BBC One, 20 September 2016
Presented by Alex Jones
In this moving BBC documentary, 'The One Show's' Alex Jones explores her own fertility and hopes of becoming a first time mother at 38, highlighting the challenges faced by those trying to conceive. The programme does a good job of describing the emotional and financial costs of IVF, while also offering hope through the promising technological and medical advances that may help more people become parents in the future.
The programme begins with Alex talking to her mother and sister about how easily they conceived their children, but Alex is shocked to learn that her mother started the menopause at just 44. Alex admits that she had never thought about a cut-off point, and always assumed that she was 'invincible' and would have children someday. She didn't plan to have a child later in life but only met and married her husband in her 30s. Fertility expert Professor Tim Child assures Alex that fertility doesn't 'fall of a cliff' as Alex fears – in fact, he says that that 50 percent of women in their early 40s can conceive within a year, although they have an increased risk of miscarriage.
To find out how fertile she is, Alex then opts for some tests to measure her fertility – a blood test to look at her ovarian health, and a scan for fibroids, cysts and to measure her egg supply. Alex appears genuinely concerned about what these tests will show, and we have to wait until the end of the programme to see her find out the results.
In the meantime, Alex has a private consultation with midwife Zita West, who explains that although women nowadays may look and feel younger, their eggs have nonetheless aged just the same. To maximise the odds of having a baby, Zita advises prospective parents to look after themselves both emotionally and physically.
Yet as Alex points out, fertility is a two-way street, so she meets Professor Allan Pacey to discuss male fertility. She is surprised to learn that men over the age of 40 are half as fertile as men under 25, and that sperm from older men is more likely to lead to miscarriage.
While visiting an IVF lab and looking under the microscope, it hits home for Alex just how fragile eggs are and that IVF may not work for everyone. She then meets Sarah, an older mother who used an egg donor to have a son with her husband. They touch on the emotional complexities of having a child that isn't biologically your own, and the potential extra costs of needing an egg donor.
The programme then goes on to investigate how can technology improve IVF success rates. She talks to Professor Child about his clinical trial in Oxford that is using pre-implantation genetic screening via next-generation sequencing to check the number of chromosomes before embryos are implanted. Initial results show that this can increase the odds of a successful pregnancy, yet this technique is currently only available privately. Professor Child is hopeful that the trial will show that the approach is cost-effective and might eventually be available on the NHS.
Alex then travels to Valencia in Spain to meet Professor Carlos Simon. He believes that each woman has an individual window when an embryo can successfully implant, and he is using a personalised medicine approach with his patients to identify this window. He carefully checks the cells of a woman's womb lining to check that the womb is at the optimum stage before implanting an embryo.
Jenny's story is perhaps the most moving of the whole programme. She has the condition Mayer-Rokitansky-Küster-Hauser Syndrome, which means that she was born without a womb. After the successful birth of a number of children following womb transplants, she travels to Sweden to find out more about the procedure. Sadly, Jenny realises that this will never be a treatment option for her as she is nearly 30 and the procedure is likely at least another ten years away from being routinely offered. She runs a support group for other women and girls in the UK with the condition, and she hopes that for the younger girls that it will be the 'magic wand' to enable them to carry their own child.
In the final scene we watch as Alex gets her test results, which show that she has a good chance of conceiving. The programme then fast-forwards to today, with Alex announcing the happy news that she is pregnant and that she experienced no problems conceiving in the end.
I found the personal stories shared in the programme very moving, and it was also wonderful to see the advances being made in assisted conception that give hope that many more couples will eventually fulfil their dream of starting a family.