Monday 30 June 2008

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

Friday 27 June 2008

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

Sunday 22 June 2008

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

Thursday 19 June 2008

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 ?

Tuesday 17 June 2008

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

Monday 16 June 2008

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.

Thursday 12 June 2008

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

Monday 9 June 2008

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

Thursday 5 June 2008

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.

Wednesday 4 June 2008

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

Tuesday 3 June 2008

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

Monday 2 June 2008

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

Sunday 1 June 2008

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.