Thanks to Herts and Essex Fertility Centre

I just wanted to thank the team at Herts and Essex Fertility Centre for inviting me along as a guest speaker this evening to talk about coping with the emotional aspects of infertility and treatment. I was amazed to see such a good turnout - and especially impressed at how many men had turned up on a night when England were playing a football match! It was great to meet so many really lovely people and to be able to share experiences, and I hope that other clinics will be inspired by the guest speaker programme at Herts and Essex as it's a brilliant idea and clearly much appreciated by patients.

I may not be a mother, but I'm still a person

If you didn't see it, take a look at this article from yesterday's Observer. It's the story of a woman in her forties who doesn't have children, and explains how marginalised she often feels as a result of her childlessness. She discusses how all-consuming the role of motherhood has become in our society, and how it can leave those who don't have children feeling ostracised and isolated.

It may surprise you to know that one in five of the female population in the UK will not have children, as it doesn't always feel that common when you are the lone childless woman in a room full of mothers. Many of us will recognise the feelings of separation from other women who have children, and the awkwardness that can arise at certain social situations. I often suggest that women who are actively trying to get pregnant should simply avoid events which are likely to be particularly difficult, but this isn't a long-term solution if you have accepted a child-free future.

If all this sounds very familiar, you may be interested in a group called Gateway Women set up by the woman featured in the Observer piece which aims to offer support to those in this situation.

Beating the biological clock...

The one hurdle fertility specialists have never been able to overcome is the ageing of human eggs, but now new research from the States suggests that it may be possible to produce eggs in the laboratory using women's stem cells, and these eggs have the capacity to be fertilised.

So far the research has been done on mice, but it could hold the possibility to transform female fertility as it shows that women's ovaries contain stem cells that hold the potential to make new eggs. It is, however, vital to remember that we are still a very long way from being able to offer women the opportunity to overcome their biological clocks - but there is a possibility that there may be new ways to put women on a more equal footing with men when it comes to reproduction at some point in the future.

The new research has been published in the journal Nature.

Triplets

How many embryos should you transfer during fertility treatment? It has been the subject of much debate recently, and I find the argument used by some medical professionals that they can do nothing to prevent their patients opting for multiple embryo transfers is fascinating. Consultants are hardly known for their inability to tell their patients what is good for them, and yet when it comes to multiple embryo transfers many are suddenly unable to overrule patients making decisions that they know very well could lead to serious medical issues.

In the UK, the Human Fertilisation and Embryology Authority is monitoring the situation and setting targets for clinics to cut their multiple pregnancy rates. Successful clinics are reducing their multiple pregnancy rate without slashing their success rates by carefully selecting the patients who are most at risk of multiple pregnancy. Some other countries, such as Sweden and Belgium, have already taken these steps but others are way behind; for example, in the United States, many clinics transfer three or more embryos.

When you are trying to get pregnant, it is easy to imagine that triplets would be a marvellous outcome - three babies all at once, an instant family and no need for any more treatment. The reality is often very far from this perfect vision. The problem with fertility consultants is that their job stops with the positive pregnancy test. They don't see the babies born very prematurely and then spending weeks in special baby care units, they don't have to witness the long term health problems or the financial and emotional impact on the parents. Of course, it is not impossible to have healthy triplets, but the risks are high.

My views on this have been swayed by interviews I've done over the years with women who've faced huge problems after multiple embryo transfers. For my very first book, In Pursuit of Parenthood, I interviewed a woman who'd had three embryos transfered and who had been overjoyed when she discovered she was pregnant with triplets. She went into labour very early and gave birth to three tiny babies. She then had to live through a horrendous week, as her three children died one after another. "We'd gone into hospital happy, pregnant with three children, come out and we were arranging three funerals. It was as simple as that", she said. She went on to have a family after more fertility treatment, but having cope with such a terrible experience convinced her, and me, that it was far better to have embryos transfered one at a time.

If you are thinking of having treatment overseas, do ask the clinic about their policy on multiple embryo transfers. I spoke to someone a while ago who was planning to go to a particular clinic overseas because they would transfer five embryos. She assumed this meant that they had her best interests at heart as she felt they were willing to take a risk in order to help her get pregnant. This is far from the case. Clinics should not need to transfer five embryos and if they do, it shows a cavalier attitude to your health and your future children's. Remember, the risks associated with multiple birth are created by the decision to put back more embryos - it's an active choice to gamble with your own future children's health. Of course, multiple pregnancies don't always end in disaster, but I think for too long fertility patients have had to suffer because some fertility consultants have not been mindful of the problems they are creating for their patients.

Happy Valentine's Day

Just to wish everyone a happy Valentine's Day - I hope you're all having a lovely evening (and for once, I hope you're not reading my blog!)

It's so easy to neglect to make time for one another when you're caught up in trying to conceive and sex can start to seem to be all about baby-making. The gloominess that can seem to spoil everything in life when you're trying to conceive can start to taint your relationship too. Some relationships are damaged by fertility problems and it is tough to keep on track, but remember that just as many couples find that infertility brings them closer together. The key to everything is communication - keep talking to one another and sharing your feelings and remember that the two of you are in this together. Never forget that it was because you loved one another so much that you wanted to have a family in the first place.

Have a happy evening x

Coping with other people's pregnancies

Dealing with other people's pregnancies is one of the most difficult things when you are trying unsuccessfully to conceive. It's the moment people tell you that is hardest - the awful sinking feeling that yet another of your friends or colleagues has been blessed while the numbers of childless people around you dwindle by the day, the horrible jealousy that you feel wondering why it can't ever be your turn and the lump in your throat as you give a brittle smile and offer your congratulations.

Perhaps the worst thing about this is that it makes you start to dislike yourself. I've lost count of the number of times that women have told me they've stopped liking themselves when they're trying to get pregnant unsuccessfully. You feel you are turning into a bitter, jealous person and it's hard not to let those feelings overwhelm you.

I think we have to accept them and realise that it is only normal to feel this way - and that other women who are trying to conceive are going through just the same feelings. There's nothing you can do to escape those terrible moments of someone breaking the news but accepting that your reaction to it is perfectly normal will at least stop you thinking you're turning into a monster.

It was a post on the Infertility Network blog that made me think of this, as anyone with experience of fertility problems would so completely understand where the writer was coming from - you can read it here

When success rates aren't all they seem...

In the UK, the HFEA doesn't just regulate fertility clinics, but also provides patients with accurate information about treatments and about IVF success rates. We often take this for granted, but a story I've just been reading about fertility clinics in Canada may make you realise quite how fortunate we are to know that the success rates produced by the HFEA have been checked and clinics monitored.

It seems that in Canada, success rates are produced by an organisation which is run by the clinics themselves, and the clinics submit their own data with no checking or monitoring. Apparently this has led to a situation where clinics only submit the figures they choose to post - and where eight individual clinics are all claiming to be at the top of the league tables.

Given the current uncertainty about the future of the HFEA, this illustrates quite how important a role the authority plays in providing patients with accurate information about clinics.

You can read more about the story here

New study looking at impact of involuntary childlessness on men

A new research project may be of interest to many men who are involuntarily childless as it explores men's experiences of being childless as they age, focusing on men between the ages of 50 and 70 who have not been able to become fathers. If you fall into this category, or know anyone who does, the research team are looking for men who may be willing to take part in the study.

Studies looking at the impact of childlessness tend to focus on women, but this new project will concentrate on men, looking at how they feel about their involuntary childlessness as they grow older and what impact this has on their relationships, their social life, health care and wellbeing.

You can find out more about the new research here and if you are interested in participating there are more details about what would be involved here.

The Two Week Wait by Sarah Rayner

There's a shortage of good novels about IVF and infertility, and The Two Week Wait by Sarah Rayner fills a gap in the market. The novel is about egg sharing, deftly weaving together the two separate stories of an egg donor and her recipient, and showing the huge impact they have on one another's lives although they never meet.

Sarah Rayner shows a real understanding of the emotions of infertility and the book will resonate with anyone who has personal experience of fertility problems. I particularly liked the ghastly sister-in-law Sukey, who epitomises those self-righteous people most of us have come across somewhere along the way on our fertility journeys who make a point of telling us that they "don't believe" in IVF - you know the type I'm sure, the people who tell you that you'd get pregnant if only you stopped obesessing about it, that it may all be in your mind, that a bit of chanting or standing on your head would probably sort you out...

The Two Week Wait features a number of characters from Sarah Rayner's last hugely successful novel, One Moment, One Morning - having really enjoyed that book, it was great to revisit their lives. The Two Week Wait is a refreshing read and leaves us with the thought that a happy ending isn't necessarily the ending we thought we were looking for - I finished the book with tears in my eyes.

My only issue with the book was a medical one as in the story it is suggested that ICSI (a form of IVF where the sperm is injected directly into the egg rather than being left to fertilise it naturally) can boost IVF success rates even when the sperm is perfectly normal. The characters pay an extra £800 for this despite having perfectly good sperm and it worries me that readers might be left thinking they should opt for ICSI when they don't need it. In fact, ICSI is a treatment for male infertility that may also be used after unsuccessful treatment where fertilisation has been a problem. Research shows that ICSI does not increase the chances of a live birth after treatment for couples who don't need it. Some clinics do carry out a lot of ICSI where the sperm is normal and it certainly boosts their profits, but if anyone recommends this for you, make sure you know exactly why they are suggesting it before you fork out any money.

Apart from that, I really enjoyed the book and would recommend it - it's a great read and you won't be able to put it down!

Egg freezing

I've just been reading yet another feature - this time from a local newspaper in the States - about egg freezing, apparently dubbed as the most significant development for women since the advent of the pill...

This piece was particularly sad as it quoted a woman who had spent twelve thousand dollars freezing her eggs, saying how lucky she felt that she could afford to do it. The fact that she was already in her early forties didn't seem to have been addressed at all.

Egg freezing is a fantastic step forward and will undoubtedly benefit many women, but it is vital that people understand that it cannot offer any guarantees, and that their chances of success are hugely diminished if they freeze their eggs when they are older. I fear that many women are spending large sums imagining that they are somehow insuring themselves against a childless future, when in fact the realistic chances of having a baby using their frozen eggs may be extremely low.

Over 50s have no increased risk using donor eggs

New research from the States suggests that women over the age of 50 who use donor eggs to get pregnant have no more complications than younger egg recipients. Older women are generally thought to be at greater risk of pregnancy complications such as diabetes, premature birth, placenta abnormalities and hypertension, but this study looked at 100 women who were over 50 and compared them with women who were under 42. In fact, the rates of gestational diabetes, hypertension, Caesarean delivery and premature birth were similar for women in both age groups.

Although there is a greater risk of obstetric complications for anyone using donor eggs, these don't seem to increase in older women. The study is published this month in the American Journal of Perinatology. You can read more about it on the Columbia University Medical Center website.

Is fertility treatment selfish - an interesting response..

I’ve just been reading a really interesting piece written by a mother of twins who expores very honestly the self-consciousness she sometimes feels about her children who were conceived using IUI. She tells how people feel no qualms about asking whether her children were conceived naturally and what an invasion of privacy this can seem.

She also addresses the criticism so often thrown at people who can’t conceive naturally that using fertility treatment is somehow “selfish” and that adopting would be a more socially responsible way to deal with the problem. The wild comments under any story about fertility treatment often imply that couples with fertility problems simply don’t think about this and that we are wound up in some feverish consumerism which makes us believe we have the right to anything we want. In fact, this couldn’t be further from the truth and couples going through fertility treatment tend to think a lot about their desire for a child and what it means, as this article so clearly explains…