Find out how the regulators regulate

The Human Fertilisation and Embryology Authority, responsible for regulating fertility treatment in the UK, is holding an open meeting on February 20th.

Anyone can attend the open meetings, and if you have any interest in assisted conception it may prove to be a fascinating opportunity to see what the Authority does, and how it works. You will be able to watch the Authority in action, and meet the members afterwards over a cup of tea.

It's free to attend, but you do have to register in advance. If you want more details you can find out how to register on the HFEA website here

Fertility pioneers at conference open to all

One of the two pioneers responsible for the birth of the first IVF baby thirty years ago is to speak at a conference open to all this Summer.

Professor Robert Edwards and his colleague Patrick Steptoe worked together to bring about the birth of Louise Brown in July 1978. Now, thirty years on, he will mark the occasion with a special address at the bi-annual National Infertility Day conference in London.

Other speakers at the conference will be addressing a variety of issues linked to infertility, and amongst them will also be Professor Andre Van Steirtehem who developed the technique of injecting sperm right into eggs known as ICSI. ICSI has transformed the prospects for men with sperm problems, many of whom have been able to father their own children thanks to the process.

Bookings are already open for National Infertility Day, and you can find all the latest news and developments on the website, www.nationalinfertilityday.com

Need for supportive parenting welcomed by campaigners

The vote by members of the House of Lords to allow doctors to consider the "need for supportive parenting" rather than the "need for a father" when they're deciding whether to offer fertility treatment has been welcomed by those campaigning for the rights of single women and lesbian couples.

Under the existing law in the UK, doctors are required to consider the need of any potential child for a father before offering treatment. Many feel this law is outdated, and in reality doctors have been offering treatment to single women and lesbian couples for many years. There was opposition to the new wording from some peers, who felt the change would sent out the wrong message about how our society regards the role of the father, but there was a substantial majority of members in favour of the change.

Solicitor Natalie Gamble, who is an expert in fertility law, welcomed the decision, saying the peers "made the right decision to amend a discriminatory piece of law which no longer has any meaning in practice."

The new wording has yet to be finalised by MPs in the Commons.

Embryo screening court case

A couple in Australia are suing a fertility clinic where they had treatment to try to prevent their child inheriting a cancer gene from his mother.

The couple, who knew their child would naturally have a fifty percent chance of inheriting the cancer gene, were told that the clinic could screen embryos to prevent this happening. They went through a process called pre-implantation genetic diagnosis, or PGD. They had IVF and then one cell was taken from the resulting embryos and tested to see whether it was carrying the cancer gene. The technique has been used to screen for a number of inherited cancers as well as other conditions such as cystic fibrosis, and only embryos free from these specific genetic conditions are transferred to the womb.

It wasn't until the child was a few months old that a test revealed the screening hadn't worked, and he had inherited the cancer gene. It isn't clear how this happened, and the couple are now suing the clinic for damages.

PGD is still fairly rare, but is offered for a growing number of inherited conditions by some clinics in the UK as well as overseas. There's an Australian newspaper report on the case here

Ovulation testing

I've just been reading about a rather strange new ovulation detector. It's a patch you stick on overnight to record your skin temperature in order to check for the rise that usually accompanies ovulation.

It seems a slightly unusual development, at a time when most doctors no longer recommend women use temperature charts to check whether they are ovulating. However, this is a more sophisticated device as it takes your temperature every ten minutes whilst you are sleeping and sends the results to a reader you can check later. The device isn't for sale yet, and the inventors are still working on prototypes.

Many doctors believe that if couples are having intercourse three times a week around the point when they think ovulation is going to occur, then missing the right time is not a likely cause of fertility problems. Equally, timing intercourse can lead to unnecessary sexual or relationship difficulties.

However, any new research into fertility is always welcome, and you may want to find out more about this development here

New chair for IVF regulator

The Human Fertilisation and Embryology Authority, which regulates fertility treatment in the UK, has just appointed a new chair.

The authority has today announced that Professor Lisa Jardine, probably best known to most of us as a presenter on BBC Radio Four, is to take over from Walter Merricks, who has been standing in as chair. Lisa Jardine is a Professor at London University, and is also the author of a number of books, both histories and biographies.

This is an interesting time for the Human Fertilisation and Embryology Authority, as the laws governing all aspects of its work pass through Parliament, and it will be interesting to how Professor Jardine will shape such an influential role.

You can read more about the appointment on the HFEA website

Miscarriage risks from caffeine

A new study suggests that women who drink more than two cups of coffee a day in early pregnancy are twice as likely to suffer a miscarriage.

The research, carried out by an American Private health organisation, found that women who consumed more than 200mg of caffeine daily were increasing their risk of miscarriage. Previous studies have linked caffeine consumption with miscarriage, but the safe limit has normally been set higher, at 300mg.

The researchers warn pregnant women to watch their caffeine intake from tea, chocolate and caffeinated soft drinks, too. Although these contain lower levels of caffeine than fresh coffee, they all can all contribute.

There's been a lot of debate about whether women who are trying to conceive should cut down on caffeine, and this research would seem to suggest that it is certainly worth watching your intake. You can see more information about the study, which is published in the American Journal of Obstetrics and Gynaecology here

More to Life

In our society, it can sometimes feel as if children and families are the be all and end all. It's often only when you're trying unsuccessfully to have a child, or are involuntarily childless, that you become aware of quite how entrenched some attitudes are, and this can make what is already a difficult experience even harder.

Making a decision to give up on fertility treatment can be tough, and yet clinics are not always ready to offer the counselling many people need to help them through this. For those who decide not to have fertility treatment, or who simply can't afford it, there may be even less in the way of support available.

Involuntary childlessness is often very isolating, and you may feel cut off from family and friends. Family-friendly employment policies and tax breaks can all seem to be set against those without children, and other people often lack sympathy, or any understanding of your situation.

However, help is at hand. More to Life is a national charity working to offer support to all those who are involuntarily childless for whatever reason. They can give advice and information, and also have a network of local contacts. They also organise groups and social events. You can find their website here

Westminster debate on the need for a father

Last night's Progress Educational Trust debate at Westminster on whether the "need for a father" should continue to be part of the considerations used by fertility doctors when deciding whether to treat patients proved to be an interesting evening.

The debate was chaired by Lord Harries, the former Bishop of Oxford and a member of the HFEA, and the first speaker was Ruth Deech, who chaired the HFEA for many years and now sits in the House of Lords. She argued that the "need for a father" was an ethical principle of equality of the sexes, that removing it would send out a bad message and would not have public support.

She was followed by Fiona MacCallum, Assistant Professor of Psychology at Warwick University, who has researched the effects of being raised without a father on children of lesbian and single mothers. She explained that although research showed that losing a once-present father through divorce caused problems for children, all the evidence suggests that children of women who have chosen to have a child alone, or with a lesbian partner, suffer no ill-effects whatsoever, and that in fact the quality of parenting in such circumstances was often better than average.

Finally Natalie Gamble, a lawyer who specialises in fertility law, explained that the law as it stands is clearly discriminatory. She said fertility doctors refusing to treat lesbian couples could face legal action, as it is against the law for those offering any goods or services to discriminate on grounds of sexuality. She said the current law has been meaningless in practice for some years, and that not removing the line about the "need for a father" would be both confusing and contradictory.

There were many questions and much discussion after the speeches, and the issue is due to be debated by the Lords sometime next week. It is possible that some kind of compromise wording may be offered instead of the "need for a father", such as the "need for supportive parenting", but that could end up leaving everyone dissatisfied. It will be interesting to see how this develops.

Great new fertility website

Infertility Network UK has just launched a new website, and it is packed with fascinating stuff for anyone with any kind of interest or involvement in the subject. There's a huge selection of factsheets on pretty much every aspect of fertility, and information about where to get help and support. There are forums where members can chat to one another, and a shop where you can buy fertility-related books and DVDs. You can also join the charity online, which will give you access to the network of regional organisers, helpliners and medical advisers.

It's worth taking a look - www.infertilitynetworkuk.com

Donor conception information on birth certificates?

The case of the adopted twins who were separated at birth and ended up marrying each other without realising that they were related has been widely discussed in the news. It has raised questions about the issue of donor conception, and whether it would be right to change the law to include the fact that someone was donor-conceived on their birth certificate. Such a change would, in theory, rule out the possibility of anything like this ever happening with two donor-conceived adults.

Some believe that this is the right way to go, as it would ensure that those conceived using donor eggs and sperm knew about their genetic background, and would deny parents the possibility of hiding such information from them. However, many of those involved with donor conception see it as a huge invasion of privacy, and feel it risks stigmatising those who are donor conceived.

For anyone who needs donor eggs or sperm to conceive, there is often a lot of soul-searching before they go ahead. It isn't an easy thing to come to terms with, and most parents of donor-conceived children want to feel that they are in control of how and when they tell their children about their conception. To insist that this information should be included on birth certificates could seem to intrude on their rights as parents to make these decisions in their own way. What's more important, it would risk infringing the rights of a donor conceived adult to choose whether or not they wished to share this deeply personal information with anyone else in the future.

For more information, advice and support on issues surrounding donor conception, you can contact The Donor Conception Network

Clearer costs for IVF treatment

The Times reports that the Human Fertilisation and Embryology Authority is going to get clinics to give patients a clear picture of how much their fertility treatment is likely to cost at the outset. This is to be welcomed, as a substantial minority of patients have been finding that their final bill for treatment is far more than they'd anticipated, and apparently only one in five are currently given a costed plan before they start.

Although the HFEA monitors clinics carefully, it has no regulatory powers when it comes to their fees. The cost of fertility treatment has soared in the last decade, and with so much IVF being carried out in the private sector, more and more people are finding they simply can't afford it. The situation in the UK is particularly acute as the guidelines set by the National Institute for Clinical Excellence, which recommended that women who needed IVF should be offered three funded cycles, have not been adhered to. The reality is that most women are fortunate if they find they qualify for one cycle funded by the NHS. Any move to make the costs of private treatment more transparent can only be a good thing.

You can find the Times report here

The perimenopause

I am becoming slightly obsessed with the peri-menopause. I suppose it's inevitable once you hit the wrong side of forty, but every time I forget anything I wonder whether it could be a sign of menopausal memory loss. My obsession started when I was writing my last book The Complete Guide to Female Fertility , and became aware that I was on the cusp of a new phase of life which would begin with irregular periods and would mark the end of my fertility with such delights as hot flushes and hair loss... Sometimes, there are things I wish I didn't know...

But seriously, what is the perimenopause and how do you tell if you are entering it? It's the phase leading up to the menopause itself (which is said to occur when you haven't had a period for a year), and can last anything from a matter of months to a worrying ten years. I found a long list of symptoms here , but I'm trying to remind myself that not everyone has all these symptoms, and some women sail through the whole thing without really noticing it.

More worrying than the perimenopause, which will come to us all eventually, is premature menopause, which can occur at any age and affects about one in every hundred women. If you're trying to get pregnant, early hormone tests should reveal this fairly early on, but premature menopause does sometimes go undetected, and if you have irregular periods or other menopausal symptoms, make sure you've had the right hormone tests. It does sometimes run in families, and if your mother had an early menopause, tell your doctors about this. Fortunately, there is an excellent support group for women who have experienced an early menopause, The Daisy Network , who can provide information and advice.

Dad not included debate

You may be interested in a debate taking place next week at Westminster about the "need for a father", something clinics had to take into consideration when they were deciding whether to offer IVF and other similar treatments. The original Human Fertilisation and Embryology Bill, which regulated fertility treatment, had made it law for clinics to think about the welfare of any future children and this had included their "need for a father".

The updated version of this currently going through Parliament does not contain the requirement for clinics to think about a child's need for a father, and next week's evening debate will be looking at a variety of views on this. The speakers are Ruth Deech, the former Chair of the Human Fertilisation and Embryology Authority, Juliet Tizzard, the deputy Head of Ethics at the British Medical Association and
Fiona MacCallum , Assistant Professor of Psychology at the University of Warwick. The debate, organised by Progress Educational Trust, takes place on January 14th, and if you might be interested in attending, you can find more details here
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Spare embryos

There's been some controversy over the revelation that more than a million embryos have been created during fertility treatment and destroyed. Figures released by the Department of Health during the debates over the new Human Fertilisation and Embryology Bill showed that 1.2 million embryos have been destroyed in the last fourteen years.

This led to calls for more couples to donate any spare embryos to others, which is undoubtedly a good idea for those who feel able to do this, and to some criticism of this "wastage". It is vital to understand that most couples going through IVF would choose to freeze any spare embryos they produce, and that the main reason for the destruction of spare embryos is the simple fact that they are not considered viable.

Perhaps the best way to prevent spare embryos being destroyed is to improve the IVF process.
In the future, more doctors may be interested in "soft" IVF which uses lower doses of drugs to stimulate the ovaries. This produces fewer eggs, and therefore fewer spare embryos, and is not only cheaper but has the added advantage of being safer for women going through fertility treatment.

Healthy eating resolutions for 2008

I don't make resolutions any more, having broken far too many over the years, but perhaps one we should consider for 2008 is to try to eat more healthily. We seem to hear endless reports about the growing problem of obesity, and now apparently we're told that eating badly is killing 70,000 of us every year.

What may be more relevant to anyone trying to get pregnant is a Dutch study that concluded that a woman's chances of getting pregnant decreased in direct relation to how overweight she was. Women who were seriously overweight were found to be 45% less likely to get pregnant than those within normal weight ranges. It's important to understand that these conclusions were only relevant for women with real weight problems, and not for curvy women who wanted to lose the odd half stone.

Eating healthily doesn't mean dieting unless you start out with a weight problem, and it shouldn't be an unpleasant chore. Anyone trying to get pregnant, or going through fertility treatment, may improve their wellbeing and chances of success by following a healthy eating regime and making sure they are getting all the essential vitamins and nutrients their bodies need.