People in different situations enter into surrogacy arrangements for a number of reasons, including:

• a woman is unable to become pregnant or carry a baby for medical reasons
• a woman is at risk of harming herself or the child if she becomes pregnant
• a same-sex couple (male or female) or individual may want to have a child, conceived using their own sperm or eggs and donor sperm or eggs
• a couple for whom repeated IVF attempts have failed
• a couple who are involved in an IVF treatment program may have embryos in storage and, if the woman dies, the male partner may wish to commission a surrogate to carry and give birth to a child.

Although most people's first priority is to be the genetic parent, this may not be possible. There are a number of alternative options:

• donor treatment
• fostering, adoption and permanent care
• volunteering within your community with organisations such as Big Brothers Big Sisters Australia, or sporting communities.

It’s up to you whether to discuss your treatment with work colleagues and your manager. If you think they are likely to be supportive it may be helpful as you will not need to explain absences.

Working with pregnant colleagues or listening to conversations about a colleague’s children can be difficult. You may be
asked questions you do not wish to answer, such as: ‘when are you going to start a family?’ Prepare your responses.

If you have decided to be open with your manager and colleagues, you might need to explain what fertility treatment is. The VARTA website is a great starting point. If confidentiality is important to you, be clear that your private information should not be shared.

It is important to discuss the number of cycles you are likely to need with your fertility specialist. Understanding the chance of a baby after one, two, or three IVF cycles can give you an idea of what you can expect. Having a plan and setting limits for the number of treatment cycles you will have can be useful for avoiding the temptation of ‘trying just one more time’.

If you have one or several unsuccessful treatments it’s important to talk to your fertility specialist about how your results can be used to predict your chances of having a baby if you continue treatment.

This may include a discussion about the number of eggs retrieved, the number of embryos formed and the quality of those embryos. If, based on this discussion, you decide to have more treatment it may be useful to agree on how many more times you try.

Deciding to stop treatment can be emotionally difficult, so you may find it helpful to talk to a clinic counsellor about how to manage this.

People are often concerned that the use of fertility drugs may increase a woman’s risk of cancer. Some studies have focussed on the relationship between fertility treatment and cancer, including large studies looking at the use of fertility drugs and breast cancer. When the results are combined, studies of more 45,000 women have found no overall increase in the rate of breast cancer among women who have used fertility treatment.

Ovarian and uterine cancers are much more uncommon and therefore more difficult to study. However, most studies have shown no significant increase in the risk of developing these cancers after using fertility drugs. Some studies have raised questions about whether there is an increase in cancer risk associated with the duration of fertility drug use, or use of specific types of fertility drugs among some groups of infertile women. To date, there is no conclusive evidence that these factors increase the risk of cancer.

Although the findings of these studies are reassuring, it is important to remember that IVF has only been available for just 40 years and that it is only in the last three decades that IVF has been used by large numbers of women. Therefore, questions remain about the very long-term risks of using fertility drugs, particularly for rare forms of cancer. Also, little is known about the effect of fertility drugs in women with a strong family history of breast or ovarian cancer, or in women with a personal history of cancer prior to fertility treatment.

Read more on the possible health effects of IVF here.

You can ask your fertility clinic about the counselling sessions included as part of your treatment.

If you want to speak to a private counsellor specialising in infertility, ANZICA has a list of independent counsellors.

When IVF fails, people often feel very disappointed and sad. However, follow-up studies show that within a few years of ending treatment, there are very few differences in terms of emotional wellbeing and life satisfaction between those who had a baby as a result of IVF and those who did not.

Fertility treatment is emotionally demanding. It is common for people to feel sad and worried during the ups and downs of treatment, particularly when waiting for results, when treatment fails, or when deciding whether to stop treatment. It’s important to know that there is no evidence that worry or sadness reduces your chance of success with IVF. Options for getting support include:

• social support networks which can be made up of partners, family members, friends and work colleagues.
• professional support from your fertility clinic
• professional support from a private counsellor

Having several sources of support is often useful and if you reach out you are likely to find people who are more than willing to listen and help in any way they can.

It’s helpful to know your options so you can make well-informed decisions. Talk to your fertility specialist and nurses about what to expect as part of your treatment and for resources about your treatment.

Studies over the years have shown that babies born after fertility treatment are more likely to be born prematurely and to weigh less at birth, and they have a slightly greater risk of birth defects.

However, by the time they become adults, research has shown that they are just healthy as other people. You can read more here