Men have a biological clock too

We’re all very aware of the female biological clock, but what we don’t hear so so much about is the fact that male sperm counts decline and DNA damage in sperm cells may increase as men get over. The fact that some high-profile men have become fathers when they are pensioners perpetuates the myth that male fertility lasts forever.

In fact, evidence shows men do have a biological clock with a decline in natural male fertility and an increase in the miscarriage rate as men get older. New evidence at ESHRE from one London fertility clinic shows that IVF/ICSI is less likely to succeed if a male partner is over 51 too.

Dr Guy Morris from the Centre for Reproductive and Genetic Health (CRGH) in London presented results at the ESHRE (European Society of Human Reproduction and Embryology) conference of an analysis of more than 5000 IVF/ICSI cycles which found that although there was no difference in miscarriage rates, there was a significant reduction in the chances of success

The results showed that that clinical pregnancy rate declined as men got older – from 49.9% when men were under 35, to 42.5% for men aged 36-40, 35.2% for those aged 41-45, 32.8% for those aged 46-50, and 30.5% in the over 51s.

The researchers also noted that 80% of couples where the male partners were over 51 were treated with ICSI, a treatment developed for male infertility. Dr Morris said: ‘There may well be a public perception that male fertility is independent of age. Stories of celebrity men fathering children into their 60s may give a skewed perspective on the potential risks of delaying fatherhood. Indeed, in natural conception and pregnancy it is only recently that evidence of risks associated with later fatherhood has become available. These more recent studies contrast with decades of evidence of the impact that maternal age has on fertility outcomes. In the context of this emerging evidence for the deleterious effect of increasing paternal age, our data certainly support the importance of educating men about their fertility and the risks of delaying fatherhood.’ 

Fertility information research

Researchers are looking at patient information currently available about fertility treatment and are keen to talk to anyone who either has had treatment in the past or is thinking about it as an option. The study is called the Empowering Patient Informed Choices (EPIC) study and it is about developing better patient-centred information. The research team wants to know what helps when it comes to making decisions, particularly related to additional treatments. 

You can take part here – it takes about ten minutes to complete the survey https://lse.eu.qualtrics.com/jfe/form/SV_bdAnfkKd2YGp5qd

Raising awareness of endometriosis

Yesterday in London while a million people joined the People’s March, there was another smaller march going on to raise awareness of endometriosis.

The aim of EndoMarch 2019 was to help to publicise tthe need for faster diagnosis, greater education and more funds for research into better treatments and an eventual cure. Marches in other cities and across the world will be taking place next weekend.

There are around 1.5 million women living with endometriosis in the UK, and it can cause painful or heavy periods, exhaustion and bladder and bowel problems. Endometriosis doesn’t always affect fertility, but around half of women with endometriosis experience difficulty conceiving and it is a common cause of fertility problems. It’s a condition where cells which are similar to the womb lining are found in other parts of the body.

Women with endometriosis are not always getting a diagnosis when they visit a doctor with symptoms, and research suggests that it takes on average seven to eight years to be diagnosed. During this time, women are often suffering in silence, uncertain of the cause of their problems.

Endometriosis one of the subjects up for discussion at the Fertility Forum in London on March 30. Ertan Saridogan is a fertility expert with a special interest in endometriosis and he will be explaining how endometriosis affects your fertility. He will cover all the options for treatment and how to choose between them.

The Fertility Forum is a non-commercial evidence-based day which has been organised by patients and all the professional bodies in the field working together, and aims to help those who have been trying to make sense of the overwhelming mass of information on offer. It takes place at the Royal College of Obstetricians and Gynaecologists and is open to anyone who wants to know more about their fertility.

Tickets for the Fertility Forum are on sale here – and you can see more details of the day including a full programme here.

Are you confused by fertility nutrition advice?

The chances are you won’t have been through fertility treatment without hearing some nutritional advice about what you should, and shouldn’t be eating. Some of it is very helpful, about following a balanced healthy eating plan, but some of it can start to become quite complicated – and potentially confusing. Should you be eating one piece of pineapple every day for three days after embryo transfer? Or should you be shaving the flesh off, slicing the core into five slices and eating one a day for five days? Should you be drinking one pint of  pure pineapple juice a day? Or are you meant to be avoiding the juice entirely and just consuming the core? And what about the Brazil nuts? Are you meant to eat seven a day? Or three? Or four? Or five? Should you be drinking half a litre of full-fat organic milk every day? Or should you be avoiding all dairy products especially milk and yoghurt as it builds up mucus which interferes with implantation? Then there’s the question of supplements? Should you be taking special fertility supplements, or a range of different individual supplements? Or should you not need any supplements at all if you’re following a healthy eating plan?

If you’ve ever felt confused by fertility eating and lifestyle advice, you may want to get some evidence-based information from an expert in the field. Reproductive biologist and nutrition scientist Grace Dugdale will be at the Fertility Forum in London on March 30, where she will give evidence-based information about health, diet and lifestyle in relation to male  and female fertility. She will talk about what can impact on your fertility, and about preparing your body for pregnancy.

The Fertility Forum is a non-commercial evidence-based day which has been organised by patients and all the professional bodies in the field working together, and aims to help those who have been trying to make sense of the overwhelming mass of information on offer. It takes place at the Royal College of Obstetricians and Gynaecologists and is open to anyone who wants to know more about their fertility.

Tickets for the Fertility Forum are on sale here – and you can see more details of the day including a full programme here.

EndoMarch 2019

For the sixth year running, women around the world will be taking part in a peaceful march to raise awareness for those who have endometriosis. The London leg of the EndoMarch will take place on Saturday 23 March with the hope of publicising the need for faster diagnosis, greater education and more funds for research into better treatments and an eventual cure.

The walk is about 2.2km through Central London and is a chance for people who have endometriosis and others who are supporting someone with endometriosis, or who are interested, to make their voices heard. It is free to join but the organisers ask people who want to go along to register so they have an idea of how many people will be joining them on the day. You can register here https://www.eventbrite.co.uk/e/worldwide-endomarch-london-uk-2019-tickets-53917781536?aff=ebdshpsearchautocomplete

You can follow the organisers on Facebook at Worldwide EndoMarch London UK, Twitter at @EndomarchLondon and Instagram at endomarchlondon

Fertility in the workplace

Patient support charity Fertility Network UK have launched a new initiative this week called Fertility in the Workplace to try to raise awareness of how difficult it can be for people going through treatment to deal with work.

FNUK chief executive Aileen Feeney said: ‘Fertility treatment is on the increase with approaching 68,000 treatment cycles carried out every year in the UK and 1 in 6 couples (3.5 million people) affected, yet the majority of employers do not have a workplace policy providing the vital support employees going through fertility treatment need. Research shows having a supportive fertility in the workplace policy is good for business and employees – levels of distress associated with fertility treatment are reduced and employees are more likely to be productive and remain in work – that’s why Fertility Network is launching Fertility in the Workplace – an initiative designed to help employers support employees facing fertility challenges.‘Careers need not be damaged or jobs lost if there is an appropriate fertility in the workplace policy identifying the specific support available for couples or individuals having IVF. Introducing Fertility Network’s Fertility in the Workplace initiative ensures employees are treated fairly and empathetically and feel fully supported. The initiative provides a framework for employers to implement a fertility in the workplace policy and, crucially, provides guidance for both employees and for employers, who may have limited understanding of the impact of infertility and what fertility treatment is really like.’

Fertility Network’s research highlights just 26 per cent of people having IVF reported their workplace had some policy relating to treatment (58 per cent said their employer did not, and 19 per cent were not sure). The lack of a fertility workplace policy was associated with even higher levels of distress.

‘Companies are failing already distressed employees if they do not provide a supportive fertility in the workplace policy,’ said Ms Feeney. ‘Fertility Network’s survey underlines just how much the lack of workplace support affects people undergoing IVF. 50 per cent of respondents worried treatment would affect their career prospects; 35 per cent felt their career was damaged.’

Advice on treatment add-ons

It is sometimes difficult as a patient in a fertility clinic to know whether it is worth paying for some or any of the add-on treatments you may be offered. Now, the Human Fertilisation and Embryology Authority (HFEA), which regulates IVF clinics in the UK, and 10 of the leading professional and patient fertility groups, have agreed how treatment add-ons should be offered ethically in clinical practice in the UK in a consensus statement published today.

It’s published in response to growing evidence of add-ons being offered to patients, without conclusive evidence to date that any of them increase the chance of a pregnancy, and the fact that many patients feel they must do anything to improve the possibility of success. The aim is to create a culture change among fertility professionals in the UK.

Sally Cheshire CBE, Chair of the HFEA, said “We welcome the introduction of new treatments that could increase the chances of success, however, we want to see responsible innovation. Fertility treatment add-ons are being offered to more patients by clinics and we know many patients are asking for these add-ons and paying for them if they have private treatment. It’s crucial that clinics are transparent about the add-on treatments they offer, including the potential costs, to ensure patients know exactly whether they are likely to increase their chance of having a baby. That is why we’ve been working with professional groups such as the British Fertility Society to decide how unproven treatments into clinical practice should be correctly and ethically introduced, which is a vital step towards a more transparent approach in fertility services. We are now expecting clinics to provide information about treatment add-ons to patients, including what evidence there is of effectiveness.”

Alongside the principles for clinics, the HFEA has also published information on the most commonly offered add-ons, with a traffic light rating system, to help patients better understand the effectiveness of treatments they might consider.

Sally adds: “It’s crucial that patients inform themselves about the add-ons they may be offered, so that they can ask the right questions, and make the right choices, when choosing what treatment to have. We’ve produced ‘traffic light’ rated information on our website that keeps them up-to-date with the latest evidence on each of the most commonly offered add-ons.”

Jason Kasraie, Chair of the Association of Clinical Embryologists, said “We support greater transparency in the sector with regard to treatment add-ons. Whilst it is important that we work to ensure patients always receive the latest treatments and have access to new technologies in order to maximise their chance of treatment success, it is also essential that we ensure patients are fully informed and that only procedures or technologies that are evidence based are used.”

Key principles of the consensus statement are:

  • Clinics should only offer treatment add-ons where more than one high quality study demonstrates a treatment add-on to be safe and effective.
  • Clinics should stop offering the treatment add-on to patients if concerns are raised regarding safety or effectiveness.
  • Patients must be clearly informed of the experimental nature of any treatment add-on which is offered, where there is no robust evidence of its safety and/or effectiveness
  • Patients should not be charged extra to take part in a clinical trial.

The General Medical Council, has welcomed the statement. Chief Executive, Charlie Massey said: “We welcome this consensus statement, which will help protect fertility patients from poor practice and feeling pressure to accept additional, unproven extras. Patients deserve to have the best available evidence so they can make informed decisions, in partnership with doctors. It’s vital that doctors innovate responsibly and place patient safety first and foremost. Our guidance on consent sets out how doctors should work with patients to make decisions together about care and treatment options. Doctors working in the fertility sector must ensure that patients have information about the options available to them, including risks and available evidence, as well as any potential benefits.”

You can read the statement here and find out more about the HFEA’s traffic light system for add-ons here 

Petition for access to IVF goes to Number 10

The fertility patient charity Fertility Network presented its #Scream4IVF petition calling for fair access to NHS fertility treatment and an end to the IVF postcode lottery to 10 Downing Street on Monday afternoon. More than 100,000 people signed the online petition. It was a remarkable feat by a small charity to get such support for this cause and to be able to present the petition in this way.

Fertility Network’s chief executive Aileen Feeney said: ‘Gathering 100,000 signatures, in such a short space of time, demonstrates the overwhelming public support to end the unethical and unfair IVF postcode lottery and create an equitable system for access to NHS fertility services in the UK.These 100,000 signatures represent the screams of pain and frustration from not being able to have a child without medical help – and not having your screams heard. The screams of childbirth are loud, but the screams of infertility are just as loud and today they are finally being heard. In the face of this overwhelming public pressure, Fertility Network urgently calls on the Government to debate in Westminster the issue of fair access to NHS fertility treatment.’

Steve McCabe, the MP for Birmingham Selly Oak has been a key political supporter of the campaign for fair access to treatment and he was present when the petition was handed in. Steve’s  Access to Fertility Services bill will have its second reading at Westminster later this month. He said: ’I am thrilled so many people have got behind our campaign to end the postcode lottery of access to IVF. Infertility is a medical condition and it is completely unfair that access to IVF treatment depends on where you live. We can’t have a situation where local NHS groups are allowed to ignore NICE guidelines and ration treatment to save money. It is simply unfair and we wouldn’t stand for it if we were talking about other medical conditions such as cancer or diabetes. It is clear that the public are behind our campaign so now we need the government to step up to the plate and take action to end this disgraceful postcode lottery.’

100,000 call for fair access to IVF

Patient Charity Fertility Network has reached 100,000 signatures on the #Scream4IVF petition calling for fair access to NHS fertility treatment and an end to the IVF postcode lottery. Petitions which reach 100,000 signatures prove the public demand for a debate in Parliament. The #Scream4IVF campaign, with partners Saatchi & Saatchi Wellness, was launched less than three months ago on 6 September 2018.

Commenting on #Scream4IVF’s success, Fertility Network’s chief executive Aileen Feeney said: ‘Gathering 100,000 signatures, in such a short space of time, demonstrates the overwhelming public support to end the unethical and unfair IVF postcode lottery and create an equitable system for access to NHS fertility services in the UK. These 100,000 signatures represent the screams of pain and frustration from not being able to have a child without medical help – and not having your screams heard. The screams of childbirth are loud, but the screams of infertility are just as loud and today they are finally being heard. In the face of this overwhelming public pressure, Fertility Network calls urgently on the Government to debate in Westminster the issue of fair access to NHS fertility treatment. Thank you, too, to the incredible women and men who have shared their #Scream4IVF and made their infertility voices heard. We are stronger together.’

Steve McCabe MP (Birmingham Selly Oak) said: ‘I am thrilled so many people are joining our campaign to end the postcode lottery of access to IVF. Infertility is a medical condition and it is time we started treating it like one. It is simply unfair that access to IVF is down to where you live and not your medical need. In the New Year my Access to Fertility Services Ten Minute Rule bill is due to have its Second Reading in Parliament. This is the first small step to ending this disgraceful postcode lottery.’

Leader of the Liberal Democrats Vince Cable said: ‘People struggling with infertility can all too often face damaging mental health issues. It is wrong that there is so little support. 100,000 backing this campaign shows the strength of feeling behind the call for change. Liberal Democrats are listening and Ministers in Whitehall must listen too.’

Congratulations to all at Fertility Network UK on this huge success, particularly Chief Executive Aileen Feeney and London Regional Organiser Anya Sizer!

Natural killers or your body’s peacemakers?

Most people having fertility treatment are keen to absolutely anything they can to try to boost their chances of success, and sometimes that can mean paying for additional treatments as well as their IVF or ICSI which they hope can increase the likelihood that they will get pregnant. The problem with many of these treatments is that there is not yet sufficient evidence to be able to say that they will do what they claim to do, but fertility patients sometimes decide to have them anyway.

One treatment offered by some clinics is related to the level of natural killer (NK) cells in a woman’s body – the very name suggests that having a lot of these must inevitably be a bad thing. If you are considering having your NK cells tested as part of your fertility treatment, you may be interested in reading this article which explains the growing understanding that at least some of a woman’s natural killer cells act as peacekeepers, preventing other immune cells from attacking the fetus. They also produce chemicals which promote the growth of the baby and blood vessel connections.

You can read more about all fertility treatment add-ons on the HFEA website, where each of the different treatments has been ranked according to the latest scientific evidence and given a traffic light grading.