Fertility – Conceiving After Fertility Treatment

Conceiving after fertility treatment can feel as close to a miracle as anything ever can – all your hopes and dreams have now been realised, and you’re actually going to have a baby! It’s wonderful, scary, and you may find it difficult to take in at first. After all, you’ve been working towards this point in your life for quite some time, and so it can feel dreamlike, a real fairytale ending. However, it’s not an ending, it’s a beginning – the beginning of a new life and a beginning of your lives together as a family, as parents. Nothing will be quite the same again, and there are a number of different issues that may affect you, your family, and your baby that you should consider.

A very special baby
A baby conceived following fertility treatment, especially if is a baby that you have wanted for a very long time, is a very special baby. But then all babies are special to their parents, whether they were conceived following fertility treatment or not, and feeling that this baby is particularly special can set up problems in the future. The biggest of these is being overly precious about your child. Letting go is an inevitable part of having a baby; the separation starts as soon as he or she is born and continues into adulthood, and this is the healthy way in which children grow up to be fully-functioning adults. Some parents, however, find it very difficult to let go, and this might be the case if the child is regarded as being particularly special because he or she was born as a result of fertility treatment.

Whose baby is it?
Feeling that the baby isn’t really yours is only likely to be an issue if your baby was conceived using donor eggs, sperm, or embryos or was carried by a surrogate. However, it can become a very real factor for these families.

Using donor eggs – if the woman has carried the baby and gives birth to it, even if it has been conceived via a donated egg, she will often feel that the baby is very much “hers”, although some women do feel rather detached.

Using donor sperm – men can’t experience the intimate feelings that exist when a woman carries a baby, and so if the baby was conceived using donor sperm, the man may experience powerful, and generally unexpected, feelings of jealousy and usurpation because his partner was fertilised by another man’s sperm. Once the baby is born, some men find it difficult to bond with him or her, especially if there is little family resemblance, and feel that they are being expected to raise a “cuckoo”, which can lead to all sorts of problems within the family.

Using donor sperm and eggs or embryos – this is perhaps the easiest to deal with for you as a couple, as the baby is not genetically related to either of you, and so you can both concentrate on bonding with this precious “gift” without feelings of jealousy or the cuckoo syndrome getting in the way.

Surrogacy – if another woman carries a child for a couple, it can be difficult for the woman to feel that the resulting baby is actually hers. In addition, carrying and giving birth to a baby can be a powerful bonding experience and so the surrogate may feel unable to give up the child afterwards, as has been the case in a number of well-reported cases. If the baby was conceived via the father and surrogate mother having sex, this can also cause problems.

Counselling can help you and your partner deal with these issues, and the best clinics will offer counselling before you conceive. If you are not offered counselling, or if you feel that further counselling would help, then ask your doctor to refer you or contact CHILD (address at bottom of second sheet), who will be able to put you in touch with a counsellor who will be able to help.

Donor conception, like adoption, can also throw up problems for your child once he or she grows up – genetic heritage is becoming an increasingly relevant part of our lives, and it is likely that he or she will want, or need, to find out about the genes he or she is carrying. This can be an overpowering, irresistible urge, but is something that just may not be possible because, unlike most adoption records, records of donors are usually destroyed by clinics to preserve the donor’s anonymity. It is worth checking with your clinic as to their policy in this area, and considering how you will deal with the problem if it ever arises.

Keeping it all a secret?
Many couples decide to keep fertility treatment a secret because not being able to conceive “naturally” can still carry a social stigma, especially to the older generation. However, few keep it completely to themselves, and many tell friends or siblings, or even everyone except the child him- or herself. Secrecy of any sort isn’t a good idea, but selective secrecy is just setting up trouble for the future. Major secrets like this have a unpleasant habit of popping out when you least expect them, often at a time of stress, and can cause immense psychological problems for your child. This is particularly so if your baby was conceived using donor eggs, sperm, or both. One woman who was conceived via donor sperm didn’t find out that her father wasn’t her genetic father until the day of his funeral, when an aunt said “Of course, he wasn’t your real father”. The daughter had had no idea and felt desperately hurt that she had never been told – and very angry that he was dead and that they couldn’t discuss it. On the other hand, telling your child that he or she was wanted so much that you went through psychological and physical hoops to have them will often make him or her feel very wanted and special, even if it does mean that you will probably have to deal with many questions from your child until he or she has sorted it out to their own satisfaction.

What if the baby has problems?
Having gone through so much effort (not to mention cost) to conceive a child, how will you feel if you miscarry, or the baby has a problem or is handicapped in some way? The ratio for handicapped babies born as a result of assisted conception is the same for those conceived “naturally”, which is just under 1%. This figure incorporates the whole spectrum of problems from relatively minor problems, such as club foot or cleft palate, to severe mental or physical handicap that are incompatible with life. Screening during pregnancy can reveal if your baby has certain handicaps, such as Down’s syndrome or spina bifida, but the decision to have such tests may be particularly difficult if the baby was conceived following fertility treatment.

What if there is more than one baby?
The rate of multiple births following fertility treatment is higher than it is in the population generally, and this can be a problem in itself. In addition, multiple pregnancies are often premature, and one or more of the babies may need intensive care for some time.

What if there are any “leftovers”?
If you conceived using your own sperm and/or eggs, then there may be surplus sperm or eggs remaining after your child has been conceived. Different clinics have different policies, but the “leftovers” might be destroyed, frozen for your future use, or you may be asked if you would like to donate them to another couple. If you do decide to donate them, how would you feel that there might be a half or full sibling to your child being raised by somebody else?

Are there any legal considerations?
If your baby was conceived using your own sperm and eggs and was carried by the mother, then there are no legal considerations. However, if you conceived using donor eggs, sperm, or embryos, if your baby was carried by a surrogate mother (which is technically illegal in the UK if the surrogate does it for financial gain), or if you donated eggs or sperm to another couple then there may be legal problems and you should check with a specialist lawyer.

Conceiving again
Some couples need fertility treatment every time they want to have a baby, others find that having had one pregnancy, conception occurs naturally, and often unexpectedly quickly, the next time around. Sometimes this can be a problem, especially if the second baby is conceived very quickly following the first or if either pregnancy is a multiple, because your body may be under an excessive amount of stress, which increase the chances of you miscarrying. Because of these risks, some couples decide to use contraception, even if just for a short period.

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