“You’re not guaranteed a baby.” What it’s like going through IVF in the bush

For couples going through in vitro fertilisation (IVF), the strain can be tangible. The stress of the cost, the quiet despair, the consuming thoughts, the distance yawning between partners as they struggle to conceive. Every scroll on social media revealing other babies being born, someone else’s pregnancy announced.

Add isolation and the tyranny of distance and, for many, it’s the perfect storm. The cost of travel and accommodation in the big smoke, time away from home and work, juggling logistics and schedules with heartbreak and hope.

Raine Holcombe grew up on a crocodile farm in the Northern Territory and lives near Timber Creek, nearly 300 kilometres west of Katherine. She and her husband Potter own and operate a contract mustering company, Farrcombe Contracting, and spent four years going through IVF before a successful result.

“I think one of the learning curves we had going through IVF was that you’re not guaranteed a baby at the end. When we first started we just thought, ‘Oh yeah, so we have to do IVF, that doesn’t matter, it just means it’ll take a little longer’,” the 34-year-old says. “We didn’t really comprehend that perhaps we wouldn’t bring a baby home. That kind of hit us a couple of years later. You don’t know where to go or what to do or how to give up because it’s the one thing you want so badly. I think the best advice at that point is trust your instincts and seek a second opinion if you think your doctor isn’t making any progress.”

Raine’s case is unique — the couple has a rare genetic condition that was undiagnosed for years. Both Raine and Potter carry the same DQ Alpha gene, which causes an embryo to self-abort — so there was just a two per cent chance of falling pregnant, even with IVF. Finding a new specialist nearly 4500 kilometres away, in Melbourne, proved the answer to their problem and they welcomed their daughter Hallie in November 2020. The light is even brighter at the end of the tunnel, with Raine expecting their second child at the time of writing. The beef producer uses her Instagram platform — @barren_old_cow — to help educate and empower others, encourage conversation and simply offer a listening ear.

“I openly recommend to speak to a psychologist if you can, because it does take a huge toll on your relationship, your feelings of self-worth and financial stress,” she says. “We spent up to $150,000 before we got Hallie, so that stress alone is enough to get on each other’s nerves, as well as the resentment around whose fault it might be, or you might be on different wavelengths about how far you’re willing to go. You need to keep talking to each other.”

Dr Nicky Purser — a fertility doctor based between Darwin and Alice Springs — understands the extra challenges. “Rural patients have a much greater restriction on their time and availability than patients living in a city,” she says to me over our Zoom call. “If there are only a small number of people on the property, they might need to wait until it’s their turn to take leave, or for the mustering or harvesting to be done, or — specifically in the Northern Territory — wait until the river goes down so they can bring a car into town.”

Put simply, IVF requires two weeks of hormone injections to stimulate egg production, before the eggs are retrieved under a light general anaesthetic.

The eggs are combined with sperm in a lab’s culture dish where — if all goes well — an embryo forms that is inserted into a woman’s uterus, where it will hopefully take and grow. It’s invasive, physically demanding and expensive, with each IVF cycle costing up to $6000 out of pocket, depending on the treatment.

“The number of cycles varies enor­mously, usually from one to six cycles,” Dr Purser says. “There are many causes of infer­tility: age, obesity, endometriosis, polycystic ovary syndrome and male causes like poor sperm quality. About 25 per cent of patients with fertility problems have unexplained infertility: their tests are normal, but they still can’t conceive. It’s very difficult and can be very hard for loved ones watching, to know what to say and how to help.”

The success rate of IVF is mainly driven by the woman’s age, with a 30-year-old having a 45 to 50 per cent chance of pregnancy every time an embryo is transferred, which drops to around 25 per cent by the age of 40.

Being in a same-sex relationship meant IVF was the obvious choice for rural midwife, Rebecca Jones*. She and her fiancée, Margot*, both live and work on Margot’s family farm in regional New South Wales, moving back to the bush from Sydney after COVID-19 hit in 2020. After two failed Intrauterine Insemination (IUI) cycles and three IVF rounds, the couple is now undergoing the necessary ultrasounds and blood tests in the nearest regional town before making the 10-hour round trip to the city every month for appointments.