The truth about “clean” eating

When you are trying to conceive, it’s inevitable that you want to do all you possibly can to maximise your chances of success and changing your diet seems a fairly easy way of doing something to help. More and more fertility patients are giving up all kinds of foods and focussing on “clean” eating in an attempt to improve outcomes of treatment or to boost their fertility. Eating a healthy, balanced diet is never going to be a bad thing and will, without any doubt, help your overall well-being and make you feel more positive. Giving up whole food groups in the pursuit of clean eating, however, may not have any merit.

This fascinating article by Bee Wilson in The Guardian picks apart the clean eating phenomenon and raises lots of interesting issues about why clean eating has become so popular – and why that probably isn’t such a good thing.

It seems that the answer is moderation and common sense – the story of the wellness blogger who began to lose her hair and whose periods stopped at the start of this piece is a clear enough message about the impact very restrictive diets can have on fertility.

I’ve met so many fertility patients who are on hugely restricted diets – and who are actually made quite miserable by their constant battles to keep on the straight and narrow with their eating plans. Fertility treatment is tough enough without making things even harder for yourself. You may end up feeling guilty if you break your own strict rules when in fact it really isn’t going to stop you getting pregnant if you eat something which doesn’t tick all your healthy eating boxes from time to time.

The most important thing is to be kind to yourself during fertility tests and treatment – that doesn’t mean living on a diet of chocolate and red wine, but it does mean remembering what a balanced diet means and following a sensible eating plan rather than something which is going to make you feel unhappy and which may not be providing you with all the nutrients you need.

 

On egg freezing

There have been a couple of interesting items on egg freezing in the last few days. The first is a piece from the Telegraph, based around a BBC Radio 4 documentary about egg freezing presented by Fi Glover which looks at the reality of egg freezing. It’s definitely worth a read – and a listen – as it looks at why people consider egg freezing and asks whether the promises it offers are a reality.

At the same time, the Guardian’s Mariella Frostrup was answering a dilemma in a letter from someone who felt angry and let down by a friend who had suggested that she shouldn’t bother freezing her eggs at 35 as she was now 40, wanting a baby and had been told she had possibly left it too late. What was most interesting about this was the completely misplaced certainty that she would have been able to have children had she frozen her eggs, when in fact as Fi Glover’s programme and the Telegraph article explain, this may be very far from the case.

There is a huge media interest in egg freezing, and this is an interesting discussion whatever your point of view…

How volunteering can help

Please read this brilliant piece for the Guardian Voluntary Sector Network written by Ridhi, one of Infertility Network UK’s volunteers, about how running a support group has helped her cope with her own fertility problems. Ride is an absolute star, runs a hugely popular group and has written a really honest and open piece which I hope may inspire other people to get involved – see here and if you want to volunteer for Infertility Network UK, you can find more details here 

Pregnancy loss

I’ve only just seen this incredibly moving article in The Guardian about the experience of miscarriage – you don’t need to have been through the loss of a pregnancy yourself to empathise with this piece. It does make you think about how little other people appreciate or understand what it feels like to lose a baby – especially when this happens more than once. Well worth reading – thanks Amy for writing it.

If you are affected by miscarriage, the Miscarriage Association can offer really valuable help and support.

Article on dealing with fertility problems

There’s a really excellent Comment piece in the Guardian this week which I would recommend to everyone to read – and to give to read to people who tell you that fertility problems are a “lifestyle choice” which don’t need NHS treatment because they aren’t going to kill you. It’s written from the heart and I am sure it will resonate with many of you – see here

National Sperm Bank in the news

DownloadedFile-17It was interesting to see the news coverage today following an article in The Guardian yesterday headlined ‘UK sperm bank has just nine registered donors, boss reveals’.  Some of you may remember that a couple of months ago The Telegraph was “revealing” that the National Sperm Bank had just five donors. In fact, that story and the two articles in The Telegraph used quotes and figures from Banking on Birmingham a BBC Radio 4 documentary I’d made with producer Steve Urquhart which had been broadcast a few days earlier – where the fact that only five donors had been recruited was discussed and put into perspective.

Today’s story was very much focused on the “just” nine donors recruited by the National Sperm Bank but in fact that’s almost double the number of donors in June which would suggest that recruitment is on an upward trend. Recruiting donors is not easy – many men who initially express an interest are put off when they discover the commitment involved and many others who would like to donate are not suitable – on average, just one in every 20 men who applies to donate will be able to as the sperm has to be very high quality and they must also get through screening tests to ensure they do not risk passing on any genetically inherited diseases or sexually transmitted infections.

To learn just weeks after we thought the National Sperm Bank had five donors that it actually has nine can only be a positive step forward; let’s hope that the coverage today will encourage many more men in the Birmingham area to come forward. But do bear in mind that every time the National Sperm Bank is in the news, it doesn’t just lead to more donors in Birmingham but to more donors across the UK – so it’s good for other banks too.

You can find out more about the National Sperm Bank here and more about donating in general here 

Fertility in art

If you haven’t seen it already, you may be interested in this article from The Guardian about award-winning artist Tabitha Moses, who currently has an exhibition about her experiences of fertility treatment at Liverpool’s Walker Art Gallery.  Tabitha had two unsuccessful attempts at IVF before finally getting pregnant using eggs from a donor, and now has a young daughter. Her exhibition, which is titled Investment, uses white gowns like the hospital gowns you wear for egg collection and she has embroidered them with images that symbolise her own experiences of fertility treatment. She worked with two other women and features the images of their experiences on other gowns.

The embroidered gowns are beautiful and will resonate with anyone who has personal experience of fertility problems and treatment. Tabitha’s exhibition has now been extended through to the spring, so there is plenty of time to catch it if you are in Liverpool over the next few months!

Free fertility advice

I wrote an article in The Guardian at the weekend about a new free fertility advice service Professor Lord Winston is setting up.  It’s due to be launched at the end of the week, and you will be able to send in any questions about fertility and treatment to Lord Winston for his response.  The service is completely free of charge, but you can offer a donation to the Genesis Research Trust, a charity which carries out women’s health research projects.

It’s a service which is bound to prove hugely popular as Lord Winston is one of our best-known fertility specialists due to his television appearances – and the prospect of free advice from a knowledgeable expert is going to be attractive to fertility patients in a world where so many people are making money from their distress.

Lord Winston has spoken out repeatedly about the commercialisation of the fertility industry which hasn’t made him flavour of the month with many other specialists in the field who will often tell you that he very sceptical about IVF in the early days.  This is entirely true, but doesn’t detract from the fact that he is seen by many patients as the trustworthy friendly face of fertility specialists.

If you want to send Lord Winston a question, the service should be up and running at www.genesisresearchtrust.com by the end of the month.

Lisa Jardine and the HFEA

I was sad to hear Lisa Jardine admitting this week that she was effectively sacked from her role as Chair of the HFEA – see the details in this article in The Guardian, and listen to Lisa talking about this on Channel Four News.

I remember everyone’s surprise when Lisa Jardine turned up on a Saturday to a patient event shortly after being appointed, showing an early commitment to trying to understand the patient perspective.  She had a high profile outside the HFEA which helped to raise interest in her appointment – and many of us were sad to see her go.  Learning now that she didn’t do so voluntarily seems a terrible waste of her talents..

When IVF doesn’t work…

There’s an interesting piece by Zoe Williams in today’s Guardian looking at what happens when IVF doesn’t work, following on from the publicity surrounding a book, Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies, written by Miriam Zoll in the States. It’s an important issue as the average success rate of IVF in the UK is still only around 25% and those who have been through unsuccessful treatment are often left feeling isolated and depressed.

That’s why it’s a shame that the Guardian piece got sidetracked at the start by the suggestion that clinics were somehow exploiting lesbians by offering them frozen donor sperm. It was implied that because fresh sperm is more likely to be successful, clinics should be telling women to use this instead. Donor sperm is frozen in order to carry out thorough screening for HIV and other infections, and it would surely be far more alarming if, in order to increase their success rates, clinics were offering women fresh, unscreened sperm with the risk that it might carry an infection or chromosomal abnormality. Yes, those who need donor sperm have the option to find a donor they trust and carry out DIY treatment and to take that risk themselves – but I’m far from convinced that clinics ought to be suggesting this as a better option.

There is a more worrying trend if you are looking to criticise the way clinics deal with people using donor sperm, and that’s around ICSI – a more expensive form of IVF where the sperm is injected directly into the egg which was developed to treat male infertility. Women who have paid for donor sperm – which should be of the highest quality – are sometimes advised that they need to have ICSI when in fact the only real indication for using ICSI is for male fertility problems. ICSI is more expensive for patients and there is no evidence that it increases live birth rates where there is no male fertility problem.

The next issue I have with the piece is around the lying about statistics. The HFEA publishes the success rates for every clinic in the country and these are carefully monitored. Anyone going for treatment is always advised to look at these if they want to know about success rates, and for patients this is one of many reasons it was so important to keep the HFEA. The fact that only 25% of treatment is successful nationally is correct, but that doesn’t mean that 75% of women who have used IVF have not ended up with a baby.  The 25% success rate is for all women and includes those who are having IVF beyond the age of 42 when success rates drop sharply into single figures. The majority of women will have more than one cycle of treatment – and that’s why the NICE guideline recommends three full cycles of treatment (including frozen embryo transfers). Even with fertile couples, natural human reproduction has a success rate of around 25% for the first month of trying to get pregnant, and it is only cumulatively that human reproduction becomes more successful. It is absolutely true that not everyone will get pregnant after IVF – but it is also true that many women are still going into treatment later in life when IVF is less successful as it cannot turn back the biological clock- this is the important message to get across as Fiona Kisby Littleton explains in the article.

The piece also raises the issue of multiple birth, the biggest health risk from IVF, claiming that there are people in the IVF industry “who no longer even see twins as a problem”.  I don’t think there are people who “no longer” see twins as a problem. There are some who have never seen multiple births as a problem who haven’t changed their minds, but there are far more who now understand that this is not a good outcome. When I first had IVF eighteen years ago, three embryos were routinely replaced after IVF treatment but the HFEA has successfully worked with clinics to reduce the multiple birth rate and now more and more women are having just one embryo transfered. While there are some clinicians who are not entirely on board with this, they are a minority. It is now generally accepted that the way to judge a successful clinic is to look for high success rates combined with low multiple birth rates

I absolutely agree that we focus too much on IVF success and don’t give enough time, care and attention to those for whom it doesn’t work. It is true that IVF has become a huge global money-making business, but this is not new. When I wrote my first book about IVF, In Pursuit of Parenthood, in 1998 one of the IVF patients I interviewed said; “Infertility treatment is an industry – an industry that’s founded on hope…. but it’s all fantasy, it’s all hope which is continually shattered”.

When you look at the article online, a list of other related pieces appears in the corner.  One goes to this article, illustrated with an image of a line of pregnant rounded bellies, about a new technique which could “revolutionise” IVF increasing the live birth rate by 50% with claims that it could be the most exciting breakthrough in treatment for 30 years. It is hardly surprising that people with fertility problems are excited by headlines like this – which refers to something that a number of the experts in the piece explain is as yet unproven. Clinics are often blamed for raising false hopes, but in fact most responsible clinicians do tell women when their chances of success are low. When this comes against a steady flow of stories about amazing breakthroughs in treatment and babies born against the odds to perimenopausal women it is often hard to keep expectations in perspective.