IVF

The adoption process is not easy, but for some parents adoption it is their last chance at a family.

After 10 years of In Vitro Fertilisation (IVF) treatments, plus two and a half years of waiting in the adoption program, hairdresser Pina and her husband John were finally able to have that chance.

The Melbourne couple, are one of the lucky sets of parents who were able to adopt a baby boy 20 years ago. Both had wanted children since their mid to late-twenties and after exhausting all their options to have their own biological child, they turned to adoption.

The 10 years of IVF treatments had taken their toll on Pina physically and mentally, seeing her future continuously taken away from her, made her feel like the adoption process would be just another form of torture and in some respects it was.

Still, she felt she had nothing to lose and if IVF had taught her anything, it was that she was willing to risk it. Thankfully, luck was on her side and after 13 years of waiting, Pina and John welcomed a baby boy into their family.

Pina explains how the IVF treatments hurt her. “We kept making beautiful embryos, through IVF,” Pina shares.

“For whatever reason, they never stuck to me. However, I think there is a reason in life, why things happen – I was meant to have Damien.”

IVF is an intrusive procedure that has a success rate per fresh embryo transfer of 38.8% for live birth and 44.9% for clinical pregnancy (ages 18-34) and 32.2% (live birth), 41.7% (clinical pregnancy) for ages 35-38, ages greater than 38 it drops even further.

“They kept saying to me that there is absolutely nothing wrong, my husband had the low sperm count that’s the reason we went on it. As the woman, I had to go through a lot,” Pina recalls.

I was at the point where I thought, I’m not meant to have kids and that’s it, end of story.” It was then, Pina’s husband, John mentioned adoption.

Although adoption seems like a great back-up plan for a family, in reality, it’s a very complex system with the average wait time being between five and seven, if one passes the qualifying stages. Between 2018-2019 there was a total of 310 adoptions Australia wide, 82% were Australian born children and 67% of the 310 adoptions were from their foster parents.

With the increase in women’s rights and family planning and the resulting drop of children in the adoption system, means there are more parents waiting to adopt than there are children needing to be adopted.

Australia’s adoption policies differ depending on the States. In Victoria there are three kinds of adoption systems: local adoption, inter-country adoption and permanent care.

There are also only 13 partner countries with Australia for adopting children, each having independent rules and regulations which can restrict options. Factors such as being married, single, male or female, in a de-facto relationship, one’s age, gender orientation and sexuality can all affect one’s chances of adoption.

The local adoption requirements are less strict, for example a persons’ orientation or relationship status does not matter but there is a demanding application process which examines a person’s life in minute detail.

The biological parents learn everything about the adopting parents as well has gaining many rights, one of which is the right to visitation.

Even though we would be adopting their children, they still get to see them,” Pina says.

Pina didn’t have a problem with this requirement because she believes it’s important for a child, any person for that matter, to know their heritage to better understand oneself.

To be qualified and placed in the adoption program would take two years for Pina and John. As Pina says, “They wanted to get to know us better than we knew ourselves.”

Answering endless questions fuelled a gruelling and extensive qualification process. It was also yet another period of trying not to get their hopes up in fear of disappointment.

The final step, after 2.5 years of the application process, was an intimidating interview with a panel of lawyers, doctors, psychologists and Department of Human Services (DHS) staff.

Pina says she thought they were successful because of her view of it not mattering to her who or where the child was from, to her a child was a child and if she could supply the home then she would gladly do it.

Two months later, they got the call that they were to be the parents of a 4.5-month-old baby boy, whom they named Damien.

The first time I lay eyes on him, I just thought he was the most beautiful little baby ever,” Pina recalls.

However, their adoption story did not end there, it has always been in the background through Damien’s childhood, adolescence and even into adulthood.

Damien has known he was adopted from an early age. Pina took the approach to start filling him in as soon as he could understand.

Pina strongly wanted Damien never to question where he belonged, she made sure he knew he was a part of this family and nothing could change it.

I told him little bits and pieces and as he got older,” Pina says.

“He knows that he has biological siblings, and yes that was a bit hard, I did not know how he would take it. I suppose growing up he knew nothing other than us; we are his parents- this is his family. He never really questioned it and had no interest in meeting her (his biological mother) or his siblings.”

Although Damien never questioned who he was and where he belonged it was still difficult to understand why his biological mother gave him up, especially when she had children already.

Even though Damien’s biological mother hardly used the visitation rights, as she wanted a clean break, she has been in contact with Damien over the past 20 years.

In some ways it was more detrimental than good for Damien. Each time would raise his expectations, to have some sort of relationship and understanding, only to be rejected all over again.

Damien does not know who his biological father is, although he knows it is where he gets his aboriginal heritage. While having no information on the biological father has been challenging in having real access to the Australian Indigenous community for Damien, both Pina and John made sure he was in touch with his cultural heritage.

“Adoption is a gamble. Any child is a gamble. Whether you adopt or whether you have one biologically. They can grow up to be the best, they can grow up to be the worst they can grow up to be anything,” Pina explains.

It has nothing to do with whether you gave birth or not. In the end it’s all the same.”

Adoption and its process are not for the feint hearted but if fate is on side it’s the best chance at having a family.

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Recent years have seen an increase in the number of women freezing their eggs for future use, establishing a trend that can be seen across every state in Australia. Over this time clinics themselves have also made information regarding the processes behind egg freezing and IVF more accessible to the wider general public.

In the two years from 2016 to 2018, national Australian IVF clinics have seen a 48% increase in the number of women freezing their eggs. This incredible increase of nearly double that of previous years has been the result of a number of social and economic factors, as well as the increasing knowledge of the methods behind the process of freezing eggs.

What is egg-freezing?

Originally, freezing eggs was an option available for oncology patients who were about to undergo cancer treatment, designed to protect their chances of fertility in the future. However, over the last 20 years there has been an increased interest in egg freezing by the general population. Treatment is now available to anyone, regardless of health conditions or potential future fertility problems. As women have a finite number of eggs, which decreases dramatically after the age of 40, egg freezing has become popular for those choosing to start families later.

Frozen eggs can be stored for many years; in some cases, a pregnancy has even occurred after the eggs have been frozen for 14 years. When women are ready to use frozen eggs, the eggs are warmed, fertilised with sperm and then if an embryo develops it will be transferred to the woman’s uterus through IVF processes.

Why are so many women considering freezing their eggs?

In times gone by, the majority of women were married and had started a family by their twenties, with only 23% of the female population in 1991 having their first child over the age of 30. This figure has since increased to 48% by 2016. While the prime fertility age for most women being on average between the ages of 20 and 35, some women are not ready to become mothers at this age.

There are a number of reasons for this. Some women have not met the right person who they would like to start a family with, others have chosen to focus on careers and establish themselves in businesses which (depending on the individual) they feel leaves them little time for both dating and motherhood. Other women who would consider having children may have experienced a change in relationship status or the ending of a long-term relationship, and are re-assessing when they will meet someone new who they might want to have children with.

The process of freezing eggs

Women undergo a self-administered hormonal stimulation for 10 to 12 days which enables 6 to 15 eggs to mature. Stimulation comes in the form of an injection which can be done at home after instruction from the clinic. The only currently known side effect from the stimulation is cases of mild bloating.

The eggs themselves are then collected from the ovaries using a probe guided by ultrasound. This part of the procedure is carried out under light-to-general anaesthetic, with the patient usually allowed to go home one to two hours afterwards.

Once the eggs are in the laboratory, they are frozen through a procedure called vitrification. Vitrification involves the rapid freezing and extraction of all fluids to prevent damaging ice forming on the eggs. Once this is completed, the eggs can be stored for many years.

Pregnancy rate after freezing

Success depends on the quality of the egg at the time of freezing. The health of eggs can be negatively affected by:

Age and individual genetic makeup.
Smoking, poor diet and obesity.
Chronic medical conditions (including diabetes and high blood pressure).

On average, for every 10 to 15 eggs that are frozen by someone under the age of 35, 1 pregnancy could be expected. For women 35 years old and under, 1 stimulation cycle (collection of 12-15 eggs) will produce between seven and nine eggs suitable for freezing and storage

Approximately 80-90% of these eggs survive the warming process.
Approximately 50-80% of those surviving eggs would fertilise.
Approximately 80-90% of fertilised eggs develop into an embryo.
1 single embryo has a 20-30% chance of developing into a pregnancy.

A simple blood test can be done when a woman is in her thirties to assess her fertility before undergoing egg freezing. However, IVF Australia reminds us, don’t leave it too late!

Financial Costs

Medicare and other government subsidies are available, but they will only pay for fertility treatment when there is a medical indication. Individual cycle costs vary according to circumstance as well as clinics across the country.

Mahsa Fatantoni of NewsDaily did an investigation into the costs of the procedure in 2018. Her figures indicate the following:

Between 2016 and 2018 there was a 48% increase in the number of women freezing their eggs.
In Melbourne clinics their patient numbers doubled in the space of two years.
IVF Australia in 2018 cost $6885 per cycle of freezing.
- This did not cover the cost of the hormonal stimulation which can run into the $1000s.
- There is an additional $500 per year storage cost for the eggs
- The cost for thawing, fertilising and transplanting the eggs (IVF) is $3650.

These figures vary from clinic to clinic, with Melbourne IVF costing nearly $2000 more for the egg cycle than IVF Australia, but with a lower per year storage cost.

IVF Australia’s medical director, Associate Professor Peter Illingworth, says,

If women wish to freeze their eggs, they should regard it as a backup and not as the main plan.”

Dr Rozen of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists says that it is not usually necessary for young women, particularly those in their early twenties, to freeze their eggs as they usually fall pregnant naturally.

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