Transcription
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Fertility Journeys introduction
Welcome to Fertility Journeys with Newlife IVF. Every fertility journey is different, especially within the LGBTQIA+ community. On this podcast, we’ll be sharing real stories as told by Newlife IVF patients, chatting about their journey and diving into the messy, heartbreaking, sometimes silly and often amazing world of fertility.
Our experienced medical professionals will also be on board to share their expertise and answer your questions. So strap your boots on, buckle up and join us on this wild journey.
Oh, and don’t forget to pack the turkey baster.
Episode 2: IVF for female same-sex couples
Emily Tresidder: Welcome to our second episode of Fertility Journeys with Newlife IVF. I’m your host, Emily Tresidder.
Last week we went through the basics of IVF and this week we’re going to dive in deeper to find out what it’s like for a female same-sex couple who are sharing their eggs. There’s more to sharing your eggs than reaching over to your partner’s plate at the local cafe. So we’re asking Dr Hugo Fernandes to give us the two-minute rundown.
Dr Hugo Fernandes explains intra-partner IVF
Dr Hugo Fernandes: As the name suggests, intra-partner IVF through egg sharing is when biological females in a same-sex relationship share or swap eggs in order to create a family. So typically, one partner will provide the eggs, which will be fertilised with donor sperm, and an embryo will be transferred into the other partner who will carry the pregnancy.
The process itself is pretty straightforward and is really similar to any other cycle of IVF. The first step is obviously to pick a sperm donor. The partner providing eggs then undergoes ovulation induction, which involves about 10 to 12 days of injections that stimulate the ovaries to grow follicles, and these contain eggs. These eggs are collected in a small procedure taking about 15 minutes. They’re then fertilised with the chosen sperm and they’re safely grown and monitored in our incubators for about 5 or so days. These are then transferred into the partner’s uterus in a procedure similar to a pap smear. For a successful transfer to occur, the uterus actually needs to be ready to receive the embryo, and we can do this in two ways. Some partners synchronise their cycles before treatment using the oral contraceptive pill, and this allows for a fresh embryo transfer to occur. If this isn’t possible or the cycles are out of sync, then the recipient partner can just have a frozen transfer at a later date. 10 days after the transfer, there’s a pregnancy test and hopefully you’re both on your way to becoming parents.
So intra-partner egg sharing is actually a really popular way for same-sex couples to have a family, because it means both partners are involved in the baby’s development and birth. One parent is a genetic mother of the baby and their partner is the birth mother. It’s also quite a useful way when there is a difference in fertility results or an age difference within the couples. The younger or more fertile partner can donate eggs to the older one, allowing them both to become parents. If there are no fertility or age issues, then the choice is purely a personal one.
It’s actually really common, however, for couples to have one child with one combination and then swap roles with the next child. Sometimes one partner prefers to be the birth mother and may carry her partner’s embryos on the first occasion and then have a second pregnancy using her own eggs. In all of these scenarios, it’s actually really common to use one sperm donor to fertilise both partner’s eggs, and in this way the children have a genetic link, which is also really nice, and that is how intra-partner IVF works.
Emily Tresidder: Thanks so much, Dr Hugo Fernandes. That was a spectacular explanation. Let’s go now to your interview with Ellie and Kate.
Dr Hugo Fernandes is joined by his patients, Kate and Ellie
Dr Hugo Fernandes: Welcome, Kate and Ellie. Thanks for coming along to the second Newlife IVF podcast. It’s the first time I’ve also met your beautiful daughter, Pippa. I’ve seen photos and she’s gorgeous and we’re here to talk about, I suppose, how she came about. I thought a really good place to start was for you to tell us how you guys met and how your story started.
Kate: I’ll take this one away. So Ellie and I met playing football, so we both started playing Richmond VFLW. God, it would have been 2016, 2017. And then Ellie, being, bless her heart, not the best footballer, didn’t continue on past her career and I’m still playing to this day, but it was probably good because we got together. And now, Ellie is my sort of number one supporter and comes to every game, obviously with Pippa, but, yeah, football has always been sort of the thing that’s connected us from the start, I think.
Dr Hugo Fernandes: And you’ve continued with football on sort of a professional level now, but you’ve moved on to a different career or being a mother.
Ellie: Yeah, yep. So I work at Beyond Blue in their corporate office, but obviously taking a year off for maternity leave, which so far has been the best job ever.
Dr Hugo Fernandes: Brilliant, and so it’s a few years you’ve been together. When did you start talking about children and families and what it was that you wanted to achieve?
Ellie: What, 24 hours a day?
Kate: Yeah, I started speaking about it on the first date, which I think is a very lesbian sort of thing to do but yeah, I think honestly very quickly – I think we both sort of knew that we were best friends, sort of immediately, and then from there it was just quite clear what we wanted to do. And yeah, we knew very quickly, but I think very seriously speaking about it during COVID.
Ellie: Yeah, so probably two, three years into our relationship probably got more serious and looking up clinics and trying to decide timelines and that kind of thing.
Dr Hugo Fernandes: And did you talk about how it would occur? Did you talk about, you know, where sperm would come from or how you saw this happening?
Ellie: Yeah, so we were always going to go with an anonymous sperm donor. Unfortunately, we don’t have any friends or anyone like that that would be able to donate but we were happy, happy with that. And it was always going to be me to carry, first, just with Kate’s football career, and then just deciding if it was going to be my biological child or Kate’s and me carry, and just going with that decision.
Dr Hugo Fernandes: Yeah, you guys have sort of a unique story, but it’s actually one very common to same-sex couples. So, as you’ve alluded, you can swap eggs, which we call intra-partner donation or intra-partner IVF, and that’s what you chose. So why did you go down that path?
Kate: A big thing for us with starting a family was that we all had a connection to feeling like a family. Like I was a little bit fearful, I think, before we started a family, that if Ellie carried with our first child, in particular with Ellie carrying her own egg and then me taking off to work and not having as much time with the baby, I was like, oh, is my connection going to be as strong? And I think that’s probably a very common theme among same-sex couples in that decision making. So this was the way in which we could ensure that we felt as much like just a traditional family as possible. And I have a really strong connection obviously with her now and so when I go to work and leave her with Ellie, looking at their connection, it doesn’t fill me with resentment, it fills me with so much happiness that they are as close as they are. I think that was super-important to us.
Ellie: Yeah, just the connection from the start, because being pregnant it’s kind of all about me, all about the baby, and it’s not like you would have felt left out. But it’s just been so good, it’s all been included from day one. This seven-week scan, it’s like I’m carrying it but it’s your biological child. It was just, yeah, super-special and we’re so glad we made that decision.
Dr Hugo Fernandes: And in your particular case I mean you’re similar ages and health and everything. So in your particular case it probably medically didn’t matter who went first. So this was a career sort of driven thing, yeah.
Ellie: So we did all the fertility testing we had talked about. I’m a couple of years older than Kate. If we happened to get the testing and I had really low fertility, I was going to carry my own egg and just get that done first, because I’m about four years older than Kate. But fortunately we did the testing and we’re really on par with our fertility, so we didn’t have to kind of make that decision. I had quite good fertility so hopefully the next time I’ll be ready to go.
Kate: Yeah, that’s right.
Dr Hugo Fernandes: And so there’s two ways I suppose that same-sex couples will do this. So sometimes there’s a swap where one partner provides the eggs and the other partner carries, but I’ve found that say for the second one, sometimes the partner who carries wants to provide her own egg. So there’s one person who carries for both. Have you guys made a decision on that, or is that something that you guys had looked into?
Kate: Yeah, so with my football career, and hoping that that continues, if my coach is listening, I’m open for a new contract extension. But if that continues, as I think it will, then that’s probably ruling me out for a few years to carry. And it’s always been important for us. I come from a family of siblings and Ellie’s an only child, so having siblings for Pippa is so important to us, and hopefully close together. So it just makes sense for Ellie to go again. She had a little bit of a tough pregnancy and a tough, tough birth but she’s really, really tough.
Dr Hugo Fernandes: Trooper.
Kate: She’s an absolute trooper. She’s ready to go again, so with her own egg this time, which will be really interesting to see sort of the differences between Pippa and the next baby, will be really cool.
Ellie: I think that the third one is definitely you.
Kate: Yeah, I’ve drawn the short straw.
Ellie: You’re doing it.
Dr Hugo Fernandes: Yeah, so I was going to say you have a few embryos and hopefully we can achieve the same with the second round. We know that they sort of remain frozen in time to use later. Is that something that you would look at?
Kate: Yeah. So I think, when it comes to the third time round, as I said, I’m one of three and I think it’s a really beautiful dynamic. My sisters are my best friends, so, yes, it’s okay. So having three is really important to me if I can convince Ellie after two, and so that would be me probably just using the embryos we have in the freezer to kind of go through the process.
Dr Hugo Fernandes: I often say to patients that we need three things to make a baby. So we need sperm, eggs and a home – so uterus – and we sorted out the first two. The sperm, you said earlier you’d always thought about using an unknown donor or a clinic-recruited donor. Why did you go down that path of sort of an unknown donor versus someone you knew?
Ellie: Essentially, we didn’t really have anyone that we thought would be suitable. Even someone that could have been, we just thought it might be easier in the long run, really.
Kate: Yeah, you make us sound like such a loner. We didn’t have anyone. We’d had so many options, but we just thought it would be clearer, cleaner cut not to have someone in our lives that has a biological connection to our daughter. So step-dad rocking up to the first birthday could be a bit strange. It was just easier I think.
Ellie: Yeah, we just wanted us to be the true mums and not have their biological father, and was just something we weren’t really interested in.
Dr Hugo Fernandes: Yeah, and a lot of patients do it for that reason. There is a slight time saving as well using clinic recruited, because we’ve already done all the testing etc. And so, with the clinic-recruited donor, how did you go about making the decision of who that was going to be?
Ellie: Yeah, so once we’d done I think the counselling had to be ticked off. Then we got the login for the online portal, we were super-excited for that.
Kate: The most exciting day of your life, I think.
Ellie: Yeah, we cracked the bottle of Veuve and sat on the couch and poured the champagne, and kind of opened it up and there was a good amount on there. There wasn’t as many, just it was coming to the middle, to the end of COVID. There was still a number on there. But essentially we logged in and the first one there was kind of tall, dark and handsome. I don’t think I ever got the credit card out so quickly, so we knew before even clicking into his profile that he was the one. So we opened it up and read through and we were just in shock of this person being on there. Even the personality traits were a mash of both of our personalities and looks-wise was just perfect. So that was the first one we opened. We of course went through the others that were on there, but straight away we knew that he was the one.
Dr Hugo Fernandes: So you mentioned the number of donors on there. It is hard to get donors in Australia, and in Victoria in particular, and so there’s only a limited amount. And when patients look on, I think they imagine there to be hundreds or thousands and you can pick eye colour and hair colour and height and education, everything about them. But it’s just not like that. So how did you feel with, I suppose, the number that were on there? How did you feel that there was only a certain number on there?
Ellie: Well, I remember actually chatting with you, Dr Hugo, and you gave us a realistic picture of what was going to be on there, because I’ve had friends that went through the process pre-COVID and they had 40 or 50 to choose from and you mentioned that it was like that quite a few years ago, but on there might be 10 to 15. So we had a good idea.
Kate: So we were primed and ready for that, I think, and we’ve had so many friends that have much less opportunities in terms of what they’re going through with different clinics, so we were actually really thankful that the 10 or so that were on there, we were like, wow, that’s more than we expected.
Ellie: Having the European donations on there as well was amazing because there was a couple on there which added to it and our donor was European, so that was perfect and we kind of love telling people that’s a little point of difference. Yeah, so we love that.
Dr Hugo Fernandes: So I think that’s interesting because I review the profiles and I obviously read them and I sort of think about them and go, how much is it to do with the look and the child or the person that you want to have, and how much is it you want by reading the personality and going, you know the personality is what I want and they don’t. You know the different eye colour or hair colour, but the personality.
Ellie: A bit of both, I think. I remember I read it. One of them was on there and this person was kind of a good height and you know, eye colour, hair colour that we wanted, but their personality was not like us. They didn’t like sport, they said they were quite quiet and shy in their personalities and so, yeah, even reading that was like, if we were completely desperate and, you know, we had to kind of pick out of a couple, but it was so good having more options because, yeah, that personality for us. Another couple might be like, oh, perfect, someone that doesn’t like sport and quite quiet that might be perfect for them, but for us being quite outgoing and sporty people.
Kate: We’d be lying as well if we said that tall, dark and handsome didn’t help Dr Hugo.
Ellie: No, I think that checked a box straight away.
Dr Hugo Fernandes: He was a particularly good one.
Kate: Yeah, thank you very much. We agree.
Dr Hugo Fernandes: And, Pips is gorgeous yeah. Fantastic combination. So with your actual, I suppose, all the medical side, it was a bit of a whirlwind. If you remember, we met mainly just for a check-up, really to assess fertility, and then you happen to get an appointment a week later for those results, and at that point had you already decided that you were going to proceed with IVF if there was sperm, or was it mainly we’re going to freeze eggs because of football?
Ellie: I think I was trying to get on a flight to Port Douglas, actually for a girls’ trip.
Kate: I was aggressively saying let’s have a baby now or yesterday, just with the football season. It would have meant if we didn’t, if we weren’t able to, you know, make the process as quick as possible, it would have been a whole another year. So Pippa still would not even be, you know, you wouldn’t be pregnant yet.
So for me, I was like, we got to go and we got to go now and we were so lucky. We didn’t think it would be literally possible to do it in the timeframe because it was a very small space of time we were asking for, but we were very lucky that we got you, Dr Hugo, and you were like, oh yeah, we’ll see how we can make this work, and it was really cool.
Dr Hugo Fernandes: So we sort of were two weeks off the point where we could start and it just happens that it needs about two weeks of counselling to use donor sperm, and that happened to be four weeks before the preseason started. And that was your thinking. In fact, I think your question was once I’ve done my egg collection, can I do football training like the next day?
We were able to just really quickly get everything done for you. How was the experience of going through that? It’s a big thing anyway, but the experience of going through it so quickly?
Kate: I absolutely loved it. I like things being efficient and neat and quick. Ellie probably would have loved, she loves an appointment – me not so much, but she probably would have loved to have seen more of you in person. Like this is obviously the first time we get to meet, being in COVID when we went through this but I loved it. I think it was so surprising how quickly we were able to get through this process, when we’ve had stories from friends that it’s taken one year, two years, three years to go through it. And here we are doing it in about six weeks. We’re, like, this just doesn’t seem real. So I was absolutely stoked.
Dr Hugo Fernandes: And you were obviously the one who was getting the injections and did the egg collection. So how did that go for you physically and especially with your work?
Kate: Yeah, it was a little tricky, but not as tricky as I thought. I mean, the injections were fine for me. I remember Ellie had to have one of the injections.
Ellie: Two, I had two. Two.
Kate: She couldn’t take them, but I was tough. They were totally fine for me. It did make me feel a little bit bloated and like a bit heavier, which obviously, being an athlete, it doesn’t make it easy to run around a football field when you’re bloated and heavy. And during that period, in those two weeks I was taking them, I also had our run test, our annual run test. I got a PB, though, so you know, it clearly wasn’t that bad.
Dr Hugo Fernandes: And how did you experience it?
Ellie: I was just awful at even giving you those injections. I just couldn’t work it out, could I?
Kate: No, it uncovered a phobia, I think.
Ellie: Yeah, but it was all good. Kate was strong and tough at doing the, probably what the 14 or so injections. I think I gave her the first one and then she just did it all herself. We had them all in the freezer. I think a friend came over for dinner and we’re like oh no, we’ve got to hide the injections behind the cabbage in the fridge section. So yeah, you’ve just kind of got to be tough, but I was… oh, it did hurt a little bit, but it was okay.
Dr Hugo Fernandes: And when you were, when you were going through this, were people aware? Were your family aware or friends, or were you just keeping it sort of within?
Kate: Much to their disgust, we didn’t tell anyone until Ellie was about 14 weeks pregnant. So we went through this whole process, probably nine months long, whilst you wait the first trimester and no one knew. Ellie’s nanny and my mum still hold it against us to this day that they weren’t part of the process. But yeah, we just kept it to ourselves as, again, we wanted to make it as similar to a traditional pregnancy as possible. And that was part of it for us.
Dr Hugo Fernandes: And so you were you each other’s support. Did you use other services? Did Newlife help you? Did you have to reach out?
Ellie: Yeah, so we leaned on each other a lot. I was so nervous, so anxious. Kate was the opposite.
She was very excited and I’m like, well, it doesn’t always work and Kate didn’t really kind of get that sometimes it doesn’t work, but Newlife were amazing, from the receptionists on the phone to staff at your office, Hugo, and the counsellors. Even when we got kind of officially discharged they were congratulations, seven weeks and good luck. Then we kind of sat there like, well, now what do we do? So we had to call back and they said, okay, now I’ve got to go to the doctors and they just kind of held our hand, which was amazing and yeah, it was all really good.
Dr Hugo Fernandes: So that’s actually a second bit that’s unique to your particular story. So when couples go through like this, we discussed during the consult that often, when the embryo’s created, the partner that’s going to carry often wants to have the embryo transferred in that cycle. The alternative is to freeze all the embryos and put them back, you know, at your convenience. The second is very much like a normal IVF cycle. The first one can be a little bit more complicated with medications, but it’s still reasonably straightforward. So why did you guys decide one way versus the other?
Ellie: I think we weren’t sure what was happening with COVID at the time, with wanting to freeze them. I had a girls’ trip planned to Port Douglas and I was still kind of hoping that was going to go ahead, so we were maybe going to have a few months of them in the freezer. So that’s why it was, yeah, it all came down to timing.
Kate: I remember that we were going to do it straight away, but then that didn’t quite work with her cycle. Like it might have been slightly too soon or something, so I think we ended up having to freeze them for a very short period of time, like two weeks, and then pull it back out.
Ellie: Yeah.
Kate: The lady on the phone was like we’ve never done this before, but it’s what works for our timeline.
Ellie: Yeah.
Dr Hugo Fernandes: Yeah, I think partly because we were doing it so quickly, one of the issues is we need to get both your cycles equal, and if they’re not equal it takes a month or so to do that and we didn’t have that time. And also, I think it gave you the opportunity to put it in whenever you wanted, which happened to be about two or three weeks later, when I saw it sort of come across my screen that you needed a transfer plan. So how was the transfer for you?
Kate: Yeah, it was good. It was the second time we’d been into the Newlife clinic at Box Hill and the first time when we went in for the egg collection, it was such a beautiful, beautiful clinic and we really liked going in there. Like I said, I like doing things face to face and not online. So yeah, going into the egg collection and then the transfer again I was petrified but yeah, it was all good. We kind of went in, it’s all super-professional and how the doctor calls kind of ‘you’re ready’, and it’s kind of like a scene on Grey’s Anatomy in there a little bit. I just wasn’t kind of expecting it, but it was all good.
Ellie: We were surprised with how efficient it was. It was kind of five, 10 minutes after you kind of strolled in, you strolled back out and they’re like yep, she can drive home, she can do whatever you need – it was just like oh wow, it was quick and easy.
Dr Hugo Fernandes: Yeah, I often say the transfer is the easiest bit of IVF and patients often ask, you know, what do we do now? And I’m like, well, you just be normal and act normal until you know what the outcome is. So how did you guys go through those two weeks before the test, the first pregnancy test? What did you do?
Ellie: I was laying pretty low, I think. We went just kind of on some walks and tried to act as normal as possible.
Kate: Yeah, they say you’re not meant to test until… I think we did about 47 home pregnancy tests.
Ellie: I didn’t want to.
Kate: Which we don’t recommend.
Ellie: I didn’t want to.
Kate: I forced it upon her. But yeah, that was exciting, kind of you saw the test and we know it doesn’t mean too much, but you saw the line getting bluer and bluer and bluer and bluer and so by that time Ellie obviously was so anxious that she was like it’s not real.
Ellie: It’s not real, it’s not happening. The drug is showing up, even though it was getting darker and darker.
Dr Hugo Fernandes: Until you got that blood test.
Ellie: Yeah, until I got the blood test yeah, I wasn’t counting. Yeah.
Dr Hugo Fernandes: And then I think there was a scan at seven weeks, and that was that.
Ellie: Again, I was very rude to the sonographer, acting like I hadn’t gone through three months of IVF. The shock I was in that there was a fetus with a heartbeat.
Kate: Yeah it was still disbelief I think for you, and even until, honestly, the third trimester was probably when you click, when they started being like, all right, what’s your birth plan? We’re like ‘oh, we’re going to have a baby?’. Like it was until then that we were like, oh this is actually going to stick, which I think you’re trying to protect.
Ellie: For me it was when we walked into the labour and delivery room and I was like oh, what’s happening? What’s happening now? This is where you’re going to have your baby. I was like, oh, okay here we go.
Dr Hugo Fernandes: It’s pretty real.
Ellie: Yeah, that’s when it was real.
Kate: That’s when we were wishing we had a made a birth plan.
Ellie: Yes, make the birth plan.
Dr Hugo Fernandes: But you just pushed on through, I suppose.
Kate: Yeah, exactly yeah, so it kind of just all turned out perfectly.
Ellie: Yeah, it did. She came perfectly. Two and a half weeks early.
Kate: It was really good.
Dr Hugo Fernandes: And so there’s, I suppose, two questions. So for couples going through this, what’s your advice about intra-partner IVF? Any advice you’d like to give?
Kate: Probably for us, I think the biggest thing is that we assumed for a long time, before we even met you, Dr Hugo, that financially it wasn’t going to work. Like it’s too expensive, it’s too hard, it’s too much time, it’s too much. Like it’s something that the super-rich people can do. And I think then we just assumed that we were just going to have to do a normal IVF and we’d come to that conclusion. But then, after that first meeting with you and you were like, oh no, it’s about the same price. And we’re like, what?
We’d spent years planning to not get what we wanted, to hear that, I think that’s why I then was like we’re doing this now. So maybe just ask the questions first. Don’t make any assumptions based on what other people have gone through, because the experience that other people have had is starkly different to how quick and easy, you know, our experience was.
Ellie: Yeah, and I recommend it to anyone looking into it, really. It just felt just so special from the start that you were involved, even though it was all about kind of me, me, me. But yeah, knowing it was your biological child, it was just special from the start and then just try and relax. That’s what I wish I did, and I’ll try to do next time, is try and think positive and not dread every day.
Dr Hugo Fernandes: And you had your own way of making a decision about sperm and sperm donors. You know the known/unknown thing. Do you have any advice for couples or women thinking about that process and how they should go about making decisions, or what should they think about?
Kate: Maybe the future and conversations you might be having with a 10-year-old, a 15-year-old.
Ellie: I guess the counselling sessions give you that space to have those discussions and they know all the questions to ask, like when the child gets to 18, they’re able to do this and that. Asking the questions with the counsellor, who would be able to help as well, rather than again asking for people’s personal experience because it’s going to be different to yours and then kind of just playing out all the options, playing out what would this look like, what would that look like, and that’s what helped us come to the conclusion that anonymous was by far going to be the best for us.
Kate: Yep.
Dr Hugo Fernandes: So, Kate and Ellie, thank you so much for coming on today. I was just wondering if you have any final thoughts, any final advice.
Kate: I think that the final advice, obviously I’ve said a few times, but just to not make any assumptions and just to ask the people that are the experts. And I don’t think either of us could more highly recommend a clinic than Newlife – everyone that played their role and knew their job was an absolute expert. We didn’t have to think about the financial complexities or the nursing complexities. It was just laid out to us in, you know, not doctor speak and that made it just so easy for us. So we could not more highly recommend, and we have, to a lot of our friends that are now going through the process, to go through Newlife because they were just amazing for us, and we will be coming back Dr Hugo.
Dr Hugo Fernandes: Thank you.
Ellie: See you soon.
Dr Hugo Fernandes: Thank you very much. We’re chuffed, and thank you very much for the kind words and I’ll see you soon.
Kate: See you soon. Thanks for having us.
Dr Hugo Fernandes: Cheers.
Dr Sameer Jatkar is joined by Emily Tresidder
Emily Tresidder: You’re listening to Fertility Journeys with Newlife IVF. That was Ellie and Kate talking to Dr Hugo about their experience of egg sharing.
Now for a short educational spot with Dr Sameer Jatkar. Sameer, what’s the difference between IUI and IVF, and why is IVF used for intra-partner treatment?
Dr Sameer Jatkar: So broadly speaking, the fertility treatment options for same-sex couples who are both themselves able to produce eggs can be either intrauterine insemination or IVF. Intrauterine insemination or IUI involves simply placing sperm in the uterus at a fertile time in the cycle, usually utilising frozen sperm. However, the fertilisation of the egg happens inside the body, so the provider of the egg is also the one who carries the pregnancy. The main difference with IVF is that fertilisation of the egg occurs in the lab, which gives us much more flexibility in who might carry the pregnancy and the time frame for that to occur. This is especially the case when there are two in the couple with both uterus and ovaries.
During IVF, medication is used to stimulate the ovaries to produce multiple eggs. When ultrasound scans show that the eggs are ready to be collected, this occurs under a light anaesthetic at our day procedure centre. Sperm is introduced to the eggs the same day and incubated to form embryos, which are usually grown in the lab for five or six days. At this point, embryos can be transferred into a different person with a uterus than the person who provided the eggs. This can either be done fresh, by synchronising both menstrual cycles with medication, or by freezing embryos and storing them for use later. The main advantage of intra-partner or reciprocal IVF like this is that both in the couple get to participate in the process – one is the source of the egg and the other carrying the pregnancy. It’s great when both can be involved in the process for starting a family. If one partner decides to be the source of the egg whilst the other carries the pregnancy, these roles could even be swapped for future pregnancies. So there you go. That’s why we use IVF for intra-partner treatment rather than IUI.
Dr Hugo Fernandes is joined by Emily Tresidder
Emily Tresidder: This is Fertility Journeys with Newlife IVF. On this episode, we’re exploring egg sharing between female same-sex couples. In this coming segment, Dr Hugo Fernandes and I get down to the nuts and bolts of the procedure.
Dr Hugo, it’s interesting that Kate and Ellie did everything so quickly. Is this process always that quick?
Dr Hugo Fernandes: So Kate and Ellie and I have often joked about just how quick the process was for them. They happen to be really, really proactive with all their investigations. It typically takes about a month of work-up beforehand to have all the blood tests and scans and counselling. And then IVF can follow straight after that – takes about two weeks. They just happened to come in at the right time, do all their tests and were very proactive with getting everything completed, and that’s probably what made it quicker than the normal.
Emily Tresidder: What does the right time mean?
Dr Hugo Fernandes: Generally an IVF cycle starts with a period. It takes three or four weeks to work up, do all the investigations as necessary. Many of these are done at the time of a period. So if you turn up to your doctor about a month out from the time of your period, then you’re at the correct time to get all these investigations done and we can get everything done and get you started.
Emily Tresidder: Which was the case with Kate and Ellie.
Dr Hugo Fernandes: Yeah, exactly, they happened to come in at that right time and then they’re very proactive. They also had the added pressure in that the football season was coming up and they needed to start pre-season, and so we made everything occur for them in the amount of time that we had. We were lucky that we’ve got a very proactive team at Newlife and we can make appointments happen around you.
Emily Tresidder: Fantastic, would you say that treating same-sex couples who are biologically female makes things extra tricky because of that synching of cycles? You know, we spoke about timing just before, or does it not really matter?
Dr Hugo Fernandes: No, it actually doesn’t really matter. The treatment for same-sex couples is the same as it is for a single woman or in a straight couple. IVF is IVF. The only process that can complicate matters if you want to sync up the cycles in order to have a fresh transfer. But there’s really no difference between having a fresh transfer or a frozen transfer. It’s just a nice thing to do, I suppose. If there’s no fresh transfer, then no, there’s no time delay at all and there’s no real difference in treatment either.
Emily Tresidder: Yeah, awesome. What would you say are some of the common misconceptions your patients have when it comes to intra-partner egg-sharing?
Dr Hugo Fernandes: So I think one of the main misconceptions is about the amount of time it takes to do and, as I’ve sort of alluded, it can be done as quickly as you want it to occur and we can work around you. The second is that this is an unusual process. Often patients sort of tend to raise the issue of you know, I’ve heard that you can maybe possibly swap eggs, to which I say, oh, this happens all the time. It’s actually a really really common thing to do in same-sex couples. Another one is probably to do with the cost of it. There’s a thought that, you know, it’s twice the cost because there’s sort of two treatments going on, but it’s not really. It’s actually not very much more than any other IVF treatment we do.
Emily Tresidder: Yeah, great. And I feel like Ellie and Kate certainly kind of touched on those misconceptions as well. They had basically the same sentiments going into their situation thinking, yeah, expensive and, you know, is this even possible? And it absolutely is. And it means that both people can be involved in the whole process, which is really lovely.
Dr Hugo Fernandes: Yeah, that was actually an interesting part of meeting them. They did come with these exact misconceptions, and they were really surprised every time we sort of undid one of those. And that’s partly why it went so quickly for them.
Emily Tresidder: On that, what would you tell someone that is considering intra-partner egg sharing or a couple that’s considering it, and what would you say is the best thing about intra-partner sharing?
Dr Hugo Fernandes: So I think the first or the most important thing is to talk before coming to see your doctor. There’s a lot of discussions about, you know, who’s going to go first, that you’re going to both share eggs. Sometimes one of the partners really likes to carry the child. Do you both want to do that? In which order are you going to do it, and are you happy to use the same sperm donor?
The second issue is to do with using donor sperm. If you’re choosing to use a known donor, that process can take three to four months as a minimum, and so have that in mind before coming to see the doctor, because we need to get that started before we can go anywhere near doing IVF.
Emily Tresidder: Yeah, so essentially once you find out that it’s a possibility, you then need to make the choices about how and which you’re going to actually make it happen.
Dr Hugo Fernandes: Yeah, and often they’re sort of drawn-out conversations that you have not under pressure, and as you get to know each other, you sort of know what way is going to work best for you as a couple.
Emily Tresidder: Yeah, absolutely. Dr Hugo, what do you think the best thing is about your role as a fertility specialist that gets to play a part in creating families for the LGBTQIA+ community specifically?
Dr Hugo Fernandes: Well, I mean, the best part is that I get to help make babies every day. And it’s always fantastic to hear about the new pregnancies and then to see them when they come back. As a gay man, I know that it was hard for me to have my own children and if I can make it easier and more straightforward and a streamlined process for others in the community, then that’s a fantastic thing to do. It’s also great just to make this a really normal and straightforward process and easier for families, so that we can create families just like anyone else.
Emily Tresidder: Yeah, absolutely. It’s so special and I mean personally you’ve had an experience of your own and now you have a family of your own, so you know first-hand how much it will mean to these families.
Dr Hugo Fernandes: Yeah, exactly, it brings a lot of joy to have children. They add so much to your life and to your family, and I think we should all be able to have children.
Emily Tresidder: Absolutely beautiful.
You’ve been listening to Fertility Journeys with Newlife IVF. To find out more about Newlife IVF, visit newlifeivf.com.au. And to find more episodes of the podcast, visit joy.org.au/fertilityjourneys or search ‘Fertility Journeys with Newlife IVF’ on your favourite podcast platform.
This podcast is produced on unceded Aboriginal land. We pay our respects to elders past and present as well as brother boys and sister girls within the LGBTQIA+ community.
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