Helping the stork

When I decided it was time for me to become a parent I was already in my 30s. I checked with my then gynaecologist to make sure everything was okay before I began what I expected to be one of the most exhilarating journeys of my life, only to be told I had polycystic ovary syndrome (PCOS), a hormonal disorder common among women of reproductive age and one of the many causes of infertility in women.

The goodly doctor, without as much as a blood test, confidently made his diagnosis and proceeded to prescribe medication to treat my condition. I admit I was taken aback and gravely concerned about my fertility then. Fortunately, I had the good sense to do some research and get a second opinion before purchasing or taking any type of medication.

As it turned out, I did not have PCOS and was able to proceed with my planned pregnancy in the natural way – a mature egg was released from one of my two ovaries, the egg was picked up by my fallopian tube, sperm swum up my cervix, through my uterus and into my fallopian tube to fertilise my egg. My fertilised egg made its way down the fallopian tube to my uterus, where it implanted and grew into my baby boy.

This may sound easy enough, but for some couples it is far from because of fertility problems. There are many causes of infertility. Among those causes in women are ovulation disorders like PCOS, damage to the fallopian tubes, endometriosis, uterine or cervical causes. In men they can range from hormonal imbalances, ejaculation issues, low sperm count and infections.

Unfortunately, sometimes the cause of infertility is never found.

But because a couple experiences fertility problems that does not mean they can never fulfil their dreams of becoming parents. There are no guarantees but there are a few legal options, among them in vitro fertilisation (IVF), artificial insemination (AI), also called intrauterine insemination, and fostering or adoption.

“When patients come to the clinic there is a process. We get some reliable tests done, doctors’ reviews, we discuss options, so it is different for everyone. Not everyone who comes to the centre needs IVF. If you are advised to do IFV or AI we guide you along the whole way,” said Dr Catherine Minto Bain of the Trinidad and Tobago IVF and Fertility Centre. With IVF the eggs are fertilised in a lab and then transferred to the womb using a catheter. With AI the sperm is manually insert through the cervix and into the uterus so they can travel into the fallopian tubes to fertilise the egg or eggs.

For people who are not inclined to go the IVF or AI way there are the options of fostering and adoption. “The Children’s Authority of Trinidad and Tobago is the only agency in TT that deals with fostering and adoption,” chairman of the Children’s Authority Hanif Benjamin told WNM.

“Foster care is meant to be a temporary shelter for a child. Generally the plan is for the child to return to their parents when they are able to provide care. Adoption refers to the permanent placement of a child with a family who is deemed suitable to meet his or her needs,” Benjamin explained.

With foster care, both short and long-term placement options are available, and how long a child stays with foster parents is determined by the needs of the child through the assessment process done by the Children’s Authority. “The intention is to have the child reunited with their family where appropriate, possible or in the best interest of the child or until other suitable long-term living arrangements can be made,” he said.

Regarding adoption, Benjamin said there are three stages in the process:

Approval, which involves the application and assessment processes

Matching, which includes the search for the child that has been profiled by the prospective adopters

Placement, when the child has been successfully matched and placed in the adoptive home

“The time frame for the entire process varies depending on a number of factors. However, once a match has been found, there is a probationary period which can last up to six months.” Once that is successfully completed, the Children’s Authority will approach the court for an order to finalise the adoption process. The Adoption Unit of the Children’s Authority can provide details about the application process.

And while many people may consider surrogacy, both Dr Minto Bain and Benjamin advise it is not a legal option in Trinidad and Tobago. “There are a huge number of legal, moral and ethical issues surrounding surrogacy,” Dr Minto Bain said. However, she thinks it is something that should be put on the table for consideration. “There are people who need it and I believe it should be debated at a public level.”