Why some people decide not to do IVF

"IVF is often seen as a panacea," grief counsellor Sarah Roberts says.

"There's this idea that if you leave [having children] too late, IVF will save you."

But she knows better than most that this is not always true.

"I went through 10 years of IVF. We conceived and lost 12 children, and then I left IVF in my mid-40s," Ms Roberts says.

She now counsels women, like herself, who have been unable to conceive, and says there are a number of financial, physical and personal reasons why people decide to not do in-vitro fertilisation (IVF) at all.

We spoke to two women about why they made that call — and what happened next.

'I was so exhausted'

Vanessa Phillips was 33 when she and her husband Craig started trying to conceive. Now, at age 44, it's a period of her life she describes as "traumatic".

After initial difficulties, Vanessa had surgery for her endometriosis. She tried alternative medicines and acupuncture. She and Craig changed their diets, trying any little thing that might help. They then turned to medically-assisted ovulation: Vanessa had hormone injections every month before timed sex (exactly 12 hours later) or intra-uterine insemination.

She says it was invasive and exhausting, but the "constant heartbreak" was the hardest part.

"You build yourself up and up and up, and then crash back down. You give yourself two weeks to get back together and then start the cycle all over again."

Vanessa says that cycle ultimately put her life "on pause". There was very little room, financially or emotionally, for fun and it created difficulties in her marriage too. 

"There's the sexual side of it [but also] the stress and dealing with each other's feelings," she says.

She did this for five years — and then her gynaecologist put IVF on the table.

"I could not fathom going through it," she says.

It wasn't the cost that put her off, though that was significant (IVF can cost around $9,000 per cycle, which comes down to $4,000 out of pocket after Medicare).

She and Craig had already spent tens of thousands of dollars and "were willing to [get loans to] spend more".

It was the emotional and psychological toll — one made worse by the nearest IVF clinic being a four-hour drive away.

Vanessa and Craig live in Bellingen, a town of around 13,000 on the mid-north coast of New South Wales. She would have had to travel to Newcastle twice in each IVF cycle — once to get the eggs removed and again to get the embryo implanted.

"The thought of [it] was too much," she says.

"My best friend was going through [IVF] and had been trying for three years at that point. I just couldn't cope with that."

Vanessa says the decision to stop trying still brings her to tears — but it was ultimately the right thing for her mental health and her marriage.

'I was waiting for that hypothetical partner to come along'

Penny Rabarts, 48, assumed kids would always be a part of her story.

"I spent my 20s and 30s thinking 'of course I'm going to find my guy and I'm going to have kids and I'm going to tick off those boxes'."

But in her late 30s, after a series of relationships that hadn't worked out, those boxes were unticked and she found it increasingly difficult to be around friends with children, some of whom assumed she just didn't want a kid.

"People didn't understand that I was actually grieving," she says. "I was grieving a life that I thought I was going to have."

It was around this time that she started the process for IVF.

"I went in and I had the six psychological sessions, I filled out all the forms, and then I got to the point where I was given all the documents with the [sperm] donors' information," she says.

"For me, it was a really critical moment where I realised I don't want to have a sperm donor or father for my child that I don't know and who's not going to play a part in my life."

Penny had some practical reasons for this decision. Being a single parent would be especially difficult as she didn't have a solid support system: she lives in Sunshine, an outer suburb of Melbourne, and her family is in New Zealand.

And there were some complex emotions involved too. Penny didn't tell any of her family she was thinking about IVF because she feared she would be judged.

She remembers loved ones looking down on fertility treatments saying "if you can't do it naturally, then it's not meant to be", and casting pity on single mothers.

Looking back on it now, she thinks she internalised those judgements (which come from problems in the wider culture) and that played a part in the decision too. Years later, however, it's not something she regrets.

What happens after making the decision

Ms Roberts says that women often feel a lot of shame and grief when they stop trying for a child.

"Childless women are represented in the media as the 'crazy cat lady', or the 'career woman' or 'spinsters' [and] women can really absorb these messages," she says. 

Vanessa says she didn't initially reach out for help because she "just felt too ashamed and too guilty".

"Through years of trying, your self worth is degraded because you just feel like a loser constantly … I literally don't know any other childless women. I don't know anyone who's been through all these fertility treatments without coming out with the child. It's very isolating."

"People would say 'oh, miracles happen! Now that you've stopped trying, it still might happen'. They just want to fix you [but] all anyone wants in this situation is empathy and compassion."

Ms Roberts advises women in this situation to find a psychologist or counsellor that really understands their needs.

It might take a couple of tries to find the right person, but she says it's important to "take some time to really have a look at your relationship with yourself".

Where to get help

After calling off her IVF, Penny took time off work and went travelling for nine months.

"I went to all my favourite places and started new adventures, and came back feeling really good about my decision," she says.

But a few years later, after a surprise pregnancy and subsequent miscarriage, she found herself in need of more support — and importantly, a community. She created a Facebook group connecting women who are going through similar experiences; a place for people to share their stories.

This group, and others like it, were hugely helpful to Vanessa too. She spent a long time just reading the posts, but is now comfortable opening up in that space and providing reassurance to others however she can.

"It's OK if you want to stop," she says.

"Your life is going to be OK even if you don't have children. It's still going to be fulfilling and joyous. And there's lots of women out there that can support you."