Experiences of first trying to conceive and seeking help varied according to people’s expectations and knowledge about their fertility. Some people we spoke with who were in heterosexual couple relationships did not expect to have trouble becoming pregnant and sought help after they had tried for some time without success. Others recalled expecting they would have difficulties because of past reproductive or other health problems, prompting them to seek advice before trying to conceive or early in the process. Women and gender diverse people who knew they would need donor sperm were aware they would need assistance to conceive, whether via home insemination or IVF. After obtaining a referral from a GP, a necessary first step in the Australian health care system, most people sought help from a fertility specialist or gynaecologist.
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Claire recalls her first experiences of trying to conceive and asking her GP for a referral to a fertility specialist. Later, she learned she had endometriosis and ovarian cancer, both discovered during IVF.
Claire: I suppose when I first realised that there was a problem after we’d been trying to fall pregnant after about 12 months. Actually maybe it was a bit less than that; maybe it was around eight months. At that point I didn’t really know what to do. I asked a friend who they were going to and they said, “Oh, I’m seeing this person, this woman, and she’s really great. So maybe you should go – start there”. So then I went to my GP and got a referral to her. Being new to it I didn’t really know what was going on. So at that point that specialist said, “Let’s run some tests and we’ll see what’s wrong”.
At that point they ran tests with my partner as well as myself, and didn’t really find anything that they thought would be causing any problems. I later down the track found out that I had quite severe endometriosis but at the beginning that was never discovered. I suppose at that point too, I was starting to read lots of literature and everything as well, and most of the information that you get from IVF specialists is, “Well, we start off by doing tests, then we find out what the problem is and then we treat it. Then hopefully you fall pregnant.”
But, you know, so I kind of always anticipated that there would be some sort of solution that would get solved, which, you know, it took five years for that to come to fruition I suppose.
Interviewer: I’m interested to ask a little bit about the impact on your relationship with your partner. Once it sort of wasn’t happening as fast as you, or when you expected it, was it you or him that sort of brought up going for help?
Claire: I think – it was probably him actually that sort of thought that we should seek out what might not be working. Because we were testing when I was ovulating, doing everything by the book, yeah, having sex three times a day for the three or four days that I was ovulating to – or the two days; I can’t even remember what it is [laughter], to make sure that we were given ample opportunity. Yeah. So making your sex life, which was all fun and kind of carefree into timings of on the hour and then me lying down afterwards with my legs in the air for, you know, half an hour [laughter].
Skye knew ‘pretty early on’ that having PCOS could make it difficult for her to become pregnant. She and her partner are about to start IVF.
I think I first realised I would have some sort of issue pretty early on. I’ve never had normal periods and I was put on the pill at a very young age, I think from my second period when I was 14. That was because they were irregular and quite lengthy and I had quite heavy periods as well. So when I was in my mid 20s I decided I wanted to try and regulate my periods without the pill and that’s when I first went to see a gynaecologist about what I could do to get them regular. He advised me that I had PCOS and to stay on the pill until I wanted to conceive, so that’s what I did.
About a year later my partner and I decided we would give it a try and try and conceive. So I went through the process of getting off the pill and going on various medications to regulate my periods and also fertility tablets and things like that. Throughout that time with the gynaecologist, you know, I’d see him probably three times a month. He would do examinations, internals, ultrasounds, things like that to try and pick the best dates and that sort of thing to fall pregnant. So after maybe two years of that I – of us trying I had enough and I said it was too much for me and I was getting too – I think I was getting too emotional and it was just becoming a chore and not really a happy thing for me to do.
So then I decided to stop. Then my partner then and I split up not long after and so then I went back on the pill and didn’t try. So since then I’ve got a new partner and in the last year we’ve been discussing what we would do if we would like to conceive and we both decided that for my mental health it would probably be better that we seek help and look at maybe doing IVF because I don’t want to – I just didn’t want to go through that lengthy process again.
Tallace and her ex-partner, a trans man, initially tried to conceive via home insemination using a friend’s donated sperm. When this didn’t work, Tallace’s GP referred her to a fertility specialist.
By the time I actually was in a relationship and trying to conceive, I was 28, and I initially was trying to conceive through donor insemination at home. I was in a relationship with someone who was a trans man, and didn’t produce his own sperm, so we were technically ‘socially infertile’, and so I had a friend who was up for it, and we tracked my cycle, and did about six rounds of home insemination; which was awkward, but free. [laughter] But just didn’t work. I wasn’t totally sure why. At that point, my friend hadn’t had any kind of investigations about his fertility, so we didn’t really know why it wasn’t working, or perhaps we weren’t getting the cycle quite right; and I knew that straight couples wouldn’t be diagnosed as infertile until they had been trying for about 12 months. So I wasn’t too worried at that point.
I had to see my GP for a referral to a fertility specialist. At that time, my GP practice was like an LGBT specialist practice, so I’d say they’d be fielding these kind of queries regularly, and they were happy to help. I was the one… I identified the specialist that I wanted to see, and that was on the basis that she was accustomed to working with LGBT people.
My partner and I then began the process of IVF. Pretty arduous. That took a little while, as well. I had two unsuccessful IUI attempts. So then we were into the IVF stream, and it was at that point that I was diagnosed as having low egg reserves.
Kim’s journey to starting IVF on her own began after her marriage ended.
So I suppose I first started looking into this about three years ago when my marriage broke down. So I was married for quite a long time, never actually tried to have kids during that time but always wanted them. And so the event of the marriage breaking down kind of forced me to think about my age and what I was going to do and it was quite a catalyst I suppose for getting on with it and going to see a GP and trying to find out more about fertility and IVF because I thought that was my only option at the time.
Actually, no – actually I looked into adoption and fostering as well as well as IVF at the same time so I went along to a couple of information sessions on both of those. But kind of felt that the process was going to be too difficult or not exactly what I wanted going down those routes so then I came back to IVF. So I booked a consult with my GP, went along to my GP and said, “I’m this age, I still want to have kids, what do I do?”, so she referred me to a specialist just to have an initial meeting, do some initial tests.
I guess at that stage I didn’t really know much about anything. My first meeting with the specialist I was just like a deer in headlights, had nothing to say, didn’t know what questions to ask. She was lovely but could see that I didn’t really know what I was doing. So, yes, it was all a bit strange and I guess I was still quite emotional from having to deal with my marriage breaking down as well so it was all a bit confronting. I guess that I’d never really paid too much attention to my fertility or I’ve never had any checks or anything, any tests done before that stage, so it was all quite new and a lot to do process and a lot of decisions to make.
So, yes, I had a first initial meeting with my specialist. She sent me away to do some tests like blood tests and then ultrasound just to check hormone levels and physically that there was nothing immediately wrong. That seemed to all come back fine. It was just mainly my age really because I was 41/42 at that stage so obviously getting on a bit already. So I went back to her after my test results came back and she basically said, “If you’re thinking about this you should start straight away because of your age and go straight to IVF. There’s no point doing IUI.”