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I realise I am writing this the day after International Women's Day which, to me, adds poignancy to the subject in hand because what I want to write about is a wider women's issue. This has been a long-brewing blog, brought to a head when reading 'No, Millenial Women are Not Failing at Fertility' in the Huffington Post this morning. It's not supposed to be a rant (although it may come across like one!) but a contemplation on the situation of hundreds of women who come through our clinic.
When I attend fertility conferences or read fertility-related articles it strikes me, over and over, how often women are blamed for the status of sub-fertility or infertility in couples. When the (usually, but not exclusively male) consultant stands up and says "Women are choosing to leave it later to start trying to conceive", I really want to shout out and question their use of the word 'choice'. Because, having worked with couples over the last 18 years for fertility-related issues, I know that most women in their late 30's and early 40's would have far rather have chosen to try to conceive earlier if a) they'd had a willing partner and 2) they had financial and employer support to do so.
Blaming women for making the 'wrong' choice is neither useful nor beneficial. First of all, women shouldn't have to make a choice at all, between fulfilling employment and child-care. The excellent author, Caitlin Moran, has a simple measuring tool for assessing life/style choices (wearing make-up, high shoes, worrying about our weight, being 'nice' etc etc) and that is, ask yourself, "are men doing it?". The answer is usually "no". Certainly no one is standing up at fertility conferences and saying "men are leaving it too late to settle down and have children". The onus, as always, falls on the women's shoulders.
But this isn't an 'anti-man' article and it's not just consultants and statisticians who are doing the blaming. I am very aware, because I see it all the time, that women find it easier to take responsibility for low fertility or infertility on themselves, even when the cause is decisively Male Factor. Fertility is a male and female issue equally but women assume the burden of blame readily and often without questioning.
Currently I have a female patient whose male partner is opting not to complete a semen analysis. This is not uncommon. He is not being 'blamed' for his choice. Instead, she is finding all sorts of ways to make it easier for him: choosing with great care the time to bring up the subject. She is taking on the responsibility for their fertility problems. Would a frank calling out of the subject with her partner help more? I don't know. She has endometriosis so is seeing it as 'her' problem and yet a semen analysis is still vital to the cause and if he wants children, which he says he does, then surely one small pain-free test (though admittedly one fraught with potential for embarrassment) isn't too big an ordeal?
There is so much that could be done to change this culture of blame, starting with improved fertility education. It is incredible how little people know about falling fertility rates associated with age and believe that IVF will solve all issues. We regularly see couples in their 40's expecting conception to occur easily and quickly, disappointed when nothing has happened after 3 months. Maybe if both and men and women had a more realistic idea about the fragility of human fertility we would be in a better position to make earlier decisions and encounter fewer problems.
Instead of blaming women for 'choosing' their jobs over childbearing, governments could be supporting women to have children earlier. Because, let's face it, it is an either or. The difficulties of trying to work and look after more than one child quickly becomes obvious and it's usually (but not always, I know) the woman who jacks in her job.
Instead of making women & couples more dependent on medical intervention later in life, let's put funds into affordable child-care and legislate so that women aren't penalised economically for being the ones who do the child-bearing and most of the subsequent child care (most men in the UK still don't use their allotted paternity leave allowance).
But most of all, let's stop the use of blame as a shaming tool. Women are up against it where fertility is concerned. Our bodies are built to conceive and carry a pregnancy much earlier than society allows. 'Early' pregnancies are frowned upon and life is hard enough as a working mother, let alone as an older working mother. Whether it's your GP, your partner, your consultant or friends who imply that it's a woman's fault when things don't go to plan, fertility is a human issue, not just a woman's issue and we need to start calling this out.
So next time I'm at a conference and a fertility consultant glibly apportions blame to women and, specifically, older women, I am going to speak up instead of sitting in the audience fuming to myself but staying silent. Women have incredible bodies and strong minds, we are resilient and resourceful, let's not let that be taken away from us.
Always wonderful to get a thank you and to know what we do really does help so many people. As my dad would always say: "Thank you for saying thank you."
People's focus inevitably turns to making improvements when a new year starts. In an ideal world we wouldn't go through such cycles of good intentions leading to slippery slopes leading to Christmas binges and then starting again. In an ideal world we'd eat well 80% of the time and leave the other 20% to occasional bits of cake, good quality wine or beer and the odd life-saving pie and chips. Not only that but we'd get enjoyment from eating well and not see it as a punishment.
We don't need to be fanatical about diet/nutrition. A balanced base point which doesn't vary throughout the year will give your body and mind so much strength and stamina and help you feel confident and energetic.
This means having a plan and trying to stick to it most of the time. We've all been caught short running for a train, out and about with no healthy options or nothing in the fridge and that's fine if you give your body goodness the rest of the time. Eating well should be in place most of the time and should be easy - it shouldn't feel imposed or like a punishment because then it's bound to fail.
Supplements can really help as they ensure (if they're the right quality) that your body gets, at least, a good amount of minerals and vitamins if you're not managing to get them from food and, let's face it, most of us don't.
Eating well is the most basic and important factor for improving fertility as long as there is nothing physically wrong like blocked tubes (in either partner). Hormonal disturbances can be evened out, stress and anxiety decreased, sleep improved as well as circulation and, vitally, nutritient levels in the blood which feeds all body cells (including sperm, eggs and womb lining).
The other massive positive to eating well is that it makes you feel great. It doesn't have to be extreme or painful. Just adding in nutrients in the form of seeds, for example chucking a handful of pumpkin seeds in your porridge or on your cereal, can transform a nutrient 'empty' breakfast into something your body can really use to give it strength and vitality.
Give it a try - come and see us if you need help and individual advice - and don't let it get over complicated or stressful. Make healthy eating your default position and look forward to 'treating' yourself occasionally. You might find that you're less likely to want to those treats over time as well as your body gets used to a healthier way of being.
We really appreciate it when people take the time to let us know how they've got on. Here's our latest testimonial from some very happy parents:
A recent article in The Daily Mail has highlighted how effective acupuncture can be for period pain (or 'primary dysmenorrhea', to give it it's proper medical name). We see this all the time in clinic but it's nice to have it highlighted and verified in the press.
Being a fertility clinic involves not only supporting IVF but working with couples on all the things that could be causing delayed conception including: period pains, irregular cycles, sub-fertile sperm, stress, a nutrient-poor diet and many, many other issues that, separately or together, can cause problems. We prefer the term 'delayed conception' to 'infertility' because it's more accurate and less negative. Not many of the couples we see are actually 'infertile'. True infertility only occurs when a woman is not ovulating or has blocked tubes or the man has no sperm or a count/motility/morphology so low that it is impossible to fertilise an egg.
In terms of Chinese Medical theory, period pains are caused by 'Blood Stagnation' which leads to symptoms of pain and clotting. Self-help ways to reduce this are to make sure you are exercising throughout the month but gently just before and during your period to keep circulation flowing; use gentle heat on the lower abdomen to improve blood flow and there are a great set of pelvic flow exercises that we can show you in clinic. One very easy exercise is to lie on your back (put your knees up if you have back problems) with your hands on your lower abdomen (ie below your belly button) and breathe into your hands. This encourages you to take deeper breaths and increases blood flow to the diaphragm & pelvis and into the bottom of your lungs which helps relaxation.
Other easy habits you can get into are adding in some gently warming spices to your food and drinks - cinnamon, ginger, garlic, turmeric and paprika are all good. Some people swear by rubbing chilli or paprika on the soles of their feet before their periods - sounds weird and I've yet to try it myself but makes sense as the spices are absorbed through the skin and improves circulation by dilating the blood vessels in the feet, legs up to the abdomen.
Acupuncture is of course brilliant for period pains and I say that with honesty because we've been treating women with period pain for 18 years now and I have seen the difference it can make to their lives. Gone are the days off work or in pain, the fun nights-out called off and the hours curled up in bed with a hot water bottle. It isn't a miracle-cure, although sometimes it seems that way, and it depends on the diagnosis (ie severe endometriosis is not always going to just disappear) but for most women there is a huge relief and a reduction in severity of symptoms or complete cessation of pain. In stubborn cases we recommend Chinese Herbal Medicine as well and Abdominal Massage, both of which are very effective and a good addition to acupuncture.
Give these tips a try and let us know how you get on! Or come into the clinic and get some on to one advice on dealing with persistent period pains - whether you are trying to conceive or not.
Your adrenal glands are important because they help you respond to stress. But if you have chronic, long-term stress, your adrenals (and the stress hormone cortisol) get over used and are no longer able to respond. This means your energy plummets and you feel simultaneously feel tired and wired. Some people get palpitations, feel anxious or have trouble sleeping and others might crave salt or get dizzy when they stand up from low blood pressure. Many people have sugar cravings because their bodies can no longer regulate blood sugar properly and are desperate for some energy. We start to crave coffee and other stimulants to feel better but these only work in the short term, if at all and are detrimental in the long term.
We get adrenal burnout from the chronic, unremitting and ongoing stresses of everyday life: stresses of our families, stresses of relationships, stresses of work, the stresses of constant interaction with Facebook and Twitter and the online world. There is not enough emphasis on putting aside time to rest and relax. You don't have to 'do' anything else - just resting is enough. Naps are a great way to reset and are you key tool to reversing adrenal burnout.
You can help to heal your adrenals by adopting a whole food, anti-inflammatory diet. Focus on anti-inflammatory foods including wild fish and other sources of omega-3 fats, red and purple berries, dark green leafy vegetables' orange sweet potatoes and nuts.
Add anti-inflammatory herbs to your food, such as turmeric , ginger and rosemary. Eliminate inflammatory foods such as refined oils, like corn, soy and safflower oils. And don’t skip meals. It can be hard for your body to recover from skipping meals if you have adrenal dysfunction.
Find ways to actively relax. Relaxation is an active choice. It is not being lazy. You could also do gentle (eg yin not ashtanga) yoga or take a warm bath at night. If you put two cups of Epsom salts, half a cup of baking soda and 10 drops of lavender oil in the bath then soak for 20 minutes it really relaxes your body and lifts your spirits. Lavender oil lowers cortisol and helps to balance the whole hormonal system. After this bath, you will end up with a really decreased stress response.
Very simple things have profound effects. Exercise is important for our minds and bodies — gentle, regular exercise like a morning walk, a light jog, a little bike ride. Do something out in the fresh air to get natural light that affects your pineal gland and helps reset your brain and the stress response.
Try to establish a regular rhythm to your days (I know this is more difficult if you're working shifts). Rhythm is the key because your hormones are balanced in rhythms. Waking at the same time every day, going to bed at the same time every day, eating at the same time every day — these are the rhythms in life that help to reset your natural balance. Following your natural rhythms of work and rest during the day is also essential. Take natural breaks when you are tired. Our bodies function best on rhythm cycles of 90 minutes of activity punctuated by a few minutes of resting or zoning out!
"You are what you eat" is a saying often bandied around but it wasn't until I reached my 40's that I realised how true it is (I know, I'm a bit slow).
Your body is, literally, produced from what we put into it. In the womb, we are made from the nutrients that our mothers take in but once we're in the outside world all cell renewal and growth can only happen if the body gets food and fluids.
Bodies can survive for a long time on not much - water and bread or rice if necessary but we can't thrive on that. You only need to look at pictures of people in war torn countries where there is no regular supply of food to see the results of malnutrition.
But you don't have to wait for The News to see the result of a nutrient-poor diet. Many people who come in to the clinic, although living perfectly safe lives, are undernourished and therefore not in the best health. It is obvious to those of us working in this field because we're on the look out for symptoms and we understand the link between a body strong in nutrients and fertility. However, we have grown up in a society where there is a disconnect between what we put into our bodies and what we expect to get out. Our food comes off white shelves, in plastic boxes covered in clingfilm with no traces of the soil it grew in or evidence of the it's origins. Food is marketed and chosen on how the packaging appeals to us, not on how it will nourish our bodies and minds. And yet we still expect it to get us through our busy days at work, long commutes, Body Pump or Spin classes and busy social lives and still have enough left over to help us conceive, or produce good enough sperm to conceive.
The latest evidence for a nutritious and healthy diet is to cut down on carbohydrates and increase healthy fats and proteins. Healthy fats come from nuts, seeds, olives, coconuts, oily fish, organic meat and full-fat organic dairy. Fats allow absorption of nutrients and feed the brain (1/6 of our brains are made up of Omega 3 Fatty Acids) and offer an effective slow-release energy source which in turn regulates insulin and our hormones. Most of these foods also offer some level of protein which are vital for cell building. Last on the list should be carbohydrates which only function as a quick-release energy source. If you stick to complex carbohydrates like brown rice, brown bread and wholewheat pasta then you're already doing your body a favour but it's vital to cut out white and processed foods because they offer nothing in the way of nutrients and only cause hormonal imbalances.
For those who want to know more - come and see our nutritionist Dr Jane Jamieson or look up Ketogenic diets online for some information on low carb eating. But most importantly, try to start looking at food in a new light - as a source of nutrients for your bodies, which should result in improved egg and sperm quality and great health of your future baby. Food can still be enjoyable and tasty, just make sure it's doing you some good at the same time.
It makes us so happy to receive your good news, it doesn't matter how long after we last saw you. We once received a thank you card 2 years after seeing a patient and were so pleased and relieved to find out what had happened and how things had turned out.
Here is our latest Thank You email - we know it helps patients to read others' stories, to feel there is hope and know that things do work out for many, many people.
Here's our latest case study from a patient, in all her own words:
I am age 38 and had four years trying and then four rounds of IVF in 2016. Unexplained infertility on my part, my husband tested fine. I had 12 eggs of which 7 fertilised, all 5 day blastocysts. My fourth frozen transfer worked and I am nearly 18 weeks pregnant J
I had been having acupuncture for around 18 months with another lady (not at the clinic) but I had a great initial appointment with Dee who gave me lots of great advice and then with Fiona who I think was for Acupuncture and Chinese Herbs. Then I had two abdominal massages with Jill just before my fourth IVF transfer.
The clinic was a real breath of fresh air, as where the practitioners. It had a spa feel about it which was so relaxing. I really only attended a few times before my fourth round of IVF worked but I think the abdominal massage and the instruction on using the castor oil packs really helped me. I really focused on keeping my uterus calm, warm and in good health which I really believe the massage and castor oil packs helped with.
The massage was just amazing, so much time spent on the treatment and really good value.
Having unexplained fertility left me with nowhere to go really as I had nothing that my doctors could actually treat so looking at natural alternatives really helped me to feel that I was still being proactive – and without spending a fortune!
The advice on things that I could do myself like the castor oil packs and going gluten free was just invaluable. Every day that I practiced this I felt that I was making a difference and that was a great feeling.
Well, all I can say is that my fourth round worked just after my visits and abdominal massage so I am sure that they definitely contributed!
I was so close to starting IVF for the fourth time that I only used the Chinese herbs very briefly so I don’t think they even had a chance to take effect. But I still think they are worth doing and would consider again.
I would highly recommend a visit to the clinic. So much good advice and you can actually have a really open and honest conversation. We talked about different case studies too so my faith was definitely restored after four long years of trying. I was also really impressed with the up to date knowledge that the practitioners had – more than my own doctors ever had or ever wanted to share anyway. And the treatments are really good value for money which helps when you may have already spent a fortune trying to conceive. My only regret is that I didn’t find the clinic sooner!
This article in the Mirror online reports that couples who's BMI is too high or too low will no longer be offered a round of IVF on the NHS (in England). We already know that women with a BMI over 35 have to cut this to 30 before being offered a round of IVF in Scotland. In England they also need to have been trying to conceive for 3 years rather than 2.
Having worked with couples who are trying to conceive for the last 12 + years, we understand how frustrating new stipulations can be. It just seems like another hoop to have to jump through. But on the other hand, we also know that many couples will go on to conceive once they have either lost or gained enough body fat to allow their hormones to balance out. So it makes sense to get this sorted before embarking on IVF.
People usually only think of body fat as a way to tell how much people eat and/or exercise - too much or too little. What is not as commonly understood is that reproductive hormones are stored in your body fat. This is why women with too little fat (like long distance runners) often stop having periods. Their bodies cannot store enough oestrogen to generate ovulation and therefore to have regular period. With men it's the same. Men with high levels of body fat will have too much oestrogen which effects their testosterone levels and sperm production.
At the weekend, some of the Natural Fertility Team were at the Fertility Fair in Manchester where we met and chatted with many couples struggling to conceive and also consultants and researchers from the IVF world. It was an interesting weekend and we did notice a number of people (hetero-sexual & same-sex couples and single women) who were overweight and a few who were obviously underweight. If these imbalances could be put right before turning to IVF then maybe fewer couples would reach the point where they felt they needed it. Obviously, some couples DO need IVF - those with blocked tubes, no sperm or other medical conditions that make natural conception impossible - and that was what IVF was invented for but many consultants and IVF nurses say readily that couples could improve their chances by addressing their general health.
To this end we will be putting up more general nutritional and life style information on our site over the next while so everyone can access the basics. In theory it's not that difficult to achieve a good level of body fat once you are motivated enough and if you can follow and stick to the advice. It can and should be a slow and steady process but it's amazing how much simple changes or additions to diet can help bring levels of body fat to their optimum place and restore hormonal balance, allowing a greater chance of natural conception as well as IVF success. We know it's not always easy in practice - and sometimes it's actually more difficult to gain body fat than lose it - but it is possible with the right support and perseverance.
Tips To balance oestrogen levels:
Increase intake of fibre especially whole grains, pulses, brown rice, flax seeds, fruits and vegetables.
Eat bitter foods such as chicory and radicchio and vegetables such as cabbage, cauliflower, Brussels sprouts, broccoli and turnips to improve oestrogen clearance via the bowel.
Reduce saturated fat intake and cut down on meat, poultry and dairy produce.
Avoid foods containing sugar, chocolate, caffeine and alcohol (see our info sheet on sugars).
Tips To help reduce inflammation:
Eat fruits rich in vitamin C and bioflavonoids, especially the pulp and inner peel of citrus fruits, grape skins and berries.
Take a daily multivitamin and mineral supplement containing vitamins B-complex, C and E, zinc, magnesium and selenium.
Take a daily supplement of omega-3 essential fatty acids and evening primrose oil.
Avoid partially hydrogenated vegetable oils including margarine.
Take regular moderate exercise, especially first thing in the morning but avoid strenuous activity during your period; Make sure you take plenty of rest when you need to
Acupuncture can help reduce pain and regulate the menstrual cycle; Chinese or Western Herbal Medicine can be useful for pain relief and hormone balance; Use painkillers that do not contain codeine but try to cut down on using analgesic drugs altogether; Relax in an Epsom-salt bath to relax the muscles deeply and release emotions and stress. Dissolve 1-2 cups of Epsom salts in hot water and immerse yourself for 20 minutes or so. When you are dry, lie down quietly for another 20 minutes.
When we refer to sugar we’re talking about fructose. Fructose is found in refined sugar, fruits, honey, agave, maple syrup and many processed foods. Sugar causes our hormones to fluctuate hugely. When your hormones are fluctuating it puts a massive strain on your fertility and fertility is about your reproductive system working to the best of its ability, regardless of gender and whether you are trying to conceive or not.
Sugar messes with your hormones: When we consume sugar it drives our insulin levels too high & too quickly for a brief period of time, then it drops dramatically. Our adrenals go into a ‘stress response, by releasing cortisol and adrenaline in an attempt to restore our sugar levels back to an even keel and this leads to a hormonal imbalance.
This impacts our fertility because progesterone (the main hormone required for ovulation to occur) and cortisol compete for the same receptor binding sites in the body and cortisol always wins. If this continues for an extended period of time it can disrupt the entire endocrine system, meaning all your sex hormones whether you’re male or female: oestrogen, progesterone and the androgens DHEA and testosterone.
Sugar causes inflammation: This is of particular importance to women who suffer from endometriosis. Endometriosis affects the uterine lining and makes the implantation of an embryo difficult. Many endometriosis sufferers who cut out sugar from their diet notice substantial changes due to the immediate reduction of inflammation. Our bodies aren’t designed to consume quantities of sugar and our gut goes into a frenzy trying to cope. Inflammation is our body’s reaction to this.
Sugar consumption affects PMS: Hormones need to be in balance in order to keep everything running smoothly and our moods even.
Sugar leads to insulin resistance: Many women who suffer from PCOS have insulin resistance. Insulin is released by the pancreas to convert sugar to energy; so the more sugar we eat, the more insulin we release, eventually leading to insulin resistance. Insulin resistance is linked to issues with ovulation, maturation of the egg and implantation of the embryo into the uterine lining. It also puts women at a much higher risk of miscarriage.
Sugar depletes essential vitamin and mineral stores: In order for our hormones to function efficiently they require specific amounts of vitamins and minerals to be well-fuelled. Fructose severely depletes our vitamin and mineral stores and this can have a huge impact on our fertility. When our stores are low, our entire body is compromised which contributes to amenorrhea, irregular periods, lower immunity, increased infection (which can be a factor in miscarriage), increased anxiety and depression and gut health issue like irritable bowel syndrome.
A deficiency of vitamins and minerals will also age you.
If fertility is important to you or is likely to be of relevance in the not too distant future, one of the best things you can do to ensure your hormones are in tip-top shape is to reduce your sugar intake.
If you're looking at cutting sugar, focus on the foods you can eat rather than those you can’t, to make quitting easier and it’s still fine to include some organic fruit in your diet. It’s not as bad as you think!
Could a micronutrient deficiency be stopping you conceiving? NFC Nutritionist Dr Jane Jamieson (PhD) examines the issue.
The patients I see at the Natural Fertility Centre are looking to improve their health and increase their chances of either conceiving naturally or through IVF. Some people have specific issues – male sub-fertility for example, or low AMH. Very commonly I see an imbalance of hormones and thin endometrial lining.
Women usually seek out nutritional help of their own accord. Most, but not all, men have been persuaded or coerced by their partners and many couples are referred to me from my colleagues at the centre. As a nutritional therapist I am more likely to see couples than most of the other complementary therapists and this makes perfect sense. Nutritional therapy impacts the sperm and the egg equally and good nutrition for both ensures the best possible embryo with the greatest chance of success.
Generally people try to eat fairly healthy diets and this is a great starting point for nutritional therapy. However, many people are often unaware of what a healthy diet really consists of for their specific needs. Patients might increase their intake of fruit and try to cut out refined sugars in biscuits and alcohol but will not be as aware of the need to add in nutrients. Because of this, many of these patients still struggling to conceive.
Reaching optimal fertility needs a multi-faceted approach. The basics are: a healthy diet, regular exercise and good sleep which all lead to balanced hormones. Sometimes these can all be in place but conception is still elusive. This is when we look at deficiencies of micronutrients. Very often people are taking in enough nutrition for their every day needs however, if they have been depleted for a period of time, they will need an enhanced programme and specific supplementation to counteract their deficiencies.
There are two types of nutrients - macronutrients and micronutrients. Macronutrients are the foundations of a healthy and fertile body. They include carbohydrates, proteins and fats. These need to be eaten in the right ratios dependent on a patient's lifestyle and underlying genetic make-up. In a consultation I help people work out what their optimal balance needs to be.
Micronutrients are nutrients that the body needs, in very minute amounts, in order to function optimally. They are the catalysts that help the body work most efficiently and effectively. They include vitamins (eg. C or E); minerals (eg magnesium and calcium); trace elements (eg chromium and copper), phytochemicals and antioxidants. Understanding where your body is lacking and addressing your specific needs can make the difference between having a successful outcome and almost being successful.
Micronutrient deficiency becomes even more of an issue when the couples are older and whilst they may have a great diet now, that may not have been the case in their 20’s or 30’s when they were training, or working hard and playing hard! It all needs to be taken account of.
My job as a nutritional therapist is to pin down deficiencies in micronutrients that may be causing difficulties with fertility and conception. It’s a complex business and requires an in-depth knowledge of chemistry and biology but the deficiencies are usually obvious to the trained eye and can be put right through a combination dietary advice, targeted supplementation and lifestyle interventions.
They key is finding out why the deficiencies arise – is it due to lack of a certain micronutrient in diets (eg not enough iron in vegetarian diets) or due to problems with absorption because of digestive issues? For example, patients with IBS are often lacking in micronutrients as the gut doesn’t have time to absorb them before they are expelled by the body. Stress also causes the body to use up its resources much more quickly than normal, so leaves you deficient in enough nutrients to help fertility.
Very often, I recommend a Hair Mineral Analysis which highlights deficiencies and give me a precise guide on which changes to recommend to a patient, but the aim is always to make it practical and manageable for you. Sometimes dietary changes seem be daunting, depending on where your starting point is, and patients either go for it full throttle or make smaller, incremental changes. Whichever way you want to go, these improvements can make a huge difference to your health and your fertility and also gives your baby the best start in life.
Ok, so they might be right about London where competition is fierce and prices are high, but we disagree about clinics here in Scotland. We know we're not over-endowed with IVF clinics up here but the ones we do have are mostly good and are patient, rather than money, focused. NHS IVF clinics, generally, do not offer many, or any, 'add on's' such as Assisted Hatching or PGD (except where genetic disorders are present). Most will offer Blastocyst transfer, which I would suggest is now the norm rather than an 'add on', and Uterine 'scratching' but we know from many years experience that they don't by any means push these on patients.
The one private clinic of note in Scotland, the GCRM (based in Glasgow but with satellite clinics in Dundee and Edinburgh), are very careful with what they advise couples. Our experience with them is that they look very carefully at the research and only recommend a treatment or technique if they think there is enough evidence to support it. We sometimes get frustrated when we read about, and have patients who successfully try, other interventions (such as immune system testing, which the GCRM is now providing) in London or abroad, but we appreciate that clinics here proceed with great care and we value that integrity.
From the perspective of our patients, we know many like to gain a wider perspective and have the options laid out in front of them. Here at the clinic we see it as part of our job to inform people about what's available both in the UK and abroad. Sometimes, a couple is happy not to find out more and would rather just go with what they've been offered but we're always here to provide information about alternative clinics or techniques to interested patients.
The BMJ also says in its report, that IVF is often offered to patients who don't need it and this we have found to be true. Conventional 'bio' medicine sometimes seems to bypass what we see as common sense and go straight to interventionist options. We have seen many, many couples where an irregular menstrual cycle, overwork (leading to high levels of stress hormones) or missing the time of ovulation is really all that's going against them and, although IVF can overcome the first and last of these, it need not be the first point of call. I have spoken to IVF nurses who say the same .... many of the couples they see do not actually need IVF at all. On the other hand, we have seen couples who, despite all the fantastic nutrition, acupuncture and other 'complementary' interventions, do not go on to conceive naturally but do conceive with IVF. In those cases, you can be sure that there is some physical or hormonal barrier which remains un-diagnosed but which IVF overcomes.
So all in all, we would say this BMJ report has some value if it makes patients more aware of being led up the garden path by unscrupulous clinics but, here in Scotland, our experience is that add-ons are carefully considered and offered in appropriate circumstances.
I'm not sure what's happening to me. On the Business Management HND course I did when I was 19, statistics were my most dreaded subject, along with accounts. Now however, that they seem to have a purpose and Excel has been invented (yes, it was that long ago), I actually really enjoy the number crunching. It's amazing what you can glean from a full spreadsheet of figures and it does really feel like 'data mining' - digging into the rock face of figures staring at me on the screen and finding those gems.
What's also lovely is seeing patients' names again - patients we treated way back in 2012. I remember them and the stories they told me, both happy and sad, over the time they came into the clinic. These memories give even a flat excel spreadsheet a warmth and richness of detail.
Of course, I understand that not many people out there get as much excitement from this as I do but I'm hoping that sharing our results means you can make informed decisions - whether or not it's worth coming to see us, for example - and whether you feel happy telling struggling friends about what we do. Not only that of course, the data also helps us keep track of how we're doing and, I'm very pleased to say, that our results/success rates have been consistently high since we started keeping track effectively (2012).
Here are some simple stats to get you in to the groove:
40% of our patients are using, or have used, ART (Assisted Reproductive Techniques) including IVF, ICSI, Egg donation and Sperm donation. That means, of course, that 60% are trying naturally.
22% of patients have had either one or more miscarriages.
14% of patients have been told they have 'unexplained infertility' and 12% have a Male Factor issue.
Importantly: 38% of the total number of patients we have seen since 2012 went on to conceive. That's from everyone, whether we actually know their results or not - when we don't know the outcome we record no pregnancy, although actually experience has shown us that people often have been successful but have just moved on in their lives and haven't remembered to tell us. Even better, of the 43% (359 people) from whom we have results, 85% have conceived.
Despite the excitement of number crunching, it's the patient's stories the shine through most in this exercise. Each little '1' in the 'pregnant' column is an overwhelming joy for you and a shout of jubilation for us. Each '0' in the same column is a deep sigh and a willingness to re-group, construct a new plan and to make things better next time. We share so much of your lives in the precious sessions in the clinic: some people want to chat, others want to close their eyes and lie still, but there is always an interchange of stories and ideas, which certainly enriches our lives and, hopefully, yours as well.
The Quiet House hits you right in the solar plexus with the raw, visceral emotions of what it's like for a couple trying to get pregnant and having to resort to IVF. From the opening scene, where Jess has to dredge up some sympathy for Dylan's stressful day, which has derailed her plans to make a baby that night, I was hooked. 'Emotional roller coaster' is a bit of a hackneyed phrase when it comes to trying to articulate how it feels to struggle with infertility, but that's exactly what this play is - the gut wrenching lows perfectly balanced with the euphoric highs - and a good dose of sweary comedy mixed in. It's beautifully well written by award winning playwright, Gareth Farr, and phenomenally well acted by the cast of four - it was a little bit terrifying to see Michelle Bonnard perfectly portray just how unhinged the experience of IVF can make you.
It's fantastic to see the topic of infertility aired so openly in this way. The play was shown this weekend as part of Fertility Fest, dreamt up and brought to life with aplomb by Jessica Hepburn, bestselling author of The Pursuit of Motherhood. Hepburn has fast become an authoritative voice on the topic of infertility, and Fertility Fest brought together 30 artists and 20 medical experts to discuss the issue. The joy of the whole event, as producer of The Quiet House, Gabby Vautier, said during the discussion with the cast after the performance, was that it made you feel something - it wasn't just about being told stuff.
This is so much more than an 'issue play' though – ultimately it’s the powerful love story between Jess and Dylan while they deal with tough times. 'It puts a magnifying glass on a modern relationship and it's beautiful', says Bonnard. Everyone in London planning on starting a family should go and see it. Everyone in London who knows someone planning a starting a family should go and see it. Actually, sod that – everyone in London should just go and see it.
Blog post 1
I’m 33. My partner and I are trying for a baby. A family. It’s proving much trickier than we thought.
The lovely ladies at The Natural Fertility Clinic are supporting us and they’ve asked me to share my journey with you. It’s a very personal one. It’s not one I’m sharing with many people and I'm finding it lonely. I’d spoken to Rachael about reaching out for support from the Clinic’s community, I let slip that I write, and we came up with this idea.
These are all my own thoughts, my experiences. They may reflect your own, they may not. You may disagree with what I say, how I’m handling things. Or something I write may reach out to you and make you feel you’re not so alone. Ultimately I’m hoping that by sharing something intimate that impacts so greatly on me everyday, but that is rarely talked about, that I’ll feel less alone too.
I’ll be publishing this blog regularly so please look out for it and comment, share, like, connect with me - and please be kind - thanks. Daisy
If you look up the word 'fertility' in a dictionary it will give you two definitions: 1. the ability to conceive children or young and 2. the quality of being fertile or 'productiveness'. Synonyms for this last definition include: fruitfulness, productiveness and prolificacy.
The article, Redefining our own fertility - and then realising we never lost it in The Huffington Post puts an emphasis on the this second definition of fruitfulness and productiveness and suggests that we have lost sight of this more general and generous aspect of Fertility. The author describes older women, in their 50's, 60's and 70's, who are enjoying a full life; exploring aspects of creativity beyond reproduction and childbearing and encourages us to discover and nourish our productive selves.
Working from within the fertility industry we tend to see only one side - that concerning reproduction. We witness the many patients who come looking for support and treatment when conception is either delayed, or, further down the line, improbable without medical help. It is easy to forget that there is a wider role for men and women as fertile beings in life.
In our role as supporters of sub- or in-fertile women and men, we should also encourage them to explore and develop the other fertile sides to their lives. Whether through sport, adventure, art, self-development, writing or even the way they manage their lives, we can try to bring to each patients' attention their ability to express themselves, create and be fertile in many other ways.