The knots of infertility

This morning, I was invited back on to breakfast television to reprise the argument I made on the programme last year regarding the NICE guidelines which recommended that infertile couples should be given 3 cycles of IVF on the NHS.

Since then it transpires that over three quarters of NHS trusts are disregarding the guidance, leading NICE to issue even stronger advice forcing Clinical Commissioning Groups to implement their IVF guidelines, to end the ‘postcode lottery’ system which produces massive inequality in terms of how qualifying couples are treated.

In this instance inequality is not an inappropriate description of the situation. The NHS should provide an equal standard of care across the country – if it has determined that infertile couples should be afforded 3 cycles of IVF treatment then that should apply to you regardless of whether you live within affluent city suburbs, in a remote part of the country or on a run-down council estate.

If IVF is an accepted medical treatment on a par with chemotherapy for example, then it should not be withheld from anyone because their local health trust has decided that they cannot afford it and their priorities lie elsewhere.

The trouble is, of course, that whilst IVF is a medical treatment, opinion is massively and legitimately divided as to whether or not this ought to be funded by the NHS, given that infertility in and of itself is not a fatal, life-threatening or even life-limiting condition, unless one extends the medical definition of life-limiting to encompass quality of life issues.

That’s not to downplay the devastating effects of infertility which can undoubtedly cause emotional ill-health, but simply to note that an inability to conceive won’t actually kill you neither is there any research to prove that it might shorten your lifespan.

This certainly seems to be the view that various CCGs have taken faced with increasing budget constraints and difficult decisions as to where to channel their funds, and its one with which many of us will have sympathy. If the choice is between paying for drugs to extend the lifespan of a cancer patient, a hip operation or heart bypass for an elderly patient and whether or not to fund a form of therapy which could lead to a couple having a much wanted child, then for most right-thinking people, the choice is clear. Our priority should be with assisting the already-living and vulnerable rather than ignoring them in favour of creating their replacements.

As I pointed out last year, NICE guidelines have a habit of becoming quasi-legislation and thus last week former health secretary Andrew Lansley (responsible for the stealthy and undemocratic liberalisation of abortion law) has said that CCGs have a responsibility to obey NICE rules despite the fact that they are not actual pieces of legislation. Spot the inconsistency. In the eyes of Mr Lansley, NICE comes before the letter and spirit of the law.

So slowly but surely, British law has introduced and supported the notion that a child is something that every single person or couple should have a right to and for which the state  should pay. Consider the language of Sarah Norcross, co-chairman of the National Infertility Awareness Campaign who says “it’s high time that patients were allowed to access the treatment that they were entitled to”.

The ethics of entitlement and so-called equality therefore override any other considerations. If you are entitled to medical treatment on the NHS, then you should be given it regardless of other factors. If not being able to have a child is automatically designated as being a medical issue, because it takes clinical measures to achieve one, then it’s some kind of ‘ist’ or phobic to deny the treatment to someone, taking into account their lifestyle or individual circumstances. The needs of the adult are paramount, the needs of the child secondary – all that’s needed is love and the desire to access costly and gruelling treatment is sufficient evidence of suitability and should overcome all other considerations.

Apologies for beating the same allegedly homphobic drum, but recent HFEA stats show that there was a 36% increase in lesbian couples using IVF between 2010 and 2012. No matter how much sympathy one may or may not have for two women deciding to disregard a child’s right to a father, it’s not bigoted to ask whether or not this is really the sort of thing Bevan had in mind when he put in place the founding principles of the NHS? Should a single man or woman have the same right to access this treatment as married opposite gender couple? If resources are scarce, and IVF is going to be an accepted treatment, is it really so heinous to prioritise the married couple in a stable relationship who have been trying to conceive over a number years and have suffered a number of miscarriages over other scenarios? Or does the defining zeitgeist of equality mean that all situations and circumstances have to be treated equally regardless of merit? To say that one person may be more deserving of another, whether that be in the field of IVF or the even more controversial field of welfare and benefits, is today’s unspeakable heresy. In our relativistic world no one set of circumstances must ever be judged as being better or worse than another.

Another unpalatable fact that no-one seems to want to discuss when discussing the ethics of IVF on the NHS is the ethics of IVF itself. So when I attempted to point out that for every live birth that comes about due to IVF, another 30 embryos are created and that of the 4 million embryos created since 1991, only a tiny proportion have made it through to birth – this point was brushed aside. The discussion has to centre around the ethics of the treatment being made available for free, regardless of whether the treatment is in itself ethical.

I don’t know what is more frustrating, the entitlement culture, the disregard for the welfare of children or the wilful short-sightedness. Any other expensive treatment costing around £3.5K to £5K a time which had a less than 25% chance of success would not see NICE attempting to impose it upon CCGs as a matter of routine, especially when the treatment itself is so physically and emotionally demanding. It would instead be allocated according to individual circumstances.

As I said on the programme, it seems that we’ve got ourselves in something of a pickle with regards to fertility. On the one hand there’s couples crying out for IVF and the opportunity for a biological child of their own, on the other almost 200,000 abortions take place in the UK every year. Added to which abortion rates amongst women in their ‘30s and ‘40s are rising as women believe that they are no longer fertile.

It’s time for some joined-up social policy thinking on this issue. We know that with a little bit of training women can be trained to monitor and track their monthly cycles and pinpoint with a high degree of accuracy the fertile periods every month.

Women are given so many mixed messages and conflicting signals about their own fertility it’s not surprising that so many of us fail to navigate successfully through the reproductive minefield. Instead of teaching young women how to avoid pregnancy and that sex can be devoid of consequences how about teaching girls (and boys for that matter) the specifics of how to track female fertility. Instead of teaching them that fertility is an obstacle which must be suppressed via chemical hormones and abortion a useful and necessary back-up, why not help them to empower themselves in terms of learning the ebbs and flows of their own unique monthly cycle.

Armed with that information, they can then make the decisions which they feel are most appropriate, especially during the window of peak fertility. Tracking monthly cycles has another advantage in that it enables abnormal cycles or potential issues and barriers to conception to be identified and treated.

If the NHS is serious about wanting to tackle infertility, then instead of chucking money at what is a not very effective sticking plaster, a more pragmatic and cost-effective solution is to enable both women and medical practitioners to become specialists in natural female fertility instead of attempting to artificially suppress it until such time as it might be needed and then attempting to employ a costly treatment with a 75% chance of failure.

Even more radical, instead of teaching young girls that pregnancy is to be avoided until an indeterminate date in the distant future, how about education that focuses their minds on real family planning and the pros and cons of early versus late motherhood? How about going a step further and implementing far better childcare and maternity solutions and options for university students. While we’re at it why not chuck in cheap starter homes for young couples and measures to make life more attractive and conducive for young families?

Unfortunately the genie is out of the bottle when it comes to IVF and it would take a heart of stone not to sympathise with women like Jessica Hepburn who was interviewed alongside me earlier. What I wouldn’t do to be able to wave a wand and give her a baby and find a method that was successful, devoid of harmful physical side-effects and didn’t involve the destruction of life. Disagreeing with the use of technology does not extend to blaming or shaming those who want to avail themselves of it.

Heartbreaking, unexplained and untreatable cases of infertility cannot be completely eliminated, but with a bit more joined up thinking, the need for both IVF and at the other end of the spectrum abortion, could be drastically reduced.

Catholics reading this might be aware that today marks the start of a novena to Mary, Undoer of Knots. Dedicating it to couples facing the pain of infertility seems a good place to start.

 

Culture Wars personified

As expected, my debate with Benjamin Cohen made it into the pages of Pink News. “Catholic disagrees with gay marriage, IVF and surrogacy” shocker! I’m not too bothered, several people expressed the perspective  that the whole affair was about Ben trying to mine some controversial quotes.

That said it’s probably worth clarifying a few points. It is not my point of view that Benjamin Cohen is transphobic and neither as the report claims, was I trying to infer that.

What I was trying to get out is that Ben (and others) clearly do have a problem with Tara and myself being friends which is why he originally intervened.

 

This is the nub of the matter – Catholic teaching on sexuality means that instead of attempting to understand and respect each other’s point of view, Tara along with any other LGBT advocate and myself should hate each other.

That we come together on issues of mutual agreement and that I make no attempt to hector Tara into accepting a Catholic vision of sexuality, completely undermines this narrative of Catholics (and me in particular) of being hate-filled spittle-flecked individuals trying to force or impose our faith onto other people.

There are two tactics going on here. One is to undermine our friendship by pointing out Catholic doctrine on sexuality. “How can you be friends with her, she thinks this, ergo she HATES you, ergo you must have psychological problems and be filled with self-hatred to be friends with such a woman”. Our friendship must not be accepted or validated as genuine, built upon principles of mutual trust, care and respect, but instead painted as deeply dysfunctional. It is hoped that this will have the effect of ending our friendship, enabling the hateful horrible homophobe narrative to continue to be perpetuated. It’s pretty hard to claim someone is filled with hate and loathing towards the LGBT community if they number them as friends. Actually Tara is not my only LGBT friend (I expect Pink News will ask them to all come forward and identify themselves) by any stretch of the imagination.  But then again as Ben Cohen has tweeted that any gays who oppose gay marriage for anyone other than themselves are homophobes, then a quarter of the UK LGBT population merit this label according to the Com Res poll conducted  in 2012.

The second, more disturbing tactic is to attempt to cut Tara off from the support of the LGBT community on account of her views. The whole point of this piece was to highlight a member of their community who is bold enough to publicly deviate from group think and hold her up for derision. While I roared with laughter at the piece, Tara’s views as presented seemed perfectly reasonable and mainstream and not at all outrageous or extreme, what concerned me was an attempt to undermine her job and political career, by rendering her controversial, toxic, untouchable, someone who causes upset.

Tara is not opposed purely to same-sex IVF or surrogacy, but to all of these issues as she explains in her blog. Although she has mentioned that she is an NHS diversity consultant, she never talked about her job or her employers on the internet, nor has she been anything other than crystal clear that these are her personally held views. Nonetheless her employers have been contacted for comment.

It is my understanding that the role of a diversity consultant is to ensure that employees and clients are not discriminated against by virtue of their ethnicity, disability, sexuality, gender or any other characteristic. Their job is to provide equal access to employment opportunities as well as client services and ensure that the workplace is doing all that it can to serve the diverse needs of the community.

A diversity consultant would have no say over whether or not services such as IVF should be available and if so how many cycles each couple should receive; these are policy decisions which are made by senior management and clinical staff. I have no idea whether the area of the NHS in which Tara works is even concerned with fertility treatments; she assures me this does not form a part of her role, but her professionalism means that even though she may disagree with IVF as a concept, she still needs to ensure that everyone who qualifies for it under the NHS is able to access it.

There is no discernible reason why someone who believes that every child deserves the chance of a loving mother and father and that babies shouldn’t be removed from their mothers, unless there is a compelling reason to do so, is incapable of working as a diversity consultant. Believing that the state shouldn’t conspire to engineer a situation in which children are removed from their natural parents shouldn’t impact upon one’s diversity and equality credentials.

When did we become so emotionally needy as a nation, that we are unable to cope with stiff differences of opinion or disagreement? The reason why people are agitating for Tara to be kicked out of her job is because they cannot bear the idea of a state agency employing someone in an official capacity who will not validate their desires. A couple who have used IVF or surrogacy might feel ‘judged’ knowing that someone employed within a particular NCT trust disagrees with a life decision that they have made and that would never do.

If Tara had expressed a belief in Jesus Christ, son of God who was crucified, died, was buried and rose again on the third day, people may have looked upon her perhaps rather indulgently or patronisingly, but it would have not have created the storm of outrage. Which is why the secularist lobby are keen to disassociate life issues from religious conscience, arguing that these beliefs are not integral to religion which should in any event be kept private. Only those who believe that LGBT are inferior human beings could possibly object to a child missing out on their mum or dad.

The only imposition going on here  is of one particular viewpoint or mindset as being acceptable for certain state employees. Since when did diversity mean sanctioning every single viewpoint as being equally valid? Since when did diversity not allow for believing that women are exploited by the surrogacy industry and that children should not be treated as commodities? Why should this view disbar you from working to help enable marginalised sections of society access appropriate services?

The only way to avoid damaging culture wars is to listen to and attempt to respect the views of other people, even if we do not wish to sanction or implement their ideas. Surely we can agree to disagree on some issues, while working together on areas of common consent rather than turn certain other groups into untouchables?

When Benjamin Cohen described me as an ‘anti-euqality campaigner’ he was disingenuously implying that I work hard to perpetuate inequality and suffering and trying to paint me as a singularly unpleasant person. I can live with the ostracism of Pink News readers, but it doesn’t really do much to foster positive relationships and raises the emotional temperature. This is the kind of attitude that makes people afraid to speak out for fear of being labelled as fundamentalists. Believing that marriage is not a matter of equality, does not mean that one considers other people as second class citizens and as long-term readers of my blog will remember, I have been criticised in the past by some quarters for my inherent support of the rights that civil partnerships accord and for wishing for these rights to be extended.

In my previous post I outlined precisely my position regarding surrogacy and IVF which is not based upon any wish to discriminate. I have no experience of infertility, I cannot begin to imagine how painful it must be not to be able to have children, but the existence of certain technologies or techniques in order to conceive them does not automatically justify their use. The argument is essentially a moral one about whether or not the ends justifies the means and the values we place upon human life. Can we do what we like in order to secure the outcome we want, regardless of the potential cost?

The most important thing to clear up here is accusations of being opposed to the Jewish religion as specifically alleged by Benjamin Cohen who states that I campaigned to stop liberal and progressive Synagogues from solemnising gay relationships. Firstly it’s worth noting that not all branches of Judaism support  gay marriage. Secondly, I did not specifically campaign to prevent Synagogues from solemnising gay relationships. I was part of an effort which campaigned to keep marriage defined as between a man and a woman in UK law. Synagogues, along with any other religious institution should be free to perform whatever ceremonies and rituals which their religion proscribes (with provisos surrounding physical harms). I do not adhere to the Islamic proposition that a man may have 4 wives, however I am not campaigning for Muslims to be prohibited from taking multiple spouses. Asking that the law reflects existing Judeo-Christian principles and only recognises marriage as one man and one woman, does not oppress religious freedom or prevent people from following different cultural or religious practices. Non-legal recognition or solemnisation of certain situations does not prohibit people from entering into them informally, nor does it make them illegal or against the law.

Yesterday Pope Francis tweeted the following.

He has also described gay marriage in far stronger terms than I, as being a move from the Father of Lies.

Anti-equality campaigner, opposed to Judaism, fundamentalist, or just someone who follows the teachings of the Catholic church as articulated by the Pope?

Kudos and prayers for Tara for her bravery. By daring to be friends with Catholics and supporting a pro-life point of view she has put her job on the line and has made an unlikely champion of religious freedom and rejected the frame of the culture wars.

Cheap IVF – a deliberate hindering of natural reproduction

I wrote in this week’s Catholic Universe column about the unholy trinity of three parent embryos ushering in a Brave New World in terms of reproductive ethics and genetically modified human beings.

One of the many disturbing facets of these advances in technology is the way in which the media reports them through an uncritical filter, as if all scientific and technological progress is automatically a positive development requiring much jubilation, without considering the wider ethical and scientific issues at stake. So today we see the BBC hailing the advance which means that the cost of IVF may be able to be drastically reduced to a mere £170 meaning that not only will it become affordable and open up the market to thousands more infertile couples, but also rolled out to developing countries in Africa who currently do not have access to IVF technology.

Not once does the BBC attempt to acknowledge let alone unpack the ethical difficulties in IVF and I don’t mean the obvious objection that we all have as Catholics. According to figures from the HFEA, since 1991 3.5 million embryos have been created, of which only 6% have resulted in pregnancies. Even if one doesn’t agree with the scientific evidence that a fertilised egg with its own unique DNA constitutes human life, that’s still a staggering amount of wastage. What are the environmental effects of this technology, which as the BBC reports, requires a large amount of carbon dioxide to be manufactured as well as large amounts of energy. Is this really a responsible use of our resources, especially when we know that IVF does absolutely nothing to diagnose or treat the underlying problems that are causing the infertility, it merely sticks a costly sticking plaster over the problem. Where is the drive to create a holistic solution, one that works with the body to heal and cure whatever it is that is causing the issue, something that doesn’t involve hyperstimulating the ovaries with synthetic hormones, overriding the body’s natural endocrine system, painful and invasive egg harvesting and the creation and destruction of embryos in a laboratory on an industrial scale.

It’s also wishful thinking that by dropping a few alka-selter tablets or whatever one has in one’s kitchen cupboard to manufacture cheap carbon dioxide that the cost savings will automatically be passed onto the client. This is all very dependent on the goodwill and charitable inclinations of companies who are assumed to want to avail themselves of the technology, re-equip their labs (which will come at a cost) and slash their profit margins. Only a few weeks ago, it was announced that time-lapse imaging can potentially dramatically improve the chances of a successful IVF cycle. Presumably this will come at a cost, so it’s naive to think that we’ll all be able to have IVF for the price of a return Easyjet flight to Rome.

We see almost everything that’s wrong with benevolent patronising Western attitudes towards our brothers and sisters in developing countries in the idea that by making IVF cheaper it may then be given to poorer nations and people, who are obviously in dire need of being able to manufacture babies in a laboratory. How does this fit in with the popular narrative that actually what we need to do is introduce and promulgate contraception into poorer nations in order to stop women from breeding and having vast numbers of children whom they are unable to feed, clothe and shelter.

Have we seen countries such as Ghana, Uganda and Cape Town crying out for assisted reproduction technology – where is the demand? How does the ability to manufacture babies actually help solve the causes and symptoms of poverty? How does growing embryos in a petri dish solve the problems of corrupt governance, of war, of terrible infrastructure, lack of decent transportation, medical care, supplies equipment and so on?

It’s almost as if we want to stop people from natural reproduction and to encourage them to use manufactured methods of contraception, buying into the Western notion that it’s better to delay motherhood. With cheap IVF it doesn’t matter if one has missed the window of natural fertility via contraception, it can easily be overcome and any abnormalities that may result in a less than perfect human being, be easily engineered away. Because recourse to IVF is going to the first thing on the mind of a unmarried childless African woman living in conditions of poverty, or an ageing married couple working every hour God sends in the slums, who have been persuaded that contraception couched in the terms of ‘reproductive freedom’ is the most responsible option.

Increased contraception and cheap IVF empowers neither women nor children, but encourages unhappiness, short-term relationships, desperation and infertility. It does however present a never-ending supply of customers for the pharma industry, who would be the real losers if everyone stopped using contraception, and opens up newer untapped markets. Poorer women are now equally able to avail themselves of the exploitation and lies of an industry that seeks to commodify and commercialise sexual activity, turning a basic human right and a natural ability into a consumer industry, something that we all need to buy. This is what happens when you divorce sex from its procreative abilities, the ability to control whether or not to have a baby is taken out of your hands, presented as something out of your hands and therefore needing to be regulated and controlled by other people.  Contraception has invited the state and capitalist industries into our bedrooms and reproductive decisions. We should not be looking to impose this on anyone else in the name of progress.

Joining the dots

I did a couple of media appearances yesterday (as my friend said, I’m getting to be like David Jason, always on the telly) regarding the revised NICE guidelines which propose that the NHS should now offer one free cycle of IVF to couples between the ages of 40-42. I didn’t get to expand upon my points about more effective techniques, ideally I would have liked to have discussed the success rates of NaPro technology and neither was it the forum to launch into apologetics surrounding assisted reproductive techniques.

Without going into a lengthy discourse as to the ethics and wisdom of IVF as a whole, one thing struck me as being missing from the entire debate. We, in the Western World have some very confused, peculiar and disjointed notions of female fertility, which are tied into the shortcomings of a society based on moral relativism, whereby personal autonomy is king and every choice is equally valid, regardless of consequences.

One of the recurrent themes of yesterday, was not that women were choosing to have their children late, simply that life didn’t pan out the way that they wanted – Mr Right didn’t turn up until their late ’30s and early ’40s by which point, female fertility is rapidly diminishing. Whilst on the one hand I totally sympathise, having made more than my fair share of romantic mistakes, I also think this must cause us to question the prevailing mentality with regards to female choice and autonomy, without wishing to remove any of those options from women.

Suzanne Moore makes some salient points here, not least emphasising the low success rates of IVF and echoing some of my themes around society’s attitudes towards the right age for motherhood. The Holy Grail of female choice, has paradoxically led to a situation whereby women feel that they have very little choice and control when it comes to the timing and amount of children. The everyday expectation for women is that following education they should go straight into the world of work, spend some time establishing financial independence and their career and only once secure should they then begin to think about potential offspring. The problem is that building up a successful career requires a substantial amount of time and effort which leaves precious little emotional and physical resources for the business of finding a life partner, which these days is treated as an optional extra to the all-consuming world of work and career. Add in the whole business of setting up and maintaining an independent home, it’s no surprise that most women aren’t really paying much attention to any sort of long-term game plan in terms of marriage and children. It’s all about surviving on a short-term basis, particularly in these days of austerity and hoping that the future will sort of magically fall into place, once everything else is established.

One of my suggestions was that women need to take into account the fact that fertility begins to decline frighteningly early at the age of 27, and begins to drop rapidly from the age of 35. Women (and men) need to be giving some thought as to starting their families earlier and we as a society need to be implementing solutions to make life more feasible for working women with children, seeing as we are in an economic situation which necessitates dual-income households. I also think that we need to readjust attitudes towards younger mothers, whilst no-one should be encouraging young teenage mothers, there is a palpable snobbery and distain towards mothers under 25. Whilst no-one should be making value judgements in terms of the age of parents, both the old and the young cohorts have their advantages and disadvantages, my experience has been that younger mothers tend to be much more flexible and adaptable in terms of their attitude to their children, and far less prone to stress as a result. Young mothers are less likely to have become perfectionist control freaks, stuck in their ways and tend to be able to take various setbacks or the less palatable aspects of childrearing in their stride, with patience and good humour – children being just the next exciting adventure. Having had a child in my twenties and then a progression of three in my mid thirties, each pregnancy becoming progressively more tiring, difficult and risky with age, I certainly think that youth has something of an advantage here.

Vanessa Feltz on BBC Radio London, felt that I was being overly prescriptive in terms of suggesting that women need to think about marriage earlier and it certainly could appear like a reactionary solution, but given not only the low success rates of IVF, but also the physical and emotional pain involved as well as the financial cost, society has little other choice and neither do women who need to accept that one day, it is likely that they are going to want to give serious consideration as to trying for a family.

Whilst Moore is indeed correct that society needs to be welcoming and accepting to mothers of all age, whether that be the teenage mother or the grandparent unexpectedly cast into a parental role as a result of unforeseen circumstances, she, in line with society as a whole, has got the whole issue back to front in terms of framing this issue of being solely about women, understandable when it is indeed women who bear the brunt of the responsibility for pregnancy and childbirth. The whole situation in terms of the growing problem of infertility, the costs of IVF and the rise in the age of the average first-time mother highlights the limitations of a society that is based solely around individualism and doing only what is right for oneself, in that our decisions always have some impact on others, especially if, as in the case of delaying motherhood, they result in others being asked to bear the cost.

Instead of thinking purely about women’s individual needs or even rights to have children, we need to start giving more consideration to children’s rights and needs in conjuction with our own.That children ideally need a loving mother and father in a stable relationship and with a permanent home is indisputable. We need to be putting that as our starting point, whilst factoring in that women have a limited window of opportunity in which they are able to conceive a child. That is not to usher people into hasty or unsuitable relationships, but that both sexes need to be giving the whole notion of finding a life partner, more thought much earlier than is currently the case. After all, who on their death bed, gives thanks for the hours spent in the confines of the office and which is a better legacy – a career as an HR manager or procurement officer for a paperclip company in Worthing, or a legacy of love and laughter in having brought and nurtured the next generation into being?

One of the whole perplexing aspects of this entire debate is that on the one hand women are being given a (worthy) ideal of being able to be in control of their reproductive destiny and then on the other, they are presented as victims who were passively and patiently waiting for Mr Right to come along. Actually I think there are several Mr Rights – Plato got this one wrong. Most women and men who marry older admit to having had several partners in their past with whom they could have had a happy and successful marriage and children, but that they had other priorities and lacked the maturity and desire for long-term commitment.

We have a situation whereby women are being enculturated into suppressing their natural fertility with long-acting hormones, (which take the body a long time to get back into sync and recover its natural rhythms of fertility), we have the NHS funding almost 200,000 abortions a year on the basis that it is not the ‘right time’ for a woman to have a baby and then on the other, they are shelling out copious amounts of cash for those who have unwittingly sleepwalked into infertility.

Female fulfilment is not solely to be found in the act of giving birth as feminists are always trying to tell us, some inelegant commentator tried to suggest that childbirth was no different to the act of defecation, but reproduction is clearly a sensitive issue that is innately and inexorably linked to our gender, which is why the feminists tie themselves in knots about it. Someone suggested that be it abortion or IVF, the whole issue is shrouded in blame in terms of women who have made the so-called ‘wrong’ decisions. Women are, according to this mentality, victims of their own Fertility with a capital F, either a rampant beast that needs to be tamed or an elusive will-o-the-wisp – but either way it should be ours to capture, pin down and use to our own ends.

Whichever way, we need to learn that we can’t have our cake and eat it too. The promotion of an ideal is not the same as shaming those who fail to achieve that, neither is it a judgement upon others’ morality, other than to note that scarce resources should not be spent on elusive and unlikely solutions that have come about as a result of a lifestyle choice, particularly when the condition does not cause an immediate and pressing threat to a person’s life, or impair their ability to go about their day to day life. The myriad of issues surrounding IVF is symptomatic of what results when sex and procreation are separated. IVF is simply a modern society’s attempt to find a solution for a self-inflicted problem. When are we going to join the dots?