Joanne and John Hill, from Edinburgh, spent five years in their all-consuming attempt to have a baby before one day making what they call an incredible discovery - Joanne was pregnant. It had not been an easy road. Both of them were infertile and her pregnancies - they now have two daughters, Erin, three, and Robyn, seven months - resulted from embryo donation, where the embryos were created from both donated eggs and sperm.

They started trying when Joanne was 33, hoping to have a baby before she was 35. By the time she had conceived, the couple had tried sperm donation and had two unsuccessful rounds of IVF, one costing them £2500.

Both she and John were in professional jobs but, like many other couples, had to pay for the treatment with a loan because they did not have the savings to cover it. "You are so desperate for a child," says Joanne.

The Hills' story ended happily - but, according to a new survey commissioned by Red Magazine, the difficulties they experienced are common. Figures released today from the magazine's national fertility survey suggest that one- third of all couples in Britain trying to conceive experience problems.

Some 3200 women, with an average age of 37, were quizzed, and many said they feared they were "leaving it too late for motherhood". Statistics show that women's fertility begins to decline at 27, and drops markedly after 35. With the average woman not now choosing to attempt to conceive before the year she turns 30, it is not surprising that age has been highlighted as an issue.

It is not, however, the only factor. The main reasons couples need fertility treatment are unexplained fertility problems (36%), which could be linked to lifestyle; male fertility problems (19%); and Polycystic Ovarian Syndrome, or PCOS (16%).

Gemma Smith, from the Isle of Lewis, knows well the frustration of such problems. She was 18 when she was diagnosed with PCOS and, now 22 and married, has been struggling for two years to conceive.

Currently on the fertility drug Clomid, this month she will decide whether to progress to IVF or start considering adoption. "It's hugely stressful," she says. "The worst part is that the treatment can make you quite upset because your hormones are all over the place. I've also had lots of scans and blood tests. And then there's the pressure of waiting every month to see what happens. There's lots of disappointment."

No matter how difficult things get, people are not giving up. The new figures claim the total amount being spent across Britain in the quest for a baby is a staggering £1.7bn, with an average spend per couple of £4782 on fertility treatment.

"Infertility is the issue of our age and, incredibly, we have entered the billion-pound baby era," says Sam Baker, editor of Red, who is concerned that fertility treatment is becoming "the preserve of the well-off".

Those staggering costs do not surprise Professor Richard Fleming, scientific director of the private Glasgow Centre for Reproductive Medicine, which opened last year.

Some treatments are more expensive than others. In the case of a problem with male fertility, costs have increased dramatically as a change in the law meant sperm donors could no longer be granted anonymity, leading to a reduction in supplies.

"The shortage of sperm donors has meant that the service is often not available on the NHS," he says. "When I worked at the Royal Infirmary in Glasgow, I used anonymous sperm from Denmark and it cost around £40, which is reasonable." Now the cost for the minimum of 10 cycles is around £2000. On top of that, treatment costs range from £300 for straightforward insemination to around £3000 per cycle for IVF.

The reason people are prepared to pay out so much, he claims, is because if they start trying later in life they perhaps can't afford to risk the wait.

He adds: "These days, when couples realise that something may be wrong, or it might be harder for them, they don't have five years to play with. That might take them to an age where fertility is declining rapidly, so they seek help, which is the most sensible thing to do."

Costs are not the only issue, says Doriver Lilley, 42, a volunteer for UK charity Acebabes, which supports couples going through fertility treatment. The emotional and psychological impact is substantial.

"It's very difficult because having a baby is expected to be so normal and natural, something that just happens," she says. "It means that couples who are finding it more difficult to conceive often feel very isolated and alone.

"Figures suggests that the number of people seeking treatment is going up, but it never seems to affect anyone you know." Instead, says Lilley, 42, who had fertility treatment for seven years before conceiving twins through IVF and having three further natural pregnancies, you watch family and friends getting pregnant effortlessly and it's hard not to be jealous.

So why are so many couples leaving it till the eleventh hour? According to Shelia Panchal, psychologist and author of Turning 30 - about the crisis that can come with reaching your third decade - it is getting increasingly difficult for couples to take the plunge.

"You now have so many more choices," she says. "Whereas the previous generation might have spent their twenties building a solid life structure, a family home and financial stability, today's 30-year-olds are just as likely to decide to change career, live abroad or have still not settled down with one partner. People are now more keen to experiment before choosing one thing, and all that trying things out takes time."

But it's not all doom and gloom. Though a quarter of couples will experience a period of infertility - the inability to conceive for more than a year - at some point in their lives, many of those will go on to have a happy and healthy family. And for those that need the help to achieve that, Scotland is a good place to be based, with better access to IVF than anywhere else in the UK. Most couples under 38 can access the three free cycles recommended by National Institute for Clinical Excellence guidelines.

Helen Lyall, senior consultant at Glasgow Royal Infirmary's Assisted Conception Services Unit, says: "In the west of Scotland we are lucky because we do have good NHS provision - it's not like it is in England."

However, she does concede: "There is more awareness of treatments available, and more people coming forward does of course lead to longer waiting lists."

Yet even non-NHS treatments do not always have to be expensive. Lucille McQuade, tutor in the Billings Method at Fertility Care Scotland, says therapy doesn't have to cost the earth. The charity, which receives a small subsidy from the Scottish Government, helps couples to chart changes in cervical fluid, allowing them to recognise when they are ovulating.

"People think of it as the Catholic method' and there's still a lot of stigma around it, but it's suitable for anyone and it really does work," says McQuade, who often sees couples for whom the method is "the last resort".

She claims the best thing you can do is relax. "If you are highly stressed, the signals the body receives say this person is in no fit state to conceive," she says. "Often after a couple of cycles with us the body settles down and a pregnancy is achieved."

And those are the words that so many couples are longing to hear.



Useful contacts


  • The UK Infertility Network can help put you in touch with couples in your area experiencing fertility problems. Visit www.infertilitynetworkuk.com or call 08701 188 088.
  • The Glasgow Centre for Reproductive Medicine offers private consultations. www.gcrm.co.uk or 0141 891 8749.
  • Fertility Care Scotland offers help in using the Billington method. See www.fertilitycare.org.uk for details of clinics or e-mail info@fertilitycare.org.uk
  • Acebabes can offer peer support for couples struggling to conceive. Visit www.acebabes.co.uk or call 0845 838 1593.
  • Verity can help support those suffering from PCOS. Visit www.verity-pcos.org.uk
  • Cradle is a support group for affected couples. Visit www.assistedconception.org/cradle