What should you do in the Two Week Wait?

For most people, it’s probably the worst part of an IVF cycle – the notorious 2ww when you get to spend a fortnight (which seems to last about ten years) on tenterhooks, worried about everything you do and don’t do in case it affects the chances of a positive outcome. One of the most frequently asked questions is what you should and shouldn’t do during this time.

You will find all kinds of advice from all kinds of experts about activities, diet and supplements during the two week wait. There are those who advise that you should take the time off work and do as little as possible, spending the first day or two lying on the sofa. Others may advise going back to work right away to try to keep your mind occupied and suggest that it’s best for your mind and body to keep active and busy. I’ve heard of people drinking pints of milk and others avoiding dairy products.  There are women who don’t take baths because they might overheat, and others who are lying around with hot water bottles on their stomachs.

If you visit any fertility forum, you will find it awash with questions and suggestions about the two week wait. Some are quite bizarre – a quick trawl produced all the usual stuff about eating pineapple core and brazil nuts, but the idea that you shouldn’t eat anything uncooked and that you need to wear socks 24 hours a day were both new ones to me!

I will always remember the nurse who cared for us during our first IVF cycle telling me that any rules about what not to do during the two week wait weren’t really set because they would cause an embryo not to implant or induce a miscarriage but rather because they were things that fertility patients often worried about. So, having a glass of wine during the two week wait is not going to stop you getting pregnant, but if your treatment doesn’t work and you’ve had a glass of wine, you are likely to question whether it was to blame.

I think the bottom line with all of this is that if you are sufficiently worried to be asking whether it is OK to do something, it’s probably a good idea not to do it. Two weeks seems a lifetime during the 2ww, but in reality it isn’t a long period to have to give anything up. There are no hard and fast rules, but following your own instincts and doing what feels right for you rather than allowing yourself to be driven to distraction by conflicting suggestions is probably the best advice anyone can give you about what to do and not to do.

Can you help save fertility services in Richmond

NHS Commissioners in yet another area are considering cutting fertility services. This time, it’s Richmond Clinical Commissioning Group which is consulting on whether to continue to offer one fresh and one frozen cycle of treatment or to cut the service entirely. You can give your views by completing their survey –
https://www.surveymonkey.co.uk/r/IVFandICSIconsultation

The consultation closes on Tuesday 4 April 2017, so please do let your views be heard especially if you live in or near Richmond.

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!

Secondary infertility

The fact that fertility problems can occur for people who had no trouble conceiving their first child often comes as something of a surprise – and yet it’s very common. You may have seen the article in The Guardian this weekend by journalist Sarfraz Manzoor about the difficulties he and his wife experienced when they tried for a second child – a subject author Maggie O’Farrell had also written about in the paper some years ago. The magazine Fertility Road covered the subject recently, and it is great that it is being talked about.

All too often, there’s an assumption that secondary infertility is somehow less of a problem because you aren’t childless – and yet in fact the pain it causes may be different, but it is still a deeply distressing problem. Parents can feel guilty about not being able to provide a sibling for their child, and it can be very difficult to escape pregnant women and babies when you have a young child.

People sometimes put off seeking medical advice if they are experiencing secondary infertility having conceived without a problem in the past. In fact, there are no guarantees when it comes to fertility and it is actually more common to have a problem second time around than it is not to be able to have a child in the first place. Sometimes the difficulties you are experiencing are just down to the fact that you are older than you were when you got pregnant before, but there can be other medical problems which may have occurred in the interim. If it is taking you longer than you would have liked to get pregnant again, you should visit your GP in just the same way that you would do for primary infertility – so usually after a year of trying unsuccessfully or after 6 months if you are over 35.

Night shifts and your fertility

A really interesting new study has found that women who worked night shifts or who had jobs involving heavy lifting produced fewer eggs when having fertility treatment than those who worked normal day shifts. The research team from the United States investigated around 500 women who filled in detailed questionnaires about their work shift patterns and any heavy lifting involved in their jobs. The researchers found that there were clear differences in the number of eggs produced by women who worked at night and those who did heavy lifting at work.

I found this study particularly fascinating as I worked night shifts before I started trying to conceive, and was very aware of the negative impact it had on my overall health – but often wondered whether it could affect fertility too. This was an observational study – which means the researchers were not linking cause and effect but just seeing what happened with the different groups of women and fertility experts have urged caution in interpreting the results. However, if you are doing a job which involves working nights or a lot of heavy lifting and are having difficulty getting, the study would suggest it may be worth investigating if there is anything you can do to change your shift pattern or lifting at work.

You can read the full details of the research from the Journal Occupational and Environmental Medicine here along with reports from The Telegraph and the Evening Standard.

Women who are depressed are less likely to have fertility treatment

New research from the States suggests that women who are depressed are less likely to carry on with fertility treatment. The researchers from the University of North Carolina (UNC) screened 416 women with fertility problems, and 41% scored positive for depression although apparently more than half said that they felt depressed most or all of the time.

The research team found that the women whose screening test showed that they were depressed were less likely to carry on with treatment, and therefore less likely to end up with a pregnancy.  You can see more about the research, which was published in the journal Human Reproduction, here 

It isn’t really surprising that so many people who are having difficulty getting pregnant experience depression, but it is sad that some may end up avoiding or delaying accessing treatment that could help because of depression and anxiety.

Leap In by Alexandra Heminsley

This is a book about swimming, about how Alexandra Heminsley overcame her fear of water and learnt not only to swim, but to enjoy swimming outdoors in choppy seas, cold rivers and dark tarns. Heminsley’s earlier book, Running Like a Girl, is about running when you don’t think you’re a runner and Leap In is the swimming version. It’s her honesty, the detail and her beautiful writing which make this such an engaging book; I could completely envisage the sweaty attempts to squeeze her body into a wetsuit, the feelings of panic in deep water, the anxiety about her bare feet when she does her first river swim.

Leap In is about pushing yourself, about facing up to difficulties – and we learn more than half-way through the book that Heminsley is going through fertility problems and IVF as she continues her swimming journey.  At that point, her battles to overcome her fears have an undercurrent of a more fundamental challenge.

Heminsley doesn’t tell us much about her fertility problems or the experiences of tests and treatment, but what she does say is rich with meaning for anyone who has been there. “When I think about never having a child, a sort of breathlessness, almost a vertigo, comes over me,” she writes, explaining in just one sentence the overwhelming hollow bleakness of infertility. She has a positive pregnancy test after her second IVF cycle, but miscarries – something she deals with in two poignant paragraphs in which she describes the sense of crushing grief and how this transforms her relationship with her body which she feels has betrayed her and which she now rejects.

I really love this book – it manages to be funny, sad, inspiring and thought-provoking. The last chapter of the first part ends with Heminsley pondering what lessons swimming has taught her and where her future lies. She says she doesn’t know if she will ever have a child, or even the strength to try IVF again, but her attitude to life is that we must Leap In, living life as a participant rather than a spectator, that we must not give into our fear of the unknown and must be courageous when we need to adapt or amend our plans and discover our inner strength and resilience. These are certainly thoughts to ponder for anyone who is in the midst of fertility problems.

Leap In is published by Hutchinson.

 

 

Finding clinic success rates

New research suggests that if you want to find out about outcomes from fertility treatment at a particular clinic, the best place to go is not the clinic’s own website. Researchers from Manchester University discovered that fertility clinics use a variety of different ways to present their data which makes it very difficult for anyone trying to compare one clinic with another.  They found that clinic websites often use league tables which they construct themselves using their own parameters to compare clinics in their area and that these are “invariably constructed so that the comparison was favourable to the reporting clinic.”

If you do want to look at outcomes, it is worth bearing in mind that most clinics have broadly similar success rates and that relatively small percentage differences can be pretty meaningless and may have more to do with the patients being treated at any given time than anything else. The HFEA publishes outcomes broken down by age and this is by far the best place to go for information if you want to look at treatment outcomes as the figures are collected and collated the same way for all clinics across the UK

You can find the full report from Manchester University which was published in the British Medical Journal here.

 

How old is too old to be a parent?

Do you think there should be a cut-off age after which people shouldn’t have children? Or is it fine at any age at which it is remotely feasible? And is it right that we ponder this subject so much when it comes to women having children later in life, and yet barely raise an eyebrow when Mick Jagger has a baby at the ripe old age of 73?

The subject has been back in the news again after Dame Julia Peyton-Jones, former director of the Serpentine Galleries, became a mother at 64. It isn’t clear how she had her daughter, although we can be sure she didn’t use her eggs and that she may well have paid for a surrogate to carry the baby too.  I know we all feel and act younger than our grandparents may have done at the same age, but she will be 80 by the time her daughter is 16 – and I can’t help wondering what it would be like for a 16 year old to have an 80 year old mother? Or what it would be like to be responsible for a teenager when you were 80?

Of course, the other problem with news stories like this is that they muddy the waters when it comes to NHS funding for fertility treatment, as many people seem to assume that it is the NHS which is footing the bill for older women to try to have babies. In fact, in most areas there is limited funding for women up to the age of 39, and often nothing at all beyond that. At most women of 40-42 will get one cycle, but if you are older, there is no likelihood of funded treatment.

Leap In

If you haven’t already seen this fabulous article from The Guardian by Alexandra Heminsley, it is worth a read.

You may have come across Alexandra Heminsley before as she wrote a previous book, Running Like a Girl,, about her experiences of running (which I found really inspiring as someone who is not remotely sporty but who has discovered an unexpected love of running – albeit very slowly…).

This article is about her new book Leap In, which deals with swimming and fertility treatment. We learn that she has been through two rounds of treatment, one of which resulted in a positive pregnancy test followed by a miscarriage. There is always a feeling of connection when you read about someone going through fertility treatment – we all understand something that others never really can – and I found her article incredibly moving. She talks about her changing feelings as she goes through the unsuccessful treatment and miscarriage, about how she feels betrayed by her body and rejects it. Describing all this through a focus on swimming somehow makes it an even more powerful read. When she talks about the “sort of breathlessness, almost a vertigo” that comes over her when she thinks about never having a child, she captures in just a few words the vast hollow emptiness and fear which are so familiar to many of us.

I’ll be posting a book review soon, but in the meantime, do read the article.