I remember putting the dishes away, one night, when my husband asked me, non-accusatory: "What happened to that cash we had in the savings account?"
"The kids," I said.
We have two - both IVF. Fertility treatment is not cheap and it doesn't always feel like a choice; more like an urgency when you are aching to your bones to be a parent.
Last night's Panorama shone the spotlight on an unethical - and un-evidenced - side to the business of making babies. For Inside Britain's Fertility Business, the BBC commissioned research from Oxford University's Centre for Evidence Based Medicine which found that 26 of 27 so-called 'add on' treatments offered by private fertility clinics did not have high quality evidence that they could improve the chances of having a baby with standard fertility care. Only one treatment had even moderate quality evidence showing an increase in the chances of a baby.
Were we ripped off when we had our two boys?
I watched with a knot in my ovaries as Professor Carl Heneghan summised: "Some of these treatments are of no benefit to you whatsoever and some of them are harmful. I can't understand how this has been allowed to happen in the UK."
Our fertility story is similar to many and more straightforward - and far cheaper - than plenty of others. A couple of years of trying for a baby, hormone treatments and miscarriage led us to an IVF referral by our GP and a three month wait for an appointment on the NHS. Hopes were high but the appointment was brief. We filled out one form with a nurse and left with our hopes at the bottom of the paperwork pile, swiftly realising that the ties on our cash-strapped hospital trust would leave us facing another nine to 12 months before treatment might, maybe, start. We contacted private fertility clinics before we left the car park. It had become an urgency.
As evidenced by the tears of the women in last night's programme, infertility is brutal, physically and emotionally, and affects 1 in 7 couples. So, by the time we signed up for private treatment, I was in no fit mental state to make an educated decision on the value of the £4,775 we were pulling out of our savings (or the extra £2,300 for two further attempts with frozen embryos or the £350 to rent freezer space for them.) If my doctor had asked me for twice that amount on the promise of heightened chances, I'd have handed it over without a moment's thought. That is why the ethics at play in last night's TV made for such unsettling viewing.
Our first son was born via IVF after we were told it was our only chance of getting pregnant
I know intelligent women with high-pressured jobs who have cried from the stress of having to make decisions about what tests to opt in and out of as they embark on fertility treatment; one had to sit down and pick apart the finances of a 'no baby, no fee' package, priced £11,000, while another tried, to no avail, to decipher a raft of tests she had forked out for over a flat white.
Patient choice is one of the celebrated benefits of medical advances - and I quite literally owe my happiness to reproductive medicine - but we enter these 'transactions' with private clinics traumatised, pumped full of hormones or, worse still, depressed from failed efforts to fall pregnant. Some people take out loans or remortgage homes to raise the cash for treatment and yet I can't think of anything else in life that is less certain or outside our control than this whole process. Never is the trust and expertise of the doctor on the other side of the consulting table more valuable or relied upon and rarely are we so fragile and vulnerable to exploitation.
My clinic never pushed add-ons - although they were advertised in the waiting room - and I would have had neither the head nor the energy to question the evidence around them if they did. I never felt like a cash cow to them; in fact we chose them because they felt less commercial and more focussed on care than their biggest competitor who I feared was more interested in profit than patient. I treasure the photos of my kids with the doctor that made them possible and have since sent friends to be treated by him.
I am under no illusion that infertility is a business and add-ons and marketing packages are part of the model but I didn't want to digest complex scientific information or bear the burden of knowing I may have heightened or reduced my own chances of parenthood to save £300 based on dodgy evidence; I just wanted someone I trusted to take my credit card, swipe it and hand me a healthy bundle of blue or pink.Suggest a correction