Pravda o léčbě IVF - 2.část

There are more than sixty clinics and each is required to supply figures for treatments and outcomes, but despite many requests the HFEA has until very recently refused to publish a league table. The official reason was that the type of people treated varies between clinics so comparisons would be meaningless. However there is also growing evidence that HFEA data is incomplete and inaccurate.

There is "wastage" at every stage in IVF cycles: one in five yield no eggs at all; where eggs are removed some do not get fertilised, and 90% of embryos replaced do not survive. Of those that do, a few develop into life-threatening ectopic pregnancies requiring urgent abortion, while others miscarry.

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The number of perinatal deaths is also double the national average, partly because multiple pregnancies are so common with IVF and often result in premature delivery.

Severe drug reactions from hyperstimulation of the ovaries are also a real problem. One woman in twelve per cycle has mild symptoms, but two in every hundred are so ill that they need hospital admission with severe pain and sometimes shock from loss of blood volume.

However the biggest costs of all are not money nor health risks, but the emotional roller-coaster with drug treatment, egg removal, sperm supply, embryo replacement, freezing of surplus embryos, high hopes and crushing disappointment. Once again, these are often played down when clinics are advising couples for the first time.

It is a strange irony that while more and more couples cannot conceive naturally, some 170,000 pregnancies end in abortion and a generation that would have been offered for adoption after birth are no longer available. Therefore IVF for many is a last chance.

Adoptions have fallen rapidly from 23,000 a year in 1974 to 6,500 in 1990 while demand has soared. The supply has almost ceased for white couples wanting a normal baby.

While the stigma of single parenting is fading, society as a whole is still very unforgiving of a brave mother who decides that her unwanted foetus will continue to live, to be cared for after birth by adoptive parents.

Any woman who dares admit that she recently gave her baby away for adoption is likely to be met with a stunned silence. The acceptance of single parents has actually made it more difficult for mothers who do not wish to parent their children at all.

The result is that many couples wanting to adopt are now facing a second nightmare: having waited years before trying to have a family, lost several more hoping for a natural pregnancy, and spent their life savings on IVF, they only turn to adoption in their mid to late thirties.

Faced with a waiting list of up to ten years for a healthy baby, many are being offered older children in care instead. Since the government spends £1 billion a year looking after such children, and since adopted children are fed, clothed and housed by their new parents, there is a financial logic to this, as well as improving child welfare.

But emptying children's homes is no answer to the epidemic of childlessness.

Part of the solution to the pain of infertility is to get across the message that having a child adopted after birth can be a socially responsible and loving step to take.

In the absence of a medical breakthrough there needs to be a complete rethink about social solutions to childlessness, rather than just expensive techniques. And more attention must be given to health, preventing Pelvic Inflammatory Disease in the first place.

* Dr Patrick Dixon is author of The Rising Price of Love published by Hodder £6-99. Full text available free on the web - press here.