Kate Barker* and her partner tried for a long time to have a child and began to wonder whether they would ever become parents. Eventually, after years of ups and downs, their daughter was born with the help of medical technology.
I was in my 30s and in a long-term relationship when we decided it would be lovely to have a child. Nothing happened for months and then I did get pregnant but ended up having a miscarriage. We left it for a little while and when we continued to try I conceived again.
I didn't realise I was pregnant at first and I was working away when I developed severe pain. Back home in London, it turned out that I had an ectopic pregnancy [where the baby grows outside the womb] and I had to have an emergency operation. The pregnancy was quite far along and had damaged the tube irreparably so it had to be removed, along with the embryo. Having only one tube left meant our chances of having a baby were reduced.
A terrible sense of lossWe kept on trying and I had two more miscarriages, one of which was more advanced than the other, and this left us with a terrible sense of loss, but also a determination to keep on trying.
I got pregnant again, but this time I had another ectopic pregnancy in the other tube. This time the medical team 'milked out' the embryo [also called 'fimbrial expression', where the pregnancy is removed through the end of the fallopian tube]. I was advised to have the tube removed as well but I kept it, and I'm glad I did.
By this stage I'd had three miscarriages and two ectopic pregnancies. As there clearly seemed to be an issue and I was already well into my 30s, we decided to try IVF (in vitro fertilisation) treatment. Although it was private treatment, we managed to get it at a reduced cost so we were able to have three chances.
Starting IVF treatmentWe went a London clinic that had quite a good success rate. I didn't know much about IVF and this was my first experience of it. At a certain point in my cycle, I had to start having injections to increase my fertility. The injections continued until my eggs were ready to be collected under anaesthetic. I had around 13 or 14 eggs, which were mixed with the sperm and left to hopefully fertilise and become viable embryos.
The best embryos were selected and two were chosen to be put back. We were in a darkened room for the procedure and I watched on the little monitor as the embryos were injected into my womb and thought, 'Ooh, this could be something.' But sadly it wasn't. Neither of the two embryos took.
You know within about two weeks whether IVF has worked or not, and on this first occasion, it didn't work for me. My period started and that was it. Once you've had an attempt at IVF, your body's in a bit of a turmoil and you can't just have another go straightaway. You have to let your body recover and spend some time calming down and preparing yourself to try again.
A few months later, we had a second attempt, using slightly different drugs that supposedly were more powerful. With the first course of treatment, I could inject myself either in my thigh or my abdomen but with the second one, it had to be injected into my buttock. It was a very big injection, and pretty horrible, but I hoped it might give us a greater chance of success.
I remember having so much hope. You always go into the treatment with hope. I imagine a lot of people think it's going to work straight away, and, that first time, I didn't think it would fail. But the second attempt failed as well, and some months later we had our third course of treatment at the reduced cost. It didn't work.
Was there something wrong with me?I was very upset and we seriously considered giving up. After each IVF attempt you long for a possible pregnancy. The fortnight between having the embryos put back and finding out whether they've taken is the most excruciating time. You're looking for symptoms: Is that a pregnancy feeling? Is that a pain? Will I know? It's like two weeks of not really living properly. And then you get your answer.
After the third round of IVF I wondered if there was another medical reason why the IVF wasn't working. In desperation, we went to a different clinic where they tested my blood. The tests showed that there might be a problem with my blood: it contained a kind of antibody which can prevent a pregnancy from taking. The new clinic suggested trying IVF again. This time, once I'd started on the treatment, they'd put me on a drug called heparin, which might help.
Heparin in pregnancy
Some women with high levels of certain antibodies can develop blood clots, which can cause problems with implantation of a fertilised egg. It might be that this is one of the factors involved in unsuccessful IVF cycles. Research has indicated that heparin, a blood-thinning drug, may help prevent this happening in some circumstances.
We decided to go ahead and try for a fourth time. I started taking the heparin tablets first, and then the usual injections. We were getting married and we'd set the date for a Saturday at the beginning of November. I had the embryos put back in late October, about nine days before the wedding.
I really wanted to know whether it had worked or not and so on the morning of the wedding I went to the clinic for a scan. The doctor said: "There's nothing there." I could see a tiny little nodule, a sort of teeny peanut shape, but the doctor said it was nothing at all; that I should come off the drugs and my period should start in a week. So I absolutely let myself go at the wedding and tried my hardest not to be too depressed.
There's a heartbeat!Five days later, while we were on our honeymoon, I thought, 'It's funny, my period hasn't started.' I was a bit concerned and after six days I said, "I'm going to go back and just get them to check me again." Luckily we were in England! We went back to the clinic and that little peanut shape I'd seen had got a tiny bit bigger. Then the doctor said, "Hang on a minute – there's a heartbeat!" Everybody was screaming and running around. "Get back on the drugs! Take the heparin! There's a chance it will survive."
So, the peanut shape was actually a pregnancy. It wasn't straightforward as I had quite a bit of bleeding and there were agonising moments when we thought we'd lost the baby. Because of my history, I was advised to have a blood test and a scan after two months, to see whether there were any issues with the baby.
The doctors told me that the tests showed a chromosomal abnormality that, for most babies, is incompatible with life. After all we'd been through, this was unbearable news. I said, "Oh god, don't tell me. I don't want to know." Incredibly, though, it turned out that the abnormality was only present in the placenta, rather than the baby.
There was still a long way to go, though. I had to be monitored throughout the pregnancy. I came off the heparin, then had to go on it again. I had scans every two or three weeks and just about got through the first three months. Then one day at work I was climbing over a building site – my job was very physical – and I started bleeding. I decided I just couldn't risk it, having got this far. Fortunately, my workplace was very understanding and gave me time off. I tried to relax as much as possible, although it was hard.
Tests showed another chromosomal anomalyBecause of the earlier medical issues, we were advised to have an amniocentesis [where a sample of amniotic fluid surrounding the baby is taken via a needle through the abdominal wall], as well as further blood tests. The tests showed that our baby was a girl, and also that she had a chromosomal anomaly called UPD16.
UPD16 stands for uniparental disomy 16. This means that on the 16th chromosome pair, instead of having one chromosome from me and one from her dad, which is what is expected to happen, she actually had one from me and one from my dad. It's not known whether this is rare or common because people aren't normally tested for it. We were told that when babies have UPD16, they are at greater risk of various conditions, including problems with the anus and certain heart abnormalities. Thankfully, she seemed to be fine as far as the medical team could see.
Our baby needed to be born earlyAlthough everything seemed more or less okay, we were still worried. I started back at work doing a job that wasn't heavy-duty, and I continued to be monitored. About three weeks before my due date, though, I started to have really bad pains and I was taken to hospital. The medical staff said I should probably be induced a couple of weeks early because my baby wasn't growing any more.
In the event, she was born two weeks early. I had an epidural and in the end gave birth naturally. My daughter Ella was here at last. She was healthy, if small: she weighed 4.2lbs (1.9kg) and seemed so tiny.
Going homeI was kept in hospital for a few days. I was desperate to go home, but the medical team wanted to monitor both of us. They needed to check that she was feeding and also by this stage I'd been put on another drug called warfarin. It was important for me to stop taking this as I was breastfeeding and when you suddenly stop taking warfarin you have to be monitored. But finally we took our beautiful baby girl home.
A couple of years later we had another two attempts at IVF, at the same clinic where Ella was conceived. Neither of these attempts worked and they were very expensive.
When our daughter got to seven, we considered the possibility of donor eggs. We went to America twice and had two tries at IVF with a donor and those attempts also failed. So then we gave up. Our journey was over.
Our daughter, Ella, is now a healthy teenager. No-one seems to know much about the long-term effects of UPD16, once a child is over any pre-birth issues. Ella is fine as far as we can tell. She was tested for all sorts of things after she was born and all the results were completely normal.
She knows the story of how we came to have her and she's very interested in medical science and what it can do. She's active and sporty, and she wants a family herself when she's older. She's also determined to have more than one child.