in people who had conceived quickly under the IVF program than in those who had suffered a miscarriage.
She said further complications could occur if the IVF treatment involved donor eggs or sperm.
In such cases her advice to couples is to talk openly and honestly with each other and avoid levelling blame.
``Families which can be open about it and tell their children truthfully about where they came from, giving them information as early as possible in ways they can understand, usually fare very well,'' she said.
Ms Bedos said she understood her book was the first of its kind.
``There are various textbooks and books about people's own experience of IVF but this is the first book which sets out to give IVF parents practical advice about their feelings at various stages and how to deal with the stress,'' she said.
``IVF parents can feel very isolated - they very rarely know anyone else who is at the same stage in the program as they are and people don't talk about IVF very publicly.
We are still learning about IVF parents and we've only just started to realise that they need to be able to talk to each other, that they have special needs and that this is OK.''
In her book, Ms Bedos has included a summary of the latest IVF research and examines issues like what to do with frozen embryos, how to tell a child about IVF conception and the need for uniform legislation throughout Australia requiring IVF clinics to make available to donor-conceived children information about their donor's identity once they turn 18.
IVF and Ever After, published by Rockpool Publishing, is available at most book stores. RRP $32.95.
IVF Australia Northshore will hold a free fertility information evening at Level 1, 24 Thomas St, Chatswood, on Wednesday, August 22, from 6.30.
Dr Robert Lahoud and other specialists from the clinic will talk about causes of infertility, treatment options and the science of assisted reproduction, followed by a Q&A session. To book, phone 1800 111 483.
MORE SUPPORT NEEDED, SAYS MUM
MICHELLE and Mark Fragias know all about the stresses of being IVF parents.
After three unsuccessful attempts at IVF, Michelle gave birth to healthy twin boys Peter and James 14 months ago.
But the lead-up succession of treatment and failure spanned several years and was about as traumatic as it gets.
During the second attempt, she carried triplets for 19 weeks before having a miscarriage. ``My waters broke at 19 weeks, I went through labour, contractions, the lot,'' she said. ``We'd had a roller-coaster of a ride before that and even now there are some days I just can't go there.''
Before the twins were born she was admitted to hospital at week 24 because there was a risk of her going into premature labour. ``About the only time I was allowed out of bed was to go to the toilet,'' she said. ``They let me go home at 33 weeks and the boys were born a week later.''
Mrs Fragias's experience has turned her into a dedicated advocate for a better support network for IVF parents.
``The IVF clinic's job is to get you pregnant, which is great, but I think there needs to be a better support service.'' she said.
``The best way to describe the situation is once you're pregnant you're no longer classed as infertile but when you lose the pregnancy there's no one to go to.
``I felt there should be some follow-up procedure, but there wasn't.''
Mrs Fragias said it was an ``unspoken reality'' that one in three couples had fertility problems.
``I was married at 23 and at that stage Mark and I weren't ready to start a family,'' she said.
``Two years later we were - that's how long it took us.
``The first time we tried IVF we had false expectations and after going through the first cycle it was so traumatic I didn't go back again until a year later.''
Mrs Fragias said she felt the most stressful part of the procedure was the waiting - the two weeks following embryo implantation before a pregnancy test could be performed.
``I could have injections day-in and day-out without worrying but the waiting was hard because you wanted it to happen so badly.'' she said.
She said having a large support network from both her extended family had helped tremendously.
``But there are times, even now, that I have fears about the twins' fragility because I have gone through so much to get them here,'' she said.
