Where is the blog?

My Fertility Matters blog can now be found here - http://fertilitymatters.org.uk/.  Please come and visit - and leave a message to tell me what you think!

afterword... The Fertility Show

This weekend's Fertility Show was very busy - more than 3,600 visitors over the weekend - and it was lovely to meet some of you and to find many old friends too.  The seminar programme this year was fantastic with really interesting topics addressed by some of the world's leading experts in their fields and most of the talks appeared to be packed out.

There were quite a few clinics from the UK exhibiting at the Show, mainly from London and the South East, but they were rather outnumbered by their counterparts from overseas who have clearly realised that more and more people are considering travelling for fertility treatment.  There were fertility specialists from Spain, Russia, Latvia, Georgia, Italy, Barbados, the Czech Republic, Norway, Denmark, Greece, Sweden and across the USA from Florida to Chicago. I spoke to a number of people who were considering treatment overseas and they'd found it really helpful to have so many different clinics from around the world all gathered under one roof.  It can be very hard to distinguish between one and another when you're only judging them on their websites and email communications, and the opportunity to meet staff face to face and get a feel for the clinics and what they can offer is quite unique.

For me, it was really good to see so many patient support organisations there too - Infertility Network UK, the Donor Conception Network, International Asherman's Association, Klinefelter's Syndrome Association, Fleur and the lovely team from Verity PCOS who must be congratulated on their purple theme which even went as far as a rather wonderful pair of handmade purple earings...

As it is National Adoption Week, it was heartening to see that a number of fostering and adoption agencies were represented too as this is an alternative route to parenthood that some may want to consider.

Everyone I spoke to who'd visited the Show had found it to be a beneficial experience.  I know some people do feel it is a rather commercial affair for a medical problem, but fertility treatment is a massive commercial industry. Personally, I think the opportunities a weekend at The Fertility Show can offer outweigh any such concerns.  If you're not into fertility astrology or crystal therapy, you don't need to spend time at the stands offering them. It's a matter of picking and choosing the things that you want to know more about and making the most of the opportunities the weekend can afford.

Come and say hello...

If you’re going to The Fertility Show at London’s Olympia tomorrow, do come and say hello.  I’m speaking at 11.45 about choosing a clinic, and then chairing a Q and A session with two overseas clinics at 3.30, so do come and find me if you’re there.   If you haven’t booked in advance, you can still turn up and pay on the door.

Piatkus, who publish my books, have very kindly donated some copies of The Complete Guide to IVF to the Infertility Network UK stand where they can be exchanged for donations to the charity, and I will also have some copies of Precious Babies, my latest book about pregnancy, birth and parenting after infertlity.

The Fertility Show is always a really interesting two days, and this year is on track to be the best yet with a fascinating array of seminars and exhibitors from around the world.  If you want to know more about exactly what’s on and when, go to www.fertilityshow.co.uk

My new blog site

If you don't know about it already, do have a look at my new blog site, www.fertilitymatters.org.uk.  I'm going to be posting in both places for the time being as I know it will take a while for everyone to find the new site, but I hope that in the long run it will be easier to use and it has room for far more content than this blog. 

Could you ask strangers for money to pay for IVF?

It may sound incredible, but apparently people are having to come up with ever more inventive ways to fund their fertility treatment in the current economic situation.  With many couples already living on overdrafts, cutting back on holidays or other luxuries will not free up the ready cash needed, and getting loans or using already overloaded credit cards is becoming increasingly difficult. So, in the States at least, some couples have apparently turned to the internet using websites or Facebook to ask strangers for money to fund their treatment – see this article.  Could you consider this? Should you have to?

Here in the UK, the postcode lottery for treatment continues to cause distress to many couples who find they can’t access IVF despite being eligible according to the national guidelines because in their local area the primary care trust has decided not to fund treatment – or to ration it.  It can be very difficult to find the money for private treatment which will cost more than the NHS would pay.  Lord Winston campaigned on this some time ago – saying that many clinics were hugely overcharging for fertility treatment and that it could be far cheaper.

Asking strangers for money may seem extreme, but does perhaps illustrate how difficult it can be to live with involuntary childlessness…

Is it ever right to raffle fertility treatment?

When plans for an IVF lottery were announced here in the UK, the overall response was far from positive with questions raised about the ethics and the finances, but in the US it appears that running lotteries for fertility treatment has become more common.  One clinic even asked people to enter a competition to win treatment by writing or making a video about their fertility problems and why they deserved treatment…

It’s true that our current access to funded fertility treatment is problematic to say the least, and that many couples simply can’t afford to go privately – but does that make running lotteries for treatment right? Those in favour argue that it offers hope, but if your chance of winning is one in a million, it’s probably more about raising unrealistic expectations.  Lotteries may be a good way for clinics to gain publicity, they may be a good way for individuals to make money – but I don’t see how a lottery can ever be a satisfactory way to offer healthcare.

If you’re interested, you can read more about the US lotteries here 

After embryo transfer...

One of the most alarming moments in an IVF cycle - for me at least - was standing up for the first time after embryo transfer.  I could never quite get over the idea that an embryo could just fall straight out when you get up after the transfer. Speaking to other people since, I've learnt that I'm not the only one to feel that way. It's quite common to worry that you might somehow jeopardise your chances of success if you stand up too quickly - or if you do too much in the days after embryo transfer.

Some complementary therapists advise a couple of days bed rest after embryo transfer, but research shows that this makes absolutely no difference to outcomes at all - and you can bet your bottom dollar that fertility specialists would all be encouraging their patients to stay in bed if there was any chance that this could possibly increase success rates.

When fertility treatment doesn't work, we want to know why and start looking for reasons.  Most often, there is no clear reason but you can rest assured that the one thing that really won't make a difference is how long you spend lying down in the first couple of days after embryo transfer.

Celebrity sperm donors

So, did you hear about the celebrity sperm donor service earlier this week, set up by a company allegedly offering "celebrity sperm" to anyone who needed to use a donor?  A number of journalists from reputable newspapers and other outlets around the world were taken in and ran features on the company whose website featured alleged donors such as an Oscar-winning actor, a former Premiership footballer and an aristocrat with a seat in the House of Lords. The ITV show This Morning even ran a studio interview with an actor claiming to be the man behind the company.

The company's website claimed the celebrities had decided to donate sperm because they had friends or family who had experienced fertility problems and that potential clients would be able to choose to have a child with the inherited character traits of a Formula One racing driver, a leading entrepreneur or scientist.

It has now, unsurprisingly, been revealed to be a hoax, set up by a TV production company for an entertainment programme.  The company claimed that the hoax aimed to highlight the sometimes detrimental impact of social media on the news culture. It is difficult to see why they decided to create a hoax sperm donor service in order to do this or what the allegedly "serious" side of this might be.

I'm still getting sent links to pieces about this new 'service' written by people who have yet to learn about the hoax.  The TV company in question clearly thought this hoax was a great joke and are doubtless congratulating themselves on a jolly jape. I'm afraid to me it just shows the total lack of sympathy and respect many people have for those who experience fertility problems - can you imagine the outcry if this hoax had featured a treatment for any other kind of medical condition?

A new website...

I've started work on a new version of this blog that I hope will look better, will contain more information and will allow you to find the information that you want more easily.  People are often surprised at how much STUFF there is here about so many different aspects of fertility - but looking for what you want can involve long trawls through lots of things that you aren't so interested in.

My new blog/website will include real-life stories and downloadable factsheets as well as details of events and the normal news updates.  If you have any thoughts about things you'd really like to know more or read more about, do leave me a message. I'll let you have the details of the new site as soon as it is up and running.

IVF or ICSI?

Anyone going through fertility treatment wants to maximise their chances of success, and you may have heard that opting for ICSI will mean you are more likely to end up with a baby whatever the nature of your fertility problems.  In fact, ICSI is a treatment for male fertility problems which is also used when IVF hasn’t worked in the past because eggs haven’t fertilised.  When it is used in these circumstances, it can increase the chances of success.  There is, however, no benefit from using ICSI for those who don’t actually need it.

I’ve just been reading a really interesting paper on this in the journal Human Fertility which looked how fertility clinics in the UK approach ICSI and found wide discrepancies with some clinics using it for around 20% of their IVF cycles and others using it in more than 80% of IVF cycles.  The criteria they used to decide when to use ICSI also varied, with many offering it for sperm that would be considered perfectly normal and letting patients to choose whether they wanted IVF or ICSI regardless of the nature of their fertility problems. 

You may feel that it’s up to you to have that choice, but patients aren’t always presented with clear evidence about what ICSI can and cannot do.  Research shows that using ICSI when you have normal sperm doesn’t increase success rates, and in fact there is even some suggestion that it could lead to a reduced chance of success.  ICSI is more expensive and there have been questions raised about the potential risks of the technique.

For men with fertility problems, ICSI has been a hugely important development allowing many couples to have the children they long for - but it’s not something that should be undertaken as some kind of optional add-on,  If you don’t need ICSI, why pay more money for something which could carry more risk and which will not increase your chances of a successful outcome?  It’s time fertility clinics started spelling this out more clearly to their patients...

Eggs for sale

When the levels of compensation for egg donors were increased, it was generally welcomed as a good move.  £750 was seen to be an acceptable rate to repay altruistic donors who faced considerable disruption and discomfort for their kindness.  The HFEA was careful to point out that the fixed rate payment had been set at a level which would not attract "those who are merely financially motivated".

Having overheard a conversation between two shop assistants earlier this week, I am not sure this has turned out to be the case.  My ears prick up automatically at any mention of fertility treatments, and when I heard one explaining to the other that she would have to go through a full IVF cycle, I assumed she was talking about her own fertility problems.  Then, to my surprise, she went on to say that it was quite a lot to go through with the operation to collect the eggs and everything, but that she had concluded it was worth doing because it would be an awful lot of shifts in the shop to get the same amount of cash - and I realised she was talking about becoming an egg donor.

Admittedly, it was only a short conversation, but at no point at all was the thought of a child, of helping someone else or of the future consequences mentioned. Whether it was worth donating eggs or not focused entirely on how many shifts you'd have to work in a shop to get the same amount of money.

It made me feel terribly sad.  I know we need more egg donors and I was in favour of the changes to compensation, but I really hope that young women like this are getting the advice and counselling that they need before making decisions about donating eggs. Although £750 probably doesn't seem much to the professionals running the HFEA, it's enough money to make a huge difference to many women in the UK.  Of course, we want to compensate people properly, but we do have to be very wary of creating a situation where for young girls in need of cash, donating their eggs is a purely financial decision.

Eggs from skin cells

It's hard not to get excited about stories like today's news of Japanese scientists successfully creating embryos from skin cells which led to the birth of fertile offspring.  The reality is that this is a technique still in the very early stages which is not going to be available in your local fertility clinic in the foreseeable future, but it's still an amazing development.

The Japanese team had already managed to create sperm from stem cells, and this is their latest advance. They performed a very complex experiment, creating eggs from skin cells, building an ovary-like structure to support the eggs when they transplanted them into the mice, and then using IVF techniques to fertilise the eggs.  Not only did the embryos implant and lead to pregnancies, but the babies themselves have been shown to be fertile and able to reproduce.

There is still a very long way to go to find out whether this could work with human skin cells and eggs, but it does offer hope for the future.  Fertility treatments have become more successful in recent years, but cannot reverse the effects of the biological clock on female eggs - and women who don't have viable eggs of their own currently need to use donor eggs.  Today's news raises the possibility that perhaps one day in the future, there will be other options available.

Scottish funding - not good news for smokers or overweight women

Well, yes it's still great that Scotland is investing in fertility services, but the announcement was swiftly followed by the news that in Fife anyone who was overweight or who smoked would not qualify for treatment.  The weight rule applies solely to women who have a BMI, or body mass index, of 30 or above but the smoking ban applies to both partners.

This kind of rationing is often presented as being only sensible because we know that smoking affects IVF outcomes and that being obese can affect fertility - why not restrict treatment to those for whom it is most likely to work? The problem is that all kinds of medical treatments are more likely to be successful for average-sized non-smokers, and yet rationing in many other areas would be seen to be out of the question.

It's yet another example of the way that couples with fertility problems are judged - and divided into those who are deemed to be deserving of treatment and those who are not.

Scotland invests in fertility services

Great news if you live in Scotland where the Scottish government is investing 12 million pounds in fertility services over the next three years.  The aim is to reduce waiting lists so that no one waits more than a year for fertility treatment - and to improve access across all local health boards.  Maybe this will inspire an improvement in the rest of the UK where the postcode lottery means that your access to treatment depends entirely on where you live.

Infertility Network Scotland, who have been campaigning hard for improvements in access to treatment in Scotland, have welcomed the move - details here

How do your sperm swim?

Male fertility problems are sometimes caused by sperm not moving properly - but although scientists can see if sperm aren't moving or are swimming backwards, their normal patterns of movement are not usually closely monitored.  Now, scientists in the States have tracked sperm using 3D techniques to see exactly how they move.  They followed 1, 500 sperm, monitoring how they swam to try to understand more about their motility and found that rather than swimming in completely straight lines, most follow slightly curved routes, and a small percentage will swim in circular whirls...

You can read more about the research on the website of the Proceedings of the National Academy of Sciences 

The HFEA debate

I was really sorry to have to miss the recent debate organised by Progress Educational Trust on the future of the HFEA, and so was pleased to find a write up of the evening in this week's edition of Bionews.  It was clearly a lively and interesting debate - it may only be a snapshot view but it's interesting that those working in fertility clinics seemed keenest to be rid of the HFEA, while those on the outside were keener for it to remain.  I'd be the first to agree that streamlining and change are both necessary, but it's far too easy to focus on the negatives and to forget all of the good work that the HFEA has done and continues to do.

One of the speakers apparently claimed that people were travelling overseas for treatment because of over-regulation by the HFEA in the UK.  Having spoken to many people who've opted to have treatment abroad, I can't remember hearing one of them mention "over-regulation" as an issue - excessive costs and waiting lists were more likely to come up as reasons for having treatment abroad, as well as higher success rates in some other places and being treated as an equal by consultants.

Sadly the one thing that wasn't mentioned in the reporting of the evening was patient information, and I don't know whether this cropped up at all.  For most fertility patients, information provision is one of the most important functions of the HFEA.  It's the publication of success rates, the reliable information about new treatments and the calm response to fertility scare stories that is so vital - and yet it seems to be the one thing that most of the experts discussing this seem to entirely overlook.

Fertility information - Northern Ireland

Sometimes it can seem as if anywhere outside London gets forgotten when it comes to fertility-related events, but for anyone living in Northern Ireland there's good news with a special Fertility Information Day set for October 20th.  

Run by the lovely Sharon Davidson from Infertility Network UK, the day will take place at the Hilton Hotel in Templepatrick, Ballyclare.  A variety of presentations and workshops are planned including sessions on new developments in treatment, donor treatments, nutrition, complementary therapies, emotions and stress and dealing with work issues. A number of fertility clinics will be running exhibition stands on the day too.

The day costs just £10 - unless you are a professional working in the field in which case it is £25 - and that includes refreshments and a sandwich lunch.  For more information, click on this link.

The FertilIty Show

It's nearly that time of year again... I've just been sent posters and flyers for The Fertility Show, which this year runs over the weekend of November 3 and 4 at London's Olympia.  Promising to be a bigger event than ever before, there's an impressive range of speakers lined up covering pretty much everything you could want to know about fertility from the absolute basics to the latest new techniques in IVF.  The seminars also take in many related issues including complementary therapies, surrogacy, treatment for single women and lesbian couples, the male perspective, adoption, fostering, treatment abroad and help and support too.

This year there are around 100 exhibitors too, giving you a chance to talk to staff from fertility clinics around the world as well as complementary therapists, legal firms and support networks. The Fertility Show gathers together leading experts in the field along with a wide range of specialists all under one roof for one weekend - and provides an ideal opportunity to learn more in a supportive environment.

I know it's not always easy to get your head around going to a "show" about fertility when it can be hard to talk about the subject to your closest friends and family, but one of the real benefits of the weekend is being in one place with so many other people who know exactly how you're feeling - although infertility affects one in six of the population, it doesn't always feel that way when you're in the middle of it all.  

Take a look at the website - www.fertilityshow.co.uk- and see what you think. I'll be there on the Saturday, talking about how to choose a fertility clinic and chairing a question session with overseas clinics - so come along and say hello1

Quintuplets - should this really be a success story?

I've just been reading about a "miracle" birth in the States, where a woman has given birth to quintuplets after fertility treatment.  The tiny babies were born at 28 weeks and are apparently "critical but stable".  It is so very sad that anyone who has had to go through the traumas of not being able to conceive should then have the further trauma of premature babies spending weeks if not months in intensive care in hospital. The babies are in an intensive care unit that has just recently been caring for sextuplets, born to a couple who had IUI.

No reputable fertility professional should be putting the lives of babies and mothers at risk by carrying out treatment which results in the conception of five or six babies at once.  We are only hearing about the babies which make it as far as being born, albeit prematurely, but it would be far more common to miscarry when so many embryos implant at the same time.

In the early days of fertility treatments, when specialists were still unsure quite how women's bodies would react to fertility drugs, such multiple conceptions may have been more understandable, but there is no need for anyone to take such risks any more - and any fertility specialist who boasts sextuplets or quintuplets on their CV should be avoided as they certainly don't have their patient's best interests at heart.

Obesity and your eggs

For some time, women who are very overweight have been told that they have a reduced chance of success with IVF - and in some areas have been denied access to funded treatment because of this - but now for the first time researchers may have found out why.  It appears that women who are very overweight are more likely to have abnormalities in their eggs and that this reduces the chances of fertilisation.

Researchers in the US examined almost 300 eggs that hadn't fertilised during IVF cycles, and found that the eggs belonging to women who were severely obese were much more likely to have abnormally arranged chromosomes.  It is important to stress that these weren't women who were just a little plump - the eggs were only shown to have a problem in women who had a BMI (body mass index) of at least 35.  Interestingly, the research team say that by losing weight woman could improve their chances of getting pregnant - so the damage is not irreversible. 

Losing weight can be difficult when you're going through fertility treatment and feeling generally rather down and depressed, but this new research suggests that for anyone who is seriously overweight, making an effort may prove to make all the difference.  Don't forget that you can always visit your GP for help and advice about weight loss - and that joining a group can sometimes give you the added impetus you need.  For anyone with PCOS who is finding it hard to lose weight, I'd suggest getting in touch with Verity - the PCOS network - not because they have some miracle weight loss magic, but because the support of others in a similar situation can make all the difference. 

Sammy Lee

I was so sad to read in Bionews this evening of the death of Sammy Lee, a leading scientist and embryologist who had worked in the fertility field for many years and had carried out a range of research projects.

I'd heard of Sammy long before I met him as he had often courted controversy in statements to the media, and I'd imagined some kind of rather pompous figure.  In fact, when I finally got to meet him, Sammy wasn't a bit like that - he was kind, gentle and fascinating company.

You can read Sammy's obituary on Bionews here, and you can contribute to a fund in his name here which has been set up in accordance with his wish to support his students.

GPs lack knowledge and empathy when it comes to fertility problems...

As you may remember reading on this blog a few months ago (yes, we're often ahead with the news...), research for the National Infertility Awareness Campaign has found that nearly half of all GPs lacked knowledge about infertility and treatment and many found that their family doctors were very unsympathetic.

It's a great shame as showing a little compassion can go a long way when it comes to fertility problems, and the NIAC research makes me realise how fortunate I was when I first went to see my GP about not getting pregnant as he immediately offered to do some tests and set us on our way.  He was very matter of fact about it all, which was actually really helpful as it made me realise that this was a common problem and that there were things we could do.

What's even more depressing about the NIAC survey is the fact that a third of women who should qualify for fertility investigations and treatment are turned away by their doctors and made to wait.  The results of the survey would suggest that it's always worth getting a second opinion if you feel your doctor isn't taking the problem seriously.  I know how hard it can be as not being able to conceive often erodes your self-confidence and you may not feel able to argue your case when faced with an unsympathetic GP - but it may make all the difference in the long run.

You can find more details about the NIAC research on the Infertility Network UK website

   

Thank goodness you don't live in Malta...

If you ever think there’s a lack of sensitivity towards infertility, you should perhaps be grateful that you don’t happen to live in Malta.  There a political debate about regulation for IVF has become increasingly heated with the Church issuing a pastoral letter describing IVF as “morally wrong” and encouraging couples “not to concede to the temptation of taking easy solutions” by having IVF.

The Catholic church has never supported IVF, but such outright condemnation is a terrible blow to religious people with fertility problems.  It’s hard enough not to be able to have a baby anyway, without being told that opting for the medical treatment that could help would be conceding to temptation - it seems to me to be a particularly cruel line in emotional blackmail.  What's more, I don't think anyone who'd had any personal experience of fertility treatment would describe IVF as an "easy" solution.  It's not as if there are any effective alternatives either...

For anyone who has had treatment, the pastoral letter allows that their offspring are apparently "still the children of God, even if the methods through which they were conceived go against Church teachings and against human dignity".  It seems incredible that such a line could be written in 2012, and after initially feeling horrified at such sentiments, I was left with a sense of sadness that religious leaders could show themselves to be so lacking in empathy, understanding and human kindness.

Could walnuts improve male fertility?

Yes, walnuts - apparently eating two and a half ounces of walnuts a day could improve male fertility...

A new study from the States has found that men who ate 2.5 ounces of walnuts a day showed an improvement in their sperm vitality, motility and morphology.  It seems that walnuts are a very good source of polyunsaturated fatty acids which are known to be important for sperm production, and are also a good natural plant source of omega 3 - which may explain the results.

The researchers only looked at healthy young men, who were under the age of 35 and who didn't have existing fertility problems, so it cannot be said with certainty that the results would be the same in older men who were trying unsuccessfully to start a family - but having said that, if you don't have a nut allergy and don't mind eating walnuts, there's certainly nothing to be lost and potentially everything to be gained - the team set the level of walnuts to be eaten very precisely in order to ensure maximum benefit without the risk of putting on weight!

There has been much debate in recent years about how our lifestyles might be affecting our fertility and whether a Western diet could have a negative impact - and this new research provides food for thought...  You can read more here 

Lower doses of IVF drugs?

There have been a number of articles about "mild" or "soft" IVF in the last few months, all suggesting that the higher doses of fertility drugs often used in the UK and USA during fertility treatment are potentially hazardous as they can lead to hyperstimulation. One recent piece described OHSS, or ovarian hyperstimulation syndrome, as a "little-known" side effect of treatment making it sound as if the condition had only just been discovered.   While it may well be little known to the journalist in question, it is hardly little known to anyone who knows much about infertility and treatment.

What's quite interesting about these articles is that they're all entirely one-sided, only quoting experts who happen to be great advocates of mild IVF and making it sound as if anyone who doesn't do this cannot possibly have their patients' best interests at heart.  Such articles would make far more credible reading if they also allowed space for those who don't use mild IVF to explain why.

While it's true that OHSS can be a very dangerous condition, it is also true that some women are at greater risk than others and that careful monitoring during treatment can reduce the chances of the condition developing.  Generally success rates are lower with mild IVF, which is why fertility specialists choose to stimulate the ovaries to produce more eggs in order to increase the chances of success.  Perhaps in the future we will be able to get excellent outcomes with far lower doses of drugs, but in the meantime it may be more prudent to continue to tailor the dose to the individual to increase the chances of success and reduce the risks.

Responses to article on fertility education for schools

I knew when I set out to write a piece for the Guardian about including infertility into the school sex education curriculum that it was a contentious issue, but hadn't anticipated how angry the idea would make some people.

None of the people I interviewed were suggesting any hugely radical changes, just mooting the thought that including some teaching about fertility awareness at school might be helpful.  It became apparent during my research that sex education isn't always as good as it could be, and that young people are often left confused about reproduction and fertility.  Even any worries about sending potentially confusing messages by teaching about infertility were allayed when it became apparent that including this as part of a coherent well-planned sex education programme would probably help to reduce teenage pregnancies, rather than encouraging young people to take risks.

So why did the suggestion make some people so cross?  I've always been fascinated as to why any mention of infertility sends a small percentage of the population - often those with quite a few naturally-conceived children of their own - into some kind of mental tail spin.  Not only did many people start raging at the very thought of mentioning infertility to young people, there were also the by-now-all-too-familiar rants about infertility itself.  What on earth induced one person to say that we should be "grateful" for infertility in the light of our rising world population?  Imagine changing that a little and suggesting we should be "grateful" for heart disease or cancer in the light of population growth...

One of the tweets I received after the piece summed it up for me, saying that the comments alone showed that infertility should be included into the sex education curriculum to encourage more understanding if nothing else -  and with that, I would most certainly agree...

Being unhappy doesn't affect IVF outcomes...

I was hugely heartened by the recent research, published in the journal Fertility and Sterility (awful title but it's an academic journal!),  which showed that feeling anxious or depressed when going through fertility treatment didn't affect the outcome.  I've always maintained that it's unhelpful to tell people who are embarking on fertility treatment that they should be cheerful and positive when they are living with  the huge emotional ups and downs of infertility - it just seems completely unrealistic.  I know I felt stressed, anxious and worried when I was having IVF.  I was not happy, I was not positive, I was unable to "visualise success" or any of the other things that we are often told will increase our chances of a successful outcome - and yet my treatment worked.

We need to be realistic, to accept that infertility is stressful, that it often makes you unhappy and miserable.  There's a growing industry surrounding conventional fertility treatments of complementary therapists and coaches who make a lot of money telling us how they feel we can improve our chances of success. Some of this can be very helpful, but it is perhaps inevitable that when those who have no personal experience take an objective view of infertility and treatment there are sometimes fundamental misunderstandings which can lead to this kind of advice that's often way off the mark. It's just like the friends who tell you that you'd probably get pregnant if you stopped thinking about it...

I've seen too many people who've blamed themselves for their unsuccessful treatment, somehow feeling that they've failed when it doesn't work, and that it must be something they've done or haven't done, that it might have worked if they'd been able to be more upbeat and positive.  Now there's research to show that this simply isn't the case - infertility and unsuccessful treatment makes you depressed - depression doesn't lead to infertility and unsuccessful treatment.

Fresh or frozen?

An interesting new piece of research has looked at the effectiveness of freezing all the embryos created during an IVF cycle and then replacing them in a later cycle where no stimulation has been used.  It seems there are concerns that when you stimulate the ovaries, this may have an impact on how well the lining of the womb receives embryos. Not only this, but replacing frozen embryos in a later cycle also reduces the risk of hyperstimulation (OHSS).

The suggestion is that freezing embryos and transferring them later could actually increase pregnancy rates and also make IVF far safer for women by cutting the risk of hyperstimuation - although most women who get OHSS have fairly mild symptoms, it can be extremely dangerous.  Now, researchers from Spain have reviewed all the relevant studies in this area and analysed the results, coming to the conclusion that the chance of a pregnancy is as much as 30% higher if all the embryos are frozen for a later transfer rather than transferring them right away.

As is often the case with these rather interesting news stories, those responsible for the study have said that more research is needed to confirm their findings before making any changes to routine treatments for patients - but it will be reassuring for anyone who is having frozen embryos transferred. We often assume that this reduces the chances of success, but the evidence seems to suggest it could be quite the opposite.

Improving your chances of IVF success

Anyone going through fertility treatment wants to try to maximise their chances of success, and a number of new reports out today suggest that there are some lifestyle factors that can make a real difference.

The first report looked at caffeine consumption, and found that women who drink five or more cups of coffee a day reduce their chances of getting pregnant after IVF by a shocking 50%. Up until now there have been conflicting results from investigations into caffeine consumption, but this new study was a large one, following up nearly 4,000 women who'd had IVF or ICSI. Interestingly, for women who drank coffee but consumed fewer than five cups, the coffee didn't have any effect.  So, there's no need to cut out your wake-up coffee altogether, but just make sure you limit your consumption.

The second study looked at consumption of saturated fats, and found that women who had a higher than average intake didn't have as many mature eggs ready for collection in IVF treatment. This was a far smaller study, but showed that different types of fat had different effects.  The doctors who carried out the research said it was too early to make any firm recommendations to patients, but as it's not good to eat lots of saturated fats anyway, this may perhaps emphasise that healthy eating when you're trying to conceive may make a difference.

The final study looked at smoking, and found that it affected the environment in the Fallopian tube and uterus, which may explain why women who smoke are more likely to have ectopic pregnancies.  The vast majority of women who get as far as fertility treatment have already given up smoking because it reduces the chance of success and increases the risk of miscarriage - but this new research provides yet more evidence of the way smoking can damage your fertility.

All of these research projects are interesting, but perhaps not entirely surprising as they sum up what we may well have suspected already - that moderation, common sense and a healthy diet can make a difference when it comes to IVF success.

We're still trailing behind when it comes to IVF

Anyone who has any personal experience of IVF will know that our funding situation in the UK is patchy at best, but the report released from ESHRE this week showing quite how badly we're trailing behind our European neighbours was still something of a shock. We came third from the bottom in a European table for funding fertility treatment, with only Russia and Ireland behind us. Belgium and Denmark both fund around three times as much treatment per million inhabitants as we do.  Even Slovenia funds twice as much.

I've just been on Radio Humberside discussing the situation, and the presenter seemed not to have considered that infertility might be a medical condition. It always strikes me as odd that if it's your fallopian tubes or your ovaries that don't work, a medical problem becomes  a "lifestyle choice".  Where do we draw the line with "lifestyle choices" and medical treatment? Infertility is not going to kill anyone, people often say. No, it probably isn't, but surely the NHS wasn't set up only to treat people who would drop dead if they weren't helped right away?  Even funding three full cycles of IVF for all those who needed it would be a tiny drop in NHS budgets - and cutting all IVF funding entirely wouldn't begin to solve our financial problems (indeed it could make them far worse, if more and more fertility patients started going overseas and coming back pregnant with triplets).

I think this debate is about something much more than infertility - although our attitudes to families and children in the UK probably provide an interesting tangential discussion. It seems to me that deciding that some medical conditions are unworthy of treatment is the tip of a very large iceberg which rests on our decisions about what the NHS is for. What other treatments might constitute "lifestyle choices"? Hip and knee replacements perhaps? Might people decide that they aren't entirely essential?  Perhaps being able to walk long distances without any pain is a "lifestyle choice" - you don't have to walk far, you can take painkillers.

Cutting IVF funding is easy - some people even think it's a good thing.  People with fertility problems are often so distressed that they haven't told their closest friends and family about what's happening to them.  They aren't going to be outside the local PCT waving banners and shouting.  Just because something is easy, that doesn't make it right - and being oblivious to the longer term consequences of short-term financial decisions seems to be all too common at the moment.

Donor conception - Ken Daniels

I went to a fantastic workshop earlier this week organised by PROGAR about donor conception. The keynote speaker was Professor Ken Daniels from New Zealand who gave an inspiring talk which covered the whole issue of how we deal with donor conception.  If you've ever had any doubts about whether telling a child they were donor conceived is the right thing to do, just a few minutes listening to Ken Daniels talking would leave you utterly convinced.

He showed how being open about donor conception, and telling children from an early age just stops it being an issue at all, and illustrated how difficult it is when there is a secret at the heart of a family.  Some of the stories he told and clips he played were so moving that they left a tear in my eye, but he passed on his information in such a calm, measured way.

There was a really interesting discussion afterwards with two people who had been conceived with donor gametes - and again, their testimony made it clear that telling is just so important.  It can be hard to know quite how, or what, to tell a child but the earlier you do it, the easier it is as it just becomes something that a child has always known rather than information imparted in a formal way.  If you're worried about how to tell, contact the Donor Conception Network, who run fantastic courses on this very subject where you will also have the opportunity to meet up with other parents

Lesley Brown

I hadn't read about the sad death of Lesley Brown, mother of the first ever IVF baby Louise Brown, earlier this month.  It makes you realise quite how long ago it is since Patrick Steptoe and Robert Edwards carried out the pioneering work that led to Louise's birth in 1978.  IVF is so common now that we may not always appreciate quite how extraordinary it seemed to people at the time, and how much suspicion there was about what Patrick Steptoe and Robert Edwards had achieved.  It wasn't just the media or the general public expressing fears and concerns - the medical establishment was very unsupportive of what had been achieved.

In the coverage in the papers of Lesley's death, I came across a wonderful line in the Daily Mail which explained that - Two years ago it emerged that Louise was actually grown in a jar rather than a test-tube. The idea that Mail readers - and journalists - had for the past 32 years been under the misapprehension that IVF babies were being "grown" in test-tubes was enough to make the mind boggle, and perhaps illustrates the level of misunderstanding that still exists about infertility and IVF today.

It's hard to imagine what it must have been like for Lesley Brown with all the fears and concerns about IVF at the time - and it makes it very clear what a brave woman she was - and how much she wanted Louise.

Meeting at the House of Commons

I've meant to tell you about the meeting of the All Party Parliamentary Group on Infertility for weeks, but am only now finally getting round to it - the picture shows Infertility Network UK Chief Executive Clare Lewis-Jones with the group's Chair, MP for Dartford Gareth Johnson.  Sadly, only one other MP came to join the meeting which was a great shame as it was an opportunity to show support and to help to raise awareness. It was fortunate that so many of those with an interest in fertility who had been invited by the National Infertility Awareness Campaign did turn up - making the meeting feel very well attended.

Clare Lewis-Jones presented the findings of some very interesting research carried out by the National Infertility Awareness Campaign which showed that more than half of all fertility patients had found their GP to be either unhelpful or lacking in knowledge about infertility and treatments when they visited. It must be very difficult for GPs who are expected to be up to date with every health problem and every potential treatment, but one of the problems for fertility patients is the lack of time that they have to give in an appointment when discussing a fertility problem is often difficult and upsetting.

Let's hope that more MPs make time to come along to the next meeting of the All Party Parliamentary Group on Infertility to show their support and to help increase understanding.

What are we called?

I was reading a blog post the other day that referred to people with fertility problems as "infertiles" and it made me think about what we call ourselves.

I prefer to think of myself as having a fertility problem rather than an infertility problem - and I tend to talk about fertility treatment rather than infertility treatment.  I know some people feel that using the word "fertility" rather than "infertility" is just evading the issue - but at the same time, most of us are actually sub-fertile and have some chance of conceiving with treatment, rather than being absolutely infertile, with no chance at all.

I'd only ever come across the use of the word "infertiles" to describe people with fertility problems once before, and I don't like it any more now than I did then. To me,  it's just a horrid word. It's so stark and seems to add to the stigma.  What do you think?

Fertility drugs for sale

I just came across a website where fertility drugs were being bought and sold, apparently from one fertility patient to another.  Judging by the number of posts put up in the last 24 hours, it's a popular business. People were reassuring one another that their drugs had been properly stored and that the dates hadn't expired.  Others were posting pleas for cheap fertility drugs, claiming that they needed them urgently.

I can't stress enough how unsafe this is.  If you're putting yourself through the trauma of fertility treatment - and often the expense too - there's really little point in trying to save a few pounds, or even a few hundred for that matter, by buying someone else's leftover drugs.  When you buy fertility drugs this way, you have no idea who you are buying them from or whether they've really been properly looked after - in fact, you can't even guarantee that they are what they say they are.  It's simply not worth the risk that you could ruin your chances of successful treatment by trying to cut costs this way.

Fertility treatment is hugely expensive - and you can save money on your drugs by shopping around - but just make sure you shop around from reputable suppliers rather than people trying to offload their leftover drugs online.

Another day, another IVF scare story

Have you noticed how every IVF story begins with a couple's "desperate bid" for a child? Perhaps that should be every cliche-ridden story, but it's such a horrible phrase.  I desperately longed for a child, but I wasn't making a "desperate bid" for one by having IVF - I was having the treatment needed to sort out a medical problem.  Do people make "desperate bids" for treatment for any other medical condition I wonder? Anyway, enough...

The newspaper story I've just been reading (which begins with the formulaic "desperate bid")  is about a couple who had ICSI twins delivered prematurely, and it suggests that the problems they experienced must be down to the ICSI - without any consideration of the fact that they were multiples born prematurely when we know that multiple birth is the biggest health risk to IVF babies. 

The article in question went on to catalogue virtually every scare story about IVF just in case you weren't sufficiently freaked out (with a small caveat admitting that actually there was some conflicting evidence). It even suggested that parents of IVF children were constantly worried about what their fertility treatment might have done to their children's health when they were much older, concluding that if you have fertility treatment it will always continue to cause you "unimaginable anxiety" - I interviewed dozens of IVF parents for my book Precious Babies and can assure you that this is simply not true.

Please don't get taken in by scare stories - talk to your fertility specialist and get an expert's insight into the situation. I'm not posting a link to the original story - if you've read it, I hope this reassures you - if you haven't, please don't bother.

What's the worst thing anyone's said to you...

If you haven't seen this video yet, it's worth watching - just to reassure yourself that you're not the only person to have come across some of these "helpful" comments from other people.  One thing we all find is that people who know absolutely nothing about infertility are more than happy to give their advice and suggestions as to what you ought to be doing or ought not to be doing - and there's often an underlying suggestion that somehow it might be your fault, which only serves to exacerbate the stigma that so many of us feel.

It's difficult. People can't always get it right, and they don't always mean to be unkind or hurtful, but most of us have out own lists of the most unhelpful things that people have come up with.  Do you have any particular favourites?  Mine include an agony aunt (surely she ought to know better?) who advised couples with fertility problems that they might want to consider buying a dog instead of continuing to try to have a baby and the person who seemed to need to remind me on a regular basis that she had got pregnant by mistake.

You're bound to recognise one or two from the video - the "maybe it just wasn't meant to happen" type comment is a regular one...  And the lose weight/gain weight/stop thinking about it/be less obsessed with your career comments are popular too...  Maybe we should compile a list...

A mother at 58

All too often, older women assume that if they've left it too late to get pregnant naturally, they can have fertility treatment and everything will be just fine. In fact, fertility treatment can't turn back the biological clock, no matter what you're told.

I've just been reading about a woman who has apparently had IVF at the age of 58 and despite being post-menopausal, was allegedly successful after a bit of "hormone treatment".  The hospital concerned, it is claimed, was seeking to downplay this extraordinary event to avoid encouraging people to have children at an "advanced age".   If only it were really that simple to reverse the menopause!

What's far more likely is that the woman used an egg from a donor.  All too often, this is conveniently omitted from stories about much older women getting pregnant with IVF and it's that which encourages people of an "advanced age" to believe that it can surmount any age-related fertility problem...

If you're interested, the article is here 

IVF in the news again

Another day, another IVF scare story... or at least that's how it sometimes feels.  We're forever being told that this procedure or that type of treatment is risky for us or our future children.  It's not always easy to make sense of what lies behind the headlines or to decide what might be best for you.

The latest story claims that fertility clinics are putting profits before women's safety by opting for traditional rather than mild IVF, which involves lower doses of drugs.  The safety aspect appears to focus on ovarian hyperstimulation, a condition that occurs if the ovaries become over-stimulated after using fertility drugs. Ovarian hyperstimulation can be very dangerous, but specialists usually have an idea of which women are particularly likely to be at risk before they start treatment and tailor drug doses accordingly.  Once fertility drugs are being administered, regular scans can give an idea of situations where the ovaries are starting to respond too strongly - and in these cases treatment is normally halted, at least for a while.  So yes, of course ovarian hyperstimulation is a risk of fertility treatment, and yes, of course you may want to talk to your fertility specialist about how they ensure the dangers are reduced - but don't be completely panicked by another scare story.

Whatever the rights and wrongs of mild IVF,  today's stories go far beyond that.  One talked about the "toxic" drugs used in fertility treatment in the UK and made it sound as if we use completely different, old-fashioned dangerous drugs here when everyone else in the world is using some kind of safe, modern drug. It's simply not true. Talk to your consultant, talk to your doctor or fertility nurse, talk to your counsellor - then make the decisions that are right for you - and take your daily paper with a pinch of salt!

The men's room

Those of you who have ever been to a fertility clinic will know exactly what I am talking about - the place where you are sent to "produce your sample". They aren't places any of us tend to think about too much - and that we'd only manage to talk about with fertility friends after a glass or two...

When I was researching my first ever book about infertility some fifteen years ago, I interviewed a dozen or so couples and two of the men had been to the same clinic, with the same men's room which had clearly had quite an impact as they both told me about it in great detail during the interviews. Not about the room itself, but about the key which was attached to what they both described as a "plank of wood".  To go to the men's room you had first to collect the key, and then walk right through the clinic carrying this thing that you couldn't disguise so that it was clear to all where you were going and what for. For the same book, another man told me about being sent to the men's toilets in a local hospital to produce a sample where an old man kept coughing in the next cubicle and where the doors left his legs and head visible to anyone who happened to come in.

I was reminded of this today during a brilliant presentation at the British Infertility Counselling Associations Study Day by photographer Aaron Deemer, who has been touring the country taking photos of the men's rooms in clinics.  The idea sounds utterly bizarre, but hearing Aaron talk, you soon understand that his personal experience has led him to discover a truly unique way of getting people talking about infertility.  The photos themselves are fascinating - a selection of very different rooms;  some cold and clinical, others designed to try to look vaguely appealing but rarely succeeding.  There's one slightly sinister room with what looks like a dentist's chair surrounded by downlit spotlights, another had what Aaron described as a "fake plastic cannabis plant" plonked in the middle of a room full of chairs that doubled up as the staff conference room.  There was a room that Aaron said reminded him of his teenage bedroom with a narrow bed and patterned curtains.  One room had bars at the window, another had a phallic photo of the Eiffel Tower on the wall.

Aaron's project is called "Please Make Yourself Uncomfortable" and if you get the chance to hear Aaron talk or to see the photos, don't miss the opportunity. He manages to access something we often find difficult to talk about and to present it in such a way that it encourages discussion.

Waiting rooms

I ended up spending a lot of time last night in a hospital waiting room (with a suspected eye problem which turned out to be absolutely fine), and it made me think about the amount of time I must have spent over the years in fertility unit waiting rooms - and how different they are. Last night, there were a huge range of people in the waiting room with all kinds of different eye problems but we were stuck there together, waiting - and so, after a while, people began to smile at one another or raise eyebrows as we waited on and on, and then began to chat. I spoke to three different people who happened to be next to me over the course of many hours as we lamented our inability to be able to read due to the drops they'd put in our eyes and wondered whether we'd ever get home. It's odd in a way that the spirit of being in an unpleasant situation together very rarely makes fertility patients start talking to one another. For the most part, we even try to avoid eye contact in waiting rooms, let alone begin conversations. Is it the stigma that still somehow lingers around fertility problems? Is it the fact that we feel so emotional and often close to tears? Or perhaps it's because talking to one another might somehow make the fact that we have to be there seem even more real. It's a shame because there's a huge amount to be gained from talking to others who have the same problem and sharing experiences. Not only is it a huge relief to talk to people who genuinely understand, it also helps to normalise the experience, reminding us that we're not alone and that infertility is really a very common problem. At this point, I have to confess that in all the years I spent in the fertility clinic waiting room I only ever spoke to one person - and that was because she spoke to me first. If talking is too much - and I accept that it quite possibly is - then maybe we should try to at least give one another a smile if we catch eyes at the clinic. It's just a gesture, but sometimes the old saying about a little kindness going a long way seems very true and may make all the difference.

Awareness of fertility

A new paper from the States has looked at student attitudes towards fertility, questioning male and female students about their views and understanding. We often think - or at least I do - that we blab on about the age-related decline in female fertility so often that most women are only too aware that their fertility will begin to decline quite sharply once they are over 35. In fact, the research suggests that maybe we should be blabbing on a bit more. The students in the survey thought that the marked decline in female fertility came far later than it actually does - and they assumed that fertility treatment would be more likely to be able to sort out any potential problems than it actually is. This is perhaps the most worrying fact, as there is still an idea that if you leave it too long to try to have a baby IVF will be able to sort it out for you. Just this morning, I read an article in the paper quoting a 38 year old celebrity who said she was in "no rush" to have a baby. We've seen endless attempts to raise awareness of this issue over the last few years, but it seems there may still be some way to go.

Fertility treatment in the news

There seem to have been a spate of scare stories about fertility treatment in the news in the last couple of weeks, and it can be very hard if you're going through it yourself to know what you should believe or whether you should be worried. When I was having IVF, the safety of using frozen embryos was quite an issue, with many people refusing to even consider the idea, and it seems ironic now as there have been a number of studies suggesting using frozen embryos may actually be a very positive thing. The latest story focuses on ICSI, and is far from the first surrounding the treatment as most experts are clear that there may be risks that we are not yet sure about as ICSI is a far newer treatment than IVF itself. At the same time it is important to stress that the real risks are small and that many thousands of healthy babies have been born after ICSI treatment, which has allowed many men who would never have been able to have their own genetic children otherwise to become fathers, If you're ever worried about any aspect of infertility or treatment, you should always discuss it with your fertility specialist or doctor.

Work and fertility treatment

You may have heard the recent news about a teacher who lost her job at a Catholic school in Indiana after having fertility treatment (see more here).  In this particular case, there were religious objections to the IVF treatment, but it does raise issues about fertility treatment and work which concern many women who are trying unsuccessfully to conceive.  There is no legal right to time of for fertility treatment, but most women do need to take at least a day or two off around the time of egg collection and embryo transfer.  Some take leave for this, but that can be hard as it is often difficult to pinpoint exactly when egg collection might occur and you may need to book leave some time in advance.  Others take sick leave, but there have been cases where employers have not been happy about this, claiming that fertility treatment is not the same as being ill.  Some more enlightened employers actually give time off for fertility treatment, and those that do generally find it is more than repaid in the grateful attitudes from staff who benefit from this.

If you are going through treatment and need time off, perhaps the best thing to do is to discuss this with your family doctor. Most will be willing to sign you off sick for a while, understanding the difficulties that can accompany fertility treatment. I wrote a feature about this some years back for The Guardian which may be worth a read if work and treatment is an issue for you.

Why sextuplets are not a good idea...

If you've thought about travelling abroad for fertility treatment and have maybe wondered whether the relaxed regulations in other countries might be part of the attraction, think again... I've just been reading an article about a woman in the States who has given birth to sextuplets after fertility treatment - ten weeks early. Five of them are apparently doing "as well as can be expected", which given their prematurity and very low birth weights will undoubtedly mean problems ahead. The sixth baby faces "greater challenges". Their mother was offered "selective reduction", which is a way of dealing with bad decisions made during fertility treatment, but felt unable to take that option. In this particular case, it wasn't that too many embryos had been transferred during IVF. These sextuplets were the result of IUI. In this country, when a fertility specialist stimulates the ovaries during IUI, the treatment is tailored to aim to produce one or at most two eggs. Any responsible specialist would immediately stop treatment if there was a danger of this this kind of risky high-order multiple pregnancy. According to the article I read, there are as many as 2,000 cases of selective reduction each year in the States, and it's little wonder that there is sometimes such vehement opposition to fertility treatment. The fact that it is "hard to regulate" IUI seems to be the excuse - but surely it is time for fertility specialists to face up to the consequences of the treatments they are offering. Our system in the UK is not without faults, but it's only when you see what can happen in other places that you realise quite how lucky we are. See the article in question here

Could you help Infertility Network UK?

Having spent some time as a trustee and then a member of staff at Infertility Network UK, I know how difficult it can be to raise funds for an infertility charity. Those who have no personal experience don't realise how incredibly valuable the support and information offered can be, and Infertility Network UK does far more than that, providing a voice for those who often don't feel able to speak out about their fertility problems and campaigning on their behalf for proper funding for treatment. Now, Jim Seenan, the husband of one of the charity's staff is gearing up to run a marathon to raise much-needed cash to help fund the vital services offered. If you're able to help sponsor him, it would be hugely appreciated by all of those who've valued the help and support that Infertility Network UK can offer. You can sponsor Jim here

Professional advice for your fertility questions

When you're trying unsuccessfully to conceive, there are often so many questions and concerns that spring to your mind that you may not always feel able to bother your clinic or your consultant with all your niggling worries. Many women resort to asking one another questions about what it is and isn't OK to do when you're trying to conceive on the many online fertility forums, but one of the problems with this is that you'll often receive misleading or even plain inaccurate advice.

What many couples don't realise is that the charity Infertility Network UK offers all its members access to a professional advice line where you can contact a medical profesisonal with all your little worries and queries, safe in the knowledge that you won't be getting anything but the best advice from someone who not only gets their medical facts right, but also understands infertility and knows just how you are feeling and why you have so many questions.

It's not expensive to join Infertility Network UK, and I'd always advise taking out membership to anyone who is trying to conceive. Not only will you benefit yourself in terms of access to information and support, but you'll also be helping to back the campaigning work of the charity as it tries to raise awareness of infertility and of the inequities in the way treatment is currently funded.

Fertility funding in Northern Ireland

Members of the Assembly in Northern Ireland have passed a motion calling on the Health Minister to fund three cycles of IVF treatment. At present, anyone eligible for funded fertility treatment in Northern Ireland will only get one attempt at IVF paid for by the health service. In England NHS funding can vary, but in Scotland couples get three cycles and in Wales they get two. The guidelines published by the National Institute for Health and Clinical Excellence recommend that those who are eligible should be offered up to three full cycles of treatment.

It is great news that the Assembly is considering the issue, and that members are minded to call for more funding for fertility. The campaigning work carried out by Infertility Network UK in Ireland is sure to have helped bring this issue to the forefront.

Healthy diet, healthy sperm...

New research from the States has found that men who have a diet high in saturated fat have considerably lower sperm counts. The researchers followed men attending a fertility clinic and analysed their diet and their sperm over a period of time. It became clear that those who ate more unsaturated fat had markedly lower sperm counts than average, and that those who had diets which were high in omega-3 fatty acids, found in fish and plant oils, had higher sperm counts. However, it is important to note that many of those who ate more saturated fat were also overweight, and many of the participants in the study were classified as obese and this could also be playing a part.

What is very apparent is that maintaining a healthy diet and keeping within normal weight parameters is definitely important when it comes to male fertility. All too often, it is assumed that women are the ones who need to make all the lifestyle changes when a couple experiences difficulty conceiving, but this research shows that men need to make just as much effort!

You can find details of the study, published in Human Reproduction, here

One at a Time

Earlier this week, I spoke at a workshop in Bristol organised by One at a Time about patient views about single embryo transfer. I know many people are worried that having just one embryo put back during IVF treatment will reduce the chances of success, but all the research shows that when clinics are selecting the right patients for single embryo transfer, it is quite possible to cut risk of multiple pregnancies without reducing the pregnancy rate.

The speaker who made the most impact on me was paediatrician Alun Elias-Jones, who talked about the problems of prematurity that he had frequently seen with multiple births. We all know so many twins who are perfectly fine that it's easy to assume that problems are relatively rate, but it was made very clear that this was far from the case with half of all twins being born early and often having low birth weights too, which can lead to all kinds of problems including brain injury, lung disease and cardiovascular problems. He explained that twins were three times more likely to be stillborn, five times more likely to die during their first year and four to six times more likely to have cerebral palsy. It was his description of the longer term problems that they can face with disabilities, learning difficulties and behavioural issues which was particularly striking. It's all too easy for staff in fertility clinics not to think about these potential consequences, and to pass on an ambiguous message to patients.

Going through fertility treatment isn't easy and all anyone wants is for it to work as quickly as possible. If you've got a team treating you who are all clear that the best outcome would be one healthy baby, it's something you're going to believe yourself. If you are faced with divided opinions or with some staff seeming to suggest that multiple birth might not be a bad outcome, it is hardly surprising that we sometimes end up confused.

Of course, there's one thing which really would make a difference to patient opinion and that would be the full implementation of the NICE guideline, which says that all those who are eligible should receive up to three full cycles of IVF. With adequate funding, it would be far easier to convince patients that all those most at risk of multiple pregnancy should consider having just one embryo put back at a time.

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.