Dad says you must have a plan B
A couple whose fertility journey crossed international boundaries and bridged Covid before the arrival of their twin sons, are advising other couples facing fertility issues to “always have a Plan B.”
Diego Fernandez and his wife Mareike presented a complicated fertility challenge when they first sought the help of Bristol Centre for Reproductive Medicine (BCRM) in their quest to start a family in 2016.
It was six years before the pair welcomed twins Lorenzo and Jaime into the world.
Diego, a researcher from Spain, said: “It was a long wait, and we learned many life lessons in the meantime, including this memorable advice from another trying-to-conceive dad, which was: Always have a Plan B.”
Mareike said: “It’s a hard journey, but we learned the most important thing is to go your own path and find what makes you happy. Live your life your way.
“We had been trying for five years with no success so I found myself struggling with my mental health when, in the middle of Covid, my sister – who had always been less child-oriented than me – conceived with no issues and had a baby.
“Counselling at BCRM gave me a new perspective at a time when we’d nearly given up and were starting to resign ourselves to possibly not becoming parents, and we are still in touch with people we met there.”
Initial investigations at BCRM had revealed fertility issues with both partners – Diego due to the result of a late operation for undescended testes, and Mareike because of endometriosis, adenomyosis (where endometrial tissue grows in the outer muscular walls of the uterus, making implantation more difficult) and a lower-than-average egg reserve which could result in early menopause.
The overall picture indicated that if the couple wanted a family, they shouldn’t delay matters.
Treatment started at BCRM in 2016, with intrauterine insemination (IUI), otherwise known as artificial insemination, a procedure that involves directly inserting sperm into a woman's womb.
The initial round was unsuccessful and by now having already committed to relocating to Spain for their jobs, just a few months remained for their treatment in the UK.
Specialist fertility consultant at BCRM, Dr Abhi Paisal, suggested switching to intracytoplasmic sperm injection (ICSI) - an alternative strategy which might give them a greater chance of success. This treatment - performed as part of IVF, with sperm being injected directly into the egg - can be beneficial where a man’s fertility is sub-optimal.
Mareike said: “We were so thankful for that advice. There were many people involved at BCRM to whom we are thankful.”
As a result of the ICSI treatment, four embryos were created for German-born Mareike and Diego and three of them were frozen in BCRM’s high-tech lab in 2017.
Unfortunately, their first fresh embryo transfer was unsuccessful, and the couple went ahead and relocated to Spain, returning the following year for a frozen embryo transfer (FET).
Diego said: “This visit was memorable for a romantic reason: I proposed to Mareike in the beautiful countryside just outside Bristol – and she said yes! But sadly, our FET failed. That left us two frozen embryos at BCRM.”
After another international relocation for their jobs – this time to Basel in Switzerland – they organised a further trip to Bristol for the next round of treatment and had the first preparatory procedures.
However, when Covid struck in March 2020 and the clinic was forced to close its doors, the couple found themselves having to wait until 2022 to resume treatment.
Added Mareike: “We were devastated but we didn’t want to give up so, because we couldn’t access the two frozen embryos at BCRM, we tried other clinics, first in Basel then in Valencia, with two cycles of egg retrieval, ICSI and one transfer but these were all unsuccessful.”
BCRM supported them to have their preparatory treatments in Basel, which meant they only needed to come to Bristol for the transfer itself.
Mareike added: “Abhi Paisal was mindful of all the failed treatments we’d experienced and the challenges of our travel situation, so the decision was taken to transfer both our remaining embryos in one operation.
“By this time, BCRM had moved to their new clinic at Aztec West, and the procedure was surprisingly relaxing, with soothing music, and low lights.
“Then the two-week wait and, finally, success!”
Twins Jaime and Lorenzo were born on 26 October 2022 after a normal pregnancy and labour, although they had to be delivered by caesarean because Lorenzo, who was presenting first, was breach.
Mareike said: “We couldn’t be happier with our lovely boys. They bring us so much joy and we are loving being parents. We are eternally indebted to BCRM for enabling us to have them, and so grateful for the ongoing support they gave us during this very challenging chapter in our lives. They are a wonderful team, and we count ourselves as very fortunate to have been treated by them.”
BCRM www.fertilitybristol.com is the longest established fertility clinic in Bristol, helping people from throughout the South West and Wales with fertility treatment for both private and NHS patients. The clinic is involved in innovative research and has one of the best success rates with IVF and other fertility treatments in the UK.
