The women robbed of motherhood by the virus

Tina Mulhern has the usual worries about lockdown: its impact on her business, finances and loved ones. But one crippling fear, that it may have robbed her of the chance of motherhood, overshadows them all.

Tina, 41, had endured one failed round of IVF in February and was awaiting a second, until a notice was posted on the website of her fertility clinic last month, stating that all treatment had been postponed, because of the threat of Covid-19, for the foreseeable future.

By the time she had plucked up courage to check the website, Tina had been following the news about enforced social distancing and so guessed what it would say. Still, seeing it in black and white, she broke down in tears as she told her partner, by then working in his home office, ‘the dreadful news’.

Because of her age and low levels of Anti-Mullerian Hormone (AMH), a good indicator of a woman’s egg reserves, Tina’s chances of a successful pregnancy were already low — just 14 per cent — and she is acutely aware that with each day, week and month that passes, they continue to fall.

‘Every month treatment is delayed takes me farther away from realising my dreams of becoming a mum. The older I get, the poorer my egg quality will become,’ says a tearful Tina, who is dreading her 42nd birthday in October. By that age, some experts believe, success rates using a patient’s own eggs are so low that treatment is almost pointless.

‘IVF is stressful,’ says Tina. ‘There’s all the injections, medication and invasive treatments, and I felt so down when mine failed to lead to pregnancy in February.

‘What carried me through was hope about the next round and that has been taken away, at least for now, by this pandemic.

‘I’m trying to be positive but it’s not easy knowing this crisis may have wiped out my chance of becoming a mum.

‘Most of us will recover and return to normal, and the economy will repair, but I can’t help tormenting myself with the thought that one consequence may be that I never have the child I so dearly want.’

In mid-March the Human Fertilisation and Embryology Authority (HFEA), the government body that regulates fertility care, ordered that no new interventions could begin and all fertility treatment must be concluded by April 15.

Of course, nobody knows how long this edict will stand. But if the rule were to remain in place for a year, it could prevent the birth of many thousands of babies. In 2017, 20,500 children were born in Britain as a result of fertility treatment.

For older women in the ‘last-chance saloon’ in reproductive terms, the next few months could be vital.

‘You can’t rewind your biological clock,’ says Dr Catherine Hill, of the reproductive research charity Progress Educational Trust.

‘Time is of the essence when it comes to fertility treatment. For some people, this shutdown means they may never become parents. This was going to be their last chance and they’re not able to have it. That is deeply distressing.’

Tina and her partner Luke Devereux, 38, began trying for a baby in early 2018, within a year of getting together, as they knew Tina’s biological clock was ticking.

She had always wanted to be a mum but didn’t meet Luke, an engineering consultant, until she was well into her 30s.

When conception failed to happen naturally, they decided to use the proceeds from the sale of the house Tina owned, before they moved in together in Glasgow, to fund fertility treatment.

Each cycle, at the Glasgow Centre for Reproductive Medicine, costs about £7,000 and, knowing their chances of success were not high — Luke also has a low sperm count — they had set aside enough money to fund five cycles.

It was a realistic approach, given that, because of Tina’s relatively advanced age, each cycle would have only a 14 per cent chance of success. Before the pandemic, the couple had intended to try to beat the clock, having successive rounds of IVF as close together as medics would allow.

But Tina, who has her own beauty business and is unable to work because of social distancing rules, now has no choice but to dip into these reserves to cover bills and other outgoings.

An added concern for her is that, after lockdown ends, fertility treatment could be further delayed by concerns about the impact of Covid-19 on pregnant women and babies.

‘My mind is working overtime and although I hope that after this, I will be prioritised because my time is running out, the doctors may decide that if my chances of pregnancy are down to, say, 12 per cent, they should treat younger people with more hope of success,’ says Tina. ‘The clinic I’m dealing with seem compassionate, so I hope that won’t be the case.

‘I also worry that, even once social distancing is relaxed, they may not be able to restart treatment until a vaccine is found, because of the unknown effect of Covid-19 on pregnancy and embryos.’

This, she believes, would be deeply unfair, given that those lucky enough to be able to conceive naturally have not been advised to avoid pregnancy.

Professor Tim Child, medical director of The Fertility Partnership, which has nine clinics across the UK, offers some reassurance, based on the medical findings to date.

‘Pregnancy would certainly not be an ideal time to get coronavirus. If you become ill and are pregnant it’s much more complicated,’ he says. ‘However, while there’s a bit of evidence that this virus can cross the placenta, there is no evidence that it harms unborn babies.’

Among the grounds for postponing fertility treatment, though, was the added risk of Ovarian Hyperstimulation Syndrome (OHSS) — ‘not common, but not a rare complication from IVF either,’ according to Professor Child — which can lead to breathing problems and require hospital admission.

Another reason was the possibility that all medical staff — anaesthetists, doctors and nurses — working in clinics may have to be redeployed to hospitals providing urgent care to those worst affected by the virus.

On the plus side, while each NHS trust has an upper age limit past which women are ineligible for funded fertility treatment — it ranges from 34 to 42 — those contacted by Professor Child’s team have implemented six-month extensions to this limit.

When the call came through from Ruth O’Leary’s private clinic in early March to say the first stage of her IVF cycle had been successful — two NHS attempts had previously failed — and that she and her husband had created a healthy embryo ready for implantation, she had never felt so elated.

But her joy was short-lived as, days later, a nurse called back from the clinic in Athens to tell her all fertility treatment had been suspended, under an order from the European Society of Human Reproduction and Embryology (ESHRE).

Ruth and her husband Matthew, both 37 and primary school teachers from Leeds, have been trying for a baby for three years and wanted more than anything in the world to be a step closer to realising their dreams of parenthood.

‘It was devastating news,’ says Ruth, her voice cracking. ‘Becoming parents has been our main focus for so long and we have faced so many hurdles along the way.

‘But I can honestly say the thought of a global pandemic affecting our chances of conceiving is one thing that had never even crossed our minds.

‘I understand, of course, that a lot of people have suffered worse fates, losing loved ones to Covid-19. But for this to happen now, just when we were potentially so close to making our baby, seems incredibly cruel.

‘What makes the experience worse is that we can’t spend time with our family and friends, who would have given us a hug and helped us get through this. Nor do we even have the distraction of work.’

While Matthew is being called in for the occasional day to teach children of key workers, Ruth, who has detailed her journey in her blog theinfertilediaries.co.uk, left her job in February, concerned about the time off she would need to travel to Greece for treatment.

It was a huge sacrifice, given that the couple need every spare penny to fund the exorbitant cost of fertility treatment.

Having had two unsuccessful IVF attempts on the NHS, they decided to go private and did extensive research into clinics abroad, where the cost of treatment can be half what they would have had to stump up in the UK.

In February, they paid £3,500 for two rounds of treatment at the Serum IVF Clinic, and in early March, after Ruth had taken the drug Clomid to stimulate her ovaries, travelled to Athens, where one egg was collected and fertilised with Matthew’s sperm.

While the couple’s infertility is ‘unexplained’, Ruth is aware that she, like Tina, has low AMH levels, a good indicator of a woman’s egg reserves, which may have hindered her chances of conceiving.

As she had taken Clomid, which can leave the uterine lining too thin for successful implantation, the clinic recommended freezing the embryo, before thawing and transferring it at a later date when Ruth’s body had recovered and the embryo was more likely to implant and lead to pregnancy.

As the chances of Ruth’s one frozen embryo becoming a baby were only 23 per cent, she was due to return to Athens at the end of March to be given injections in the hope of stimulating the release of another egg and creating a ‘fresh embryo’ that could be transferred along with the frozen one, increasing her chances of conception.

But with both travel and fertility treatment suspended for the foreseeable future, this process, like the O’Learys’ precious embryo, is on ice.

Ruth’s 38th birthday is less than four months away and the couple cannot help tormenting themselves with the statistic that a woman’s pregnancy success rate is estimated to fall from 23 per cent to just 15 per cent by the age of 38.

Their circumstances are further complicated by travel restrictions which could delay a return to the clinic in Athens, even once normal services begin to resume in the UK.

‘I’m trying not to project my mind too far into the future because so much is beyond our control,’ says Ruth. ‘I can’t bear to think about our life without children. It would always feel like there was something missing.’

Professor Tim Child says thousands of British patients have been left with similar anxieties.

‘This has affected hundreds of patients in our clinics alone and breaking the news that treatment had to be postponed was hard,’ he says. ‘Fertility treatment is not considered urgent, unlike cancer treatment, but the clock is always ticking for our patients, so many of them do see it as urgent.

‘Understandably, patients are asking when they can start, or resume, their cycles, but I can’t see anything being relaxed in the very near future.’

While two or three months should make little difference to the chance of a successful outcome for most, Professor Child says restrictions lasting much longer could have an impact.

According to NHS figures, the success rate for IVF among women aged 35 and under is about 29 per cent. It is 23 per cent for those aged 35 to 37; 15 per cent at 38 to 39; 9 per cent from 40 to 42; 3 per cent at 43 and just 2 per cent for those over 44, if the woman uses her own eggs.

‘For most people this wait is upsetting and frustrating, particularly because they will have waited a while to get to the point of being ready to start treatment,’ says Professor Child.

‘If women have lower egg numbers or are in their late 30s to 40s, a few months can make a difference. But even then, I would be reassuring them that any change in their personal chances of success was very small, as long as we get going again in the next couple of months. However, if the ban extends into next year, that’s completely different.’

Vicki and William Fenton, who have had more than their fair share of exposure to NHS emergency care, fully appreciate the need to protect the vulnerable but have, nonetheless, been left devastated by the postponement of their Intra-Cytoplasmic Sperm Injection (ICSI), a form of IVF in which a single sperm is injected directly into an egg.

William, 32, had Hodgkin lymphoma, a type of cancer that develops in the lymph glands, diagnosed six years ago and was advised to have sperm frozen before receiving chemotherapy, which adversely affects semen quality.

The former chef, originally from Leamington Spa, Warwickshire, and now living in Caithness, Scotland, has come perilously close to death more than once but, following a bone marrow transplant in November 2018, has been in remission for 17 months.

Vicki, a dementia carer, married William in late 2016, when neither of them knew if he would survive cancer. But the one thing both were certain about was that they longed for a family.

So in March 2018 they had their first round of ICSI, using William’s frozen sperm, at Aberdeen Fertility Centre.

A further four rounds, all NHS-funded on medical grounds because of William’s cancer, followed, leading to just one pregnancy, which sadly ended in miscarriage at five weeks, last February.

Having exhausted all their NHS-funded treatment, shortly before lockdown the Fentons were about to embark on their first private round of ICSI.

‘It’s heartbreaking. I honestly don’t know how much more we can take,’ says Vicki. ‘The thought of facing another year not being parents is so painful, especially when it seems everywhere I look now I see people with prams.

‘My sister-in-law is pregnant and due to give birth in June and I haven’t even been able to congratulate her because it hurts too much. I don’t want to feel this way but I can’t help it. It eats me up inside.’

Neither of them is currently able to work — they haven’t left their home for four weeks — because William’s immunity has been so compromised by cancer treatment that catching coronavirus could be lethal for him.

As this is considered voluntary isolation, they are not being paid, either. So to avoid dipping into their precious fertility-treatment coffers, they are living on beans on toast and other low-cost meals.

So when will it all end? Tina contacted her clinic last week to check if there was any news on when her treatment might restart. She was told that, for now, there is ‘no guidance’.

For her, like so many others struggling with infertility, the uncertainty surrounding this pandemic adds to an already ever-present fear that she may never experience the joy of parenthood.