IVF in 3 Different Countries

Because no two paths to parenthood look the same, “How I Got This Baby” is a series that invites parents to share their stories.

Elena and her husband, Anders, were living in New York City when they decided to start trying for a baby. Elena, a photographer, was 37 — “I knew that probably my fertility wasn’t that amazing,” she says — but the couple didn’t feel too much pressure, and hoped they’d have success the old-fashioned way. After a few months, they’d had no luck but decided to keep at it. They might have pursued fertility treatments had they not been so busy: The couple moved cities, and soon after, the pandemic started. They had been in England for about nine months when they decided to seek help. A fertility doctor, who was part of England’s National Health Service (NHS), assured the couple that even though they’d been trying for about a year and a half, they should just continue to try. 

“By that time I was already 38,” says Elena. “That should have been a little bit alarming. At this age, you should probably test the woman and see if she’s still okay to get pregnant naturally, right? But they didn’t bother.” 

Elena recounts what happened next.

We continued trying for eight or nine months longer. I was still 38 when we came back to the fertility doctor and said, “This is really bothering us. It’s really not working. What can we do?” And they said, “Okay, let’s do some tests.” But because this all happened during the pandemic lockdowns, six months passed between that visit and the test being done. By the time we went to see the doctor to get our results, I was nearly 40. I was really stressed.

First they gave us the results of the testing they did on Anders. We found out that he had a really low sperm count and low motility — almost nonexistent. We were so angry. I felt devastated. Why didn’t anybody suggest we do those tests earlier?

They told us that we should try IVF, because, even if somebody has a very low sperm count, there’s technology that can fish out the sperm that are still alive and viable. It’s called ICSI — intracytoplasmic sperm injection — and it involves injecting the sperm directly into the egg mechanically, as opposed to traditional IVF when they just put some sperm around the egg and then the sperm swim. So Anders started going to a male fertility clinic. Then my test results came back: “Unfortunately, we cannot refer you to the IVF clinic here because your ovarian reserve is too low.” One of my tests had shown that I would not qualify for the state-funded IVF program. I was devastated again. If only we had known all of this much earlier!

We started thinking, Okay, so what are our options? We both really wanted to have children — that was kind of our whole vision of our future. When you see yourselves as a couple with children, it’s really hard to restructure that in your head. Your identity and your whole idea of your future life is completely shattered.

We knew we had to try IVF privately or adopt a child. I had always wanted to adopt. When I was younger, I thought, even if I have my own children, maybe I’ll have one of my own and one adopted. The adoption rules where we are — we live in the U.K. — are quite strict. We realized that we would probably not even qualify to be approved to adopt because you need to have a certain income (I’m a freelancer), and you also need a separate bedroom for a child (at the time, we lived in a one-bedroom apartment). I thought I could get some kind of part-time job to show a steady income. But nothing seemed realistic. I make a good income as a freelancer; I’m in good financial standing, but I can’t prove that according to their standards.

I felt frustration, but also anger — they should go case by case, looking into our situations and what kind of other qualities we have, rather than just the ability to make a lot of money in the current economy, when the rents are so high. You can’t put all your income into renting a huge house to show to the adoption authorities, yeah, look at my amazing home. But then you have no savings, nothing for the future! So we decided to just save up money and try to do IVF privately.

It took us another year to collect all the funds.

We started by going to private U.K. clinics and doing all these blood tests and exams. We spent around £2,000 on just the cost of prepping — the cycle itself, the egg collection and procedure, would be another £7-8,000. We couldn’t really afford it. The clinic was also very discouraging, saying things like, “With your levels, the chances of getting pregnant are less than one percent. It’s so tiny!” I guess they didn’t want to lie. But when you’re already feeling vulnerable, you want someone to be kind and supportive, no matter how low your chances are. My husband is from elsewhere in Europe, and his mom suggested a clinic there, so we decided to try it.

The clinic was such a contrast. They said, “It doesn’t matter if we collect only a couple of eggs, there’s still a chance those eggs will fertilize and you’ll get pregnant!” They did raise the possibility of using donor sperm, because we didn’t know if my husband’s sperm would even work. But my husband was like, “No, I feel really uncomfortable if you are going to give birth to a child from another man.” I said, “It’s still going to be me giving birth. It’s still going to be our child.” And he said, “Yes, yes, I know all of that, but it still makes me feel super uncomfortable.”

But we didn’t even get to the part of transferring his sperm. We’d stayed for about two weeks to get through the process. They assessed and prescribed medications, and then we came back to the U.K. and I did all the injections and pills at home. Then for the last two weeks of the cycle, I had to go back.

The cycle didn’t work because my eggs weren’t good enough for the transfer. We were devastated, because it took us a year to collect the money and go through all these tests. The cycle itself involves injecting hormones, taking medication — you have to endure a lot, both physically and emotionally. You’re doing all this for this great goal, and in the end, there’s just emptiness.

I felt hopeless. We were thinking, Should we try again? Is this even worth trying again? We were just spending so much time just waiting.

The treatment at the clinic cost around £4,500, plus about £1-1,500 for medication. We circled back to the adoption idea, thinking: Maybe we could move. Or maybe we could do something to qualify to adopt a child. But we ultimately decided, okay, let’s try one more time and then we’ll close the door on a genetically related child. We were literally thinking this would be our last try.

It’s like an evolution. At first, you think, I only want to have my child naturally. Even IVF sounds scary — all these chemicals in my body, then the child is conceived in a lab … what if something goes wrong? You don’t really have control. It’s something that’s so foreign to you, so you just naturally are afraid of it. It took us months of talking and talking and talking before we decided to go with IVF at all. But then once you are already in it, it’s kind of hard to stop. You’re thinking, I’ve sacrificed so much that I need to do just another cycle. Just another cycle!  

And then when it didn’t work, we had to have, again, discussions and discussions. Should we try a donor egg? I had to talk to myself and convince myself that even with a donor egg, it was still going to be my child no matter what. But it was an incredibly hard decision. I read a lot of articles and watched videos with donor children trying to understand how they feel about not being genetically related to their parents. I wanted to make sure it was ethical. There were so many emotions, so much consideration, and so much thinking.

If you go on YouTube, there are these videos when some grown-ups who are donor children say, “I hated that my parents did that. I hate my life.” And it’s like the most horrible thing. But then there were other children saying, “I felt so special. My parents really wanted me. They’ve been through so much. They did all this just to have a child.”

It was very, very hard. I don’t know. I guess at this point you just feel so desperate — it’s either that or close the door completely and hope adoption could work. It was a very, very difficult decision.

I started researching options in different countries. It’s fascinating how different the laws on sperm and egg donation are in different countries. In the U.S., at least in California, I read an article about how a couple was able to go and literally click through a database and look at pictures of their potential donors and read about their education, height, weight, interests, hobbies — everything. Where my husband is from, it’s complete anonymity. You cannot get any information about the donor except maybe skin color, hair color, and eye color. That’s it. Nothing else, not even the donor’s age.

There are a lot of clinics in Spain and Greece with big online presences, and we had calls with a few. They advertise themselves quite aggressively, especially for older couples who have either sperm or egg issues, because they have really big sperm and egg banks. It’s a whole industry. In the end, I didn’t like any of them because everything they said sounded like a sales pitch. The doctors weren’t interested in my recent tests or the history of my previous failed IVF round. They were just giving me information about their results and success rates. I wanted a more individual approach — someone who would really listen to me. I didn’t want to just feel like a part of this baby-making industry. Even now, thinking about that experience … It’s horrible.

I ended up choosing a clinic that was able to tell us the education of the egg donor and their height, weight, eye color, hair color. The education level was very important to us. There was a consultant at the clinic whose job was specifically to do matching. She has a lot of information about the potential donors that she doesn’t show you, but she can help make a match. I couldn’t ask, obviously, the name, or ask her to show me a photo. But if I wanted to know more about a donor’s personality, she was willing to share. We are both artistic, so that was kind of important. She told us that the donor we chose was very bubbly, very easygoing. I was like, “Okay, that’s good. That sounds good!”

We had a video call with the clinic and this doctor was much more attentive and personal, asking a lot of questions. She had asked me to send her all my blood tests and all my husband’s tests, and all of our treatment history. She looked into it and said, “I understand why your cycle failed, and my honest recommendation would be to do the ICSI procedure where we introduce the sperm to the egg, but to use a donor egg instead of yours.” So that’s what we decided to do.

The first time we went in, they assessed everything, took more blood tests, and then the doctor wrote a procedure protocol. Then, we traveled back for a test cycle. Basically, the doctor wanted to assess when to do the transfer because some women have pre-receptive endometrium and then some women have post-receptive. So even though you know your cycle, you still need an ultrasound to check if your endometrium is the right thickness, or the fertilized egg might not attach. That’s what she wanted to test. So we did a first run without the transfer.

When we went back for the third time, to transfer the embryo, I suddenly got this terrible virus. I was so sick I couldn’t walk. The clinic said they could still do the transfer, but if it didn’t work, we would never know if the problem was the virus or my reproductive system. So we decided to stop that cycle there.

We had collected ten eggs; eight of them got fertilized, and then they were supposed to transfer one. Some of the embryos are stored in the freezer, and if the first one fails to attach, they can go another round to attach another one. In our case, the first six all failed before they were even ready to transfer, and they froze the remaining two for the next round.

I had to go back home, then start all the medication and injections again on my next period cycle. (Not counting flights and the accommodations, our total cost for all the treatments at this clinic was just under £8,000.) We came back for the transfer, and we ultimately only had one embryo that was viable. It wasn’t even the best grade — they give grades to the embryos, and if it’s a good embryo, it’s like A or AA or A+. We had a grade-B embryo.

But it worked! People often say they have to do multiple cycles because the pregnancy doesn’t “take” or doesn’t progress, or they lose the embryo. But this worked. We thought it was a real miracle.

We went back home. You have to wait 14 days and then do the pregnancy test. And if it’s positive, you go to a clinic for a blood test. When I first saw our at-home test, my body wasn’t feeling anything — I know some women feel like they are pregnant, but I didn’t feel anything. I saw the test, and just thought, Is it true? Can I trust it? We hugged of course, and cried a little bit, but we couldn’t fully allow ourselves to be happy.

And then when the test came back from the clinic, the blood test, I was like, Oh my God. Oh my God! I was so excited and so emotional — everything. Our doctor really brought me back to Earth. She said, “You need to focus, you need to do everything very methodically, dah, dah, dah.”

I continued injecting the hormones for maybe 12 weeks. I also had to take aspirin as a blood-thinner, because at my age there’s a higher chance of miscarriage. So it was still quite nerve-wracking and we weren’t able to relax and fully celebrate, because it’s so common to lose these pregnancies early on. For the first three months, I wasn’t even kind of admitting to myself that I was pregnant. I would say, Maybe pregnant, maybe not. Maybe I’m pregnant! in my head. We told our families that we had a positive pregnancy test after the blood test, but we said, “Don’t be too excited about it, it’s very much up in the air. We’ll see what happens in three months!”

Then, at ten weeks, I had some bleeding. We went into the emergency room and I was so scared. It was too early for a regular abdominal ultrasound, so they had to perform it transvaginally. They went in very quietly, and they’re moving around and moving around, and we were just sitting there. It was so quiet. I was digging my nails into my husband’s hand. And finally they said, “Look at the screen, there’s a heartbeat!”

That was probably the most emotional moment of the entire pregnancy.

There were several reasons the doctors didn’t want me to carry to 40 weeks, primarily my age, as I was 41 already, and I had gestational diabetes. I was on a strict diet and had to measure my sugar levels four times daily. My doctors were concerned because the baby was measuring quite big — at five-foot-one, I’m tiny, and my husband’s very tall. They feared trauma either to the baby or to me or both of us due to potential complications like shoulder distortion or spinal damage.

I decided to go for an induction at 37 weeks, even though I initially wanted a natural water birth with no pain medication. I just wanted everything to be as natural as possible — I thought, Nothing was natural about how the baby got in, but maybe it could come out the natural way. By then, they were estimating that the baby could be almost five kilos — that’s nearly 11 pounds.
The induction involved several attempts over three days, including a cervical sweep that was the most painful thing in my life, even more than all the painful IVF procedures. I did everything — walking around the block, dancing, bouncing on a fitness ball. But each time, my labor eventually stopped. We were at 37 and a half weeks by then, and the doctors recommended a C-section because they said further delay increased risks. I was really hesitant because I was scared, but I eventually agreed, with a heavy heart.

When they pulled her out, the baby started crying immediately. Tears just rushed out of my eyes. So that was a very happy experience. They said, “Looks like a very healthy baby. Everything is good!” And then I could see panic in the doctors. Something was going wrong. My husband was standing there with a crying baby — she kept on crying and crying and crying. So I was worried. “Is she okay? Is she okay?”

“Yeah, she’s fine. She’s fine. She’s just crying!”

And I was like, just give her to me, because you’re supposed to do skin-to-skin as soon as possible. That was very important — it was in my birth plan that I wanted the baby right away on my chest. But they said no; I had an anesthesiologist sitting next to me and he was like, “They’re working something out. Just give it a bit more time. We’ll give you the baby. Just be a little bit more patient.” He was a very nice doctor, trying to calm me down without giving too many details. But then at some point I overheard them saying something like, “Should we take her uterus out again?” I could see the stress on their faces.

I didn’t know what was happening, but my husband told me later that he could see blood pouring out of me. Apparently the doctors couldn’t find where I was bleeding from, and I had to have a blood transfusion, which was one reason I was so scared of a C-section in the first place. I couldn’t even hold the baby, because there were needles in both my arms, so I couldn’t bend my wrists or elbows. Somebody put the baby on my chest for a moment, but I couldn’t hold her.

Finally, after about 40 minutes or so, they patched me up. And Clara ended up being only about three and a half kilos — about 7.7 pounds. She was very healthy. I was so happy.

That first night, all that adrenaline and the hormones of just holding the baby, finally, meant I didn’t care that much about all the needles and everything that had happened. I didn’t feel the pain.

Even after Clara was born and home from the hospital, I had this feeling that something terrible would happen. I had to get some counseling — I was able to get therapy through my husband’s work insurance — because I was having these terrible thoughts that something would either happen to me or to her. It was as if it wasn’t meant to be, and I had cheated the universe.

We didn’t tell anyone. Our families don’t know. Nobody knows. We wanted Clara to be the first to know — when she’s a little bit older, of course, when she’s able to comprehend the whole concept of conception. We will not hide it from her, so she’ll be growing up knowing everything. But I wanted her to be able to make the decision whether she would like to share this information with our families, with anyone else.

It’s a really heavy weight on my shoulders, because I still haven’t had this conversation with her yet.

You imagine how your life will change, but it’s impossible to really know. How I see life now — it’s just so different. I feel like every decision or even any news that you encounter, you start viewing it from a completely different perspective of a parent. Maybe I’m just more emotional now.
Before I had Clara, if I had a bad day at work, for example, or something didn’t work out, didn’t go as planned, I would get so upset with myself. But I now feel like it all doesn’t matter. A client is upset? Oh well! This child and her life are so much more precious and valuable and meaningful than any personal project or job that I’m working on.

Maybe because of Clara being so precious, and the length of our journey and everything, I feel like all the emotions are tripled. I don’t know. Maybe if I got pregnant easily at 25 and had other things happening in my life, I would be less obsessed with her!

She’s very funny. I feel like she has a really good sense of humor — she’ll point out something funny in a book. She’s only a year old, so she doesn’t talk yet, but she just points with her finger and starts laughing. She’s very active; a very cheerful, funny, active baby. The first year wasn’t so easy for us because I was struggling with breastfeeding. We were also struggling with sleep cycles. She still doesn’t fully sleep through the night, but we are getting there.

She’s a real joy. I don’t think you can compare it to any other feeling in the world. You know, when you hug your child, it’s like nothing else.

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