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Worldwide, nearly one in every six couples experience problems with conception. Some may still conceive spontaneously in the course of time, but others will be deemed infertile thereby requiring fertility treatment.
Recommended fertility treatments depend on the eventual diagnosis. The range of treatments spans from simple lifestyle modifications to more advanced interventions like IVF (in-vitro fertilisation, commonly referred to as ‘test-tube babies’).
If infertility is correctly diagnosed, and appropriate treatment offered, the expectation is conception and delivery of a healthy baby. Many couples will conceive once appropriate treatment is given. Unfortunately, fertility treatment outcomes are also fraught with failures. Sometimes the cause of the failure is easily identified and resolved. Other times it is elusive, leaving patients and fertility clinicians quite frustrated.
If fertility interventions fail, there must be a review of all the accrued data prior to further treatment. This is some form of a medical audit undertaken to make relevant adjustments to further treatment cycles. Some couples will end up with entirely different recommendations, and possibly additional interventions to enhance chances of success. Others may still be suitable to try the same treatment all over again, ending up with success along the way.
Repeated fertility treatment failures are not unheard of, despite the best efforts by all teams. When that happens, the options become rather limited. Some may have failed with their own eggs and/or sperms, and may be open to donated eggs, sperms or even embryos (fertilised eggs).
Some may require a willing female to carry their pregnancy (called surrogacy). Others may feel that they have reached the end of the road and discontinue further treatment. The options of adopting a child, or just choosing to live childless become realistic alternatives.
The stress of fertility treatments is sometimes underestimated, more so by those who have never faced infertility, or interacted with infertile couples. Those who provide fertility treatment must always be empathetic to their clients.
Couples must be treated with dignity, compassion and honesty. They must feel that their journey to conception is well supported and fully optimised towards success. Those who fail must never be casually dismissed, they deserve even more support as they explore other options.
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Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist.
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