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FERTILITY CLINICS: The Good, The Bad And The Ugly

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Fertility Clinics: the good, the bad and the ugly

My first experience of a fertility clinic was disastrous. I was forced to undergo invasive treatment in a hospital corridor and ended up refusing to go through with it and walking out. The clinic never contacted us again and we never went back. Let’s just say it wasn’t an auspicious start.

Since then I have been through the multiple rounds of IVF and over a dozen clinics. I’ve become a fertility veteran and had every test known to woman and doctor in a bid to diagnose and cure my infertility. Here are my top tips for choosing a clinic and how to separate the good, the bad and the ugly.

I think the first shock about fertility clinics is that most of them don’t look like the sort of place you’d go to create a baby. Over the years I’ve come to expect the unexpected – from the clinic that looked like it was straight out of a Dickens novel to the one that doubled for some sort of New York contemporary art gallery.

One thing, however, I have never got used to is the fertility clinic waiting room. Most places don’t think about the privacy and anonymity that many patients want and need. In the worst offenders, couples are crammed together, chairs facing each other so there’s nowhere else to look, with maybe a pile of children’s toys in the corner to remind you of what you haven’t got.

Three months later it turned out that I was pregnant but the** foetus was ectopic and had implanted in my stomach**. This was a life-threatening situation that could have been avoided if a more accurate pregnancy test had been done at the end of our treatment.

The best waiting room I ever attended had clearly taken the patient experience into consideration in its design. The walls were curved so that each couple got to sit in their own private space. Given that there is always a lot of waiting involved, it made it so much nicer.

Sooner or later in your fertility journey, your partner (or you) are going to experience the horror of the ‘Producing Room’ – the place where men and magazines convene to produce a sperm sample. Most rooms are tiny, often doubling as a toilet or a cupboard. The one at our first clinic had a bucket and mop in the corner, boxes of surgical gloves piled from floor to ceiling, the obligatory well-leafed top shelf magazine and a very uncomfortable looking plastic chair.

It has always disappointed me that couples are not routinely asked if they would like to be together for this part of the process so that, as a mother, you can say to your child: “I was there.” Whenever we’ve been bold enough to request this, the clinic staff have treated us as if we were weird, despite the fact that generally speaking it does take two to make a baby.

Perhaps if producing rooms were designed more like bedrooms with soft lighting and maybe an iPod with a selection of music then couples, if they wanted to, could choose to start the assisted conception process together in a more natural way.

Nowadays most fertility clinics allow partners to be present for the embryo transfer procedure and that’s definitely a positive thing. But one of the best clinics we ever went to also allowed us to watch the ICSI process when the embryologist injected sperm into the egg. The thought that we might be able to say to our child in years to come that we had witnessed that moment was such a privilege.

In addition, new technology such as the Embryoscope – which takes continuous film footage of your embryos during their first few days in the laboratory – is amazing. Of course, given the choice, all of us going through fertility treatment would rather conceive a baby naturally but these opportunities are unique and special and do offer some compensation for having to confront what is, let’s face it, an artificial and difficult process.

If you are being treated privately (and most women who are going through fertility treatment are) then taking the time to choose the right environment and quality of care is really important. In the busiest clinics, it can sometimes feel akin to being a cow in a cattle market with a number printed on your backside. I went to one clinic where not only the waiting room was full but you’d regularly find people sitting on the stairs. I also recently spoke to a woman who said that her clinic was so busy that they never answered the phone so if she had a question, however small, she had to get on the train from Brighton and come up to London.

The best fertility clinics have time for you and make you feel like an individual. You are given the opportunity to develop a relationship with one doctor who makes the effort to understand your story and, rather like a detective, attempts to work out what the problem is and what should be done. Ideally, that same doctor will be the person who sets your stimulation drug dose and does your scans, egg collection and embryo transfer.

I have been to only two clinics that took this approach – at most clinics, you see different people at different stages and sometimes you never see the same person twice. But at those two clinics, the doctor/patient familiarity and care made a huge difference to how I felt about my treatment.

Sadly even the best clinics have to face failure. One of the things I strongly advocate is that all IVF patients be given a blood test at the end of their treatment to measure the levels of the pregnancy hormone, hCG. No-one likes that trip to the clinic when you’ve started spotting or even bleeding to take a test which you know in your heart is going to be negative. No-one likes the pain of waiting for that dreaded call to give you the result.

But, and I say this from personal experience, you should never be allowed to simply take a urine test at home. I went to one clinic that only offered their patients this option and because the home test looked negative and I was bleeding, I assumed it was. Three months later it turned out that I was pregnant but the foetus was ectopic and had implanted in my stomach. This was a life-threatening situation that could have been avoided if a more accurate pregnancy test had been done at the end of our treatment.

I do feel for the staff who regularly have to make that terrible call to tell you that your test is negative – current statistics indicate that only a third of cycles succeed. At the same time, I have to say that most clinics don’t handle the management of failed cycles well. When a close friend of mine had her first negative result after NHS treatment, she asked if she could see a counsellor and was told that there wasn’t an appointment available for the next three months.

I also heard another story recently where a woman was distraught when she found out her blood test was negative but wasn’t allowed to leave the clinic before going into Accounts to settle up for the test. (Why not at least ensure that all patients pay for their hCG in advance?)

Moreover, there hasn’t been a clinic I’ve attended and moved on from, not a single one, that has contacted me at a later date to find out how I am or where I’m going next on my fertility journey. It has always made me feel as if I’m the black sheep of the clinic, the one who bought their live birth statistics down and, thankfully, eventually disappeared.

One of the disadvantages of the whole process is that even though fertility is big business these days – just spend a weekend at the annual Fertility Show at Olympia to see – patients are still way too powerless in the face of doctors who hold our happiness in their hands. We don’t want to make a fuss; we want all the clinic staff to ‘like us’ so that they will do their best to deliver us the baby we long for. This means that many people are prepared to put up with the ‘bad’ and even the ‘ugly’.

I have done it myself over and over again. So choose your clinic carefully. Success rates are important but so are other things. Think about the sort of environment, involvement and care you want in your treatment. And when it’s not good enough or there’s something that could make it better, let’s shout about it so things will eventually change. If as customers we start to demand better clinics and a more personalised approach to our treatment, it will eventually happen, and I have no doubt that results will improve.

The Pursuit of Motherhood is published on February 1, by Matador, priced £8.99. For more information, visit thepursuitofmotherhood.com

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Fertility 360

NEWS: Get access to adult photos of the Cryos sperm donors

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Adult Cryos Sperm Donors Photos

Viewing adult photos of Cryos sperm donors is now a reality. Visit dk.cryosinternational.com today and get access to the new feature.

At Cryos it is now possible to access adult photos of sperm donors on our website, thus adding another dimension to your search for the perfect donor.

The unique chance to see both childhood and adult photos of your sperm donor, provides you with a more comprehensive idea of who your sperm donor is and moreover of the features of your future child. We hope that this extra dimension will upgrade your experience making your decision of a sperm donor easier.

The 5-6 adult photos are taken by a professional photographer and are a part of the donors extended profile where you also have access to childhood photos, an audio recording of the donor’s voice, a handwritten message, an emotional intelligence profile, and finally our staff impressions of the donor, amongst other exclusive features.

The adult photos require special access on our website. Visit our website and find out more and get access to this new feature now.

Please note that the person in the photos is a model and not a Cryos donor.
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Fertility And Sex: Why Her Orgasm Matters

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Why her orgasm matters

For many couples, trying to conceive can make sex feel less fun and more pressured. Instead of being an intimate and enjoyable experience, baby-making sex can start to seem like a finely choreographed routine. Often, the female orgasm is one of the first things to go, but the maleorgasm is not the only orgasm that matters when it comes to fertility.

Before I dive into discussing the potential benefits of the female orgasm for fertility, it’s important to note that reaching climax is not technically essential for conception. If you never, or rarely, achieve orgasm, don’t worry, you can still get pregnant! Around 1 in 10 women don’t experience orgasm, ever. What’s more, the exact nature of the female orgasm remains somewhat elusive. Some experience orgasm through clitoral stimulation, some through vaginal intercourse, some through both, and others through something else entirely, or not at all.

Even without reaching orgasm, sexual arousal is itself beneficial to fertility. Like an orgasm, arousal is, first and foremost, a good indication that sex is enjoyable. Sexual arousal and climax causes significant changes in your levels of neurotransmitters including noradrenaline, oxytocin, prolactin, dopamine, and serotonin. These ‘reward’ neurohormones help you bond to a sexual partner and make it more likely that you’ll have sex more often, thereby increasing your chances of conception.

Second, orgasm and arousal have a range of physiological effects that might aid conception, which I’ll discuss in a moment. And, third, sexual arousal and orgasms for everyone can help sperm-producing partners avoid feeling like they’re being used just for their sperm. In fact, some studies show that male partners who engage in cunnilingus prior to vaginal intercourse have greater sexual arousal and produce more semen!

HOW ORGASMS ENHANCE FERTILITY

The female orgasm can help relieve stress, and promote healthy circulation and balance in the body. Stress is a key cause of diminished libido and may also reduce the chances of conception by raising levels of the stress hormone cortisol. Conversely, good sex can help raise levels of oxytocin and the other neurohormones mentioned above. These help you to relax and bond to your partner.

Published in 1967, the author even went as far as suggesting that the increase in these hormones after orgasm help support conception by temporarily incapacitating you. Put simply, this ‘poleax’ effect means you’ll feel so relaxed that you’ll stay lying down, which may increase your chance of conceiving. Whether staying supine does make conception more likely is still under debate, but I’m all for promoting relaxation, so if this theory provides added motivation, go for it!

CERVICAL TENTING

There is some suggestion that orgasm affects the shape and function of the cervix. These effects, which may include cervical ‘tenting could enhance the likelihood of conception by promoting the movement of sperm into the uterus and beyond. If you are curious as to what your cervix looks like during different stages of your cycle, check out these photos.

THE ‘UP-SUCK’ THEORY

One of the main ways in which female orgasm has been linked to fertility is something called the ‘upsuck’ theory (or, sometimes, the ‘insuck’ theory). This theory proposes that the female orgasm causes uterine and vaginal contractions that actively draw semen up into the uterus and towards the fallopian tubes, thereby increasing the chances of an egg being fertilized.

Scientific evidence to support this theory is rather inconsistent, but there’s certainly no harm in trying! One proposed underlying mechanism of this theory is oxytocin-mediated uterine peristalsis, i.e. the same mechanism that causes uterine contractions during labour could be partially responsible for increasing the likelihood of conception. Indeed, some research has found higher pregnancy rates in women shown to experience this ‘insuck’ phenomenon.

SPERM RETENTION AND FERTILITY

More recently, one small study found that orgasm may increase sperm retention. This study involved women using a syringe to insert a sperm simulant (lube) prior to external stimulation to orgasm. As such, the study’s findings may be especially applicable to anyone undergoing artificial insemination (IUI).

The take-away: Chances are that if you orgasm 1 minute before or up to 45 minutes after insemination (whether artificial or otherwise), you will probably retain more sperm, which may increase your chance of conceiving.

IN CONCLUSION

To sum up, the female orgasm might enhance fertility in a variety of ways, but it isn’t essential to conception.

The take home message is that orgasm and sexual arousal itself have many benefits to fertility, partner relationships and stress relief. Don’t worry though, if you have a low libido, conception can still happen even in the absence of arousal and orgasm!

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What Is Polycystic Ovary Syndrome (PCOS)?

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Polycystic Ovary Syndrome

Polycystic Ovary Syndrome or PCOS is a hormonal imbalance that affects 5 to 10 percent of women of reproductive age across the world, and results in irregular or absent periods, acne, excess body hair and weight gain. It is also a major cause of infertility and yet is frequently misdiagnosed and often missed completely.

PCOS gets its name because under an ultrasound scan, the ovaries can look like a bunch of grapes, each one covered in what look like multiple cysts. In fact, these aren’t cysts at all, but are small, undeveloped follicles.

Symptoms

Not every woman with PCOS will get the same symptoms, but common signs to look out for include:

  • Few or no periods
  • Excess hair on the face or breasts or inside of the legs or around the nipples
  • Acne
  • Oily skin
  • Scalp hair thinning or loss (male pattern baldness)
  • Skin tags (known as acrochordons)
  • Skin discolouration (known as acanthosis nigricans) where the skin looks ‘dirty’ on the arms, around the neck and under the breasts
  • Mood swings
  • Depression
  • Lack of sex drive
  • Weight gain especially around the middle of the body
  • Difficulty in losing weight
  • Cravings and binges
  • Irregular or no ovulation
  • Difficulty in becoming pregnant
  • Recurrent miscarriages

PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. With PCOS, the problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. But linked to this is the very common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone. Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal.

How is Polycystic Ovary Syndrome diagnosed?

The most widely accepted criteria for the diagnosis of PCOS says that you should have two out of these three problems:

  • Infrequent or no ovulation
  • Signs (either physical appearance – hirsutism or acne – or blood tests) of high levels of male hormones
  • Polycystic ovaries as seen on an ultrasound scan

The Seven Nutritional Steps to beat Polycystic Ovary Syndrome

Good nutrition is the foundation of your health and you should never underestimate how powerful it can be. It is the fuel that provides you with the energy to live your life and it gives your body the nutrients it needs to produce your hormones in the correct balance. The better the supply of those nutrients, the more healthily your body will function.

The fundamental aim of my nutritional approach to PCOS is to target a number of areas simultaneously so that you get the maximum effect in the minimum amount of time.  

Here’s how:

  1. Switch to unrefined carbohydrates (eaten with protein) and never go more than 3 hours without food to keep your blood sugar levels balanced
  2. Eat oily fish and foods rich in Omega 3s to help your body to become more sensitive to insulin so it can overcome insulin resistance
  3. Cut out all dairy products for 3 months to bring levels of male hormones under control
  4. Eat more vegetables and pulses to which helps control male hormones
  5. Cut right back on or cut out alcohol for 12 weeks to allow your liver function to improve
  6. Cut down on caffeine to give your adrenal glands a rest
  7. Cut down on saturated fats and eliminate trans fats to help control the potentially damaging inflammatory processes PCOS causes in the body

PCOS Symptons

Best Supplements for PCOS

The use of certain vitamins and minerals can be extremely useful in helping to correct Polycystic Ovary Syndrome, along with a good diet.

Chromium

Chromium helps to encourage the formation of glucose tolerance factor (GTF), which is required to make insulin more efficient. A deficiency of chromium can lead to insulin resistance.  It also helps to control cravings and reduces hunger. Can help to reduce insulin resistance associated with PCOS

B vitamins

The B vitamins are very important in helping to control the symptoms of PCOS. Vitamin B2 helps to burn fat, sugar and protein into energy. B3 is a component of GTF which is released every time blood sugar rises, and vitamin B3 helps to keep the levels in balance. Vitamin B5 has been shown to help with weight loss and B6 is also important for maintaining hormone balance and, together with B2 and B3, is necessary for normal thyroid function.

Zinc

Zinc helps with PCOS as it plays a crucial role in the production of your reproductive hormones and also regulates your blood sugar.

Magnesium

Magnesium is an important mineral for dealing with PCOS because there is a strong link between magnesium levels and insulin resistance – the higher your magnesium levels the more sensitive you are likely to be to insulin.

Co-Enzyme Q10

Co-Q10 is a substance that your body produces in nearly every cell.  It helps to balance your blood sugar and lowering both glucose and insulin.

Alpha lipoic acid

This powerful antioxidant helps to regulate your blood sugar levels because it releases energy by burning glucose and it also helps to make you more insulin sensitive. It also has an effect on weight loss because if the glucose is being used for energy, your body releases less insulin and you then store less fat.   

Omega 3 fatty acids

Omega 3 fatty acids taken in supplement form have been found to reduce testosterone levels in women with Polycystic Ovary Syndrome.

Amino Acids

Certain amino acids can be very helpful for PCOS as they can improve your insulin sensitivity and also can have an effect on weight loss.

N-Acetyl cysteine

In women with PCOS this amino acid helps reduce insulin levels and makes your body more sensitive to insulin. Study using NAC in women who were clomiphene resistant and had ovarian drilling.  After ovarian drilling, the women given NAC compared to a placebo showed a significantly higher increase in both ovulation and pregnancy rates and lower incidence of miscarriage.

Arginine

Arginine can be helpful in reversing insulin resistance. In one study, a combination of both arginine and N-acetyl cysteine were given to women with Polycystic Ovary Syndrome.  The two amino acids help to improve blood sugar and insulin control and also increased the number of menstrual cycles and ovulation with one women becoming pregnant on the second month.

Carnitine

Carnitine helps your body break down fat to release energy and can help improve insulin sensitivity.

Tyrosine

Tyrosine is helpful for women with PCOS who are overweight as it helps to suppress the appetite and burn off fat.

Glutamine

This amino acid is useful for helping with sugar cravings as it can be converted to sugar for energy and so takes away the need to eat something sweet.  It also helps to build and maintain muscle which is important for fat burning.

Branched Chain Amino Acids (BCAAs)

BCAAs include three amino acids leucine, isoleucine and valine. They are important in PCOS because they help to balance blood sugar and having good levels of these BCAAs can have a beneficial effect on your body weight

Inositol

A study used inositol (2,000mg) in combination with NAC (600mg), a significant increase in ovulation rates.

Having a good diet, regular exercise, controlling stress and taking key nutrients will help in getting your hormones back in balance and reducing the negative symptoms associated with PCOS.

More information can be found on www.naturalhealthpractice.com

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