Happy Christmas

Happy Christmas to you all, and best wishes for 2009.

A tree for Christmas

If you're stuck for a last-minute Christmas present, you may want to consider dedicating a tree in the Fertility Forest.

The Fertility Forest is a joint venture between the Woodland Trust and Infertility Network UK, and anyone who has had any kind of brush with infertility is welcome to dedicate a tree in an area set aside on the Hucking Estate near Maidstone in Kent. It costs just £25 to dedicate a tree, and is open to everyone whether you are marking the decision to celebrate a new way of life without children, remembering a pregnancy loss or making a wish for the future. Others choose to dedicate trees to celebrate the arrival of long-awaited children, or grandchildren.

You can pay for a tree online and write your own dedication. There are more details on the Infertility Network UK website at www.infertilitynetworkuk.com

Men wanted - donor fathers to share stories

Do you know any fathers of donor-conceived children who may be willing to talk about their experiences? The Donor Conception Network are looking for some fathers to help at their highly successful Talking and Teling workshops.

If you - or someone you know - is the father of a child conceived usng donor sperm, eggs or embryos, the DC Network would like to hear from you. You would need to be happy to talk about your experiences, feel comfortable with the way you have created your family and willing to share your stories. You will be paid for the work, and training is given. You need to be available for at least three Saturdays a year. If you want to know more, you can get in touch with the DC Network through their website, www.dcnetwork.org .

If you're thinking of using donor sperm, eggs or embryos to become a parent, you can find out more about preparing for parenthood and the courses run by the DC Network from the website, too.

The risks of surrogacy overseas

More and more couples considering surrogacy are opting to do this overseas, where it can appear to be easier and cheaper, but the case of a British couple who recently ended up in the High Court to save their baby twins from life in a Ukrainian orphanage should give a warning of the dangers that can arise.

The couple had paid a Ukrainian woman more than twenty thousand pounds to act as a surrogate mother. However, the differing laws in the two countries meant that their twin babies were effectively left stateless and without parents. Under Ukrainian law, the surrogate had no responsibilities for the babies once they had been born, and the children had no right to residence in the Ukraine. However, under British law the surrogate and her husband were the children's legal parents, and this meant that the children had no right of residence in the UK either.

After a legal battle, the couple were awarded a parental order by the judge in the High Court and the children will become British citizens. However, the case illustrates the problems anyone who enters into a surrogacy agreement overseas can face, and why it is so essential to take legal advice before going ahead.

The Roman Catholic view

Pity any devout Catholics who are having problems getting pregnant - the Roman Catholic church has recently made clear that it is opposed to IVF as well as to embryonic stem cell research and the morning-after pill. One of the most difficult areas seems to be the freezing of embryos, where the Vatican says that not only is the destruction of frozen embryos wrong, but they should not be donated to other couples either, or used for research.

There are always ethical dilemmas when it comes to assisted conception, but many couples find that they soon forget any religious or moral qualms if they are offered a possible solution to the pain of infertility and childlessness. There's more detail on the Vatican's position here

The dangers of second-hand smoke

We may be well aware of the impact smoking has on fertility, but now new evidence shows quite how damaging someone else's cigarette smoking can be.

According to research carried out at the University of Rochester Medical Centre, women who have been exposed to cigarette smoke for six or more hours a day have a 68% higher chance of experiencing fertility problems or suffering miscarriage. What's most alarming is the fact that this doesn't have to be smoke a woman is exposed to as an adult - those who grew up with parents who smoked have exactly the same risK. So, parents who smoke may be putting their children's future fertility at risk.

The research is published online, and you can find out more at the University website at www.urmc.rochester.edu

Your chance to have a say

If you've found it hard to find answers to your questions when you've been comparing fertility clinics, now's your chance to have a say. The Human Fertilisation and Embryology Authority is interested in your views on how information about clinics is presented, and also on the new code of practice which includes information on the consent forms patients sign when they have IVF.

Most of us turn to the HFEA for information when we're looking for a fertility clinic, but not everyone finds it easy to access the information they want in the way that they'd like. The Authority is considering whether they should include information about the patient experience of clinics, and about safety and the quality of service. If you'd like to make your thoughts known, go to the HFEA website at www.hfea.gov.uk where you will be able to find out how to do this.

The truth about the male biological clock

If you're a man, worried about whether you've left it too late to have a baby with all the recent reports about the male biololgical clock, you may be interested in an informative piece from The Observer on the subject - see www.guardian.co.uk to take a look

Placebo acupuncture best for IVF

A fascinating new study has found that using a placebo for acupuncture in IVF patients increases the pregnancy rate. The researchers from the University of Hong Kong compared the pregnancy rates of patients undergoing acupuncture and those having a placebo instead. It found that the rates were markedly higher for the group who had the placebo treatment.

There is endless debate about acupuncture and IVF, and a whole host of studies with evidence supporting either side of the argument. This new research, published in the journal Human Reproduction, is an interesting new angle on the subject. You can find more at www.eshre.com

Ovary transplant success

The birth of the first baby born after a complete ovary transplant must offer hope to women who have been through an early menopause. The baby was born to a woman in her late thirties who had an ovary from her twin sister transplanted into her body after she went through a premature menopause.

The female biological clock is largely related to egg quality and quantity, and once this is in decline there is little that can be done to reverse it. The fact that the female body is still capable of maintaining a pregnancy after this stage can be illustrated by the fact that egg donation pregnancies are successful in women in their forties and fifties. However, this is the first pregnancy after an entire ovary has been transplanted and shows that a transplanted ovary can ovulate successfully.

You can read more here

New measures to recruit sperm donors

Finally, a call for measures to recruit more sperm donors... Anyone who needs treatment with donor sperm in the UK will be only too aware of the shortage of
donors here. It's often blamed on the removal of anonymity, although some say it has just as much to do with the lack of time and effort clinics have put into recruitment.

Now, the British Fertility Society has highlighted the problem, and is calling for new measures to encourage the recruitment of donors and to reduce waiting lists. The expert group suggests sperm sharing schemes could be considered, where couples who need fertility treatment could be offered it more cheaply if the male partner donates some sperm. They have also suggested that the limit on the number of children born from an individual's donation could be increased. You can read more about their proposals at www.britishfertilitysociety.org.uk

High-pitched voices mark ovulation

Well, here's a novel way of testing whether you're ovulating - check the pitch of your voice... New research has found that a woman's voice gets higher when she is closer to ovulation.

A team at the University of California monitored and recorded women's voices at different times during their menstrual cycle. They found that the pitch rose when a woman was close to ovulation, and was significantly lower during less fertile times of the month.

The research is published in the Royal Society Journal Biology Letters, and you can read more about it on the Royal Society website

HFEA conference

I had the pleasure of speaking at the Human Fertilisation and Embryology Authority conference yesterday, where the regulation of IVF treatment was up for discussion. I'm always pleased when the HFEA want to hear patient views but I must admit, I'd been rather daunted when I was given the title of the talk - "What patients want from a regulator". The reality is that most people going for IVF treatment are only concerned with one thing - whether they are going to be successful - and the role of the regulator is one of the last things on their minds.

However, it made me realise how much of what the HFEA does we take for granted as patients. We expect clinics to be inspected and treatments monitored, we expect to be able to feel confident that our eggs, sperm and embryos are kept safe, we expect to be able to get accurate information about clinic success rates. In the UK, our fertility treatment is quite tightly regulated, and it can seem that the pendulum has swung too far and that the regulation has become interference. Many fertility doctors complain openly about the HFEA, about the paperwork and the endless requests for information but for us as patients, it is absolutely crucial that we can feel secure and know we will be safe at any licensed clinic.

Meanwhile the HFEA has just published the latest national figures on IVF success - the numbers of patients having IVF has risen once again and the success rates have also gone up slightly. You can read more on the HFEA website

Procreation vacations

I've just been reading about the latest fertility-enhancing idea from the States - the procreation vacation! Yes, seriously...

They range from weekend breaks in luxurious and romantic hotels to full-on holistic fertility treatment extravaganzas with acupuncture and dietary supplements thrown in. We all like to imagine that maybe a bit more of this, or a bit less of that, accompanied by a few sessions of acupuncture or reflexology could make us fully fertile. Unfortunately, the reality is that for many people no amount of complementary therapy or romance is going to make a difference - unless it is accompanied by some medical treatment.

I'm not against complementary therapies - far from it - but I do worry that some people end up feeling they're never going to get pregnant if they don't opt for every fertility-enhancing offering available. The cost of many of these procreation vacations runs into hundreds of dollars a night - fine for those who have the spare cash, but that's not many of us in the current economic climate. If you can afford it and it will help you relax, then a procreation vacation may be for you. For most of the rest of us, there are probably far less expensive ways of helping ourselves feel suitably calm and relaxed - try a yoga class, or even a glass of wine!

What to do with spare embryos?

Couples going through IVF are sometimes left with spare embryos that they may not want to use themselves, and deciding what to do with them can cause all kinds of ethical dilemmas.

Now, researchers at the University of Ilinois have conducted a study to see what IVF patients think about the issue. It showed that 73% of the 1,350 women surveyed were in favour of their spare embryos being donated for stem cell research, and 56% would be happy for them to go to another couple for their fertility treatment. The researchers found that younger women, and those with less money, were more likely to be resistant to donating their spare embryos for reearch.

The findings are published in the journal Fertility and Sterility, and you can read more on the University of Ilinois website.

Autism link for older dads

We're always hearing about the female biological clock, and the risks for mother and baby of trying to get pregnant later in life. Now, new research from Japan has found a link between paternal age and autism.

The researchers found that children born to older dads had an increased risk of having an autistic spectrum disorder. However, when they looked at children born to older mothers, they didn't find any corresponding link. The research is published this month in the British Journal of Psychiatry

IVF pioneer wins award

Professor Robert Edwards, the pioneer whose work led to the birth of the world's first IVF baby, was given a lifetime achievement award at this year's Pride of Britain event. He may be in his early eighties, but Professor Edwards still maintains an active interest in infertility and treatment.

He faced condemnation when he began experimenting with in vitro fertilisation, and even after the birth of Louise Brown, the first IVF baby, in 1978 there was still widespread criticism from many other scientists as well as in the press. He weathered the storms, and was soon treating patients from across the world at the clinic he set up in Cambridgeshire. It wasn't long before others were achieving success with IVF, and more than three million babies have been concevied using the methods he perfected. This award is a much-deserved recognition of his pioneering work.

Back again

It's been a long time... Fertility Matters has had a very extended break - waiting for the Summer that never came. I'm pleased to tell you we are now back in business, and ready to bring you all the latest news and views on issues related to infertility and treatment. It's good to be back!

Time to celebrate in the East of England

Anyone who needs fertility treatment and lives in the East of England should be celebrating today with the announcement that the area is to be the first to fully implement the guidelines on fertility treatment and offer three full cycles of IVF.

This fantastic news will offer new hope to many couples living in Norfolk, Suffolk, Essex, Cambridgeshire, Hertfordshire and Bedfordshire. There are some criteria, but unlike those used by many other primary care trusts, these are perfectly reasonable - the female partner must be between the ages of 23 and 39, they should not smoke and there should be no existing children from the current relationship.

The funding will start next April - just five years after the initial guideline from the National Institute of Clinical Health and Excellence which recommended that all primary care trusts should be funding three full cycles of treatment. It may have taken time, but maybe now more trusts will realise that these guidelines are meant to be followed rather than ignored, and perhaps couples in other parts of the country will eventually be able to access the treatment they need.

You can read the full details of the proposals for the East of England at www.eoe.nhs.uk/news

To rest or not to rest

I've been thinking about the two week wait after IVF recently - not something I too often choose to remember, but I've been addressing the debate about bed rest after embryo transfer and whether it's a good thing in the new book I'm just completing.

Nowadays some holistic fertility centres recommend that you lie flat on your back for a few days after embryo transfer (once you've got home from the hospital, of course..), Back when I had treatment, I'd always been told that being fairly active was beneficial as it increased the oxygen levels in the blood. It seems that although doctors in the UK don't generally recommend bed rest, in other parts of the world they often do, which makes it all even more confusing for anyone having treatment.

I've been looking up the available research on the subject and it seems that most studies have found no increase in the pregnancy rate amongst women who have gone to bed for a few days after embryo transfer. In fact, one paper found that women who opted for bed rest had a LOWER pregnancy rate. However, many women do say that it helps them feel calmer and more relaxed. I think I've concluded that you just have to do what feels right for you, but whether that's lying on the sofa watching television for a few days or dashing about as normal, you should feel assured that whichever you choose is unlikely to have much influence on the outcome of your treatment.

A cause of endometriosis?

Scientists think they may have worked out why some women get endometriosis - a common condition where tissue similar to the womb lining starts growing elsewhere in the female body. Endometriosis occurs in about 15% of women, and it can affect their chances of getting pregnant.

Now scientists at Liverpool University have identified an enzyme called telomerase that they believe may be responsible. They hope that this will enable them to diagnose and treat endometriosis more effectively. You can read more details about the research, and the enzyme, at www.liv.ac.uk

The treatments that don't work for unexplained infertility

It seems that two commonly used fertility treatments are a waste of time when they're used to treat couples with unexplained infertility. A research project in Scotland looked at the use of Clomid (clomifene citrate) and IUI (intra-uterine insemination) and concluded that they neither of them really made much difference to the chances of conceiving.

The study followed 580 women with unexplained infertility. Some were prescribed Clomid, some were given IUI and some weren't given any treatment at all. Perhaps surprisingly, the lowest pregnancy rates were amongst the group who took Clomid. Although the IUI group did have a slightly higher pregnancy rate than those who had no treatment, the research team say the differences are small enough to be statistically meaningless, and have concluded that there may be no medical justification at all for prescribing Clomid or attempting IUI in women with unexplained infertility.

No one would want to be given a treatment that isn't going to work, and we must welcome any research that looks into the efficacy of fertility treatment. However, it does worry me that this may make it easier for local trusts to cut their spending on infertility yet further - at the moment many will pay for Clomid and IUI, but not for IVF. If they decide to stop spending on Clomid and IUI for unexplained infertility, I fear they are not going to increase their spending on IVF, and some couples may find that they can't access any kind of treatment at all. What's more, commissioners may start to assume that couples with unexplained infertility would all get pregnant eventually if they left it to Nature. I know from personal experience of more than 13 years of unexplained infertility, that this is not the case. So although it's helpful to know that these treatments may not be much use if you don't know why you aren't getting pregnant, it may not be so helpful if you end up not being able to access any other treatment instead.

You can read more about the research which is published in the BMJ at www.bmj.com

Polycystic ovary syndrome support

If you have PCOS, you may be interested in attending a one-day conference organised by the polycystic ovary syndrome support network, Verity. The agenda for the day has now been set, and includes discussions on nutrition, acupuncture and complementary therapies as well as fertility.

The event will take place in Manchester on 25 October, and you can see the agenda and book online at www.verity-pcos.org.uk

IVF rationing in Yorkshire

In one of the most ludicrous attempts at rationing IVF I've come across, women who need IVF in one area of Yorkshire will only qualify for funded treatment once they are approaching their fortieth birthday. North Yorkshire and York Primary Care Trust now only offers IVF to those who happen to be in the six months between the ages of 39 and a half and 40.

What possible logic can there be to limiting treatment to women who've reached an age at which it is far less likely to succeed? How can anyone consider this to be a sensible use of limited funds? It would perhaps be more honest to admit they are not really funding any treatment at all. The way treatment is being restricted by eligibility criteria in some parts of the country just goes to show how little understanding those who make decisions have of the things they are making decisions about...

I can only imagine that perhaps this is a deliberate attempt to make it impossible for anyone to qualify for NHS-funded treatment in the area, and to have so very few successful NHS-funded cycles that they can then claim IVF is simply not cost effective and stop paying for it altogether. The government keeps making noises about the unfairness of the postcode lottery, but surely a decision like this illustrates that it is time to give primary care trusts very strict guidance as many are clearly incapable of making sensible funding decisions themselves. You can read more about the situation in North Yorkshire and York here

Lifestyle issues

You've probably heard a lot in the last week about the survey of fertility experts that showed they thought people's lifestyles should be taken into consideration when deciding whether they should have IVF. The survey, for the British Fertility Society, questioned about 200 experts in the field, and just 29% of them thought that treatment should be offered to all, regardless of their lifestyle. So anyone who couldn't get pregnant and was overweight, who drank or who smoked should beware...

It is true that all of these things can affect your chances of conceiving, but it is also true that many people who smoke, who are overweight and who drink get pregnant naturally without any trouble. No one in their right mind would smoke or drink to excess when they were pregnant, but it does seem that those of us who don't get pregnant easily are expected to turn into paragons of virtue in order for others to feel we should be allowed to try to have children. We shouldn't forget the immense stress of living through year after year of trying to conceive unsuccessfully, and perhaps should forgive rather than chastise those who end up succumbing to bad habits every now and again. And when it comes to weight, one of the most common causes of female infertility, polycystic ovary syndrome, makes it harder for women to lose weight.

When I wrote The Complete Guide to Female Fertility , I gave lots of advice on lifestyle changes you can make to try to maximise your chances of getting pregnant because I know that people want to do whatever they can. However, it is also important to recognise that making your life utterly miserable in order to have the best possible lifestyle for conception may be counterproductive.
Professor Bill Ledger , one of the country's leading fertility experts, gave an absolutely fascinating presentation on this at National Infertility Day, in which he explained how guilty fertility patients are made to feel about their lifestyles, and how this can cause stress, which is known to damage fertility. It was a refreshing look at the subject, as all too often we end up feeling we are to blame for our fertility problems. Of course you should try to give up smoking, of course you shouldn't drink too much, and if you are overweight you should try to lose some excess pounds, but if you don't reach your ideal weight, or get drunk at a party, or find yourself having the occasional sneaky cigarette, you shouldn't feel you've ruined your chances of ever being allowed to try to have a baby. Guilt, Professor Ledger told us, is the new black!

But getting back to the
British Fertility Society survey ... Apart from the stuff on lifestyle issues, one of the main findings was that most experts in the field wanted to see more research into new techniques used in IVF, such as immume therapy and PGS, and felt they were offered to patients too quickly before scientific trials had shown them to be effective. This is something patients would welcome, as it is impossible to know who to believe or what to trust when the evidence on these treatments is so scanty. From the patient perspective, perhaps the most reassuring finding of the survey was that the majority of the experts believed fertility treatment should be funded by the NHS - maybe one day we'll see the implementation of the government's own advisory body's recommendation of three funded cycles for those who need them...

Your chance to hear the experts in reproductive medicine

You may not know that the Human Fertilisation and Embryology Authority holds an annual conference that is open to the public, and gives you the opportunity to hear from many leading experts in reproductive medicine about the latest news and developments in the field.

This year the meeting is to be held in central London on October 13, and speakers will include the Health Minister Dawn Primarolo and the new Chair of the HFEA, Professor Lisa Jardine. I've been to a few of the conferences, and although some of the subjects up for discussion can be quite complex and scientific, it's still possible to learn a lot about fertility treatment and the latest hot topics.

If you think you may like to attend, the details are on the HFEA website at www.hfea.gov.uk

Planning to use donor eggs or sperm?

Anyone who is faced with the prospect of using donor eggs or sperm may be particularly interested in the Donor Conception Network's annual conference which is to be held in Nottingham on October 11th.

This year, speakers at the conference will include donor-conceived teenagers and young adults who will talk about their experiences and what donor conception has meant to them. If you know you may need to use donor eggs or sperm, if you're about to start donor treatment, or if you already have younger donor-conceived children, this may prove to be an invaluable insight into how families deal with it and what young people think about the issue.

You can find out more on the Donor Conception Network website

The Fertility Forest

If you'd like to do something positive about your experiences of infertility or miscarriage, dedicating a tree in the Fertility Forest may be just the right thing. You will be donating money to charity, helping the environment and preserving precious woodland, whilst also leaving a tangible memory of what you've been through.

The Woodland Trust has just signed an exciting new contract with Infertility Network UK to join forces to plant the first ever Fertility Forest. The Woodland Trust has set aside land on the Hucking Estate in Kent for the project, and anyone who has had a brush with infertility can dedicate a tree at the site.

You may wish to dedicate a tree to commemorate a loss, or as a wish for the future. It may be marking the decision to embrace a life without children, or to celebrate a long-awaited arrival. Relatives or friends may also choose to dedicate a tree in the forest.

The scheme is open for dedications now, and will be officially launched at a planting event in November. If you'd like to find out more, take a look at the webpages here.

Treatment abroad - why so many are considering it

The results of the Infertility Network UK survey into fertility treatment abroad are now out, and they show that 3/4 of those who replied to the questionnaire would consider going overseas. The main reasons for this are the cost of treatment abroad, and the quick access, along with higher success rates and the availability of donor eggs and sperm.

It's often assumed that only those who need donor eggs and sperm are travelling for their treatment, because we know waiting lists in the UK tend to be long, but the results show that there are now many others considering going abroad for IVF, ICSI or other treatments using their own eggs and sperm.

There has also been an assumption that people going overseas for treatment using donor eggs or sperm are partly choosing to do this because they want anonymous donors. In fact it seems that many people don't want this, and that they are accepting donor anonymity as the downside of going overseas, and the price they and their future children must pay for quick access to treatment.

Of those who've been abroad, the vast majority have been happy with the treatment they've received, and the atmosphere, facilities and staff at overseas clinics were all singled out for praise. Just 12% of those who'd been to clinics abroad hadn't been happy, and in most cases this was down to language and communications problems. There had also been some issues with clinics charging more than patients had originally anticipated.

The survey shows that most people who go abroad for fertility treatment make all the arrangements themselves, and don't have recommendations from a clinic at home. This does highlight the importance of doing your research before you opt to go ahead with something like this. The UK fertility sector is tightly regulated and you shouldn't assume that clinics in other countries have to follow similar rules or guidelines. It is important to try to talk to others who've been to any clinic you are looking at, to make sure you understand the regulations the clinic must follow and to be sure you are as confident as you possibly can be that you are not going to encounter problems communicating with the clinic, or getting there when you need to.

Not too late for National Infertility Day

It's not too late to book for National Infertility Day this Saturday if you haven't done so already. It promises to be a fascinating occasion, and the presence of the IVF pioneer, Professor Robert Edwards, will be interesting as it marks thirty years since the birth of the first IVF baby.

There are a huge range of speakers covering virtually every topic you can imagine. You can learn more about the latest developments in fertility treatment, about male and female fertility problems, about donor issues and complementary therapies. There are sessions on surrogacy, adoption and involuntary childlessness as well as assisted reproduction. I am going to be speaking about treatment overseas, and sharing the results of a survey on the subject that will be released tomorrow.

The day-long event is held in Covent Garden in central London, and costs just fifteen pounds. There will also be the opportunity to visit the exhibition stands run by organisations and clinics involved in the field, and to buy books from the bookstand.

If you want to find out more, go to the National Infertility Day website at www.nationalinfertilityday.com

Too much ICSI?

When researchers first discovered that they could inject sperm straight into an egg in order to fertilise it (Intra-cytoplasmic sperm injection or ICSI), the prospects for men with fertility problems were transformed. Thousands of men were able to father their own genetic children thanks to ICSI when once they would have had to use donor sperm.

ICSI was soon being used in clinics across the world, and seemed to promise higher success rates than normal IVF. Some doctors no longer use it just for male fertility problems, but are also suggesting it for older couples or in cases of unexplained infertility. The European Society of Human Reproduction and Embryology meeting in Barcelona was told that ICSI is being used twice as often as IVF, despite the fact that it is far more expensive. What's more worrying, it doesn't actually improve the chances of success unless there is a male factor problem, so many people are paying more unnecessarily.

Some countries use ICSI far more than others. In the UK we have a relatively low ICSI rate, along with the Nordic countries, but in Greece, Italy and Spain it has become incredibly popular. You can read more on the subject on the ESHRE website

The male biological clock

Although we're often told about new evidence that suggests perhaps there is a male biological clock after all, the evidence doesn't seem to back this up. We've all come across men who have fathered children in their fifties and even sixties - at an age when women will have stopped producing any eggs at all

The latest research on the subject presented to the European Society of Human Reproduction and Embryology (ESHRE) in Barcelona earlier this week is interesting, as it suggests that women who have partners who are over 40 don't just take longer to get pregnant, but that they are also more likely to miscarry. The researchers studies couples who were having intra-uterine insemination, or IUI, and found clear patterns emerging where the male partner was over 40. It's thought age-related DNA damage may be the cause of the problem. You can read more about the research at the ESHRE website

Good news for frosties

I was fascinated to read that new research from Denmark has shown that babies born after frozen embryo transfers tend to weigh more, and to be less likely to be admitted to neo-natal units than their fresh counterparts. Freezing embryos is an everyday part of IVF, and yet the idea of a life being frozen in time is still quite extraordinary when you think about it.

When I started having fertility treatment about 13 years ago, some fertility experts were still suggesting that freezing embryos was potentially risky as we didn't know whether it would have any long-term side effects. Some patients chose to discard frozen embryos rather than "risk" freezing them. When I found I was pregnant after a frozen embryo transfer, I had to keep reassuring myself that the thousands of babies who'd already been born that way hadn't shown any adverse outcomes.

Now, this Danish study suggests that in fact frozen embryos may be stronger because they have to survive the freezing and thawing process, and that only the toughest will do this. You can read more here

Acupuncture and IVF

it's the one complementary therapy that we really thought could make a difference to IVF outcomes, and it wasn't just patients who were convinced - some clinics have allowed acupuncturists in to work with patients going through fertility treatment. Now, researchers are claiming acupuncture makes absolutely no difference. A team from Guy's and St Thomas' analysed all the published research on the subject, and concluded that there was no evidence that acupuncture had any effect at all on the chances of getting pregnant after IVF.

It had been thought that acupuncture could increase the likelihood of an embryo implanting in the womb if it was carried out around the time of embryo transfer, and that's one reason why it has proved so popular with fertility patients. In fact it seems the only clear effect of acupuncture is to reduce the need for pain relief at the time of egg collection.

When I wrote The Complete Guide to Female Fertility , I interviewed dozens of women who'd been through IVF, and many of them had tried acupuncture. Not one of them felt it had been a waste of time or money, and in fact most claimed they were sure it had made a real difference. Perhaps this is all psychological, but when we know that stress has a role in causing infertility, anything that helps reduce that must surely be of some benefit.

You can read more on this on the BBC website

The truth about IVF twin risks

You're probably aware of the controversy over moves to reduce the number of multiple births after IVF, but now the deep disagreements on the subject have been highlighted at a European fertility conference in Barcelona.

An American fertility specialist, Norbert Gleicher, claimed that doctors have been exaggerating the risks of twin pregnancies to try to mislead patients who will end up having more treatment if they put back one embryo at a time. His speech at the conference was immediately condemned by many leading fertility specialists, including the chair of the European conference, who are adamant that the claims are at odds with all the evidence.

Here, the Human Fertilisation and Embryology Authority has called on clinics to cut the twin rate in order to ensure babies, and mothers, do not face unnecessary risks. One of the problems with trying to do this successfully is that not all fertility doctors are behind the move and some, like Norbert Gleicher, believe the dangers are not so great.

For most patients, it is difficult to assess what any of this means in relation to your individual situation and how many embryos you should be choosing to put back in an IVF cycle. The reality is that single embryo transfer is never going to be the right thing for everyone, but for women who have a high chance of having a twin pregnancy, it can cut out the risks without having a great impact on the chances of success. How we view the risks as patients may be largely governed by how our doctors see them and if you're treated by Norbert Gleicher you're unlikely to be insisting on a single embryo transfer. If your doctor spends time explaining what the risks might mean for you, you may be happy to give it a go. If you want to find out more about single embryo transfer, there's lots of information on the oneatatime.org,uk website.

Predicting IVF success

One of the most difficult things about fertility treatment is that no one can really give you any idea of how likely it is to work. They may tell you that based on your age, or medical condition, your chances are slightly higher or lower than average, but predictions are always vague at the best of times.

Now, researchers in the United States have managed to predict with 70% accuracy whether IVF is likely to be successful or not. The team from Stanford University in California didn't use any amazing new techniques for the study, which was published this week. Instead, looking at 665 treatment cycles, they managed to work out how to predict success from existing evidence, using four basic measures.

They found the relevant factors were
1. The number of embryos
2. The number of embryos that had 8-cells
3. The percentage of embryos that had stopped dividing and would perish
4. The woman's FSH levels

By combining these factors, they found they could obtain a surprisingly accurate analysis of the chances of success. You can read more about the research at www.plosone.org

One at a time

Many people are understandably very concerned about proposals to cut the number of multiple births after IVF, and there's a lot of online chat about the issue. Some patients are worried that everyone going through IVF is about to be forced into putting back just one embryo at a time.

What's actually happening is that clinics with very high multiple pregnancy rates are being asked to try to lower them. Putting back one embryo at a time is never going to be a good idea for everyone, but in the right patients it can mean reducing the risk of twins without reducing the chances of pregnancy.

One study estimated that at least 220 babies die each year in the UK as a result of multiple births after assisted conception, twins are far more likely to be born prematurely and there are often other complications for both mother and babies. This is why high twin rates are such a worry.

If you want to know more about the issue, there's a new website with all the relevant information on the subject, not just for patients, but also for professionals, too. It's www.oneatatime.org.uk

Apologies

I'm afraid I haven't been updating much this week, but I've just been finishing my new book, the companion to The Complete Guide to Female Fertility, which is due out next year. The first draft is completed, and I'll be back on track again now!

There has been some interesting coverage of the postcode lottery for IVF funding this week, after the Department of Health published their survey of local primary care trusts. All the trusts were questioned about what arrangements they had for funding IVF, and the majority are finally offering one cycle of treatment. The problem is that some invent such stringent criteria that it's virtually impossible to qualify, and others refuse to pay for freezing and transferring any frozen embryos, which doesn't really count as paying for an IVF cycle. It's great that people are finally taking notice of this, four years after the government's own advisory body, The National Institute for Clinical Excellence, said that anyone who needed it should get three funded cycles. There doesn't seem much point in having an advisory body if you ignore the advice it gives, but at least people are finally starting to take some notice of the problems fertility patients face. You can see details of the survey at here

More evidence of damage cannabis causes to fertility

Many people assume that cannabis is really pretty harmless, but there's now yet more evidence to suggest that it has a damaging effect on male fertility. In fact both cannabis and opiates such as heroin and methadone can cause problems with the ability of the sperm to swim properly, or their motility. The new research found that sperm have a number of receptors that are affected by these drugs.

The good news about this is that the damage doesn't have to be lasting if you give up. It takes a few months for sperm to be produced, and you will notice an improvement in sperm motility soon after this time once you stop.

Good news on egg freezing

Anyone who is considering delaying motherhood, whether for medical or social reasons, will be pleased to hear that new research from Canada suggests that the latest methods of egg freezing are perfectly safe, and do not have any health implications for babies.

Many women who have cancer freeze eggs or ovarian tissue, as cancer treatments often destroy fertility, and this gives some hope of having a family in the future. It is also an option for those who want to delay having children for social reasons, often because they haven't met the right person to start a family with. Up until now, egg freezing has not been particularly successful, but the latest freezing technique, known as vitrification, ensures that far more eggs survive the process.

The new research followed up the children born as a result of this technique, and found they had no greater risk of health problems than others. It was carried out by a team from McGill University in Montreal, and you can read more in The Times online at www.timesonline.co.uk

When you can't have another baby...

Women who've got pregnant once tend to expect to be able to do it again, and yet apparently about a third of the patients in fertility clinics have been pregnant before, and are experiencing what's known as secondary infertility.

It's a difficult issue. GPs are often slow to refer patients to specialists for secondary infertility, assuming they'll get pregnant naturally if they keep trying, and couples themselves tend to delay seeking help because they don't believe they can have a fertility problem.

So how can it be that someone manages to get pregnant once, and then can't again? It is possible for problems to develop, or for a minor problem to become more serious, and age can also play a role here. It may be easier to overcome a minor fertility problem when you are in your early thirties. By the time you are approaching forty, the same problem combined with a reduction in your fertility may mean you don't get pregnant.

I was speaking to a consultant about this yesterday, and was surprised to hear that some of the patients who find it hardest to cope with fertility problems are those who are experiencing secondary infertility. For me, the raw yearning you feel when you can't have a child is never going to be quite the same when you can't have a second, or third. Of course, that doesn't make it any easier, and perhaps some people find it particularly tough because they know what they are missing? What do you think ?

Could you help highlight the need for egg donors?

If you've needed a donor egg to get pregnant, or have donated your eggs to help other women have children, The National Gamete Donation Trust would like to hear from you. They're launching a new campaign next month to try to highlight the need for more egg donors, and are looking for women who would be willing to tell their stories to encourage more donors to come forward. They're particularly keen to hear from anyone living in London. Birmingham, Bristol, Manchester or Liverpool who would be able to talk to the media. They will pay expenses and help you prepare for this.

This is a really important issue as there are incredibly long waiting lists for donor eggs in the UK now, and more and more couples are having to seek treatment overseas. If you think you may be interested, you can get in touch with the National Gamete Donation Trust at www.ngdt.co.uk

Fat men no less fertile

We've always known fertility is discriminatory when it comes to age, and whilst men can carry on fathering children when they're collecting their pensions, most women stop being fertile in their early forties. We've tended to assume that other factors, like being overweight, affect both sexes in the same way, but new research from the States suggests this may not be the case.

Researchers in New York looked at sperm samples from 292 men who had an average body mass index of 28, which is in the definitely overweight category. They found that weight didn't make any difference when it came to sperm quantity or quality. Although being overweight was linked to lower testosterone levels, this only seemed to have an effect when men were enormous rather than just on the big side. The results of the research are being presented at the annual conference of the US Endocrine Society this week.

Heartening news for any larger men out there - but perhaps not so cheery for larger women. However, doctors warn that men shouldn't use this as an excuse not to lose weight if they need to, as being overweight may have other health implications.

Fertility treatment slammed by experts

It was claimed it offered hope to those who were least likely to be successful with IVF - women who were over 35, who'd had repeatedly unsuccessful attempts at treatment or recurrent miscarriages. By screening embryos, some experts believed they could select the best ones to replace, and increase the chances of success. The treatment is called PGS, or preimplantation genetic screening, and although it was costly, many couples felt it was worth paying for anything that might increase their chances of success.

Now, a group of leading experts from the British Fertility Society have issued new guidelines on the use of PGS, as they say research suggests women who use it are LESS likely to get pregnant. PGS involves taking a sample cell from embryos and testing for chromosomal abnormalities. Only embryos that appear to be normal are replaced. However, in their early stages embryos can contain a mixture of normal and abnormal cells, so results may not be accurate.

There is controversy over the existing research in the field, with doctors who practice PGS claiming the studies that show it may lead to a reduced pregnancy rate are flawed. Now, the British Fertility Society says new research should be carried out as a matter of urgency to find out the truth for once and for all. That may come too late for anyone who is going through treatment, and considering PGS, but you may want to talk it through with your doctor before going ahead. You can see the British Fertility Society press release here

Should IVF be more successful?

I'm never sure whether to call him Lord Winston, or Professor Robert Winston, or Professor Lord Winston (does Professor go before Lord or after it?). Anyway, I'm sure you know who I'm talking about - the friendly TV fertility expert with the moustache... He's hit the headlines again after a speech at the Cheltenham Science Festival in which he claimed that the pregnancy and birth rates after IVF are too low.

Apparently, he said IVF success rates were disappointing, that there was not enough research looking at how to improve them, and that doctors were too complacent. He's also reported to have said that the chances of success could be doubled with new methods.

From a patient perspective, imagine what a difference it would make if he's right. The heartache, the time and the money that might be saved if treatment were twice as likely to work. It does sometimes seem that there is still so much we don't know about fertility, and the further down the line of tests and treatment you get, the more you realise how true this is. Neither doctors nor scientists can say why some embryos implant and others don't, and IVF appears to be a rather blunt instrument to solve very subtle problems.

I'm sure our fertility specialists would have a swift response to claims that they were complacent, and Lord Winston has rocked the boat before by challenging others in the field. It doesn't always make him popular with fellow clinicians, but if this ends up making a difference, he could be about to become even more popular with patients.

You can read about his comments online in The Telegraph at www.telegraph.co.uk

Fertility support Groups

Now it's so easy to talk to one another online that the traditional clinic support group has become rather neglected. It's much more convenient to be able to chat to one another online, and to be able to access support as and when you need it. It's also far easier, as it takes courage to walk into a roomful of strangers when the only thing you have in common is your fertility problems.

Earlier this week, I went to a clinic support group in Woking, and it made me realise that there's a lot to be said for this rather old-fashioned kind of get together. This group - like many others - has a speaker at most meetings, so you get the chance to learn more from people who are experts in their individual fields, and more importantly you also get to meet one another face to face. There was a very welcoming atmosphere, and by the end of the meeting people were happily chatting and swapping information which is what these events should be about.

It may not be easy to gather the strength to get there in the first place. I still remember how we dithered when someone set up a support group in our area. We nearly didn't get into the car to drive there, and then we nearly didn't get out of the car once we arrived, sitting there telling one another that we weren't the sort of people who went to support groups, as if anyone is... Once we'd managed to knock on the front door and get inside, it was incredibly reassuring to be in a roomful of others who all knew what it was like, and who weren't going to start asking those "when are you going to get around to having children" questions. For the first time, we even managed to laugh about some of our experiences, and we went home feeling so relieved that we'd finally met other people who were going through the same thing.

Of course, you can get that reassurance online. But you never know who you're talking to, and you don't have that human contact which can really help when you're feeling lonely and isolated. I wish more clinics made the effort to run support groups, but they aren't going to do that if they think patients aren't interested. I know it's not for everyone, but if you have a local support group, do think about giving it a try. You may be pleasantly surprised.

Last chance to give your views on treatment abroad

What do you think about the growing trend to go overseas for fertility treatment? Is it something you've thought about yourself? Or would you have grave concerns about the prospect? Have you already looked into it? Or perhaps even been abroad for treatment?

Whatever your thoughts on the subject, there's a last chance to air them by answering a survey on treatment abroad being carried out by Infertility Network UK for National Infertility Day in July. The survey is due to close in a couple of weeks, and the response so far has been fantastic - but if you've got strong views either way, don't leave it too late to make them known.

You can go straight to the survey here

Free calls for fertility help

It's now free to call Infertility Network UK to get help and advice on fertility issues. The charity has just announced a new freephone number that will enable anyone in the UK to call completely free of charge. The number is 0800 008 7464.

Infertility Network UK is the largest charity working for couples with fertility problems and can offer members help and advice on all aspects of fertility and treatment. You can see the charity's website at www.infertilitynetworkuk.com

Complementary therapies in Edinburgh

If you're based in the Edinburgh area, you may be interested in an evening about complementary therapies for fertility to be held in July.

The evening meeting will look at a variety of different therapies, with expert speakers discussing how they may help couples with fertility problems. You can find out about acupuncture, nutrition therapy, homeopathy,chinese herbs and hypnotherapy amongst others, and it may help you decide whether you want to give complementary therapies a try.

The event will be held on July 15, and is due to run from 6.30-9.30pm. There is a charge - twenty pounds for an individual, and thirty for a couple - and you can find out how to book at www.fertilityandbeyond.com

See the HFEA at work

If you've always wondered how IVF is regulated, or who the people are who do the regulating, don't miss the opportunity to see the Human Fertilisation and Embryology Authority at work next month.

The HFEA is holding an open meeting, which anyone can attend, on the afternoon of July 2. It will be held in central London. You can observe how the Authority makes decisions, and there is usually time for questions. There's an opportunity to meet the members of the HFEA afterwards over a cup of tea or coffee, and the new Chair, Professor Lisa Jardine, will also be there.

There is no charge to attend, but you do have to register first at www.hfea,gov.uk

Calling anyone in Woking

If you live in or near Woking, and happen to be free on Tuesday evening, I am going to be speaking at a meeting of the Woking Wish Support Group at 7.30pm.

The group meets at the Woking Nuffield Hospital in Shores Road - there are more details here . It would be great to meet you if you can make it.

Another IVF scandal story

You may have heard about the "exclusive" story in The Sun newspaper yesterday, claiming that a couple had abandoned their IVF twins in hospital after their birth because they were the wrong sex.

According to the report, the couple had left their twin girls in hospital because they'd wanted boys, and had immediately asked when they could start trying IVF again in order to have a child of the right sex. Their ages added to the scandal, as the husband was in his early seventies and his wife in her late fifties. Not only that, they'd also travelled to India for their treatment, and were of Indian descent. Since the twins had been born, the paper claimed the parents hadn't been to see them at all.

As is often the case with this kind of story, there does seem to be another side to it. The local trust involved has denied the reports, claiming that in fact the babies have been moved from the hospital where they were born to another closer to the parent's home so that they could see them more easily. Another member of the family has suggested that language problems may have led to some kind of misunderstanding.

Whatever the truth, it is stories like this that muddy the waters of opinion about fertility treatment, and add to the general assumption that IVF is too often abused. The reality is that this kind of IVF scandal story makes the front page precisely because it occurs so infrequently, and that the details seem to suggest that this one may not have occurred at all.

There's an update on the story in The Times at www.timesonline.co.uk

Commentary on funding

If you're struggling to pay for fertility treatment, at the end of a long NHS waiting list, or just wondering what the situation might be if you ever needed IVF, you'll be interested to read a commentary by Clare Brown, the Chief Executive of Infertility Network UK, about funding for treatment.

Four years after the government's own advisory body suggested those who needed IVF should have access to three funded treatment cycles, the reality is that in many areas people struggle to get any NHS treatment at all, and Clare's commentary highlights this very clearly. You can read it at www.bionews.org.uk

Fertility risk for painters and decorators

There's always a lot of speculation about exposure to chemicals and infertility, and now a new study has shown that men who work as painters and decorators may be putting their fertility at risk if they use products containing glycol ethers.

The study surveyed men at fourteen fertility clinics across the UK, and found that painters and decorators who used products such as water-based paints containing glycol ethers on a regular basis were two and a half times more likely to have poor sperm motility. Sperm should swim forward in a straight line fairly quickly, and those with poor motility may move erratically, or just twitch about rather than moving ahead, which makes them less likely to fertilise an egg suggessfully.

The research was carried out by a team from the University of Sheffield, and published in the BMJ journal Occupational Environmental Medicine. You can read more about it on the University website at www.shef.ac.uk

Identifying premature menopause risk

One or two women in every hundred will experience a premature menopause, when their ovaries stop functioning many years before they should. We know that for some women this seems to be a hereditary condition, and if your mother had an early menopause, you are more at risk of experiencing the same thing yourself.

Now researchers from China and the United States have identified a specific gene mutation that they've found in a percentage of women who have a premature menopause, and they hope to be able to use this to work out those who are most at risk. Details of their research can be found at www.ajhg.org

if you think you may be likely to have an early menopause, are experiencing menopausal symptoms way before you should or if you already know that you are amongst the percentage of women who have a premature menopause, you can get help and support from the Daisy Network

Chemicals and future fertility

We're all exposed to more and more chemicals in our everyday lives, found in everything from packaging to pesticides, and there's growing interest in how, or whether, these can affect our fertility.

Now, a team at Nottingham University have been given a grant to study the effects of some of these toxins on female mammal reproduction. They'll be focusing on how potential problems may pass from mother to foetus by studying sheep. It is thought that exposure to these products may not damage the fertility of the woman herself, but could instead have an impact on a foetus growing in her womb. If this proves to be the case, we may be storing up fertility problems for future generations.

There's so much discussion about chemicals and fertility, that it will be fascinating to see what the team in Nottingham uncover. You can read more about the project at www.nottingham.ac.uk

What counts as consent?

You may remember the case of Diane Blood, who had to fight to get the right to use her husband's sperm after he fell into a coma and died. She wasn't allowed to do this in the UK, and her legal battle went on for some years. Eventually, she was allowed to use his sperm, although she had to go abroad to Belgium to do so, and she went on to have two children.

Now another British woman is trying to follow down the same path. Her husband died suddenly, just a week after they'd been to see a consultant for fertility advice. She was granted permission by a judge to have sperm taken from her husband, but must now fight to be able to store and then use that sperm.

It's a tricky legal area, as it all focuses on consent, which someone clearly can't give after they've died, but in this case the woman must hope that the fact that they had been to see a specialist so shortly before his death must make his intentions at the time very clear. The woman's MP, Vince Cable , has now proposed a change in the law so that evidence from a fertility specialist in a case such as this can be admissable.

You can read more about the story here

Could you be a member of the HFEA?

The Human Fertilisation and Embryology Authority, the body that regulates IVF in the UK, is looking for a number of new members. Some will be doctors or scientists who have experience in the field, but the majority of spaces on the authority are for lay members, who will have other relevant skills to offer. It's a fascinating opportunity for anyone who has an interest in this area, and if you want to find out more you can follow this link

That bill again

If you do have a particular interest in the Human Fertilisation and Embryology Bill, you may be interested to know that you can see the the amendments to the Bill under discussion at the Commons website at www.publications.parliament.uk . It probably won't make much sense if you're not following the progress of the Bill with a keen eye, but anyone who is may want to check it out!

Talking and Telling for donor parents

You may have read here before about the "talking and telling" workshops for parents of donor conceived children, or anyone pregnant with a donor conceived baby. The series of events have now kicked off successfully with a first meeting in Oxford, and another this weekend in London. They've been filling up quickly, and the London dates are now full with waiting lists, but there are still some spaces at most of the other workshops if you haven't had a chance to book. The Donor Conception Network, who are responsible for organising the workshops, say they'll be arranging another date in London in the Autumn, and if you're interested in learning more about the workshops, or booking, you can do so via their website at www.donor-conception-network.org

Waiting rooms

What is it about fertility clinic waiting rooms? I've spent a lot of time in them - both as a patient and whilst researching my books - and however different they may look, they all have that same weird atmosphere.

I suppose you could say that hospital waiting rooms are never pleasant places to be, but there's something particularly odd about fertility clinics. It's almost as if you can feel the hope and fear and anxiety in the air. When you're going through a treatment cycle, they soon start to feel like a second home. You often see the same people there, who you know are probably going through the same treatment at the same time. And yet, it's most unusual for anyone to break the ice and actually talk to anyone else. We're all there, in the same boat, experiencing the same emotional traumas, and yet we avoid looking one another in the eye, let alone smiling or having a chat. I did once have a conversation with someone in a clinic waiting room. Once. In more than six years of going to the clinic, and spending I hate to think how many hours in that always overcrowded room.

So what is the best strategy for getting through all the time you spend in the waiting room? I read something the other day that suggested taking a good book. That's a great idea if you can concentrate on a good book when you're waiting to find out how many follicles you've got and whether they're growing properly. Newspapers may be easier, or a magazine. Some clinics do have a television in the waiting room, but the last time I was in a waiting room with a TV, it was showing one of those house-finding programmes, with a woman who was heavily pregnant and in need of a new house because she wanted more space. No one dared to turn over. We all just focused on the chlamydia leaflets instead.

Perhaps the ideal solution to the waiting room problem is to take the fertility book or magazine you don't want to be seen reading on the train or in the office canteen. You'll be able to concentrate on something so relevant to your situation, and for once you don't have to worry what anyone else might think.

DNA testing

We've come along way in the thirty years since the first IVF baby was born, but the sticking point for scientists and doctors is implantation. We still can't be sure which embryos are most likely to settle into the womb lining and develop, and we don't know why some embryos that look beautiful in the laboratory don't lead to a successful pregnancy.

A research team in Australia have just published some interesting work, taking samples of cells from embryos that have been allowed to develop in the laboratory for about five days, to become what is known as blastocysts, or embryos that are ready to implant. The team used DNA fingerprinting on the cell samples, and the blastocysts were transferred to the patient's wombs as normal. They then took DNA samples from the babies that were born after this, and by comparing them were able to work out which blastocysts were most likely to implant.

It is still very early days with this kind of research, but it does give hope that at some point, fertility treatment will be able to become far more successful, and if we know which embryos or blastocysts are viable, it will also make it easier for patients to avoid the risks of multiple births. The results have been published in Human Reproduction

Commons debate on Human Fertilisation and Embryology Bill

For anyone who is really interested in the Human Fertilisation and Embryology Bill, the full debate from the House of Commons can be read from Hansard here

Parliamentary debates are always rather long-winded and verbose, but if you're particularly interested in the progress any of the issues in the Bill, it may be worth wading through to find the subjects you want to follow.

MPs debate Human Fertilisation and Embryology Bill

MPs are discussing the new Human Fertilisation and Embryology Bill in the Commons today, with interest focusing on some of the more controversial proposals. It's the bill which is at the root of all our current rules and regulations about IVF and embryo research.

The MPs will be able to vote according to their conscience on issues such as hybrid embryos, which cause particular difficulty for Roman Catholics. Hybrid embryos are created using a mixture of human and animal genetic material, and have great potential to help in the treatment of genetic conditions. They are never allowed to develop, and there is no possibility of a hybrid embryo being implanted into a womb and becoming a viable pregnancy, but some feel even an embryo is a step too far.

Then there's the issue of what are known as "saviour siblings" where parents use diagnostic tests along with IVF to have a new baby who will be genetically matched to an existing child with serious medical problems. Bone marrow or cells from the umbilical cord of the new baby can then be used to help save the existing child.

And there's also the issue of the "need for a father". The curent law says clinics must consider this before carrying out IVF treatment. In reality, it's something clinics often choose to ignore anyway, as lesbian couples and single women have been having fertility treatment for many years. Getting rid of this is sometimes seen as an attack on the role of the father, which is perhaps a rather emotive response to an overdue update in order to stop the law being discriminatory.

It will be interesting to see how MPs choose to vote on the bill, and whether they are more swayed by the scientific arguments, religious opinion or their own instinctive qualms about some parts of the legislation. You can read more here

For anyone with polycystic ovary syndrome

If your life is affected by polycystic ovary syndrome (PCOS), you may be interested to know that Verity, the support network for women with PCOS, is organising a conference on the subject in the Autumn.

Held in Manchester on Saturday 11 October, the conference will include sessions on how acupuncture can help and on acne and PCOS as well as a talk from one of the country's leading fertility experts, Professor Bill Ledger of Sheffield University.

You can find out more about the conference, and book yourself a place, by visiting the network's website at www.verity-pcos.org.uk

Polycystic ovary syndrome is a common cause of female fertility problems. Many women have lots of small cysts just below the surface of the ovaries, which are actually follicles that haven't developed properly. Generally the cycsts aren't accompanied by any other problems, but if you have PCOS, you will usually have irregular, infrequent or absent periods. The syndrome is sometimes associated with weight problems too, and other signs that can accompany it are unwanted facial or body hair and skin problems such as oily skin or acne.

Support for single women

If you're a single woman contemplating motherhood alone, you may be interested to know that the Donor Conception Network now has a web page for those in your situation. Not all of the single women in the network have fertility problems, but some do and it may be helpful just to talk to other women who are considering becoming single parents using donor sperm.

The network has contacts around the country and can put you in touch with other women in your area, which can be an invaluable source of support. You can see the new page on the Donor Conception Network website at www.donor-conception-network.org/single_wmen .

You may also be interested in the chapter in my book, The Complete Guide to Female Fertility which considers going it alone to become a mother.

An idea when treatment doesn't work

When we think of using complementary therapies for infertility, we always imagine using them to try to help get over a fertility problem, to get our bodies into the best condition for treatment, and then perhaps to calm and relax us once we are being treated. What we may not think about is turning to a complementary therapist if the treatment doesn't work, but this can be the time when they are really very helpful.

Most of us feel completely devastated when the fertility treatment we've invested so much hope and money in doesn't work. When you've been spending lots of time going to and from the clinic, you may feel isolated and abandoned if your treatment is unsuccessful, and it can seem as if no one is interested any more. Friends and family don't understand how awful you feel, and however much they try to say the right thing, they often end up making you feel worse.

This is perhaps when you could really do with the calming and relaxing effects of some kind of complementary therapy, not to mention the time to talk that you often get in a session with a therapist. It was during an interview I did with a homeopath for my new book just a few days ago that she mentioned how helpful homeopathy could be for people who'd been through treatment that hadn't worked - and it made me wonder why there wasn't more interest in using complementary therapies in this way. Perhaps it's partly because we are too often looking to them for miracle cures, rather than the calming support which they can so often provide.

Surrogacy laws

Anyone who is either considering surrogacy, or has an interest in the subject, may be interested to read an online commentary on the subject written by solicitor Natalie Gamble, who specialises in fertility law.

Writing for BioNews, published by Progress Educational Trust, she puts a strong case for changes needed to the current surrogacy law. She explains how the "intended parents" - that is those who wish to have the child - are currently not considered the legal parents at birth, and explains why this makes things difficult. With more and more people travelling abroad for surrogacy arrangements which can be cheaper and easier to arrange outside the UK, she also details why this can cause real problems for both parents and for the child concerned. You can read her commentary at www.bionews.org.uk

Is ovarian tissue freezing for cancer patients safe?

When women who would still like to have children discover they have cancer, they are often offered the option of freezing eggs or ovarian tissue for use in the future, in order to preserve their fertility which is often destroyed by the cancer treatment regimes.

Now, a team of Israeli researchers have raised questions as to whether this could lead to women being re-infected if the tissue isn't properly screened before it is returned to the woman's body. They suggest that very few fertility clinics have the expertise to screen ovarian tissue properly to ensure that this can't occur, and have concluded that proper testing is necessary before tissue is put back into the body if doctors want to eliminate that risk.

The Israeli research has been published in the journal Human Reproduction

Nurses call on government to end IVF lottery

Members of the Royal College of Nursing have voted to call on the government to fund three cycles of IVF for those who need it, and to put an end to the current postcode lottery for treatment.

Delegates at the RCN's annual Congress voted nine to one in favour of the proposal to lobby the government to ensure that local primary care trusts put the guidance they were given four years ago into action.

In 2004, the National Institute for Clinical Excellence (NICE) recommended that the primary care trusts should fund three cycles of IVF for those who needed it. At the time it was welcomed by all those in the field, but things have not improved for patients since.

in some areas there is still no funding for IVF at all. In others there is funding for one cycle, but many primary care trusts have invented their own eligibility criteria which means that many couples don't qualify.

It is wonderful news that the Royal College of Nursing have recognised the heartache caused by the current system, which has been branded a 'disgrace'.

The story has been taken up by the Daily Mail, and you can read more about it at www.dailymail.co.uk

The best test to predict menopause

I was particularly interested to come across some new research from the Netherlands after my last post about ovarian reserve tests. A team from the University Medical Centre in Utrecht have concluded that anti-Mullerian hormone, or AMH, is the best way to test a woman's reproductive age.

AMH is a hormone produced by the follicles in the ovary when they are still at their tiniest stage, and the levels of the hormone seem to be the surest way to predict the ovarian reserve (the number of eggs left in the ovaries) and to see how close an individual may be to the menopause. The research team studied 144 healthy, fertile volunteers, and used their AMH levels to predict their reproductive age. They concluded that AMH levels are able to predict this better than your chronological age, as women will not all reach the menopause at the same point in their lives.

The research is due to be published in the Journal of Clinical Endocrinology and Metabolism, and you can read more about it at http://jcem.endojournals.org

Ovarian reserve testing

I've just been reading about the launch of a new "biological clock" test for women, but on closer investigation it turned out to be the American launch of a product we've had here in the UK for a few years now.

PlanAhead is a test of your ovarian reserve, a term used to describe the quality and quantity of eggs left in your ovaries, which can give an indication of your fertility. PlanAhead involves a blood test for three separate hormones, FSH (or follicle-stimulating hormone), AMH(or Anti-Mullerian Hormone) and Inhibin B. Anyone can buy the test, but you then book yourself in for a blood test either privately or with your family doctor, and send off the resulting blood sample to the lab for a result which comes back within a few weeks.

PlanAhead is a good test because it looks at the levels of all three hormones. Traditionally, doctors have used FSH testing to get an indication of a woman's ovarian reserve, but experts in the field now believe AMH may be a better test. However, it is an expensive test, and if you have any reason to believe you may be approaching an early menopause, you'd be better off asking your doctor to do the test without shelling out for it yourself. It's also really important to understand that this isn't a test of your fertility, just of the store of eggs left in your ovaries, and you shouldn't assume that a good result means you'll be able to get pregnant when you want to, as there could be all kinds of other fertility problems that this test wouldn't highlight.

If you are interested you can buy the test online at www.planaheadtest.com

Bananas for boys

You've probably heard about the new research suggesting that women who eat bananas, and breakfast cereal, are more likely to give birth to boys.

The research group from Exeter and Oxford Universities looked at what women had eaten in the months before they got pregnant. They found that those who had high-calorie diets were more likely to have boys. Breakfast cereal appeared to play a major role, and women who ate it had a significantly higher chance of giving birth to a son. Intake of potassium - found in plenty in bananas - and salt also seemed to be relevant.

I wonder whether these findings would still be relevant for embryos fertilised in vitro...

You can see details of the research on the Exeter University website at www.exeter.ac.uk

Easy IVF

According to The Times , IVF could be about to become so much easier that you could do it in your lunch hour.

Apparently a new device called Invocell would enable most of the treatment to be carried out in a GPs surgery. Instead of mixing eggs and sperm in dishes in the laboratory, the eggs would be put into the device along with washed sperm, and then put back into the vagina. The device would be removed a few days later and fertilised eggs could then be transferred into the womb.

It all sounds quite straightforward, but even with this device, you'd still have to have eggs collected from the ovaries, which isn't something you are ever going to be able to do in your lunch hour, and from a patient perspective I'm not entirely sure the advantages of saving on laboratory bills would make it worthwhile. You can read more at www.timesonline.co.uk

Hope for cancer patients from new research

For some time, fertility clinics have been storing ovarian tissue from women who have cancer and have to undergo chemotherapy, as this can destroy the ovaries and lead to infertility.

Until now, storing the tissue has been a measure doctors have undertaken in the hope that at some point in the future, it may be possible to use it to develop eggs in the laboratory.

Now a team from Edinburgh University have managed to do just that. They added artificial growth hormones to ovarian tissue taken from volunteers who were having caesarean sections, and managed to observe a number of follicles, or egg sacs, developing in the tissue.

It has been suggested that this research means the eggs that develop inside follicles could be used for IVF for cancer patients, and even that it could offer an opportunity for all women to preserve their fertility by freezing ovarian tissue. However, it is important to note that the research team admit they are a long way from this at present, and that they cannot be certain that the eggs they are growing in the laboratory are normal. Despite this, it is still a significant scientific development and a large step forwards. There's a balanced analysis of the research here

A new look

I hope you like this new green look - I think it's more fun than the old one, but if no one else likes it and it hurts your eyes / gives you a headache / is just too green, then let me know, and I'll think about changing back to the old one!

New IVF technique

I've just been reading about a "new technique" for IVF, which researchers claim could double IVF success rates if recent trials using mice can be replicated in humans.

The trials have been carried out at the University of Adelaide, and the researchers have been given a grant to carry out further investigations. The new method involves putting just one embryo back in the womb, and it is hoped that the increased success rates would lead to more patients opting for single embryo transfer which would cut out the risks associated with multiple births for both mothers and babies.

Despite reading a number of reports on the subject, I'm still no clearer as to what this "new technique" might involve, or how it could double the IVF birth rate, but if you want to read more, you can see an Australian news report here

Questions over vitamin supplements

Many of those experiencing fertility problems, or going through treatment, will be taking vitamin supplements in an attempt to boost their general health and increase their chances of conception, and the recent debate over the efficacy of some of these supplements is bound to be of interest.

Complementary fertility therapists often believe that vitamin deficiencies can play a role in fertility problems, and many prescribe their patients with a cocktail of supplements to try to help.

The latest study on the subject was a review of 67 existing studies into the use of vitamins A, C and E, beta-carotene and selenium, which have been considered to help increase life expectancy due to their antioxidant qualities. In fact, the researchers found no evidence that the supplements could help you live longer, and in the case of vitamins A and E and beta-carotene, there was actually some suggestion that they may have completely the opposite effect, with vitamin A in particular increasing the risk of death by 16%.

Many doctors believe that most of us should be able to get all the vitamins we need by eating a healthy diet, and there are concerns about people taking combinations of many different vitamins in large doses. There is no evidence in this study about fertility, but it does perhaps show that you shouldn't assume that all vitamin supplements are always good for you.

The study was a Cochrane review, one of a series of studies which looks at all the existing research on a particular subject in order to draw a balanced conclusion, and you can read more on the website at www.cochrane.org

Research identifies problems for lab-matured eggs

Researchers from Yale University have been looking at egg development in the laboratory, and may have found some clues as to why in-vitro maturationn (IVM), hailed of late as a great new advance in assisted reproduction, doesn't have higher success rates.

In standard IVF, eggs grow in their natural environment in the ovary and are given their last hormonal boost to mature them inside the female body. However, IVM, or in-vitro maturation, involves taking immature eggs from the ovaries and maturing them in the laboratory. It uses less drugs and is cheaper than IVF, so was heralded by many as a significant way ahead, but it is not suitable for everyone as you need to have lots of immature eggs in the ovaries to make it worthwhile.

The research team looked at eggs matured in the laboratory and compared them with eggs that were matured in the woman's body, and found that there were significant differences in their genetic development. The eggs matured in the lab had differences in their gene activity as they developed, and in their genetic profile.

This new research suggests that we don't yet have the ideal laboratory conditions for maturing eggs, and this may be why IVM success rates are not higher. The research team were aiming to find better ways to culture these immature eggs, and to identify the eggs most likely to lead to a pregnancy. The details of the research are on the Yale website " www.yale.edu

Workshops for donor parents

Bookings are now open for the first dates in a series of workshops aimed at parents who have used donor eggs, sperm or embryos. The one-day courses are also open to anyone expecting a baby conceived using donor gametes.

The "Talking and Telling" workshops are organised by the Donor Conception Network, a self-help organisation for families created with the help of donor eggs, sperm or embryos and for those who are hoping to start a family this way. The network also supports adults who were conceived using donor gametes.

The workshops will look at how and when parents can tell children about their conception, and will also provide a valuable opportunity to get to know others in the same situation; whether other parents, or others who are expecting a child.

The first workshop is on May 10 in Oxford, followed by May 17 in Twickenham, June 7 in Amesbury, June 21 in Bristol and July 5 in Bloomsbury.

The Donor Conception Network is also planning some workshops to help those who are considering parenthood using donor eggs, sperm or embryos but the dates and locations have yet to be set for these.

You can find out more on their website www.dcnetwork.org

Fraudulent online donor services

Anyone considering using an online sperm donor service should be warned by the conviction of the founder of one such company for fraud and financial misconduct.

The company was offering fresh sperm, delivered to your door, and claimed to have had around 5,000 customers. However, the very fact that they were offering fresh rather than frozen sperm rang alarm bells for experts, as it suggested they couldn't be carrying out proper screening and checks on the samples they were offering.

Now it has emerged that behind the scenes money was being siphoned off, whilst the company was claiming to be pursuing a mission to help women get pregnant. According to reports, customers had reported problems such as samples being delivered by minicab, or in one case in a dirty coffee flask, and employees claimed people were not always sent sperm samples from donors with the physical characteristics they'd requested.

Finding a sperm donor through a reputable clinic may take more time, but the safeguards that are in place will ensure you know your donor has been properly screened and that the sample they have provided is safe.

You can read more about the case here

New approaches to IVF

You may not be aware of the existence of the International Society for Mild Approaches in Assisted Reproduction, or that it held a World Congress on the subject in London a few days ago, but if you've had any personal experience of IVF, you would probably welcome moves to make it an easier treatment.

When you go through an IVF cycle, you can end up feeling like a battery hen as your ovaries are stimulated to churn out more eggs at one go than Nature would deem possible. The doctors and scientists in the International SocIety for Mild Approaches in Assisted Reproduction are advocates of a more gentle approach, which they hope will prove to be just as successful.

Some consultants do offer a form of IVF where you don't take any drugs to stimulate the ovaries, known as natural cycle IVF. Although it has many advantages, it doesn't have particularly high success rates, which often puts people off. Now, more doctors are considering mild, or "soft", IVF where patients are given far lower doses of drugs. There will not be as many eggs, but research presented at the World Congress suggests that the resulting embryos may be better quality, with fewer genetic abnormalities.

This milder approach can cost less as it cuts down on the hefty IVF drugs bill, and it can also be less risky for patients, as it reduces the chances of over-stimulating the ovaries which can be dangerous. IIVF may seem a bit of a sledgehammer treatment for what are often subtle fertility problems, and a milder form of treatment could be the way ahead.

Nurses to debate fertility funding

Members of the Royal College of Nursing (RCN) will discuss funding for infertility treatment in a debate at their annual conference in Bournemouth at the end of the month.

The RCN's Congress will consider a motion calling on the union to lobby for proper funding for fertility treatment, recognising the inadequacies of the current system. Most people still pay for their IVF in the UK, despite the recommendation by the National Institute for Clinical Excellence (NICE) that women under 40 who needed IVF should get three cycles of NHS treatment. That guideline was issued in 2004 and at the time the government responded by saying that, as a first step, all those under 40 who needed IVF should get one NHS cycle by 2005.

In fact, this still hasn't happened. Instead, there are a wide variety of different criteria applied in many areas to make sure fewer women will qualify for their single cycle of treatment. In other parts of the country, there is simply no funded treatment available at all. Whatever you think about funding for fertility treatment, the current system is unfair and causes heartache for thousands of couples who find they can't get the help they need.

You can read more about the RCN motion on the issue at the union's website www.rcn.org.uk

Thirty years of IVF

This year's National Infertility Day in July will mark thirty years of IVF with a speech from Professor Robert Edwards, the pioneer whose research led to the birth of Louise Brown, the first IVF baby, in 1978.

National Infertility Day is open to anyone who'd like to attend, and a whole host of speakers will cover a wide range of fertility-related topic from specific medical treatments and conditions to complementary therapies and ethical issues. There will also be a good selection of exhibitors, all giving their own advice and information on infertility and treatment. The event is being held at the New Connaught Rooms, close to the heart of London's Covent Garden, on July 19th.

The organisers have also just announced an evening social event with a champagne reception and barbecue at the Grange Whitehall Hotel, where delegates will have a chance to mingle with speakers and exhibitors.

You can book a place now online at www.nationalinfertilityday.com

Metformin and polycystic ovary syndrome

It's a drug that was developed for the treatment of age-related diabetes, but in recent years metformin has been fairly commonly prescribed to women with polycystic ovary syndrome. However, recent studies have suggested that it may not be particularly useful in helping them ovulate or increasing pregnancy rates.

Now researchers in the States have discovered that the way women with polycystic ovary syndrome (PCOS) respond to metformin may all depend on a variation in a particular gene which is involved in controlling levels of blood sugar, and that the women were more likely to ovulate after taking the drug if they had this variation. It may help to explain some of the conflicting data on the subject.

Polycystic ovary syndrome is one of the most common causes of fertility problems, as most women who have it ovulate irregularly or infrequently. It is often associated with weight problems, and may also lead to unwanted body or facial hair and skin problems. Women who have PCOS usually have imbalances in their hormones.

You can read more about the research here . Anyone who is affected by polycystic ovary syndrome, or wants to learn about it, may like to look at the website for that national charity supporting those with PCOS, Verity www.verity-pcos.org.uk

Synthetic oestrogens and fertility

We are often told that environmental toxins can damage fertility, but it is not something fertility doctors usually rush to suggest as a cause of an individual's fertility problem as it is often impossible to tell exactly what might be to blame.

Researchers at Yale School of Medicine have been investigating the way synthetic oestrogens, which are sometimes found in plastics, can impact on our future fertility. They exposed mice to a particular type of synthetic oestrogen, DES, which is actually no longer widely used but which they believe has a similar effect to other products we may often encounter. They found that the synthetic oestrogen alters the gene which is necessary for uterine development. The future fertility of the female offspring of the mice exposed to DES was found to be affected.

There seems to be growing evidence that some of the fertility problems we are experiencing today date back to our mother's wombs, but what is possibly more alarming is the worry that we could still be unintentionally putting the fertility of future generations at risk. You can see more about the Yale research on their website www.yale.edu

Premature birth risks

We've always known that there were many short-term risks for babies born prematurely, but new research suggests that some of these health risks may carry on into adulthood.

This may be of particular interest to anyone going through fertility treatment, as the question of whether to put one or two embryos back is often a difficult one for patients. Of course, everyone wants the best possible chance of getting pregnant, but at the same time, the risks associated with multiple pregnancy cannot be denied.

Prematurity is the greatest danger for twins and triplets, and this new research suggests that those born before 37 weeks may face long term complications throughout their lives even if they don't seem to have any immediate problems. The teams from Duke University Medical School and Bergen University found that the earlier you are born, the higher those health risks will be.

You can read more about the study at www.dukemednews.org