For many, the journey to parenthood doesn’t happen as quickly or easily as they expect. Understanding fertility options and the range of routine tests to help identify any potential issues can be the first step towards becoming a parent, as Audrey and Cafer experienced.
Christmas this year for Audrey and Cafer will be very different from how they pictured their life even just a few short years ago.
Both in their mid-twenties, they hit a fertility wall when they started trying for children, and without any answers as to why, they began to fear that they may never have the family they hoped for.
Two years into trying to get pregnant, they decided to seek advice. Audrey was put on Clomid to stimulate ovulation but after another year of no success and no answers, she stumbled upon the open day notice for Sims IVF clinic and decided to go along.
"You want to be a mother – you want it so badly"
"I was so disheartened at that point. Nobody could tell me why things weren't going the way I wanted them to. Within moments of our new consultation, the doctor said 'so you have Polycystic Ovarian Syndrome, I can tell by all those scans and readings'.
"It was such a relief to pinpoint what we had to do from that point. He suggested Intrauterine Insemination (IUI) first and we had two unsuccessful rounds of that which was really hard.
"You want to be a mother – you want it so badly. It is the only job you want at this stage. I felt like I'd failed."
Audrey says that telling those around her what she was going through provided the support she needed.
"Emotionally it is draining. Then there is all the medication you are on so you are hormonal and scared and anxious and afraid of failing. I know there are a lot of people who don’t tell family or friends – I was honest from the start. I never hid it like it was a secret I was ashamed of. It is probably a protective thing but I don't think people should be ashamed or hide it because it can't happen for them naturally. It's so good to talk to others about what you are going through."
Deirdre Gorman is the Group Head of Nursing at Sims IVF. She says that the first step of fertility intervention is to get in tune with your body. "They should have a good understanding of their own natural cycle and when ovulation occurs. As a guideline, we would suggest that any couple having regular unprotected intercourse for a period of one year to 18 months without a positive pregnancy test should seek advice from a fertility clinic.
"For those who wish to delay pregnancy, it is important to be aware of their own ovarian reserve and to understand the age limit on pregnancy. We recommend that women empower themselves by checking their AMH level and discuss their family planning with a specialist to ensure that they are informed.
"Any woman struggling to conceive should first try and find out why."
Knowledge is power
Deirdre explains the process. "Some basic testing includes an AMH – a blood test to determine your ovarian reserve, some other bloods including thyroid test and prolactin and also a test to check the tubes, ovaries and womb. These are all straightforward tests that may provide indicators as to why pregnancy has not happened.
"If the woman in question has a male partner he should also be assessed to ensure his sperm count and quality are good.
"Treatment options will depend on the cause of any fertility problem. For younger women with functioning tubes, timed sexual intercourse or intrauterine insemination may be a good option.
IVF will be indicated if there are any issues with tubes or a prolonged time trying to conceive. Donor sperm and donor egg treatment options are also available if indicated."
After their disappointment, Audrey and Cafer decided they wanted to keep going with the process. They went for a round of Intracytoplasmic Sperm Injection (ICSI), in which the sperm is injected into the egg after harvesting.
"Nothing can prepare you for all the injections, medication, gels. I remember going into the chemist to collect my month's prescription and I was so shocked to walk out with two full bags. I thought, what am I getting myself in for? But I also knew I had no choice in the matter if I wanted to be the mother I knew I would be."
Then she got the phone call that would change her life. She was pregnant. A scan revealed that they were welcoming twin baby girls.
"My dad, who sadly passed away last November, was always saying 'always leave them laughing'. Even when he was really unwell in the hospital, he'd make everyone around him smile. And I tried to remember that as we went through such a sad time — don't forget to smile and laugh.
Now, we have two four-year-old daughters who keep us so happy and so busy.
This year, Saara and Sofia are asking Santa for dogs that walk and wag their tail and dolls that cry and close their eyes.
And they will be getting something pretty close to that in real life come next year too. Audrey successfully implanted another of the embryos and a year exactly to the anniversary of her dad's death, she has just had the happy news that she is pregnant again.
"I had too many nights where I never stopped crying and now, look where we are. Don't give up hope, that's my advice. How can you stop trying to be something that you know you are born to be? It is worth all of the struggle."