Widow wins legal fight for IVF with husband's sperm

 A widow has won a legal battle to have IVF treatment using her late husband's sperm after a ruling by judges.

The man - identified as JB - died from cancer, but had stored sperm in the hope of one day starting a family.

He left instructions in his will, however, he did not sign the necessary forms before his death.

His widow instructed lawyers to go to the Court of Session in Edinburgh, and judges ruled in her favour.

The man lost his life in 2019 after he and his wife, identified as SB, consulted doctors about starting a family.

The court heard that when JB stored his sperm he gave written consent for it to be used for intrauterine insemination - a method of conception where sperm is introduced directly into the uterus.

Following his marriage, JB made a will which stated that his donated sperm should be donated to his wife for as long as possible and for as long as she may wish.

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Day before he died

However, medics discovered the day before he died - when he was unconscious - that he had only completed forms which provided consent to intrauterine insemination.

Doctors have told SB that her best chance for conceiving children is through in vitro fertilisation (IVF) - a different technique in which eggs are removed from the body and fertilised in a lab.

However, JB had not signed the necessary forms needed for his reproductive material to be used for IVF.

This prompted her legal team to go to Scotland's highest civil court to obtain an order which would allow JB's sperm to be used in this way.

They argued that JB had given permission in his will for his semen to be used for IVF.

Effective consent

Lawyers for NHS Grampian did not oppose the move but the Human Fertilisation and Embryology Authority (HFEA) was unable to conclude that JB gave effective consent for the purposes of the legislation governing the matter.

Their lawyers stated that the will did not make reference to the creation of embryos or to the purpose to which sex cells were to be used.

However, HFEA's legal team argued that if the court should find the necessary legal requirements were met, the authority considered there would be no impediment for SB to begin IVF treatment.

On Friday, judges Lady Dorrian, Lord Glennie, and Lord Woolman ruled in favour of SB.

Lady Dorrian - who gave the judgement - ruled that the man's statement in the will meant that he intended his sperm to be used in IVF treatment.

The court ruled that the terms of the dead man's will amounted to effective consent to the use of his sperm for IVF treatment.

Lady Dorrian wrote: "It is the sort of provision that would only sensibly be made by a man contemplating his death in the near future, and seeking to make his wishes clear."

(Source: BBC)

‘She said she’d be babysitting our embryo’: What’s it like to carry a child for a friend?

Surrogacy between friends can be life-changing. The people who have done it talk emotions, legal hurdles – and WhatsApp birthing groups

In a flat in north-east London, Abi is cradling her best friend’s baby. At 15 weeks old, the little boy is smiling up at her, testing out his first sounds. His mother, Rachel, prepares his bottle while Abi rocks him, showing all the love she would to any of her friends’ children. The only difference is that Abi gave birth to him.

Abi and Rachel, both 35, met on their first day at university in Birmingham in 2003 and rarely left one another’s side. At 16, Rachel had been diagnosed with MRKH, a congenital condition meaning her uterus was undeveloped. 

Although she produced eggs, she would never be able to carry children, something she kept to herself. “I’d tell people I didn’t want kids but deep down I was insanely jealous,” says Rachel, who works as an events producer in London. “I wanted them so badly but assumed I’d never have my own, so I learned to live with it.”

After meeting her boyfriend, Sam, at a warehouse party on the eve of 2014, she avoided the “family” chat for two years before confiding in him. “We continued our relationship knowing kids may or may not happen,” she says.

A weekend stay at Abi’s home, in November 2017, bringing together five friends, their partners and kids, presented an opportunity to open up to them, too. Abi, a mother to three boys, remembers: “My partner, Rich, was cooking a curry, the kids were asleep and we were sitting around the kitchen table. Everyone spilled something personal. When Rachel told us about her condition, I knew, in my gut, that I would help her to have a child.”

Rachel and Sam had explored IVF, surrogacy and adoption, but had dismissed using agencies, which can be vastly oversubscribed, with waits of up to two years to find a match. “It felt too impersonal; too life-changing somehow,” she says. Her younger sister had yet to start her own family; had she already had children, Rachel might have asked her to be a surrogate.

Abi and Rich, meanwhile, “spent Christmas contemplating what being a surrogate would mean for everyone. We had been so lucky, yet one of the people I love most hadn’t,” she says. “I hate this phrase but it was a no-brainer.”

She called Rachel in the new year and told her to sit down before offering to carry her baby. Rachel remembers: “She said it would be like ‘babysitting’ our embryo and that term stuck. She’d made up her mind, and that blew me away. I hadn’t told my friends expecting one of them to be the answer. When Abi offered, it felt, for the first time, as if having a child was a very real possibility.”

***

In the UK, the number of children born by surrogate is up to 10 times higher than it was a decade ago, according to the Law Commission, which recently consulted on modernising the process to better support parents, surrogate and child. While US states such as California have commercialised the arrangement, with surrogates earning well in excess of $50,000 (£38,300), it is illegal to pay someone for acting as a surrogate in the UK, meaning the process relies on the altruism of strangers recruited through an agency, or loved ones. It is not routinely available on the NHS, and the private medical costs are typically up to £16,000. “Known” surrogacy – between friends or relatives – is still rare: at Care, the UK’s largest private fertility group, they accounted for 10% of more than 100 surrogacy cycles at their clinics last year.

‘I could hardly believe it was real’: Rachel (right) with her baby, for whom Abi was the surrogate mother. Photograph: Silvana Trevale/The Guardian

Surrogacy is a delicate arrangement with high stakes. Pregnancy and childbirth can be gruelling, and present health risks, while the unknown territory of handing over a baby you have carried – or parenting the child you have not – presents added fears over bonding or changes of heart, albeit rare.

When there is an existing friendship at the arrangement’s heart, the stakes can feel higher still, for both the surrogate carrying a longed-for child and parents asking such as sacrifice of someone they care for, typically with a family themselves to consider. (Medics and lawyers advise against surrogacy until women have completed their own families, citing concerns about reproductive health and fears that it would be harder for them to give up the baby.) Not surprisingly, the friendships that underpin these arrangements are life-changing.

Abi, Rachel and Sam embarked on medical appointments at a London fertility clinic. The friends were invited for counselling and asked to consider everything from how they would feel if Abi backed out, to how she would feel if she gave birth to a girl, after three sons. They set up a WhatsApp group. “We left Rich off that,” Abi says. “I’ll talk about body parts and womb washing till the cows come home but he saw his role as keeping things normal – remaining practical and pragmatic in a hyper-emotional situation.” They told their families, including Abi’s boys – four, three and nine months at the time. “We always talked about ‘Rachel and Sam’s baby’. We said, ‘Rachel’s womb doesn’t work but Mummy’s does, so we’re going to look after a baby for them.’”

In hindsight, living miles apart was good. If we were round the corner I’d have been posting steak through her letterbox

After initially being refused any NHS fertility treatment that would lead to surrogacy, Rachel successfully lobbied her local commissioning group for a single round of IVF, in May 2018, allowing her eggs to be extracted for fertilisation by Sam’s sperm, creating a viable embryo. It would later be placed in Abi’s uterus at a private clinic, using money Rachel’s parents had saved for her wedding. “Surrogacy is still seen as something you do if you’ve got money rather than through biological need,” Rachel says.

Abi was given oestrogen and progesterone, and the embryo was transferred, via catheter, in a simple, minutes-long procedure, on 2 October. “From that moment, it was out of my control,” Rachel says. “I felt like I was holding my breath.”

When Abi took a pregnancy test, at 7am on a Saturday morning nearly a fortnight later, Rachel and Sam were in bed, on the end of the phone. “When she sent through a picture of the positive test, we were in total shock; it was extremely emotional. We didn’t know how to get on with our day other than staring at that picture.” They remained in daily contact and Rachel travelled the 150 miles to Abi’s home for midwife appointments and scans, as well as attending antenatal classes, along with Rich. “In hindsight, the distance was a good thing,” Rachel says. “If we were round the corner, I’d have been posting steak through her letterbox.”

They had to consider how to announce the pregnancy. Rachel would say: “We’re expecting a baby, but I’m not pregnant. My friend is carrying our baby.” Abi, who works in public engagement at the BBC, recalls: “Everyone’s mouths dropped at work. My mum asked, ‘Why you?’ But they all thought it was amazing.”

When it came to maternity leave, Abi was entitled to a year, but took six weeks, while Rachel was entitled to a year’s adoption leave. Outdated surrogacy laws require that Abi’s name is on the birth certificate alongside Sam’s; had Abi and Rich been married, he would have been named as the father. They also recognise Abi as the mother until Rachel obtains the court order granting her legal parental status. Seven months on, she is still waiting. “The fact that on paper he’s still not my son is upsetting,” she says, “but I can’t dwell on it. It’s a process, so we treat it that way.”

Many surrogacy pairings put an agreement in place. Although not legally binding – it is illegal for solicitors to negotiate one – it helps mitigate against concerns over all aspects of the pregnancy, from supplements to who first holds the baby. Rachel and Abi decided against it. “If Abi had changed her mind on anything, we all would have,” Rachel says.

Surrogates can receive reasonable expenses, such as extra food, travel, childcare or housekeeping costs, and Rachel and Sam gave Abi a cash card. “It’s the trickiest part because no expenses can repay her,” Rachel says. “She was militant about not asking for too much, but I wanted her to have a meal on us because she had our son with her.”

The baby was born on 8 June 2019. Rachel and Sam drove Abi to the hospital and witnessed the birth. “I could hardly believe it was real,” says Rachel, who fainted as he was delivered into her arms. The couple spent the first two nights after his birth in hospital, down the corridor from Abi.

“Rich was working late and arrived to find us all in the room together and the baby just minutes old,” Abi says. “He stayed for the placenta delivery, had some tea and toast and went home to be there for our boys in the morning. I don’t think the scale of what we’ve done will hit us for a long time. I’m relieved at how normal it feels when I see the baby. Rachel was so generous with her trust in me.”

Rachel adds: “Abi put herself mentally and physically through the most selfless act for me, to make us a family. She gave up a huge part of her life during those months to change ours for ever. I couldn’t handle what I was putting her through at times but she’d always say: ‘You’re not putting me through this, I’ve chosen to do it.’ If I ever asked why, she would say: ‘Well, I can’t think why not.’”

***

As fertility medicine has advanced and different family units evolved, surrogacy has emerged as a more familiar route to parenthood, but demand far outweighs the number of women willing or able to volunteer, and the British legal system is playing catchup. London-based family lawyer Joanna Kay, who has advised on surrogacy for more than a decade, says: “The landscape of what a family looks like has changed beyond recognition, but the laws are from the mid-80s. Without a court order, intended parents can’t make decisions about their child’s medical care or education; there can be problems with passports and inheritance. I don’t think anyone would argue against the need for reform.

“In most cases, everyone knows what they’re signing up for and is happy to honour their agreement. On rare occasions things go wrong and the courts are asked to intervene. There have been a handful of cases where the surrogate didn’t want to hand over the baby or the intended parent didn’t want it.”

Other relationships between parents and surrogates have been deep and enduring. Kim Cotton, who became Britain’s first surrogate in 1985, went on to help her friend Linda, who was unable to carry children because of complications associated with a miscarriage; Cotton gave birth to twins in 1991. “The family moved to New Zealand when the twins were teenagers but I still track their lives, mostly through Facebook now,” says Cotton, who is 63, and the founder of the Cots surrogacy agency. “Christmases and birthdays are still special and the twins and I always send messages to mark them. My friendship with Linda remains the kind where you are for ever aware of that person and can pick up with them anytime, even if you don’t speak often.”

***

Yet even longed-for pregnancies don’t always run smoothly. After Laura was made infertile five years ago, at 28, by treatment for stage two cervical cancer, her best friend Kerrie represented her only hope of becoming a biological mother. Last year, Kerrie offered to carry Laura’s fertilised eggs, frozen before she began intensive chemo and radiotherapy five years ago.

They had been friends since childhood and shared everything, Laura says, over a cup of tea at Kerrie’s home in Lancashire. “Relationships, breakups, marriages, my illness; she cries with me and laughs with me,” she says.

In 2014, Laura, a nursery manager, and her now-husband Grant were about to start IVF for problems unconnected to her own fertility when a routine smear test detected cancerous cells. “They talked about a hysterectomy,” she remembers. “Knowing my illness would take away my chance of having children was what broke me, not the cancer.” By this point in the story, both women are in tears. “As we left the hospital, I told Grant to leave me,” Laura adds. He didn’t. And while a hysterectomy was ruled out, Laura spent Christmas and New Year’s Eve undergoing treatment, with Kerrie by her side. She had delayed it by one month, so her eggs could be extracted and later used to try for a child via surrogate.

In April 2015, a scan revealed the tumour had gone. When Grant and Laura married in Cyprus in 2016, Kerrie was a bridesmaid. “When I was ill, a few friends had offered to be a surrogate,” Laura says. “And when we finally came round to thinking about it, two years ago, it was Grant who said: ‘It has to be Kerrie.’”

Kerrie, 33 and a hairdresser, had a similar conversation with her husband, Danny. “At the clinic, he told us he knew when Laura became ill that I would do it one day. I’d had two good pregnancies and it would only be nine months of my life to improve hers for ever. I focused on seeing them with a child.”

Although it was NHS-funded IVF that had led to the discovery of Laura’s cancer, when surrogacy became her only option, the funding was withdrawn. 

“I didn’t let it go without a fight,” she says. “Ultimately they were taking it away because I had cancer. The NHS saved my life; to then dictate that life isn’t fair.”

In the end Laura’s family paid for her treatment. “They would have helped me with a house deposit but I said, no, give me a baby, please.” The surrogacy was delayed when Kerrie unexpectedly became pregnant with her third child in 2018, but in October 2019 Laura’s eggs were thawed. Eight had been fertilised – but only one looked viable for transfer and pregnancy. It was placed in Kerrie’s womb on 7 October. The women held hands as they sat on the clinic’s bed. “When they told us there was only one chance, I couldn’t look at Laura,” Kerrie says. “She can read my thoughts. I wanted to stay positive for her but the pressure was huge.”

I’d been carrying her most treasured possession. We were numb. We drove home in silence

On 23 October, two clear lines showed on the pregnancy stick, but Kerrie tested and retested, with Laura by her side, to be sure. Both women were ecstatic. However, on 1 November Kerrie started bleeding. A miscarriage, at five weeks, was confirmed two days later at hospital.

She gave me my only chance of being a biological mum,’ says Laura (left) of Kerrie. Photograph: Shaw & Shaw/The Guardian

“It hit me like a ton of bricks,” Kerrie says. “I’d been carrying her most treasured possession. We were numb. We drove home in silence. My priority was being strong for her but I was broken. We went from speaking all day, every day, to nothing for 48 hours. I’d type a message asking, ‘Are you OK?’ then delete it. When we eventually sat down together, we cried our hearts out. I felt responsible but I knew I’d done everything I could.”

Laura is still coming to terms with her grief. “I was uncontrollable, heartbroken. We each had our own grieving to do; it wasn’t that we didn’t want to speak, we just didn’t have the words and didn’t want to add to each other’s pain.”

Kerrie has offered to be a surrogate again, with a donor egg, but Laura says she couldn’t put her friend through it. She has also thought about adoption but needs time to heal before giving it serious consideration.

“I don’t think anybody realises how difficult the process is,” she says. “Kerrie gave me my only chance of being a biological mum. I didn’t know I could love her any more than I already did.”

***

Despite the spike in surrogacies over the past decade – and a rise in profile following the examples of celebrities Kim Kardashian, Elton John, Sarah Jessica Parker and Tom Daley – just 302 (0.4%) of 75,425 fertility treatment cycles recorded by UK watchdog the Human Fertilisation & Embryology Authority (HFEA) in 2017 were surrogacies. But it has become a viable route for gay men who want to start a family. At Care, two-thirds of surrogacies in 2018/19 were for men in same-sex relationships, an option aided by the HFEA’s 2011 decision to offer £750 compensation to egg donors, triggering more women to help others on their parenthood journeys. This, says consultant gynaecologist David Polson, “opened up the options for same-sex couples to seek out a surrogate and become parents”. Advances in freezing fertilised eggs have also made it more likely that a thawed embryo will be suitable for transfer to another woman’s womb.

In Kent, Kevin, 45, a chief marketing officer, and Spencer, 30, a solicitor, are getting their six-month-old son ready for bed when the other half of “Sawyer’s birthing squad” (the name they gave their pregnancy WhatsApp group) arrives: surrogate Leanne, 36, and her sister Rachael, 33, Sawyer’s egg donor. “There’s not many teams like us out there,” says Leanne, grabbing a bedtime cuddle.

Spencer and Kevin have been together 10 years and married in 2015. “I told Kevin on our first date that I needed to be a dad,” Spencer says. “The biological connection was important to us. We wanted to be involved from the start.” They explored agencies but the networking aspect turned them off. “It was like speed dating. There were more couples than surrogates. It felt hard to be your true self.” They spoke to relatives and asked close friends but none provided an obvious solution. So, despite reservations, they turned to an agency and invested five months getting to know a potential surrogate, only to be let down by an early morning text weeks before treatment was due to start.

The one thing they did have was an egg donor. (Medics typically discourage having the same woman perform both functions, to offset concerns around the possibility of bonding too strongly with the baby.) Spencer and Rachael, a credit controller, had become friends two years earlier after meeting on an IVF forum on Facebook. Rachael, then pregnant with her third child, was exploring egg donation, and Spencer wanted to know more about surrogacy. They lived nearby and began meeting up, forming a close friendship that involved weekends together, takeaways, dinners and days out. Spencer and Kevin became unofficial uncles to Rachael’s youngest son and joined in family celebrations, which is how they grew close to Leanne, a mental health support worker who had three sons of her own.

Leanne remembers: “Kevin and Spencer were lovely, and I’d seen how close they all were and how badly the boys wanted to be parents. When Rachael told me their surrogate had let them down, I instinctively offered.”

The group drew up a 12-page “intention agreement”, detailing expenses, medical tests, pregnancy supplements and protection – including life and critical illness insurance – for Leanne’s children in the event that anything went wrong. Kevin and Spencer spent £25,000: £6,000 for the cost of Rachael’s egg donation; £6,500 on medical appointments, screening tests (for all four), medication and scans; £2,500 to transfer their embryo to Leanne’s womb; and £10,000 on surrogate expenses. On pregnancy test day, they sat around Leanne’s kitchen table together, dipping the stick in a cup she’d wee’d in.

“This was the next best thing to carrying the baby ourselves,” Spencer says. “We were so involved. Friendship-first gave us trust and openness.” The expectant dads attended scans, sent hampers each trimester – the first contained ginger biscuits and tea for morning sickness – and downloaded an app that allowed them to read bedtime stories for Leanne to play to her belly. 

When her waters broke three months early, at 28 weeks, the responsibility weighed heavily for all. Leanne says, “You don’t want to let anything go wrong. Decisions about what happened next were theirs to make. I felt guilty.” The men felt responsible, too. “Leanne has three children; she had to go home perfect at the end of this,” Spencer says.

Some nurses called Leanne ‘Mum’ which none of us wanted. It felt antiquated

‘There’s not many teams like us out there’: Rachael (left), egg donor, and her sister Leanne (right), surrogate for Kevin (left) and Spencer. Photograph: Silvana Trevale/The Guardian

Leanne was monitored as an outpatient until labour started a month later. When Sawyer arrived, at 2.36am on 6 April, eight weeks premature and weighing 5lb, all four were in the room, Rachael as birthing partner. Sawyer spent 16 days in neonatal intensive care. His fathers stayed by his side but the now familiar outdated legalities meant Leanne had to return for his discharge.

Even once they have left hospital, it is common for surrogates to be contacted by health professionals seeking consent for newborn checks, despite parents being present. Kevin remembers: “Before the birth, our consultant emailed ahead to enforce our right to be there. Some nurses called Leanne ‘Mum’ which none of us wanted. It felt antiquated. I think it’s sexuality and gender more than surrogacy. It took us being by his side for 16 days to prove ourselves, and it shouldn’t be that way.”

After the birth, Leanne was flooded with emotion: “Your body doesn’t know you’re a surrogate; he was premature and my natural instinct was to know he was all right. I talked a lot with Rachael to be sure what I was feeling was OK. The openness and honesty between me and the boys was vital. Once home, I was back to being Leanne again.”

She expressed and froze milk for Sawyer for two weeks before returning to work. Going home from hospital, Kevin and Spencer stopped at her house, “to give her boys the first cuddle,” Spencer says. “They’d been through a lot, too.”

When the friends share their story with others, it is the egg donation that tends to generate the most interest, Kevin says, but for Rachael it represented nothing more than a tiny piece of DNA. “It’s that black and white for me,” she says. “My own children are the ones I’ve created with my husband. The way Kevin and Spencer look at Sawyer is the exact reason I wanted to do this.”

They see each other often and last month shared a Christmas outing and an early New Year’s Eve celebration before Sawyer’s bedtime. “I want our son to know who the two most incredible women on the planet are,” Kevin says. 

“They’ll for ever have that bond with him. The more love he has, the better.”

Back in north-east London, Rachel and Abi echo the sentiment. As the baby goes down for his nap, the friends leaf through a photo book of their pregnancy, created for their children. “I can’t wait for my son to know how many people brought him into the world,” Rachel says. “It’s the biggest act of kindness imaginable; I can never thank her enough.”

Abi smiles. “But you don’t need to thank me,” she says, “because it just feels entirely normal. We were going to be friends for the rest of our lives anyway; it’s just cemented our bond.”

(Source: The Guardian)

I've taken the pill most of my life – it hid my endometriosis symptoms and cost me my fertility

Emerging research suggests the pill can also affect your brain, a topic which I believe needs to be talked about more to make women aware of the trade-off they might face

I have taken the contraceptive pill in various forms for most of my adult life.

Initially I was prescribed it as a teenager because my periods were heavy, painful and irregular, something years later I discovered was because of endometriosis. I was therefore concerned to discover that new research suggests the pill can change a woman's brain, and the way she behaves and thinks.

Sarah E Hill, a professor of social psychology, has published a book looking at the science behind the topic, called "How the Pill Changes Everything: Your Brain on Birth Control".

There has also been other emerging research suggesting the pill can affect your brain, a topic which I believe needs to be talked about more to make women aware of the trade-off they might face by taking it.

It is only now I have finally stopped taking the pill for a significant amount of time, after having surgery to remove my endometriosis, that I can look back and realise it did have an effect on me.

It took a long time to find a pill which worked for me, with many of the varieties giving me horrific mood swings or headaches. I eventually found a compromise with one which didn’t cause mood swings, but which did numb other emotions.

Whilst the pill held off my symptoms of endometriosis, this wasn't necessarily a good thing. It meant that for years the endometriosis was growing without me realising. I had niggling problems which GPs couldn't attribute to anything in particular, until I came off the pill to try for a baby and the symptoms of endometriosis hit me severely and aggressively.

I was then diagnosed quickly, but by this time the endometriosis was stage three of four, and affected my fertility.

GPs who are presented with a woman suffering from period-related problems shouldn't be so quick to prescribe the contraceptive pill, as this masks the symptoms without figuring out the root cause. In my case, it cost me my fertility, resulting in me needing IVF to conceive.

I can also see that the pill did change the way I felt, putting a stop to the natural highs and lows that come with a monthly cycle.

This might be great for removing the negative feelings associated with PMT (pre-menstrual tension). However, it's not so great when it removes other feelings, such as having a good cry at a soppy film, being attracted to men or feeling sexy, none of which I felt as strongly whilst on the pill. It stabilised my mood but left me feeling a bit flat as a result.

Some women might see this as a positive. But I enjoy some of the of feelings I now experience without being on the pill, and believe they are a key part of what makes me who I am.

Professor Hill’s book explains this in more detail. She describes how the pill mimics the second half of a woman’s monthly cycle during which the hormone progesterone is dominant.

This shuts down the brain signal that prompts egg development, meaning the ovaries don’t produce oestrogen.

However, oestrogen is responsible for some of the more enjoyable feelings women experience each month such as making us feel sexier and more energetic.

Unfortunately, for those of us with endometriosis, oestrogen is our kryptonite, feeding the disease and enabling it to grow, meaning many treatments for the illness are based on reducing this hormone in the body.

I find it deeply concerning to now find out that doing this can have an impact on how we feel.

This is particularly worrying when GPs seem so quick to prescribe the pill, with little monitoring afterwards as to how a woman might be feeling.

Whilst I recognise that the pill is great for many women, I hope that, armed with this new research, GPs are now having conversations with patients about the possible side effects, so they and their patients can make more informed decisions. If a woman does take the pill, there definitely needs to be better monitoring afterwards.

I’m all for women being in control of their bodies and having a way to prevent an unwanted pregnancy. The contraceptive pill makes this possible.

However, we need information so we can understand the true impact that taking hormones might have on our body.

I now face the reality of having to go back on the pill at some point to control my endometriosis – a condition which isn't curable. Maybe I should be grateful that the pill exists and can reduce any pain I might experience.

Instead, I feel frustrated that there are few other options available for the one in ten women who suffer from endometriosis, which don’t involve pumping the body full of potentially personality changing hormones.

(Source: Independent)

Indian woman, 73, gives birth to twin girls

A 73-year-old woman in the southern Indian state of Andhra Pradesh has given birth to twin girls.

Doctors delivered the twins, who were born following IVF treatment, on Thursday.

"The mother and the babies are doing well," Dr Uma Sankar, the woman's doctor, told BBC Telugu.

Mangayamma Yaramati said she and her husband, who is 82 years old, have always wanted children but had been unable to conceive until now.

"We are incredibly happy," her husband Sitarama Rajarao told BBC Telugu on Thursday, hours after the babies were born.

Mangayamma Yaramati is 73 years old

But just a day later, Mr Rajarao suffered a sudden stroke and is currently being treated in hospital.

"Nothing is in our hands. Whatever should happen will happen. It is all in the hands of God," Mr Rajarao had said when asked who would care for the children in case anything were to happen to the couple due to their advanced age.

Having children was important to the couple, who also said that they felt stigmatised in their village.

"They would call me a childless lady," Ms Yaramati said.

"We tried many times and saw numerous doctors," she added, "so this is the happiest time of my life."

The twin girls were delivered by Caesarean section, which is the usual method in such rare cases.

In 2016, another Indian woman in her 70s, Daljinder Kaur, gave birth to a boy.

(Source: BBC)

Why I chose to have a 'fertility MOT'

An increasing number of women are paying to have their fertility assessed. How much do the tests really reveal about their ability to conceive?

I am in a determinedly neutral room on Harley Street, my feet in stirrups, my dignity nearly preserved by a flimsy sheet. On the monitor in front of me is my womb, empty of baby but nevertheless being energetically narrated by Prof Nick Macklon. He points out my contraceptive device, my uterine lining gearing up for evacuation in about a fortnight, the visible vacancy left by my just-departed egg – Macklon describes it all as being like a pivotal scene in an action movie. The stakes, certainly, feel high.

I am midway through my “fertility MOT”: yes, like for a vehicle, but for my ovaries. The two-part process – offered by the London Women’s Clinic (LWC) and other fertility clinics like it, for a few hundred pounds – consists of a blood test followed two weeks later by a “not overly invasive” pelvic ultrasound. Alongside a consultation about your medical history and lifestyle, the results help you to understand your own fertility status and likely ability to conceive, now and in the future. “I must say, I really hate that term, ‘MOT’,” Macklon, medical director of LWC, had remarked earlier, back at his desk. “Women aren’t cars.” We aren’t cars – but there are a lot of fiddly parts, which we are mostly ignorant of until they don’t work.

If you had asked me half an hour ago – as I sat in the clinic’s stately waiting room, a baby’s cry faintly, ominously audible from afar – I would have put my grasp on my fertility as slightly above average. I knew, for example, that I had been born with a finite number of eggs and that, at 28, I was approaching the age at which I should be starting to take it seriously. But with the reality of children still entirely, ludicrously at odds with my day-to-day life, I had felt content to leave the picture blurry.

 Elle Hunt at the London Women’s Clinic with Prof Nick Macklon. Photograph: Sarah Lee/The Guardian

I wasn’t even sure that I wanted them, after all. From when I was a little girl to my mid-20s, I had steadfastly maintained that I would never have children of my own. In recent years, my flatmate had amassed a collection of photographs of me holding babies, their faces creased in terror, that, as a whole, seemed to form some damning body of evidence of my lack of maternal instincts.

But as I reached my late 20s, something started to shift, tediously on schedule. Choices such as whether to move country, or change job, or dump or not-dump a boyfriend started to seem properly consequential. Friends my age started admitting to concerns about “running out of time”; older friends who had witnessed too many heartbreaking struggles to conceive, urged me to take them seriously. And the reality of being a woman means you are afforded the luxury of ambivalence only for so long.

The MOT service, offered by LWC for the past two years, was born of two things, says Macklon: greater clarity about the impact of time on fertility, and the widespread lack of awareness of it. A 2018 meta-study concluded that “knowledge is insufficient, particularly in determining when female fertility markedly decreases” – and this despite the tendency to delay children until later in life. In 2016, the average age of women at first birth was 28.8 years, compared with 27.3 years in 2006. “There is clearly a lack of understanding among women that, essentially, their fertility ends about 10 years before they get their menopause, rather than when they get their menopause,” says Macklon. “That is a huge information gap.”

Though they may be getting periods, many women do not even start reliably ovulating every month until they are in their mid-20s. Fertility peaks soon after then starts to decline, though “not catastrophically”, Macklon adds. “It’s probably a steady progression downwards from about the age of 27 or 28.” My age, then. I am starting to feel a bit panicked. The fertile window is from the mid-20s to the mid-30s – not exactly languorous, even with physiology on your side, and that can vary significantly.

I was correct that women were born with all the eggs they will ever have, about 1m of them, but that number has usually halved by puberty – and I am shocked to learn that we lose about 30 to 40 eggs each month. Before each period, Macklon explains with enthusiasm, “a whole group of eggs will have decided: ‘It’s our time now. We’ve been waiting 20-odd years; this is it, off we go.’” Hooked on hormones, they start growing.

Two weeks before ovulation, between about five and 20 eggs – a clutch, if you will – will be contenders. “Of those 20, maybe one will be a little bit more mature, a little bit more sensitive to the hormones” – and that frontrunner will start producing another hormone to stymie its competitors. “It’s very interesting sibling behaviour,” says Macklon, almost fondly. (And just as cut-throat as sperms’ race to fertilise, I note – without any of the mythologising.)

 Elle Hunt undergoes fertility tests at the London Women’s Clinic. Photograph: Sarah Lee/The Guardian

Over time, women not only lose eggs, but their quality depletes. “The consequences are, as women leave childbearing until their late 30s, their chances of producing an egg that is of high enough quality to produce a healthy baby falls,” says Macklon. The fertility MOT can give an indication of “where an individual is on their biological clock”, and that there is demand for it reflects a more proactive approach to family planning.

Ranging in price from about £200 for a consultation with no pelvic ultrasound, up to £450 for a male and female package (and £640 for two women), the service is not cheap, and about half the 800 women a year who undergo the consultation with LWC do so as a first step towards starting fertility treatment, “rather than for reassurance or help with future planning”, says Macklon.

Those women whose MOTs return problematic results may also be advised to consider egg-freezing, prompting concerns that the tests could be steering them down an uncertain, expensive path.

The British Fertility Society (BFS) says that it is important to remember that these tests were developed to inform IVF treatment, not natural fertility, and as such are open to interpretation: “There is no doubt that tests showing a good ovarian reserve are reassuring but they by no means guarantee a baby; equally, a poor or impaired ovarian reserve does not mean you will struggle and need fertility treatment.

Dr Raj Mathur, the BFS secretary, says his view of egg-freezing is “cautiously favourable … but like everything, we are in danger of overselling its benefits and not adequately reflecting the problems”.

Similarly, he said, though the MOT might help some women and couples in their family planning, it should not be mistaken for a comprehensive diagnosis of individual fertility. “They are not looking at other aspects of women’s fertility – whether you ovulate or not, whether your fallopian tubes are blocked – and they are often not looking at the man. They are a kind of incomplete snapshot of one aspect of a couple’s ability to conceive, and that can easily give false reassurance.”

 In 2016, the average age of women at first birth was 28.8 years, compared with 27.3 years in 2006
The blood-test component of the MOT measures levels of the anti-Müllerian hormone (AMH) given off by growing follicles, which indicates how many eggs you have left – but a study last year found that a diminished ovarian reserve was not associated with infertility. “If you’re just starting to try for a baby, a low AMH or a high AMH will not affect your chance of conceiving,” says Mathur. Macklon agrees that a single measure of AMH says little, but adds that in the context of the MOT, and discussed in the broader context of the individual’s medical, personal and lifestyle history, it helps to estimate the length of the patient’s reproductive period.

At the start of his career, Macklon says, he was typically tasked with problems of infertility: “You know: ‘I’ve tried for children for three years. It hasn’t worked; can you help?’ Now, it’s completely different.” Over the past decade, and particularly the past five years, he has been more often approached by single women and new couples wanting to know if they should get a move on. There is “increasing realisation”, reflected in the rising interest in the MOT, “that maybe it’s a good thing to plan these things”.

Yet many women – even those who know for sure that they want children one day – still leave any further interrogation of the idea until it is either a practical reality or there is possible cause for concern. “One of the hardest parts of our job is having to break bad news to women who don’t think they’re going to have a problem,” said Ben Cordle, a spokesman for LWC, when I called him a few weeks ago to make an appointment. It was possible for a fit, healthy woman in her early 30s with no reason to second-guess her fertility to record an AMH level as low as 2, from a healthy given range of 4.1 to 58.

In fact, the thought occurred to me only this morning: that this appointment I had made on no greater impulse than mild curiosity could change the course of my life. On my way to the clinic, questions that I had so far kept comfortably peripheral were brought to the front of mind, where they jostled for prominence.

The big one, obviously: what if I’m infertile? Then the shades of nuance: if I’m infertile, would I still write a story about it? What if I’m certified so fertile, I can safely push motherhood out to 40-plus – would I leave it as late as I can, or keep pace with my peers? Could I afford to freeze my eggs? Do I even want a baby? And the most frightening thought of all: what if the test says I must have one right now, or never?

In this tastefully carpeted clinic, returning to Macklon’s desk after my ultrasound, I am about to find out.

Relative to his somewhat whimsical tour of my womb, Macklon is all business as he goes over my results and medical history. I have a normal uterus. A normal endometrial thickness. My right ovary appeared normal, with 10 follicles – also normal – and “the left ovary looked similar”. My AMH level was “within the normal range for a woman of your age”, though on the lower side of the mean value, meaning that I might not like to leave having a baby until my late 30s – but I’d assumed as much.

The worst thing I could do between now and then, as far as my fertility is concerned, Macklon says, is take up smoking or get chlamydia.

It all somehow feels a bit anticlimactic. But then I realise I am lucky to have that result, lucky to know that I’ve got a few years to go yet. The MOT, Macklon says, presents “some options which we didn’t have in the past other than to say ‘get a move on’ or ‘you can relax’.” A remark he makes in passing lingers with me long after the appointment: “If you think about it, women have to get almost all their life events into a period of about 15 years: career, having children.” It is not long, but I have time – and just the process of finding out has focused my mind on how I want to spend it.

(Source: The Guardian)

Top fertility doctors got woman pregnant with someone else’s babies, lawsuit alleges

Couple forced to return babies to natural parents after tests confirmed they were not related

A US fertility clinic that brags to be the “mecca of reproductive medicine” got a woman pregnant with someone else’s babies, a lawsuit alleges.

A New York couple of Asian ethnicity, whom the court documents only refer to with their initials to avoid “embarrassment and humiliation”, paid the California-based CHA Fertility Centre tens of thousands of dollars to have children – but then wound up giving birth to non-Asian babies.

Adding insult to injury, the couple even had to relinquish custody to their natural parents after tests confirmed the babies were not genetically related to them.

The incident started to unfold in January 2018, when they decided to travel to California after struggling to have children, the New York Post first reported.

Higher rates of maternal deaths and stillbirths among black mothers are 'tip of the iceberg', experts say ( Getty Images )

They eventually underwent treatment to prepare for In Vitro Fertilisation (IVF) with CHA Fertility, which describes itself as one of the world’s “premier fertility treatment networks” and claims to have “fulfilled the dreams of tens of thousands of aspiring parents from Southern California and beyond in over 22 countries.”

During IVF, an egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory, according to the NHS.

In all, the couple alleges they spent some $100,000 on doctor fees, medication, lab expenses and travel costs.

The couple decided to have two female embryos implanted in August 2018.

But months later, sonograms started signalling that something wasn’t right – they showed the wife was carrying twin boys, not girls.

CHA Fertility allegedly dismissed the results, saying the sonogram was inaccurate.

When the babies were born, it became apparent that they weren’t of Asian descent. DNA tests then revealed that the two boys were not even genetically related to the parents.

The couple was eventually also forced to give custody of the children to their natural parents.

The couple doesn’t know what happened to their actual embryos that were supposed to be used.

They accuse CHA Fertility, its doctors and related companies of medical malpractice, intentionally inflicting emotional distress and other allegations.

CHA Fertility has been contacted for comment.

(Source: The Independent)

Men have a biological clock too – so why is women’s fertility still such big, often unregulated, business?

As crackdowns on reproductive rights and fertility clinics’ methods are exposed for being exploitative, the gender bias in the public discourse surrounding pregnancy and fertility has never been clearer

It’s a truth universally acknowledged, that a woman over the age of 25 is likely to be reminded of her ticking biological clock by friends, relatives and strangers, every year, until the year in which she conceives. The unsolicited advice ranges from: “You better hurry up!” or “When do you think you’ll have kids?” to “Oh, you don’t want to leave it too late now”. As a twentysomething myself, I’ve heard these comments become more frequent (and no less annoying) in your thirties.

We love presuming that all women want kids and scaremongering others into thinking that women’s fertility accounts for any problems when trying to conceive. But contrary to popular opinion, studies show that around half of all cases of human infertility are caused by factors related to the male partner. Somehow, the age-old stereotype of the barren old maid prevails, while it’s still incredibly rare to see the words “male” and “infertile” paired together.

A recent study review confirmed that men also experience physiological changes after a certain age, which can decrease a couple’s chance of becoming pregnant. The 40-year review of previous medical literature by researchers at the Women’s Health Institute at Rutgers University found that men past the age of 45 found it much harder to get their partners pregnant, even if the woman was much younger.

Getty

They also found that men aged 45 years and older can increase their partner’s risk for pregnancy complications such as pre-eclampsia, gestational diabetes, premature birth, and increase the likelihood of the child being born underweight, with congenital heart disease or a cleft palate.

Babies born to older fathers also suffered higher incidences of newborn seizures and, as they matured, were found to have an increased likelihood of childhood cancers, psychiatric and cognitive disorders and autism. In short, the evidence proves that men are very much in possession of a ticking biological clock, too – so why aren’t we talking about it?

It’s probably because women’s fertility – and our subsequent fears around it – is big business. Google “how much to freeze eggs” and you’re met with over 56 million search results. Switch the word “eggs” for “sperm” and you’re met with less than 5 million matches. The Human Fertilisation And Embryology Authority notes that “the average cost of having your eggs collected and frozen is £3,350” and that “the whole process for egg freezing and thawing costs an average of £7,000-£8,000”. But for men they quote just “£175-£450” per year as an average cost for sperm-freezing.

A recent four-year study of 350,000 fertility patients also found that private fertility clinics are leaving the NHS with annual bills of around £120m, after failing to treat sick and premature babies born in their care through complications.

Dr Gulam Bahadur, a senior consultant fertility specialist at North Middlesex University Hospital in London, who led the study, explained that private clinics are profit-led, and will often push expensive IVF treatments which can lead to more complications like twins and triplets.

While the clinics charge women high prices to get them pregnant, the NHS then foots the bill for any other complications. Dr Bahadur commented: “The people operating these clinics are taking the profits and not paying anything for the mess they are making.” He also found private clinics are less successful than they market themselves to be, noting that “73 per cent of people who have IVF treatment never get a baby”.

In the States, where Alabama recently waged war against women’s reproductive rights by passing a near-total ban on abortion in May, women’s health remains an ideological and political issue too. One popular female health app has recently come under fire for offering biased advice and concealing its funding sources.

Femm, which has been downloaded over 400,000 times around the world and is designed to help women track their menstruation cycle to plan or avoid pregnancy, as recently reported by The Guardian, was revealed as receving most of its funding from the Chiaroscuro Foundation – a charity supported by wealthy, Catholic, pro-life hedge fund manager Sean Fieler.

Fieler has also backed vice president and anti-abortion campaigner Mike Pence. The app’s literature also questions the safety and effectiveness of hormonal birth control, despite the fact that natural family planning – the method promoted by Femm – has been proven to be the most unreliable.

The gender bias in the public discourse surrounding pregnancy and fertility is clear, and is having notable impacts on the quality of healthcare women are receiving around planning, having or aborting a child.

Sadly, it doesn’t look like change is coming any time soon; laws are becoming more draconian in the States, and here in the UK the methods of fertility clinics are incredibly exploitative. It is therefore more important than ever to keep yourself as informed and up to date as possible on your medical options. Because when it comes to women’s health, the personal is certainly always political.

(Source: Independent)

IVF clinics exploiting older women by trading on hope, says fertility watchdog

‘They are catering to a bunch of vulnerable women’

In vitro fertilisation (IVF) clinics have been warned against “trading on hope” after the fertility watchdog said older women were being exploited.

Sally Cheshire, chair of the Human Fertilisation and Embryology Authority (HFEA), told The Daily Telegraph some private clinics were using selective figures to promote IVF to middle-aged women with low chances of success.

Ms Cheshire urged clinics to be “honest and transparent” with prospective patients about their chances of successful IVF treatment. IVF is typically not recommended by the NHS for women over the age of 42 due to low success rates.

But recent figures show the number of women in their forties undergoing fertility treatment in the UK has doubled since 2004, with more than 10,800 cases in 2017 alone.

Ms Cheshire said “vulnerable” women were being targeted by enticing sales tactics, and revealed she had been offered IVF treatments herself at a fertility show in Manchester by individuals who were unaware of her role at HFEA.

The 50-year-old added: “We now see things like, ‘Guaranteed baby or your money back’.”

Ms Cheshire said some private IVF clinics charge four times as much as they should for treatment, with prices going up to £20,000 per cycle.

“I would like our clinics to be honest about the success rates,” she said. “They are catering to a bunch of vulnerable women. What the clinics shouldn’t be doing is trading on that hope. That hope and vulnerability. They should be honest and transparent about a woman or a couple’s chances.”

The National Institute for Health and Care Excellence (Nice) fertility guidelines recommend IVF be offered to women under the age of 43 who have been trying to get pregnant through unprotected sex for two years.

However, younger women are more likely to be successful with IVF. Between 2014 and 2016, the percentage of IVF treatments that resulted in successful pregnancy and birth were 29 per cent for women under 35, 23 per cent for those aged 35 to 37 and 15 per cent for women between the ages of 38 and 39. The figures dropped to nine per cent for women aged 40 to 42 and two per cent for those aged over 44.

(Source: Independent)

'Three-person baby' born after world's first clinical trials of controversial technique

Doctors raise concerns over use of procedure to treat infertility rather than purely to prevent disease

Fertility doctors say a “three-person baby” has been born in Greece, using genetic material from two women and a man.

The technique was reportedly used to overcome the mother’s infertility – she had tried IVF treatment four times without success.

The 32-year-old Greek mother then heard about a clinical trial of the new method by Spanish doctors.

The medical team in Barcelona used a technique called maternal spindle transfer (MST), in which maternal DNA is put into the egg of a donor woman, which is then fertilised using the father’s sperm.

The technique hinges on cell structures called mitochondria which turn food sources into useable energy.

The procedure was developed to help existing IVF treatments in which mothers have mitochondrial diseases. To avoid passing these on, the nucleus in the donor woman’s healthy egg is removed, and the mother’s nucleus inserted. The vast majority of the mother’s DNA is contained in the nucleus, but a small amount of DNA remains in the mitochondria in the donor egg.

The healthy baby was born on Tuesday and reportedly weighed 6lbs (2.9kg). The mother is also well.

But the technique remains controversial and some doctors have questioned the ethics of the procedure.

A Spanish company called Embryotools collaborated with fertility specialists at a clinic in Athens called the Institute of Life.

The study took on 25 women under 40 years old who had already had at least two previous failed IVF attempts.

The team had to conduct the trial in Greece because the procedure is not approved in Spain, according to health news website Stat News, which reported the woman’s pregnancy in January this year.

The trial’s leader and co-founder Embryotools, Dr Nuno Costa-Borges, insisted the procedure is a useful solution for infertility.

He told the website that in this case 99 per cent of the baby’s genes come from its mother and father, and just one per cent from the egg donor. 


“For some patients, it’s very hard to accept that they cannot get pregnant with their own [eggs],” he said.

“Spindle transfer may represent a new era in the IVF field, as it could give these patients chances of having a child genetically related to them.”

The president of the Institute of Life, Dr Panagiotis Psathas, said: “Today, for the first time in the world, a woman’s inalienable right to become a mother with her own genetic material became a reality.

“As Greek scientists, we are very proud to announce an international innovation in assisted reproduction, and we are now in a position to make it possible for women with multiple IVF failures or rare mitochondrial genetic diseases to have a healthy child.”

Variations of the technique have been used before, with families from Jordan, Mexico, and Ukraine. Those cases also sparked controversy.

In the UK, doctors in Newcastle were given the green light in February last year to use the technique to create Britain’s first three-person babies for two women who may otherwise pass on genetic diseases to their children.

Some academics have expressed their concerns about using the procedure to treat infertility rather than only to prevent disease.

Tim Child, from the University of Oxford and the medical director of The Fertility Partnership, told the BBC: “I’m concerned that there’s no proven need for the patient to have her genetic material removed from her eggs and transferred into the eggs of a donor.

“The risks of the technique aren’t entirely known, though may be considered acceptable if being used to treat mitochondrial disease, but not in this situation.”

(Source: Independent)

Number of adoptions plummet 'due to IVF treatment success'

Rate of fertility treatment success has nearly tripled since 1978, while adoptions fell by two-thirds

Increased IVF use among couples unable to have children has led to a drop in adoption rates, a prominent child advocate has said.

Since fertility treatment began 40 years ago, its success rate has almost tripled, rising from 7 to 29 per cent for under-35s, while adoptions in England and Wales have fallen by almost two-thirds (62 per cent).

Meanwhile, the number of children in care has reached a record high, with 90 young people entering the care system each day in the 12 months to March 2017 – marking the biggest annual surge of children in care in seven years.

In 40 years, the success rate of fertility treatment has almost tripled, rising from 7 to 29 per cent for under-35s ( Getty Images )

But despite a total of 72,670 children entering the care system during that year, less than 5,000 children were adopted in 2017, compared with 12,121 in 1978.

Anthony Douglas, head of the Children and Family Court Advisory and Support Service, told The Daily Telegraph adoption was competing with “lots of other ways of having children”.

He said this was also in part due to the length of time it takes to become an approved adopter in England and Wales – a process he said was “far too slow”.

“Every child deserves a family to live and grow up in but adoption still takes twice as long as it should, which puts people off,” Mr Douglas said.

The fall in adoptions also follows warnings that adoptive parents are being “overwhelmed“ by a lack of support from social services to deal with pressures, with recent research suggesting more than a quarter of such families are in “crisis”.

Figures show that children in care are waiting longer to be placed with adoptive families, with a 30-day increase in waiting time in just the past six months.

Youngsters waiting to be adopted currently outnumber approved adopters by three to one.

This does not only pose a risk to the long-term outcomes for children, but new analysis by charity Coram also shows the cost to local authorities. Failing to find adoptive families for just 30 children a year costs £1m for each extra year they remain in care, their findings show.

Earlier this month, the National Adoption Service put out a call for prospective parents in Wales to come forward to help, following an “unanticipated increase” in children looking for homes.

IVF – or in vitro fertilisation – is a process in which an egg is removed from a woman’s ovaries and fertilised with sperm in a laboratory, before the fertilised egg is returned to the woman’s womb to develop.

(Source: The Independent) 

The secret shame of having no sperm

There is an urgent need to tackle a decline in male fertility and address the "absurd" reliance on giving female partners expensive and invasive IVF treatments to try to overcome the man's lack of quality sperm, a leading fertility expert has said. For men, being told you are infertile can be a crushing and lonely experience.

Male infertility is now the most common reason for couples in the UK to seek IVF - but when Craig Franklin was told bluntly that he had no sperm, he felt alone and emasculated.

"The GP essentially said, 'You're producing no sperm, you won't be able to have children. Out the door, away you go,'" the 39-year-old explains.

"There was no support whatsoever."

The effects hit him hard and almost led to him breaking up with his partner Katie.

"I was very angry for a long time. I went mad with money," he tells the BBC's Victoria Derbyshire programme.

"My performance at work deteriorated quite significantly to the point that I lost my job late last year."

"It broke my heart. I saw a man break, basically," says Katie. "He didn't feel like a man, and that's so unfair."

Prof Sheena Lewis is one of the UK's leading fertility experts

Leading fertility expert Prof Sheena Lewis - chairwoman of the British Andrology Society that aims to improve care in men's reproductive health - says the lack of focus on male infertility within the health system is an "urgent" problem.

"Men are not being looked after properly, not diagnosed, and not cared for," she says.

The quality of men's sperm in the Western world is in decline, but little is known about how to improve it - and there are few treatments available on the NHS.

This has led to an "absurd" case, says Prof Lewis, where women routinely have to undergo IVF - even if there is nothing wrong with their own fertility.

"The woman actually acts as the therapy for the man's problem [of poor sperm]," she says.

"We are giving an invasive procedure to a person who doesn't need it, in order to treat another person. That doesn't happen in any other branch of medicine."

Prof Lewis adds that it is also a "huge expense for the NHS", at a time when IVF is being rationed in many parts of the country.

DNA damage
One couple, who spoke to the Victoria Derbyshire programme anonymously, might never have had their son had they not explored other options privately.

On the NHS, they were given a round of IVF - despite the female partner having good fertility - but it failed due to the man's poor sperm.

"It was really unpleasant. Injecting yourself with needles that don't go in the first time is not a walk in the park," she explains.

So instead, the man sought the help of a private clinic and had an operation - cheaper than a round of IVF - to treat varicocele, an abnormality in the scrotum that affects up to 40% of men with fertility problems. His wife conceived naturally.

For Stephen Harbottle, a consultant clinical scientist who helped develop the fertility guidelines for health watchdog NICE, while varicocele treatment will not work for every man, the NHS must ensure other options are explored before IVF is offered to a couple.

This includes simple solutions such as dietary supplements, or tests to check for sperm DNA damage.

The reason this does not happen currently, he says, is that "doctors don't have any other options available other than to refer patients for IVF".

"Men in some ways are just being farmed through the system," he adds.

Mark and Suzanne Harper have two children via donor sperm

Some men with fertility problems also report feeling sidelined by GPs, who they say focus on the women.

Mark Harper - from Ilkeston in Derbyshire - has two children through donor sperm.

But when he was originally found to have no sperm, it was his wife whom the doctor called with the news rather than him.

"If you're talking to a male about his infertility problems, you ought to be talking to the male about it," he says.

"I'm here, I'm a person, I was the one sitting in front of you, and I'm the one you need to be talking to."

The Royal College of GPs said in a statement that its members were "highly trained to have sensitive, non-judgemental conversations with all our patients... including why someone might have problems with their fertility and the best options for them going forward".

Men's biological clock
Prof Sheena Lewis says the lack of attention on male fertility also means men are not educated on their reproductive health, and may wrongly take it for granted.

"Men do have a biological clock. As time goes on, because of their lifestyle, there are more and more opportunities for mutations to occur in their sperm.

"Men who are over 45 when they have children are more likely to have children who will have childhood cancers, or may have psychiatric disorders such as bipolar disorder or autism," she says, adding that she believes this is also likely to be the case for younger men with poor sperm quality.

Katie and Craig say it took them a year-and-a-half to come to terms
with not being able to have children without donor sperm

Katie and Craig say doctors presumed the reason they were not able to conceive was because of Katie - and she was tested before Craig's fertility was ever considered.

The couple are now looking for donor sperm privately, having been denied IVF on the NHS.

The stigma surrounding male infertility means this is the first time Craig has ever spoken openly about the issue - until now, even his friends did not know.

"It's not a manly thing to discuss," he says. "It's boxed up... and not spoken about."

The couple say it took them a year-and-a-half to come to terms with not being able to have children without donor sperm - made worse by the fact emotional support was never offered to them.

But now they are coming through it.

"We're stronger than ever," Katie says.

"But other couples might not be as strong as us. They might not be able to work through that and I can see why - it's so hard for the man to be able to come to terms with not being able to give his wife a child."

(Source: BBC)