"...The financial strain caused by the lack of NHS-funded fertility treatment is a huge factor in our deteriorating mental health…What makes it even harder is that we are having to go through this in secret. Many members of our close family are opposed to LGBTQ+ people having children and using IVF to do so”

As we sit staring at the stark white pregnancy test confirming the failure of our fourth IVF cycle (and seventh overall round of fertility treatment), we findourselves thinking back over our journey and all the decisions we made. Could we have done anything differently? All the ‘what-ifs?’ crowd at the front of our minds. What if we’d known more about our infertility from the start? What if we’d tried a more specialist clinic? What if we’d gone straight to donor eggs? What if we lived in a county that funded our treatment? The list is endless…

Like many first embarking on this journey from the LGBTQ+ or single-person community, we started out nervous but excited, with romantic ideas about what our future family might look like… Although we didn’t know the term for it at the time, we already knew we had social infertility to contend with because we would require a sperm donor to conceive, but beyond that we didn’t expect any other fertility issues. We had LGBTQ+ friends who had breezed through IVF, conceiving on their very first try and with enough spare embryos in the freezer for a sibling. They assured us that it was bound to work for us because ‘don’t worry, the low statistical success rates for IVF are based on patients with diagnosed infertility’. We would have nothing to worry about, having periods like clockwork and no health concerns; we just lacked the sperm. How naive we were…

We soon discovered that our journey would not be so smooth. Despite discovering that we both had diminished ovarian reserve (DOR), our local ICB (Integrated Care Board) required us to ‘prove’ our infertility by self-funding 12 rounds of IUI (intra-uterine insemination) through a private clinic! Not only does this go against the NICE (National Institute for Health and Care Excellence) guidelines (which advises moving to IVF after 4 unsuccessful IUls), it is a prohibitive financial barrier, costing in the region of £30k! When the announcement of the Women’s Health Strategy came in July 2022, advocating for equitable access to fertility treatment for same-sex couples and single people, we really thought our luck might have changed, but the discriminatory requirements remain the same, two years on, and people like us are still barred from support.

Having infertility and going through multiple rounds of treatment is exhausting and debilitating, both physically and mentally, and there is very little support. The single free counselling session per round offered by our clinic doesn’t scratch the surface. The last two years have been dominated by failure after failure (three rounds of IUI and four full rounds of IVF), compounded by having no financial support. We’ve spent nearly £30,000 with no baby. The most upsetting thing is that if we were a heterosexual couple, we would have been able to ‘prove’ our infertility for free! Indeed, we could easily have lied about it, which is something that happens all the time (after all, no-one is standing at the foot of anyone’s bed to check each month!). To add insult to injury, we are not even eligible for counselling on the NHS in our area, even though the financial strain caused by the lack of NHS-funded fertility treatment is a huge factor in our deteriorating mental health. We have managed to access some specialist fertility counselling at a subsided rate through a local charity, which has helped us to navigate some of the lowest points in our journey.

What makes it even harder is that we are having to go through this in secret. Many members of our close family are opposed to LGBTQ+ people having children and using IVF to do so. If we were in a heterosexual relationship, not only would we be able to access funding, but we would family rooting for us and supporting us. Perhaps the most upsetting thing is that no-one ever questions why we are in our mid-thirties and (apparently) not trying for a family. Probably because we don’t fit their idea of what a family should look like. The shockingly inequitable access to funding for LGBTQ+ and single people across England all but cements the idea that we don’t deserve the same rights as heterosexual couples to be able to build our families. Our mental health is deteriorating by the day, and yet we must put on a brave face and pretend everything is normal. It is a lonely place to be.

It saddens me that we can’t truly relate to many in the LGBTQ+ community who enjoy early success at a fraction of the cost that we’ve had to face, and who never experience the darker side of infertility and loss. Nor can we fully relate to the medical infertility world, where many struggle with the physical and mental toll of treatment, but rarely contend with the financial strain of the postcode lottery or lack of support from prejudiced family. There are others like us, of course, caught between the two worlds (some like us, with both social and medical infertility, and some heterosexuals who can partly relate if, for example, they did not qualify for funding). But it is a lonely club to belong to, and as people ‘graduate’ from fertility treatment and go on to build their families, we’re still here, trying, failing, desperate and increasingly left behind…

As we toss away our negative test, those ‘what-ifs’ continue to spin through our minds, weighing so much heavier as we think of all that money down the drain… We remind ourselves that there are no right or wrong decisions in this process; we did the best we could with the information we had at the time. But what next? Will we look back in another two years’ time having spent another £30k and still no prospect of a baby? It’s gambling. We won’t know if we’ve made the right decision until we look back… Like gambling, it’s addictive, because you can’t predict the future. What if the very next attempt brings us our longed-for baby? What if we give up and we’re left always wondering? What’s the point of everything we’ve been through if we don’t see it through to the end? And then comes the creeping sense of dread because we don’t know where this journey ends…

We’d like to thank FNUK (Fertility Network UK) for this opportunity to share our story and its impact on our mental health. We hope to raise awareness of the unique challenges facing those of us battling infertility in the LGBTQ+ and single-person community. If you are reading this and also struggling, please know that infertility is not your fault; you matter, your dreams of building a family are valid, and you are making the best decisions you can within an inequitable system. We urge you to reach out to charities such as FNUK for support; we benefit hugely from their monthly LGBTQ+ support group and their free, impartial helpline. They can also help you to navigate treatment decisions and know your rights at work. Reach out to the NHS for support with your mental health, and if possible, seek out a therapist specialising in LGBTQ+ fertility (some charities may offer subsided rates if cost is a barrier). If family is not there for you, reach out to friends and build your chosen family. A positive to have come out of this painful journey for us has been learning who our true friends are. It’s so scary stepping into the next chapter, not knowing what it will bring, but we hope that sharing our story helps you to know that you are not alone.