Experiences of conceiving, IVF, surrogacy and adoption

Nearly all parents talked about how their babies were conceived. Many conceived spontaneously or what one mother termed 'the old-fashioned way'. Others who had fertility problems, or who were single or in same-sex relationships considered a range of options for conceiving or having baby. This included surgery for problems such as blocked fallopian tubes or fibroids, assisted reproductive technology (e.g. intrauterine insemination (IUI) or in vitro fertilisation (IVF), including sometimes using donor eggs or sperm), self-insemination using fresh donor sperm, gestational/IVF surrogacy or intercountry adoption. Many parents in this situation tried more than one option or method.

A few parents talked about feeling 'pressure' to become pregnant, whether from family or self-imposed, often commenting that this made conception more difficult. Ajay, a father of one, said he and his wife's family wondered if they had 'medical problems' when after 18 months of marriage they had not become pregnant, while Jane reflected on her husband having to tell family about her surgery for an ectopic pregnancy: 'Once they know that you've gone through that, they know you're trying, so then you've got this delightful added stress of everybody knows that you're trying and everybody wants you to have them 'cause they've been waiting all these years. So it suddenly became very public'.

Parents who conceived spontaneously often commented on how long this had taken. For some, conception was unplanned (see Anticipating becoming a parent) including Alice who became pregnant at 17 when antibiotics she was taking reduced the effectiveness of her oral contraceptive pill. Others who planned to try for a baby said the time taken to conceive ranged from 'straight away' to several years.

Anna and her husband were not 'in a hurry' to conceive. It took two years of trying and just as they were about to get a referral to a fertility specialist they conceived their baby.

A few people described conceiving spontaneously after undergoing IUI or IVF - usually welcome news, although a 'shock'. After conceiving their twins via IVF, Andrew and his wife had a daughter whom they described as their 'freebie'. Andrew who had a child from a previous marriage described his wife's reaction: 'Not having been able to conceive naturally, and then it happening by chance, it was a very positive thing for her - "My body's doing what it should be doing"'.

Tina and her husband tried to have a baby for six years in their home country, Iran. They had several cycles of IUI before deciding to explore adoption, but then conceived spontaneously.

Many parents experienced difficulties conceiving for physical reasons. For women, problems included polycystic ovarian syndrome (PCOS), fibroids , blocked or missing fallopian tubes (including as a result of past surgery gone wrong), advanced age of eggs, and recurrent miscarriage (see Experiences of miscarriage). A couple of mothers mentioned being advised that earlier endometriosis had possibly contributed to their fertility difficulties.

Male fertility problems included issues with sperm motility (speed) or morphology (shape). Sometimes the cause of fertility problems could be clearly attributed to one partner or the other. Josie recalled fertility testing revealed her eggs to be 'okay' but problems with her husband's sperm motility and morphology, while for Jane and her husband it was her eggs that were the 'problem'. For others, there was no clear 'diagnosis' of the causes for infertility, as Michelle and her husband, now parents to one child, experienced: 'It's just one of those unexplained fertility things. I actually have PCOS so that's probably a factor. On his side - morphology - the shape of his sperm, it was a little bit on the high side. It's just one of those things. I have a few issues, he has a little issue and yeah it just doesn't ... but nothing major'.

Sara L described how polycystic ovarian syndrome made it hard for her and her husband to conceive, and their discussions around other options.

A few parents experienced secondary infertility - conceiving their second child took considerably longer than their first. Some people were not concerned about this, including Kate: 'Our second child was quite hard to conceive. I had several really awful miscarriages, which is not uncommon apparently. Our first child had been really easy to conceive but our second took a while and that was okay for a long time because we were sort of struggling with the arrival of the first anyway'. Others such as Louise found it 'really hard emotionally'.

Louise experienced three miscarriages between her first and second child, and felt this impacted on how she adjusted to second-time parenthood.

Several parents were unable to conceive on their own because they were single or in a same-sex relationship (see Anticipating becoming a parent). Single parents chose IVF (Sian), asking a friend to help them conceive (Kahli), or gestational surrogacy using an egg donor and a surrogate mother (Matthew).

Matthew explained the different options for having a child he tried before settling on surrogacy.

Mothers in same-sex relationships had to decide who would provide the egg and carry the baby, and choose between IVF or self-insemination and between a known or clinic-recruited sperm donor. Susanne and her partner opted for IVF and a clinic-recruited donor, while Lara and her partner chose to self-inseminate and use a known donor. Daniel and his same-sex partner considered several different options before deciding to have a baby via gestational surrogacy overseas.

Lara described the process of finding a known sperm donor who was willing to not take on a parental role, but would be happy to be contacted by their son if he wanted to when he was older.

Daniel and his partner considered several different options before deciding on surrogacy.

A few people who were unable to conceive without assistance (because they were single or in a same-sex relationship) also experienced physical fertility problems. Sian, a single mother of a four-year old boy, and a baby girl who was stillborn at 17 weeks gestation, had a particularly challenging experience.

Sian decided to undergo IVF as a single parent as she had not met 'the right person' by her late 30s. She then experienced a 'couple of early miscarriages' related to PCOS and a fibroid.

Parents who underwent IVF, although they were happy when they conceived, all found the experience challenging. Words people used to describe the experience included 'gruelling', 'draining', 'impersonal', 'stressful' and 'weird'. Several people also commented on the high cost of IVF. Most were relieved to conceive after one or two cycles, but two couples who were concerned about cost ended up implanting two embryos and gave birth to twins.

Erin reflected on the emotional impact on her marriage and her children of going through IVF to conceive her third child while her mother was ill with cancer.

Andrew and his wife underwent seven cycles of IVF before conceiving. After the first few they began implanting two embryos to 'try to increase the odds' and ended up conceiving twins.

Two men became parents (separately) through surrogacy using surrogate mothers in India, and one mother adopted three children from India after experiencing several distressing miscarriages, including with IVF. Along with surrogacy, intercountry adoption was expensive and complex. Surrogacy was particularly challenging when things went wrong due to a lack of support or guidance both in India and 'back home'. Nonetheless finally becoming a parent was a special moment especially after processes taking several years and significant sums of money - 'a deposit on a flat' as Matthew, a father of one, put it.

French described her experience of getting 'the phone call' about being 'matched' with three siblings in India for adoption.