For anyone with any experience at all of fertility problems, there’s a general understanding that probably the worst thing someone can say to you is “just relax…”, and yet this is the advice a TV doctor gave on ITV’s Lorraine programme. Dr Hilary Jones apparently said to a caller who was asking for advice after three unsuccessful rounds of IVF; “What I would say is, and this is probably the hardest thing to do, is just relax about it. There have been so many people that I’ve known who’ve gone through several rounds of IVF and nothing happens. And when they’ve given up, and gotten on with their lives, it miraculously happens naturally… Sometimes stress itself can have a very negative effect. So try living your life as normally as you can.”
I suppose this just shows why you should stick to asking fertility specialists for advice rather than a TV doctor, but there has been an understandable backlash from fertility patients and the charity Fertility Network UK. There is certainly a lesson to be learned for TV producers about the risks of getting a GP, who is by nature a generalist rather than a specialist, to offer advice to those who have already been treated by experts in any field of medicine. But should any doctor, even if they are a GP rather than a specialist, be telling people to “just relax” or suggesting that stress might be to blame for infertility? Apart from anything else, we all know that fertility problems cause huge amounts of stress – and that telling someone who is trying to conceive to “just relax” is about as helpful as telling them to get a dog, go on holiday or any of the other helpful advice that non-experts in the field like to pass on.
There is another problem here though, and that’s to do with blame. Suggesting that your stress levels might be responsible for your blocked fallopian tubes or endometriosis is nonsense, and yet many people do end up feeling that it’s their fault they can’t conceive in a culture which encourages you to believe that you can make the difference to outcomes by thinking positive, clean eating or complementary therapies. The truth is that none of these things are going to unblock your tubes or get rid of endometriosis, and for a medical professional to suggest that getting pregnant might miraculously happen naturally if you just relax is quite bizarre.
If you are interested in a role in the world of women’s health, there are some fabulous opportunities open at the moment. For anyone looking to volunteer, the Women’s Network which I chair at the Royal College of Obstetricians and Gynaecologists has some spaces. It’s a fantastic group of dynamic women committed to improving women’s health experiences, and members must be able to commit at least two full days at the College (in central London) every three months when meetings take place. New members of the Network will be expected to become involved in the work of a committees relating to RCOG’s work too, and to have regular email contact. It is a big ask, but it’s an extremely rewarding and interesting role and a chance to make a real difference. There are more details here
There are also two jobs at the charity Fertility Network UK. One is a short-term cover role for a co-ordinator for the charity for the whole of England, which is an amazing job. The other is for a co-ordinator for More to Life, the part of the charity which works for people who are childless, after stopping treatment or deciding not to have it – a really important role.There are some fabulous people working for the charity and you will have great colleagues. If you are interested, you can find out more here.
One discussion theme which comes up now and again on fertility websites and forums is whether to put back one embryo or two when you are having IVF, and there are always people advising others to “go for two” because it will double the chances of getting pregnant if you “don’t mind” having twins. For anyone who is struggling to conceive, the idea of twins can seem hugely attractive – an instant family in one go – but it’s important to be clear that multiple pregnancy is the biggest risk from IVF treatment for you and for your baby.
The best advice to anyone who is thinking about this as a dilemma is that you should be guided by the embryologists at your clinic, assuming you are having treatment here in the UK where your health and that of your babies is always put first when it comes to numbers of embryos to transfer. Most women should have one embryo put back, and two are only considered if you have had repeated unsuccessful attempts at IVF in the past, if you are older or if your embryos look less likely to implant. Putting two embryos back will not double your chances of getting pregnant. In fact, when single embryo transfer is based on your embryologist’s advice, it should not reduce your chances of getting pregnant and if you would have got pregnant with twins, you will still get pregnant with one embryo. A multiple pregnancy is more likely to end in miscarriage but this is not always considered when people are making decisions about how many embryos to transfer.
Although we all know lots of twins who are flourishing and healthy, we don’t hear so much about those who aren’t. The increased risk of miscarriage, and of problems for the babies who are more likely to be born prematurely and may have disabilities or long term problems is very real. There are also risks for the mother such as high blood pressure and pre eclampsia and haemorrhage. You can read more about this here on the HFEA website.
This is why the best fertility clinics – those who really have your interests at heart – have a good success rate and a low multiple pregnancy rate.
I’m going to be running a new fertility group for Fertility Network in Greenwich in South East London which you are welcome to join! We are having our first meeting on the evening of Tuesday March 27. It will be great to see you if you are able to come along!
I first went to a group when I was going through IVF myself and found it hugely helpful to meet other people who understood how we felt. I was a bit uncertain about going along – I didn’t think I was the sort of person who went to group meetings – but in fact it wasn’t gloomy or depressing or any of the other things I’d expected. If anything, it was actually quite uplifting to be in a room full of people who weren’t going to stat asking questions about when we were going to have a baby and why we were leaving it so late…
I’ve run a number of different fertility groups over the years since then and have seen at first hand the benefits they can bring. So why not come along and join us and find out for yourselves…
You can join our brand new Facebook page to find out more or you can get in touch via the contact page here – and hope to see you on the 27th.
Congratulations to the brilliant team at the Fertility Education Initiative for getting the subject of fertility education on the agenda. It was fabulous to see the subject covered on the front page of The Times, and also covered in the Sun and the Mail. The Fertility Education Initiative’s Jessica Hepburn and Professor Joyce Harper even featured on the Victoria Derbyshire show talking about this.
It’s such an easy subject to misunderstand or misinterpret – and people are often worried that talking to young people about infertility will mean they assume they don’t need to worry about contraception. In fact, this couldn’t be further from the truth as fertility education is about ensuring young people really understand and are fully informed about their own fertility. All too often, women who find they’ve left themselves a fairly small window of opportunity to conceive feel that they weren’t fully informed about their own reproductive clock or about the limits of fertility treatment.
You can read more about the Fertility Education Initiative here where you can also find answers to some common questions, and see a video of the Fertility Education Initiative’s Health Summit Choice Not Chance held in 2016.
Since 2009, the Lister Fertility Clinic has been offering a small number of free IVF cycles each year to try to help people who are unable to access NHS-funded fertility treatment. The cycles are offered in conjunction with the charity Fertility Network UK and there are some criteria for entering into the draw for the free cycles.
You have to be a UK resident under the age of 42, with a cause for your fertility problems. Your BMI must be in the normal range and you can’t have any children from your current relationship. You can’t have been sterilised in the past and you can’t have had a free cycle at the Lister before. There are also some restrictions on the type of treatment you can have, which can’t include egg donation.
You need to send your entry to Fertility Network UK – and you can find the details here
Pineapples are much-discussed by those trying to conceive as their cores contain the enzyme bromelain, which is a natural anti-inflammatory which some believe could help implantation.
Now, the online fertility magazine ivfbabble is using pineapples as part of a campaign of solidarity for those experiencing fertility problems. Their “stronger together” campaign is a brilliant idea which aims to bring people together and to make us all realise quite how common fertility problems and that we are not alone.
The latest figures released by Fertility Fairness earlier this week about funding for IVF treatment have been described as “shocking” by the President of the Royal College of Obstetricians and Gynaecologists, Professor Lesley Regan.
Commenting on the fact that so few clinical commissioning groups (CCGs) are currently following national guidance and that the number which have completely removed NHS IVF has almost doubled in the last year, Professor Regan said “These figures are shocking and it’s very disappointing to see even fewer CCGs following NICE guidance and providing full access to NHS fertility treatment. Current access to treatment is a postcode lottery and these health inequalities people face are unacceptable. Infertility can have a devastating effect on people’s lives, causing distress, depression, and the breakdown of relationships. IVF treatment is cost-effective and should be available on the NHS. The RCOG is committed to working with UK commissioners and healthcare providers to support them in following NICE Fertility Guidelines.”
There are also a couple of very helpful videos on what it’s like to have IVF and ICSI. You can find out much more by having a look at the HFEA’s posts and you can follow for regular updates from the Authority.
The campaign group Fertility Fairness has produced a league table of different areas of the country to show how they rank when it comes to fertility treatment. Fertility Fairness has found that 90% of local clinical commissioning groups, who make the decisions about fertility treatment provision, found that nearly 90% were failing to provide the treatment that NICE has deemed to be both clinically effective and cost effective.
The BBC have provided a link to the full table in an article on the subject which shows that the best places to live if you need fertility treatment are Bury, Heywood, Middleton and Rochdale, Oldham and Tameside and Glossop. In some areas couples who are experiencing fertility problems cannot access any treatment. These are Basildon and Brentwood, Cambridgeshire and Peterborough, Croydon, Herts Valleys, Mid Essex, North East Essex and South Norfolk.
Fertility Fairness Co-Chair Sarah Norcross has been doing media interviews this morning calling for the government to take urgent action about the current funding situation. The government has suggested that commissioners should follow NICE guidance but in practice many are still choosing to completely ignore the evidence about best practice and about cost-effectiveness leaving many patients unable to access treatment at all,