Dr Mary Mc Caffrey, FRCOG, Consultant Obstetrician / Gynaecologist at The Scotia Clinic, Tralee and Kerry General Hospital discusses the options available to single women planning a pregnancy.
While the majority of children growing up in Ireland are conceived in heterosexual relationships, the number of children being reared by single women is growing. Advances in medical technology, such as egg freezing and IVF, are making this option easier for women. The attitudes of Irish people are also changing.
Over the last twelve months Ireland has passed legislation recognising same sex marriage and the 2014 Rose of Tralee ‘came out’ as a gay woman; in doing so she provided the support for other to follow suit.
Traditionally, women went abroad for such treatments. Clinics visited by Irish women report a significant in the numbers of Irish women pursuing parenthood with donor sperm. As attitudes and acceptance change in Ireland, women are staying in Ireland for such treatments.
IUI with donor sperm
The option of donor sperm, which is placed in the womb in a controlled medical environment, is the most common option pursued by single women. Legislation ensures that the used is safe and securely acquired. At The Scotia Clinic the sperm used is imported from Denmark and is monitored and traced under the Regulations of the HPRA (previously Irish Medicines Board). Pregnancy Rates with IUI and donor sperm vary, depending on a woman’s age, from 20-33 per cent. Women take medications and are scanned to optimise the timing of insemination.
It is recommended that women check their fertility in advance to ensure the treatment is appropriate for them.
IVF with donor sperm
Very occasionally additional medical factors such as endometriosis, reduced ovarian reserve may suggest that IVF is required. IVF is a more technological treatment and incurs additional cost.
Embryo donation and adoption
For some women IUI or IVF with their own eggs may not be possible, usually as they are older. In such cases the option of adopting embryos stored in an IVF clinic can be explored. Some women or couples prefer to opt for using both donor eggs and donor sperm to create embryos – we refer to this as embryo donation. In most cases we work with clinics in Spain or the Czech Republic who have a track record in this area.
In recent times the technology called vitrification has enhanced the ability for freezing a woman’s eggs. Some women realise at an early point in their lives that they have not found their “lifelong” partner or that they will “go it alone” in years to come when they are ready for motherhood. Egg freezing is now an option. However, I would recommend attending a clinic with good expertise in this area. Having a check on Ovarian Reserve i.e. AMH blood test helps women to see whether they eggs to freeze. It is always best to do this at a young age (under 35).
Counselling prior to treatment
While most women /couples intending to undergo fertility treatments are content in their decision, it is a good idea to do a session or two with a Fertility Counsellor. This allows the parties to reflect on issues such as how to choose a donor and when to tell their children how they were conceived.
• Irish legislation, which is derived from the EU Human Tissue Directive, ensures high standards, well regulated fertility care in Ireland. Any clinic providing IUI or IVT must be licenced to do so and regular inspections take place. More recent legislation means that sperm donors will no longer be anonymous; some couples may now wish to link to clinics outside of Ireland.
• A wide range of fertility treatments exist and your fertility clinic can guide you on what is best for each individual.
• Counselling has an important role in making the final decision on single parenting.