Tuesday 29 June 2010

Why freeze eggs

Why do some women choose to freeze their eggs for the future rather than get pregnant sooner? Two new studies have looked into the reasons behind this, and although one which questioned younger women found that they'd rather focus on their careers, the other discovered that it's the lack of a partner that drives women to make the decision when they are older.

We tend to assume that women who have children later do so because they are too busy furthering their careers when they are younger, but in fact most of the women I've spoken to who were trying to get pregnant in their late thirties and early forties are adamant that this isn't the case. For them, it was a matter of waiting for the right partner - so it's not surprising that the idea of egg freezing seems attractive.

In fact, freezing eggs is not a guaranteed insurance policy. The technology is still quite new, and it's an invasive and expensive business. Women have to go through most of an IVF cycle in order to harvest a crop of eggs, and it can take two or three goes to ensure there are sufficient eggs to freeze. If women leave it until their late thirties to decide to freeze their eggs, the chances of success will have diminished as egg quality will have begun to decline.

The studies on egg freezing were presented to the European Society of Human Reproduction and Embryology conference in Rome and you can read more about them at www.eshre.eu

Fertility support

I've been facilitating a number of support groups in the last few months, and have also attended some too, and at the end of every meeting I go to, I am more convinced that meeting other people in the flesh is hugely helpful to anyone experiencing fertility problems.

Online support has grown so much in recent years that most clinics have completely given up on the idea of providing a support group for patients - with one or two notable exceptions! It's a great shame, as although patients want good success rates, they also want to feel supported. Too often, patients come to the group with stories of insensitivity and lack of understanding from clinic staff. It's a great shame, as these same staff are often working flat out to improve the clinic and the treatment in every way that they can, but the little things can easily get forgotten.

Chatting to someone else online can be helpful, but actually meeting someone and talking to them is a far richer experience, and can be far more rewarding. I've yet to meet anyone who went to a support group and left concluding it wasn't for them. Once you take the plunge, you may be surprised at how much you get out of it.

Details of support groups meeting in England can be found at www.infertilitynetworkuk.com

Sunday 27 June 2010

Advance testing for menopause

Researchers have found that they can accurately predict the age at which women will reach the menopause - giving women a clearer idea about their reproductive future.

The team from Tehran tested the levels of Anti-Mullerian Hormone (AMH) which controls the development of the follicles in the ovaries. AMH has been used as a test of ovarian reserve, or the number of eggs likely to remain in the ovaries, for some time. In this new test, blood samples were taken every three years and looked at in conjunction with information about a woman's reproductive history. The women were also given a three-yearly physical examination. 266 women were involved in the study, and the researchers predicted their menopause very accurately - on average they were just a third of a year out. More research is now needed to see if the findings can be replicated in a larger group.

The research is particularly useful for women who want to plan when to start a family, but it is vital to remember that having a later menopause does not guarantee your fertility until that point. Women are less and less fertile for years before they reach the menopause, and there are many other problems that can cause infertility. However, any new research in this field is very welcome and will undoubtedly help many women.

A press release about the research can be found at www.eshre.eu

Thursday 24 June 2010

Official warning on online sperm agencies

The UK's fertility regulator has just issued a warning about online donor services, after a number of media stories about agencies offering to put people in touch with potential donors.

It all sounds quite simple, but in fact there are very real risks to using this kind of service. The agencies often claim to operate in a grey legal area where they only provide an introduction, rather than eggs or sperm. Even so, many online donor services are still working on the wrong side of the law. The reason for our stringent legislation when it comes to sperm and egg donation is to keep people safe. Using an agency, you can't guarantee you get the donor you think you are paying for, you don't know if sperm samples are screened or are safe and none of the safeguards that the law provides will apply.

I think it's particularly frightening that many of these sites offer fresh sperm. In licensed clinics, sperm samples have to be frozen before use to ensure that the donor hasn't contracted any kind of infection, such as HIV, since he was last screened. With an online service providing fresh sperm, it simply isn't possible that a sample can be guaranteed to be safe.

Not only are there safety issues, using an online agency can cause huge issues in the future over legal parenthood. If a man donates through a licensed clinic, he is not the legal father of the child born through the donation. This is not the case with an unlicensed donation where, in fact, the donor would be the legal father and could be legally and financially responsible for any offspring.

It may seem an attractive idea, it may be quick, but it certainly isn't safe or sensible to use an online agency and you could be creating problems for both yourself and your future child.

The HFEA have issued at statement which you can read at www.hfea.gov.uk

Tuesday 22 June 2010

Chlamydia

I was talking to a journalist earlier this week about what young women can do to preserve their fertility, and came to the probably unhelpful conclusion that most of it was little more than common sense and a healthy lifestyle. However, the one thing that many young women don't think about is chlamydia, and yet it can have such devastating effects on your future fertility.

Apparently one in ten sexually active young people has chlamydia - and that's an estimate which some believe could be conservative. For up to 80% of women who have chlamydia, there are no symptoms which means people don't worry and don't get tested. It may only be years later that they discover their fertility has been compromised.

When I was writing The Complete Guide to Female Fertility I interviewed a young woman who was in her early twenties, but knew she would have to have IVF in order to conceive. She had sensibly been tested for chlamydia at an early age, but it was already too late. The infection had completely blocked her fallopian tubes (which connect the ovary to the womb, allowing eggs to get from one to the other). She was longing for a family, but was too young to qualify for IVF in her local area.

It's easy to forget about something that has no symptoms, that you may not know you have - but if you could be at risk through unprotected intercourse, it's worth having a test. It's simple and quick - and really could help preserve your fertility.

Tuesday 15 June 2010

Indian triplets for 66-year old mother

I've just been reading about the triplets born to a woman of 66 in Northern India. Her doctor seems rather proud to announce that she is the oldest woman in the world to give birth to triplets. This was apparently her third attempt at IVF and she had three embryos transferred as the two embryos put back in the earlier cycles had failed to implant. The three babies are now in intensive care as they are very underweight.

The treatment was carried out at the same clinic in Haryana where a woman of 70 who became the world's oldest mother was treated. The clinic seems to specialise in treating pensioners and the website is quite bizarre, featuring pictures of elderly couples next to tiny babies. In India, the average age expectancy for a woman is 66 and it's even younger for a man, so the clinic are helping to create babies whose parents are highly unlikely to live past their first few years. And surely carrying three babies and then having a Caesarean at 66 is hardly going to increase your life expectancy...

It's stories like these that have to make you glad that we have such a highly regulated system in the UK, and that our fertility doctors consider what is right for potential parents and children when they are making decisions about treatment, rather than the desire to break new ground in totally unethical territory.

The French Study...

You may have heard about "The French Study" over the last few days... It has been quite widely reported in the media as it shows that there is a small risk of malformation for children born after IVF. The study looked at more than 15,000 IVF children's health records and found that 4.24% had some kind of congenital malformation. It sounds incredibly alarming, and is enough to worry anyone considering IVF.

As usual with these stories, there is a however... First, this needs to be put into perspective, as in the general population who have not had IVF, there is a risk of up to 3% of congenital malformation so the increased risk is very small. Second, although you may not have been aware of this, previous studies had put the figure of congenital malformation after IVF as high as 11%, so this is actually a lot better than many scientists had expected. The French researchers believe their figure is more likely to be correct because this was such a large study.

This is certainly an issue that needs further investigation, and makes the case for more long-term follow-up studies of children born after assisted conception. At the same time, it is important to understand that this increased risk is very small. If you do have worries about it, you should talk to the team at your clinic. See more here

Thursday 10 June 2010

Maybe being calm doesn't make you more fertile...

It seems to go against everything we've heard in the past, but new research apparently shows that neurotic women are more fertile and have more babies than their calmer laid-back sisters!

The research, which was carried out in Senegal, seems to contradict previous studies in Western countries which had suggested women who were had neurotic personality traits were likely to have fewer children. It is certainly interesting, especially as we tend to assume here nowadays that being chilled and relaxed is key to improving your fertility.

You can read an article on the subject at www.dailymail.co.uk

Wednesday 9 June 2010

Is it too easy to buy eggs and sperm in the US?

I've just been reading an interesting piece in the New York Times which compares the complicated process people face when adopting a child with the ease with which donor sperm and eggs can be purchased in the States. During adoption, the interests of the child are always paramount, as they should be, but with donor conception, the interests of the prospective parents may seem to lead the way.

Columnist Ross Douthat discusses a study of donor conceived adults which showed that many of them felt some unease about their conception, often because money had changed hands. Unlike the UK, donation in the States is not only paid but can also be anonymous. Although getting rid of anonymity in the UK was initially seen to have reduced the donor pool and created longer waits for donor treatment, it is likely that in the long run it will reduce the potential problems of donor conception making it possible to trace a donor parent.

You can read the article at www.nytimes.com

Tuesday 8 June 2010

Considering fertility treatment?

If you're considering fertility treatment, you may be interested in a new publication from the HFEA, called Getting started: Your guide to fertility treatment. It's for those who are at the beginning of their fertility treatment journey and explains what the different treatments are, what to think about before you start, what to expect at a clinic, funding options, potential risks and where to get support.

You can order your free copy at www.hfea.gov.uk/order or pick up a leaflet with a pre-paid order form at a GP surgery.
Each section of the new guide directs people to the HFEA website for more detailed information and the latest data on licensed clinics.

You may also be interested in my books The Complete Guide to IVF of The Complete Guide to Female Fertility , which is also ideal for anyone at the start of their journey and for any woman who is wondering how late she can leave it to have a baby.

Reduced fees for single embryo transfer patients

Did you know that the Human Fertilisation and Embryology Authority (HFEA) will no longer charge clinics for patients who have frozen embryo transfers after putting back just one embryo in a fresh cycle?

At the moment, fertility clinics pay the HFEA a fee for each cycle they carry out, and the clinics pass this charge directly on to their patients. From October onwards, the fee will be dropped if a patient who had an unsuccessful single embryo transfer goes on to have additional frozen embryo transfers. The idea is that this will help reduce any additional financial burden from the decision to have just one embryo put back at a time.

Single embryo transfer does make sense for younger women who have good quality embryos as it means you are more likely to have a single, healthy baby. However, in the current economic climate many people do worry that it may end up costing them more to get pregnant this way. The HFEA hopes the decision will show the authority's commitment to helping patients who choose the safe and sensible option.

You can see more here

Monday 7 June 2010

Abortion after IVF

So, "dozens" of young women are apparently having abortions after getting pregnant by IVF because they have "changed their minds". The report that eighty women who'd had IVF went on to have abortions was said to show that infertile couples were treating babies as "commodities" and it brought out the anti-IVF brigade in force. It's such a terrible shame that something affecting a tiny number of the couples who have IVF every year has been allowed to taint the arguments about whether fertility treatment should be funded by the NHS.

The reality is that the number of women who went on to have abortions after IVF is less than one per cent of the total number of IVF pregnancies. The fact that one woman had told a newspaper reporter that she had been pushed into IVF by her partner, and changed her mind once she got pregnant has been assumed to apply to the other 79 women who didn't continue with their pregnancies. We have no idea what motivated them, but there is no evidence that it wasn't problems with the baby's or their own health, a relationship breakdown or even the death of a partner.

IVF is not something that anyone undertakes lightly - it involves huge emotional and usually financial commitment and is often a pretty traumatic process. The vast majority of those going through treatment would do anything they could to have a child, and using the example of one woman in order to make assumptions and draw conclusions about the three and a half million people having difficulty conceiving is both wrong and unfair.