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The worst five words you can say to a couple experiencing infertility

12 November 2018
By Anya Sizer
Anya is a Regional Organiser at Fertility Network UK
Appeared in BioNews 975

'Why can't you just adopt?' It is a phrase that is repeatedly aimed at one of society's most isolated and misunderstood groups: those facing infertility. Time and again we hear those words, as though a magic formula has been found to sweep away years of trying, treatment and heartache. If only it were that simple; 'just' demeans the one in six couples facing infertility, it demeans the child now being described as second-best and it shows a woeful lack of comprehension as to the realities of the UK adoption system. There is just no 'just' in adoption.

Last weekend as I made my way to the Fertility Show, the newspapers declared that England's adoption rate was falling because IVF had improved. I braced myself for the inevitable and 'logical' conclusion that wider society would draw: that those facing infertility and choosing treatment (a loaded concept at best) were selfish, that the choices had a direct correlation in causing adoption rates to fall. And that, of course, they should simply adopt.

Let me break down this message and have a look at the assumptions behind it.

Firstly, yes, over the past 40 years IVF has certainly seen some improvements and the success rates per cycle have increased, yet it is a science that is still unsuccessful for many people. Unsuccessful often – and this is crucial – not because of the technology and cumulative success rates but because of the emotional repercussions. The average number of cycles a UK patient currently undergoes is between one and two, not because of success or lack of it, but because of the emotional toll and strain it puts on a person.

IVF, I would argue, is not a choice at all in a simplistic sense. It is a medical solution to a medical need. Infertility is a disease of the reproductive system, not a lifestyle choice. The language of choice indicates options, the very thing that most people facing infertility feel they do not have.

But what of the first part of the story above, that adoption rates are falling? Certainly, this is true, and it comes at a time when there is an increase in numbers entering the care system. Last year there were 72,670 children in care, yet only around 4350 were adopted that year. This is a wider social issue and needs to be addressed holistically. There is a huge gap between rich and poor in our society, at a time when austerity has also broken down so many of the structures that should be there to help those most in need.

The result, among many other things, is the breakdown in care, which leads to a rise in damaged families and, crucially, which hurts children. We should not be surprised at this equation; angered, yes, but not surprised. Children are finding themselves within a care system that has seen huge cuts at all levels of the service while coping with complex and complicated needs. Indeed, children living in the poorest areas were 10 times more likely to end up being taken into care.

It is this last point that I believe is the heart of the fall in adoption rates, rather than the rise in IVF cycles. The children so desperately in need of adoption today have various levels of trauma and additional needs. Their stories are complicated and often deeply upsetting. It is an incredibly specific family who can take that on. 

To quote Krish Kandiah, director of the adoption charity Home for Good: 'Ultimately, adoption is not about family completion but the flourishing of vulnerable children. Conflating infertility and adoption is not helpful.'

To return then to the 'just adopt' statement – we are talking about two very different issues and two very different types of family. As a mother of two IVF children and one adopted son, I know this is the case all too well. I know the enormous joy and hope that adoption brings, and I will never regret adopting our amazing, resilient, wonderful son. But neither will I see the decision as a 'just'. Our lives are testimony to adoption being anything but simple or straightforward. Adoption has been the hardest thing we have ever been through and has tested us far beyond what we thought we could deal with. We have had to fight time and again for any state support and it has been exhausting.

What it hasn't been is a 'just', a second best or an easy choice. All this, along with headlines such as the one last weekend, reduce an immensely complicated issue down to a false equation. The children within the care system and those facing infertility deserve more than that.

12 November 2018 - by Sarah Pritchard 
Improvements in the success rates of IVF treatment have been cited as part of the reason fewer people are choosing to adopt children in the UK, despite the number of children currently in care reaching a record high...
12 November 2018 - by Sarah Pritchard 
Improvements in the success rates of IVF treatment have been cited as part of the reason fewer people are choosing to adopt children in the UK, despite the number of children currently in care reaching a record high...
8 October 2018 - by Professor Sheena Lewis 
There has been much media interest in male infertility care this year, but two major issues have stood out. The first is the inadequacy of care for the man, from incomplete diagnosis to non-information about his treatment choices. The second is the use of a vulnerable woman to undergo invasive fertility treatment in order to treat a third party – her male partner. This is unparalleled in other branches of medicine...
6 August 2018 - by Grace O'Regan 
Forty years ago last month, the first IVF baby came screaming into the world, after ten long years of pioneering medical trials...
16 April 2018 - by Dr Nicoletta Charolidi 
'The Real Cost of IVF' event organised by Progress Educational Trust (PET), despite its an ambiguous title, had a very specific purpose: to acknowledge, discuss, and to raise awareness of the emotional and psychological price paid by people who undergo fertility treatment...
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