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.