The men's room

Those of you who have ever been to a fertility clinic will know exactly what I am talking about - the place where you are sent to "produce your sample". They aren't places any of us tend to think about too much - and that we'd only manage to talk about with fertility friends after a glass or two...

When I was researching my first ever book about infertility some fifteen years ago, I interviewed a dozen or so couples and two of the men had been to the same clinic, with the same men's room which had clearly had quite an impact as they both told me about it in great detail during the interviews. Not about the room itself, but about the key which was attached to what they both described as a "plank of wood".  To go to the men's room you had first to collect the key, and then walk right through the clinic carrying this thing that you couldn't disguise so that it was clear to all where you were going and what for. For the same book, another man told me about being sent to the men's toilets in a local hospital to produce a sample where an old man kept coughing in the next cubicle and where the doors left his legs and head visible to anyone who happened to come in.

I was reminded of this today during a brilliant presentation at the British Infertility Counselling Associations Study Day by photographer Aaron Deemer, who has been touring the country taking photos of the men's rooms in clinics.  The idea sounds utterly bizarre, but hearing Aaron talk, you soon understand that his personal experience has led him to discover a truly unique way of getting people talking about infertility.  The photos themselves are fascinating - a selection of very different rooms;  some cold and clinical, others designed to try to look vaguely appealing but rarely succeeding.  There's one slightly sinister room with what looks like a dentist's chair surrounded by downlit spotlights, another had what Aaron described as a "fake plastic cannabis plant" plonked in the middle of a room full of chairs that doubled up as the staff conference room.  There was a room that Aaron said reminded him of his teenage bedroom with a narrow bed and patterned curtains.  One room had bars at the window, another had a phallic photo of the Eiffel Tower on the wall.

Aaron's project is called "Please Make Yourself Uncomfortable" and if you get the chance to hear Aaron talk or to see the photos, don't miss the opportunity. He manages to access something we often find difficult to talk about and to present it in such a way that it encourages discussion.

Waiting rooms

I ended up spending a lot of time last night in a hospital waiting room (with a suspected eye problem which turned out to be absolutely fine), and it made me think about the amount of time I must have spent over the years in fertility unit waiting rooms - and how different they are. Last night, there were a huge range of people in the waiting room with all kinds of different eye problems but we were stuck there together, waiting - and so, after a while, people began to smile at one another or raise eyebrows as we waited on and on, and then began to chat. I spoke to three different people who happened to be next to me over the course of many hours as we lamented our inability to be able to read due to the drops they'd put in our eyes and wondered whether we'd ever get home. It's odd in a way that the spirit of being in an unpleasant situation together very rarely makes fertility patients start talking to one another. For the most part, we even try to avoid eye contact in waiting rooms, let alone begin conversations. Is it the stigma that still somehow lingers around fertility problems? Is it the fact that we feel so emotional and often close to tears? Or perhaps it's because talking to one another might somehow make the fact that we have to be there seem even more real. It's a shame because there's a huge amount to be gained from talking to others who have the same problem and sharing experiences. Not only is it a huge relief to talk to people who genuinely understand, it also helps to normalise the experience, reminding us that we're not alone and that infertility is really a very common problem. At this point, I have to confess that in all the years I spent in the fertility clinic waiting room I only ever spoke to one person - and that was because she spoke to me first. If talking is too much - and I accept that it quite possibly is - then maybe we should try to at least give one another a smile if we catch eyes at the clinic. It's just a gesture, but sometimes the old saying about a little kindness going a long way seems very true and may make all the difference.

Awareness of fertility

A new paper from the States has looked at student attitudes towards fertility, questioning male and female students about their views and understanding. We often think - or at least I do - that we blab on about the age-related decline in female fertility so often that most women are only too aware that their fertility will begin to decline quite sharply once they are over 35. In fact, the research suggests that maybe we should be blabbing on a bit more. The students in the survey thought that the marked decline in female fertility came far later than it actually does - and they assumed that fertility treatment would be more likely to be able to sort out any potential problems than it actually is. This is perhaps the most worrying fact, as there is still an idea that if you leave it too long to try to have a baby IVF will be able to sort it out for you. Just this morning, I read an article in the paper quoting a 38 year old celebrity who said she was in "no rush" to have a baby. We've seen endless attempts to raise awareness of this issue over the last few years, but it seems there may still be some way to go.

Fertility treatment in the news

There seem to have been a spate of scare stories about fertility treatment in the news in the last couple of weeks, and it can be very hard if you're going through it yourself to know what you should believe or whether you should be worried. When I was having IVF, the safety of using frozen embryos was quite an issue, with many people refusing to even consider the idea, and it seems ironic now as there have been a number of studies suggesting using frozen embryos may actually be a very positive thing. The latest story focuses on ICSI, and is far from the first surrounding the treatment as most experts are clear that there may be risks that we are not yet sure about as ICSI is a far newer treatment than IVF itself. At the same time it is important to stress that the real risks are small and that many thousands of healthy babies have been born after ICSI treatment, which has allowed many men who would never have been able to have their own genetic children otherwise to become fathers, If you're ever worried about any aspect of infertility or treatment, you should always discuss it with your fertility specialist or doctor.

Work and fertility treatment

You may have heard the recent news about a teacher who lost her job at a Catholic school in Indiana after having fertility treatment (see more here).  In this particular case, there were religious objections to the IVF treatment, but it does raise issues about fertility treatment and work which concern many women who are trying unsuccessfully to conceive.  There is no legal right to time of for fertility treatment, but most women do need to take at least a day or two off around the time of egg collection and embryo transfer.  Some take leave for this, but that can be hard as it is often difficult to pinpoint exactly when egg collection might occur and you may need to book leave some time in advance.  Others take sick leave, but there have been cases where employers have not been happy about this, claiming that fertility treatment is not the same as being ill.  Some more enlightened employers actually give time off for fertility treatment, and those that do generally find it is more than repaid in the grateful attitudes from staff who benefit from this.

If you are going through treatment and need time off, perhaps the best thing to do is to discuss this with your family doctor. Most will be willing to sign you off sick for a while, understanding the difficulties that can accompany fertility treatment. I wrote a feature about this some years back for The Guardian which may be worth a read if work and treatment is an issue for you.

Why sextuplets are not a good idea...

If you've thought about travelling abroad for fertility treatment and have maybe wondered whether the relaxed regulations in other countries might be part of the attraction, think again... I've just been reading an article about a woman in the States who has given birth to sextuplets after fertility treatment - ten weeks early. Five of them are apparently doing "as well as can be expected", which given their prematurity and very low birth weights will undoubtedly mean problems ahead. The sixth baby faces "greater challenges". Their mother was offered "selective reduction", which is a way of dealing with bad decisions made during fertility treatment, but felt unable to take that option. In this particular case, it wasn't that too many embryos had been transferred during IVF. These sextuplets were the result of IUI. In this country, when a fertility specialist stimulates the ovaries during IUI, the treatment is tailored to aim to produce one or at most two eggs. Any responsible specialist would immediately stop treatment if there was a danger of this this kind of risky high-order multiple pregnancy. According to the article I read, there are as many as 2,000 cases of selective reduction each year in the States, and it's little wonder that there is sometimes such vehement opposition to fertility treatment. The fact that it is "hard to regulate" IUI seems to be the excuse - but surely it is time for fertility specialists to face up to the consequences of the treatments they are offering. Our system in the UK is not without faults, but it's only when you see what can happen in other places that you realise quite how lucky we are. See the article in question here

Could you help Infertility Network UK?

Having spent some time as a trustee and then a member of staff at Infertility Network UK, I know how difficult it can be to raise funds for an infertility charity. Those who have no personal experience don't realise how incredibly valuable the support and information offered can be, and Infertility Network UK does far more than that, providing a voice for those who often don't feel able to speak out about their fertility problems and campaigning on their behalf for proper funding for treatment. Now, Jim Seenan, the husband of one of the charity's staff is gearing up to run a marathon to raise much-needed cash to help fund the vital services offered. If you're able to help sponsor him, it would be hugely appreciated by all of those who've valued the help and support that Infertility Network UK can offer. You can sponsor Jim here