New research from Canada suggests that mothers who are exposed to certain pollutants before they get pregnant could have less fertile daughters.
The pollutants involved are known as polycyclic aromatic hydrocarbons and they're found in cigarette smoke, car exhaust fumes and woodsmoke as well as charred and smoked food. The Canadian research suggests that when mothers are exposed to these, their daughters have fewer eggs in their ovaries.
Given the levels of car exhaust fumes many of us live with in towns and cities, this would suggest a somewhat gloomy outlook for the future, but it is worth noting that the research evidence was based on an animal rather than a human study. If you want to read more, see this link
Thursday, 29 November 2007
Wednesday, 28 November 2007
Seventeenth century fertility cures
The London auctioneers, Sotheby's are selling a seventeenth century health guide which lists some unusual alternative fertility treatments.
The book, called The Ladies Companion or The English Midwife, suggests a number of rather unappealing remedies for fertility problems. Apparently mixing some hare's spittle into your wine will help you get pregnant, or alternatively you could always try eating a hare's womb. I must admit I don't know why hares were particularly linked with fertility, but there are some hare-free remedies - another method is to dry a new-born boy's "navill string" (or umbilical cord), grind it up into a powder and drink it with wine.
The book was written by a physician, William Sermon, and published in 1671. It claims to explain how women ought to "govern themselves during the whole time of their breeding children". Sotheby's are selling it next month at auction, where it is expected to fetch as much as two thousand pounds. Perhaps unsurprisingly, I'd advise reading The Complete Guide to Female Fertility instead!
The book, called The Ladies Companion or The English Midwife, suggests a number of rather unappealing remedies for fertility problems. Apparently mixing some hare's spittle into your wine will help you get pregnant, or alternatively you could always try eating a hare's womb. I must admit I don't know why hares were particularly linked with fertility, but there are some hare-free remedies - another method is to dry a new-born boy's "navill string" (or umbilical cord), grind it up into a powder and drink it with wine.
The book was written by a physician, William Sermon, and published in 1671. It claims to explain how women ought to "govern themselves during the whole time of their breeding children". Sotheby's are selling it next month at auction, where it is expected to fetch as much as two thousand pounds. Perhaps unsurprisingly, I'd advise reading The Complete Guide to Female Fertility instead!
Tuesday, 27 November 2007
A date for your diary
The date has now been set for the next National Infertility Day, which will take place on the 19th of July at the New Connaught Rooms in Covent Garden in Central London. The event will mark thirty years of IVF, and delegates can expect a wide range of speakers on different aspects of fertility. For further updates, you can check the National Infertility Day website here
Warnings over sperm donor service
A recent investigation by The Guardian's science correspondent, James Randerson, has revealed that online sperm delivery companies may be operating illegally, and putting women who are using their services at risk.
The online companies provide donated sperm for single women or lesbian couples who want to try to get pregnant. They offer to deliver fresh sperm samples from anonymous donors to your door by courier within a couple of hours of being produced. However, this means that the sperm is unlikely to have been thoroughly screened for HIV.
In properly regulated clinics, a sperm sample is taken and frozen for sixth months, during which time the donor is tested twice for HIV, as it can take that long for the virus to show up in tests. The sperm delivery company used by The Guardian tells potential donors they can give their first sample just days after being tested for sexually transmitted infections.
The Guardian has passed details of the investigation to the Human Fertilisation and Embryology Authority, but the story highlights the dangers of buying sperm online. See more details here.
The online companies provide donated sperm for single women or lesbian couples who want to try to get pregnant. They offer to deliver fresh sperm samples from anonymous donors to your door by courier within a couple of hours of being produced. However, this means that the sperm is unlikely to have been thoroughly screened for HIV.
In properly regulated clinics, a sperm sample is taken and frozen for sixth months, during which time the donor is tested twice for HIV, as it can take that long for the virus to show up in tests. The sperm delivery company used by The Guardian tells potential donors they can give their first sample just days after being tested for sexually transmitted infections.
The Guardian has passed details of the investigation to the Human Fertilisation and Embryology Authority, but the story highlights the dangers of buying sperm online. See more details here.
Monday, 26 November 2007
Young adults risk fertility problems
Young people are failing to listen to warnings about sexually transmitted infections according to a new report, and this could mean more fertility problems in the future.
The Health Protection Agency's latest report on the UK's sexual health shows that there has been an increase in sexually transmitted infections amongst young adults. Women under 20 and men under 25 seem to be at particularly high risk, and the increase suggests that safe sex campaigns to encourage young people to use condoms are falling on deaf ears. Ten percent of young adults tested positive for chlamydia, and there were rises in some other sexually transmitted infections.
There is growing awareness that chlamydia has long-term risks for fertility, but it's not the only infection which can cause problems. Gonorrhea also affects fertility, and syphilis can be particularly dangerous in pregnancy, damaging babies and leading to miscarriage or still birth. Young adults don't always realise that taking a risk may not just affect their immediate future, but can have implications for the rest of their lives.
The Health Protection Agency's latest report on the UK's sexual health shows that there has been an increase in sexually transmitted infections amongst young adults. Women under 20 and men under 25 seem to be at particularly high risk, and the increase suggests that safe sex campaigns to encourage young people to use condoms are falling on deaf ears. Ten percent of young adults tested positive for chlamydia, and there were rises in some other sexually transmitted infections.
There is growing awareness that chlamydia has long-term risks for fertility, but it's not the only infection which can cause problems. Gonorrhea also affects fertility, and syphilis can be particularly dangerous in pregnancy, damaging babies and leading to miscarriage or still birth. Young adults don't always realise that taking a risk may not just affect their immediate future, but can have implications for the rest of their lives.
Thursday, 22 November 2007
The advantages of being an older mum
We all know the problems about waiting to have a baby. You're less likely to be fertile if you're too far on the wrong side of 35, fertility treatment isn't as successful if you need it and you're at greater risk of having a miscarriage. A lot is made of that fact that you may find pregnancy physically more demanding than a younger woman, and that you will get more tired. It all sounds distinctly gloomy, so why do statistics show that more and more women are having children later rather than sooner?
In fact, there are some clear advantages for older mothers and their children. Women who wait to get pregnant are often more settled both financially and emotionally. They've often achieved what they want to in their careers and have lived a little. They are less likely to feel the need for an exciting social life or to resent the restraints of life with a baby or small child.
They may have more time for their children, and more patience, and the children of older parents can benefit greatly from this. It's true that physically they may find life with a baby tough, but older mothers are often able to adapt to this. In comparison to their teenage counterparts at the other end of the motherhood age scale, they tend to take better care of themselves, eating more healthily and taking exercise.
Whatever our views on older motherhood, more and more of us are having children later for a variety of reasons, from wanting to achieve things in our careers to waiting for the right partner. There's a great website for older mothers mothers35plus which anyone who wants to know more about the subject should have a look at.
In fact, there are some clear advantages for older mothers and their children. Women who wait to get pregnant are often more settled both financially and emotionally. They've often achieved what they want to in their careers and have lived a little. They are less likely to feel the need for an exciting social life or to resent the restraints of life with a baby or small child.
They may have more time for their children, and more patience, and the children of older parents can benefit greatly from this. It's true that physically they may find life with a baby tough, but older mothers are often able to adapt to this. In comparison to their teenage counterparts at the other end of the motherhood age scale, they tend to take better care of themselves, eating more healthily and taking exercise.
Whatever our views on older motherhood, more and more of us are having children later for a variety of reasons, from wanting to achieve things in our careers to waiting for the right partner. There's a great website for older mothers mothers35plus which anyone who wants to know more about the subject should have a look at.
Tuesday, 20 November 2007
Could you have polycystic ovary syndrome?
Around twenty percent of women have polycystic ovaries, but most of us won't ever be aware of the fact and they won't affect our lives. Tiny cysts are found on the ovaries, which are actually undeveloped follicles. Polycystic ovaries won't necessarily affect your fertility, but sometimes when they are accompanied by other symptoms, they can indicate polycystic ovary syndrome, a common cause of female fertility problems.
There are a number of signs to look out for which could indicate that you may have polycystic ovary syndrome, or PCOS. Women with PCOS usually have irregular, infrequent or absent periods. About a third of those with PCOS are overweight, although it is perfectly possible to have the syndrome and to be very slim. Women who have the eating disorder bulimia seem to have a higher risk of having PCOS, too.
Women with PCOS may have difficulty getting pregnant, or have had miscarriages. Some women have other signs, such as unwanted facial or body hair, and oily skin or acne. Women may also find that they lose hair from their scalp, or have thining hair. There are often hormonal imbalances which can be checked by a blood test. Women who have PCOS sometimes suffer from depression and mood changes.
You can find out more about polycystic ovary syndrome by contacting the support group Verity
There are a number of signs to look out for which could indicate that you may have polycystic ovary syndrome, or PCOS. Women with PCOS usually have irregular, infrequent or absent periods. About a third of those with PCOS are overweight, although it is perfectly possible to have the syndrome and to be very slim. Women who have the eating disorder bulimia seem to have a higher risk of having PCOS, too.
Women with PCOS may have difficulty getting pregnant, or have had miscarriages. Some women have other signs, such as unwanted facial or body hair, and oily skin or acne. Women may also find that they lose hair from their scalp, or have thining hair. There are often hormonal imbalances which can be checked by a blood test. Women who have PCOS sometimes suffer from depression and mood changes.
You can find out more about polycystic ovary syndrome by contacting the support group Verity
Monday, 19 November 2007
IVF funding
When the government promised one full cycle of IVF on the NHS for all eligible couples by April 2005, it looked as if things might be about to change for all of those who were having difficulty conceiving. At last, the problem was being taken seriously. Perhaps the chances of getting at least some funded help would no longer depend on where you lived.
Two years on, that government promise remains unfulfilled. In some areas, there's no funding at all for patients who need IVF. In others, trusts have come up with stringent criteria to ensure that the majority of those who need treatment won't qualify. Is it really logical to refuse to fund treatment for women who are under 36, when we know that IVF is far more likely to be successful for younger women? And is it fair to refuse to fund anyone who has ever paid for treatment in the past? Or anyone whose partner may have adult children from a previous relationship?
The postcode lottery is more complicated than ever, and your chances of getting treatment depend on your age and your situation now, as well as where you live. Fortunately, there is an ongoing survey by the charity Infertility Network UK with the backing of the Department of Health to look at the way funding is working, or rather not working, which aims to help lay the foundations for better provision of treatment across the board. Maybe this is the first step towards keeping that government promise.
Two years on, that government promise remains unfulfilled. In some areas, there's no funding at all for patients who need IVF. In others, trusts have come up with stringent criteria to ensure that the majority of those who need treatment won't qualify. Is it really logical to refuse to fund treatment for women who are under 36, when we know that IVF is far more likely to be successful for younger women? And is it fair to refuse to fund anyone who has ever paid for treatment in the past? Or anyone whose partner may have adult children from a previous relationship?
The postcode lottery is more complicated than ever, and your chances of getting treatment depend on your age and your situation now, as well as where you live. Fortunately, there is an ongoing survey by the charity Infertility Network UK with the backing of the Department of Health to look at the way funding is working, or rather not working, which aims to help lay the foundations for better provision of treatment across the board. Maybe this is the first step towards keeping that government promise.
The "need for a father"
There's been a lot of debate about the "need for a father", which fertility specialists have in the past had to take into account when they're considering whether to treat single women or lesbian couples. The latest legislation on IVF is being discussed in the House of Lords today, and there's controversy about removing the requirement to make sure a father is involved in the new Human Fertilisation and Embryology Bill.
The leader of the Roman Catholic church has said it would be "profoundly wrong" to change the rules about the need for a father, but the reality is that around a quarter of children in the UK are currently brought up in single parent families. These one-parent families are not the result of fertility treatment, but of the disintegration of the traditional family unit.
When I was writing my book, The Complete Guide to Female Fertility , I interviewed dozens of single women who'd decided to have fertility treatment. Their awareness of their biological clocks, and the fact that they hadn't met the right partner in time, meant a stark choice between having a child alone, or not having one at all. None of them had gone into this lightly, and they had spent far more time thinking through the consequences for their children and working out how they would cope financially and emotionally than most of those who get pregnant naturally. Having a child without a partner may not be ideal, but it is a reality of life we cannot ignore.
The leader of the Roman Catholic church has said it would be "profoundly wrong" to change the rules about the need for a father, but the reality is that around a quarter of children in the UK are currently brought up in single parent families. These one-parent families are not the result of fertility treatment, but of the disintegration of the traditional family unit.
When I was writing my book, The Complete Guide to Female Fertility , I interviewed dozens of single women who'd decided to have fertility treatment. Their awareness of their biological clocks, and the fact that they hadn't met the right partner in time, meant a stark choice between having a child alone, or not having one at all. None of them had gone into this lightly, and they had spent far more time thinking through the consequences for their children and working out how they would cope financially and emotionally than most of those who get pregnant naturally. Having a child without a partner may not be ideal, but it is a reality of life we cannot ignore.
Thursday, 15 November 2007
Giving up smoking
When we first started trying to have children, I smoked - a lot. I always knew I'd give up if I got pregnant, but as getting there took longer and longer, it was harder to find the motivation. Occasionally a nurse or doctor would ask whether I smoked, but no one seemed particularly bothered about it. When we started our first IVF attempt, the consultant suggested I should stop, and I did. Until we found out it hadn't worked, when the first thing I did was to dash out for a packet of cigarettes.
I did finally stop, and our treatment did eventually work, but in retrospect I wish I'd been made more aware of the effect smoking can have on fertility. Research suggests that female smokers are twice as likely as non-smokers to have fertility problems, and that they also tend to reach the menopause earlier. In fact, one study concluded that smoking can shorten a woman's reproductive life by ten years. Even passive smoking is thought to make a difference, and living with a smoker can mean it will take a woman longer to get pregnant.
The good news for smokers is that the damage seems to be reversible. If you give up, your chances of conceiving are back to normal after just a year. It's not always the easiest time to quit, and adding the pangs of nicotine withdrawal to the emotional turmoil of infertility and treatment is tough - but giving up smoking really can make all the difference to a successful outcome.
I did finally stop, and our treatment did eventually work, but in retrospect I wish I'd been made more aware of the effect smoking can have on fertility. Research suggests that female smokers are twice as likely as non-smokers to have fertility problems, and that they also tend to reach the menopause earlier. In fact, one study concluded that smoking can shorten a woman's reproductive life by ten years. Even passive smoking is thought to make a difference, and living with a smoker can mean it will take a woman longer to get pregnant.
The good news for smokers is that the damage seems to be reversible. If you give up, your chances of conceiving are back to normal after just a year. It's not always the easiest time to quit, and adding the pangs of nicotine withdrawal to the emotional turmoil of infertility and treatment is tough - but giving up smoking really can make all the difference to a successful outcome.
Wednesday, 14 November 2007
Surrogacy warnings
When surrogacy goes wrong, the consequences can be devastating for everyone involved, and a couple of recent stories highlight the dangers of not making thorough checks before entering into a surrogacy agreement.
In one case, a surrogate mother was found to have deliberately duped two couples into believing she'd miscarried their babies. She'd used sperm from the prospective fathers with the intention of keeping the children herself. In the other, an American woman was arrested in Ukraine when trying to leave the country with the baby a surrogate had carried for her. The baby was taken into care because there were problems with the woman's papers.
Travelling abroad may seem to offer quick and easy solutions for couples who need to use surrogates, but it can cause unexpected complications when it comes to bringing a child back home. Surrogacy is illegal in much of Europe, and you should check the law very carefully if you are planning on going overseas.
The laws on surrogacy are strict precisely because it is an area where there is so much room for exploitation, and it is absolutely vital to make sure any surrogacy agreement is completely legal and watertight. For more information about surrogacy, contact Surrogacy UK
In one case, a surrogate mother was found to have deliberately duped two couples into believing she'd miscarried their babies. She'd used sperm from the prospective fathers with the intention of keeping the children herself. In the other, an American woman was arrested in Ukraine when trying to leave the country with the baby a surrogate had carried for her. The baby was taken into care because there were problems with the woman's papers.
Travelling abroad may seem to offer quick and easy solutions for couples who need to use surrogates, but it can cause unexpected complications when it comes to bringing a child back home. Surrogacy is illegal in much of Europe, and you should check the law very carefully if you are planning on going overseas.
The laws on surrogacy are strict precisely because it is an area where there is so much room for exploitation, and it is absolutely vital to make sure any surrogacy agreement is completely legal and watertight. For more information about surrogacy, contact Surrogacy UK
Friday, 9 November 2007
Chlamydia - fertility threat for men
We've known for years that chlamydia, a sexually-transmitted infection, is a huge threat to female fertility, but new research shows that it's a risk for men, too. Most people who have chlamydia don't have a clue they've been infected. There are often no symptoms at all, or at most very mild, non-specific symptoms. Chlamydia has become a serious problem in the UK, where it's estimated as many as one in ten sexually active women under 25 are infected.
The new study shows that chlamydia can damage sperm quality, affecting the ability to swim and causing defects. Fortunately for men, once chlamydia is detected and treated with antibiotics, the sperm quality does improve. For women, however, the fertility problems associated with chlamydia tend to be irreversible. It can cause pelvic infection and block the fallopian tubes, which carry eggs from the ovary to the womb. If this happens, a woman will need medical help to get pregnant.
All the more reason to get tested. Chlamydia screening involves a simple urine test or swab, and antibiotics are prescribed if the test comes back positive. Most at risk are young people who have unprotected sex, and the more partners you have, the more likely you are to get chlamydia. Even those who aren't considering parenthood in the near future should think about going for a test to make sure they aren't putting their long-term chances of having a family at risk.
The new study shows that chlamydia can damage sperm quality, affecting the ability to swim and causing defects. Fortunately for men, once chlamydia is detected and treated with antibiotics, the sperm quality does improve. For women, however, the fertility problems associated with chlamydia tend to be irreversible. It can cause pelvic infection and block the fallopian tubes, which carry eggs from the ovary to the womb. If this happens, a woman will need medical help to get pregnant.
All the more reason to get tested. Chlamydia screening involves a simple urine test or swab, and antibiotics are prescribed if the test comes back positive. Most at risk are young people who have unprotected sex, and the more partners you have, the more likely you are to get chlamydia. Even those who aren't considering parenthood in the near future should think about going for a test to make sure they aren't putting their long-term chances of having a family at risk.
Monday, 5 November 2007
IVM - is it for you ?
Anyone with an interest in fertility is likely to have heard the recent news about the first babies born in the UK after a new type of treatment called in vitro maturation, or IVM. The glowing newspaper reports on the subject suggested IVM was about to revolutionise fertility treatment. Cheaper than IVF, less invasive and less risky, it sounded the perfect solution and patients could be forgiven for rushing off to their clinics to demand it immediately. The reality is that IVM is not yet widely available, and is not suitable for everyone anyway.
IVM doesn't use drugs to get women to produce lots of eggs. Instead, it involves taking immature eggs straight from the ovaries, maturing them in the laboratory, and then injecting them with sperm. The technique relies on women having lots of immature eggs, and success rates are low for anyone with normal ovaries who is unlikely to have sufficient quantities to make it worthwhile. IVM is most suitable for younger women with polycystic ovaries because they tend to have an abundance of immature eggs, but even then, success rates are not particularly high at between 20 and 30%.
IVM is a relatively new technique, which has only produced 400 babies worldwide so far, and at the moment only one clinic in the UK is licensed to carry it out. It is cheaper than IVF because you're not using any drugs to stimulate the ovaries, so you save on the hefty drugs bill. It also cuts out the risk of hyperstimulation, which is a particular danger for women who have polycystic ovaries when they take the stimulating drugs.
IVM is undoubtedly an exciting step forward in reproductive medicine, but the revolution the news reports may have led us to expect is still some time away.
IVM doesn't use drugs to get women to produce lots of eggs. Instead, it involves taking immature eggs straight from the ovaries, maturing them in the laboratory, and then injecting them with sperm. The technique relies on women having lots of immature eggs, and success rates are low for anyone with normal ovaries who is unlikely to have sufficient quantities to make it worthwhile. IVM is most suitable for younger women with polycystic ovaries because they tend to have an abundance of immature eggs, but even then, success rates are not particularly high at between 20 and 30%.
IVM is a relatively new technique, which has only produced 400 babies worldwide so far, and at the moment only one clinic in the UK is licensed to carry it out. It is cheaper than IVF because you're not using any drugs to stimulate the ovaries, so you save on the hefty drugs bill. It also cuts out the risk of hyperstimulation, which is a particular danger for women who have polycystic ovaries when they take the stimulating drugs.
IVM is undoubtedly an exciting step forward in reproductive medicine, but the revolution the news reports may have led us to expect is still some time away.
How to choose a fertility clinic
Anyone going through fertility treatment wants to be sure they're being treated at the best clinic they can afford. We invest a huge amount both financially and emotionally in our treatment, and it isn't always easy to feel completely sure you've made the right choice if you're faced with a bewildering array of statistics on success rates for different treatments.
Sometimes there may not be a choice of clinics if you're not in a position to travel long distances or if you're having state funded treatment, but for those who are going to have to choose, I've compiled a quick checklist below. I hope it may help you feel more confident that you know what you're looking for, and that you understand what may, and may not, be important.
1. LOCATION
It sounds obvious, but a journey that seems perfectly acceptable for an occasional visit to the clinic can soon become too much when you're doing it two or three times a week during fertility treatment. As more and more of us travel for treatment, and often not just a few miles down the road but to clinics in different countries, it is important to be realistic about how long the journey is going to take, and how you are going to do it. If you're travelling overseas, you may want to feel confident you could get to your clinic at short notice if necessary.
2. COST
Some clinics charge far more for treatment than others, and paying more isn't a guarantee of better treatment or higher success rates. It is really important to check what is included in the price you are quoted, as you can end up with a far larger bill than you'd anticipated if tests, scans or drugs are paid for separately.
3. SPECIALISMS
It is always worth checking that your clinic has experience at dealing with patients with your particular fertility problem, and that it offers all the relevant treatments. Although most clinics are used to dealing with a range of problems, some only provide a limited range of treatments and others specialise in certain areas.
4. WAITING LISTS
If you're worried about your biological clock, you are not going to want to opt for a clinic with a really long waiting list for treatment. Find out how long it will take to get an appointment, and how long you will then wait for any necessary treatment.
5. SUCCESS RATES
Be careful with these - they're not always as straightforward as they look. Make sure you are comparing like with like - a pregnancy success rate is not the same as a live birth success rate, and check whether the figure is a percentage of the treatments started, of those which got as far as egg collection, or for those where embryos have been replaced. Success rates are also dependent on the patients being treated, so a clinic with a lot of older patients who've been through lots of previous treatment may have a lower success rate than one treating younger women, or those with less complex problems. In the UK, the HFEA publish clinic success rates for all registered clinics.
6. ATMOSPHERE
Some people feel more comfortable in smaller clinics where they will get a more personal service, where staff will get to know them and where they may feel more relaxed. Others are happier in the slick, professional atmosphere of a larger clinic, where you may see a variety of staff. Only you know what makes you tick, but going through treatment is hard enough anyway and if it's possible to find an atmosphere you like, it may make all the difference.
7. RECOMMENDATION
A personal recommendation can be a great help. If you know someone who has been to a particular clinic and is keen to recommend it, that's certainly a good sign, but do remember that what is right for one person isn't necessarily going to be right for another.
Fertility treatment is never easy, but if you've done your homework, and you feel comfortable and secure with your choice of clinic, that will be one less thing to worry about.
Sometimes there may not be a choice of clinics if you're not in a position to travel long distances or if you're having state funded treatment, but for those who are going to have to choose, I've compiled a quick checklist below. I hope it may help you feel more confident that you know what you're looking for, and that you understand what may, and may not, be important.
1. LOCATION
It sounds obvious, but a journey that seems perfectly acceptable for an occasional visit to the clinic can soon become too much when you're doing it two or three times a week during fertility treatment. As more and more of us travel for treatment, and often not just a few miles down the road but to clinics in different countries, it is important to be realistic about how long the journey is going to take, and how you are going to do it. If you're travelling overseas, you may want to feel confident you could get to your clinic at short notice if necessary.
2. COST
Some clinics charge far more for treatment than others, and paying more isn't a guarantee of better treatment or higher success rates. It is really important to check what is included in the price you are quoted, as you can end up with a far larger bill than you'd anticipated if tests, scans or drugs are paid for separately.
3. SPECIALISMS
It is always worth checking that your clinic has experience at dealing with patients with your particular fertility problem, and that it offers all the relevant treatments. Although most clinics are used to dealing with a range of problems, some only provide a limited range of treatments and others specialise in certain areas.
4. WAITING LISTS
If you're worried about your biological clock, you are not going to want to opt for a clinic with a really long waiting list for treatment. Find out how long it will take to get an appointment, and how long you will then wait for any necessary treatment.
5. SUCCESS RATES
Be careful with these - they're not always as straightforward as they look. Make sure you are comparing like with like - a pregnancy success rate is not the same as a live birth success rate, and check whether the figure is a percentage of the treatments started, of those which got as far as egg collection, or for those where embryos have been replaced. Success rates are also dependent on the patients being treated, so a clinic with a lot of older patients who've been through lots of previous treatment may have a lower success rate than one treating younger women, or those with less complex problems. In the UK, the HFEA publish clinic success rates for all registered clinics.
6. ATMOSPHERE
Some people feel more comfortable in smaller clinics where they will get a more personal service, where staff will get to know them and where they may feel more relaxed. Others are happier in the slick, professional atmosphere of a larger clinic, where you may see a variety of staff. Only you know what makes you tick, but going through treatment is hard enough anyway and if it's possible to find an atmosphere you like, it may make all the difference.
7. RECOMMENDATION
A personal recommendation can be a great help. If you know someone who has been to a particular clinic and is keen to recommend it, that's certainly a good sign, but do remember that what is right for one person isn't necessarily going to be right for another.
Fertility treatment is never easy, but if you've done your homework, and you feel comfortable and secure with your choice of clinic, that will be one less thing to worry about.
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