If you are happy to talk to a Radio 4 journalist about this – and it can be done anonymously if you prefer – please email Catherine Hill at firstname.lastname@example.org
New research suggests that ethnicity may affect the chances of ending up with a baby after fertility treatment. A team from The University of Nottingham and the fertility unit at Royal Derby Hospital analysed data from the Human Fertilisation and Embryology Authority to see whether ethnicity had an impact on treatment outcomes, and found that there were some significant differences. According to the data, White British women are more likely to get pregnant with IVF or ICSI than women from a number of other ethnic groups.
This is the biggest study to look at the outcomes for individual ethnic groups in this way, and it considered the number of eggs collected and fertilised and the number of embryos produced as well as the pregnancy and live birth rate. The researchers also considered potential reasons for the differences in outcomes for the different ethnic groups and discuss factors such as genetic background, environment, diet, socio-economic and cultural factors and attitudes to medical care and accessing fertility treatment. They also discuss the fact that South Asian women are at higher risk of polycystic ovary syndrome (PCOS) which can affect egg quality and success rates.
You can find out more about this research here
If you’d seen the Daily Mail headline earlier this week suggesting that the “Most popular form of IVF given to thousands of couples is ‘ineffective’“, you may well have been worried. In fact, the headline was referring to ICSI which is far from ineffective as a treatment for male fertility problems, and has allowed many men who would otherwise have had to use a donor to have their own genetic child.
The story in the Mail concerned the fact that ICSI isn’t an effective treatment in other cases, and it said that the editor-in-chief of the Human Reproduction journal, Professor Hans Evers, had criticised IVF clinics for offering ICSI to couples who will not benefit from it.
The fact that ICSI isn’t for everyone is not news. The NICE guidance in 2013 made it clear that ICSI should only be used where there were male fertility problems although it could also be considered where previous fertility treatment had resulted in failed or very poor fertilisation. ICSI is sometimes offered more widely, but there is no evidence that this would increase the chances of IVF working, and some research has suggested that it could actually reduce the chances of pregnancy where there is no indication that it is needed.
If you have male factor problems, you can ignore this as ICSI may well be the most effective treatment for you. If you are being offered ICSI where there are female issues or unexplained infertility, then you should make sure you talk to the team treating you about this before going ahead.
Liz Gale, a Senior Lecturer in Midwifery at the University of Greenwich, is interested in the experiences of parents to be who are expecting their first child through IVF. This study is open to prospective parents who live in London or the South East and are expecting their first child, conceived using IVF or ICSI, genetically belonging to both parents. Full ethical approval for the study has been granted from the University of Greenwich research ethics committee.
Involvement in the study will entail 3 interviews, one antenatally at 34 weeks, the second when the baby is six weeks old and another 3 months following the birth. Interviews will take place in participant’s own home or somewhere convenient to you. You will also be asked to keep a diary to complete at your own convenience; this will not be onerous but will allow you to record your early experiences of parenthood; the diary will be reviewed by the researcher but will be yours to keep as a record of your early days with your baby. Anonymity is guaranteed and if you choose to participate you would have the right to withdraw at any point.
The study is undertaken as part of Liz’s PhD and once completed, the findings will be used to improve the care and support for parents with an IVF baby. If you are interested in taking part or wish to find out more information, please contact Liz at email@example.com
Another research request, this one from a team at Oxford University. They are keen to interview people who have had IVF/ICSI in the UK in the last five years. They want to talk to people about their views on allowing their personal data to be used in fertility research – if you had treatment in this time frame, you would have been asked if you were willing to allow information to be used for research purposes.
If you have had fertility treatment at a clinic in the UK in the last five years and live in England, you can contact Dr Claire Carson if you would like to know more about this research project or are interested in taking part. You can call her on 01865 289755 or email firstname.lastname@example.org
If you’re currently going through IVF/ICSI or donor treatment – or if you’ve had IVF/ICSI or donor treatment – and you went to a UK fertility clinic for this treatment, you could help the charity Infertility Network UK with a survey aimed at finding out more about the level of emotional support people receive from their clinics and what they are told about the counselling service.
It will only take a few minutes to complete the survey – and there is space to leave any comments you may have about this and the end of the questionnaire. It would be incredibly helpful if you could do this as the more people who are willing to complete it, the better a picture we will have of the provision across the UK and the more meaningful the results will be. You can find the survey here – please be reassured that it is totally anonymous.
So, North East Essex are the latest commissioning group to announce their plans to stop funding fertility treatment. The commissioners claim that in North East Essex there are “substantial numbers of people whose health, including their fertility, is affected by their lifestyle (for instance smoking, excessive drinking, and lack of exercise)”. Are there really huge numbers of smokers who drink to excess trying to access NHS-funded fertility treatment in the Colchester area? Most people I talk to who have fertility problems lead extraordinarily healthy lifestyles, so I’d be interested know what you think…
They are suggesting that fertility treatment should only be available for people who have had cancer and for couples where the male partner has Hepatitis C or HIV (in these they are proposing to offer ICSI despite the fact that NICE doesn’t recommend this at all).
You can read more about their proposals here. They are arranging a series of consultation “events”, so if you are able to get along to any of these, please do speak up for fertility patients. You can email email@example.com to say you’ll be there.
The first is on Tuesday 7 July in Colchester at 6pm at Room 12a, Primary Care Centre, Turner Road, Colchester CO4 5JR.
The next is on Friday 10 July at 2pm in Clacton at Princes Theatre, Town Hall, Station Road, Clacton CO15 1SE
Then on Thursday 16 July at 6.30pm at Clacton at the Princes Theatre, Town Hall, Station Road, Clacton CO15 1SE
And finally on Tuesday 21 July at 10am at Walton on the Naze at Columbine Centre, Prince’s Esplanade, Walton on the Naze CO14 8PZ
When a treatment cycle doesn’t work, there’s often a temptation to wonder whether it could be something to do with the clinic. People sometimes ask if they ought to consider a different clinic with a higher success rate or one which offers a wider range of additional (often scientifically-unproven) treatments if an IVF/ICSI cycle has been unsuccessful.
Why hasn’t my IVF worked?
One question that people always want answered after an unsuccessful cycle is why it hasn’t worked. The reality is that IVF doesn’t always work – we know that around 75% of cycles are unsuccessful. That may sound a rather poor rate of success but we also know that when people try to get pregnant naturally only around 20% will be successful in the first month of trying. No one really knows why some embryos implant and others don’t, and it’s not all down to clinics but also to nature.
The other key issue which often gets overlooked is age – the older you are, the less likely it is that an IVF cycle is going to work. Once you reach your forties, the success rates really plummet and the vast majority of cycles will be unsuccessful. The reason treatment hasn’t worked can often be age-related, but clinicians don’t always spell this out to patients.
A new IVF clinic
Moving to a different clinic may feel like a fresh start, and if you haven’t been happy with your treatment in some way it will certainly be a very sensible thing to do. However, if you’ve liked the clinic and you are only thinking of moving because your cycle hasn’t worked, it may be worth thinking again. Although a new place can feel different, there are some advantages to staying at a familiar clinic where you know the staff and they knew you, how you respond to the drugs and to the treatment. It will be familiar, and many people find that this can be very helpful when they start another cycle.
Some people do move clinics and find that they are far happier somewhere else if they feel they are getting better care or more attention, but it is something to think about carefully before jumping ahead – and one treatment cycle not working is not necessarily in itself a reason to change.
Access to NHS-funded fertility treatment in the UK is still a postcode lottery, and what you get depends entirely on where you live. What’s also becoming more apparent is that in some areas people are paying for additional tests and treatment when they are having NHS-funded IVF or ICSI, but this doesn’t happen everywhere.
Some fertility patients are paying for time-lapse imaging, for endometrial scratch or for embryo glue for example – and others are reporting being asked to cough up for tests before treatment such as AMH tests or even sperm freezing and storage.
Your experience of extras for NHS-funded IVF
The patient support charity Infertility Network UK is trying to build up a picture of what people are currently experiencing, so if you’ve paid for any additional tests or treatments on top of your NHS-funded IVF or ICSI, it would be really useful if you could let them know. All responses will be totally confidential, and you can email firstname.lastname@example.org. If you have paid and are able to give a rough idea of how much you have paid this would be helpful, and they would also like to hear from you if you would have liked to pay for some extras but this was not permitted.
Would you be able to spend a couple of minutes completing a quick questionnaire to help a research team who are planning new project? They want to know your views about time lapse imaging which some clinics are now offering with IVF/ICSI treatment. They want to know if fertility patients think a research trial to see how effective this is would be useful – you don’t need to have any personal experience of it but you do need to have had or be going to have IVF/ICSI.
If you have a spare couple of minutes, you can find their questions here – https://www.surveymonkey.com/s/66KDPTQ