Treatment on ice, lockdown further delays IVF treatment
01 Dec 2021
After six years of struggling with infertility, A&E nurse Jessie and her husband Victor had just started IVF treatment at Bourn Hall’s Wymondham clinic when the country went into lockdown in 2020 and once again their lives were put on hold.
Waited a year for NHS funded IVF treatment
The couple have been together for 10 years and began trying for a baby just after they got married in 2016.
“I have wanted children all my life, so it was difficult,” says Jessie. “I was more worried than Victor. He thought ‘we would like to have a result so we can fix it’. I just thought ‘I am longing for a baby’. We went for an appointment at the local hospital to discuss the results of our fertility tests and were told it was unexplained infertility and ‘the only thing we can offer you is IVF’.
“It was a massive shock to be told we would need IVF. I think we expected some sort of treatment but not to go straight to IVF. I remember coming out of the appointment in July and thinking ‘oh now what?’
At that time IVF in South Norfolk wasn’t funded, but the CCG later announced that it would be reinstating funding in April, so the couple waited – a delay of nearly a year.
In April 2019, the couple were referred for NHS funded IVF and chose to go to Bourn Hall in Wymondham, near Norwich, for their treatment, and once there it all happened quickly.
Freeze all gives time to recover
Jessie responded strongly to the medication, which is used to stimulate the ovaries to produce many mature eggs at the same time. She produced 28 eggs which were fertilised to form embryos. Eleven embryos made it to blastocyst, of which five were of suitable quality for freezing, with one kept for a fresh embryo transfer.
Before embryo transfer the fertility drugs need to have cleared your system, as there is some evidence that the body’s hormonal response to fertility drugs can affect the lining of the womb, which makes it more difficult for the embryos to implant. Freezing the embryos means they can be transferred back into the patient when the womb lining is well developed.
“I was literally on the table to have my transfer and they said ‘no, your ovaries are far too big’ and it was decided to freeze all the embryos to give me time to recover before transferring any embryos,” says Jessie. “I was in bits. I had been expecting to have my embryo put in that day. We had to wait until the October 2019 to go back for the frozen embryo transfer – it wasn’t that long but if felt like forever.
“As it turned out it was the right decision and it put me in a better way for pregnancy and when I went for the embryo transfer it was quite exciting. I was going in with the right frame of mind and body.
“I got pregnant and at the first scan the heart rate was reasonably good but then I had a bleed just before the next scan and the baby’s heart rate went down to about 50. They said ‘this baby is not going to make it’ and we lost the baby two days before Christmas, at ten weeks.
“We really struggled after the miscarriage, we didn’t cope well. I wanted to try again straight away to fill the void but had to wait until March 2020 for my body to recover. Then the country was put into lockdown. Fertility clinics were ordered to suspend treatment and temporarily close, and our treatment had to be put on hold. We were in limbo.
“I think having the miscarriage brought us closer as a couple and we went through the grieving process together. We didn’t ignore it, we talked about it. We remember that baby every time we get to the due date and will always remember that they were part of our family.”
Baby dreams on hold
“When in May 2020 Matt Hancock said fertility clinics could open up again, I was so happy. I had been watching every announcement just to see when clinics would be allowed to open,” says Jessie.
“I think working got us through,” says Jessie, who was working in A&E. “It was a distraction. We were in the middle of a pandemic, so we kept going for everyone else but in the background our baby dreams had been put on hold.”
Coming out of lockdown
The couple were among the first patients to be recalled to Bourn Hall Wymondham when fertility clinics were allowed to re-open.
“Our frozen embryo transfer was on 3 July 2020, and two weeks later we found out that I was pregnant again,” says Jessie. “We were excited, but I did hold my emotions back a bit as I was scared that I might have another miscarriage. I felt he was real after the 12-week scan, but I don’t think either of us truly relaxed until our son arrived.
“The nurses at Bourn Hall were amazing; if we ever had a query they were always at the end of an email, and when we had the scans they all came in and were saying ‘oh we are so happy for you!’. They felt like our family at that point, which was lovely.”
On 28 March 2021 the couple’s son Rupert was born at the Norfolk and Norwich Hospital where Jessie works.
“The best part was seeing Victor, who normally doesn’t really show his emotions, looking at his new baby son and getting all teary eyed,” says Jessie. “Every single day since then he has told Rupert how much he loves him.”
Being a mum, says Jessie, has completed her. “I feel like a little piece of me was missing before and now that Rupert is here I feel whole,” she says.
Freeze all can be the best option
Dr Thanos Papathanasiou is the Medical Director for Bourn Hall. He says that sometimes advising a freeze all embryo cycle can be the best option. This would be discussed with the patients. In some circumstances it is best practice to delay the embryo transfer to give the body a chance to recover and also the patient time to prepare for the next stage.
Unlike a usual IVF cycle, where one to two fresh embryos are transferred a few days after the egg collection, in a freeze all cycle no embryos are transferred in the ‘fresh’ cycle. Instead the frozen embryos are thawed a few months later and transferred to the patient’s womb as part of a frozen embryo transfer (FET) cycle.
According to the HFEA, there is some research that suggests that the chances of having a baby can be increased by using frozen embryo transfers (FETs) rather than fresh transfers, and that the risk of ovarian hyperstimulation syndrome (OHSS) and of low birthweight are lower, for some patients.
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