Review of Inconceivable: A documentary

I cringed a little, when I saw that TVNZ was going to run a documentary series following eight couples going through infertility over a period of two years. It was, inevitably, titled Inconceivable, and “follows the highs and lows of ordinary Kiwis trying to conceive.”

I recorded it, but due to my misgivings, waited a few weeks before watching. The other night it felt right, and I ended up watching the first four episodes, finally falling into bed around 1 am.

Other than at the beginning, there is no commentary. The voice-over is purely informative – eg ,couple D are going in for their 2nd egg collection today, etc. This is the (edited, obviously) story of the couples in their own words, and the words of their medical professionals.

The introduction of just a few sentences notes that nearly 1 in 4 couples will face difficulties when trying to conceive. It mentions that this is a journey that now often ends in failure, and has no guarantee of success. It notes that with each couple, their constant companion is hope.

The eight couples are a mix of ages, gender preferences, ethnic groups and diagnoses, although they are all couples. Seven are trying for their first child together (though some have children with previous partners), whilst the eighth are trying to conceive their third, having had successful IVF cycles for the first two. There is male factor infertility, unexplained infertility, genetic conditions causing repeated miscarriage, and a same-sex couple. There are a variety of treatments – IUI, IVF, ICSI, and donor egg IVF.

The medical experts – both doctors, nurses, and lab technicians – on the programme explain very clearly and simply the medical issues, the processes that the couples go through, and the chances for success. One doctor notes the myriad things that need to go right before they can get a take-home baby. We get to see them going through all the procedures – their first injections, egg collection, sperm extraction for ICSI, egg transfer, IUI, work done in the lab, blood tests, laparoscopies, HSGs, ultrasounds, and dildocam. They show the embryo photos that each couple receives.

There is no doubt of the emotional stress each couple goes through. There are no holds barred. A couple is shown being told that their pregnancy had failed at 8 weeks, we see the stress of the 2ww or of having a cycle cancelled, we wait with them to receive the phone calls from the clinic, and we see them receiving the news that they are pregnant or not. One husband describes egg collection as “brutal.” Another couple says, “'The further you get into it the more you have to lose.” A woman looks at her husband after a failed cycle, and says, “I’m sorry.” After yet another negative, they say in frustration, “there's no control. It doesn't matter what you do.” One woman says, "I'm not sure how you're not supposed to be stressed!" Anotherwoman says, “you feel broken" and another couple talks about losing sight of their relationship by focusing on treatment. Two of the woman talk about the real problems of stress eating. One woman said that she’d been married for 18 years, but had never bought anything for a baby, because the prospect that it would never be used was too heartbreaking. One or two of the couples take breaks in the process, trying to reduce their stress levels.

They show a counsellor talking to the couple who have miscarried, and one of the most experienced and well-known specialists in the country talks to another couple about the different emotional experiences of men and women.

The financial costs are not emphasised, but not ignored either. The requirements for public funding are talked about when relevant. We hear that one couple has had to save for six years after their first IVF cycle to have another chance, a chance which the doctor then gives them as about 40%. We see another woman desperately losing weight to qualify for public funding, and another talks about using up all their savings. The lesbian couple had to find a private donor because it was financially more affordable than working through a clinic (and besides, there were no donors available through the clinic), until they could qualify for public funding.

There is humour. One guy laughs that in his first examination with the doctor, knowing that he had a zero sperm count, the doctor said to him, “I’m going to cop a feel.” Another couple giggled about the fact that the mother-in-law asked when her son-in-law was going in to make his “donation.” “Every man’s dream,” he said wryly. Another woman laughs (sort of) about clomiphene (clomid), explaining to the camera that it is “the drug that turns you into a monster.” The lesbian woman said that, having announced to friends that yet another IUI had failed, someone said to her, “never mind, it will happen when you least expect it to.” The couples laugh, showing how brave they are when you can see that tears are so very close too.

Public pressure and insensitivity is also discussed. The comment the lesbian woman received was particularly ridiculous, but they all feel under pressure. They get annoying comments and suggestions from siblings and parents. The Tongan man said he was mocked, and that his brothers have all offered their “help” to get his wife pregnant. He shrugged, saying they’re trying to be helpful, but you can see how those comments have hurt. Another woman was told that she and her husband needed God in their lives. One of the women notes that Facebook is “baby central,” and pregnancy announcements by friends, after trying for only after 2 months, are hard to take.

The couples talk about their conviction that they want to be parents. One couple says, "we feel it's meant to happen, we're meant to be parents," but then note that “a child would be the icing on the cake, not the be all and end all.”

The whole approach taken in the series is calm, honest, sensitive. My nervousness at the outset was that the documentary would be filled with myths, that it would try and hide the emotional, physical and financial stresses. Whilst it is very understated in manner, all these issues are addressed. One couple did get pregnant a month or so after finishing their clomiphene cycles, but the words “miracle” or “just relax” weren’t uttered.

In the end, after two years following these couples, there were conceptions through IVF, miscarriages and births, one using donor egg, and the others using their own eggs. Some couples are left facing life without children or accepting that their family is now complete, at least one or two pledge to continue, and there is a surprise adoption within a family (unsurprisingly, for NZers at least, it is in the Pacifica family). The balance achieved in such a small sample is remarkable.

As someone who has experienced this, and spent the last 15 years in a community of loss, and infertility, I found this deeply moving and, best of all, accurate. I’m hopeful that it will inform many people – young women and couples who may face infertility in the next few years, friends and family of those going through infertility, and the wider public – that infertility is common, it is stressful and expensive, and that there are no magic answers.