Night shifts and your fertility

A really interesting new study has found that women who worked night shifts or who had jobs involving heavy lifting produced fewer eggs when having fertility treatment than those who worked normal day shifts. The research team from the United States investigated around 500 women who filled in detailed questionnaires about their work shift patterns and any heavy lifting involved in their jobs. The researchers found that there were clear differences in the number of eggs produced by women who worked at night and those who did heavy lifting at work.

I found this study particularly fascinating as I worked night shifts before I started trying to conceive, and was very aware of the negative impact it had on my overall health – but often wondered whether it could affect fertility too. This was an observational study – which means the researchers were not linking cause and effect but just seeing what happened with the different groups of women and fertility experts have urged caution in interpreting the results. However, if you are doing a job which involves working nights or a lot of heavy lifting and are having difficulty getting, the study would suggest it may be worth investigating if there is anything you can do to change your shift pattern or lifting at work.

You can read the full details of the research from the Journal Occupational and Environmental Medicine here along with reports from The Telegraph and the Evening Standard.

Women who are depressed are less likely to have fertility treatment

New research from the States suggests that women who are depressed are less likely to carry on with fertility treatment. The researchers from the University of North Carolina (UNC) screened 416 women with fertility problems, and 41% scored positive for depression although apparently more than half said that they felt depressed most or all of the time.

The research team found that the women whose screening test showed that they were depressed were less likely to carry on with treatment, and therefore less likely to end up with a pregnancy.  You can see more about the research, which was published in the journal Human Reproduction, here 

It isn’t really surprising that so many people who are having difficulty getting pregnant experience depression, but it is sad that some may end up avoiding or delaying accessing treatment that could help because of depression and anxiety.

Thanks to Steve McCabe

We should all thank Steve McCabe, the Member of Parliament for Birmingham Selly Oak for raising the issue of NHS funding for fertility treatment in a Backbench Business Debate at Westminster supported by Tom Brake, the MP for Carshalton and Wallington, and Ed Vaizey, the MP for Didcot and Wantage. He’d been contacted by a number of constituents about the problems of the postcode lottery for fertility treatment, and called on the Health Secretary to investigate the cost disparities and the variations of IVF provision across England to find out why NICE guidance isn’t being followed universally.

The Health Minister Nicola Blackwood said that she would be writing to NHS England to ask that it communicates clearly with CCGs the expectation that NICE fertility guidelines should be followed by all.

It is a difficult time for the NHS which we know faces financial challenges, but stopping funding IVF would make little difference to the monetary woes – and indeed may actually end up costing far more if you factor in the long-term distress and depression caused by not being able to access treatment and the risk of patients having multiple embryo transfers overseas and returning with multiple pregnancies which can lead to health risks for both mother and baby.

The debate at Westminster was not well-attended, despite a big campaign by the charity Fertility Network and the campaign group Fertility Fairness. If you haven’t written to your MP about the problems of the postcode lottery yet, it is not too late. You can find details of how to find your MP and what to write on the Fertility Network website and if you are interested in watching the Westminster debate, you can find it here 

Finding clinic success rates

New research suggests that if you want to find out about outcomes from fertility treatment at a particular clinic, the best place to go is not the clinic’s own website. Researchers from Manchester University discovered that fertility clinics use a variety of different ways to present their data which makes it very difficult for anyone trying to compare one clinic with another.  They found that clinic websites often use league tables which they construct themselves using their own parameters to compare clinics in their area and that these are “invariably constructed so that the comparison was favourable to the reporting clinic.”

If you do want to look at outcomes, it is worth bearing in mind that most clinics have broadly similar success rates and that relatively small percentage differences can be pretty meaningless and may have more to do with the patients being treated at any given time than anything else. The HFEA publishes outcomes broken down by age and this is by far the best place to go for information if you want to look at treatment outcomes as the figures are collected and collated the same way for all clinics across the UK

You can find the full report from Manchester University which was published in the British Medical Journal here.

 

How old is too old to be a parent?

Do you think there should be a cut-off age after which people shouldn’t have children? Or is it fine at any age at which it is remotely feasible? And is it right that we ponder this subject so much when it comes to women having children later in life, and yet barely raise an eyebrow when Mick Jagger has a baby at the ripe old age of 73?

The subject has been back in the news again after Dame Julia Peyton-Jones, former director of the Serpentine Galleries, became a mother at 64. It isn’t clear how she had her daughter, although we can be sure she didn’t use her eggs and that she may well have paid for a surrogate to carry the baby too.  I know we all feel and act younger than our grandparents may have done at the same age, but she will be 80 by the time her daughter is 16 – and I can’t help wondering what it would be like for a 16 year old to have an 80 year old mother? Or what it would be like to be responsible for a teenager when you were 80?

Of course, the other problem with news stories like this is that they muddy the waters when it comes to NHS funding for fertility treatment, as many people seem to assume that it is the NHS which is footing the bill for older women to try to have babies. In fact, in most areas there is limited funding for women up to the age of 39, and often nothing at all beyond that. At most women of 40-42 will get one cycle, but if you are older, there is no likelihood of funded treatment.

Leap In

If you haven’t already seen this fabulous article from The Guardian by Alexandra Heminsley, it is worth a read.

You may have come across Alexandra Heminsley before as she wrote a previous book, Running Like a Girl,, about her experiences of running (which I found really inspiring as someone who is not remotely sporty but who has discovered an unexpected love of running – albeit very slowly…).

This article is about her new book Leap In, which deals with swimming and fertility treatment. We learn that she has been through two rounds of treatment, one of which resulted in a positive pregnancy test followed by a miscarriage. There is always a feeling of connection when you read about someone going through fertility treatment – we all understand something that others never really can – and I found her article incredibly moving. She talks about her changing feelings as she goes through the unsuccessful treatment and miscarriage, about how she feels betrayed by her body and rejects it. Describing all this through a focus on swimming somehow makes it an even more powerful read. When she talks about the “sort of breathlessness, almost a vertigo” that comes over her when she thinks about never having a child, she captures in just a few words the vast hollow emptiness and fear which are so familiar to many of us.

I’ll be posting a book review soon, but in the meantime, do read the article.

Don’t bother with that detox

images-4Most people think about their lifestyle when they are going through fertility tests and treatment – there is so much information out there now about how diet and lifestyle can impact on fertility that it’s not surprising that people often feel a need to take measures to improve what they eat. It’s never a bad thing to eat healthily, but it’s also true that there’s little scientific evidence about so-called fertility “superfoods” or that supplements are going to make a real difference to the outcome of treatment.

At the start of a new year, many of us feel we want to use the opportunity to improve ourselves in some way and the idea of a detox to start the year is often very popular. However, doctors have issued a warning after one woman who did this last year became seriously ill as a result of taking herbal remedies and drinking too much water. She collapsed and suffered a seizure before being admitted to hospital.

Please don’t worry that eating your five a day and cutting back on alcohol is going to make you unwell – this was a full-on detox diet which is a very different thing. In fact, the British Dietetic Association told the BBC that the whole idea of detoxing is nonsense – so whilst eating well and cooking fresh wholesome food is always going to be good for you, this makes it clear that there is not only no need to follow extreme diets, it can also be very dangerous. You can read more about this here and here 

Other people’s fertility treatment

laptop-computers-1446068-mThe Internet can be a fantastic resource when it comes to finding out more about fertility and treatment, and many people gain important insights by reading other people’s fertility stories online. This can, however, have a less helpful side. Although it may be useful to get practical tips, to read about what happens during a cycle and to feel that you are more prepared for what is about to happen, it is also vital to remember that everyone’s treatment is different. The tests carried out, the protocols used, the drugs prescribed can all vary depending on your own individual situation.

Recently I’ve been contacted by a few people asking about their treatment who have become worried that something might not be right because they’ve come across other people who have had different tests or treatments – or who have been prescribed different drugs at different doses. Just because your treatment is not exactly the same as someone else’s, that doesn’t mean it is wrong or less likely to work. If you have concerns, you should never worry about asking at your clinic, but remember that fertility treatment is always tailored to an individual to some degree and that clinics may not all do everything exactly the same way.

Fertility funding schemes

unknown-6I’ve come across quite a few mentions of fertility funding schemes recently where you pay a lump sum and are then offered your money back if you don’t get pregnant. Of course, the usual criticism of these schemes is that they are only available for younger women who are most likely to get pregnant. So I was interested to read of one recently which was apparently open to women of all ages with no age cut off. However, reading further down the article, it was apparent that actually although there wasn’t an official age cut off, women did have to pass a “screening” – and it is highly likely that by their mid forties, very few women would pass such a test.

These schemes can seem a great option – but it is important to understand their limitations as they are not open to everyone.

Can you ever stop plans to cut IVF

images-10If there are plans afoot in your local area to reduce the number of IVF cycles offered to those who need treatment, or even to cut treatment altogether, you may be left wondering whether there is anything you can do to make a difference. Although there are sometimes public consultations when funding is due to be cut or reduced, it can be tough to have the confidence to put forward your point of view – and sometimes it may start to seem as if there is very little point anyway as people wonder whether those who commission treatment are really listening.

This excellent piece from Bionews written by Richard Clothier tells how he fought back against planned cuts to fertility treatment in his local area. It’s a great read – and you may be surprised by the outcome.