"All the way through those years, I had to keep hoping it would happen, because the alternative – not having children – was too scary for us to contemplate," she says. "I would go in to have embryos implanted and would just stare at the slide on the microscope, looking at the little mass of cells and thinking that might be my baby. But each time the embryo wouldn't implant, I wouldn't get pregnant and we would go through another grieving process.
"There would be people at work having baby showers or we'd be going to christening parties, and it can be hard to smile, but you don't want to tell everyone what you are going through because it's such a roller coaster. It is a very emotional, very private journey."
One in six couples in the UK has problems conceiving. The medical fertility industry – clinics offering IVF, donor insemination and other treatments – was worth an estimated £500 million at the last count in 2008. Unofficially, experts believe it is now worth well in excess of £600 million.
The demand for fertility services has never been so high. New analysis by the Office for National Statistics published last week showed that women now wait on average five years longer to have their first child than their mothers' generation – a key factor fuelling the growing dependency on IVF. The increasing age at which women contemplate motherhood, coupled with the rise in single women and gay couples seeking treatment, is helping to fuel demand for the fertility sector.
Add in the huge commercial market in supplements, alternative remedies, counselling, coaching and other products, and some analysts put the burgeoning fertility industry at worth more than £1 billion.
More than 3,000 visitors are expected at the sixth annual Fertility Show at London's Olympia next month, where clinics, doctors and alternative therapists will showcase their services. Set up in 2009 by events organiser Jonathan Scott after a close relative had to endure IVF treatment, the Fertility Show has been an unexpected money-spinner. Visitor numbers have doubled in the past six years, while the number of exhibitors has risen from 80 to 140.
Scott says: "When I first started the show, I thought it would be a one-off – I never thought it would still be going, but the demand is there. It was incredibly controversial at the beginning. We had Jenni Murray from Woman's Hour claiming it was all too commercial and awful. But it's about giving people information on fertility and conception. Now it seems a lot more mainstream to be holding an event like this."
Claire Collins with husband Steve and 14 week old Ralph (David Rose/The Telegraph)
Since Louise Brown became the first IVF baby to be born in 1978, the number of women having fertility treatment – and becoming pregnant as a result – has soared, with a total of more than five million births globally. While the fundamentals of the science behind IVF haven't changed dramatically in those three decades, the industry surrounding infertility and the pursuit of the perfect family certainly has.
According to the Human Fertilisation and Embryology Authority (HFEA), 47,422 women underwent fertility treatment at the 77 licensed clinics in the UK in 2012. But the course can still be ruinously expensive – a single cycle can cost more than £8,000, and the majority, 60 per cent, are paid for privately by patients rather than by the NHS – with hugely varying rates of success. HFEA figures suggest that for women aged 43 and 44, the average live-birth rate across all clinics in the UK is just 5.1 per cent.
Guidelines from the National Institute for Health and Care Excellence state that women under 40 who have been trying to conceive for more than two years should be entitled to three cycles of treatment on the NHS. In reality, the postcode lottery of funding means that patients in many areas of the UK are denied this, while those over 40 – an increasing proportion of those seeking treatment – are automatically excluded and forced down the private route.
All of which means that fertility is an increasingly big business – although not everyone is a winner.
Theatre director Jessica Hepburn, 43, has spent an estimated £70,000 on 11 failed cycles of IVF over 10 years. She believes there should be more of an onus on clinics and doctors fully to inform patients about their chances of success – and to support them afterwards.
"I don't regret spending the money because I really wanted to become a mother, but I did feel abandoned when the treatment didn't work," she says. "You go into the doctor's consulting room and they have pictures of all their success stories, parents smiling with their babies – but when it doesn't happen for you, they don't want to know. There is very little follow-up care and counselling. They've got your money, so it doesn't matter."
Hepburn, who has written a book, The Pursuit of Motherhood, about her quest to become a parent, adds: "I think the really important thing is for doctors to be upfront with women in their late thirties and forties about what their chances are. There is also this cult of motherhood in our society, the idea that you must become a parent to be fulfilled. I think that's something we need to challenge."
Over the decades, the availability of treatment and the type of women receiving it has changed dramatically. Dr Robert Forman worked with the British doctors who "created" Louise Brown, and is now medical director of the CRM Care London clinic, part of the country's biggest fertility company, with seven "branches" in the UK and Ireland. Care now performs more than 7,000 cycles of treatment a year and boasts success rates of up to 50 per cent.
"When IVF started, it was purely for women with blocked fallopian tubes," says Dr Forman. "One of the biggest changes over the years is that we are now increasingly treating people who are not technically infertile. It is single women who are opting for egg freezing or donor insemination, gay couples coming for treatment, as well as those who can conceive but have genetic testing of embryos, for instance, to screen out cystic fibrosis if they know they are carriers of that gene."
Dr Forman says that these "fertile" groups now account for 30 per cent of all his patients, up from less than 5 per cent 10 years ago.
Last week, Facebook and Google announced plans to fund egg-freezing treatment for their female employees who want to delay motherhood in order to pursue their careers.
The Care company is also an example of how the profile of the fertility industry is changing, according to Kevin Grassby, managing partner with the Bowmark Capital private equity group.
"It used to be very much an old boys' network," he says. "A woman would go to her GP who would refer her to an NHS specialist. There were a lot of single clinics run by individual practitioners who would dictate what care the woman received.
"What we see now is that the consumer has a lot more power. Patients go on the internet, look at the success rates, choose whom they want to go with and are very informed. They won't just go where they're told or accept what they're told to do. That has led to increased branding and marketing in the field. It's no longer about single practitioners doing their own thing in Harley Street. It's a big business."
For some, the business has become too big. Mandy Parry, who runs the Motherhood Dreams firm advising women on fertility treatments, says: "I've heard of one woman who was on the operating table of a private clinic, about to have an embryo transferred, when the doctors said she needed an extra procedure, and she had people running down from the finance department with her credit card demanding more payment before they went ahead."
In the US, where the fertility industry is worth £2.5 billion, business is even bigger. Some clinics offer finance deals involving "a baby or your money back" and discounts for poorer, younger women willing to donate eggs to older, wealthier patients.
Hundreds of international experts were gathering in Honolulu this weekend for the start of the annual meeting of the American Society for Reproductive Medicine, at which the latest technologies and treatments will be discussed. But of equal attraction is the exhibitors hall, where drugs companies woo doctors with free gifts, dinners and samples in the hope of selling their products on to desperate patients.
The UK industry is internationally respected because of its tight regulations, and yet has managed to remain at the forefront of technology and innovation. But Mandy Parry, who had her daughter at 46 following recurrent miscarriages and seven failed IVF cycles at a cost of £60,000, believes there needs to be a "sea change" in the provision of fertility treatment on the NHS.
"It should be seen as a basic human right to have children," she says. "It's not a lifestyle option. Women have a right to demand treatment and we shouldn't be kicking them for it. When I was trying to conceive, it would upset me massively when people would tell me things such as 'What will be will be'. You wouldn't say that to someone with cancer, would you?"
Fertility expert Zita West – who is evangelical about informing couples about their options, both natural and medical, when it comes to getting pregnant – believes women need to educate themselves about their own fertility before they even start contemplating children.
"It's not just about IVF as a solution," she says. "The irony is now that we spend so much time teaching teenage girls about not getting pregnant – then they're on the Pill from the age of 16, only come off it when they're in their thirties and want to start a family, and then hit problems. They have no idea about their natural cycle, and for some they have no real clue about the importance of having sex. They become obsessed with things like ovulation but still have sex only once a week or when they're ovulating, and that puts such pressure on a couple trying to conceive.
"If you're having sex three times a week, you have a much greater chance of success, rather than just waiting for that ovulation window. We need to talk about these things as well as IVF."
Meanwhile, in Surrey, Claire Collins is coming to terms with the lack of sleep that goes hand in hand with a newborn, and is even contemplating doing it all again. "We always wanted more than one child," she says, "and we do have a frozen embryo we could use."
She pauses: "I don't think we could ever go through seven cycles again – and we couldn't afford to do that many. But when you really want a baby, there's nothing you won't try to get one."
Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/3f99653c/sc/36/l/0L0Stelegraph0O0Cwomen0Cwomens0Ehealth0C111713110CYoure0Ebig0Ebusiness0Enow0Ebaby0Bhtml/story01.htm
