Elsa Cheshire has suffered the heartache of losing three babies over the last 20 years, before finally becoming a mother on the last throw of the IVF dice. But, had she lived elsewhere in the UK, Elsa might never have been given that final, crucial opportunity. Sheena Grant reports.
A 40th birthday is a big event for anyone, a significant milestone on life’s journey. But for Elsa Cheshire the day was especially momentous. It was the day she discovered she was pregnant with her son, Howard.
It was Elsa’s fourth pregnancy but she had never yet brought a baby home, never marked that first smile, first tooth or nursed a tot through a childhood illness.
This time, she hardly dared hope, things would be different.
Elsa knew, as she celebrated her 40th birthday, that this was probably her last throw of the dice, the final chance she had of realising her dream to become a mother.
Over the previous 20 years, she had lost three babies and seen her marriage collapse. She had been through more than most people could imagine but she wasn’t ready to give up.
“I had lost a baby in every single trimester of pregnancy. I couldn’t conceive or carry a child without medical intervention. I had to risk going through that heartache again or accept that I was never going to have a child,” she says. “To me, there was only one choice.”
And so she began her fourth - and last - cycle of NHS-funded IVF treatment, resulting in that 40th birthday pregnancy test.
All her prayers were answered when Howard was born on October 4, 2012, weighing 8lb 2oz.
He has just celebrated his first birthday and Elsa beams with pride as she talks about him.
“He’s into everything,” she says. “He’s walking, trying to say a few words and generally doing really well.”
Yet in some areas of the country, Elsa would never have even been given the chance to have Howard. Medical guidelines from the National Institute of Clinical Excellence (NICE) recommend up to three cycles of NHS-funded IVF treatment for women aged up to 40. In 2009, the East of England (covering Suffolk, Norfolk, Essex, Cambs, Beds and Herts) became the first commissioning group in the UK to accept these recommendations in full – unlike most other areas. In 2011, 73% of (now defunct) Primary Care Trusts were still offering less than the three cycles recommended by NICE.
Campaigners are calling for an end to this postcode lottery and say the latest data from Bourn Hall Clinic, the largest provider of NHS-funded IVF treatment for patients in the east of England, shows that if NICE guidelines were adopted nationally a “take home baby rate” of more than 70% would be possible.
Infertility Network UK chief executive Clare Lewis-Jones says: “Infertility is a health issue not a lifestyle choice. The consistent patient pathway introduced in the East of England means that patients with symptoms of infertility are properly investigated and the causes diagnosed. Where IVF treatment is required, the data from Bourn Hall demonstrates clearly the benefit of adopting the NICE guidelines in full.”
Elsa, who lives in Ipswich, actually benefited from four, not three NHS-funded IVF cycles, an unusual situation that was only agreed to because of her particular circumstances.
She is extremely grateful to have been given that chance and supportive of the Infertility Network’s campaign to end the IVF postcode lottery.
“Everyone should have access to the same treatment,” she says. “Unless you have been through it or are going through it you don’t know how much of an effect it has on your life. It dominates everything. It can tear relationships apart. It is devastating.”
For her, the joy of parenthood will forever be tinged with the sadness of what went before and all those babies who didn’t make it.
Elsa, now 41, first fell pregnant when she was just 21 years old and not long married.
“At that age it never occurs to you that something could go wrong,” she says. “I was young, healthy and all the signs were good.”
The pregnancy progressed normally until only about a month before full term.
“Then the baby just stopped moving,” she says. “Being young and inexperienced I didn’t really think anything was wrong. I thought perhaps he was getting ready to make an appearance.
“I was actually at a parent-craft class when I started getting tightenings across my stomach. They thought I was going into labour too but then they couldn’t find a heartbeat.”
The baby boy, who Elsa and her then husband named Wilbur, was stillborn. There was no explanation as to what had gone wrong or why he had died.
“My husband and I both dealt with the grief in different ways,” says Elsa. “It can bring you closer together or drive a wedge between you and in our case it did the latter.”
Losing Wilbur was like “falling into a black hole” but despite the horror of what she had suffered Elsa believed his death was a one-off and would not affect her chances of becoming a mother in the future.
After her marriage failed all thoughts of more children were put to one side for several years as Elsa, who now runs a marketing and design company, focused on her career.
That all changed, however, when she got together with her partner, Ashley Ravenscroft, now 39, in 2005.
By then, she had been diagnosed with polycystic ovary syndrome (PCOS), a condition that affects about one in every five UK woman. Tiny, harmless cysts develop in the ovaries meaning they do not regularly release eggs.
The couple started trying for a baby, but for three years were unsuccessful so were referred by their GP to Ipswich Hospital for fertility testing.
Other than the PCOS, the test showed neither of them had any obvious fertility issues.
Elsa was given fertility drugs to stimulate her cycle and a booster injection to encourage ovulation. Doctors hoped she could get pregnant without the need for IVF treatment.
The stimulation treatment put her on an emotional rollercoaster.
“I was flitting between despair, hope and back to despair,” she says. “The treatment takes up a lot of your time and puts a lot of pressure on your relationship.”
After two rounds of drug treatment, Elsa fell pregnant. She was deliriously happy but just weeks later she suffered a miscarriage.
“It is horrifying to lose a baby at any stage of pregnancy,” she says. “There is a lot of dismissal in society about miscarriage but it is heartbreaking to think you were not able to give that child life and I suppose, in my case, it brought back those feelings from my earlier loss.”
A further cycle of stimulation treatment failed to work, and the couple decided to opt for IVF treatment at Bourn Hall Clinic near Cambridge. They first tried IVF, and then IVF with ICSI (intracytoplasmic sperm injection), in which a single sperm is injected into each egg to fertilise it. After five days growing in the laboratory an embryo is transferred to the womb.
“It is physically and emotionally gruelling,” says Elsa. “The eggs have be collected and fertilised and the embryos have got to survive long enough to be put back into the womb. There are nerves and anxiety but also hope and optimism. When you get to the ‘embryo transfer’ stage that’s a really optimistic day.”
Unfortunately, the first two IVF attempts did not lead to pregnancy. The third cycle, in 2011, did however, bring them the news they had been waiting for. Elsa was pregnant.
“The happiness of that is not just for you but for all your family and friends who have supported you,” she says. “You know it is not only going to break your heart if anything goes wrong but break their hearts too.
“At first everything was fine. The initial six and 12-week scans showed the baby was developing normally but the 20-week scan revealed a problem with one of the baby’s kidneys. It had cysts on but was functioning ok. It wasn’t a big problem.”
Elsa was referred to Addenbrooke’s Hospital in Cambridge. By then, she had noticed she was losing fluid from her womb and asked doctors to investigate.
Her cervix had completed dilated, meaning a stitch had to be inserted to try and close it again.
It didn’t work,” she says. “I was admitted to hospital and for three weeks mananged by lying in bed with my legs raised to keep as much weight off the cervix as possible. My waters had broken and I had developed an infection, which led to labour.”
Elsa and Ashley’s baby daughter was born prematurely at just 24 weeks old.
“We called her Eloise,” says Elsa. “She died five days later in intensive care. We were heartbroken. I was thinking by then that I just wasn’t meant to have a baby, after everything I had gone through. I had lost a baby in the first trimester of pregnancy, Eloise in the second and Wilbur in the third. But I wasn’t ready to accept I was never going to have a child.”
Still deep in mourning for the loss of baby Eloise, Elsa and Ashley knew they could not delay. Elsa was just over six months away from her 40th birthday, the cut-off point for NHS-funded IVF treatment.
“We went to our GP for help, and he managed to convince the NHS decision-makers to consider us an exceptional case and fund one final cycle,” says Elsa. “We were so grateful to all involved. I think they realised we’d already been through so much, that they gave us one last chance.”
Only a fortnight before Elsa turned 40, the experts at Bourn Hall Clinic transferred another embryo to her womb. The couple had to wait two weeks for the pregnancy test that would keep their dreams of becoming parents alive.
“This was my last chance as I knew we weren’t going to get any more funding. Ash and I had been through a lot already, and now I was entering the last chance saloon,” she says.
On February 20, 2012, Elsa’s 40th birthday, she took the test that was to change her life forever. She was pregnant.
“To say emotions were mixed was an understatement. There was joy and optimism about the future, mixed with guilt, sadness, and a huge sense of loss.
“At no point in my pregnancy did I feel safe. I was trying to balance the fear of losing this baby with staying calm.
“I rested a lot. From about 18 weeks onwards I worked from home and stopped completely from about 22 weeks. From then on, I was pretty much on the sofa or in bed. We knew we really had to fight for this baby.
“It’s really difficult to put into words just how brilliant the staff at Bourn Hall were. The empathy they have for you is amazing. At no point did I feel they’d taken their eye off the ball. The care we received at the Rosie maternity unit in Cambridge was also first class.
“When I got to 32 weeks I relaxed a little because I knew that even if the baby was born early now there was every chance everything would be OK, although I still had the fear of a stillbirth hanging over me.”
When she was about 34 weeks pregnant, Elsa was admitted to hospital so she and her baby could be closely monitored. Regular scans revealed the baby wasn’t moving as much as the specialist doctors would like, and Elsa opted for an elective caesarean about three weeks off full term.
“Although it was a nerve-wracking time I had this conviction, deep down, that it was all going to work out OK. That kept me sane. I had a feeling I was carrying a boy and I felt like I knew him already when he was born.”
Immediately after his birth in Cambridge, baby Howard was taken to the NICU, the intensive care unit for babies, in case he had water on his lungs. Thankfully, he was fine, and the family was allowed to return home to Ipswich a few days later.
Just over a year on, Howard, known as Howie, is doing well and Elsa and Ashley couldn’t be happier. She beams: “He’s massive, absolutely huge, completely cool and developing how he should. Looks wise, I think he got the best bits from both of us.
“I still have moments of deep sadness over everything that went before but the fact is that he is a miracle. And if I can do it no-one should ever give up. If talking about my experiences results in one couple giving it a go and it brings a baby into their lives it would be worth it. It’s an amazing thing.”
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