fertility road magazine issue 1

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ISSUE 01 | SPRING 2010 £3.95/€4.95EUROPE'S NO.1 FERTILITY MAGAZINE

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TRAVELLING FOR TREATMENT:

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AGED TO PERFECTION?How To Know When

The Time Is Right

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“Motherhood is my raison d’être” ISSUE 01 WWW.FERTILITYROAD.COM

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04 fertility road | spring

FERTILITY ROAD

CONTRIBUTORSIntroducing the Fertility Road team...

ISSUE ONE - SPRING 2010

Group Publishers: Jeff Crockett, Ginny Garrick, Giorgio Severi

Managing Director: Alex Gordon

Managing Editor: James Evans

Contributors: Kelly Rose Bradford, Carrie Dunn, Andy Greeves, Sarah Hart, Siobhan O’Neill, Johanna Payton, Zita West, Jani White

Art Editor: Damian Browning

Sales Manager: Daisy Chadwick

European Sales: Anastasia Horsen, Frederica Martinez, Toby Price, Katie Putricks

Client Liason Offi cer: Tracy Carter

Reprographics: KFR Pre-Press

Printed by: ACORN printing

Cover image: Dan Kennedy / Celebrity Pictures

Advertising Enquiries: [email protected]

Contact details: Fertility Road MagazineSuite 318, Building 50, Argyll Road, London SE18 6PPTel: 020 8316 8923Email: [email protected]

www.fertilityroad.com







The Time Is Right

5 GREATGUIDES



AW, F

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Nancy Sorrell


Neither this publication nor its contents constitute an explicit endorsement by Vibration Media, or by LRN Media, of the products or services mentioned in advertising or editorial content. The editorial content in this publication does not necessarily represent policies or recommendations of Vibration Media or LRN Media. This publication is not intended to be exhaustive. While every eff ort has been made to ensure accuracy, neither Vibraton Media nor LRN Media shall have any liability for errors or omissions. Readers who have questions should consult their healthcare providers or other competent sources of information and guidance.

© All copyright Vibration Media unless otherwise stated. Reproduction in whole or in part without written permission is strictly prohibited.

Welcome to Fertility Road magazine, Europe's leading title dedicated to providing all the information you need in your dreams of starting a family. From detailed features on clinics, health and psychology, to practical guides looking at fi nance, law and alternative remedies, our aim is to off er a platform on which you, the reader, can build your fertility dreams. Enjoy the magazine... James Evans, Managing Editor

OUR EXPERT...Zita West is a renowned expert in her fi eld, having successfully assisted thousands of couples through the trials and challenges of conception. Zita writes exclusively for Fertility Road, answering an array of reader questions and concerns, imparting the kind of knowledge that sees her regarded as the UK’s leading light in pregnancy and fertility.

Kelly Rose Bradford is a writer for the Daily Mail and Daily Express, and a specialist in parenting and family matters. A huge fan of babies, home-birthing and cloth nappies, she does not however weave lentils or hug trees. Kelly is mum to seven-year-old William.

Carrie Dunn is a freelance journalist who has written for publications including The Times, The Guardian, The Independent, Cosmopolitan and Pregnancy Baby and You. When she’s not writing, she will be found at the theatre, at the cricket, or playing World of Warcraft!

Siobhan O’Neill is a mum to fi ve-year-old Una and 11-month Aoife. As a writer she specialises in features about parenting, health and nutrition. As a mum she specialises in cuddles, snotty noses and messy dinner times. She has written on the rollercoaster that is parenthood and pre-parenthood for a variety of titles.

Johanna Payton is a journalist, author and broadcaster who has been writing about fertility, pregnancy and parenting since her son, Eliott, was born six years ago. Her features have been published everywhere from Grazia to Maternity & Infant magazines. She has conducted interviews whilst changing nappies!

Sarah Hart is a former editor of Pregnancy & Birth and acting editor of Mother & Baby magazines. She has also been editor of Mothercare magazine and Boots Parenting Club writing across a vast range of topics, from conception to schooling! She lives in London with her husband and daughter.

Andy Greeves is based in Dorset and works as Marketing & PR Offi cer for the Bournemouth-based Anglo-European College of Chiropractic. His interest in fertility issues stems from his mother Janet, who is alternative medicine practitioner, so Andy has heard many happy pregnancy stories as a result!

OUR WRITERS...

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05www.fertilityroad.com

CONTENTSIn this issue...

12 THE TIME IS NOW?Choosing the right moment to start your family

18 MAN IN THE MIRRORWhat men say about fertility, and what they don’t…

24 NANCY SORRELLFertility Road’s exclusive interview with the model, actress, loving mother, and wife of iconic comedian Vic Reeves

31 ON THE FERTILITY ROADTravelling for treatment – the positives and the pitfalls

40 SENDING IN THE VICE SQUADThe real eff ects of a misspent youth revealed

44 EXPERT WITNESS: ZITA WESTThe UK’s leading fertility expert answers your questions

ALSO IN THIS ISSUE:

FERTILITY ROAD GUIDES: Eating, Exercise, Acupuncture, Finance, Law

SCIENCE: The latest lab developments

LIFEFORCE: Win six sessions with LifeForce Intuitive Counsellor Jules Williams, plus get your hands on their exclusive fertility app

BOOKS: Zita West, Alan Beer, Kate Brian and Katrina Logan all reviewed

LETTER FROM THE HEART: Pixette, from Cardiff , shares her brave story

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In a recent surprise announcement Natalie Cassidy – the Strictly Come Dancing star who played Sonia in EastEnders – told OK! magazine that

she was three months pregnant expecting her fi rst baby with boyfriend Adam Cottrell.

The actress, whose baby is due in Sep-tember, told the magazine that she had concerns about her ability to conceive quickly because she has PCOS – Polycystic Ovarian Syndrome. Fortunately however, Natalie and Adam struck gold fi rst time.

“I wanted children so much, it was a worry. I came off my contraception in November but I never thought I’d get pregnant that quickly!” said Natalie who was 12 weeks pregnant in March.

PCOS was little mentioned until 2001 when Posh Spice Victoria Beckham announced she suffered with it. Following

the birth of her fi rst son Brooklyn in 1999, Victoria experienced radical weight loss which was the subject of much speculation in the press. However in an interview she talked about how her weight was affected by PCOS.

“I had polycystic ovaries before I had Brooklyn, which made me put on weight and gave me bad skin,” she said. “After Brooklyn was born I lost a lot of weight. From being Podgy Spice pre-Brooklyn I had become Skeletal Spice. What upset me was that I ate like any normal person, but I lost weight. The same happened to my mum and my sister after they had a baby.”

GPs diagnosed something called post-pregnancy metabolism. “They just said it’s something that can happen after you’ve had a baby. But I was upset about how I looked,” she said.

So suddenly PCOS was big news, but Victoria had done millions of women in Britain a favour. As the press began writing about the symptoms of PCOS, women everywhere realised this was something they were affected by and – if they were trying for a baby – could do something to help their bodies cope with.

It’s estimated that one in fi ve women in Britain have polycystic ovaries, and that Polycystic Ovarian Syndrome affects about 10% of women. If a scan reveals more than about 10 harmless cysts per ovary, doctors may say you have polycystic ovaries. It can affect fertility because women with

polycystic ovaries often have irregular, infrequent periods as ovulation is obstructed by the cysts. It is one of the main causes of fertility problems in women.

Other symptoms of PCOS can include weight gain, acne, or hair disturbance, such as thinning, loss, or even facial hair growth. This is due to raised levels of the male hormone testosterone. Women may also suffer with depression and mood changes. Symptoms usually begin in the 20s but many may not realise PCOS is a factor until they have trouble conceiving.

Later in life women may be at risk of developing Type 2 diabetes or raised cholesterol. This is down to weight gain because the PCOS affects the way your body processes carbohydrates and impairs insulin production. Healthy eating, a low carb or Glycemic Index diet and weight loss is one of the best ways to combat PCOS and return periods to a more regular pattern, but there are other treatments that can help which your GP can discuss with you.

If you have PCOS you’re certainly not alone and Victoria Beckham and Natalie Cassidy are not the fi rst or last celebrities to announce they have the condition. Coronation Street star Kym Marsh has talked about how the condition affected her time with the band Hear’Say, and pregnancy success story Jools Oliver is another sufferer.

“Even when I was 17, I thought there might be a problem and that I’d have trouble conceiving because my periods were irregular,” she said. When Jools and husband Jamie struggled to conceive she

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Kym M

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went for a check-up. “I was quite quickly diagnosed with Polycystic Ovarian Syndrome, which meant that I wasn’t ovulating each month like normal,” she said.

Jools ended up taking the fertility drug Clomid to help her get pregnant but struggled with side effects. However she and Jamie have recently announced she is expecting their fourth child, so PCOS certainly needn’t mean a small family.

Struggling with fertility issues can be a lonely time – especially if your friends and family seem to fall pregnant with ease. So it’s often encouraging to hear other people’s fertility success stories and there are many celebrities who are eager to share their fertility experiences.

EastEnders actress Jo Joyner, who plays Tanya Branning, gave birth to twins in December last year and has been happy

to talk about her IVF experiences. Like thousands of couples Jo and her husband Neil Madden had tried unsuccessfully for years to get pregnant. When they went to see doctors they were given the news many people dread – that Jo may never be able to have children naturally.

“It was very scary when we were fi rst told,” Jo revealed recently. “It was like our world had fallen apart around us. It is very scary and quite saddening. You kind of have a mourning period for the route you thought you might take,” admitted Jo. “All the natural things you take for granted. So you just have to kind of go, all right, that’s not our way.”

Jo and Neil tried IVF and fi nally fell pregnant with twins after doctors used a pioneering technique called ICSI or Intracytoplasmic Sperm Injection, where a single sperm is injected directly into the egg.

After four years of trying, Jo - who is 31 - and Neil were overjoyed to meet their beautiful twins Edie and Freddie who were born by Caesarean section. Three months later Jo took the twins on to ITV show This Morning to tell her story. “We’re very lucky. It’s a miracle really,” she said.

And she explained why she was so keen to share her experiences. “When we fi rst found out we were going to have IVF I was constantly searching through the press and the media. I could only fi nd scientifi c stuff,” she said. “I really wanted to hear

positive news. I just really wanted some-one to go, ‘It’s all right. It doesn’t mean you’ll never have kids. It is possible.’”

Now Jo hopes that her story will encourage other couples who are worried about the potentially diffi cult fertility journey they’re facing.

These days there’s an ‘app’ for everything. iPhone fans will know their applications – or apps - can help them get a good night’s sleep, fi nd their nearest Tesco and play guitar if they so desire.

But one happy Scottish couple were delighted when their iPhone app helped them conceive. After four years struggling to get pregnant Lena Bryce downloaded the Menstrual Calendar application after husband Dudley bought her an iPhone for her birthday. The free application told her when her most fertile time was and two months later she was pregnant.

When Lena gave birth to daughter Lola in January, Dudley said, “That phone was the best present I ever gave Lena. I’m absolutely over the moon. It was hard seeing other people have children. We were desperate to be parents.”

Lena and Dudley had begun to think IVF or adoption would be the only way they could have children so were surprised and delighted when the free app helped them. “We’re young, fi t and healthy and just expected everything would be fi ne, so it began to weigh a bit heavily on us,” Lena explained.

Little Lola was born on the exact day the app predicted and is at home doing well with her overjoyed parents.

Free Menstrual Calendar is available to download from www.FertilityFriend.com

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NEW MALE HOME FERTILITY TEST DEVELOPEDScientists in Holland have developed a new male fertility test, which can accurately measure sperm levels in a simple home kit.

Researchers at the University of Twente’s MESA+ Institute for Nanotechnology hope the Fertility Chip will prove an important break-through in the pre-scanning of male fertility.

While ‘over the counter’ male fertility tests have been available in the UK since 2006, they can only give a simple ‘above or below’ sperm count reading. The com-puter chip inside the device enables an accurate spermatozoa reading to be given. Testing for sperm levels is currently a complex process, requiring stringent pre-test preparations and a specialised laboratory. Tests often have to be repeated between two and fi ve times to ensure accuracy. With a third of cases of infertility in the UK due to the male partner, the need for a fast and effi cient testing method is clear.

The fertility chip, the brainchild of Loes Segerink, is able to count spermatozoa concentration. The normal amount of spermatozoa for fertility is around the 20 million mark per millilitre of ejaculation. The chip works by measuring the change in electrical resistance as sperm fl ows through it to give an indication of spermatozoa levels. White blood cell levels are also recorded, which is important to give an idea of sperm quality. The next step before this device is able to be brought to market is to see if the chip can measure movement and shape of spermatozoa, two other factors vital in fertility criteria.

FERTILITY FAUX PASSome classic old wives’ tales in terms of determining the sex of your baby, passed down through generations, and generally rubbished by science!:

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FOR A GIRL: Have intercourse in the afternoon, climax fi rst and think pink, have intercourse during a full moon, eat chocolate.

NEWSFERTILITY ROAD

The latest developments from the fertility worldv

Danish mum, Stinne Holm Bergholdt, 32, has created medical history after giving birth to a second child after an ovary transplant operation.

Bergholdt was diagnosed with Ewing’s sarcoma, a form of bone cancer, in 2004. She feared the chemotherapy treatment required to recover from such a disease would leave her infertile and decided to freeze a part of her right ovary – a process known as Cryopreservation.

After eight months of cancer treatment and a year of recovery, doctors re-implant-ed 20% of the ovary. In September 2008, Bergholdt gave birth to her fi rst daughter, Aviaja, through in-vitro fertilisation. Her second daughter, Lucca, was born a year later through natural conception.The case has recently been reported in the medical journal Human Reproduction and her doctor, Professor Claus Yding

Andersen, has heralded the technique behind Bergholdt’s remarkable tale.

“These results support cryopreservation of ovarian tissue as a valid method of fertility preservation,” comments Andersen.

“We should encourage the development of this technique as a clinical procedure for girls and young women facing treatment that could damage their ovaries.”

Bergholdt is understandably delighted with what she has described as “a miracle”.

“Myself and my partner had an appoint-ment at the fertility outpatient clinic to talk about the possibility of a second baby but it turned out I was already pregnant – naturally,” she said.

“It was a very nice surprise to fi nd out that my body was now functioning normally and that we were having a baby without needing to go through the fertility treatment. It was indeed a miracle.”

Danish mum becomes fi rst to give birth twice after ovary transplant

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New release of life for over 55s?It has been revealed that six women over the age of 55, including two women aged 58 plus, are set to receive in-vitro fertilization (IVF) treatment at the London Women’s Clinic.

Sue Tollefsen (pictured with daughter Freya), 59, gave birth to her fi rst child aged 57 at a Moscow-based clinic and is among those women being considered for treatment. If her treatment goes ahead, she will become the oldest woman in the UK to have an IVF baby.

The news comes amid growing debate over the age at which women should be allowed to receive fertility treatment. A recent BBC documentary caused controversy when it was revealed that doctors at the London Women’s Clinic were holding consultations with women aged 50 plus.

Age restrictions on IVF in the United Kingdom were offi cially withdrawn in 2005, though many fertility clinics and hospitals set age limits of their own. The NHS does not give treatment to women over 40 and most private clinics do not provide IVF for women over 50.

The oldest known birth mother in the world is Omkari Panwar, who delivered twins at the age of 70 in India in November 2008.

A decision on whether treatment is to be given to the six patients at the London Women’s Clinic is expected shortly.

A new study published in the journal Human

Reproduction suggests women who undergo fertility treatment are four times more likely to have a stillborn baby than those who conceive naturally.

While the risks of giving birth to a still-born child after IVF treatment have long been known, this is the fi rst time a study has been able to show the scale of baby deaths.

The study, carried out by Dr Kirsten Wisborg, involved more than 20,000 singleton

pregnancies in the Danish city of Aarhus between 1989 and 2006. Of the 20,166 fi rst-time singleton mums, 4% of them conceived through IVF or intracytoplasmic sperm injection (ICSI) – a procedure in which the sperm is injected into the egg.

Out of the mothers who conceived naturally, there were 86 stillbirths – giving an overall risk of 4.3 per thousand pregnancies. Findings showed that the risk of stillbirths was signifi cantly higher amongst the mothers who had undergone IVF or ICSI, at 16.2 per thousand.

Despite the worrying fi ndings, Dr Wisborg has been quick to point out that the risk of stillbirth is still “very low” after IVF or ICSI treatment.

“We do not know whether the increased risk is due to the fertility treatment or to factors pertaining to couples who undergo IVF or ICSI,” she added in an interview with The Guardian.

Stillbirth study results revealed

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TOP FIVE BABY NAMES!

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The latest developments from the fertility worldv

20-24 YEAR-OLD WOMEN:

BIRTH RATE

13% in 1973 VS

7% in 2008

30-34 YEAR-OLD WOMEN:

BIRTH RATE

6% in 1973 VS

11% in 2008 *Offi ce For National Statistics

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FEATURE | the time is now?

Kelly Rose Bradford examines the factors behind what can amount to

the biggest deliberation of them all...

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WORDS | KELLY ROSE BRADFORD

When is the right time to have a baby? Is there a defi nitive answer? Should fi nance and career be the deciding factors over age, relationship status, or health and fi tness? Is it wiser to have a baby in

your late teens when your energy levels are supposedly at their peak and you’ve youth and vitality on your side, or is being an older mum with life experience and perhaps more fi nancial stability benefi cial? Or is there, in reality, never a ‘perfect’ time other than when feels right for you? Our cross section of mums would suggest the latter may be the nearest thing to the truth...

The Teen MumBritain’s high rate of teen pregnancy and birth makes for perpetual news stories and ‘shock’ statistics, despite the government’s own data typifying an overall trend towards later childbearing. Since 1971, the average age of mothers at childbirth in England and Wales has increased by three years from 26.2 to 29.1, and over the past decade, the average age of women at the birth of their fi rst child has risen by one-and-a-half years to reach 27.1. Teenage pregnancies though, have also increased, with fi gures released in 2009 showing a rise for the fi rst time in fi ve years, with conception rates among girls increasing from 40.9 per 1,000 in 2006 for those aged 15-17, to 41.9 per 1,000 in 2007.

Jo has two children, her fi rst pregnancy was unexpected at 17, her second planned at 24. She is now 31 and has no regrets over being a young mum.

“I had my fi rst baby when I was just 17, and it isn’t something I’d particularly wish on my own daughters, but on refl ection it has worked out very well for me. I now have a 14-year-old who some-times gets mistaken for my sister, and because I am still young enough to remember being a teenager, I feel much more able to empathise with her. As a result we have a very close relationship, and she feels able to share her problems with me quite openly.”

But some aspects of pregnancy came as quite a shock to Jo – particularly the lasting effect it had on her physically:

“My fi rst pregnancy really left its legacy – I am covered in stretch marks all over my body. I was always under the illusion that young skin was stretchy and supple, but apparently that doesn’t equal no stretch marks! My stomach, waist and hips are seriously scarred.

“I can’t say I particularly enjoyed being pregnant, either. First time round I was sick a lot - pretty much after every meal for the fi rst four months. The second time I was actually only sick half a dozen times, but felt a hideous nausea throughout and was per-manently exhausted. I was commuting two hours a day to work, and by the time I got home in the evening I would be shattered, with a pounding headache. Being so young, I didn’t have any »

I chose to have kids at 27 and 30, and it proved a huge novelty amongst my friends at the time – most of them are just trying now in their late 30s. We hadn’t had a chance to develop a lifestyle before we had kids so didn’t have so much to miss when they were little. PATRICIA, 40

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real pregnancy problems though – and clearly I am quite fertile - with my second baby, I came off the pill and was pregnant a month later, before I’d really even got used to the idea of trying.”

Having devoted her late teens and twenties to pregnancy and babies, Jo feels in some ways that she is now ‘over’ motherhood:

“Being single at the moment, I haven’t given a lot of thought to a third baby. Part of me would really like to do it again, if just to correct all the mistakes I feel I made fi rst and second time around, and to do it all with a more ‘grown-up’ hat on. And then I think of the exhaustion of pregnancy, those awful early months with a newborn and no sleep, and I don’t think I could face it again. When I was younger I had a lot more energy and enthusiasm. I almost feel now like I am coming out the other side of parent-hood - I’ve been a parent for nearly 15 years now - and I’m not sure I could start again. I would never say never though. I’m still young and who knows where my life might be fi ve, or even 10 years from now?”

The Motherhood DelayersThroughout the 1990s, ‘having it all’ almost become the phrase with which to parody the working mum – the woman who had her career and her kids. But for all those who skipped effortlessly from birthing pool to boardroom, there was another breed emerging – the motherhood delayers – those who made sure their life and careers were in good order before embracing pregnancy.

Lindsay, now 40, delayed mother-hood in favour of a career until her 30th birthday, when Mother Nature and the tick of her biological clock took over.

“I never wanted to have kids in my 20s, not at all. My 20s were for study, my career, having fun, going to parties. I got married at 24, and my husband had two children from a previous relationship whom I adored, so in a way I got to have my cake and eat it whatever. I was a part-time parent to two great kids without having to sacrifi ce my time or my job – it was wonderful!

“But I never ruled out having my own babies. I always fi gured that one day I would, and that day came when I was 30 and my hormones kicked in. I suddenly realised that I desperately want-ed a baby. One of my elder sisters who was childless by choice told me just to ignore the feelings and they would go away! I knew in my heart though that it was more than just hormonal: I really wanted a baby.”

After much consultation with her husband, Lindsay fi nally felt ready to begin trying to conceive at the age of 33.

“By the time I was 33 I knew for sure that having a baby really, really mattered to me, so we started trying. I thought I’d just get pregnant, you know? But it didn’t happen. A year went by and still nothing. Two years passed. I wanted us to go and get tested but my husband was really reluctant. Even though he said that he was up for starting a family, it either had to just happen or it wasn’t meant to be.

Someone once told me that if you wait until you can aff ord to have children you will never have them. We kept that in mind and it is so true. JULIE, 29


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“This was rather heartbreaking for me, worrying that maybe I was missing out on a baby for something that actually could be quite insignifi cant and easily fi xable. But I’d never know. I went once to the doctor who was really unhelpful and very condescending - along the lines of ‘well if your husband won’t get tested too there’s really not any point’. I was too embarrassed to go again.

“Finally after nearly fi ve years of trying for a baby, my husband was made redundant. It was the fi nal straw. I just threw up my hands and said ‘right, that’s it. I give up. This just is never going to happen.’ Then I almost immediately fell pregnant. But I knew in my heart that something was wrong. I went for the 12-week scan and sure enough, it was a ‘missed’ miscarriage. The baby had probably died around the fi ve or six-week mark but it was still ‘there’. I was devastated, thinking, ‘well this is it, that took fi ve years and now I’m 37. I don’t really have another fi ve years.’ How-ever, miraculously, I got pregnant again almost straight away and had my baby boy, Daniel, a month after my 38th birthday. Just hours after the birth, my husband sat holding his new son in his hands. He looked up at me and said: ‘Let’s have another one!’”

The Multi-Decade MumYou’d assume those who eschew the 2.4 children trend and add to their families throughout their fertile lives would have the ‘what age is best?’ debate neatly sewn up. Not so - Jackie, now 37, had her fi rst baby at 29, then three more in her 30s. Her last baby was born last year when she was 36 – but she now wishes she’d begun motherhood earlier:

“I was 29 when I had my fi rst baby. Now that I have four, I really wish I had had them earlier and not listened to the negative comments about how hard it is as a young mum. For some reason, when I was younger there was a part of me that felt I would never be able to have kids – a lack of confi dence I guess. We had friends who’d had fertility problems and we lived through that with them, so we never took anything for granted. Our fi rst baby took two

attempts, but the others all happened immediately! With my last baby, I was hugely aware that 35 was somehow the ‘cut off ’ point, but again, I had no problems.”

“Despite wishing I had started my family earlier, having my babies was actually the best career move I have ever made - having the children gave me the kick I needed to get out of offi ce life and do what I had always wanted to do in starting my own business. I didn’t want to leave my children with childminders so knew I just had to get on with it and get the work in.”

I think that the best age to have a baby is the age you’re at when you have one! My family is all terribly fecund, so it came as a huge shock when I found that I didn’t get pregnant at the drop of the hat. In fact it took fi ve years. So instead of having my family in my early 30s I didn’t get started until my late 30s. LISA, 39


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Women are born with around 1 million eggs in their ovaries, yet by the time puberty kicks in, this has already dwindled to around 300,000, and, amazingly, only about 300 are released

over the course of a woman’s fertile years. As a woman ages, the egg quality ages too, making them less viable for successful and healthy fertilisation.

Teens...With youth on your side, your late teens and early twenties are biologically the ideal time to have a baby, but many women will still be in education or in the early stages of a career, so practically, and fi nancially, the timing isn’t always right, even if the biology is...

Twenties...With the average age for fi rst time birth for women in the UK being 27, the late 20s are seemingly the ideal time to become pregnant. However, although these years are generally considered the time at which a woman reaches her fertile peak, studies by scientists at the National Institute of Environmental Health Sciences in North Carolina, and the University of Padua in Italy, have indicated that female fertility actually declines before the age of 30.

Thirties...Egg deterioration increases the likelihood of fertility issues in your 30s, and doctors acknowledge that women of 35 and over should seek advice sooner rather than later if they are experiencing problems conceiving. Despite this, studies show that the highest fertility rates in England and Wales are attributed to women in their 30s. (Offi ce for National Statistics research, England and Wales: 112.3 live births per 1,000 women aged 30 to 34.)

Forties...The risk of miscarriage and foetal abnormalities increases with age, and the deterioration of egg quality is rapid throughout the forties – however, many women will still fall pregnant. Concern should centre around maintaining the pregnancy and foetal health.

Beyond...Many fertility clinics in the UK treat women into their 50s using stored embryos or donor eggs. The Human Fertilisation and Embryology Authority (HFEA) states patients can now store their embryos until they have reached 55. Although there is no offi cial upper age limit for IVF, clinics do have to justify their treatment – with the interest of the baby being priority.

The chances are...Good general health and fi tness, along with a sensible diet, minimal alcohol intake and a smoke-free environment are all the obvious pointers for becoming pregnant and maintaining a healthy and hassle-free pregnancy, but what else can a woman do to increase her fertility and chances of conception?

Have more sex - sounds obvious, but as a woman only has a few fertile days each month, the more sex you have, the more chances you have of conceiving.

Relax - Scientists at Emory University, in Atlanta, Georgia, discovered that women with high levels of the stress hormone cortisol stopped ovulating and were therefore unable to conceive.

Watch your weight - being underweight or overweight can disrupt ovulation and your menstrual cycle.

Check your partner’s undies - tight pants are not conducive to healthy sperm – overheating can lower sperm production, so go for loose fi tting boxers over posing pouches!

AGE AND FERTILITY

THE FACTS

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FEATURE | male fertility

Think that your man is obsessed with work? Think again. If a recent survey is to be believed, it’s probable that the thought occupying his mind is whether or not he’s able to father children.

MAN MIRRORIN THE

Yes, men are more concerned about quality of their sperm than the quality of their career trajectory – and 14 per cent of them rate their fertility as their number one priority in life.

So it’s unsurprising that when a problem is found with a man’s fertility, the news can affect him deeply.

But if you fi nd yourself in a similar situation with your partner, don’t expect to be able to second-guess his reaction – there is no textbook response to this kind of news.

“Nobody wants to fi nd a problem, and reactions range from being shocked and upset to relief that a cause of the infertility has been identifi ed,” says Emma Cannon, founder of Harley Street practice A Healthy Conception.

Though a diagnosis of infertility is diffi cult for anyone to deal with, she thinks that women tend to cope better with the news simply because they decide to take an active part in dealing with their condition.

“As a rule, but by no means in all couples, women fi nd diagnosis of a problem in themselves easier to manage and accept than men do. Women are generally better at making positive changes to improve their fertility; I think it is fair to say that they are more motivated.” ©

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It’s easy to conclude that a diagnosis of infertility affects a man’s concept of his own masculinity which in turn affects his behaviour – and quite often this seems to be the case.

“I think for some men the semen analysis is a ‘measure of manhood’ and therefore it can be a real setback if it is poor,” agrees Cannon. “Interestingly, women often report that they would rather the problem had been with them as emotionally the situa-tion would have been easier to deal with.”

“This kind of news will have a big impact on any man,” concurs psychologist Trudy Hill from the Susie Ambrose Clinic, “and many studies have shown that involuntary childlessness in men has a big impact on mental health, self-esteem and many other areas. Masculinity and fertility are linked equally as much as femininity and fertility; they are linked by our biology, by our nature and through the concept of evolution and sexual selection as we select the mate most likely to give us healthy children and be able to care or provide well for them. They are also linked through our society, through our media and our social norms.”

No wonder there is still, unbelievably, such a stigma around male infertility. Women with conditions preventing them from conceiving are likely to discuss their endometriosis or fi broids or polycystic ovaries with their friends and get sympathy; men with a low sperm count won’t confi de in their friends because of all the laddish jokes they’ve swapped concerning poking fun at others ‘fi ring blanks’ in the past. And yet men can suffer terrible psychological pressure after their diagnosis, and need support and understanding.

Mark (not his real name) agrees. “I feel worthless for not being able to get the job done the natural way,” he says. “I feel like we have to go through all these procedures because I’m not man enough.”

Jane found her husband reacting in a similar way. “He defi nitely feels he’s less of a man because he’s unable to have children,”

she says. “He feels as though he has let me down, even though of course he hasn’t, and even if I’d known about our fertility problem before we got married, I still wouldn’t have done anything differently.”

If your man is horribly hurt by the diagnosis, you’re bound to want to talk to him about it, particularly to reassure him that you still love him and wouldn’t change him for anyone in the world – but broaching that tricky topic is probably easier said than done.

“Men are less at ease with discussing emotions,” says Hill bluntly. “Men and women, while equal, are still very far apart. Not only has our biology evolved differently but we have also been social-ised differently. From a biology viewpoint, some would go as far as to say that men are actually less comfortable having strong emotions than women full-stop, let alone discussing them. Some research, for example, shows that men’s immune systems »


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FEATURE | male fertility

and cardiovascular systems take longer to recover when experiencing extreme emotion than a woman’s does. That is to say, men have health consequences when exposing themselves to severe emotion.”

If that’s true, then it’s no wonder men may fi nd it diffi cult to discuss their feelings on infertility.

Hill sees an evolutionary basis to men’s unease with emotional issues:

“Discussing emotions is not something that is hard-wired into the male psychology the way it is with females,” she says.

“We can guess this from evolution – the man feeling upset, angry, scared and wanting to sit and talk about it will have been less effi cient at hunting successfully if he was unable to turn his emotions off and get on with the task at hand. We can also now, with modern-day technology, confi rm this by looking at brain functioning. There

is some evidence to suggest that male and female brains are wired differently. In men, emotions are compartmentalised into a particular area and are usually linked to action – not communication centres. In woman the boundaries are much less obvious and activity as a reaction to emotion can be seen in many centres and is usually linked with communication. So when a woman is under emotional stress she usually likes to talk about it; when a man is under emo-tional stress he likes to stop talking and fi nd ways to start ‘doing’.”

Kelly has a husband who refuses to discuss how he feels about his diagnosis of infertility, or even put potential courses of action that might improve their chances of conception into practice. “He just doesn’t feel the need to talk about it, for whatever reason,” she explains. “He relies on the doctor’s opinion for everything involving his health

anyway, so I’ve had to be the proactive one when it comes to our infertility too.”

Sarah has a similar problem with her partner, so she avoids talking to him about it unless he specifi cally raises the subject. “I don’t want to make him feel worse and talk about babies and infertility rarely, even though I think about it all the time,” she confesses. “When he brings it up we discuss it, but not usually any other time.”

So how should women in the same situ-ation as Kelly and Sarah deal with their need to communicate?

“Never use the word ‘should’ – don’t use it to attack your partner about lifestyle issues,” advises Cannon. “Try to let him come round to things in his own time with-out trying to fi x it for him. Conclusions that he makes himself will have more meaning.”

It sounds surprising, but Hill also reveals: “Many men struggle facing up to infertility and in many couples the women opt to tell the outside world the problem is theirs.”

That might not be the best option for you, but it’s completely understandable that you might feel you want to protect your man’s wounded pride as part of your effort to fi x as much as you can for him.

If your partner still isn’t keen on sharing how he’s feeling, Hill recommends Sarah’s strategy of leaving him to it for the time being – hard though it may be for you. “The best thing you can do is to understand his desire to keep quiet and give him some space,” she says. “Then when you do talk it through the emotion will be slightly less raw. In addition, a good opening will be to try and talk from a practical angle to start with.”

That means looking at those possible lifestyle options that could improve your chances of conception, and talking them through – but remembering not to push your opinions on him too strongly, which may come across as unhelpful nagging.

“The extent to which a man is affected will depend usually on how in control of the situation he feels,” concludes Hill.

“Remember, much of infertility is not absolute and there are things that the man can do to improve the situation. When he is told this he feels more in control. When we feel in control we feel less stressed – and we cope better.”

Much of infertility is not absolute and there are things that the man can do to improve the situation. When he is told this he feels more in control. When we feel in control we feel less stressed – and we cope better.

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FEATURE | celebrity

She’s a model, an actress, a TV presenter and, most recognisably, the female other half of comedy connoisseur Vic Reeves. But more than that, Nancy Sorrell is a mum; someone who has overcome the pain and frustration of fertility battles – experiences that she shares in an exclusive interview with Fertility Road.

WORDS | ANDY GREEVES

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Being a Mum is fantastic... there’s no other word for it,” smiles Nancy Sorrell. “It has been an experience that has transformed who I thought I was, and has made me reassess a lot of my life,

and how I think about things. It is a humbling thing, but one that requires so much presence, and given the struggles that we went through, I believe the delight is even greater.”

And Vic Reeves’ glamorous wife has every reason to be delighted. The continuing joys of parenthood reinvent with every passing day, challenges that Nancy now feels she can’t imagine being without.

But, soon after her marriage to Reeves in January 2003, there was a time when the couple feared they might never experience the thrill of bringing up their own children. Nancy discovered that she had a fertility problem which would prevent her from conceiving naturally – the diagnosis was blunt and severe.

Yet, armed with the confi dence and level-headedness that has prompted a career in its own right – and not only via the association with one of the country’s best-loved entertainers – the 35-year-old Essex-born model refused to allow the devastation to envelop a household of positivity and ambition. Leaning heavily on support from Vic (real name Jim Moir) the couple began to investigate alternative measures, and almost immediately, a painful situation began to change.

“We got married and had been trying to have a baby from 2003 onwards. After a year or so of nothing – and although it’s the last thing you want to have to admit – the realisation soon developed that something was wrong.“You’re in a bit of a daze when that happens. There’s so much uncertainty, fear, even regret, but ultimately you need to clear your mind of anything that you don’t know as fact, and just look at the reality of what you have in front of you, and what information you can fi nd.

“As a fi rst stop we went to see our local GP here in Canterbury. Dr Davies initially suggested we tried folic acid along with the drug Clomid, renowned the world over for improving your chances of conceiving.

“Leaving the surgery you feel as if you have a new opportunity, something that will stack the odds back in your favour. Of course, when that too fails, the gathering clouds become even darker and more terrifying.”

The next diagnosis for Nancy and Jim was IVF treatment.“If I’m honest, I’d never even considered it in the past.

I suppose there is a feeling of IVF being something that happens to other people. When you fi nd that you are that person it’s frightening, but if you can stay positive, it actually becomes something very exciting at the same time. Both Jim and I wanted a baby very much and there was never any doubt that we would try IVF to achieve that, or any-thing else for that matter.

“To this day, it remains something of a mystery as to why Jim and I couldn’t conceive naturally. We had a number of tests, both sperm and ovary, which came back as normal. Of course, that’s not always a defi nite as far as getting pregnant goes, but we found that the sooner we moved on from the ‘why not’ and into the ‘how’ we were in a much better place.

“Even when we were trying (and failing) to get pregnant, I tried not to become too concerned. It’s just not in my nature. I guess I never viewed it as being the fi nal answer in terms of us having children because I wanted them so much and so did Jim. IVF was just the next phase, that’s how I learned to see it.”

The couple ventured to the Chaucer Clinic in Canterbury, a private fertility practise regarded as one of the leading centres in Kent. There, they learned about the true science behind IVF treatment, and the perceived path ahead.

“Everything was explained in layman’s terms; you need that or the science and psychology behind the whole thing is »

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FEATURE | celebrity



so great that it can really affect how you think about things. We went on from there.”

That confi dence and level-headedness is something that Nancy holds as true to her-self. Even when describing the subsequent two years of IVF treatment that she undertook between 2003 and 2005, Nancy maintains a sense of humour, a smiling brilliance, and a ‘glass half-full’ approach. It’s not an attitude that many can maintain, but she is a fi rm believer that positivity of mind equals positivity of body.

And on May 25, 2006, the couple welcomed twins Elizabeth and Nell into the world.

“The birth itself was surprisingly straightforward and I loved my girls straightaway. Jim and I were ecstatic at the birth of our two bundles of joy. The girls were a healthy weight with Elizabeth weighing 5lb 8oz and Nell at 5lb 3oz. I remember Jim jokingly telling the press we were going to call the twins Simon and Garfunkel or Batman and Robin!

“Away from the fl ashbulbs it felt like I had come full circle. To anyone going through full IVF it can be a torturous ride. You just have to picture your end result and stick to that positive thought.

“There are so many emotions. I certainly didn’t feel ashamed or guilty, this wasn’t my fault, it was just something Jim and I had to deal with. It was something we would have preferred to have kept to ourselves, but a newspaper took a picture of

Jim and I entering the fertility clinic and our story became public knowledge. At fi rst, I was a little bit uncomfortable with that, but I soon came to thinking that I was experiencing something lots of couples go through, and to be able to talk publically about it was and still is a very positive thing.

“I’m not for one second pretending I can say anything that isn’t already out there, but so much of this is about empathy and support, and there are many negative emotions concerned with fertility that I feel passionately about banishing.“It surprises me that in some quarters there is still a great deal of stigma attached to fertility problems and IVF. That’s so negative. Why hide a problem or feel ashamed when there are things you can do to help yourself?

“There is so much information out there – I started the IVF process in 2003, by which time I felt like a mini-expert on the subject. I think that’s a great thing about the communication channels we have open to us these days – it’s no longer some-thing that, metaphorically, only happens behind closed doors.

“That’s not to say that there weren’t episodes during the IVF process when I wasn’t scared – on the contrary, injecting my-self for the fi rst time was pretty daunting, as I’d never been near a needle before. I had to inject into my leg and I cringed

The birth itself was surprisingly straightforward and I loved my girls straightaway. Jim and I were ecstatic at the birth of our two bundles of joy.

FEATURE | celebrity

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Nancy with girls Lizzy and Nelly (above), while the happy family – including husband Vic Reeves – enjoy time posing for the camera (far right)



at just the thought of that to begin with. I was determined to do the injection myself though rather than Jim as I thought ‘I am quite capable’.

“It took me a few goes – I was frightened, yes, but you have to focus on the end result. I soon became confi dent at doing it; it became routine – I just got on with it.

“There were scares along the way, too, of course. One night, Jim and I were at an event in London and I didn’t have part of my kit to do the injection. I panicked, I was crying, fretting. Could one night of forgetfulness scupper our whole plans? Luckily, I was able to call the Chaucer Clinic who reassured me everything would be okay. If you miss one injection, especially towards the end of a cycle, you will usually be fi ne, but it proved to me that you can never take what you are doing lightly. You are dealing with the creation of a new life – two, in my case – and when you think you have relaxed into a process your security can be swept from beneath you.

“Throughout the whole IVF process, I was fi lled with the thought that I had been given a great opportunity that wouldn’t have existed a few decades ago – a second chance, in a way. Not everybody comes through the IVF process with a baby at the end of it – I was lucky that it worked for me and for that I feel so fortunate.”

And husband Vic, the super-cool, devastatingly deadpan comedian – did he retain that long-established public persona?

“Jim was fantastic throughout the whole experience. Obviously he is different away from the cameras anyway, but he was totally down to earth, supportive, and everything I would have expected of a great husband. It means so much to have that support – there should really be no-one else you need turn to.

“He used to keep my spirits up and every time there was a positive sign, he’d say ‘this is working like clockwork’. I suppose it did work like clockwork. I’m very lucky in the sense that if you could have a perfect IVF patient, I was it – there were never any complications, not even side-effects from the treatment which I was told I might experience.”

And what of that memorable moment when the couple discovered that the IVF had been successful?

“When you are going through IVF, you are not meant to do a pregnancy test until a certain date in the procedure. I couldn’t wait though and did mine earlier than I should have.

“To see that cross on the pregnancy kit is one of the best sights anyone desperate to have children will ever see. We were running round our room screaming! I honestly couldn’t believe it – I

remember scratching and tapping the test to make sure it had defi nitely worked!

“One diffi cult choice we had to make during the IVF cycle was knowing how many eggs to return to my body. I had two eggs removed initially and there remain many different points of opinion on the subject. I had to consider that if I put two eggs back, I could lose both at the same time. If I only put one back, I could have lost it and the opportunity for the other egg to have been fertilised. After a day of agonising, we decided to insert both eggs back as Jim and I felt it gave us the best chance. Amazingly they both took and we could have even had triplets at one stage. I was having a 4D ultrasound scan when I found out that I was going to be having twins. I came over a bit shaky and went ‘oh dear, oh dear’ but course I was delighted.”

And now, the couple’s two girls are approaching their fourth birthdays. Nancy, who has modelled extensively in the fashion world for the likes of M&S, Next, Ann Summers and Pampers, admits that she could never picture a time when she would be thinking about buying school uniforms and making packed lunches.©

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“You can never imagine what will be like, but it is the excitement of the unknown that keeps you going. I have two girls with very different personalities – Nelly is very funny and quite mad, a bit like her dad. Lizzy is a bit more scatterbrained like me. I think that works in a way!

“Nelly did the most amazing drawing of a fl ower the other day. She’s certainly following in her fathers’ footsteps as the artistic one in the household. Jim’s got some art due to appear in the Saatchi Gal-lery this June and Nelly’s fl ower wouldn’t look out of place there. Lizzy on the other hand drew a picture of some hair! I found that hilarious – I can imagine myself drawing something random like that when I was young.”

So what of Nancy’s advice to couples either thinking of or already in the early stages of IVF treatment? Hers is a public story, played out at times in front of journalists’ notepads and seductive photoshoots, but despite all of that, she believes that self-control and inner strength are the most important things:

“I would say that staying calm throughout the IVF treat-ment process is the most vital thing. I know that’s easier said than done but I think the fact I stayed cool and collected through what was, despite the smiles, an incredibly emotional and trying experience, helped massively. If absolutely nothing else, it certainly enables you to take on board all the information you are presented with. And that’s one of the most important things, because you’re stepping into a whole new world.

“If you have the money, I would recommend doing the IVF treatment privately. That’s not to knock the NHS, but I advise

that because you avoid the waiting lists when you go private. I was so desperate to go ahead with the IVF treatment that it seemed money well spent.

“I think I’m right in saying that the NHS funds just 600 IVF treatments per million women in the country, which means you could be waiting a long time if you go down the conventional route. With one in seven couples in the UK affected by fertility problems, you’d think there would be greater provision. The information is out there when it comes to infertility, but not the funding. Other places, Scandinavia in particular, support far more couples with this than we do in the UK. That should change.”

Gradually relaxing back into the public eye, celebrity demands combined with motherhood certainly haven’t calmed Nancy’s desire to play her part in helping others:

“Through all of the elation I can never forget those couples who aren’t as fortunate... after all, we felt that might be us, for a long while.”

“I’m glad I can use the experience to advise other couples who fi nd themselves in the same position as Jim and I did fi ve years ago. It doesn’t matter who you are or where you come from, as mothers and prospective parents we are all in this together, and if something I have done or said could help just one person, well... that’s a great feeling.”

“I am involved too with a great charity too called Tommy’s, which funds medical research into miscarriage, stillbirth and premature birth. I take a hands-on role as an ambassador for

them, meeting mums or mums-to-be. I always feel sentimental and close to tears when I hear some of the stories from those who come along, but I try to stay strong for them.

“Another thing I love is being a member of ‘Twins Club’ in Ashford, Kent. It is somewhere where parents as their twins can go to get support and meet other adults and children – it’s quite surreal seeing lots of twins and mums all in one room, that’s for sure! There are lots of these places around the country and they are invaluable. It’s strange because for couples who have been through fertility problems they may feel that giving birth is the end of the ride. It is in one sense, but it is also the start of a much bigger one!

“As far as work goes at the moment, I’m just waiting and seeing what happens rather than actively pursuing anything. Right now, I’m loving being a mum and given what Jim and I have been through, work isn’t top of my agenda. This is what I’ve always dreamed of and I am going to continue enjoying this experience. It’s my raison d’etre.”

It doesn’t matter who you are or where you come from, as mothers and prospective parents we are all in this together, and if something I have done or said could help just one person, well... that’s a great feeling.

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p029 ADS.indd 1 29/04/2010 16:51

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SIMS Clinic 1pp.indd 1 13/04/2010 14:52

FEATURE | on the fertility road

F ertility treatment can be a stressful business. Being assessed and tested, dashing to and from clinic appoint-ments, sitting impatiently on a waiting list; few aspects of the experience are relaxing. So why are increasing

numbers of British people complicating matters further by travel-ling abroad for treatment?

In 2009, information from the fi rst study of so-called ‘fertility tourism’ around Europe was released. The research, which looked at 44 European clinics, revealed that hundreds of people travel abroad from Britain for fertility treatment every month. Another survey of over 300 British patients, conducted online by Infertility Network UK, found that 76 per cent of couples needing fertility treatment would consider going abroad and that 88 per cent of those who had already been overseas were happy with their treatment.

There are many reasons why people decide to travel. Unlike other medical treatment undertaken overseas, it’s not always a case of cutting costs (although IVF is half the price in parts of Southern and Eastern Europe). Some women travel because they

are over 40, and do not qualify for IVF on the NHS. Couples requiring donor eggs, or sperm, may also seek help abroad, where donor recruitment has different regulations and shorter waiting lists.

“Lots of people choose to go abroad because they simply can’t access the treatment they want in this country,” says Susan Seenan from Infertility Network UK. “Until the donor situation changes here it is right that they should have that choice.

“The world has become a smaller place. A few years ago people wouldn’t have dreamed of going abroad, but travelling for medical treatment is more common in general, and much more affordable, so it’s becoming a popular option.”

Dr Sue Ingamells, consultant obstetrician and gynaecologist at Southampton’s Wessex Fertility Clinic, says that people go abroad for very different reasons. “Some countries are defi nitely perceived to be more of a bargain than the UK,” she says, “but when single women are travelling for fertility treatment, they might choose to go to a country such as the USA, where more information is provided about donors.

ON THE FERTILITY ROAD

Johanna Payton assesses the increasing number of UK-based couples travelling away from home in order to realise their dreams of starting a family…


WORDS | JOHANNA PAYTON

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“Although the availability of donors abroad is the most popular reason, some people do want to have a holiday at the same time as treatment. It can help them relax and give them a sense of privacy; they can book a holiday from work as normal and don’t necessarily have to tell everyone at their workplace that they’re going for fertility treatment.”

There are other motivating factors for some couples. While British women can have a maximum of two embryos implanted in the UK due to the risk of multiple pregnancy, this number is higher in other countries. Some women may feel that gives them a higher chance of success. Medically assisted sex selection for non-medical reasons is also banned in the UK, so couples may turn to clinics in countries where gender selection is permitted if they are desperate for a son, or daughter. In some countries, the upper age limit for patients is far higher than even private clinics in the UK.

It’s perhaps no surprise then, that when we read about ‘fertility tourism’ in the press it is often accompanied by sensational head-lines. Elizabeth Adeney, 66, made the front pages in 2009 when she became Britain’s oldest mother after undergoing fertility treatment in the Ukraine, for example. But for most couples, a simple dream of becoming parents is at stake, and if travelling for treatment increases their chances, packing a suitcase isn’t such a big deal.

For some people, this could mean travelling within the UK and the Human Fertilisation and Embryology Authority (HFEA) pro-vides a ‘Choose a Fertility Clinic’ service, so prospective patients and donors can fi nd a registered clinic that best suits their needs.

“If couples can’t get donor treatment locally,” says Susan Seenan,

“other areas of the country may have a better supply of donors. If they need specifi c medical treatment, they might fi nd an expert somewhere in the UK.”

When travelling abroad, the process of choosing a clinic is more complex. Doing lots of research, and bearing all the potential pitfalls in mind before you book your fl ight, is a must. The HFEA says that clinics in other countries may, or may not, be regulated to local standards which vary hugely from country to country. How success is calculated may be different, making it hard to compare overseas clinics with treatment centres in the UK.

Confi dentiality and the safeguarding of information may also be subject to different rules and regulations.

“Find out as much as you can before you travel so your choice is informed,” advises Susan Seenan. “A clinic might boast amazing statistics, but you need to feel comfortable there, confi dent and relaxed enough to ask all your questions. Fertility treatment is stressful enough without adding additional anxiety.

“Visit the clinic if you can and you’ll know if it feels right. You’ll also need to ask yourself if you’re happy to be out there on your own, without friends and family on hand for support. Some couples fi nd it easier that way, but everyone is different. Make sure that any language barriers are going to be addressed and talk

For most couples, a simple dream of becoming parents is at stake, so packing a suitcase isn’t such a big deal.


to people on forums who have been through the experience, to get a sense of what it’s going to be like.”

Sue Ingamells also urges people to think about the commit-ments and risks they may be taking if they travel abroad. “One woman I met was supposed to be travelling abroad for her embryo transfer during the winter,” she says. “Her fl ight was cancelled due to the snow and she was devastated.

“Travelling at short notice can also prove too much for some. Even if you get there on time, there are other serious concerns. Although clinics abroad may offer multiple embryo transfer, the risks of multiple pregnancies cannot be underestimated for women in their 40s, and while mistakes can happen in the UK, depending on where you travel you may have no guarantee that the right sperm will be matched with the right egg.”

Although there are pitfalls, careful consideration of your options can lead to a positive experience abroad. Sue Ingamells says that some UK fertility clinics now provide a ‘link service’ to bridge the gap between home and the clinic abroad where their patients are receiving treatment, and the HFEA provides extensive advice about travelling for treatment on its website.

Whatever your reasons for going abroad for fertility treatment, talking to as many people as possible whilst making your decision is a smart move. The community of ‘fertility tourists’ is expanding in the UK, so there is no need to feel isolated if you’re considering joining them – and with the right preparation and research, you might even add your name to the growing list of success stories.

CASE STUDY:DYUDTUDYUDUDTUSTSTTUST DYY:Y::Y:CCCC E SCASEE E SASESEASACAAS

‘Travelling to Spain for treatment

was the best thing we ever did’

Nicola Dawson, 36, and husband Nigel, 42, travelled to the IVI Clinic in Barcelona for donor treatment. They are now the proud parents of 17-month-old twin daughters, Hannah and Mia.

“Our fertility treatment started in 2004. Nigel had a low sperm count, and after three unsuccessful cycles of IVF, the quality

The Dawson family

»


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Fertility clinics are situated all over the country – and the globe. No one clinic is right for every couple and you need to do your own research, ideally visiting a clinic before deciding which is best for you.

• International options

If you want to combine a holiday with your treatment, the Barbados Fertility Centre has state-of-the-art facilities and a beautiful setting. www.barbadosivf.org/clinic

Nadiya Repo, Ukraine are one of Eastern Europe’s biggest clinics, responsible for 1,500 cycles in 2008 and, in total of 1,300 births following ART treatment, including sex selection. www.ivf.com.ua/en

The European Fertility Institute in Madrid, Spain, exclusively studies and treats reproductive disorders. www.iefertilidad.com/eng

The Red Rock Fertility Center in Las Vegas is described as a “boutique-styled clinic specialising in personalised physician care”. www.lasvegasfertility.com

The Origin Fertility are based in India, promising a highly competitive price with what many fi nd to be a memorable trip to Asia. www.theoriginfertility.com

The Stork Klinik in Copenhagen, Denmark which, in particular, specialises in providing fertility solutions for single and lesbian women, though does also cater for heterosexual couples. www.storkklinik.dk

North Cyprus Fertility is a new but forward-thinking clinic based in Famagusta. Opened in 2005, they are regarded as modern pioneers of fertility in the Eastern Mediterranean. www.cyprusivf.com

On the south-west coast of Norway, Scanhealth is 15 minutes from Haugesund Airport - which is a one-and-a-half hour fl ight from Stansted or Edinburgh. www.scan-health.co.uk

Over the last recorded three-year period, the independent EmBIO Clinic in Greece boasted a 56% success rate for women 37 years or younger. www.ivf-embryo.gr

Avaclinic are an experienced and well-regarded clinic, off ering six diff erent bases across Europe, in Finland (2), Russia, Portugal, Latvia and Azerbaijan. www.avaclinic.com

The Ceram clinic in Marbella, Spain, is perfect for the short hop, located close to Malaga

airport and providing an easily accessible option for busy couples, in warm surroundings. www.ceram.es

Cardone & Associates Reproductive Medicine in Massachusetts off er all the trimmings of the US experience, and with it potentially a truly life-defi ning trip. www.cardonerepromed.com

• Closer to Home

Care Fertility has clinics across the country, with main bases in Manchester, Sheffi eld, Northampton and Nottingham, plus seven satellite clinics. www.carefertility.com

The Harley Street Clinic in London can rightly boast that its name is a byword for excellence, although its spread of specialisms shouldn’t ever detract from the precision of its craft.www.theharleystreetclinic.com

Finally, SIMS were responsible for the fi rst donor gamete programme in Ireland as well as being the fi rst practitioners of blastocyst culture and transfer, and are based in Dublin. www.sims.ie

• Further information:

www.infertilitynetworkuk.com

www.hfea.gov.uk/fertility-clinics-treatment-abroad

15 GREAT CLINICS

of my eggs was also in doubt. Our healthcare team suspected I was heading into an early menopause.

The treatment left us physically and emotionally exhausted and although we desperately wanted children, we needed a break. We spent 18 months look-ing at our options. Although we knew we’d make great adoptive parents, factors outside our control meant it wasn’t an option for us. We were interested in using donor eggs, but waiting lists in the UK were very long. We had a consultation at the Lister clinic in London to talk through our options and they suggested travelling abroad, where waiting lists can be shorter.

We chose Spain because it has a long history of fertility treat-ment and a seemingly ethical donor recruitment programme. Barcelona appealed to us because it was a city we had always wanted to visit, and it made sense to be somewhere nice when putting ourselves through a stressful medical treatment.

We had our fi rst consultation in August 2007, and after assessment they recommended using donor sperm and donor eggs. Because

we’d considered adoption, we’d got our heads around having children that weren’t ours genetically, so the idea of double donation seemed like absolutely the right thing to do.

The clinic went to great lengths to fi nd donors who were a close match for us genetically, in terms of blood group, eye colour and all our physical characteristics. Just fi ve weeks later, they found a successful match and in January 2008, I went back to Barcelona for embryo transfer. On February 1 I did a pregnancy test. It was positive and we were ecstatic. A scan 19 days later confi rmed a twin pregnancy; Nigel is a twin and my brother has twins, so

If you make an educated decision about travelling, you are much less likely to get ripped off , or rush into a detrimental situation.

»


p031_036_Fertility_Spring10 NEW.indd 35 05/05/2010 09:14


having twins ourselves seemed completely normal. Given that they wouldn’t be ours biologically, the fact that they would always have a genetic link to each other was also very special.

My pregnancy was healthy, although I was sick as a dog in the fi rst trimester and ended up the size of a house! The clinic in Spain stayed in touch with us, and they were always there to provide advice, even when I worried about little things – like all fi rst time mums do.

The girls were born via Caesarian section in September 2008. I’ve been blown away by how fantastic it is being a mum and the girls mean everything to us. They are so lovely, and we are a very happy family.

I have absolutely no regrets. If I could change anything, I’d like the girls to have access to medical information about the donors, so they’d have a sense of genetic identity. Spain has a policy of donor anonymity which was one of the drawbacks we had to face when we decided to go abroad.

We had a brilliant experience, but we did lots of research and came to terms with life-changing decisions before we even set foot on a plane. If you make an educated decision about travelling, you are much less likely to get ripped off, or rush

into a detrimental situation. It’s easy to get carried away when you fi nd out overseas clinics have short waiting lists for donors, or that some are relatively inexpensive, but you need to consider how other legal and ethical consequences will affect you, and more importantly, your children. The implications of going to another country are far reaching, but by thinking everything through and making informed choices, many people can achieve their dream.’

Hannah and Mia Dawson

Thinking of having a baby? Finding it diffi cult to get pregnant?Looking for some answers?

Since opening in 1999, the StorkKlinik offers inseminations to heterosexual couples, same sex couples and single women, to whom insemination is a possible solution to childlessness.

We have no waiting time, when your paperwork is complete, you can be inseminated. By your next ovulation, you may choose to be inseminated with so-called open donor sperm or anonymous donor sperm with no waiting time.

We have great knowledge of the special process it is to follow a fertility treatment and our experienced team will provide a holistic program of care.

It is important that your insemination becomes a caring and personal experience that you can think back on with joy. Therefore we have created different surroundings, so that you can feel comfortable. We are accredited by the EU Tissue Directive.

FOR MORE INFORMATION ABOUT THE TEAM AND COSTS PLEASE VISIT WWW.STORKKLINIK.DK

A different Fertility Clinic in Copenhagen, Denmark.



When issues of infertility occur, we might think of the woman fi rst for the cause. But male infertility is as often behind a

couple’s conception problems, and some studies have shown it can account for between a third and almost 50% of infertility cases.

Sperm quality can be to blame. Low sperm count, poor sperm motility, or poorly shaped sperm can prevent conception and it’s why male fertility issues are usually examined before checking the woman.

Although the causes of sperm problems might be complex, it is also true that men can be less likely to maintain a healthier lifestyle. By improving this - especially their diet - men can go a long way to improving sperm health. Men with low sperm counts are often shown to have low fructose levels – the sugar associated with fruit and vegetable consumption. Fructose is important because it provides energy for the sperm to survive and travel to the ova.

Poor quality studyCouples desperate to conceive and struggling with the implications of medical fertility treat-ment may look for ‘natural’ solutions instead. But online they could encounter an oft repeated study that suggests diet supplements can have a dramatic effect on fertility.

Many websites refer to a 1992 study by the University of Surrey that appeared to suggest that couples taking a diet supplement went on to have an 80% conception success rate. This report has since been highlighted by the NHS as being based on “very low quality research”. Because there was no control group in the study against which to balance the fi ndings the NHS say, “it is not possible to determine whether the Foresight programme was effective or whether there were other variables which infl uenced the numbers of pregnancy outcomes.” They say the study was “very poorly designed” and in fact the authors of the report themselves drew no conclusions which could point to the supplements or other factors playing a role in the pregnancy success rates.

Nevertheless it is true that a healthy eating regime is important and may go a long way toward improving sperm health and quality.

Of course, it’s boring thinking about healthy eating, but it is one of the easiest changes anyone can make to improve their chances of conceiving, and improvements can be fast and dramatic.

Zinc and folatesZinc is the key nutrient for healthy sperm and any balanced diet should include it as men are frequently zinc defi cient. Don’t go overboard because high zinc levels can also present problems, but ideally around 15mg a day is about right. Zinc-rich foods include dark chicken meat, baked beans and lean minced beef.

Serving sizes are:

Chicken (dark meat) 85g = 2.4mg

Baked Beans 170g = 3.6mg

Minced beef (lean) 85g = 4.5mg

Like women, a diet rich in folates is also important. They’re in dark green vegetables like cabbage, sprouts and broccoli. Beans, jacket potatoes and dried apricots are also good, but careful cooking is needed to ensure the vitamins aren’t destroyed.

If you smoke, you should really try to stop, but if you can’t, increase your vitamin C intake because nicotine reduces absorption and vitamin C is essential as it can’t be stored in the body. Further-more, it helps release iron into the blood stream.

Small amounts of alcohol are okay, but too much is very bad for sperm. It reduces testosterone levels and can lead to lower sperm counts and a higher incidence of abnormal sperm. Drugs are a big no-no. Cannabis, for instance, has been linked with sperm abnormalities.

However, on the plus side, if you love coffee you may be okay keeping up the caffeine habit. Some studies have suggested men who drink coffee may have increased sperm motility, but if you are a high caffeine consumer and have been shown to have a low sperm count you should try cutting the caffeine and getting re-tested to see if that makes a difference.

You (and your potential offspring) really are what you eat.

GUIDES/DIETFERTILITY ROAD

Helping you plan for every stage of your journey... p

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What’s important?FolateWhy? Helps prevent neural tube defects in your developing baby. Foods: A 400mcg daily folic acid supplement, leafy green veg, beans and citrus fruits.

IronWhy? Boots your iron stores to prepare for increased iron needs during pregnancy. Foods: Red meat, pulses, dried fruits and leafy green vegetables.

Vitamin CWhy? Improves iron absorption in your stomach and boosts immunity. Foods: Citrus fruits, kiwi fruits, berries, peppers and leafy green vegetables.

CalciumWhy? Essential for your baby’s development and helps to protects mother’s bones. Foods: Dairy, leafy green veg, dried fruit, sesame seeds, beans and chickpeas.

AlcoholCutting it out will boost fertility, remove any alcohol related risks when you do get pregnant and limit your intake of “empty” calories for a healthy weight.

Top foods to eat to boost your fertility!

A healthy weight and well-balanced diet for both men and women before you conceive will boost your fertility, ensure you are at the best of your health during pregnancy and make sure that you have the energy you will need when your baby finally arrives.

Laura McLoughlin, Tesco Diets Nutritionist

Special Offer for Fertility Readers! 2 weeks extra free*If you are looking to follow a healthy, balanced diet, we offer 16

personalised diet plans and support from nutritionists to help

you every step of the way. To find out more and get 2 weeks

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p038 ADS.indd 1 04/05/2010 11:38


Stress is something couples struggling to conceive will be very familiar with. That seemingly endless monthly procession and the repeated disappointments, rituals and routines; the tests and the constant wishing for a

baby. It all adds up to a very fretful lifestyle. And for those on the IVF cycle, stress levels may be even higher.

And we’ve not yet even factored in the normal everyday demands of life, work, money, family, friends and all of the other countless pressures that we have on us.

Yet, of course, stress is not conducive to conception. High adrenalin and blood pressure levels associated with stress can affect the hypothalamus – the gland in the brain that controls emotions and appetite, whilst also monitoring the hormones that produce testosterone in men, and that trigger egg release in women.

This is why a woman’s periods might be affected when she’s going through a particularly stressful time – like moving house or coping with bereavement. Ovulation and menstruation can be delayed. That said, the body does have the ability to adjust and adapt to continued stress, and periods may not be adversely affected by, say, a stressful job.

Perhaps this stress effect accounts for the stories we all hear of couples who gave up trying for a baby and then fell pregnant. When the pressure is off the body relaxes, hormone levels return to normal and the inevitable happens. It’s not easy though when the ‘helpful’ advice amounting to “just relax and it will happen” makes you want to scream!

All this aside, the stress, pressure and structured monthly rou-tine hardly make for romance which is fairly essential for you and your partner to get up close and personal.

So don’t take your stress out on each other - you need another way to burn off that adrenalin whilst bring-ing your hormone levels under control. And the best method is obviously through exercise. Not only will it help with the type of healthy lifestyle so conducive to boosting fertility, but it should help you feel better about yourself as a whole.

Stress relieving exercise releases en-dorphins into the bloodstream. These are the body’s pleasure chemicals and they can help you deal with anxiety more easily. Regular exercise can also help you sleep which is essential for any healthy lifestyle. Repetitive and rhythmic exercise is especially good for switching off from thinking about the things that worry you.

Many people fi nd running to be a great stress buster, but it is high impact and hard on the joints so a good alternative is cycling. Boxercise and aerobics that get the heart pumping are good for boosting endorphins, while weights can help some people feel less tense. Be careful though, they can also be quite tiring and you may not get that rejuvenating buzz you feel after a good work out.

For something a little gentler, a swim can be good. Many people fi nd being in the water to be very relaxing. Being a

slower exercise it can be harder to switch off, so try to empty your mind and focus simply on yourself and the swim.

If you like the idea of being around water, but are thinking of something that raises a sweat you might like the rhythmic exercise of rowing.

Finally, why not consider pilates or yoga? Not only are their meditative qualities relaxing but some studies suggest that cer-tain yoga poses can help boost fertility. Because it can increase blood fl ow to targeted organs it can be especially good for women as it heightens the receptivity of the womb to ova, and stimulates ovulation. Some IVF clinics now run classes for couples and in some cases it seems to have increased conception success rates.

As with anything, it’s a case of doing what feels right for you, but some exercise, no matter what it is, is always better than no exercise at all.

Stress relieving exercise releases endorphins into the bloodstream. These are the body’s pleasure chemicals and they can help you deal with anxiety more easily.

GUIDES/EXERCISEFERTILITY ROAD


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FEATURE | health

Big nights out, meals on the run and more caffeine, nicotine or alcohol than is strictly good for you (and that’s not even mentioning illegal substances)… if this list brings back fond

memories of your student days or a fl at-share in your 20s, you’re probably not alone.

But now you’re settled down and trying for a family, how much does any misspent youth affect your chances of conceiving? And what extent should you worry about any vices you may still have?

Here’s the lowdown on what you need to know.

The eff ects of smoking If you used to smoke or haven’t given up yet then the bad news is that, for women, smoking has an irreversible effect on your eggs and ovary (egg) reserves.

Tarek El-Touhky, consultant in repro ductive medicine and surgery at Guy’s and St Thomas’ Hospital in London, explains. “Smoking is detrimental to egg quality and quantity. If you are 30 and you smoke, your ovaries

may behave as if you are 40. It makes the likelihood of responding to [fertility] treatment less.”

Anita O’Neill, group practice manager and consult-ant midwife at the Zita West Clinic agrees: “Women who smoke are at higher risk of an early menopause – in other words, premature ageing of the ovaries.”

“In addition, women can’t undo any damage to their egg supply,” says Anita. “But a man who may have been smoking 10 years and who has sub-optimal sperm levels can give up cigarettes and you will invariably see an improvement.”

What’s more, it doesn’t matter if you smoke a little or a lot. The effect is the same. “There’s no ‘safe’ smoking level,” says Tarek. “You also need to look at things in the wider perspective. For example, if a woman who smokes conceives, the pregnancy is more likely to be complicated.”

The upshot is if you haven’t yet packed in the habit, make it your priority to quit now. Not only will it boost your health generally, as a woman you’ll be

SENDING IN THE VICE

SQUAD?

Whether it’s smoking, drinking too much or a having bad diet, most of us have been guilty of leading a less-than-perfect lifestyle at some point. But how much do these bad habits – past or present – aff ect your chances of getting pregnant?

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A report, published in 2004 by the British Medical Association entitled ‘Smoking and Reproductive Life’, concluded that smoking reduces fertility in both men and women and highlighted that:

• substances present in cigarette smoke are toxic to the testes and ovaries.

• women who smoke take longer to conceive: among smokers, the chances of conceiving are decreased by 10–40% per cycle.

• men who smoke have a lower sperm count than non-smokers, and their semen containsa higher proportion of malformed sperm.

• by-products of nicotine present in the semen of smokers have been found to reduce the motility of sperm, aff ecting their normal swimming patterns, whilst also damaging the genetic material in sperm cells.

41

WORDS | SARAH HART

helping to limit any damage to your egg supply, while men will see an immediate improvement in the quality of their sperm.

The impact of alcohol While the odd glass of wine as the can be a great way to unwind after a hard week’s work, if you’re trying for a baby, keeping tabs on how much and how often you drink could improve your chances of success.

A recent study (2009) of 2,500 US couples by doctors at the Harvard Medical School in Boston found that men and women who drank six or more units of alcohol per week (two strong pints of beer or two large glasses of wine) “signifi cantly reduced their likelihood of pregnancy”. For women, it cut their chances of getting pregnant by 18%.

The researchers also found that women who had between one and nine units of white wine a week had a 23% greater chance of failed implantation of an IVF embryo, while men who drank a beer daily contributed to a 38% greater chance of failed implantation.

So should you cut out booze altogether if you’re trying? “Alcohol causes free

radical damage which is a big factor with sperm in particular, but also eggs,” says Anita. “Regular heavy drinking or binge drinking can interfere with ovulation and contributes to poor ovary reserves.

“There is no ‘known’ safe limit, so it’s best to avoid it,” she continues. “But this is hard if you’re trying to conceive naturally – because it may, for example, take fi ve years to conceive. So in this instance it’s about moderation. A glass of wine on a Friday evening is fi ne, but women should stick to four units a week (or below), and six to eight units (or less) for men.”

As with smoking, men are in the lucky camp. Simply stopping can immediately improve the quantity and quality of sperm levels. While for women, not just current but past drinking may have contributed to poor egg quality.

“Poor ovarian reserves is the single biggest problem contributing to infertility,” says Anita. But whatever you may or may not have done in the past, her advice is to now focus on the present and do all you can to maintain the eggs you have left and try to keep them in the best quality condition.

MEN WHO DRINK A BEER DAILY HAVE

A 38% GREATER CHANCE OF FAILED

IMPLANTATION.

MORE REASONS TO QUITSMOKING

2004 by the British


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HARLEY STREET FERTILITY CENTREMAURITIUS

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Why pay more in Europe, when you can have the same expertise and technology including a 10-day holiday in a tropical paradise?

The Centre is headed by Dr Rajat Goswamy, FRCOG, who has been providing IVF

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Success rates at the Centre for these treatments have been consistently above 40 %

• Laparoscopic Surgery for Endometriosis and Polycystic Ovaries (PCO) • Hysteroscopic Surgery for fibroids, polyps, and intra-uterine adhesions

These keyhole surgical procedures are performed at Fortis Clinique Darné.

Pregnancy rates following these procedures match those obtained with the artificial reproductive techniques listed above.

For further information about us, and on treatment packages which include hotel accommodation, visit our website : www.harleystreetfertility.comw

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43

Doing drugsIt shouldn’t come as a surprise but recrea-tional drugs are a big ‘no’ for anyone who is trying to conceive.

“Recreational drugs can affect sperm in particular,” says Tarek. “We know, for example, that drugs such as cocaine and marijuana can disrupt the regeneration and multiplica-tion of sperm.”

Indeed, scientists at Buffalo University in 2003 found that men who regularly smoked marijuana (on average 14 times a week for at least fi ve years) had signifi -cantly less seminal fl uid and a lower sperm count than non-drug users. Their sperm were also more likely to swim too fast too early, leading to ‘burn-out’ before they reach the egg. It’s thought this was due to several chemicals contained in marijuana, including tetrahydrocannabinol (THC) which may disrupt the way sperm swim or block the mechanisms designed to weed out malfunctioning sperm.

“Recreational drugs can also affect the way the egg matures,” says Tarek. An egg has to go through various phases of maturation, and the effect of drugs may be to create a situation where, says Tarek, “you may have a prematurely aged egg or one that has not matured well – in other words where the genetic make up is not right.

“People who take recreational drugs now and then, say two or three times a month, may not see this as an issue,” says Anita. “But even this amount certainly damages eggs and sperm.”

You are what you eatSkipping breakfast, grabbing a shop-bought sandwich and then coming home to a ready-meal may not sound like it could have a big impact on your chances of conceiving but, according to Anita, diet is one of the major factors affecting the chances of conception, especially for women.

“Many women think they know about nutrition, but actually they know more about ‘diets’,” she says. “For example, a woman’s typical day might include a diet-ready meal, which is highly processed. Diet foods contain chemicals and sweeteners too. Instead, you should think in terms eating quality food: cooking from scratch with fresh foods that are as close to their natural state as possible. Eating well means that your blood sugar level will be more balanced, so your hormones will be more balanced too,” she continues. “High levels of insulin [the hormone released by the body to regulate the level of sugar in the blood] in the bloodstream are damaging to eggs and can lead to problems with ovulation and hormone balance.”

Anita advises following a diet that consists of good quality protein, complex (starchy) carbs and plenty of fruit and vegetables.

Meanwhile Tarek also recommends that both men and women have a diet that’s rich in antioxidants, which include Vitamin C, E, zinc, selenium and folic acid. “There is emerging evidence that antioxidants can improve sperm quality,” he says. Good sources of Vitamin C and E include citrus fruits and nuts respectively, while zinc is found in meat (such as lamb) and pumpkin seeds. Brazil nuts and eggs are rich in selenium and good sources of folic acid include green leafy vegetables, pulses, oats and wholegrains.

Conclusion“While a so-called mis-spent youth may make notable differences to your body’s health and strength in terms of reproductive biology, for most men and women the effects are minimal, and for all individuals, the biggest infl uence on fertility are the lifestyle choices in the present, not the past.”

Whatever your present or past lifestyle, it’s worth bearing in mind that the age you are when you choose to start a family is another big factor aff ecting your chances. As Tarek explains.

“Delaying starting a family probably has the biggest impact on the chances of pregnancy. The chance of a couple aged 25 becoming pregnant within six months is three or four times greater compared to a couple aged 35 or 40, for example.

“Fertility in women starts to decline at 31. There’s no concrete evidence as to exactly when it starts to decline rapidly – one theory is that an acceleration of decline occurs at between 35 and 38; another is that the decline is gradual until 40, 41 or 42. In reality it’s academic. For all women fertility declines from 31 and the pace at which it continues to decline will vary between individuals.”

And the eff ect of age is greater on women than on men. This is because, says Tarek, “women only have a fi nite supply of eggs whereas men can regenerate their stock of sperm all the time.”

MANY WOMEN THINK THEY KNOW ABOUT NUTRITION,

BUT ACTUALLY THEY KNOW ABOUT

‘DIETS’


AMATTER OFAGE

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Q&A | zita west

Q I start IVF shortly and wanted to know if acupuncture will help improve my chances of a successful treat-ment cycle. I read an article recently from British

Fertility Society that says that acupuncture has no eff ect on success when undergoing IVF treatment, is this correct? – Sharon Selwick, Aberdeen

A I am a great fan of acupuncture personally and would recom-mend its usage. While I can’t sit here and say acupuncture works in 100% of cases, we’ve had many patients who have

told us that it has helped reduce the side effects of IVF treatments, which has to be a good thing.

As a drugless and non-evasive therapy, there is no associated risk in terms of its usage, so my advice would be that it’s worth trying as it could help you during the IVF cycle. I think what is very diffi cult with acupuncture is randomising it and giving statistics about its success, as you may be able to do in mainstream medicine.

The whole thing about acupuncture is that it is an individualised and holistic treatment and no one person is treated the same way. The fact that no person is treated in the same way makes it hard to test in clinical trials. This applies to a lot of complementary therapies.

We use a lot of acupuncture at my clinic and what patients constantly feed back to us is how the treatment gives them a sense of wellbeing, helps them feel in control of the situation they are going through and that it is a positive and supportive measure.

EXPERTWITNESS

WITH ZITA WEST

We ask a leading fertility expert to take time to answer questions sent in by readers via the Fertility Road website. In this issue, renowned pregnancy and fertility expert Zita West takes time out to address your concerns...

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Q I have regularly suff ered from irregular cycles. Am I at a defi nite disadvantage when it comes to being able to conceive? Or are there methods I can put

in place to help?– Lucey Cotton, Manchester

A Irregular cycles can impact on the time it takes to get pregnant certainly as you are not having as many periods and also making it diffi cult to know the time in the month

best to try to conceive.What is important is that the cause of your irregular cycles is

explored. There are many factors that can bring about irregular cycles, including your age and lifestyle factors including your weight and stress levels. If you come off the pill, that can also cause irregular cycles to begin with. You could also have an underlying medical problem, such as an underactive or overactive thyroid.

There are methods you can put in place to help reduce the impact of irregular cycles or likelihood of suffering with them in the fi rst place. As with most medical issues, diet and exercise are vitally important. I would recommend a diet of bright fruit and vegetables which contain antioxidants, as this helps maintain a balanced metabolism. Problems with metabolism can impact on fertility and pregnancy cycles.

Foods which are high in Omega 3s and iron are also recommended as they are proven to help keep your reproductive health strong.

Q My confi dence has recently been shattered by IVF failure. I don’t know how to move on and feel

stuck. Will these feelings pass, and what can I do to help them pass more quickly. My specialist is so scientifi c that it feels as if there is little emotional support from someone who, I imagine, knows the most about what I am going through.– Paula Barrett-Ramsamy, Norwich

A No matter who you are, an IVF failure will have a negative impact on you psychologically because there is so much hope and emotion that goes into this process.

How long it takes you to move on from these feelings is diffi cult to say. Some people can get over this kind of setback in a matter of days, for others it can take years.

The best way to overcome feelings of despondency is to create a plan of what you are going to do next. Go back to your specialist and decide what to do. Lifestyle is very important when re-approaching IVF cycles and putting in place subtle changes can make all the difference second time around.

Mindset is also crucial and a lot of work we do with our patients here is helping them feel positive after IVF setbacks. If you fi nd you are not getting the appropriate levels of support

from your specialist, don’t despair, as there are people out there who understand what you are going through. Find someone who can talk to you in layman’s terms, rather than science speak - be that another medical professional, or a forum online where you can converse with people in the same situation as yourself.

Q During my last treatment I suff ered from mood-swings and headaches. Is there anything I can take to reduce my symptoms to drugs?

– Angela Branning, Woking

A Fertility medication and IVF treatment affects different women in different ways. Some can suffer little side effects, whereas others will commonly experience things like

mood swings and headaches.Preparation for IVF treatment is essential and you should

look to go into it in the best shape possible. As I mentioned previously, diet and exercise are two key factors in reducing your likelihood of side effects. Getting lots of sleep and keeping well hydrated are other important elements you should consider to help reduce problems.

The best way to overcome feelings of despondency is to create a plan of what you are going to do next. Go back to your specialist and decide what to do.


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Q&A | zita west

Q My husband and I have just decided to start trying for a baby, yet he has suff ered from underlying stress in the past which has caused him to take time off work. As fate would have it he has just been off ered a job in New

York and the chance is there for us both to move out to the States for a minimum of two years. I realise that this move wouldn’t be conducive to good fertile health, but should we really pass the move up?– Caoimhe Patrick, Limerick

A Stress has a massive impact on hormones and, as a result, fertility in both men and women. Relocating would obviously be a stressful experience for you both but it is not for me to say whether or not you should take up the move.

There are measures your husband could take to overcome stress if you made the move and hopefully your dream of pregnancy could still be realised in the States.

Twenty minutes of deep relaxation every day is a great stress buster and you can meet experts who are able to show you precise techniques for this kind of relaxation. I’d suggest your husband exploring whether you move or not, as it will undoubtedly affect his overall wellbeing.

Q What are the causes of bleeding in early pregnancy? My bleeding has ranged from a brown-pinkish discharge to bright red. Many sites say this could be implantation bleed but it seems that it’s too far down the

line to still be considered implantation.– Chloe Redmond, London

A I wouldn’t want to comment too much on this as bleeding, especially when it is discoloured – it is a serious issue and one which a GP should explore directly.

Implantation bleed is usually reddish brown in colour and occurs intermittently. It tends to appear over a period of just one to three days and shows as light spotting rather than the heavy fl ow of a menstrual period. If you conceive, you will experience implantation bleeding before your period is due, usually around nine days after you ovulate.

If you have any questions for our Expert Witness please visit www.fertilityroad.com

Zita West has given specialist fertility and pregnancy advice for over 25 years, as a midwife, an acupuncturist, a nutritional advisor and as an author and consultant.

She has also written numerous books on fertility and pregnancy, with her latest title, Zita West’s Guide to Fertility and Assisted Conception now available.

Zita’s Clinic is based at 37 Manchester Street, London, W1U 7LJ and can be contacted on 0207 224 0017 or [email protected]

For more information on Zita, her clinic or books, visit www.zitawest.com

MORE ABOUTZITA WEST

Stress has a massive impact on hormones and, as a result, fertility in both men and women. Twenty minutes of deep relaxation daily is a great stress buster.

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Excellent hypnosis downloads are available for Natural Conception and IVF at www.thefertilebody.com/Shop/MP3s

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Whether you are trying naturally or going through assisted fertility treatments, we can help you address the mental, emotional and physical factors which may be affecting your fertility.

Using a powerful combination of effective counselling, hypnosis and other mind-body approaches our therapists aim to:

• Empower you with simple self help tools that allow you to regain control

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• Enhance the effectiveness of IVF and other fertility treatment

• Provide you with good emotional support

p048 ADS.indd 1 04/05/2010 12:04


There has been a lot said about acupuncture for fertility in the last few years, and often the messages about whether acupuncture ‘works’ are confl icting – ‘yes it does’, ‘no it doesn’t’!

I’d like to talk to you as an acupuncturist and explain what I understand about why acupuncture is such a wonderful treatment for fertility – how it can provide support and nourishment, correct imbalances, and help you to improve your fertility through diet and lifestyle choices appropriate to your constitution.

Practitioners of TCM (Traditional Chinese Medicine), refer to the ‘constitutional diagnosis’ which helps us to determine the overall relationships of function in the complex of systems that is your physiology. In Chinese Medicine your emotional and mental state is considered to be part of your physiology. The body is never seen as separate from your heart and mind.

The constitutional diagnosis is identifying the quality and state of the climate of your body; understanding your physiology in the same way a farmer needs to understand the climate and soil to grow healthy crops. Internally, some people may have too much heat, others may be too cold, or there may be an inappropriate accumulation of fl uids (known in TCM as damp).

A TCM practitioner (acupuncturist) is uniquely qualifi ed to advise you of the climate and condition of your body, particularly in relation to your fertility. We use pulse and tongue diagnosis and in combination with your history, the signs and symptoms (e.g. how your period is behaving/what the sperm parameters show) we can offer you a constitutional diagnosis and help to apply the corrective treatment to balance your systems.

This is how we determine which acupuncture points to use, and this is why every person’s acupuncture treatment is unique. You will receive points that are most appropriate for your particular constitution, helping to resolve excesses, to supplement defi ciencies (and who doesn’t have those?!), and to improve the functions of all your systems. This is one of the key reasons that acupuncture is so calming and is so effective for relieving stress.

The Baby Making Bible by Emma Cannon is an excellent book ex-plaining, clearly and in detail, how to understand the importance of your constitutional type, teaching you specifi c ways to adapt your diet and lifestyle to enhance your fertility. This is a superb guide to helping you to be very pro-active in fi nding the best ways for you to improve your fertility, using the wealth, depth and breadth of the wisdom of Chinese Medicine as your signposts.

Gynaecology and fertility is one of the most studied aspects of TCM, and here in the UK we have a growing number of practitioners with a special interest in this fi eld. The AFN, Acupuncture Fertility Network (www.acupuncture-fertility.org) is a group of practitioners who have all done integrated postgraduate training, studying fertility and assisted conception from a western viewpoint, coupled with specialist training on the application of acupuncture for:

• unexplained infertility

• pre-conception care and assisted conception support

• low sperm parameters: count, motility, morphology

• PCOS

• endometriosis

• ovulation issues

• menstrual cycle irregularities

• recurrent miscarriage

The National Network of Zita West Affi liated Acupuncturists are practitioners who have also done specialist training in supporting fertility with Chinese Medicine.

When you are looking for an acupuncture practitioner do be sure to ask them about their fertility training and experience. A well qualifi ed practitioner will be happy to discuss their approach with you, and don’t hesitate to shop around, it is important to fi nd a practitioner who you feel comfortable and confi dent with.

There is so much more to say about all the reasons why acupuncture is so benefi cial for fertility. Please log on to www.naturechild.co.uk to fi nd ‘Jani’s Blog’, and read more about this fascinating subject…

WORDS | JANI WHITE

GUIDES/ACUPUNCTUREFERTILITY ROAD


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GETTING TO THE POINT

p.49_fertility_road.indd 49 29/04/2010 10:20


The average cost of raising a child up to the age of 21 has exceeded the £200,000 mark for the fi rst time, according to recent research.

An annual report from the UK’s largest friendly society, LV=, has revealed parents spend an average of £201,809 on raising a child – a 4% rise on 2009 fi gures. And most startling is that since the survey began in 2003, the average cost has risen a staggering 43% from an estimated level of £86,778 seven years ago.

The survey’s fi ndings mean that UK parents are typically spending nearly £10,000 to feed, clothe and educate their children every year. In Greater London, the yearly average fi gure is £10,513, or £220,769 over 21 years. In contrast, Yorkshire and Humber are the cheapest areas in which to raise children according to the research, coming in at £177,706, but the costs remain considerable wherever you live.

Of the £201,809 fi gure, childcare is shown to be the largest outgoing to families, costing as much as £54,696 for one child between the ages of six months and 16 years of age where both parents are working. Education-related costs come a close second, with an average of £52,881 being spent on school uniforms, sports equipment and trips.

And if you put your child through private education, you can expect to pay nearly a third more than the average family. The overall fee to advance a child through day school is £70,000, and more than £130,000 for a place at a boarding school. And should your son or daughter make it to university, you can also expect to pay a whopping £13,677 a year on a three-year undergraduate programme.

It may come as a great surprise, particularly for those without children, to see the cost of raising a child increase for the seventh consecutive year, despite the current fi nancial climate. In total, 77% of parents polled in the LV= survey say they have had to rein in their expenditure. Despite this, the cost of being a family has still risen.

The charity Daycare Trust, which campaigns for high quality and affordable childcare in the UK, has expressed its concern at the costs of raising a child. They have highlighted the fact that the price of a nursery place for a youngster had risen by 5.1% over the last two years - almost double the rate of infl ation.

In an attempt to stretch family budgets, seven out of 10 individuals interviewed said they regularly shopped for bargain basement supermarket items in ‘value’ ranges; while over a third of families were selling unwanted goods through online auction sites and car boot sales to make extra cash.

The average UK family has 1.8 children and a household income of £32,779 per annum, meaning at least one third of take home earnings each year are spent on children.

Clearly, the cost of caring for our little ones until they are 21 is going to cost the average family a small fortune. Yet while fi nance is only one small proportion of the whole family-making process, which also seems to be fl ooded with tradition, preconceptions and superstitions, there is one adage that links them all and, for many, hits a particular resonance:

‘They’re worth every penny and you wouldn’t swap them for the world!’

And the right time is almost always decided in our hearts, not our wallets, but planning and budgeting well, and seeking out sound advice along the way, will almost certainly make the fi nancial fear seem that bit more manageable.

GUIDES/FINANCEFERTILITY ROAD


And if you put your child through private education, you can expect to pay nearly a third more than the average family.

The little bundle of joy which costs a small fortune...

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The average wait period for an egg donor across the UK is currently around two-and-a-half years and rising. Recent fi gures have revealed that in London alone, over 500 couples are in desperate need of a donor egg to become

parents. Nationally, there are less that 500 registered egg donors despite yearly demand for over 1,200 from women who may have undergone radiotherapy treatment, early menopause or other medical conditions which makes them unable to produce eggs of their own.

Changes to regulation affecting people donating sperm, eggs or embryos has seen a signifi cant drop in egg donors ever since. Five years ago, people donating sperm, eggs or embryos could remain anonymous. They were asked to provide some non-identifying information which could be given to people choosing a donor for treatment, and to any person conceived using their donation (at age 18).

The Government lifted anonymity for donors in April 2005, meaning that anyone born using donated sperm, eggs or embryos can obtain identifying information about the donor from the Human Fertilisation & Embryology Authority (HFEA) when they reach the age of 18. This change in regulation is thought to be a key factor behind the current donor egg shortage.

The maximum payment which an egg or sperm donor can currently receive is also thought to be prohibitive. The maximum a UK donor can receive is £250, while in the USA, donors can get up to £6,600 a time.

There has been a 30% drop in egg donors in the UK over the last three years and a number of leading fertility experts have spoken out against regulation which is blamed on the current shortage.

HFEA Chair Professor Lisa Jardine told The Times newspaper recently that she felt a “responsibility” to look at the ban on selling donated eggs and sperm to help ease the current situation. Professor Jardine felt that a payment “comparable to the cost of a cycle of IVF treatment” – around £3,000 – would be an appropriate

level of compensation for women who donate eggs. The London Bridge Fertility, Gynaecology and Genetics Centre (Bridge) has urged for “a more enlightened solution” to ensure that, at a minimum, egg donors are not left out of pocket.

A spokesperson for Bridge told Fertility Road:“The withdrawal of donor anonymity and the regulations

governing the reimbursement of egg donors in the UK have combined to ensure that there are insuffi cient UK donors to meet requirements – hence the emergence of the alternatives. A more enlightened solution is necessary and, while the anonymity provi-sions are, perhaps, beyond change, an approach that ensures that

donation does not involve a fi nancial loss must surely be possible. “The right solution may not be too diffi cult to defi ne – realistic

and, if necessary, generous allowances must completely remove any possibility that legitimate donor expenses cannot be covered in full. In addition to this, modest but necessary compensation must be allowed for the invasive discomfort of the donation process without creating a fi nancial incentive in itself. There must still be an element of motivation and commitment on the part of the donor that necessarily transcends the fi nancial considerations.

“We do not live in an altruistic society and we cannot continue to allow the current regulations to act as a major disincentive. It is only when this is recognised, addressed and corrected that the boom in fertility tourism will come to an end and centres like Bridge will be able to treat most of the patients requiring donor eggs in their home country.”

There has been a 30% drop in egg donors in the UK over the last three years and fertility experts have spoken out against regulation which is blamed on the current shortage

GUIDES/LAWFERTILITY ROAD


CONCERN OVER SHORTAGE OF DONOR EGGS IN THE UK.

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If you’re just stepping out on your own fertility road, you’ll most likely have been bombarded with ideas, suggestions, marketing speak and other messages.

Deciphering what relates to you and what doesn’t is a task more diffi cult than many imagine, though with the help of the Infertility Network UK (INUK ) – a national charity for those experiencing fertility problems – you may well be able to see a clearer path ahead.

INUK are always at hand to help individuals and couples in need of information, offering face-to-face and over-the-phone advice and information at both national and regional level.

Its prime goal is to help couples make informed decisions throughout the infertility process. Another is to provide emotional support. Whatever help is needed, they will endeavour to provide it – even if it is simply showing the way forward.

And most crucially, a freephone line offers help, advice, support and a listening ear at any time in the strictest of confi dence, sometimes at those most painful moments.

The Infertility Network’s Helpliners are people who have experienced fertility problems themselves, and who are happy to talk of their trials, while a dedicated daytime Advice Line, manned by trained nurses with counselling skills can often help explain procedures and other aspects of treatment in everyday language.

Information over the internet is also easily obtainable, and the INUK website contains a huge amount of content as well as chatrooms and forums providing mutual support.

There’s additional help for infertility sufferers facing treatment who often have problems when trying to gain access to NHS treatment, either because they do not meet the criteria for that treatment, or worse still, because their PCT or Health Board fund limited treatment or none at all.

Infertility Network UK and Infertility Network Scotland have been work-ing with these PCTs and Health Boards through a project funded by the respective Government Health Departments to share good practice and encourage full implementation of current guidelines and recom-mendations.

It is important that those with fertil-ity problems know that they have people within INUK who are working to try to ensure a fair and equitable

service is made available to everyone irrespective of where they live. Anyone faced with problems in accessing treatment can contact INUK for help. Or for information on what your PCT or Health Board currently provide, you can go to the Funding for Fertility section of the website – see more information on the following page.

There are many other services the charity provides to help those facing fertility problems, including factsheets, a quarterly magazine and an electronic newsletter to name but a few.

The INUK are ready to assist from day one, and will continue that help and support, whatever the outcome, throughout the process.

For more information, call the SupportLine on 0800 008 7464, or visit www.infertilitynetworkuk.com

FERTILITY ROAD | Infertility Network

Infertility Network UK services

• Professional advice line• Interactive website• Quarterly magazine• Medical advisers• Fact sheets• Regional network• Information days• Infertility publications

INFORMATION STATIONS THE INFERTILITY NETWORK

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ADVERTORIAL

Also worth investigating:

Funding For Fertility is another crucial part of the Infertility Network.

FFF was created in order to help the many thousands of people suffering the effects of infertility, who have the added distress of fi nding they cannot access treatment because

their PCT or Health Board offers limited – or indeed in some cases no – assisted conception treatments.

Infertility Network, working with The National Infertility Aware-ness Campaign, has campaigned tirelessly for better NHS provision and provides a section on their website where those seeking treatment can go for information and advice on the options avail-able when seeking NHS fertility treatment.

FFF has been designed to answer readers’ questions whilst trying to help alleviate concerns in various key areas, including:

• How fertility issues are currently managed by the NHS• What fertility care you are entitled to• To what extent the NHS funds fertility care in your local area • What you can do if the NHS will not fund the fertility

treatment that you are entitled to.

An interactive map enables easy identifi cation of the NHS funding for fertility provision in your local area and also allows you to compare that of neighbouring areas.

There are also template letters available for you to download so you can write to your PCT or Health Board, and also to your MP or MSP.

Don’t just accept it if you fi nd yourself faced with being unable to access NHS treatment, go to www.fundingforfertility.co.uk for help and advice. You can also email FFF with details of your funding access problems to [email protected] and they will try to guide you in your fi ght for funding.

The following two initiatives are also accessible through the Infertility Network website…

More to Life is an organisation for those who either were not successful with treatment or never had treatment and face involuntary childlessness.

ACeBabes, meanwhile, is another part of the INUK. This organi-sation provides advice and information for families following assisted conception. Whatever the issues faced, they can help.

g ACeBabes mean

p.52_fertility_road_network NEW.indd 53 30/04/2010 11:29

Cardone Reproductive Medicine and Infertility: Your U.S. Source for Egg Donation and Surrogacy

Are you considering infertility treatment in the United States? If so, Cardone Reproductive Medicine and Infertility can offer you personalized egg donation, gestational surrogacy and in vitro fertilization services from one of the Boston-area’s leading infertility specialists.

Medical Director Vito Cardone has been instrumental in perfecting egg donation protocols and headed the medical team that achieved the first egg donation pregnancy in New England. He has conducted hundreds of egg donor and gestational surrogacy cycles and thousands of IVF cycles during his two decades

of practice. Speaking four languages, Dr. Cardone has treated many international fertility patients.

Boston is only a five-hour plane ride from London and currency exchanges rates are very favorable. Please visit our Web site to learn about the many resources we provide for international patients and their families. We look forward to hearing from you soon.

Boston Egg Donation & Surrogacy Program

www.cardonerepromed.com

International Infertility Specialists

REPRODUCTIVE MEDICINE & INFERTILITY, LLC& ASSOCIATES

Caring, Compassion and Experience When You Need It Most

Cardoneone 1pp .indd 1 29/04/2010 08:56


Zita West’s Guide to Fertility and Assisted Conception

Vermilion Books, £14.99

Fertility expert Zita West returns with a defi nitive guide that lifts the lid on the real ways to increase your chances of IVF success.

Zita compiled research from over 10,000 couples in order to present possibly the industry’s most conclusive ever guide to the dos and don’ts of good fertility. Also featuring contributions from 15 recognised IVF consultants, this is an extensive guide for couples at any point along the fertility timeline, and Zita isn’t afraid to mix practical advice with sound and impartial thinking. This is an invaluable reference for the growing number of people who are considering, or have already embarked on, medical intervention.

Is Your Body Baby-Friendly? - Dr. Alan Beer

Gazelle Books, £20.99

Acclaimed fertility specialist Dr Alan Beer documents why infertility, IVF failures and recurrent miscarriages happen.

Even today, the majority of pregnancy complications - including premature delivery and stillbirth, and in addition to IVF failure and infertility - are labeled ‘unexplained’. The book details how the immune system can behave in a way that prevents a pregnancy from continuing, and comes with expert comment from world-leading profes-sionals, including Professor David Clark.

• Available at the special price of £19.00 including p&p for readers of Fertility Road. Telephone 01524 68765 or email [email protected].

The Complete Guide To IVF- Kate Brian

Piatkus Books, £12.99

Mother-of-two Kate Brian looks into the estimated 200,000 IVF babies born world-wide each year, celebrating the success of assisted conception whilst offering an invaluable and insightful approach to the process. This book is beautifully crafted, and the author has paid particular attention in using case studies of real people as opposed to expert analysis. It succeeds in going truly ‘behind the curtain’ in a way that is honest yet ultimately reassuring for anyone looking to discover more.

BOOKSFERTILITY ROAD

Our review of the latest fertility titles…

We have copies of the above titles to give away to 15 lucky winners, drawn at random. To enter, simply email your name and contact number to [email protected], stating your top two preferences of books. Entry closes on August 1.

Husband and wife team Katrina and Geoff Logan write and illustrate two fantastic IVF books aimed at educating children on the passage and process of the treatment. We can at times be guilty of concentrating

purely on the mother and father, yet young family members are involved centrally in the sometimes lengthy emotional strug-gles of conceiving.

Author Katrina delves behind the adult jargon in creating two children’s titles designed to reassure young minds. These make a fantastic guide that can be looked back upon throughout and after this nervy yet exciting process. Order from www.ivfbooks.com

Who’s Ivy F? / I’m IVF - Katrina Logan

IVF Books, £14.99

WIN!

p.55_fertility_road_books.indd 55 30/04/2010 11:25

Smith's Medical 1pp.indd 1 13/04/2010 14:47


ADVERTORIAL

In 2008, a team at CARE Fertility, led by Professor Simon Fishel, pioneered the use of Array CGH (Comparative Genomic Hybridisation) to screen the eggs of patients undergoing IVF. In the fi rst case, a 41-year-old woman

with 13 previous failed cycles of IVF at other clinics, successfully conceived through CARE using this revolutionary approach. Fishel, who led the pioneering team, said that the arrival of baby Oliver showed that the test could help couples who have repeatedly failed to become pregnant.

“Approximately 70% of embryos produced either through natural conception or IVF are lost before birth. A major cause of embryo loss, including miscarriage, is a chromosome anomaly (known as aneuploidy) where there is either a loss or gain of a chromosome. Using the technique of Polar Body Array CGH, it is possible to screen all the chromosomes of a human egg prior to the creation of the embryo.

“During the procedure, a microscopic structure called the polar body that lies between the egg itself and its outer ‘shell’ – and contains a copy of all the chromosomes in the egg – is removed before the egg is fertilised. The polar body of each egg is tested using the Array CGH method, providing us with information on the complete chromosome make-up of the egg. In this way we can screen for the chromosomally normal eggs. As the polar body is a ‘surplus’ structure within the egg and normally disappears a few days after fertilisation, this is an ideal way of testing the chromosome material without disrupting the actual chromosomes within the egg itself.”

The technology of Array CGH has the potential to:

• Greatly improve IVF birth rate per embryo transferred

• Minimise the incidence of miscarriages and birth defects caused by irregularity in the chromosome number of eggs (and conditions such as Downs, Edwards or Patau Syndromes)

• Reduce the incidence of multiple pregnancies whilst maintaining a high live birth rate

Array CGH is suitable for all patients. It is particularly suitable for the following groups: women who are aged over 37; men who

have been shown to have sperm at risk of carrying abnormal chromosomes; plus couples who have had several miscarriages or several attempts at IVF but failed without explanation.

But, knowing that even the younger female is at risk of up to half her eggs carrying a chromosome anomaly, it could be argued that using Array CGH to effectively eliminate all such eggs or embryos will increase the chance of success for those couples.

“Ultimately, we could reach the holy grail of one cycle of IVF, one egg, one embryo and one baby,” says Professor Fishel, CARE Fertility.

CARE Fertility is one of the world’s leading providers of

fertility treatments, genetic diagnosis and screening techniques

and associated fertility preservation procedures.

For more information on Array CGH, or CARE Fertility, visit

www.carefertility.com where you can download a Patient

Information Document or telephone your nearest CARE clinic:

Manchester - 0161 249 3040

Northampton - 01604 601606

Nottingham - 0115 852 8100

Sheffi eld - 0114 258 9716

The hope for Array CGH: One IVF cycle, one egg, one embryo – one baby!’

THE NEXT STEP

IN THE EVOLUTION

OF IVF...

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p.57_fertility_road_care_fertility.indd 57 29/04/2010 10:24


SCIENCE | IVF treatment

Type the word ‘infertility’ into an internet search engine and within a matter of seconds you are bombarded with a selection

of real-life stories and miracle cures for a condition that affects one in seven couples in the UK.

The advancements in treating fertility problems nowadays are such that many people are under the misconception that in vitro fertilisation (IVF) is successful in all cases. Stuart Lavery, a consultant gynae-cologist at Queen Charlotte’s Hospital and director of the IVF Hammersmith fertility clinic, says he is regularly coming across patients who do not realise that for all IVF success stories, there are an equal number of disappointments too.

“I believe fertility treatments are one of the greatest medical success stories of the past 30 years,” says Lavery, who is also a private fertility consultant at the 92 Harley Street Clinic. “There have been major

“Technology cannot overcome our biology”, says leading reproductive medicine expert.

MAN...WOMAN...VERSUS MACHINE


59

WORDS | ANDY GREEVES

advancements in the fi eld and patients across the world are benefi ting from this.

“You do have to keep everything in proportion though,” he adds. “There is a belief amongst some people that all IVF treatment works, all of the time and for everyone. This is not the case at all. There is a danger that we are being lulled into a false sense of security that IVF is a fallback policy, and that’s not right.”

Lavery is unsure where such misguided views on IVF treatments have evolved from, but believes it is important that all couples know their chances of success when considering this form of treatment, to have a balanced view of the road ahead.

“The media has created a certain level of ambiguity,” he says. “There’s a tendency to focus on success stories in the press and there’s never really a balanced mention of the events or consequences behind IVF failure.

“I think people’s faith in IVF stems from more subtle sources than the media though. Technology has advanced to the point where it can be perceived to be taking over our natural biology. We need to correct this. The fact remains that whatever technology we have available, that cannot and will not overcome the most simple of biological factors – age. That is crucial when we are talking about issues of fertility.”

An assessment of the latest Human Ferti-lisation and Embryology Authority fi gures shows that IVF treatment isn’t and should never be assumed to be a sure success method. In 2007, 36,861 women received IVF treatment (all forms) in UK clinics and in 24%, a live birth resulted. For women aged 35 or under, nearly a third of all treatments were successful. This fi gure drops to just 12% for those aged 40-42 and a heart-breaking 3% for women aged over 43.

Stuart Lavery believes these statistics show that while IVF is a remarkable treatment, technology cannot overcome our natural biological clock.

“Age is a much bigger factor in female fertility than male. While the male age is important too, the fundamental factor to IVF success is the woman’s age. These statistics emphasise the fact that as you get older it becomes harder to conceive even through the use of IVF. Biology gives an unfair asymmetry here in that men are producing new sperm every second of their reproductive lives, whilst women are born with all the eggs they will ever have.”

While age plays a fundamental role in the success of IVF treatment, Lavery believes that every patient case should be judged on its individual merits when considering treatment options ahead. He stresses: “If there’s even a remote chance that you can make a life-changing differ-ence to someone’s life, then you should.

“Our ideal is to do our very best to help couples achieve their dream. Overall, I have a relaxed attitude to age-capping patients for treatment at my practises. We acknowledge what a stressful time it must be coming to terms with infertility and

considering the options ahead. In other words, we never underestimate the psychological factors in any case.

“People suffering with infertility should always be dealt with fi rst and foremost as human beings and that is a vital message. IVF treatment is at the very heart of current and new life, and is arguably the most important thing many couples will do in their entire lives. As experts, we have a duty to our profession, to those who come to us, and to the overall creation of new life. For that reason, I am always open-minded and comfortable in offering treatment to anyone up to the menopause. In my mind, if conception is biologically possible, as it is before the menopause, then who should we be to judge on age?”

A new hormone injection called Kisspeptin is the latest fertility innovation to hit the news in recent months. Scientists at Imperial College London have found that it increases the levels of sex hormones that control the menstrual cycle. While Lavery describes this as “a potentially exciting fi nding”, sex hormones are just one factor in successful conception.

With various technological advances continuing to be found, Lavery pleads that the fi ltering of information should be more “grass roots” rather that “sci-fi in-spired”, the emphasis being placed on the

importance of our biological clocks in the fertility process.

“It is important that both men and women are supported in their reproductive choices through knowledge of our biological clocks and the impact of age,” he says. “It’s undoubtedly the most important thing, and critical in allowing fully informed decisions to be made about the ‘right’ time to start a family.

“Having a baby is the most important, joyous and life-defi ning thing that can happen to any couple and giving your-selves the best chances of success, either

for natural or an IVF-supported birth is vitally important.

“Really, the time has come to break apart the science from the speculation. I feel we’re on the way towards doing this, but while the invention of communication tools such as the internet have undoubtedly enhanced knowledge, they also run the risk of clouding it with false beliefs and unqualifi ed suppositions.

“It’s a quality versus quantity argument, and it really is worth couples taking the time to make that distinction.”

IVF treatment is at the very heart of current and new life, and is arguably the most important thing many couples will do in their entire lives.

Stuart Lavery is Director of the IVF Clinic, Hammersmith and also practices at 92 Harley Street, London.

For more information:www.ivfh ammersmith.comwww.92harleystreet.com


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ADVERTORIALFERTILITY ROAD | DuoFertility

There have been great strides made in the fertility monitor market in recent years – both in terms of practicality and ease of use. The recent launch of DuoFertility by innovative technology company

Cambridge Temperature Concepts (CTC) appears to signify a signifi cant breakthrough. DuoFertility takes all the time and trouble out of fertility monitoring – and also gives you the reassurance of fertility expert support for up to a whole year. You even get a comprehensive fertility report every six months.

The DuoFertility concept is brilliantly simple. You simply wear a sensor as a patch. Every few days you download data from the sensor to a stylish handheld reader – and your fertility status for the week ahead is revealed at the touch of a button. If you connect your reader to a computer with internet connection, the data downloads to the company’s fertility centre where it is analysed by PhD-qualifi ed fertility experts – then uploaded back to your reader making it ever-more personalised to your particular cycle.

The device is so sensitive it can even be used to forecast fertile days in irregular cycles, the like of which women often experience in PCOS. CTC recently reported giving three days notice of fertile days after an 80-day cycle and their customer conceived. Other success stories on the DuoFertility website (www.duofertility.com) tell of couples who have previously been through IVF using the product, conceiving within months.

Yet despite this astonishing success, fertility monitors appear to be a bit of a grey area as far as the NHS is concerned. Of particular interest is the stance of the National Institute for Clinical Excellence (NICE), who issue guidance to the medical profession on assessing and treating people with fertility problems. They reviewed their guidelines as recently as April 2010 and their advice is clear and to the point. If you want a baby, have intercourse at least every 2-3 days of the month. Fine – if you have the time and the energy. But it’s NICE’s stance on timing intercourse with

ovulation has had the fertility monitor manufacturers (and just about every-body else) scratching their heads given that they also state: “Timing intercourse to coincide with ovulation causes stress and is not recommended.”

To many this advice seems to defy logic and human biology. For it is a certain fact of nature that you will certainly not get pregnant unless you do time intercourse with the few days around ovulation! Surely whether you choose to do that by accident or design should be up to you. And for most women, knowing a week in advance when they are fertile would be hugely reassuring and valuable to know.

NICE guidelines, which are reviewed only once a decade, assume it is stressful for couples to know when a woman is ovulating. But is such a school of thinking out of date? At the same time, as a direct result is it affecting millions of couples, and potentially costing the NHS billions of pounds?

With so few days each month when conception is possible, it’s possible that one of the key reasons that this country is facing an infertility crisis is that the clinical guidelines could be discouraging people from getting pregnant naturally. Surely embracing a notion that monitoring a woman’s fertility can be stress-free could lead to a fundamental change in how infertility is treated – with major benefi ts to the couples in-volved – and to the NHS?

Fertility monitors, such as DuoFertility, solve this problem and give up to a week’s notice of fertile days. This allows couples to plan ahead of time and know when their best days are each month. This is what many fertility monitor manufacturers wanted NICE to review.

CTC, the company behind DuoFertility, believe that if more couples understood the ovulation cycle and utilised a fertility monitor such as DuoFertility, their chances of conceiving would be greatly enhanced.

Dr Oriane Chausiaux, lead fertility consultant at DuoFertility, told Fertility Road magazine:

“Often the answer is very simple – couples need to time sex with the optimum time for conception. Many couples assume they know the best time to try – but they can be wrong. In many cases a woman does not ovulate on day 14 of her cycle. By using a monitor such as DuoFertility they can see fertile days, plan ahead and are much more likely to succeed”.

DuoFertility is available direct from CTC via their website. It is the only fertility monitor on the market that gives you personal support for up to a year from PhD-qualifi ed fertility experts. www.duofertility.com

FERTILITY MONITORS

“Timing is all important”, say Fertility Monitor developers

The help and support you need to get pregnant - naturally

p.60_fertility_road_fert-MONITORS.indd 60 29/04/2010 11:08


SCIENCE | endometrium WORDS | VALERY ZUKIN

It’s a simple fact – in terms of female biology, achieving a normal pregnancy requires at least two factors - the normal embryo and the receptive

endometrium. As scientists, we are learning all the time

about the increasing complexity of requirements relating to the endometrium. We know, for instance, that a thinness of the endometrium in the mid-cycle (regarded as less than 6mm) causes a sharp decline in the chances of achieving pregnancy.

Anything below this value and the chances plummet to below 1%. To say that experts in the fi eld of reproductive

medicine are not trying to fi nd a method of increasing endometrium capacity would be unfair, but progress is frequently caught up in theory and testing.

There are a number of touted methods, everything from the use of well-known stimulant drugs such as Viagra, to leeches, and even massive doses of hormones. However, published results do not lean heavily in any one direction. Given the low effectiveness of Assisted Reproductive Techniques (ARTs) in patients with thin endometrium, the realisation of not being able to conceive is often relatively imme-diate, and infertility support or possible surrogacy considerations often follow.

But at the Nadiya Clinic in Kiev, Ukraine, a second year of study has, it is hoped, brought a group of specialists closer to overcoming the severe fertility limitations a thin endometrium implies.

The basic idea centres around the regen-eration of the endometrium and, more specifi cally, the steady fl ow and health in the basal layer of endometrial stem cells for a woman throughout her reproductive life. As we know, stem cells are special cells that can manipulate themselves into any tissue of the human body, with the main source of stem cells coming from the bone marrow and adipose tissue.

The experts at the Nadiya Clinic are extracting so-called mesenchymal stem

cells from the cells of adipose tissue, these being facile and versatile and capable of further transformation.

The Clinic have been pioneers in the introduction of these stem cells into the endometrium. While our studies were conducted with a perceived positive out-look on results, the scientifi c conclusions were stunning.

In one case study, a patient was intro-duced with stem cells extracted from her adipose tissue and fell pregnant – this, after previously enduring 11 unsuccessful attempts. We continued to monitor the progress of her pregnancy, which by March 2010, was 12 weeks on and in good health.

The Clinic are aware of the many questions that surround this innovative fertility procedure, but patients who have progressed with treatment describe the stem cell endometrium advances as “a light at the end of the tunnel”.

The specifi c treatment and process undertaken by the Nadiya Clinic of Repro-ductive Medicine remains unique, and although this mode of thinking is still very young, experts continue to look over the methods and results with immense interest, as do our patients.”

Valery Zukin is Director of the Nadiya Clinic of Reproductive Medicine, Ukrainewww.ivf.com.ua/en

The endometrium is the uterine lining; specifi cally, the cells that line the womb. The tissue is shed monthly in response to the monthly changes of the menstrual period, afterwards growing back and thickening until the next cycle. The health of the endometrium is thought to relate directly to good fertility. A lining of less than 6mm or greater than 15mm is generally considered a problem.

SIMPLIFIED SCIENCE:

THE END OF THE ENDOMETRIUM DEBATE?

Specialist Valery Zukin explains how stem cell technology is changing our way of viewing endometrium research…

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READER STORY | letter from the heart

I was 29 and my maternal cravings were getting stronger by the day. I had always loved kids, dreamed of being a mummy (this started as young as 10), and had spend many hours, weeks, months babysitting, au-pairing around the

world and nannying. My part-time jobs always involved children and I later became a violin teacher, teaching more children.A perfect environment to bring up a family - I had it all planned.

After almost three years of trying to conceive I started to get worried, especially as I found out that my ex-boyfriend now had a daughter! ‘Damn – it’s not him then!’

I didn’t know much about IVF or how it worked. Living in Cardiff, the waiting list was long and I had to wait over a year to see a consultant. When I eventually saw one, his English was so bad I could barely understand him. I left the room in tears, shocked at the bad reception we’d been afforded. He said he’d do tests. I also made it quite clear that I didn’t want to go ahead with IVF if they didn’t fi nd anything wrong with me, thinking I was still young enough to keep trying o’naturel. The results came back and I was fi ne!

Little did I know this was the start of a very long journey. Three IVFs, two FETs, one IUI, three miscarriages and seven years later I am writing this, still childless. It has been simply devastating. It has taken over my life, it has consumed me daily and I have fought on, still passionate to achieve my dream. My body has

taken a battering, my spirit has been scarred yet I still believe that if I try hard enough I might get there one day. There are many days, even months where I decide it is time to move on, but other days I take a rare glance in the wrong direction and see a baby in a pram and hope comes down and grabs me. I am also losing friends as fast as I can fi nd them, as they are all slowly but surely making babies and most days it’s just too painful to bear.

Three years after my initial appointment, and now aged 33, another consultant at the same hospital told me that in fact I was far from fi ne. I had endometriosis (level three, four being the worst), and a congenitally deformed left fallopian tube, meaning that natural conception was unlikely. You can imagine my shock - I had originally been misdiagnosed. I was mortifi ed. I had just had a laparoscopy and had already had my fi rst IUI (intrauterine insemination) which obviously had not been successful due to the dysfunctional fallopian tube.

LETTER FROM

THE HEART: PIXETTE’S

STORY

Pixette, from Cardiff , opens her heart to tell Fertility Road readers about her rollercoaster ride of conception

There are many days, even months where I decide it is time to move on, but other days I take a rare glance in the wrong direction and see a baby in a pram and hope comes down and grabs me.

‘‘


63

The hospital have since apologised but they can never give me back those lost years. The power these doctors have makes you very much at their mercy; I just shut up and waited for my fi rst IVF treatment.

That fi rst IVF resulted in a pregnancy. Euphoria was followed by complete devastation. I had a blighted ovum (an empty sac) - the embryo had died very early on. I had to have a medically induced abortion which, to anyone who has had one, is quite distressing and very painful. The process was made worse by a doctor prescribing me the wrong medication. I was given a clotting agent and it took me three weeks to miscarry my baby. It was quite horrifi c and I again received an apology from the hospital.

Despite this, three or four months later I decided to go ahead and have my fi rst FET (frozen embryo transfer). I was lucky enough to have three - the process was less arduous than the full IVF, but emotionally it was still hard going. My embies had made the thaw - they were perfect. Of course, I took the time off work again, and did everything I could to improve my chances. We had just bought a house but ploughed everything into treatment - the decorating would have to wait. Changing my whole lifestyle, I focused my entire body and mind on improving my chances, no stone was left unturned. I was back again. Full of hope and determination and on test day I couldn’t believe my eyes, I had done it again. I was pregnant. But a week later I miscarried again. At least this time I was spared the chemically induced abortion.

After my second miscarriage my husband and I were concerned that something else was wrong. We decided to go for all the tests relating to miscarriages, which would take about six months to complete – I was now 35, and panicking. The tests came back and I learnt that I had Factor V Leiden, a blood clotting disorder that could possibly be the cause of my miscarriages. The test cost £20, a simple blood test that could easily have been done at the begin-ning of my journey (at the age of 29), but is not considered obligatory in this country; I wasn’t even given the option.

Two miscarriages and £5,000 later they did the test and I was factor fi ve, along with 5% of the population. I was shocked and fl abbergasted. They decided to prescribe me heparin for my second attempt of IVF, which was my long-awaited NHS cycle. This one was going to be free at least, but had I known what the hospital would do, I would have spared myself the trauma.

Everything went to plan until after egg collection when, still groggy and sore, my husband and I were asked in to see the embryologist. He proceeded to tell us that my husband’s sample was ‘even lower in quality than last time’ and that he wanted us to consider ICSI (intracytoplasmic sperm injection). It was like being hit so hard – it didn’t hurt! ‘What do you mean lower than last time?’ We had never been told that my husband’s sample was of diminished quality in the fi rst place.

I asked the embryologist what he thought considering we’d had nine fertilised the fi rst time with IVF and he said it was worth a shot – stick with IVF. The next day, out of 10 eggs, only one fertilised. The whole procedure had been a waste and my husband and I were completely confused. Not surprisingly, the treatment did not result in a pregnancy.

We have since received another apology and confi rmation that my husband’s sperm sample was not below the norm, however it

took a small dive on the day. Discouraged, hurting and having lost all faith in the British system, we opted for medical tourism. We desperately needed a holiday too and, after much research, decided to go to the Superior ART clinic in Thailand, Bangkok. We stayed fi ve days and were treated like royalty. The treatment went very well and I ended up with nine blastocysts, grade A. An amazing result and a huge success, we were ecstatic. The clinic had done its job and now all we had to do was wait 10 days for the results. I had had three embies put in and froze the other six. Test day came - it hadn’t worked! I was inconsolable and knew this was pretty much the end. I knew I couldn’t go on, and that my whole life plans would have to change. How could I keep teaching, staring failure in the face every day?

But I picked myself up and retrained. After some counselling sessions, my fi rst lot of exams, and a lot of umming and arring, in June last year my husband and I decided we’d go back to

Bangkok to pick up two of our frozen embies. I was now 36. My motto has always been you have to be in it to win it. We went to the same clinic, saw the same doctor, the only difference this time is that I had insisted on not taking the blood-thinning agent heparin until I got pregnant. I would take it from test day. Both my pregnancies to date were achieved without heparin – I wanted to give it a go. Maybe it was just women’s intuition – who knows?

Ten days later I was back in Britain and pregnant! Finally my body had responded. It was working. I worked! At seven weeks I saw my little embryo’s heart pumping so strongly I couldn’t believe my eyes. We had fi nally done it. We were both overwhelmed and so happy. What a journey it had been. But at seven-and-a-half weeks my embryo’s heart stopped beating. I was told three months later that it was due to chromosome 16, the most common cause of miscarriage and one that doesn’t support life. It was just bad luck.

At this stage, I have just fi nished my Diploma. I feel so proud that I can now focus on my new career and have so much to look forward to. My husband and I are strong together. We have been married for 10 years and are still very much in love. I retain hope and believe that maybe one day, if I am strong enough to continue, my dream might come true. If not, then at least I tried. We are going back to Bangkok to pick up three more embies in October and I have one more fresh cycle left in me. We will see.

We have spent about £20,000 so far. I still have hope and believe that if you have a dream, you have to pursue it. But I don’t let it take over my life anymore, treatment comes second. I try to enjoy the good things and realise that plans don’t always work out. Although it is very painful, I have to look forward and enjoy life. There are so many people much worse off than me.”

I retain hope and believe that maybe one day, if I am strong enough to continue, my dream might come true. If not, then at least I tried.




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Fertility Road is Europe’s number one fertility magazine, aimed at guiding women and men on the path to parenthood. Its lifestyle-feel is a breath of fresh air in an industry sometimes obsessed with science, and in each issue we off er you the stories behind top celebrity names, plus advice, information and stimulating features from some of the UK’s most accomplished fertility writers, tackling issues ranging from health, diet, fi nance and travel, through to law, exercise and same-sex parenting.

We showcase the latest developments and present your heartfelt and often optimistic stories.

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COMPETITION FERTILITY ROAD | LifeForce

The London-based team have hit the headlines recently with the launch of the LifeForce Fertility application, suitable for iPhone and iPod touch. This is the fi rst of its kind, and offers the user a

complete holistic and medical guide to optimum fertility.Available through iTunes it is priced at just £3.99, affording

subscribers access to support and intensive information from Jules and fellow expert Laurence Shaw.

Jules guides you through a 60-day programme to clear your subconscious blocks to fertility, while Laurence leads a person-alised consultation, advising on all things medical.

Whether you have only just started trying for a baby, are investigating your fertility, have decided to try IVF or are moving on from IVF there will be something for you within this application and LifeForce looks forward to beginning along the path to pregnancy with you.

And to celebrate its launch, LifeForce are off ering SIX sessions with Jules Williams to one reader, while fi ve others will receive for free the LifeForce Fertility Application. To be in with a chance of winning, just email [email protected], leaving your name and a contact telephone number. Entry closes on August 1.

For more information on LifeForce, head to: www.lifeforceteam.co.uk


At Fertility Road magazine, our aim is to present a quarterly guide to the industry’s most enlightening and inspiring events, and there is also a thriving online community where readers can discuss the aspects of fertility really matter.

The Fertility Road Forums are a concise yet dedicated base to talk, advise or even express concern over any aspect of

conception, from general IVF chat, to information on starting out, threads on UK clinics, support, advice, lifestyle and science. Are you looking for a cycle buddy, or hoping to empathise with others in respect of FET? There’s also the chance to put your own questions to our fertility expert.

It’s the internet’s most expansive fertility communication resource, so why not check out the Fertility Road Forums today?

Head to www.fertilityroad.info. Membership is free and instant. All new members who sign up between now and August 1 will be entered into a draw to win a free year’s subscription to Fertility Road for themselves and two friends.

COME AND DISCOVER FERTILITY ROAD FORUMS:



FERTILITY ROAD |

The post World War I baby boom is in full swing, and nowhere more so than in Tonbridge, Kent. It’s March 1926, and pictured is proud mother Emily Lucas, who proudly shows off her 23rd child. Despite her achievement, it’s unlikely Emily matched the total of

Russian Feodor Vassilyev, whose 69 children included 16 pairs of twins, seven sets of triplets and four sets of quadruplets.

ITY ROAD |

not forgotten


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fertility road magazine issue 1

Health & Medicine