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Monday 15 September 2008
Source: Journal of the American Board of Family Medicine.
Natural fertility treatment has been found to be far more effective than IVF.
A study by the University of Utah looked at over 1000 fertility-challenged couples who used natural procreative technology treatment or NPT.
What they found is that 25% of them achieved a successful pregnancy, a success rate higher than average 18.4% for IVF.
The study also found that NPT also resulted in far fewer multiple births with only 4.6% of women becoming pregnant with more than one child compared with 34% rate among couples undergoing assisted reproductive technology including IVF.
The research is that much more significant because it is the first ever into the effectiveness of NPT to be published in a respected peer-reviewed medical journal.
Joseph Stanford from the University of Utah in Salt Lake City who lead the study hopes his research would help overcome the "current information deficit" surrounding NPT.
He told the Sunday Times that "many GPs and obstetricians are not aware of NPT because of a lack of published studies," and that "now physicians can inform themselves of this treatment approach and hopefully recommend it to their patients."
Another fertility expert Phil Boyle who works at a natural fertility clinic in Galway also hopes this research will help doctors refer patients to natural fertility centers because "for some couples, IVF does not work and NPT does."
NPT is also a much cheaper alternative to IVF, costing about 4 times less.
So if you're interested in having a closer look at natural fertility treatments, a good start is The Fertility Plan » which is an excellent and instantly downloadable eBook on the topic. It's basically a guide to overcoming infertility naturally, containing very useful and up-to-the-minute information and tips even I never heard of about achieving a successful natural pregnancy. It also includes a free eBook called Preventing Miscarriage so you'll have all angles covered! For more on The Fertility Plan eBook click here » .jpg)
According to my naturopath who was intrumental in helping me achieve a successful pregnancy, you can take drugs (of the IVF variety) while on herbs, but according to my doctor you can not take herbs while on the drugs. Who is right and who is wrong? Both and neither.
What it comes down to is that when you've put an exorbitant amount of money (equivalent to the down payment on a BMW) in the pocket of a doctor and their clinic but only paid fifty dollars for a bottle of herbs, the strong inclination is to go with what the doctor said. It's a form of looking after your investment, making sure it gets a return. You can gamble with fifty dollars but not five thousand.
There's also the emotional investment. To undertake the rigorous and demanding IVF drug routine and procedures takes a lot of inner strength from you, unlike putting a tablespoon of herbs in a glass of water. So when subjected to the former the inclination is to do it as the booklet requires.
However, in terms of success rates for either approach on its own, there is overwhelming research to support either. It is what you feel comfortable with. I couldn't have thrown myself into the rigors of IVF in the early stages of my struggle to conceive, I just wasn't psychologically prepared for it and, whatever approach you choose, it is extremely important for you to feel right with it, to believe in it.
I have no doubts whatsoever that the herbal regime that I was on until succumbing to IVF played a major role in the success of IVF. The herbs cleaned out and toned out my reproductive system and in that way were immeasurably helpful.
So, IVF herbs vs IVF drugs - both have their usefulness and to my mind both played a role in the conception of my daughter.
To find out how herbs can help prepare for a successful IVF cycle, do have a look at Stacey Roberts' aka "The Baby Maker's" eBook ‘Herbs and IVF' here »
I'm convinced it was her ground-breaking formulas that got me across the line at my first attempt at IVF.
Jodi Panayotov
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What's wrong with this sentence? ‘Fertility Treatments may not produce more babies'.
Well for starters, as the reproductive equivalent of ‘Osama Bin Laden may not have caused September 11', it instantly upends everything those of us struggling to reproduce have believed until now.
In news fresh (9 August 2008) out of Scotland Aberdeen to be specific, researchers studied 580 couples and came to that conclusion. But how did they go about it?
They divided the group into three.
First a placebo group who received no treatment, except, and I can hardly stand this, they were counselled on "the need to have regular sex".
‘And what, doctor, do you mean by regular sex?'
‘You know, sir, the, ah, penis in the, how shall I put it? Er, vagina..yes, vagina. That method.'
Stunned silence as couple look at each other, thinking, who would have thought?
So there was a second group who took Clomid and the other who had IUI (artificial insemination where the sperm is sent kicking and screaming into the womb via syringe).
At this point it must be pointed out that all of the couples had been diagnosed with ‘unexplained infertility', otherwise known as ‘the too-hard-basket'.
It was the results that surprised, well, everyone. Especially the doctors. There were twenty-six babies produced with the help of Clomid, forty-three by IUI and an encouraging thirty-two produced by the people who'd apparently forgotten to have sex until they were reminded.
According to Allan Pacey, from the University of Sheffield, secretary of the British Fertility Society and king of the understatement, "It's not in the realm that you would expect it to be if these treatments were really performing."
Still, he conceded that IUI was useful in certain situations, especially with donor sperm.
Could this mean the end of Clomid as a fertility treatment? No, as it has long been linked to the successful pregnancies of women who have problems ovulating. Yet for others it may be more useful to spend the money on lingerie instead of filling a Clomid script.
During my darkest hours, when I thought I'd never be a mother, I turned to a number of shows for comfort that showed a sizable lapse in judgement on my part.
I have no way to explain it other than I was in an altered state of consciousness and these programs, obviously designed for people like myself, filled a kind of void.
The void was created when I gave up my job, my leisure pursuits and most of my friends in the obsessive pursuit of parenthood and there was something about watching shows like Jerry Springer, where a cast of freaks aired their cataclysmic lives on stage, that distracted me from my own impending madness.
The truth is, I was feeling like a bit of a freak myself and therefore identifying increasingly with his guests. Had there been a show entitled, ‘Women Who Can't Stop Taking Their Temperature and Checking Their Mucous', who knows, I may have signed up. God knows I needed to get out more…
A curious piece of knowledge I unwittingly gained when watching Jerry Springer, was that the vast majority of his guests had achieved parenthood in some shape or dysfunctional form. It didn't matter what their circumstances were, what shape or form their lives took, whether they were a pimp or a paedophile, they had an offspring or ten out there. If my memory serves me correctly there was even a man who had managed to impregnate an unidentified farm animal.
Now clearly either this show or the people who applied to be on it had some secret fertility ingredient that loving couples at IVF clinics missed out on. I don't know what it was but I do intend on studying the show further to find out.
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A guide for relatives, friends and acquaintances who wish to remain relatives, friends and acquaintances:
1. Just relax and it'll happen
2. It (the miscarriage) was meant to be
3. Have you tried having lots of sex?
4. You're trying too hard
5. You just have to try harder
6. Forget about it and it'll happen
7. You've left it too late
8. Don't panic
9. I told you that you should have started earlier
10. I can't imagine what it's like but then I fell pregnant first go with all four of my children
Further explanations that may be necessary for R, F and A's that still don't get it.
To make a point let's substitute the struggle to conceive with the struggle to pay off a steep mortgage, with a few alterations to the above comments.
1. Just relax and it'll happen
2. It (the large mortgage) was meant to be
3. Have you tried earning lots of money?
4. You're trying too hard to pay it
5. You just have to work harder
6. Forget about it and so will the bank
7. You've left it too late - you'll never be debt-free
8. Don't panic even if your house is repossessed
9. I told you you should have bought a house earlier
10. I can't imagine what it's like but then I own four houses and have mortgages on none of them
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Just when you think the odds are against you, think again. This true story is a triumph over everything that shouldn't have happened and did, an extraordinary beating of the odds. It's along the lines of a person cutting off their own head, eating it and surviving - just as strange, but in this case true.
Right. Take a seat while I try and work out where to begin. Pour yourself a drink if you're in between IVF cycles. OK, here goes.
A 57 year old woman, Susan Tollefsen from Romford, East London walks into an IVF clinic in Russia, hoping to have a child with her 46 year old partner. At this point her odds of achieving a pregnancy with IVF are zero with her own eggs, and, using the rates of success in Britain at private clinics treating women over 50, roughly twenty five percent with donor eggs.
She has already tried a few other ‘foreign' clinics over several years without success. She undergoes treatment and has 2 embryos implanted.
The first miracle occurs - she achieves a pregnancy but less than four weeks after transfer starts bleeding and miscarries. The odds of miscarrying at 45 or over are greater than fifty four percent.
Her GP confirms the miscarriage as does a negative home pregnancy test. (HPTs are 99% accurate in the lab but do have a higher rate of false negatives than positives).
Susan reluctantly relinquishes her dream.
Fast forward to twenty-four weeks later when she has been suffering from a swollen abdomen and presents at hospital with what her GP cited as a ‘hard abdominal mass'.
The fear is that she has ovarian cancer - the odds being high for a 57 year old with a swollen abdomen who has never been pregnant. It is the fourth leading cause of cancer death in women of this age.
She is fully expecting the sonographer to relay some grave news but instead he says, "Congratulations. You are pregnant." Thirty weeks pregnant to be exact and the baby is healthy.
Susan has now given birth to her first baby, a girl she has named ‘Freya'.
And if that's not a miracle, I'm not sure what is.
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Anger and infertility go together like a horse and carriage, love and marriage, like bad hair and Donald Trump. Don't let anyone tell you otherwise. Whilst there may be serene and blissful pregnancies the battle to conceive is anything but.
I don't think I was ever so cranky as when I was trying unsuccessfully to have a baby, culminating in the IVF process. And giving IVF drugs to an already emotionally fraught woman is like waving a red flag at a mallee bull.
For the first time in his life my two metre tall husband was actually scared of me. I'm not sure what he thought I was capable of but he didn't want to find out. Which is why, when we were halfway up the mountain on our weekend away and I yelled that we had to turn back as I'd forgotten my basal thermometer, he did. Without arguing. Just went a little pale before putting the indicator on and doing a swift U-turn.
In a past life, BTTC (before trying to conceive), it would have been out of the question but this was now, I was mad and he was nervous.
Not that I ever shared what was going on in my head or anything. No, I kept the homicidal thoughts towards pregnant women, people who blew smoke in their children's faces and power walking pram groups to myself. Nor did I share any of the ideas I had about what should happen to people who abused their kids, Courtney Love, Jordan and other abysmal celebrity mothers.
Then there was the small stuff - the ‘you left the light on', ‘you forgot to buy parmesan cheese' and so forth. It was quite fortunate by the time it came to IVF and no sex was required because there couldn't have been any with my moods, unless it was of the make-up variety. But you better get in quick, I just spotted a mould spot on the ceiling and it's making me furious.
Seriously though, why do we get so angry? And why do we get so down on ourselves for being that way? The answer to the second question probably lies with the fact that there is still some expectation, stemming from last century that women aren't supposed to get really angry. Bulldust!
All those 1950's magazines with the perennially happy homemakers, grinning whilst they ironed, beaming while they vacuumed, twinkling as they fetched their husband's scotch and slippers set some pretty warped notions of how we should be. Had there been IVF then, no doubt the woman would have been pictured there in backless gown and matching paper hat sunnily beaming her way through the egg pick-up, or smiling beatifically in wasp waisted dress as she injected herself with Puregon.
As for why we get so angry, well, aside from the sense of injustice that this is happening to us, and the lack of understanding and insensitivity we often experience from others, including loved ones, anger is a part of grief. A healthy part.
The grieving process comprises four parts - denial, anger, sadness and acceptance and when we suffering infertility which is something we struggle to deal with we will experience these emotions before we can either resolve or learn to accept the situation. Anger has as much of a role as sadness though different people experience each in different measures.
In accepting that anger is OK you can start to tame the beast, not feel so out of control with it. This doesn't means trying to suppress it - it will reveal its ugly head again later anyway, usually when you're at an important work party with your husband.
There are things you can do to take the edge off it - yoga, various forms of exercise, boxing, counselling, just putting headphones on and going off for a walk.
And if it's your partner that bears the brunt of it, talk. Tell him that this is how you are right now and it's not about him. It's about the situation. 
Unfortunately for him you can't shout at your ovaries or your IVF doctor.
The other thing to know is that it will pass, either when you fall pregnant or when you have worked through the process and reached a new place to be in.
Unlike Donald Trump who is stuck with his hair forever, you won't be stuck with the anger.
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The following is an article by author Allison Rushby who contacted me if I wanted to respond to her piece. My response follows. Both articles were published in the January 2008 edition of Australian Parents magazine.
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Allison Rushby suspects that naturally fertile women are the new pariah…
I am fertile. Disgustingly fertile. Pregnant within a few weeks of trying, no complications, full-term babies, first labour three hours, second labour 40 minutes, one girl, one boy. Like I said, disgustingly fertile. And I never thought I'd be marginalised for what is, of course, a very run-of-the-mill thing to be, but ever so slowly this is what seems to be happening. Apparently IVF is the new black. So, I wonder, what does that make me and my hard-working ovaries.
Suddenly terms like ‘smug pregnants' are being bandied about the place and the fertility goddesses are being accused of ‘flaunting' their pregnancies. Did I ‘flaunt' my pregnancies? I didn't think so. But if ‘flaunting' meant that I wore fitted maternity clothes rather than tent-like constructions, maybe I did. The thing is, at week 39, it's hard to hide three kilos of baby attached to your mid-section. The infertility goddesses may have snazzy Mercedes convertibles, but I'm hardly going to ask them to keep them garaged at all times just because I fancy having one too.
It's now so not the done thing to be fertile, that I had to stand by and watch recently as a girlfriend of mine hid her third pregnancy. She managed to keep her ever-growing belly a secret until the 22-week mark. And the reason for her reluctance to tell her family and friends? Her sister-in-law was in the midst of IVF round three and she was too scared to come clean about her fertility, having just had child number two nine months ago.
Of course, I don't think being unable to have a baby is anything even close not owning a Mercedes convertible. And I feel terribly for women who want children and suddenly find themselves in a place where it's looking like an impossibility. I have to admit I was shocked, however, to find myself the spring chicken of the private obstetrician's waiting room at what I thought was the grand old age of 29.
It seems that while there are lots women who can't start having kids till later in life for varied reasons, there are also many who can, but who are choosing not to. Instead, they decide to focus on their careers, or come to the conclusion, year after year, that it just ‘isn't the right time'. And there's nothing wrong with this - as long as you know full well what you might be giving up. Inconvenient and scary as it may be, the ‘right' time to have kids is during the early to mid 20s. Are we as a society starting to forget that our fertility peaks in our 20s? Perhaps if we spent as much time planning our families as we spend planning our mortgages, we wouldn't be in this mess.
In hindsight, I've realised I'm extremely lucky to have had children easily. It was only after I had my two that all the horror stories came out - women who gave birth to stillborn babies and had to spend the night in labour wards listening to other, luckier people's babues cry, women who miscarried time and time again, women whose babies mysteriously just stopped moving at 38 weeks. So, so sad.
The infertility goddesses accuse us of being ignorant of their plight, but I don't think this is true. The fertility goddesses know and we care. It's just that there's not a whole lot we can do other than listen, and when someone else has something you so desperately want - well, sometimes listening just doesn't cut it, does it?
I guess if I sound slightly riled, it's because I am. Like some of the infertility goddesses, I'm reaching the end of my tether. I'm getting tired of being stared at with accusing eyes that say I'm not really deserving of my children because I didn't struggle to have them. That I don't appreciate my kids because they came to me easily. Yes I'm fertile. Disgustingly fertile. I'm a fertility goddess. But please don't ask me to apologies for that.
Allison Rushby.
And my response…
I am infertile. I will always be infertile even though I've had a child. You see, I didn't have the child in the way nature intended. I had the child courtesy of that great 20th century invention, In Vitro Fertilization. And I consider myself one of the lucky ones, as IVF doesn't work for everyone. Many of those who sign up for it leave the clinic empty-walleted, empty-armed and broken-hearted.
Three percent of babies born in the western world today are the result of IVF and over one in six couples of reproductive age find it difficult to conceive. Yet until recently when the media has picked up on the issue, who would have known?
People certainly don't discuss their fertility problems. During the years I worked as a flight attendant I was the unwitting recipient of every gory birth story and every pregnancy tale told by my fertility goddess colleagues but not once did I hear anyone's infertility story. And I ask, why? Why, if it's kosher to be infertile, is it something you don't talk about? To not tell anyone you've had a miscarriage or are undergoing IVF? To not tell anyone how you've been trying for five years to have a child with no success?
I went on to write a book about my bumbling quest to become a mother, because of this and because there is scant literature available for those who struggle to reproduce. Whole shelves and even sections of bookshops are devoted to pregnancy and babies but you'd be lucky to find one book devoted to infertility.
To the pregnant women I lampooned in my book, I'm sorry. It was the IVF drugs I was taking, combined with the ragged mental state I was in after those years of trying to conceive. I know you don't all purposely flaunt your pregnancies, (those that do, you know who you are). Now that I've been pregnant and rejoiced in it, I can understand why you wouldn't want to hide it and nor should you. And I don't for a minute think that pregnancy wear should be confined to curtains for the stomach, i.e. smocks. Goodness knows there are enough fashion obscenities out there already without adding to them.
Yet I must explain on behalf of the other fertility-challenged women out there why we are like we are to the point of occasional militancy. Why we shun parties where there are young children or babies, why we can barely manage a smile when you say you're pregnant, why at times we can't stand the sight of you.
It's nothing personal, but it's borne of an aching emptiness, like a hunger pain that isn't confined to your stomach but cuts to your very soul. And like a hunger pain it gnaws at you day and night. We can't control it, it exists as part of our being and once unleashed it's impossible to bury it. There is no cure for it either, except of course a baby.
So when we're out and about the sighting of a pregnant woman or a baby is like a sighting of someone tucking into a hamburger when you haven't eaten for days. The pangs you feel are similar but a hundred times more intense.
If and when we do manage to have a child it is like being presented with a gourmet meal when you've been starving for a long time. It's only natural therefore to think that the person who's only been waiting a few hours for food perhaps won't savour and appreciate every mouthful in the same way. It's not based on fact but on feeling.
Had I known that my fertility would take off to an uncharted destination sometime in my thirties and not left a forwarding address, I would probably have done things differently, not attempted to get ahead with the mortgage and enjoy my career. How could I have known though, when nobody talked about it? Media coverage was practically non-existent and women's magazines focused on things like ‘Multiple Orgasm', not ‘Multiple Birth as the Result of Fertility Treatment'.
Similarly had I been offered half the information about miscarriage and IVF at work that I received about episiotomies, I'd probably be the mother of two teenagers now.
Yet many women don't have the luxury of choice. Factors way beyond their control contribute to the postponing of motherhood, for example finding a partner who has not only evolved to a Homo Sapien, but is willing to have children NOW.
So please don't judge us but listen to us instead. You've been talking for years and we've just found our voice.
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1. Buy and carry an extremely cute puppy. As there are more dog lovers than kid lovers in the world you will instantly attract attention away from smug pregnants and their cute toddlers.
2. Introduce the dog in a gushing cutesy voice as ‘my/our baby' which will stop people asking the whereabouts or existence of a real baby. Nobody ever said to Paris Hilton, "Nice dog but when are you having a baby?"
3. Consider having a T-shirt boldly emblazoned with the name of your fertility clinic, e.g., Monash IVF and wear it. That way people will instantly know where you're at without asking or else they will ask about what it means and you can tell them. Either way you will be educating a group of ignoramuses and that can't be a bad thing. Also guaranteed to give instant immunity to birth/baby story viruses.
4. Arm yourself with phrases like "Of course for our next trip to Paris we'll be staying at the Ritz. It's far more convenient to those fabulous magasins (shops) off Rue de Rivoli, the ones where Katie Holmes shops." or "What have I been up to? Well in between learning mandarin, setting up my art studio and planning my volunteers trip to Nepal I've hardly had time to scratch myself." 6. If someone says, "So when are you starting a family?" simply reply, "Good question. I have no idea but let me consult my herbalist, fertility counsellor, gynaecologist, clinic nurse and God. If any of they can enlighten me, I'll get back to you." 
7. In response to the oft and thoughtlessly repeated phrase, "Having children makes you less selfish," do not choke on your hors d'oeuvre or spit out your drink, as much self-restraint as this will require. Calmly point out that you find this puzzling because you always see evidence to the contrary. When asked what you mean, roll your eyes, laugh and say, "Where do I start?" before launching into how this morning alone you have been run over by two wide-bodied prams without apology, viciously cut off by an oversized vehicle driven my a ‘selfless' mother and at lunch your table and others at the café became a de facto playground courtesy of a nearby group of mothers who were busy enjoying their lattes in a selfless manner.
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Maybe they had guides showing them from room to room. ‘And here is the room where it all happens and that's the stirrup chair. What, the guy in the white coat? He's the embryologist. You wanna photo with him? Sure, wait till he brings the blastocyst up on screen…' Actually I had it wrong. An IVF tourist is someone undergoing IVF who chooses to do it in a vacation spot. Greece is one of the more popular ones if the marketing can be believed. Here you can have it all, apparently - embryo transfers, ultrasounds, ruins, and sun and sea all in the one package. And who can resist an IVF clinic in a quaint stone village? Or a donkey ride up a cobbled alley before the Egg Extraction? How about a set of worry beads to help you through the two week wait? Getting your pregnancy test result at a taverna with a jug of ouzo handy in case it's negative? There are so many plusses you can hardly stand it. Right. But where do you go to organize this? My travel agent? Or do you buy the plane tickets direct from the IVF clinic? Hmm, this is all a bit unusual. How about the accommodation - is it attached to the IVF clinic, part of the same complex? ‘Oh you'll be staying in the luxury Hellenic Fertility Villas, breakfast buffet and blood tests included.'‘Great but what about the ultrasounds?' ‘For them to be included you'll have to upgrade to our Deluxe Infertility Package which also includes donkey transfers to and from the clinic.'
‘Fabulous, where do I sign up?' And of course the airline is one of those budget ones with one kilo of hand baggage and ten kilos of check-in between you. So you have to discard almost all of your clothes as the IVF ice box with all the preliminary drugs that you received weighs more that the hand baggage limit on Aristotle Air. You'd forgotten what it was like getting through airports these days with all the security measures and what should be a simple three and a half hour flight (they forgot to mention the ten hour transit in Athens) turns into almost a twenty-four hour ordeal. By the time you reach the villa you're exhausted, shattered. But you have a week to recover before the egg retrieval and you realize you're going to need it. Now if only that rooster that seems to have stationed itself beneath your window (it's 3am) will shut up. The next day you'd kill for one of those greek coffees that the entire population of the island sits sipping in the cafes, but coffee's not part of the IVF diet. So you head to the beach, having first injected yourself in the thigh with a follicle stimulating hormone. You get so sunburnt you can barely move and spend the next few days leaving trails of skin and syringe packets throughout the villa. Though every now and then you must drag yourself to the little surgery down the alley to have blood tests administered by a surly woman. All of this, combined with the relentless consumption of greek salad (fried foods are a no-no in the pre-conception diet), the smell of souvlaki wafting in from the taverna on a nightly basis, are giving you nightmares about calamari. Though this could well be the as-yet un-researched effect of a foreign diet when combined with Gonal-F.
The donkey sent to fetch you for the egg extraction looks as regretful as you feel. How did you let the travel agent talk you into this? Your partner is practically estranged. He's gone off on his own donkey as he's still cranky about you berating him for being carried home unconscious from the taverna last night. He said someone spiked his ouzo but it's obvious he drank till he passed out. The smell of souvlaki must have taken up residence in your nostrils as the clinic, the only building on the island with working air-con, smells of it too. Surely they can't be chargrilling sheep out in one of the back rooms as that could be the only other explanation? The doctor has the same manner as your doctor at home but there is something express-lane about this place. Maybe it was the crowd of sunburnt sweaty foreign couples in the waiting room, some of whom obviously hadn't opted for the donkey package and looked as if they'd been hiking for hours in the blazing sun to get here. The injection of the anaesthetic gives you the first rush of relaxation since you arrived. When you wake up in recovery the smell of souvlaki has gone and you are told it was a good harvest. They are optimistic but they don't know about your partner's ouzo sperm. Surely they'll be too drunk to swim properly. The only taxi on the island is here to take you back to the villa, a relief until it starts to move. Every cobblestone is felt in your uterus, it's the most excruciating car ride ever. The next few days pass in a haze of boredom. You've already read the couple of books you brought, having imagined an entirely different holiday scenario involving floaty summery dresses and romantic beach walks and dusky tans. A German woman departing from the next villa recognizes the desperation in your eyes as your partner departs to partake in yet another dangerous beach sport and hands you a used fashion magazine. The anxiety of watching him suspended at the end of a dodgy-looking parachute attached to a boat driven by Kostas is more than your fragile mind can take so you accept it gratefully. It occurs to you that under normal circumstances if this were a holiday without IVF you'd probably have broken up with your partner by now but you're bound by whatever's happening in the lab on the hill. It also occurs to you after turning a few pages that German fashion is an oxymoron. The dejected donkey is waiting to take you to the embryo transfer. Tomorrow it'll be waiting to take you to the boat transfer to the airport or the trip home. It's the one thing you'll miss about this place and sadly at the moment you feel it understands you more than your partner does. You take a photo of it on the off chance that one day you'll have a child to show it to. The boat comes in, bearing a bunch of tired but hopeful couples. Amongst those waiting for the boat you recognize some couples from the clinic. They look stricken. Actually they look in dire need of a holiday. Jodi Panayotov author of In Vitro Fertility Goddess » 
Apparently there exists a phenomenon called the IVF tourist. My first thought when informed of this was of someone in golf pants and white joggers doing tours of IVF clinics during their annual leave. The kind of tourist who's bored with monuments and wants an ‘experience'.