would be interested in. She only had a vague memory from researching her book of what the procedure involved and progress in this area was rapid.
‘I’ll let Isabel explain, as she’s the one who’d be doing the procedure.’
‘I’ll try and make it as simple as possible.’ Isabel took a sip of water. ‘We stimulate the ovaries, in the same way we do for our infertile ladies, and then fertilise the eggs in the lab. Once the eggs are fertilised they start dividing—one cell becomes two, two become four and so on. We wait until we have eight cells, then we remove one and test for the BRCA1 gene. If it’s positive, we move on to the next embryo and so on until we find one that doesn’t carry the gene. When we do, that is the embryo we replace.’
‘Don’t some people think this is too close to eugenics?’ Robina asked. ‘As in designer babies?’
‘Not at all,’ Niall interrupted quietly. ‘This isn’t selecting embryos based on hair colour or intelligence or anything like that. This is selection that will prevent someone almost certainly suffering from breast cancer later on in life.’
‘I know some people find it distasteful,’ Isabel continued, ‘but the truth of the matter is that we select embryos anyway to put back.’
Robina was puzzled. ‘What do you mean?’
‘We add sperm to all the eggs we retrieve. Say we have fourteen. Out of those, sometimes only a proportion will fertilise. We study the ones that are under the microscope and grade them according to specific, recognised criteria. We select the ones with the best grades, and choose one from these to replace. So in a way we are already selecting. PGD only takes it a step further.’
Robina was fascinated and knew viewers would be too. Some might find it controversial, but she had never shied away from controversy. She would present both sides of the argument and leave people to make up their own minds.
‘Isn’t destroying perfectly healthy embryos wrong?’
‘Sometimes we freeze the leftover embryos—the ones that are of good quality, that is—in case the women want further treatment. If they don’t, then yes, we dispose of the remainder,’ Isabel continued, her face animated. It was clearly a subject that was close to her heart. ‘In many ways it’s no different to what happens in normal pregnancies. The ovary starts to produce several eggs, but there is always one dominant egg which then releases a hormone that stops the other competing eggs from developing further. In a way we are simply replicating nature.’
‘The issue I have is more of a scientific rather than a moral one,’ Niall said. ‘Not for this gene, which would be present in every cell of the embryo, but when we are testing for other genetic conditions, for example Down’s syndrome, there is the risk that out of the eight cells, we test the one cell that doesn’t carry the genetic abnormality and are led to falsely believe that the embryo is free of the condition. It is important that anyone considering PGD understands this.’
‘She wouldn’t be considering it if she weren’t desperate,’ Mairi interjected. ‘And she’s already shown how serious she is by having a double mastectomy. I’m not surprised she doesn’t want her daughter to go through the same thing.’
Robina leaned back as lively discussion broke out around the table. She wondered how it felt to have to make these kinds of decisions on a daily basis, knowing you held people’s dreams in the palm of your hand. Her heart went out to all the couples. The people in this room had such power over their lives. How could so many women bear to put themselves through so much potential disappointment and heartache? She knew she couldn’t put herself through it again. Never, ever. She had thought she would never get over the pain of losing one baby. How could she possibly risk doing it all over again?
‘Let’s take a vote,’ Niall said. ‘Everyone in favour of my seeing this lady, remembering I intend to make sure she understands the pros and cons before we proceed, raise their hands.’
It seemed that everyone was in agreement.
‘Let’s move on then,’ Niall said, but before he could continue, the receptionist popped her head around the door.
‘Annette has arrived for her scan, Sally. I’ve made her a coffee, but I don’t want to keep her waiting—she looks terrified.’
Sally stood. ‘Are you coming?’ she asked Robina, who immediately got to her feet. ‘Keep your fingers crossed, everyone,’ she added over her shoulder as Robina and her cameraman, John, followed her out of the room.
Sally showed Annette and her husband into one of the consulting rooms and then left them with Robina and John while she went to set up the scan.
Annette was pale and held on to her husband Mike’s hand as if for dear life.
Robina asked the nervous couple if they were sure they were happy to be filmed. ‘You can still change your mind,’ she told them gently.
‘No, we said we’d do it and we will.’ Annette raised her chin. ‘We want people to know what it’s like to go through IVF.’
Robina nodded to John, who focussed the camera on Annette.
‘Only people who have been through this know what it’s like.’ Annette’s voice was so soft, Robina had to strain to catch her words.
‘At first, every month you hope that this will be the month, but you tell yourself not to get too excited, but you can’t help yourself. You just want it so much. And then, when it doesn’t happen, it’s like a dark cloud descending on top of you. So you ask yourself, why me? What is wrong with me? And then eventually you realise that you have to seek help, because it’s not going to happen on its own—no matter how much you want it to. Suddenly, you can’t bear seeing babies. Sometimes you’ll cross the street so you don’t have to look at them, and you even avoid friends and relatives who are pregnant or have young children—even though you know it’s wrong and selfish.’
She took a shaky breath. Robina wanted to reach out and put her arm around Annette’s shoulders and tell her she knew how she felt, but she forced herself to stay still and let her have her say.
‘People tell you to relax, that it will be all right, that there is always adoption, and yes, for some people adoption is the right thing. But although they mean well they just don’t know how much it hurts not being able to have children of your own.’
She paused for a moment, her eyes welling up with tears. ‘And then, when you decide to go for IVF, you think that this is it. That soon you’ll be pregnant. Oh, you know the treatment might be unpleasant, but you don’t care. And they tell you it might not work, but you’re not really listening, cos you have hope again. So you do everything you are told, and loads of other stuff that you read about on the internet and in magazines—just in case. You go through the injections, do the diets, try the alternative treatments—put up with the hormones making you a little crazy, because you just know that soon you’ll be holding a baby in your arms, and you’ll do anything to have that feeling. Then when the drugs work, and they take you to Theatre, the hope is almost painful. So you have your eggs collected, but you have to wait again to see if they fertilise, and if they do, and one or two are replaced, you have to wait again to see if they implant. And even if you know there is still a chance you won’t fall pregnant, you go out and buy the cot, and start to think of names. And it’s the longest two weeks of your life as you wait. You are almost too scared to do anything, even though you know it won’t make a difference, and every twinge and niggly pain terrifies you. Then, at last, it’s pregnancy test day. And you tell yourself you must be pregnant because you couldn’t bear it if you are not.’
Annette took another deep breath. ‘But if you are like me, then the first time the test was negative, and I couldn’t believe it. I was devastated. But Mike wouldn’t let me give up, so we tried again. And this time the test was positive. We were so excited, even though Sally warned us it was only the beginning.’
She paused as Sally re-entered the room. ‘We didn’t listen, did we? We told everyone and they were so happy for us. But