Fertility battles: navigating medically assisted procreation in Luxembourg

Pregnancy rates are known to decline significantly after women reach the age of 35. However, some couples face challenges conceiving even before this age.

To shed light on this deeply personal and often challenging journey, RTL Today spoke to Ana*, an Italian woman who shared her emotional and unpredictable experience with IVF. Her story provides valuable insight into the difficulties of navigating fertility treatments.

Some facts about Medically Assisted Procreation

According to Luxembourg's National Health Fund (CNS), health insurance covers ovarian stimulation, artificial insemination, in vitro fertilisation (IVF), and intracytoplasmic sperm injection (ICSI). This coverage is available until a woman reaches the age of 43, or after a tubal ligation or vasectomy. However, IVF and ICSI procedures require prior authorisation from the CNS.

The two main points of contact in the field of reproductive medicine in Luxembourg are the Centre Hospitalier de Luxembourg (CHL) and the Infertility Treatment Centre of the Hôpital Robert Schuman (HRS) Maternity Hospital. These centers offer various reproductive procedures, including ovulation induction, intrauterine insemination (IUI), in vitro fertilisation (IVF), and IVF with frozen embryos.

Both CHL and HRS provide robust support systems to help maintain a healthy mindset during the process of trying to become pregnant. Treatments are conducted by doctors specialising in reproductive medicine, alongside the woman's regular gynaecologist.

Ana's IVF journey

Ana has been undergoing medically assisted procreation since 2019. After trying to conceive for two years, she and her husband sought medical options to fulfill their wish for a child. Ana acknowledges that while the clinical aspect of the process is straightforward, the psychological toll is difficult to manage.

She frequently grapples with questions such as, "Why can't I conceive naturally?" and "Am I the problem?" These doubts leave her feeling defeated, as she struggles with the societal and natural expectations placed on women to conceive naturally.

Ana and her husband began their journey at the Fertility Center at CHL, where she feels well-supported and cared for. Even during the COVID-19 pandemic, Ana maintained regular check-ups.

When Ana and her husband first encountered difficulties, both her egg cells and her husband's sperm were tested. The doctors followed specific protocols to determine the appropriate procreation method. Initially, the team of gynecologists and doctors at the Fertility Center attempted to stimulate Ana's ovulation using medication or injections, which she had to take throughout the fertilisation process.

The pregnancies resulting from this stimulation are referred to as "biochemical pregnancies." Unfortunately, these often lead to early losses due to significant abnormalities within the embryos that prevent them from continuing to grow.

In Ana's case, the initial injections for ovulation stimulation did not result in successful pregnancies and ended in miscarriages. Subsequently, she underwent a clinical intervention to have her matured egg cells retrieved. Once retrieved, the process began, and Ana started trying to conceive.

Additionally, she made the decision to preserve her embryos by freezing them at a sub-zero temperature, which allows them to be stored for an extended period.

Interestingly, the Fertility Centre sends annual reminders to check if Ana and her husband still intend to conceive. If not, their combined cells will be destroyed. Ana's husband is actively involved in the process, needing to consent to and attend every insemination appointment.

Since freezing her eggs in 2020, Ana has been consistently trying to conceive. Over time, she has found the procedures and paperwork to be routine, though initially overwhelming as she struggled to come to terms with her journey.

After the embryo transfer, Ana experienced a significant waiting period. The first twelve days were critical, during which she maintained her daily routine but felt the emotional impact. Blood tests at the end of this period would confirm if she was pregnant. Ana then waited an additional week for complete certainty. Unfortunately, during this time, her doctor informed her of a possible early loss due to the embryo being too small to survive.

Upon receiving this news, Ana was supported by the team at the MAP Fertility Centre once again.

After experiencing her first miscarriage, Ana took a year to process and come to terms with what had happened. During this time, she also harbored fears about potentially facing the same physical and emotional pain again.

However, after this period of reflection, Ana returned stronger and even more determined the following year. She reminded herself that if having a child was truly their shared goal, she and her husband needed to stay resilient, trust in the strength of their relationship, and persevere.

Despite their efforts, when things did not progress as hoped in April, Ana decided to go into autopilot mode and continue trying repeatedly.

Reactions from family, friends, and strangers 

When Ana began her medically assisted procreation (MAP) journey in Luxembourg, she chose to confide only in her sister and her husband. While her family was supportive, they had not experienced similar challenges themselves, which sometimes made it difficult for them to fully understand or comfort her.

Ana found certain questions particularly hurtful. She was deeply affected by people's assumptions that having children naturally follows marriage, their insensitivity highlighting a lack of understanding. Such remarks disregarded any previous struggles she might have endured, like miscarriages or other setbacks.

Another painful question for Ana was, "Why don't you adopt?" This suggestion overlooked the complexities and emotional weight involved in adoption, especially when the desire to have a biological child is strong. Ana explained that adoption wouldn't fulfill her because she and her husband had been striving to build their own family for five years.

These insensitive comments underscored the importance of empathy and sensitivity when discussing fertility challenges, as well as the unique emotional journey that Ana and others like her navigate.

The tough side

The most challenging part of Ana and her husband's journey has been navigating through two miscarriages. These experiences have not only taken a physical toll on Ana's body but have also caused immense emotional pain. She candidly admits that each early miscarriage feels like it "kills you from the inside."

Additionally, the hormonal fluctuations associated with assisted reproduction treatments have been difficult to manage. One day, Ana might feel euphoric and hopeful, only to feel sadness, lack of motivation, and existential doubt the next. She emphasizes the importance of creating a support system where women with similar MAP experiences can share their doubts and personal stories.

Ana believes strongly in encouraging other women facing similar challenges. Her message is one of resilience and trust in the process. She advises others to trust in Mother Nature, trust their doctors, and above all, maintain belief in themselves. Despite the ups and downs along the way, Ana believes that the ultimate outcome will make the journey worthwhile.

*Name has been changed.