Juliet & Rob’s Story

Full of compassion, love, care, joy, hope and suspense, ‘The Quiet House’ is, at its heart, a love story which holds a magnifying glass up to many a modern-day relationship as a couple struggle with childlessness and choose to embark on IVF.  To mark the amateur premier of this play, with her theatre group Amersham Playgoers, Director, Juliet, 40, shares her journey of endometriosis surgery and three fresh and four frozen rounds of IVF to become mum to Isaac and Hope:

Case_study_Juliet_Ince_3.jpeg (1)

“Both Rob and I come from large families and although we took our time to get to know each other and settle down, we both wanted children.  In anticipation, I retrained to become a teacher, as I thought it would be a child-friendly profession, and then came off the pill.

“It was then that my periods became incredibly painful.  Some days I couldn’t get out of bed.  I was referred to a specialist who diagnosed endometriosis. The pill had masked the pain, whilst the endometriosis became widespread, including an endometrioma cyst the size of a grapefruit which fully enveloped my right ovary, rendering it inactive. I underwent immediate surgery to have the cyst removed, alongside some cervical cautery, but my consultant advised that this was only keeping the endometriosis at bay. I ultimately needed a hysterectomy to control the rapid spread of the disease and he therefore recommended we embark on IVF as soon as possible before the opportunity to conceive and carry a baby was entirely lost. Now as newlyweds, we were very unprepared for that devastating news but suddenly found ourselves thrust on to a very necessary and time critical path.

“Because of our urgency, we received the go ahead that we could have NHS funded IVF very quickly.  We did our research, looking at clinics, and selected Oxford Fertility.  It achieves good results and we liked how active it is in research.  In no time at all, we were at Oxford Fertility attending a patient information evening.  It felt very strange, looking around, knowing most people would have been on a long journey to get here, and we were so suddenly joining them.

“We started funded treatment in the summer. It was then that we discovered that I had a high FSH, indicating that I had reduced ovarian function and may not produce many eggs.  Sure enough, this was the case, but those few eggs did produce top quality embryos, which was reassuring, but sadly, on this first round, they didn’t take.  We tried not to see this as a failed round, but instead a benchmark from which to work from.

“So, six months later we self-funded and tried a fresh round again, this time with a slightly higher drug level, which did help. Three embryos were frozen and one top quality embryo was transferred and to our amazement it worked! Our beautiful baby boy Isaac, meaning ‘laughter’, was born in the November, just in time for a magical first Christmas as parents!

Physically, I recovered quickly, but emotionally it was all a very harsh reality.

“Aware of my pressing health issues, we returned to Oxford Fertility the following year to add to our family.  It was then that another problem was piled on us. Routine tests diagnosed me with hypothyroidism, common after childbirth, which was also going to hinder our chances of future success. It needed to be treated before I could start another round of IVF.  I felt so bad, as Rob’s tests were all fine, it was me each time where the issues lay.  He was very supportive and reassured me that it would be far worse if we both had challenging test results.  I knew he was right, but it was still tough to accept at times.

“Eventually my thyroid levels stabilised, and my body was ready to start IVF again. Using the best of our three frozen embryos, I underwent natural IVF, timing the transfer day to my natural cycle, which had become more regular since pregnancy.  Again, I became pregnant, but soon I was in a lot of pain as I experienced an ectopic pregnancy. It was utterly devastating. Somehow our healthy embryo had embedded in one of my fallopian tubes, which was life-threatening to me.  It was so hard agreeing to receive surgery to have our precious baby removed, along with the fallopian tube connected to my only functioning ovary, but we knew our baby had no chance of survival where it was, so I was rushed into emergency surgery. Physically, I recovered quickly, but emotionally it was all a very harsh reality.

We could ask them anything and trusted they would always give us an honest answer.  We got to know the people who became part of our lives.

“Following some discussions with Oxford Fertility about possible next steps, we decided to try some additional techniques offered, but remained very realistic and open minded about their effectiveness based on the research available. So, on our fourth natural round I underwent an endometrial scratch and we incorporated embryo glue during our frozen transfer. Sadly, this was to no avail for us and subsequently we had little option than to embark on a further fresh round to generate a larger pool of embryos again. Miraculously, on this round my second ovary decided to respond to drugs, following the endometrioma removal, and generated follicles. We ended-up with eight eggs, our best result so far! Seven of them fertilised but one later became unviable and although two more took a lot longer to develop than the others and weren’t of the best quality, we remained hopeful and froze them just in case.  We had our best 2 embryos transferred on both our fifth fresh round and sixth frozen natural round but each time they failed.

“It was then that it was suggested that my auto-immune condition, hypothyroidism, was possibly producing antibodies that attacked my tissues and the embedding embryos. We took advice and worked with Oxford Fertility to come up with a course of treatment to alleviate this, but we now only had the two lower quality embryos left.  We resolved not to doubt them and clung on to every positive thought we could muster as they were both thawed and transferred back to me. This time, finally, it worked!  Our beautiful daughter, who we aptly named Hope, completed our family – our little rainbow after the storm – and it made every minute of struggle over the past five years worthwhile and justified.

“Had the last embryo not worked, I think we would have stopped. I didn’t want all of Isaac’s early years to be compromised with me continually receiving treatment. But whilst we still had embryos frozen, we had to try.

“Looking back, I can see that I became too focused on the quality of the embryo, even though the team explained it is just one factor when deciding which embryo will give the best chance of success. Nobody knows the quality of embryos in natural, unassisted conception anyway, but good quality embryos were the only thing I ever felt like I did well, so I think I just latched on to that.  Our son was a top-grade embryo and our daughter was weakest but looking at my children side by side today you would never know any different – both perfectly healthy, independent, intelligent and happy.

“So many people told us to stop along our journey. We had Isaac; we should be grateful for him. But it was because our life with Isaac was so amazing, we wanted to experience it all a second time.  Why should we have to limit our dreams? Isaac also had started asking us when he was going to have a brother or sister.  We couldn’t let it go.

“I’ve always been someone who has set their mind to something and worked hard to achieve it. But with IVF, I couldn’t work harder or study more – I felt like I was failing, and it was simply out of my control and I found that incredibly hard. All we could do was place our hope and trust in the team at Oxford Fertility and lean on each other as a couple and our wonderful family and friends around us for support.

“The team at Oxford Fertility were amazing. They had put us at ease from the moment we entered the building. They have understanding and empathy for what you are going through and always took the time to talk us through everything. We could ask them anything and trusted they would always give us an honest answer.  We got to know the people who became part of our lives.

“Every stage of our treatment was bespoke to what we, Juliet and Rob, needed. They treated us as a couple, a patient and not a patient number. We will forever be grateful to them for our two greatest gifts and are proud of our IVF journey we took with them which resulted in our greatest achievements.”

‘The Quiet House’ was to be performed in May, but was postponed due to COVID-19. The team hope to perform in 2021.