Your views needed!

If you are having fertility treatment, or have done recently, you may have been offered some additional extras on top of your IVF or ICSI. These additional treatments include things like time-lapse imaging, embryo glue, endometrial scratching or reproductive immunology. Not all clinics offer every type of additional treatment. Some may not suggest them at all, others include them in the price of IVF or you may be given the option to pay for add ons if you would like them.

Fertility Network UK, the patient charity, and the fertility regulator the Human Fertilisation and Embryology Authority, or HFEA, is interested in finding out more about what you think about these add ons, how they should be offered and what you need in order to make decisions about whether to pay for them. Most of these add ons are not fully proven to increase your chance of getting pregnant.

If you have had treatment recently or are going through treatment currently, do take a minute to answer the short questionnaire to help them find out more about what your views are on this subject. You can find the link by clicking here

 

Need help choosing a fertility clinic?

If you are trying to decide where to have fertility treatment, you may have already found the Human Fertilisation and Embryology Authority’s new website, but if you haven’t, the Choose a Clinic section is worth checking out. It is much simpler and easier to understand that the previous website and as well as giving details about the clinic and the treatments offered, it also tells you about treatment outcomes at the clinic, how other patients have rated the clinic and about what the HFEA’s inspectors have reported back on the clinic too. If you are trying to work out which clinic is nearest to you and which might be the best for you to visit for treatment, all these factors may be taken into consideration and you can see the clinics as a list or on a map.

There is a wealth of information if you want to look more closely at individual clinics and it’s a very helpful and highly recommended resource for anyone making decisions about where to have their treatment.

The Fertility Show goes to Manchester

Did you know that the Fertility Show will be in Manchester next month? The event which has taken place at London’s Olympia for many years is spreading its wings and will be held at Manchester’s Central Convention Complex in Windmill St on March 25 and 26.

There will be a wide range of speakers including Allan Pacey,  Geeta Nargund, British Fertility Society Chair Adam BalenCharles KingslandSimon Fishel, John Parsons, Rachel Cutting, Jane Stewart, Raj Mathur, Tony Rutherford and Zita West. The HFEA’s Juliet Tizzard will also be speaking as well as specialist lawyer Natalie Gamble and Fertility Fest Director Jessica Hepburn. The sessions will cover a wide range of topics suitable to those just starting out and wanting to know more about their fertility through to more detailed sessions on specific fertility problems and treatment options. There will also be a separate platform for Q and A sessions and a wide range of exhibitors.

Tickets are now on sale here so do come along if you are nearby – I will be there too speaking about how to choose a fertility clinic and will be on the Fertility Network UK stand so come and say hello!

Left confused about intralipids?

lipidemulsionIf you watched Panorama yesterday and were left worried or confused about intralipids, there are sources of accurate and sensible information.

Looking at some of the comments from fertility patients after the programme, it seems that many people were actually surprisingly unconcerned by the lack of evidence for many of the treatments discussed because they felt if there was any chance at all of something making a difference, they would still be happy to try it.

What the programme didn’t make clear was that there are some potential health risks from using intralipids. These are clearly explained on the current HFEA website which has excellent information on reproductive immunology and covers intralipids. There is also a basic information sheet on add-ons from the British Fertility Society.

Choosing a fertility clinic

800px-Woman-typing-on-laptopThose of you who came to my talk at the Fertility Show will know that I promised to put up some notes from my talk on the blog this week – here they are at last!

The HFEA website

We begin with the HFEA website which is the best place to start. You can search for your local clinic using the Choose a Clinic tool – just type in your postcode or local region and you will get a shortlist of local clinics.

You can see more about the treatments they are licensed to carry out, services, facilities and staff. It will tell you whether they take NHS patients, the opening hours, whether there is a female doctor and links to a map.

Of course, the one thing you really want to know is how likely am I to get pregnant there? Which is the one thing no one can honestly tell you. The HFEA publishes success rates for all licensed clinics, but they may not be as clear cut as you imagine. Most clinics have broadly similar success rates and the majority of clinics in UK have success rates which are consistent with national average. Don’t forget, the patients treated affect the success rates.

You may want to look at the success rate for someone of your age, and make sure you are comparing like with like. The HFEA also gives the multiple birth rate, but a high rate doesn’t suggest a good clinic which has your best interests at heart. Naturally multiple births occur in 1 in 80 of all pregnancies, it’s around one in six after IVF. That may sound positive, but in fact multiple birth is the single biggest risk after fertility treatment. 1 in 12 multiple pregnancies ends in death or disability for one or more babies, and it is also more risky for mothers. Good clinics should not have very high twin rates. A really good clinic will have good success rates and low multiple rates.

When it comes to success rates, don’t get bogged down in fairly small percentage differences – in general they’re probably not that meaningful.

NHS Funding 

You will also want to know if you qualify for NHS funding. The guideline from NICE recommends 3 full cycles (fresh and transfer of any frozen embryos) for women of 39 and under and one full cycle for women of 40-42 who have had no previous treatment, who have a good ovarian reserve and who have spent 2 years trying)

In England funding comes from your local CCG (Clinical Commissioning Group) not your clinic so you need to find out their rules – and unfortunately they all make their own up as the NICE guideline is only a guideline. You can find out what your CCG is offering by visiting the Fertility Fairness website. The CCG will also set eligibility criteria – and each will have their own

Location 

Think about how close the clinic is to your home or workplace. Be realistic as a long journey is fine as a one-off, but think about doing it three or four times a week. Ask the clinic how often you will have to visit as some will want you in every day of the cycle, but others just a few times a week.

Think about how you will get there and how long the journey will take? Are you going to use public transport or drive? Will you be travelling in the rush hour? Can the clinic offer early morning appointments or will you need to take time off work? Will it fit around your job?

Cost 

Fertility treatment prices are not regulated and can vary hugely. Clinics that charge more are not necessarily better so do look into prices. The headline figure on clinic websites is rarely the total cost of treatment  – ask instead what the average person actually pays

The HFEA does require clinics to offer you a personalised costed treatment plan, but check what is included – drugs, counselling, scans and bloods, freezing and storing spare embryos, follow-up consultations etc.

Unproven treatments 

Many clinics offer unproven additional treatments. Many are not scientifically proven. The HFEA has advice on some of these . Additional treatments can be very expensive, and you may risk paying a lot for something that may not make a difference – and may even bring additional risks.

Support

Will there be someone you can call with any problems/concerns? You should be given a contact to call if you are concerned about anything at any time. And is counselling included in the cost of treatment? You may think you don’t want or need it, you may may find it helpful once you have started treatment. So check if you are going to have to pay for counselling, and if it is included, ask how many sessions.

Is there a counsellor based at the clinic? Some counsellors also offer telephone counselling and you can find a list of fertility counsellors on the British Infertility Counselling Association website. Is there a patient support group?

Waiting 

How soon could you get an appointment and when could you start treatment if it is recommended ? How long are waiting times for donor eggs or sperm? At some clinics,
there are still waiting lists for donor eggs and sperm but others have plenty of donors, so do check.k

Do you like the clinic?

I think this is far more important than you might initially think.

Talk to anyone else you know who has been there, look online for views – but remember that everyone is different. Go to any open days or meetings for prospective patients and think if the clinic feels right for you. It may sound ridiculous, but it matters.

Trust your instincts, and don’t hink they don’t matter. Make sure that you have chosen a clinic that you will be happy with.

Treatment isn’t always easy, but it is certainly much easier if you are being looked after by people you like and trust.

Choosing a fertility clinic

800px-Woman-typing-on-laptopOn Saturday, I’ll be speaking at the Fertility Show at London’s Olympia about what you need to think about if you are choosing a fertility clinic. If you are fortunate enough to have NHS-funded treatment, you may not have a wide range of clinics to choose from, and in some parts of the country there are fewer clinics than in others – but if you live in London or the South East and you are paying for your treatment, the choice can be overwhelming.

I’ll be explaining how to make sense of what can seem an overwhelming array of different clinics all claiming to be the best, and what factors you should take into consideration when making your choice. I’ll cover treatment outcomes – how to make sense of the IVF success rates published by the HFEA and why they may not be the only thing you want to look at when making a decision – and will look at a number of other issues that can affect which clinic might be right for you.

If you’re at the Show on Saturday, I look forward to meeting you – make sure you come and say hello!

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

Latest report on clinic incidents

4cell_embryo.tifThe fertility regulator, the Human Fertilisation and Embryology Authority, has just published its report on the number of incidents in fertility clinics. These incidents can be all kinds of things going wrong in a clinic from a patient suffering from hyperstimulation to a letter sent to the wrong person by mistake.

Incidents in fertility clinics are rare – they occur in less than one percent of the treatments performed in the UK fertility clinics – but each incident is one too many.

The HFEA’s annual report on fertility clinic incidents shows that the total number of incidents increased slightly but for the first time since the HFEA began publishing incidents reports, there were no A grade (the most serious) incidents reported at all.

HFEA Chair Sally Cheshire called on fertility clinics to substantially reduce the rate of incidents next year. She said “The UK’s fertility sector is one of the most developed in the world, and the high level of professionalism in the sector is highlighted by both the fact that fewer than 600 incidents were reported out of more than 72,000 treatments, and that no ‘grade A’ incidents were reported in the last year. We want to ensure clinics give patients the best possible treatment, so that they have the best chances of having the families they so dearly want. So, while incidents are already occurring infrequently, we want to see them reduce even further. I’m setting the challenge to all clinics in the UK to make sure that the overall number of incidents has decreased by this time next year. It’s not only ‘grade A’ incidents that can have an adverse effect on patients. All incidents, whether it’s a letter sent to the wrong address, or a case of ovarian hyper-stimulation, can have serious consequences for patients, and more has got to be done to make sure that fewer people are affected in the future.”

The report can be found here: www.hfea.gov.uk/9449.html.

A “potent” new treatment

images-21Another week, another Daily Mail story about IVF. You may have read this one about a “potent” new fertility treatment that is cheaper and less invasive than IVF and leads to a “50% increase in embryos”.  As usual with these stories about marvellous new advances, it all sounded wonderful and there was little to suggest that it might not be available at a clinic near you tomorrow.

I always read to the bottom of these stories. You usually find a sensible quote from a British expert, often Professor Adam Balen of the British Fertility Society or Professor Allan Pacey of Sheffield University if it’s a story about male fertility. In this case, there was no British expert, just a paragraph from the HFEA about in vitro maturation which wasn’t quite the same thing as the whole point of this “potent” treatment is that it is apparently an addition to in vitro maturation where substances are added to the egg cells to try to improve egg quality.

At the end of this article, a final paragraph explained that researchers are now starting to carry out some safety studies to ensure that adding these substances to the egg cells has no impact on the long-term health of babies – so probably not coming to a clinic near you just yet…

The HFEA would like your views

logo-hfeaThe Human Fertilisation and Embryology Authority (HFEA) have launched the beta (draft) version of their new website to the public and it is aimed at people like you – fertility patients. They want to know what you think of it. Have they got it right?

They have put together a survey so you can give your feedback about the new site. This includes a number of questions about how the information on clinics is presented – including their birth statistics in the Choose a Fertility Clinic section. The HFEA are keen to hear your views about how they have chosen to present these.

The beta service is a work in progress, with new information and features planned for the next weeks and months. You can give your views by completing the beta survey that can be found on the website. Please take a look at https://beta.hfea.gov.uk