From shame and grief to joy and gratitude: four experiences of IVF in Catalonia

It’s estimated that one in every ten children born in Spain are born after assisted reproduction treatment, and despite the number growing year after year, there’s still a lot of stigma surrounding getting fertility treatment and infertility. 

According to the World Health Organization, around 17% of the adult population around the world suffer from infertility, which is defined as a disease where the reproductive system doesn’t manage to achieve a pregnancy after 12 months or more of trying.

Montserrat, age 37, is now pregnant with her first child through an egg donation after having gone through multiple rounds of IVF that all resulted in miscarriages. She explains to Catalan News that it’s important for her to share her story with infertility in part because some people don’t treat infertility as a disease, but almost as a luxury problem not to be taken seriously.

“I think the topic of fertility treatments needs more attention because it’s still frowned upon, especially by older people, and people don’t understand how long and painful this process is,” she says. “After two miscarriages after IVF, I went into a deep depression, it was a very painful time.” 

When Paula, aged 40 and currently expecting to be a single mother to her first child after a long road of failed IVF processes, got the news that she was infertile while in an abusive relationship, she felt alone and “deeply defective.”

“It was hard getting the news that I was clinically infertile, I felt alone and a lot of shame and guilt,” Paula says. “I started looking for stories – I needed them – about people who were infertile and who spoke about it, there were so few because there’s a lot of shame.”

Montserrat says that one of the problems that creates a vicious cycle of stigma and taboo is that people tend to only talk about the positive things about a pregnancy: “Everyone talks about becoming a mother like it’s easy. ‘I had a child; I became pregnant, I gave birth, and that’s it.’ We never talk about how complicated it is to get pregnant, to give birth, the postpartum period, breastfeeding…” 

“Grief is something that we do in silence, but we should be able to do it publicly,” Paula says. 

For Violeta, who is 38 and has a 17-month-old child after doing IVF, it’s also important to talk about men’s infertility. For a couple of years, she and her partner had tried conceiving naturally without any luck before finding out that her partner had a low sperm count. “I remember in the first test when we had results from my partner, the doctor saying this is incredibly common. Men's habits can influence sperm quality, very simple things like smoking less, quitting coffee, eating properly.”

Financial barrier

The mothers that Catalan News spoke with for this story all mentioned that money played a role in their decisions, both in terms of the price of fertility treatment as well as the cost of raising a child in general. 

Marta, 41 years old and co-parenting with an ex-girlfriend after giving birth after IVF, says that becoming a mother “has become a class issue.” “If you don’t have the money, it’s very difficult to move forward with a pregnancy and then raise a child.”

The cost of fertility treatment through the private system can also be a factor that prevents some people from having kids. At a private clinic, prices at the lower end of the scale can range from €600 for artificial insemination to over €5,000 for one IVF cycle. “We had to choose between buying a house and having a baby,” Montserrat says, a feeling shared by Marta: “You spend all the money you have to become a mother.”

Success far from guaranteed

IVF cycles and assisted reproduction are costly procedures that have no guarantee of success. In Spain, the percentage of IVF procedures with own eggs that result in the birth of a child are between 12% and 34%. The age of the person carrying the child greatly influences the chances of success, with rates significantly lower over the age of 40. With egg donations, the percentage is higher, between 43% and 46%. 

Montserrat ended up miscarrying three times in the first trimester all after IVF, and is now 31 weeks pregnant as she speaks with us. “It’s a process that wears you out a lot because it’s something that you want a lot, and more and more as time passes you will do anything to get there.” 

Violeta’s child is now 17 months old, but disappointment and frustration were also part of her process. “This is probably one of the hardest things I ever did in my life. You have to put injections in your stomach for a long time and you have to wait on lots of news, lots of very intense phone calls.” 

As well, Violeta received some “bad phone calls” during her process telling her she was not pregnant which left her “incredibly sad.” In her case, after her child was born, she says that “you tend to forget” this part of the process, as “the happiness replaces the previous nervousness.”

'Thankful'

Despite the ups and downs, the high costs and sacrifices, through assisted reproduction, two of the women Catalan News spoke to were able to have children already, while the other two are approaching their due date.

Montserrat says she is “so thankful for that person” who donated an egg to her. Yet, she admits she spent three days with mixed emotions that her daughter won’t look like her and won’t have her features, but this was a feeling she soon overcame, with the emotions overtaken by the joy of having a child. 

For Paula, becoming a single mother thanks to assisted reproduction is a way of breaking stereotypes of what a family should look like. “I love the subversive potential of assisted reproduction when it comes to the traditional type of family.”

When telling friends and family about her pregnancy, she tells of the inevitable follow-up questions of who her partner is, and how she is happy to be direct in her response, “because I think we have to break these barriers.”

'Be prepared psychologically'

All the women interviewed for this story agree that there’s still much more that we as a society need to know and learn when it comes to assisted reproduction, from how bodies work to the hardships of fertility treatment.  

“I have learned so much about how it actually works and I still have thousands of doubts of how my period works, and I’m 38,” Violeta says. 

Montserrat was eager to give advice to those who are considering seeking fertility treatment: “I want you to be prepared psychologically and have a great support system because it’s really hard - both on the person who’s pregnant but also the partner.” She also thinks it’s important to research all the different clinics “because it’s a business and there are so many clinics and all of them treat you differently.”

Montserrat had further criticisms about the “impersonal” treatment she received at clinics. “It would be a different doctor every time, they never remembered our medical record, and when you’re going through a process like this one with a lot of medication, stress, two miscarriages, two operations… I was actually very depressed and I was seeing a psychologist. 

For Marta, although she felt well monitored during the fertility process, she didn’t feel the same support once the embryo was transferred. “The clinics and the doctors abandon you through the hormone process and the process you have to follow to get pregnant. They do the in vitro or the transfer and suddenly there is silence for two weeks where no one tells you anything, you just wait. The silence is awful.”

For Marta and Paula, expanding our understanding of who gets assisted reproduction and what a family can look like is important. I think it’s good to explain that it’s not only for people who have fertility problems but also for those who simply want to become a mother, this option exists,” Marta says.