Terrible threes

Successful fertility treatment can be a mixed blessing for some couples. By Emma Haughton

Imagine you have been trying for a baby for 10 years without success. Month after month your hopes are raised, then shattered. You undergo dozens of painful and inconclusive tests. You blow your savings on three cycles of physically and psychologically exhausting IVF treatment. All three fail. Running out of money and emotional resources, you decide to have one last go.

Three weeks later, the pregnancy kit tests positive - euphoria! - but you go for a scan to make sure. The radiologist (CHK) stares hard at the picture and suddenly you know that something is wrong. Seeing your look of panic, she points to an indistinct grey mass on the screen. "There's nothing wrong with your baby," she says, "but it's not one, it's triplets."

You'd feel shocked, of course, numb ... but what then? "I was absolutely staggered when they told me there were three," says Caroline Handley, 35, who had already had one son, Matthew, by IVF 18 months before. "I just couldn't imagine how I would cope, going from one to four children under two-and-a-half. When I got to the car I became hysterical. I can't remember driving home."

"It wasn't a very easy thing to come to terms with, especially as the pregnancy was so awful. I felt so bad because I felt so sick. I spent most of the nine months on a drip and had 11 admissions into hospital. Matthew had to go and stay with relatives. It was quite a depressing time really... I felt quite desperate."

It's 10 years since the birth of the first test-tube quintuplets and IVF is commonplace. So, unfortunately, are multiple births as a result of fertility treatment. Last year some 300 sets of triplets were born in the UK - 12 times as many as 20 years ago. Couples undergoing IVF have a 25 per cent chance of twins and a 5 per cent chance of triplets, compared with one in 90 and one in 9,000 of the general population.

Caroline's reaction is not unusual. Despite the fact that IVF parents have tried very hard to become just that, triplets are far more than they bargained for. "You desperately want one baby and you end up with three," she says. "It dashes your hopes for normal parenthood. If you have trouble getting pregnant you see being a parent as extra special, you want to do everything for your children."

"But with triplets that's just not possible. One pair of hands simply isn't sufficient. You try and give them a cuddle, for instance, and they fight on your lap for your attention. It really grieves me to see their frustration. I feel they're missing out."

Coming to terms with multiples as the result of fertility treatment can be so difficult that the Twins and Multiple Births Association (Tamba) has set up a special infertility support group. "You have this idealistic vision of looking after this wonderful baby, you imagine what you will do and what you will buy for it," says Lorraine Wallace, 44, who co-ordinates the group, "but when you've got twins or triplets you haven't got the time or the money to do any of that."

Family and friends, however, may see the prospect of an instant family as something to rejoice in. "The problem is that everyone expects you to feel happy, and that just makes you feel even more guilty," says Lorraine. "You feel you can't complain about your children, that it's somehow all your fault because you clearly chose to be parents. But you didn't choose to have three."

Lorraine's story tells a more tragic side to conceiving multiples. After discovering she had suffered blocked tubes after an operation when she was 19, she became pregnant after three attempts on IVF. "I started to bleed just after I discovered I was pregnant. After 24 hours it stopped, but I thought I had lost the baby. When the scan revealed there were triplets I was over the moon."

"I was petrified all through the pregnancy. I used to be a nurse so I knew it was high risk. You give yourself milestones, get past 12 weeks and the threat of miscarriage, past 28 weeks and they're viable and so on." But at 37 weeks Lorraine's placenta stopped working. "That morning was a nightmare. I can still remember every detail. A scan showed that one of the babies was dead; I knew it was true but I still hoped they were wrong."

Although five-year-old Jack and Laura are perfectly healthy, Lorraine still grieves for Amy, the daughter she lost. "It was terrible trying to cope with her death while looking after two tiny babies. We tried a support group for bereaved parents but it was very difficult. No one said anything but I could feel the vibrations - you've got two tiny babies, why on earth are you here? People just don't acknowledge your grief for the one you lost.

"Even now I get bad days. The children were four before I could even let them have a party. I feel very mixed up on their birthday, not much like celebrating."

Yet Lorraine would still describe herself as one of the lucky ones. "Some people in the infertility group give birth early and all three die, or some are disabled. I can't even begin to think about what that's like." Twins are five times and triplets 12 times more likely to die around birth than single babies. And as they are born on average six to seven weeks premature, triplets are often much smaller and more vulnerable, and at increased risk of cerebral palsy and other disabilities.

Then there's the mother. Along with the emotional overload of worrying about miscarriage and how you will cope after the birth, carrying multiples is physically exhausting. And as most triplets are born by Caesarean, most will start motherhood recovering from major abdominal surgery.

Jane Ryan, for instance, suffered a haemorrhage and kidney failure after her triplets were born by Caesarean. "I came out of hospital after 10 days but my iron levels were still very low from the blood loss and I felt absolutely shattered. I just hadn't imagined how horrendous it would be when they first arrived. The first few months were awful."

However much IVF parents have longed for children, nothing can prepare them for the sheer immensity of the task of caring for three young babies, she believes. "I felt as if I was on autopilot most of the time. By the time I had finished feeding and changing all of them, it was time to start all over again. Tony and I had to work in shifts through the night just so we could each get enough sleep to survive."

And however delightful three may be, it doesn't get much easier as they get older, admits Caroline. "They're into everything and together can do things one child can't. They light the gas hob, one turning the knob while another presses the ignitor. Leave them in the car and the lights and horn go on instantly. One day I expect to see them drive it away."

She pauses for a moment, then laughs. "I suppose you have to see the funny side, or you'd just go mad"n

Tamba Infertility Support Group (0151 348 0020); Multiple Births Foundation (0181 740 3041)