HFEA Ethics and Law seminar

If you're interested in the ethics of IVF, the HFEA is holding an Ethics and Law horizon scanning seminar in central London on the 24 February 2010. There will be an opportunity to meet members of the HFEA's Ethics and Law Advisory Committee at this event.

There will be sessions with speakers in the morning, looking at the ethical, policy and regulatory issues around fertility treatment abroad, followed by workshops.

There are limited places available, but you can register by email - event@hfea.gov.uk - or find out more by visiting www.hfea.gov.uk

infertility books

If you're looking for a book about any aspect of infertility, do check out this - link to the best online source of fertility books. It has the widest range of books available, and you should be able to find a book on pretty much anything you might be looking for - assuming it has been written, of course!

Fertility drugs for sale online

I've just come across some online posts where people are selling IVF drugs that they haven't used, or have left over from a treatment cycle. Fertility drugs can be incredibly expensive, and it may be tempting to get them for what can appear to be a knock-down price - what's the harm, you may think, in buying something someone else hasn't been able to use? Surely everyone benefits - you get cheap drugs, they get some of their money back.

In fact, this really isn't a good idea. Even if you're confident the drugs are what they say they are, and that they aren't past their use-by date, there's still the issue of where they've been. Many drugs have to be stored at certain temperatures in order to work properly, and when you buy them new from a reputable pharmacy, you can be confident that they've been looked after.

Going through an IVF cycle involves a huge emotional and often financial investment so do make sure you check out the prices from reputable pharmacies as some will charge less than others, but don't take a risk buying left-over drugs from someone you don't know...

RCN calling for better IVF funding

It's great to see that the Royal College of Nursing has come out to call for better access to IVF funding. Although infertility affects one in six of us, 70% of trusts are still not offering the three full cycles of treatment recommended.

In a policy briefing paper, the RCN also calls for an end to the access criteria some trusts have invented in order to ration treatment. There are clear guidelines on who should qualify, but some trusts have chosen to ignore these and to invent their own rules instead. The paper also says that nurses should use their knowledge of the huge psychological impact of infertility to help commissioners understand what is involved. There is far too little awareness of the way infertility affects the well-being of those who can't conceive, and if nurses were able to help commissioners to have a proper understanding of this, it would make a huge difference.

The briefing paper also makes the point that providing three full cycles of IVF funded by the NHS would reduce the temptation to go for multiple embryo transfers which can have health implications for mothers and babies. This would not only lead to a safer system, but would also save NHS funds.

You can see the RCN press release at www.rcn.org

Christmas

It's the most difficult time of year when you're trying unsuccessfully to get conceive. It brings back memories of your own childhood - the smell of the tree, the rustle of the stocking at the end of the bed when you wake up in the morning - and the regret that you aren't able to recreate that for someone else. The things that everyone else loves about Christmas are the things that can make you feel so sad and isolated.

Perhaps the solution is to try to do something totally different at Christmas - go away for a few days or break the conventions and spend Christmas Day out on a long country walk or a cycle ride. Don't feel obliged to get involved in other people's celebrations just because you think you ought to. Take some time to think about what you'd really like to do - and that way you will find that you can enjoy Christmas too.

Payment for egg donors

There's an interesting piece on the BBC News website about payment for egg donors which is being discussed by the HFEA. It's an issue that always causes controversy, raising fears about creating a market for the sale of body parts.

Donating eggs is a time-consuming and invasive business, a million miles away from donating sperm. There are shortages of altruistic donors, and many women now donate as part of egg-sharing schemes, where they get free or cheap fertility treatment in exchange for some of their eggs. This could be considered to be unethical, as sometimes these women are making the choice to donate eggs because it is the only way for them to ever have a child.

No one would want to see a situation where women are donating eggs purely to make money, but at the same time it is only fair that those who go through the process of egg donation are justly recompensed. We must also remember that eggs are not like other body parts as they are produced regularly.

Can payment ever be right? Will it encourage women who wouldn't ever choose to donate eggs voluntarily to do so for money? Is there an effective way of monitoring the system? What do you think?

What is infertility?

Well if you weren't sure, the World Health Organisation has now come up with the latest definition - apparently infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected intercourse.

Yes, I know it doesn't sound particularly interesting, but actually it may be very helpful. The idea that treating infertility is a lifestyle choice rather than a medical one is often used by people who don't agree with IVF or with NHS-funded treatment. Now we know that no less an authority that the WHO has declared that this argument doesn't hold water, as it defines infertility as a "disease".

It is also helpful to know that anyone who has been trying for a baby for more than a year without success should be taken seriously - all too often couples are fobbed off by doctors who tell them that they need to keep trying for a bit longer before it is worth doing any tests or considering any treatment. We now know that the WHO considers a year to be quite long enough.

The definition is part of a glossary of terms used in reproductive medicine that the WHO has produced - find out more here

Going overseas

I've been to the Central London support group for Infertility Network UK tonight, talking about fertility treatment overseas. It's a subject that always generates so much interest, whether you're keen to travel for treatment yourself or are convinced that it is all some kind of dubious exploitative racket.

We did a survey for Infertility Network UK a while back on this very subject, and found that 3/4 of those who responded were interested in travelling overseas for fertility treatment. Of those who'd been abroad already, the vast majority had been really happy with the clinic and the treatment. However, there are always stories about dubious clinics and unethical practices which it can be impossible to prove, or to categorically deny.

The thing that emerged most clearly from the survey was the importance of thorough research - talk to people, check out as much as you can online, try to find others who have been to the same place. It does seem that if you choose the right place, treatment overseas can be a wholly positive experience, but if you jump in too quickly, you may find all kinds of problems you hadn't anticipated.

Body clock testing

I've just been reading about yet another type of body clock testing - see this

It sounds like a great idea - take a simple test and see how late you can leave it to try to get pregnant. However, there are a number of problems.

For a start, this particular body clock test costs £350 - a tidy sum for a scan and some bloods... Perhaps you could justify shelling out that much if you were worried about your declining fertility and seeking some reassurance - but that's exactly where the second problem lies. The results could suggest that you're in tip top reproductive condition, nowhere near the menopause, and have some years to go. What they won't show is any other underlying fertility problems you may have, such as blocked fallopian tubes. You could risk delaying starting to try for a baby until it's too late for you - all because this test showed that your ovaries looked fine.

These tests also work on the premise that if there is a problem, you'll be able to freeze your eggs right away as an insurance policy against reproductive ageing. And that's the final issue. Egg freezing is still a relatively new science, and having eggs in the freezer doesn't guarantee a future pregnancy. It is expensive and is only worth doing if you understand the limitations and have no other options.

So, body clock testing may sound sensible - but should probably be taken with a large pinch of salt!

Free IVF treatment...

Yes, it's true. The Lister Fertility Clinic in London is offering 21 free treatment cycles - and that's full cycles, to include the freezing, storage and transfer of any additional embryos.

If you are under 45 and need IVF treatment, you can apply for one of the 21 free cycles. They are being offered through the charity Infertility Network UK and you can find out how to access the scheme on the I N UK website

The free cycles will be allocated by a random lottery, so anyone who applies stands an equal chance. At the moment in the UK, women should be entitled to up the three cycles of NHS IVF treatment, but the reality is that access to treatment depends entirely on where you live, with some primary care trusts only offering one cycle of treatment and others inventing their own criteria to limit the amount of treatment offered.

The Lister officially opened a new state-of-the-art fertility clinic last week, and the clinic is planning to offer some free treatment cycles every year.

Good news for Wales

Good news for those needing fertility treatment in Wales - from April next year, you will be able to access two cycles of NHS-funded IVF treatment.

The announcement was made by the Welsh Health Minister yesterday, and is to be welcomed as a move towards implementing the guidelines laid down by the National Institute for Health and Clinical Excellence which suggest that all those who are eligible should be offered three cycles of treatment.

You can read more here

stuff of nightmares

Apparently a fertility specialist in the US has been accused of using his own sperm to fertilise a woman's eggs during treatment rather than her partner's sperm. The case first emerged some years ago and was settled out of court, but is now being investigated again.

When you go to a fertility clinic, so much trust is involved in letting someone else take control of your eggs, sperm and embryos. Thankfully, mix-ups are rare in our tightly regulated system here in the UK, but deliberately changing a child's genetic heritage like this is horrendous. There's more on the story here

With more and more couples travelling overseas for treatment, it is important to be aware that the rules and regulations clinics follow here are not universal. There are horror stories, like that of the clinic where embryos were "shared out" between all the patients or of another where no embryos were ever transferred during embryo transfer. If you're going abroad - do your research and make sure you are going to a reputable clinic.

Support for single women

It's hard enough not being able to have a child when you are going through it with a partner, but having to cope with fertility treatment by yourself can be really tough. At Infertility Network UK, we're thinking of setting up a support group for single women if there's sufficient interest. You can find out more by checking out the forums at www.infertilitynetworkuk.com

Comments

Apologies to all those who have commented on the blog recently - I just found the comments, and then managed to delete the whole lot! Next time I will be more careful...

The Fertility Show

Yes, another post about The Fertility Show. It will be my last word on the subject - until next year of course... It was an amazing two days - very busy and wonderful to see so many people there. The talks were a sell-out, and that was hardly surprising as it provided a unique opportunity to catch many of the UK's leading fertility specialists explaining their areas of expertise. There were some slightly odd stands - fertility astrology anyone? - but most provided information and access to instant advice.

I've been slightly surprised by some of the negative comments from journalists about the show, as everyone I spoke to had found it both interesting and informative - and being with thousands of other people going through the same thing made it clear quite what a common problem infertility is. The negative comments have all focused on the commercialism and the fact that many people were there to make money. I must admit that this sudden sense of horror at the idea that anyone should make money from infertility seems a little odd to me - fertility clinics have been raking it in for decades and you'd be hard pressed to find an impoverished fertility consultant.

I do take the point that some of the people working on the stands were perhaps a little forward - but one piece in the Daily Mail which criticised the Fertility Forest and More to Life - that's the charity that supports people who are living with involuntary childlessness -was just plain nasty. I'm not going to link to the piece but if you happen to have read it and felt the same way, you could always write to complain...

Last chance for The Fertility Show

It's finally here - it starts tomorrow. You can still buy tickets on the door. It promises to be a fantastic event and there are a huge range of speakers and exhibitors. My talks have both sold out (!), but there are still spaces for some of the others - check out the website and see what's on - www.fertilityshow.co.uk

The Fertility Show

The Fertility Show is less than a fortnight away on November 6th and 7th at Olympia. Online ticket sales are booming, and the 45 scheduled seminars are rapidly filling up. There are more than 80 exhibitors at the show, and a huge range of speakers covering everything from complementary therapy to coping strategies, as well as all the latest developments in reproductive medicine. Come and say hello if you're there - I'm speaking on Friday about choosing a clinic and on Saturday about travelling overseas for treatment - in between you'll probably find me at the Infertility Network UK stand!

Back to green

I've gone back to green with the background! I missed it - and actually I think it's much easier to read...

Womb transplants

There was huge excitement in the media last week about womb transplants, which we were told could take place in humans within just a couple of years. At Infertility Network UK, we were inundated with interview requests and the news was widely hailed as a huge step forward, offering hope to women who would never otherwise be able to carry a child.

In fact, it seems that this may have been one of those hype over substance stories, as the research project had involved rabbits, who have completely different wombs to humans. Although five rabbit womb transplants were carried out and two of the rabbits survived, neither became pregnant. The transplants were seen as a success because the rabbits, who had been given immunosuppressant drugs, did not reject the transplanted wombs. In fact, being able to get pregnant and the womb being able to expand to accommodate a baby are pretty crucial if the technique is to help women have children. The only previous attempt to transplant a womb into a human was unsuccessful.

Of course, this is an interesting development - but it may be some time before we see successful womb transplants in humans.

Exciting new advance for IVF

Despite all the advances in IVF over the years, the one big hurdle has been knowing which embryos were most likely to implant in the womb. Now, a new screening technique can be used to check for genetic abnormalities which can lead to a miscarriage. Using this technique, researchers have had success rates of more than 66%, a remarkable level considering that most of those in the trial were around the age of 39 and had tried IVF a number of times before. Although the numbers involved in the trials have been quite small, if this could be replicated elsewhere, the potential is enormous.

More on this story here

Have you had fertility treatment overseas?

A research team are looking for people who've travelled abroad for fertility treatment as part of a large-scale survey into cross-border treatment. More and more people are going outside their home country for treatment for all kinds of reasons - to escape certain regulations, to access treatment more easily or simply because it costs less. There's still very little research into the subject and no one really knows how many people seek treatment overseas - what's more we don't know much about their experiences. One of the only pieces of research into the issue so far was carried out by Infertility Network UK but this new work will be an academic project, going into far more depth. If you'd like to know more about volunteering for the project see www.transrep.co,uk

Asian support group

Talking to others who are in the same situation can be a huge help when you are trying to conceive, but sometimes cultural differences can cause particular problems that not everyone can appreciate. Now, British Asians with fertility problems are about to benefit from a group aimed specifically at them, which will be set up in London early in the new year. For more information, check out the Infertility Network UK website.

Fertility monitoring device

If you happen to have a spare 500 quid knocking about, you may be interested in purchasing a new device designed to take your temperature twenty thousand times whilst you are asleep to try to pin down the most fertile days in your month. Many years back, doctors would always suggest that you started any fertility investigations by taking your temperature every morning, but more recently it has been recognised that the results are not always accurate when you are using a thermometer to do this.

Now there's a small sensor about the size of a pound coin that you can put under your armpit, and a monitor that lights up to show your most fertile days. It's all very well if you don't have anything better to do with five hundred pounds, but for you may be better off saving your money and trying to have intercourse more frequently, especially around the time you think you are most likely to be ovulating. If you happen to be one of the monied few, it's called DuoFertility by the way!

Unregulated clinics

I've been reading about some fascinating Canadian research which calls for fertility clinics in Latin America to be regulated. Apparently, more and more fertility clinics are opening up in developing countries, where it is possible to offer treatment at relatively cheap rates. In order to make things easier for overseas patients, the clinics offer package deals which include travel, accommodation and treatment, allowing patients to have a "holiday" along with their IVF. The problem with the plethora of new clinics is that no one can be entirely sure of the standards they adhere to.

This can be a particular problem for patients travelling for treatment from the UK. Here. all fertility clinics offering IVF are tightly regulated and monitored, and it is easy to assume that clinics overseas must have the same rules and ethics. This is why it is so important to do your homework when you're looking for a fertility clinic abroad.

If you're interested in the Canadian research, you can find details on the University of Montreal website. You may also be interested in coming along to The Fertility Show where I will be giving a presentation on treatment overseas.

Risks of IVF?

Do you think women are putting their lives at risk from IVF treatment? That was the claim just a few weeks ago in some national newspapers - see here . I think women who have dozens of cycles of IVF are always going to be in the minority - not many of us could afford the financial or emotional cost. It is true that a little more honesty about the chances of success might not be a bad idea, but most women come to their own decisions about when to call it a day.

As for the suggestion that women with cancer are dying because they've waited to get pregnant - surely they would be better advised to consider freezing embryos rather than putting their cancer treatment off for years? If women are doing this, it must raise questions about the quality of the counselling they've been receiving.

Then finally, there's the thorny issue of IVF drugs and cancer - it's one of those subjects that pops up now and again. No one has any proof, but there have been a few high profile women who have believed that their IVF treatment was related to their cancer. In fact, earlier this year a large-scale study found no evidence of this whatsoever, and it seems somewhat irresponsible to raise the subject without mentioning this.

I think if you're going to make claims like these, you need to be able to back them up with solid evidence. Scientists often say the rest of us rely too much on anecdotal evidence, but there seems to be little more than that for any of these suggestions.

Find a clinic

The HFEA launched a brand new version of the online "find a clinic" service today. The information it offers is great - really detailed for those who like that kind of thing, but with a clear overview for anyone who just wants to get a general picture.

There's also a more statistically-accurate version of the success rates that have always been pounced on by journalists keen to create league tables of fertility clinics. These figures have been changed because the real differences between most clinics are small and giving blunt figures was not a very accurate representation of an individual's chances of success. The new figures give a range between which success rates will fall, and include a "most likely around" percentage which will doubtless be what most of us focus on. There's also information about the types of fertility problem the clinic treats, all the things it can offer and practical stuff like opening hours.

It's all fantastic - but at the moment it seems to be suffering a lot of glitches. I've been on it a few times during the day and it hasn't been able to get the information I wanted - instead I've had error messages and been told certain pages are too busy! Early days... Once these teething problems have been sorted out, it should be a fantastic resource - see here

The WoW show

It's not too late to book for the Wellbeing of Women show this Saturday in Central London. There are a wide range of speakers on all aspects of women's health and fertility, and it promises to be a fascinating day. I'll be there on the Infertility Network UK stand so come and say hello!

You can find out all the details and information about how to book here

Starving worms...

Well, I am not sure what it means for humans, but scientists in the States have apparently found that fasting can turn back the reproductive clock in worms!

A research team found that when adult worms were not given any food, they stopped ovulating and part of their reproductive system simply died off. When they were then given food again, the stem cells that had been left behind started producing new, fertile eggs. The old worms in the survey were able to produce healthy babies at a time when normally they would have been dead.

The researchers have made it very clear that there is no suggestion that going on a fast, or severely restricting calories, would lead to humans producing new eggs, but they hope that their findings might be used to help understand the mechanisms that control fertility. They are particularly interested to find out whether their research could have any relevance for women who are recovering from cancer treatments that can destroy the immature eggs in the ovaries might in fact be able to regain their fertility.

You can read more about the research here

New storage limit for frozen embryos

Many couples who have frozen embryos in storage will be delighted to learn that the government is set to extend the limit on the time they can be kept from five years to ten.

Often people are not ready to use all their frozen embryos within a timescale of five years, and changing the rules is a sensible and rather overdue move. Most women produce more eggs during an IVF cycle than they can use immediately, and freezing spare embryos allows another, less intrusive, treatment cycle at a later date. However, not everyone is able to use all their spare embryos within the time limits, and there can be little more distressing than having to allow them to be destroyed.

You can see a statement from the HFEA at www.hfea.gov.uk

Back again!

Apologies for the long silence - I've been away, and now I'm back. Watch this space for more news and views.

The Fertility Show

Get out your diary now, and make sure you don't miss The Fertility Show on November 6 and 7 at London's Olympia. It's aimed at anyone who wants to know more about fertility, from those who are wondering how late they can leave it to try to conceive to those who have already started fertility tests and treatment. There will be exhibitors from the UK and overseas, experts on conventional and complementary therapies and talks on a wide range of topics. I'll be speaking at the show and will let you know what about and when closer to the date. You'll be able to book tickets online in just a few weeks. To find out more, go to www.fertilityshow.co.uk

Survey on funding

I've been on Channel Four News this morning, talking about the latest survey on funding for fertility which suggests that 80% of primary care trusts are not offering the treatment they should.

The website www.fundingforfertility.com has all the latest details on NHS funding for fertility treatment, and shows that your chances of getting treatment depend entirely on where you live. The system is blatantly unfair, with individual primary care trusts making up their own criteria. In some parts of the country, you only get treatment if you are over the age of 36, in others if you are under the age of 35.

Many are refusing to pay for spare embryos to be frozen and transferred, which means patients end up having more than one embryo transferred and the multiple birth rate rises. The cost to the NHS of more multiple births would far exceed the cost of freezing and transferring spare embryos, but there seems to be little in the way of joined up thinking on this issue.

There is little point in going to the expense of having a National Institute for Health and Clinical Excellence to look carefully at all aspects of a problem and make recommendations if primary care trusts are then free to ignore them entirely and make up their own rules.

You can see more of the Channel Four News coverage at www.channel4.com/news

Fertility worries of over 30s

A new survey for Red magazine has revealed that seven out of ten childless women who are over the age of 30 are worried about their fertility. The women surveyed for the poll had an average age of 37, and the survey results showing that 34% of them had experienced fertility problems have been quoted in some papers as suggesting that 1 in 3 women are infertile -double the normally quoted rate. This is probably due to the age of the women surveyed as older women are far more likely to experience fertility problems.

The survey also showed that six out of ten women thought they would use IVF if they didn't manage to get pregnant naturally - which is rather worrying given the average age of the respondents. IVF is not a solution for the biological clock and can't reverse reproductive ageing.

Apparently, the survey suggests that the recession has had no impact on the fertility industry. Many of those questioned who'd had IVF had turned to their parents to help foot the bill, as the postcode lottery means that not everyone can access the funded treatment the government's own advisory body believes they are entitled to.

You can read a take on the story here , or go and browse a copy of Red in your local newsagents!

Researchers want your views

If you've been trying to conceive unsuccessfully for six months or more, researchers at Cardiff University are interested in your views. They're conducting an online survey - so no need to talk to anyone face to face - and you can give your views from home when you'd like to do it. You can find the survey here

IVF for lesbian couples

News in The Times today of a lesbian couple winning the right to equal access to IVF funding. They'd originally been refused NHS treatment. Some local trusts are less enlightened than others when it comes to treatment for lesbian couples and single women, but later this year changes to legislation will remove the need to consider the need for a father when considering who should be offered treatment which should put an end to discrimination. You can read more about this case at www.timesonline.co.uk

Attractive men produce less sperm

If you've got a low sperm count, it may be down to the fact that you're so good looking... New research suggests that attractive males don't produce as many sperm as their less handsome counterparts. Apparently this is part of a pattern seen in some animal species where males who attract more females produce fewer sperm each time they mate. The males who aren't as popular with women need to produce more sperm each time they ejaculate in order to maximise their chances of reproducing, as they will get to mate less frequently.

The research is part of a study from researchers at University College London and the University of Oxford, and you can find out more at www.ucl.ac.uk

New hope for male infertility

You've probably heard by now about the human sperm created in the laboratory along with dire warnings about men becoming redundant in the future.

The sperm were made using embryonic stem cells by a team from Newcastle University and the NorthEast England Stem Cell Institute, and the researchers believe the development will offer hope to many couples with fertility problems. You can read all about the research at www.nesci.ac.uk

However, some other experts in the field have expressed doubts as to whether what has been produced are actually real sperm, or something similar with many of the same characteristics - clearly a case of watch this space!

The real cost of IVF

It's something patients have been complaining about for years - the hidden extra charges they often face when presented with a bill for their fertility treatment. Now, the HFEA is taking action on the issue, and has told clinics that they will be expected to present patients with a clear plan of how much their treatment is going to cost.

When so many people have to save or borrow to pay for treatment, an unexpectedly large bill can cause real problems and costed treatment plans at the start should make a real difference. There's a press release on this with more details on the HFEA website at www.hfea.gov.uk

New survey on treatment overseas

More and more people are travelling overseas for fertility treatment, often to escape rules and regulations in their own countries, according to a new cross-European study. For patients from the UK however, a major reason for travelling was the difficulty of accessing treatment. Many couples who need donor eggs find they face long waits in the UK and may choose to travel to Spain or the Czech Republic where there are more women willing to donate eggs. Age also played a part, as more than 60% of British women travelling for treatment were over the age of 40.

In Italy, freezing embryos is not permitted, so it is perhaps not surprising that Italians are the largest group of people travelling for treatment, whilst in France, lesbian couples are not eligible for IVF, so many same sex French couples travel for treatment. You can find out more about the new research at www.eshre.com

Can cycling damage sperm?

Spanish researchers have found that serious cycle training seems to damage sperm. They looked at a group of triathletes, and found that those who focused on cycling in their training had the poorest sperm quality. Apparently the time spent training and the distance cycled could be seen to have direct links with the quality of sperm. It isn't clear why this should be, although it is possible that it is due to heat damage or compression. You can read more on the report released at ESHRE this week at www.eshre.com

Latest statistics on IVF funding

If you want to check whether you'll qualify for funded IVF treatment, the Department of Health has just published the latest detailed statistics on what the NHS provides and where.

It makes fascinating - if somewhat depressing - reading. Overall, the situation is getting a little better, and we are gradually working out way towards the three funded cycles suggested by the government's own advisory body. However, it's a slow process and in some areas access to treatment is restricted by some very strange rules.

The government's advisory body had suggested that treatment should be available for couples when the female partner was 39 or under, but in North Yorkshire and York, they've decided to fund treatment for women who are older instead. There, you only qualify for treatment in the six months between being 39.5 and 40 - despite that, they did manage to treat a total of 19 women who fell into that category in 2008! We know that treatment is less likely to be successful by the time a woman reaches 40, and it seems an odd decision not to offer help to younger women who have a greater chance of getting pregnant.

Some areas are still only funding fresh cycles, and not making any allowances for freezing spare embryos and transferring them later. This is going to make it very difficult for clinics who are being encouraged to promote single embryo transfer in younger women - if the NHS will pay for you to create the embryos but then refuses to pay for you to store them, you're more likely to ignore the risks that a multiple pregnancy could bring.

Overall, there's still a long way to go - but things are moving, albeit gradually. You can see the detailed breakdown of what is being offered where by checking out www.dh.gov.uk

Call for electronic tagging in IVF labs

A leading fertility expert has told The Times that all fertility clinics should be using electronic tagging systems to prevent mistakes in laboratories after news of a mix up in Cardiff. The last frozen embryo belonging to a couple was accidentally put into the womb of another woman, who was then given the morning after pill to prevent a pregnancy.

Gedis Grudzinskas told The Times that the use of electronic tags to track embryos, eggs and sperm samples should be mandatory. He believes it would reduce the risk of accidents and said that the HFEA should insist that all clinics install tagging systems. At the moment, many clinics use a system of witnessing where two members of staff have to check whenever samples are moved around the laboratory. Despite this, there have still been a number of errors.

In the case in Wales, a trainee embryologist was blamed for the mistake where proper witnessing procedures were not followed, but it may lead to more calls for electronic tagging to reduce the risk of mix ups.

You can read more at www.timesonline.co.uk

HFEA consultations on donor conception

The HFEA is holding a couple of events related to donor conception - one for people who were conceived using donor sperm or eggs and their families, and one for those who are donors or who are considering becoming donors. Both events will be an opportunity to discuss issues surrounding donor conception.

The event for donors and prospective donors will be an evening workshop on 22 July in Hatton Garden, London between 5 and 7.30. Donors will be able to discuss the kind of guidance and information the HFEA could provide to support them. To register for this free event, see details on the HFEA website

The second event is for donor conceived people and their parents, and is also in Hatton Garden between 10.30 and 3.00 on Wednesday, 29 July 2009. This will be an opportunity to find out more about the changes to the information which donor-conceived people can request about their origins. The HFEA wants to hear their views about the support they need to access this information from the HFEA. Again, details can be found on the HFEA website

Couple speak of horror of embryo mix up

A couple who suffered the horror of a mix-up in the embryology lab when they were going through IVF have been talking about their experience. Their only remaining frozen embryo was transferred to the womb of another patient by mistake, and she was then given the morning after pill in order to prevent a pregnancy.

It is hard to imagine how utterly devastating the impact of a mistake like this must be. When you are going through IVF treatment, you think of frozen embryos as your potential family, and to discover that one has been lost in this way is just awful.

Most clinics have stringent witnessing procedures in place, where embryologists are only allowed to move eggs, sperm or embryos around the laboratory if a second member of staff witnesses what they are doing and double-checks the labels. This mistake was blamed on a trainee embyologist who didn't follow the correct procedure. However, the blame lies further up the hierarchy than this - even the most junior and inexperienced member of staff should be aware of the importance of witnessing, and no one should be allowed to move embryos around the laboratory until they understand this. The University Hospital of Wales in Cardiff admitted gross failure, and whilst we must welcome the fact that the mistake was quickly recognised and reported, patients should be able to go to a licensed fertility clinic feeling confident that procedures are followed properly. You can read more on the BBC News website

Congratulations to Clare

Congratulations to Clare Lewis Jones, Chief Executive of Infertility Network UK, who has just been awarded an MBE in the Queen's birthday honours list. It's a great recognition of her years of work campaigning for those with fertility problems - you can read more about it here

Only in America...

The latest infertility prevention idea from the States is a Manicures and Martinis evening... Organised by the American Fertility Association, the aim is to help women who know they want a baby, but aren't quite ready yet. A team of fertility experts will offer information about what might damage your chances of getting pregnant - and about the all-important biological clock.

Where do the manicures and martinis come into it, I hear you ask. Well, everyone who attends gets a free manicure during the evening along with either a martini, or a non-alcoholic organic version known as the Fertilini. Apparently these evenings, part of an infertility education outreach programme, are proving hugely popular! You can find out more here.

Seeking fertility treatment overseas

There was an interesting article in The Guardian recently about the scale of what is often referred to as "fertility tourism". It's not a term many of those who have had fertility treatment abroad would use, but travelling overseas for donor treatment in particular has become more and more common in recent years.

Couples who face long waits for donor eggs or sperm, or who find the costs of IVF and ICSI in the UK are simply beyond their budgets, may travel in order to access treatment. There are no accurate statistics to show how many people end up doing this, and it's an area which is now attracting interest from researchers. To date one of the only surveys looking at the issue was carried out by Infertility Network UK - a project I was involved with. If you're interested, see the article here

IVF twins risk

New research suggests that twins born after IVF are more likely to be premature and to have health problems than twins conceived naturally. Although it has been known for some time that twin pregnancies carry additional risks for mother and babies, it has often been assumed that these are risks for any twin pregnancy, no matter how it began. Now it seems that the risks are greater for IVF twins although it isn't clear why this should be.

It's yet another argument for moving away from multiple embryo transfers wherever possible - I think that fertility patients have often been misled about the risks of twin pregnancies by consultants who are focused on pregnancy rates. We should be pressing for more affordable and more successful treatment so that single embryo transfer becomes the perfectly acceptable norm for younger women who are deemed to have a good chance of success.

You can read more about the research, which is published in Human Reproduction at http://humrep.oxfordjournals.org

Embryology errors

Earlier this month, newspapers were reporting problems in the embryology labs in the IVF unit at Guy's, where it was alleged that eggs had been fertilised with the wrong sperm and had to be destroyed. There was a great deal of criticism of the unit and of the HFEA for failing to regulate and monitor such problems.

When I was researching The Complete Guide to IVF , I spent time watching embryologists at work, and one of the things that really struck me was how rigorous the witnessing procedures are in labs in order to ensure that mix-ups don't happen. Two embryologists would double-check everything whenever eggs, sperm or embryos were moved from one part of the lab to another and there seemed little room for error.

However, we all make mistakes and even the best systems sometimes go wrong. What we should be noting about the incidents at Guy's is that they were immediately reported to the HFEA. This is good practice and is the only way embryologists can learn from one another to try to prevent any future problems. It would be a great shame if the fact that honest clinic staff, those who admit to their mistakes, end up in the firing line leads to others being more wary about being honest themselves.

Interviews...

I've done quite a few interviews over the past month for my new book The Complete Guide to IVF . I've rather belatedly discovered a link to this one from the London Evening Standard

UK's first fertility law firm

If you think you might need legal help for any fertility-related problem, you will be interested to know about the launch of the UK's first ever fertility law firm. Gamble and Ghevaert specialises exclusively in fertility and parenting law, and will be able to offer advice to anyone who is trying to conceive through fertility treatment or in non-traditional family structures.

The firm is founded by fertility lawyers Natalie Gamble and Louisa Ghevaert who have recognise the need for legal support in sometimes complex and unchartered areas - for example where parents are starting families with surrogates, using donor gametes or travelling overseas for fertility treatment.

Natalie Gamble is a leading fertility lawyer who has championed the rights of fertility patients, and was last year nominated by gay rights organisation Stonewall as a Hero of the Year for her work supporting the new rights for gay and lesbian parents. Louisa Ghevaert is an experienced family law litigator with a specialism in fertility and children's law.

You may want to look at the firm's website, www.gambleandghevaert.com for helpful information about fertility and parenting law

How old is too old to be a mother?

So, a single woman of 66 is set to be Britain's oldest mother after having fertility treatment at a clinic in Ukraine - the kind of news that sets alarm bells ringing about unscrupulous IVF clinics, and allows for ethical debates about the rights and wrongs of helping women in their sixties to have babies.

It's true that we wouldn't raise our eyebrows very far at the prospect of a 66 year old man fathering a child, and it could be seen as sexist to be condemning a women of that age for wanting to have a child of her own. However, the very real risks for both mother and child of pregnancy at this age should not be underestimated.

What I can't understand is why it would take someone so long to realise that they wanted a baby? Surely, if you were so keen to get pregnant that you managed to arrange to go through donor treatment overseas in your late sixties, you could have done this at least ten years earlier...

Not quite so rosy in Scotland after all...

Scotland has often been praised for a forward-thinking attitude to infertility, but new evidence is emerging that maybe the picture north of the border isn't quite as rosy as imagined.

Depending on where you live, you can wait for as long as three years for IVF treatment, and the upper age limit also varies from one area to another. This postcode lottery means that two patients who are due to receive treatment at the same fertility clinic may wait for just a few months to have IVF if they live in one area, but two or three years if they live elsewhere. There are also differences in the number of cycles of treatment offered, with some health boards offering just two rather than the recommended three. There's even confusion over frozen embryo transfers, which are counted as separate treatment cycles in some parts of Scotland.

You can read more on the story at www.theherald.co.uk

Call for fertility funding in Wales

Campaigners are trying to persuade the Welsh Assembly to honour guidelines set down by the government's advisory body and fund up to three cycles of IVF treatment for eligible couples.

In some parts of the country, the guidelines set down by NICE are now being followed, with up to three cycles of funded treatment. Campaigners in Wales feel this is far from becoming a reality where they live - the most they can hope for under the current regime is one attempt at IVF funded by the NHS.

If you'd like to find out more about the campaign, to sign the petition or to get copies from organiser Kara Ellard you can see www.walesonline.co.uk

The problem of infertility in Africa

We often think of infertility as a problem of the Western developed world - and when it comes to sub-Saharan Africa, news tends to focus on the problems of high fertility rates rather than those who have difficulties getting pregnant.

Now, an anthropologist from Brown university in the States has published some fascinating research about the stigma of infertlilty in Nigeria where the lack of understanding and sympathy that some women who can't conceive face can be shocking. In certain areas, infertile women are treated particularly badly - they are not regarded as proper women and often find they are forced to live on the margins of society. Their fertility problems frequently lead to divorce and financial difficulties. The researchers say that "the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman's treatment in her community, her self-respect, and her understanding of womanhood." I wonder quite how different we really feel it is here...

You can read more about the research at www.scienceblog.com

Twittering

Do you get it ? Twittering, I mean. I'm not entirely sure I do, but I was at a gathering of authors the other night where I felt hopelessly out of date as everyone discussed their twittering and podcasts. So, since podcasting sounds far too technical I decided to have a go at Twitter instead. I don't quite get it yet, but I must admit that it took me about a year to understand Facebook. Maybe by summer 2010, I'll be merrily twittering away. You can find me here http://twitter.com/katebrian

Early menopause support

The Daisy Network - which offers advice and support to anyone affected by early menopause - is organising a one-day conference in central London in June.

The conference is open to all, and partners, friends and family will be warmly welcomed. The date is Saturday June 13 and it lasts all day, with informal discussion groups planned for the afternoon.

Experiencing an early menopause can be difficult and is often isolating, so anyone who would like more information about the day, or about what the Daisy Network can offer, may be interested in visiting the website at www.daisynetwork.org.uk

PCOS fertility workshop

I'm delighted to have been asked to speak at a workshop on Polycystic Ovary Syndrome (PCOS) and Fertility organised by Verity - the PCOS support network - in June.

It's a one day event, with a range of sessions exploring how Polycystic Ovary Syndrome can affect your fertility, and what you can do about it. PCOS is a very common female fertility problem, and can be linked with other upsetting symptoms such as weight isssues and excess body hair.

I'll be speaking about what to expect when you're trying to conceive. Other speakers at the event include Professor Stephen Franks and Dr Davinia White, and there will be sessions on funding for fertility treatment and on infertility and complementary therapies. The event will be held in Croydon on June 27. You can find out more at www.verity-pcos.org.uk

Free seminars on fertility treatment.

If you know you are likely to need fertility treatment and want to find out more about it, you may be interested in some free seminars being offered on the subject at one UK clinic. Bourn Hall, just outside Cambridge, is the clinic originally set up by the IVF pioneers, Patrick Steptoe and Robert Edwards, and now it is a large unit offering a range of treatments.

There is a seminar every month held on a Saturday afternoon, where senior members of the medical and scientific team are on hand to provide information about the treatments and counselling offered at the clinic. The clinic do ask that you notify them in advance if you'd like to attend one of the seminars, but there is no obligation to continue with treatment there, and the question and answer session may prove informative.

You can find out more on the Bourn Hall website at www.bourn-hall-clinic.co.uk

Fertility warnings for cancer patients

According to an interesting article in the New York Times, it seems that many cancer patients are still not being warned about the risks treatment can pose to their fertility.

The paper reports that many patients don't think to ask about this during consultations, and that specialists often forget to tell them in the rush to start treatment. One study estimated that only 1/4 of specialists told patients that their cancer treatment could mean they would not be able to have children. In the US, a new programme has just started to help cancer patients who are worried about their future fertility.

It is surprising that even now many people are unaware that infertility is a fairly common side effect of cancer treatments. If the risks are explained before treatment starts, there is often a window of opportunity to freeze sperm or eggs before it begins. The chances of a successful pregnancy with frozen eggs are still low, but this is a rapidly changing field and this is certain to improve in the not too distant future.

Oxfordshire petition

It's one of those areas of the country with a completely nonsensical IVF funding policy - where only older women, who are less likely to be successful, qualify for NHS help. In Oxfordshire, you have to be 35 to be eligible for funded treatment - and so one couple who would have to wait nine years to qualify have started a petition to call on the local Primary Care Trust to change their policy.

It certainly can't be seen as cost effective to be funding treatment only when there is less chance of it working, but this kind of rationing helps keep waiting lists low and ensures many couples simply have to pay for their own treatment whilst still allowing health officials to claim that they are offering funding for IVF. The government's guidance is that up to three cycles of funded treatment should be offered to eligible couples where the woman is under 40, but in reality this is not happening in much of the country.

The couple who started the petition in Oxfordshire were told that their chances of success if they had IVF now would be 50%, but if they waited until they were eligible for funding, they'd only have a 24% chance of the treatment working. Surely the argument for a change of policy could not be clearer. You can sign the petition at gopetition.co.uk/online/26607.html and you can read more about the story in the Oxford Mail at www.oxfordmail.co.uk

Medical causes of excess body hair

Women who have excess body hair, known as hirsutism, don't always realise that this may indicate an underlying medical problem. Many women are upset and embarrassed if they start growing excess hair but the condition is surprisingly common, affecting up to 15% of the population, and women should feel confident about seeking medical advice. Hirsutism is often a sign of polycystic ovary syndrome (PCOS), and the vast majority of women who have excess body hair also suffer from PCOS.

A new study to be published in The Obstetrician and Gynaecologist looks at the causes of hirsutism and also investigates the treatments that may be used successfully. If a woman is overweight, then weight loss can sometimes make a real difference, as can hormone therapy, such as taking the oral contraceptive pill. Women may also be offered cosmetic or medical treatment for hirsutism. There's more on this at www.rcog.org.uk

Funding for Fertility

If you want to know what your chances are of getting NHS help for IVF, a new website has just been launched that can help. The map at www.fundingforfertility.co.uk covers the whole of the UK, and by clicking on an area you can discover whether funding is available, and what restrictions have been set on who can receive it.

The website has been set up by the charity Infertility Network UK, and shows that even now, five years after the IVF postcode lottery was meant to have ended, your chances of getting funded treatment depend entirely on where you live. Government guidance suggests that eligible couples should be able to receive up to three cycles of IVF, but for most of those who need treatment this is still far from becoming reality.

Some areas are not funding treatment at all, whilst many others will only help with one cycle. Even in areas where there is funding, the local trusts often set strict limits on who is eligible in order to ration treatment. You may find that you are too old, too young or too heavy, and smokers are ruled out in most areas. The problem is that these criteria are not always created by people who have an understanding of infertility and IVF, and the current situation is far from fair or just.

See the Fertility Funding map at www.fundingforfertility.co.uk

Donor anonymity and sibling tracing

The Donor Conception Network has highlighted a problem that has recently arisen for the parents of donor conceived children who had been able to ask clinics for the codes given to their donor by the clinic in order to help with sibling tracing. The HFEA has recently changed the advice given to clinics on this, and suggested that they should stop issuing these codes to parents.

There are apparently some concerns about donors being identified from the codes, and worries that they may be used to track down half siblings before children have reached the age of 18. However, the Donor Conception Network is concerned about the way that the decision to stop issuing the codes has been taken so suddenly. If you have donor conceived children and have any thoughts on the issue, you can get in touch with the network through the website at www.dcnetwork.org

Post-natal depression and multiple pregnancy

When you're trying hard to get pregnant, it's easy to assume that having two or three babies in one go would be the ideal solution to your problem, giving you an instant family. The fact that there are medical risks attached to multiple pregnancy is well-documented, but a new study from the States has found that mothers of twins and triplets are 43% more likely to suffer post-natal depression.

More than seven thousand mothers took part in the study and the researchers found that those who had been through the stress of a higher risk multiple pregnancy and delivery were far more likely to become depressed. It was also thought to be partly due to the exhaustion they experienced caring for more than one baby. The research is published in the April edition of Pediatrics, the journal of the American Academy of Pediatrics. You can find more at www.aap.org

Book review

An early review for my new book The Complete Guide to IVF has just appeared online - if you're interested in finding out more about the book, you can read it at www.thebookbag.co.uk

Drug hope for male infertility

New research suggests that combining a common fertility drug with vitamin E can improve male sperm counts and increase pregnancy rates.

Researchers at Cairo University used clomiphene citrate (sometimes known by the brand name Clomid), which is often given to women to help them ovulate, along with vitamin E in their trial. Sixty men with fertility problems took part in the study, and half were given clomiphene citrate and vitamin E for six months whilst the others were given a placebo. The results showed that the men who had taken the combined drugs had higher sperm motility and concentration. The pregnancy rate for partners of these men was considerably higher at 37%, whilst the pregnancy rate for the partners of men who'd had the placebo was just 13%.

The scientists say more research is needed but in the meantime you can read more about the study in Fertility and Sterility. You will need to scroll down the page to get to the relevant research.

Cause of IVF failure?

Scientists in Australia think they may have discovered what could cause some IVF cycles not to be successful. Researchers at Queensland University of Technology in Brisbane discovered that sometimes the liquid in surrounding eggs in their follicles is infected with bacteria, and that this made IVF less likely to succeed. Their initial findings have led to an ongoing larger study to look into this. You can find out more about the results so far at www.news.qut.edu.au

New book out TODAY

My new book, The Complete Guide to IVF , is out today, published by Piatkus. If you're considering IVF, having iVF or just want to know more about the subject I hope it will be really helpful.

I spent far too long researching it, partly because I found it absolutely fascinating to spend time behind the scenes at fertility clinics and to have the opportunity to quiz consultants, fertility nurses, embryologists and counsellors about their perspective on the subject, at the same time as talking to many patients. I hope that has paid of in terms of the detailed information the book contains. I don't have a scientific background myself, and I think in many ways it was an advantage when it came to writing this book. I had to get people to simplify their explanations so that I could understand them and was never ever afraid of asking really stupid questions which means it is certainly written in a way that makes the sometimes complex treatments very simple to understand.

I hope you'll enjoy reading it - and do get in touch via my website www.katebrian.co.uk if you want to know more.

Talking and telling

The Donor Conception Network are organising more of their special 'Talking and Telling' workshops for anyone who has children conceived using donor eggs and/or sperm. The last series of workshops were hugely successful and the Network is now offering places in London, Southampton, Manchester, Nottingham, Bristol and Sheffield, There's a special course in Central London for single parents only, and another for parents who have children of eight and over. You can find out all the details, and pick up a booking form at www.donor-conception-network.org

The risks of using surrogacy agencies

If you needed any warning of the potential pitfalls of entering into surrogacy arrangements without legal advice, an article in the New York Times provides just that.

The paper reports that a California-based surrogacy and egg donation agency that had taken tens of thousands of dollars from would-be parents has closed, taking their money with it.

The agency had clients and surrogates not only in the US, but also in other parts of the world. It is estimated that up to two million dollars may have gone missing. You can read more in the New York Times article.

No word from the HFEA..

Despite some of the frightening stories in the media over the last few days about the increased risk of defects for babies born after IVF treatment, there has been no reassurance for patients on the HFEA website. Many of the papers have quoted the HFEA, but it seems that providing patient information on this issue is less of a priority than talking to the media.

I rang the HFEA press office this morning to ask when some advice to patients would be put up on the website, and was told that it would possibly happen later today. Nothing seems to have appeared yet. This is despite the fact that the HFEA must have known that this story was about to hit the papers since Friday at the latest.

It is easy to forget how frightening stories like this can be for people who are having fertility treatment, and allowing journalists to run wild with the story without a word of reassurance to patients is singularly unhelpful. If you are concerned, the HFEA have apparently found time to tell The Independent that " some of the potential risks needed further investigation and, when the new advice comes into full use from October, it will be pointed out that the majority of IVF babies are born health".

I hope that patients won't have to wait until October to receive this reassurance directly from the HFEA.

PCOS and your emotions

There's an interesting all-day workshop for anyone who can get to Birmingham this Saturday, looking at the emotional aspects of polycystic ovary syndrome, or PCOS.

If you have PCOS, you will find it an interesting day and speakers include a psychologist, a hypnotherapist and a nurse. You can find out more about the workshop here, at www.verity-pcos.org,uk

IVF safety

If you've read the story in the papers today about the increased risk of defects for babies born after IVF treatment, don't panic. Some of the reports make it sound as if huge numbers of IVF babies are being born with serious defects, providing the opportunity for those who "don't agree" with IVF to have a field day, explaining that messing with nature or attempting to play God was always bound to lead to disaster and that it's only our own selfish desire to have children by IVF on the NHS rather than adopting one of the millions of unwanted babies that has led to this...

Where to start... IVF has been around for 30 years. If there was really a huge risk of children being born with serious defects, we would have seen the evidence from the start. The reality is that there is a slightly higher risk of having some very rare conditions if you have an IVF baby - but the fact that these conditions are very rare to begin with means that the chance of having these defects even with IVF is still extremely low. What isn't clear is whether some of this increased risk may come from the underlying fertility problems or the fact that IVF mothers are often older, rather than the IVF process itself.

It's sad the way a story like this brings out so much misinformed opinion about IVF and infertility - why do people seem to think that most IVF is funded by the NHS in the UK ? And have they any idea how few babies in the UK are waiting for adoptive parents? Why does the desire for a child suddenly become selfish if you need IVF to do it?

What we really need is some good, solid research to clarify the truth about the risks for IVF babies. Only then will we see an end to the scare stories.

Award for Infertility Network UK

The charity Infertility Network UK has been listed as one of the winners in a prestigious health award scheme.

The Impact Awards aim to reward charities who are doing excellent work to improve people's health, and this is well-deserved recognition for Infertility Network UK. The awards are funded by GlaxoSmithKline and managed in partnership with the King's Fund.

Possible new fertility treatment

Scientists say they may have discovered a new fertility treatment. It is believed that a hormone called KISSPEPTIN could help women who are experiencing hormonal fertility problems. Kisspeptin can stimulate the hormones which control a woman's menstrual cycle, and may be able to restore her fertility.

A small trial group of women who had stopped ovulating were given the drug, and their hormone levels improved considerably. Rather than stimulating the ovaries, this treatment would help by re-booting a woman's own reproductive system. You can read more about the research here .

Suspended for having IVF...

The case of an immigration officer who was suspended from work for taking 12 days off for IVF treatment shows we haven't come as far as we might hope when it comes to attitudes to infertility.

Although more than 35,000 women have IVF in the UK every year, what they are entitled to in terms of time off is a grey area. Some employers still insist that infertility is a "lifestyle issue", despite the fact that many IVF patients have clear-cut medical problems. When I worked with Infertility Network UK on a survey on this issue, we found that some employers would not allow women to take sick leave if they felt unable to work during treatment. Around a third of women hadn't even told their employers they were having IVF, often fearing the consequences for their careers, and some of those we surveyed had faced discrimination at work after admitting they were having IVF.

This may present a bleak picture, but if you're having IVF and have an unsympathetic employer, you can always go to your GP as most are happy to give a medical certificate if you don't feel fit to go to work. More and more employers are now adopting a sympathetic attitude to IVF, and those who have allowed flexible working during treatment or paid leave find that the payback in terms of goodwill is more than worthwhile.

If you're interested in the arguments, I've written about this issue in this week's edition of Grazia magazine.

Plans to regulate IVF in California

The birth of octuplets in the United States has raised awareness of the problems that can arise when fertility treatment is not tightly regulated. Now, according to newspaper reports, politicians in California may re-classify fertility clinics in order to gain more control over how they work. Accrediting the clinics as outpatient facilities would mean that they would be able to be more closely mointored.

In other states, there have been moves to tighten the rules on fertility treatment as despite claims to the contrary, it is clear that self-regulation has not worked in the United States, where many clinics routinely ignore guidelines. You can read the story at www.aftau.org

Biomechanics and IVF success

According to new research, the physical positioning of a woman and the size and shape of her womb make all the difference to IVF outcomes, along with gravity and the mechanics of the womb.

Researchers at Tel Aviv University are studying how embryos implant into the wall of the womb, and say that the mechanics of what happens during this process can play a vital role in whether it is successful. This is a key factor in IVF, as we still don't know quite why some embryos implant and others don't.

You can read more about the research at www.aftau.org

HFEA wants your views

The Human Fertilisation and Embryology Authority would like to hear your opinions about the way information held on IVF patients should be disclosed to researchers.

Under the new Human Fertilisation and Embryology Bill, information about patients can be disclosed to medical and non-medical researchers, but exactly how this might be done is still being discussed. The information held on patients by clinics is quite detailed, and the HFEA has access to the name, date of birth and cause of infertility of those who have IVF treatment. More research in the field of IVF could benefit us all, but at the same time it is perfectly understandable to have some reservations about how identifying data is released. Now's your chance to express your views on this, at the HFEA online survey which you can find at www.hfea.gov.uk

US clinics ignoring guidelines on embryos

I've just been reading an alarming story explaining how many clinics in the US completely ignore professional guidelines on the number of embryos that should be transferred during IVF for younger women. Here in the UK, a maximum of two embryos would be used and many women under 35 are now choosing to have one embryo put back at a time to reduce the risk of multiple pregnancy.

Apparently 80% of clinics in the US regularly transfer more that the recommended number of embryos, with some routinely transferring four embryos for women who are under the age of 35. Of course, many blame "pressure from patients", which clearly indicates that they haven't made any attempt to warn their patients of the often tragic consequences of high order multiple pregnancies. What's more likely to be the cause is their own lack of awareness of the risks they are taking with the lives of these future children and their mothers - and perhaps their own inadequacies as fertility specialists, as any consultant worth his or her salt should be aiming for success without needing to transfer four embryos.

These statistics were highlighted by the recent case of octuplets in the States. In that case, the doctor claimed to have transferred just six embryos, but even six is probably five too many in a younger women who'd already had a number of successful IVF pregnancies. You can read more about the findings here

NaPro Technology debate

Unless you happen to live in Ireland where it is quite common, you may never have heard of Natural Procreative Technology, more often known as NaPro Technology. It's a form of treatment which may be offered to couples who don't want to use any form of assisted conception, and it is often said to have high success rates. Now a debate is raging in the Journal of the American Board of Family Medicine about how effective it may be.

NaPro Technology involves close monitoring of a woman's cycle, and advocates claim it often reveals relatively simple problems that have been overlooked by conventional testing, particularly where a couple are experiencing unexplained infertility. These problems can often be treated without having to resort to assisted conception, and women who get pregnant have their hormones regularly monitored in an attempt at reducing the chances of miscarriage.

A recent study had claimed a success rate of more than 50% using NaPro Technology, with many of the patients involved having a long history of fertility problems, including unsuccessful IVF attempts. However, the response to this in the most recent edition of the Journal of the American Board of Family Medicine expresses grave concerns about using the method, particularly with older women. It is suggested that they may miss their only chance to conceive by spending time on NaPro Technology as the treatment involves monitoring for months, and may take up to two years. At a time when so many fertility problems are age-related, this does raise questions about how effective NaPro Technology may be for women who are over the age of 35. You can find more of the discussion at www.jabfm.org

Marijuana link to cancer

Dope smoking is often seen as the acceptable face of illegal drug use, and it's easy to assume that smoking marijuana is really pretty harmless. However, a new study suggests that the dangers may be even greater than previously thought.

The link between regular marijuana use and impotence, low sperm quality and reduced testosterone levels in men has been established for some time, but this new research has discovered that there is also a link with testicular cancer. Regular marijuana users have double the risk of getting testicular cancer, and they seem to be particularly susceptible to the most aggressive form of the disease. You can see an abstract of the research paper here

Regulation at work

If you have an interest in the way IVF is regulated in the UK, there's an opportunity to see the regulator at work in March when the Human Fertilisation and Embryology Authority holds an open meeting. Anyone can attend the meeting on March 18 which will be held in central London. The topics up for discussion include the public consultation on the new Code of Practice. For more details, see the HFEA website at www.hfea.gov.uk

It couldn't happen here...

The story of the American octuplets left most of us who've had fertility treatment wondering why anyone would choose to have eight embryos transferred, and what kind of clinic would agree to such a move. Like me, you'd probably assumed the mother must be in her forties, and the eight embryos had been a last ditch attempt at fertility treatment after many unsuccessful cycles in the past. The fact that she was only 33, and had already had six children by IVF, must surely lead to questions about the lack of regulation of fertility treatment in the US.

The Human Fertilisation and Embryology Authority often faces criticism from patients in the UK that it regulates too strictly and with an excessively paternalistic attitude, but it is thanks to our regulatory framework that high order multiple pregnancies after fertility treatment are largely a thing of the past in the UK. The case of Mandy Allwood, who lost all her eight babies more than ten years ago, led to many questions about multiple pregnancies and fertility treatment although she had not actually had IVF but had been taking fertility drugs (which does not fall under the HFEA's remit).

Transferring eight embryos is always going to be deeply questionable medical practice, but the clinician who decided to transfer eight embryos for a woman under the age of 35 who'd already had six successful IVF attempts has some difficult questions to answer. An octuplet pregnancy is dangerous for mother and babies and, as Mandy Allwood's experience shows, can so often end in tragedy.

Could household products be damaging your fertility?

New research suggests that some chemicals used widely in consumer products could be causing infertility. A team from the United States checked amount of these chemicals in women's blood, and found that those with high levels took much longer to conceive.

The chemicals, known as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are used in all kinds of household products and may be found in clothing, upholstery, carpets and toiletries as well as pesticides. They are also used in manufacturing, and we're all exposed to them to some degree. They were introduced in the 1950s, and have since been found to have toxic effects on animals, and have been associated with miscarriage.

You can read the research paper, which is published in the journal Human Reproduction here.

Don't worry about your stress levels

Have you been told you'd be far more likely to get pregnant if you could just relax and forget about your fertility problems? I'm sure most of us have had to listen to advice like this somewhere along the line in our fertility journeys... If you'd just stop trying to get pregnant / go on holiday / chill out you'd conceive, people tell you, and of course they like to mention that couple everyone except me seems to know who had been trying for a baby for years and finally had a child just a few months after adopting a baby/giving up on treatment/moving to the other side of the world... There's an underlying implication that somehow our infertility is our own fault because we're too stressed. Even doctors and consultants will often suggest that you need to lower your anxiety levels if you want to get pregnant. For patients, it's a vicious circle - infertility causes stress, which then apparently leads to more infertility.

Well, we can all take heart from a new Dutch study published in the latest edition of the journal Human Reproduction which has found that anxiety and depression levels before and during treatment have no influence on pregnancy rates. The researchers followed more than 700 women at seven fertility clinics, and you can read their paper here . So next time someone tells you that you need to stop being so anxious if you want to get pregnant, you can enjoy telling them it wouldn't make the least bit of difference.

First pregnancy from new egg-screening technique

A new technique for screening eggs and embryos has been used successfully for the first time at a UK clinic, amid claims that it could hugely improve the outcome of IVF treatment for many couples. It's not yet widely available and will probably prove to be a costly addition to your IVF bill, but if it lives up to the hype, it may be well worth it.

The CARE Fertility Group have used a technique called Array CGH which involves testing chromosomes. As women get older, they tend to have more and more eggs that are chromosomally abnormal. These eggs will not always fertilise or implant, but when they do they are often lost during pregnancy. Using this new method the abnormal eggs can be detected and the only the most viable healthy eggs replaced during IVF. There is no need to freeze the eggs or embryos to carry out this process, and the sample is taken from the polar body - previous screening tests involved taking a cell from an embryo.

Trials using frozen embryos led to a doubling of the implantation rate, and the patient who is currently pregnant had been through 13 unsuccessful IVF attempts before trying array CGH (or comparative genomic hybridisation).

Staff at CARE hope this will not only improve the pregnancy and birth rates, but will also decrease the risk of miscarriage or birth defects. Other fertility specialists have given the new development a cautious welcome.

You can read more on the CARE website at www.carefertility.com

Water pollution and male infertility

We're often told that environmental pollution affects male fertility, but new research strengthens that link as scientists have found testosterone-blocking chemicals in rivers in the UK.

The researchers have found a new group of chemicals in our rivers that inhibit the function of testosterone, and combined with the oestrogen type chemicals we already know are in our water, these have had the effet of "feminising" male fish. This has led to reproductive problems and some male fish have even changed sex. The oestrogens arrive in the water via the sewage system from the contraceptive pill or industrial chemicals, whilst it is not entirely clear where the new group of chemicals originate.

It is thought that there may be a link between what is happening to the fish and the increase in male fertility problems in humans.

You can read more about the research at www.brunel.ac.uk/news

New sperm quality test

A new method for testing sperm quality is already leading to claims that it could increase IVF success rates.

Scientists at the University of Edinburgh have worked out a way of evaluating DNA damage in sperm by capturing the sperm in laser light and inspecting the DNA by looking at vibration patterns. The process is known as Raman Spectroscopy. It would allow them to choose the healthiest sperm when carrying out IVF or ICSI.

When couples conceive naturally, only the strongest sperm survive the journey through the woman's body to reach the egg, and this new method allows scientists to weed out the healthiest sperm in a similar way.

It all sounds great, but apparently it will take at least five and possibly ten years before this will be available to patients as research is still ongoing.

You can read more here .

IVF book available for pre-order

Having suggested that you read other people's books, I thought it was a good time to let you know that my new book The Complete Guide to IVF is now available to pre-order online. It will be published on April 2, and tells you everything you could possibly want to know about IVF.

I had a fascinating time researching it, spending time behind the scenes at fertility clinics, and interviewing consultants, fertility nurses, counsellors and embryologists as well as lots of patients. The book takes you through the IVF journey from the first appointment to the outcome of treatment, and includes sections on counselling, emotions, complementary therapies and the things you can do to help yourself get through IVF and maximise your chances of success. There's also a chapter on the male perspective on IVF, which is ofen overlooked, The book will be published by Piatkus and you can order it here

Could your hormones make you more likely to have an affair?

In a paper titled "Oestradiol level and opportunistic mating in women" (yes, really...), researchers have discovered that women with higher levels of the hormone are more likely to have affairs.

We know that oestradiol levels have an effect on your fertility, but this research shows that they are also related to how physically attractive you feel, and how attractive others think you are. Cheerfully for those of us with fertility problems the researchers conclude that "Results provide support for the relationship between physical beauty and fertility"! As if not being able to get pregnant wasn't enough to contend with...

If you can bear to read more, the details from the journal Biology Letters are here

PCOS book

I've just been reading a good book on polycystic ovary syndrome that would be really helpful to anyone who has PCOS, or who thinks they may be suffering with it. Coping with Polycystic Ovary Syndrome goes into real depth about what PCOS is and the signs to look for, but also takes time to talk about living with symptoms such as excessive body hair and weight problems. The book looks at exercise, diet and includes information about complementary therapies that may help, as well as considering the emotional impact of PCOS. Co-authored by a leading expert on the subject, Professor Adam Balen, Coping with Polycystic Ovary Syndrome provides a really thorough guide. Here's a link to the book.

Appeal for sperm donors

There's such a shortage of sperm donors in the South of England that one local trust has issued an appeal for men to come forward to help childless couples.

Southampton University Hospitals NHS trust runs a sperm bank and donor programme, but staff have seen such a decline in the number of donors in recent year that they've made a public appeal to try to recruit more men. It's a national problem which has meant long waiting lists for couples who need to use donor sperm to conceive. In the UK it is no longer possible to donate sperm anonymously, and people who are conceived through donation can find out the identity of their donor once they are 18.

Anyone who is interested in donating should be between the ages of 18 and 45, and there will be some medical tests and counselling to ensure that potential donors have a chance to talk through any concerns. If you're interested in becoming a donor you can find out more on the trust website at www.suht.nhs.uk

New developments in stem cell research

Anyone who is interested in stem cell research will want to find out more about new work from the United States on stem cells from the testes which has concluded that they can change into other body tissues. The science of stem cell research is fiendishly complicated for non-scientists, but the work has shown that these stem cells from the testes are similar to embryonic stem cells although they are not exactly the same. Researchers at Stanford University School of Medicine say they could be used in the future to treat infertility. The full details of the work can be found on the school's website at http://med.stanford.edu

Why freezing embryos is worthwhile

If you've had IVF treatment, you'll probably appreciate why freezing any spare embryos is a good idea - it gives you another chance to try to conceive in a less invasive (and cheaper) way than a full IVF cycle. However, some primary care trusts don't include the cost of freezing and transferring any spare embryos when they fund an IVF cycle - so if you can't afford to pay for it yourself, you won't have an opportunity to use all your embryos. It has always seemed wrong to me to agree to fund the treatment to create the embryos, but not to pay for their storage and use.

Now, there's more evidence to show that embryo freezing really does make all the difference to IVF success rates. Researchers at the Oxford Fertility Unit have shown that the chances of getting pregnant are fifty percent higher when you freeze and transfer spare embryos, which surely illustrates that it is not just sensible but also cost effective to fund freezing programmes.

There's more on the subject here