Facts and headlines

120px-Sperm-eggSo another day, another “helpful” IVF headline. Today the Daily Mail tells us about the “£100 ‘condom’ that is £4,900 cheaper than IVF but just as effective”…

The only evidence to back up this suggestion are some figures which are apparently due to be released at the weekend claiming that 150  people have got pregnant who have used the device.

We learnt earlier this week that new figures from the Human Fertilisation and Embryology Authority show the number of babies born after IVF treatment now stands at more than a quarter of a million. I am not quite sure how 150 pregnancies leads the Daily Mail to conclude that this device is equally effective to the 250,000 babies from IVF…

I won’t say any more but if you are thinking of spending £100 on this device, please discuss it with a fertility specialist first.

Fertility worries for women

800px-Woman-typing-on-laptopNew research has suggested that many young women are worried about their fertility, and that conflicting information and pressure from friends and family all contribute to the problem. It is not clear from the press release for this study how many women were surveyed or how the survey was carried out, but it has apparently suggested that:

  • Nearly half (47%) of under 45s surveyed said they worry about not being able to have a baby and this rose to 62% among 18-24 year olds.
  • Almost two thirds (63%) reported feeling upset, stressed or pressured by conflicting fertility advice, with one in three women saying that they found it hard to get information that they could trust.
  •  Women aged 18-24 said pressure to have a baby came from family and friends (33%), the media and celebrity culture (18%), or even people they didn’t consider close friends (8%).
  •  Women aged 25-34 reported the highest level of pressure from family and friends (52%), while older women (aged 35-44) felt less pressure from the media and celebrity culture than younger women.

For women who were concerned about getting pregnant, nearly half (49%) of those surveyed were worried that they may have a fertility problem that they didn’t know about..

Dr James Nicopoullos, Consultant Gynaecologist at The Lister Fertility Clinic, said:
“It’s understandable that women are feeling both worried and confused about their fertility. There is so much information (and also misinformation) out there which in some situations is causing unnecessary stress, but the truth is that there’s no one size fits all approach to fertility advice.”

The consumer research apparently suggested there was some confusion about factors that can affect fertility, and James Nicopoullos, Consultant Gynaecologist at The Lister Fertility Clinic, has addressed some of these issues.

Respondents to the survey said: Being on the pill for a long time could make it harder to get pregnant (41%)

James said: This is a common myth that I hear, but it’s actually false. 75% of women ovulate and cycle normally within a month of stopping the pill and 90% within 3 months. Those who don’t have regular cycles thereafter may have some underlying issue causing this (such as polycystic ovarian syndrome).

They said: Doing regular exercise can help improve fertility (64%)

James said: There is no consistent evidence that regular exercise negatively effects fertility so I would always suggest keeping in shape is a good thing. In extreme cases, there have been instances where women have decreased their body fat stores through exercise, leading the body’s hormonal production to switch off and prevent periods, which negatively impacts on fertility.

They said: Drinking alcohol can make it harder to get pregnant (60%)

James said: Some studies have indicated that alcohol can affect fertility so decreasing intake or stopping completely is never a bad thing. The evidence, however, at low levels is inconsistent. National guidelines suggest no more than 1-2 units of alcohol once/twice per week.

They said: Smoking can affect your fertility (66%)

James said: Smoking tobacco even a small amount can significantly impact on fertility and the evidence for this is much more clear-cut than with alcohol. There is evidence of a negative effect on natural fertility, an increase in miscarriage risk, ectopic pregnancy risk as well as lower chances with assisted reproduction. There is even a significant risk of earlier menopause. Some studies have also shown a correlation with number of cigarettes smoked. Just as important are the increases in risk in pregnancy of complications such as preterm labour, stillbirth and placental problems.

They said: A positive state of mind can help improve fertility (47%)

James said: Stress is a very hard thing to quantify but my motto is “don’t be stressed about being stressed”. At extremes, it can again cause periods to cease but in most this will not be an issue. A large study in the British Medical Journal suggested that stress caused by fertility problems or other life-events did not seem to impact on the outcome of fertility treatment.

They said: Being overweight or obese can make it harder to get pregnant (71%)

James said: Both extremes of weight can be detrimental. Those underweight may have issues with their cycles stopping affecting chances of natural conception and as body mass index rises above normal there are risks to fertility and once pregnant. Studies have shown that it may be harder to conceive naturally, as well as lower chance of success with fertility treatment. Miscarriage rate is also higher as BMI increases. Ideally we should aim for a BMI of 19-25 and strongly recommend a BMI of <30 when trying to conceive.

They said: ‘Wearing loose clothing can help improve fertility’ (12%)

James said: This is a myth. While some studies have suggested that wearing tight underwear may affect sperm production in men, the same can’t be said for women.

They said: Pilates and yoga can improve your fertility (21%)

James said: Anecdotally, I would say that being calm, happy and in good shape could help you conceive, but whatever works for you. I think it would be false to attribute good fertility to doing yoga.

The true impact of fertility problems

Cmhc-LqWYAAWk88It’s all too easy for those not affected to brush off the impact of fertility problems on people’s lives, but a new study from Fertility Network UK with Middlesex University London has come up with some bleak figures.

As Susan Seenan, Chief Executive of Fertility Network UK explains, “This survey paints an incredibly stark, distressing picture of what it is like to experience fertility problems in this country. Sadly, in the UK, the inability to have children without medical help means having to face a series of emotional, social and financial hurdles. These include often having to pay crippling amounts of money for your own medical treatment, a lack of affordable, accessible counselling and emotional support, and the deterioration of core relationships. Far more needs to be done to help individuals through the far-reaching devastation fertility issues wreak.”

Key findings include:

  • 90 per cent of respondents reported feeling depressed; 42% suicidal
  • 54% had to pay for some or all of their treatment; 10% spending more than £30,000 (the average was £11,378)
  • 74% said their GP did not provide sufficient information
  • 70% reported some detrimental effect on their relationship with their partner
  • 75% noted the lack of a supportive workplace policy
  • 75% would have liked to have counselling if it was free; only 44% did receive counselling and, of these, over half had to fund some of it themselves

You can read the full survey results here 

The Fertility Show London – 5 and 6 November

the-fertility-show-london-logoIt’s next weekend and if you haven’t booked your tickets yet, there is still time. It’s true that the Fertility Show can feel a bit like some kind of Ideal Home Exhibition for fertility problems, but it’s well worth visiting for the amazing seminar programme alone where you can catch many of the country’s leading experts and benefit from their wisdom and advice.

Talks on Saturday include:

  • How To Get Pregnant (and to have the best possible pregnancy) with Zita West
  • Innovations in embryo selection. Do they really make a difference? with Rachel Cutting MBE, Chair 2010-2014 of the Association of Clinical Embryologists and Principal Embryologist at Jessop Fertility in Sheffield
  • Stress and its impact on fertility with Jacky Boivin, Professor of Health Psychology at Cardiff University and Lead Researcher at Cardiff Fertility Studies
  • Surrogacy in the UK with Sarah Templeman, Nurse Manager at Herts & Essex Fertility Centre and Helen Prosser from Brilliant Beginnings
  • Natural Cycle and Mild IVF – fertility treatment without the drugs? with Professor Geeta Nargund, Medical Director of CREATE Fertility
  • The Basics. What you need to know to get pregnant and how to prepare for pregnancy with George Christopoulos, Subspecialty Registrar in Reproductive Medicine and Surgery at IVF Hammersmith
  • Next Generation IVF? with Professor Simon Fishel, CEO of CARE Fertility
  • Dealing with recurrent miscarriage with Dr Vidya Seshadri, Consultant Gynaecologist & Specialist in Reproductive Medicine at The Centre for Reproductive & Genetic Health
  • Reduced ovarian reserve: Is anyone too difficult to treat? with Sam Abdalla, Director of the Lister Fertility Clinic
  • Factors to consider when choosing a fertility clinic with me! (Kate Brian, journalist, broadcaster, author of bestselling The Complete Guide to IVF, mother of two IVF children, Lead of Women’s Voices at the Royal College of Obstetricians and Gynaecologists and London Representative for Infertility Network UK)
  • Going abroad for treatment? Question time featuring 2 overseas clinics with Dr Bruce Shapiro of The Fertility Center of Las Vegas and Dr Natalia Szlarb from IVF Spain.
  • Counselling through infertility with Tracey Sainsbury, member of the British Infertility Counselling Association.
  • Boost fertility and prevent recurrent miscarriage with nutrition with Dr Marilyn Glenville
  • Immunology – potentially hazardous treatment or your best chance of success? with Mr Mohammed Mahmoud, Consultant in Reproductive Medicine of The Newlife Fertility Clinic and Siobhan Quenby, Professor of Obstetrics and Director of the Biomedical Research Unit in Reproductive Health at the University of Warwick.
  • Improving the odds of IVF working for you with Yacoub Khalaf, Consultant Gynaecologist and Medical Director of the Assisted Conception Unit at Guy’s and St Thomas’ NHS
  • Coping Strategies with Wendy Martin, specialist fertility counsellor with Bristol Centre for Reproductive Medicine NHS
  • Testing your fertility and the value of your ovarian reserve with James Nicopoullos, Consultant Gynaecologist at the Lister Fertility Clinic.
  • Freeing your mind to improve fertility with Russell Davis, Cognitive Hypnotherapist.
  • Dealing with Polycystic Ovary Syndrome (PCOS) with Adam Balen, Professor of Reproductive Medicine and Surgery at Leeds NHS Centre for Reproductive Medicine and Chairman of the British Fertility Society.
  • Issues for families created with donors with DC Network founding member Olivia Montuschi.
  • What men need to know about their fertility – testing it, boosting it, treating it with Allan Pacey, Professor of Andrology at the University of Sheffield and former Chairman of the British Fertility Society.
  • Complementary Therapies – can they boost your fertility? with Dr Gillian Lockwood, Medical Director of Midland Fertility Services and ethics spokesperson for the British Fertility Society, Andrew Loosely who practices herbal medicine and Barbara Scott, chair of the Association of Reproductive Reflexologists.
  • Fertility treatment for older women with Tarek El-Toukhy, Consultant in Reproductive Medicine and Surgery at Guy’s and St. Thomas’ Hospital.
  • How to keep costs down – do you really need those add-ons? with  Dr, John Parsons, part of the team that established the first IVF pregnancy to deliver at the Hammersmith hospital.
  • Sperm and egg donors from the UK with Laura Witjens, egg donor and former CEO of the National Gamete Donation Trust, and Venessa Smith, Donor Services Co-ordinator from the London Women’s Clinic.
  • Can acupuncture improve fertility? with Michael Dooley, Medical Director of Poundbury Fertility and Emma Cannon, acupuncturist.
  • The arguments for travelling to the USA vs Portugal vs Norway with Dr Angeline Beltsos of Vios Fertility Institute, Dr Vladimiro of Ferticentro and Dr Jon Hausken from Norwegian Klinikk Hausken.
  • Steps to choosing the right adoption agency with First4Adoption’s Gemma Gordon-Johnson.
  • Travelling to the USA for egg donor treatment – the patient’s perspective and the clinic that treated them with Sarah Esdaile and her partner who had treatment in the USA and Dr Michael Levy, Director of the Donor egg programme at Shady Grove Clinic.
  • A patient’s experience of the fertility rollercoaster and what to expect with Jessica Hepburn, trustee at Infertility Network UK and author of  The Pursuit of Motherhood.
  • Why should I give it another go? with Tim Child, Associate Professor and Subspecialist in Reproductive Medicine, University of Oxford and Honorary Consultant Gynaecologist, John Radcliffe Hospital.
  • Planning Treatment abroad? The arguments for travelling to Greece vs Spain vs Russia with Dr. Dimitrios Dovas of The NewLife IVF Centre in Greece, Dr Ramon Aurell, IVF Unit Medical Director of Hospital Quirón Barcelona and Dr Yulia Gurtovaya, a consultant at West Middlesex University Hospital who speaks on behalf of Russian IVF clinic CRM MAMA.
  • Single women and lesbian couples – options for conceiving with Dr Raúl Olivares, Medical Director of Barcelona IVF.
  • An overview of the common causes of infertility and the main approaches to treatment with Kamal Ojha, Medical Director of Concept Fertility and Honorary Senior Lecturer at St George’s Hospital.
  • Fertility treatment for older women with Dimitrios Nikolaou, Consultant Gynaecologist, lead clinician at Chelsea and Westminster NHS Hospital’s Assisted Conception Unit and Medical Director of Fertility for Life.
  • Options for adoption with Jan Fishwick, CEO of PACT
  • Unknown donor vs known donor vs co-parenting with fertility lawyer Natalie Gamble and Erika Tranfield of Pride Angel.
  • What to think about before going abroad for treatment with Ben Saer, who with his wife Becky had successful fertility treatment in the Czech Republic, Dimitris Kavakas of Embryolab based in Thessaloniki and Dr Carlos Doscouto of Spanish IVF clinic Women’s Health Dexeus.
  • Dealing with and treating, endometriosis with Haitham Hamoda, Consultant Gynaecologist in reproductive medicine and surgery at King’s College Hospital.
  • Top Ten ways to cope with infertility with Anya Sizer, rregional organiser at Fertility Network UK.
  • Surrogacy arrangements with Helen Prosser from non-profit UK surrogacy agency Brilliant Beginnings and Natalie Gamble, campaigner and founder of leading fertility law firm Natalie Gamble Associates.
  • Single woman in your 30s or 40s? Thinking about having a baby on your own? with Caroline Spencer, trustee for the Donor Conception Network.
  • New technologies in IVF with Lucy Richardson, Senior Embryologist at the UK’s Herts & Essex Fertility Centre and Dr Elizabeth Barbieri from US-based Oregon Reproductive Medicine.
  • Getting your head around treatments, clinics and statistics with Juliet Tizzard, Director of Strategy and Corporate Affairs at the HFEA
  • .Men Matter Too with fertility Counsellor Anthony Ryb.
  • Fertility treatment on the NHS? with Anil Gudi and Amit Shah, Consultant Gynaecologists who run the NHS fertility service at the Homerton Fertility Centre in East London.
  • Nutrition to help with PCOS, endometriosis and fibroids with Dr Marilyn Glenville.
  • How to deal with the diagnosis of unexplained infertility with Dr Jane Stewart, Consultant in Reproductive Medicine at the Newcastle Fertility Centre.
  • How to keep costs down – do you really need those add-ons? with Yacoub Khalaf, Medical Director of the Assisted Conception Unit at Guy’s and St Thomas’ NHS.
  • Overseas egg donors. Who are they and how are they chosen? with Dr Israel Ortega of IVI Madrid in Spain and Nancy Block of Fertility Source Companies in the US explain.

As you can see, there is something here for everyone and having access to so many experts under one roof presents a unique opportunity to learn more about fertility and the treatments which may help. You can buy tickets from the website www.fertilityshow.co.uk

Iwan Lewis-Jones

It was these tributes from the Liverpool Echo which inspired me to write a few words here in memory of Iwan Lewis-Jones who very sadly died last weekend. Iwan was one of those doctors you long to come across as a fertility patient – kind, understanding, empathetic and brilliant at his job working as a male fertility specialist at the Hewitt Fertility Centre in Liverpool. Long before I ever met Iwan, I interviewed a couple who’d been treated by him. They were so enthusiastic about this wonderful doctor they’d seen, how he had immediately understood their fertility problems and had known the best way to help, how lovely he had been to them and how they didn’t think they would ever have had their much-loved children if they hadn’t happened to find him.

Iwan brought such joy into many lives, and was a really lovely man. He was a great supporter of Infertility Network UK and understood the needs of fertility patients. It is just so terribly sad that he is no longer with us. You can read more about Iwan in the Liverpool Echo and the Daily Post. He will be remembered with warmth and fondness by all those whose lives he touched. Our thoughts are with his wife Clare and family.

Men speaking out

Sex_educationWhen you read about fertility problems, it’s nearly always women who are speaking out and telling their stories, but I’ve been really heartened to see that more and more men are opening up about their experiences of fertility tests and treatment. This article by Dan Rookwood in the Evening Standard is a great example.

Dan makes it clear that it isn’t just women who find it difficult when other people announce their pregnancies, that it isn’t just women who feel the disappointment when every period comes, that it isn’t just women who come to dread that question about when they are going to get around to having children… And anyone who has struggled with a diagnosis of unexplained infertility and who has been told that being less stressed might help will know exactly where Dan is coming from when he says that “nothing stresses you out more than someone who can’t give you any definitive answers telling you not to stress out“.

It’s a great article and well worth a read – it’s really important that we start to realise that fertility problems affect men just as much as they affect women.

One small quibble though – Dan says that he and his partner opted to transfer two embryos in order to “double our chances of success“. It is very important to be aware that although it may feel that way in fact putting back two embryos most definitely doesn’t double your chances of success – it just increases your chance of having twins. Dan explains that he and his partner began their treatment in the US, and if that’s where they had their IVF, it would explain this entirely as not all clinics in the States are as concerned as we are here in the UK with reducing multiple pregnancy. Here, a team would usually recommend single embryo transfer for a first IVF cycle if the embryos were good quality. Although we all know twins who are fine, many others are not – and multiple pregnancy is the biggest health risk from IVF, which is why it is so important to choose a fertility clinic which has a good success rate combined with a low multiple rate.

A story I’d love to be true – red wine and PCOS…

1024px-a_glass_of_red_wineAccording to the Daily Mail, “A glass of red wine a day could keep polycystic ovaries at bay”, which is one of those stories you’d just love to be true.  So often it seems that anyone trying to conceive is told to avoid many of life’s small pleasures – like coffee and wine – so a story suggesting that a glass of red wine every day is actually a good thing for some fertility patients sounds delightful.

The story claims that a natural compound called resveratrol which is found in the skin of grapes could potentially re-balance the hormone imbalances that women with PCOS experience. The women in the trial were given resveratrol in a pill form for three months and it was found to reduce testosterone levels and fasting insulin levels. The scientists leading the trial, which was published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, suggest it might help reduce the risk of metabolic problems common in women with PCOS. You can find the full report here.

But it reminded me of something – a story some years back about red wine which claimed that drinking lots of red wine would make you lose weight which was duly taken to pieces by the excellent NHS Choices. They made it clear that the amount of the magical resveratrol found in wine is “a fraction of that present in grapes and berries, as much of the chemical is filtered out during the wine production process. You would gain more resveratrol from eating the grapes and berries themselves than drinking wine – but that makes a much less exciting headline.”

And of course, the women in this PCOS study weren’t given wine to drink – they were taking a daily supplement of 1500 mg of resveratrol. Apparently, to get just 500 mg of resveratrol daily by drinking wine, you’d need to be consuming 40 litres, which means to get the benefit from it these women had you’d be getting through 120 litres of red wine a day. Which I don’t think anyone is going to recommend…

 

Have you booked your tickets for the Fertility Show?

the-fertility-show-london-logoThis year’s Fertility Show will take place at London’s Olympia on November 5 and 6. If you haven’t been before, it is certainly worth considering a visit as you will find many of the country’s leading experts under one roof offering a wide range of talks on every aspect of fertility over the two day show. There are also more than 100 exhibitors from clinics around the world as well as advice groups, charities, acupuncturists, diet, nutritional & lifestyle advisors and many others.

You will find something for you in the seminar programme and speakers include Professor Adam Balen, Professor Allan Pacey, Yacoub Khalaf, Professor Geeta Nargund, Zita West, Marilyn Glenville, Emma CannonJessica Hepburn and many more.

Tickets are on sale now, and there will be another Fertility Show in Manchester in March if you can’t make this one – details can be found at www.fertilityshow.co.uk

Can you help advise researchers?

Can you help? University of Cambridge researchers are looking for a few people to advise them on the best ways to attract people to share their fertility journey stories. They will be bringing a stand to the Fertility Show in November and have a few ideas that they are looking for feedback on. Do you have 15 minutes to spare over the next week (daytime or evening) for a Skype call with someone from their design team? If so please email amanda@the-liminal-space.com

Not too late to watch the BBC fertility programme

images-6If you missed it last night, the BBC TV programme on fertility presented by The One Show’s Alex Jones (and yes, it was on quite late!) is available to watch here and the BBC also has a good information page about getting pregnant at 35 plus which has links to some great factsheets on a variety of fertility-related issues from the British Fertility Society and the patient charity Fertility Network UK.

The programme is definitely worth watching – all too often media coverage of fertility is inaccurate or looks at extreme cases, but this managed to be balanced and interesting, covering the subject in a sensitive and empathetic way with lots of sensible advice.