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Expert Witness

Five Industry Experts Reveal Their Fertility Advice Secrets

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Industry Experts Reveal Their Fertility Advice Secrets

 

FIVE EXPERTS, FIVE SOLUTIONS

Fertility Road’s impeccable contacts book sees us line up five of the industry’s most respected voices in matters of fertility, each using a career’s worth of experience in their chosen field.

Our Five Experts

DR SARAH JARVIS

Sarah is a leading UK general practitioner who regularly appears as an expert on terrestrial television and radio shows. She graduated from Oxford University in 1986 and also works as a Clinical Consultant for health website patient.co.uk

DR HILARY JONES

Hilary is one of the UK’s best recognised TV doctors having initially appeared on screens in the late 1980s. He is a prolific writer on health, wellbeing and happiness.

LORD ROBERT WINSTON

Robert is a professor, medical doctor, scientist, television presenter and politician, whose medical research has led to him being regarded as one of the leading pioneers in reproductive and sexual health.

RICHARD WESTOBY

Richard is an international surrogacy expert, whose book Our Journey One Couple’s Guide to US Surrogacy is an Amazon bestseller in category. His website guidetosurrogacy.com provides guidance for anyone at any point along the ladder.

MARTIN LEWIS

Martin is the king of moneysaving in the UK, a financial journalist and consumer campaigner. He is Governor at the London School of Economics and recently received an OBE from the Queen as recognition of services to consumer rights.

The brief for each was simple

 

If they could give one piece of fertility advice to an individual or couple, what would it be

 

DR SARAH JARVIS on understanding Fertility

Sarah is a leading UK general practitioner who regularly appears as an expert on terrestrial television and radio shows. She graduated from Oxford University in 1986 and also works as a Clinical Consultant for health website patient.co.uk

“The thing that often strikes me is that people don’t know what fertility is; they don’t know how normal it is to take time to conceive. So, for me, my advice would be for people to really have a think and work out what infertility is.

Put in simple terms, the average couple should never expect to get pregnant straight away. Most people who don’t get pregnant within the first six months will get pregnant within the second six months. And of the people who don’t get pregnant within a year, about half will conceive the following year. We need to give our bodies a chance.

A lot of this comes back to the fact we all work very hard these days, and with that comes the expectation of being in full control of our lives. Yet where fertility is concerned, most people find that this is the first time in their lives when they’re not in control, when it’s in the lap of the Gods, if you like. Consider it, if you work hard enough at school, you will succeed, you’ll get the job, you’ll be able to afford a home and you’ll be able to afford to live. So, until now you’ve been dependent on you, whereas when it comes to getting pregnant, very often you feel a sense of being powerless.

‘But I want to get pregnant now’, you say. Yet that goes against the logic we’ve taken previously, because up until then we’ve spent so much of our lives thinking about not getting pregnant and practising not getting pregnant. We’ve pretty much controlled that, so I think the expectation is that you can control getting pregnant too, but it just doesn’t work like that.

So for goodness sake be realistic to yourself. If you haven’t got pregnant within three months then, you know, it doesn’t mean you’re not going to get pregnant at all. Just focus on all the things that can aid the process, like stopping smoking, cutting down on alcohol, taking folic acid and vitamin D, because if you go to a GP after three months he or she will tell you to come back after a year.

Of course, on the flipside, know when you should go. So if you’ve been trying for a year then go and see a GP. Or if you’ve had other medical problems – perhaps pelvic inflammatory disease, or surgery on your tubes or on your testes – then go forward sooner. But be absolutely certain you’re in a good place and a realistic place before worrying, before feeling as if you have to go to the next point. Know when you should and know when you shouldn’t, and relax!”

“The thing that often strikes me is that people don’t know what fertility is”

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Dr Sarah Jarvis – UK General Practitioner

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DR HILARY JONES on Supplements

Hilary is one of the UK’s best recognised TV doctors having initially appeared on screens in the late 1980s. He is a prolific writer on health, wellbeing and happiness.

“I’ve been researching a lot into diets and supplements recently, and while I’m not aware of any fertility boosting effects of Omega 3, I would always encourage any woman who’s thinking of conceiving to think about preconceptual care – it’s really important.

It’s a reality that the majority of women don’t initially know when they become pregnant. Omega 3, because it’s an essential part of the foetus’s brain and nervous system, is pretty essential for the mother in the very early stages of pregnancy. It’s important there is enough Omega 3 in the body because it’s about development in the baby – its eyes, its brain, its nerves as well as the heart.

There is growing evidence that Omega 3 is an essential part of the growing foetus and the infant. There’s evidence it helps, for example, in the treatment of ADHD, of behavioural disorders, or dyslexia, because it is helping with the function of nerves in the brain and the development of brain tissue.

In evolutionary terms we all ate more oily fish and less of the processed food we eat today, so any way we can help our bodies regain some of those key nutrients from days gone by, we should be embracing.”

“There is growing evidence that Omega 3 is an essential part of the growing foetus and the infant”

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[column md=”6″]Dr Hilary Jones

Dr Hilary Jones – Doctor

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LORD ROBERT WINSTON on Stress

Robert is a professor, medical doctor, scientist, television presenter and politician, whose medical research has led to him being regarded as one of the leading pioneers in reproductive and sexual health.

“The pain of infertility prevents people from having a normal life. It prevents them from enjoying and embracing the aspirations which most of us expect as part of normal activity. It causes severe depression and great anxiety; it invades the most private parts of a couple’s life and it is very corrosive.

However, if you flip it on its head, the evidence for stress causing infertility simply isn’t there, and this is an interesting angle to explore.

I see out there so many treatments, courses and initiatives designed to reduce stress and, from that, boost a person’s chances of falling pregnant. Well, stress relief may make people feel better about themselves, and that is fine, but there is no good data – archived or current – which shows that stress treatments really help.

This is important because it means self-blame is wrong. Put another way, I think to argue that people have caused their own infertility is really a very shocking thing because the evidence is just not there.

But when stress does confront an individual or couple, it can affect emotional wellbeing and the ability to feel one can find a path forward towards parenthood. Of course, some people cope better than others. A lucky proportion can be very supportive of each other – they see doctors they trust and they don’t clutch at straws. And with a lot of stress management it is about making life easier on yourself. So make sure you end up in the hands of a doctor who you really trust. If you don’t trust him or her, find another. Try to go to a centre which is comprehensive and can offer a range of treatments, not just IVF, and be aware of the fact that millions of couples have had successful treatment after very lengthy times of failure.

So while stress may not be a perfect bedfellow in a time period when you’re trying to conceive, don’t consider it as the main factor in not falling pregnant, because that assumption simply isn’t backed up by any research. Instead, I would recommend finding a way of working alongside stress (which is usually a necessary byproduct of us looking to maintain our daily commitments), whilst channeling energy into the things that have been proven to increase the chances of fertility, such as diet and exercise, and having a set plan for timing intercourse to the most fertile times of the month.”

“Infertility prevents people from having a normal life embracing the aspirations”

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[column md=”6″]Lord Robert Winston

Lord Robert Winston – Medical Doctor

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RICHARD WESTOBY on International Surrogacy

Richard is an international surrogacy expert, whose book Our Journey One Couple’s Guide to US Surrogacy is an Amazon bestseller in category. His website guidetosurrogacy.com provides guidance for anyone at any point along the ladder.

“International surrogacy seems to be one of the most controversial topics of the day, and sure enough I receive multiple enquiries every week from intended parents who are totally confused by the amount of information they can find on the internet. Commercial surrogacy is in fact a minefield of opacity and to wade your way through it takes time and effort.

The primary thing I explain to intended parents is that they need to understand the legal framework for the country in which they are looking for surrogacy. In the UK, surrogacy is legal, it just cannot be done for commercial gain. In other countries the structure is different, and it’s important to understand individual jurisdictions. For example, in 2014 Thailand changed its law around surrogacy overnight and Nepal has just done the same thing pending a Supreme Court decision.

But how do you know what is right? If you are going to be going down the international surrogacy route then my best advice would be to follow eight simple rules, without exception:

  1. Talk to as many people as possible who have been through surrogacy
  2. Do as much due diligence on the jurisdiction and the legal situation around surrogacy
  3. Understand the immigration implications of undertaking surrogacy and bringing your child back home
  4. Talk to a local lawyer about what legal steps you need to do in your home country to make sure you are recognised as the parent(s) of the child(ren)
  5. Picture how you see your family and always have this picture in your mind when you are talking with the professionals
  6. Talk to IVF clinics to see their success rates and how they operate with regards fresh or frozen embryos
  7. Talk to surrogacy agencies to understand how they work, how they select their surrogates and what support they provide throughout the process
  8. Finally, make sure that the people you end up choosing to help create your family understand you and your dream and that they are all aligned to make your dream a reality.”

“In the UK, surrogacy is legal, it just cannot be done for commercial gain”

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[column md=”6″]Richard Westoby

Richard Westoby – International Surrogacy Expert

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MARTIN LEWIS on Finance

Martin is the king of moneysaving in the UK, a financial journalist and consumer campaigner. He is Governor at the London School of Economics and recently received an OBE from the Queen as recognition of services to consumer rights.

“Many people ask me about the finances behind fertility, be that whether they can realistically afford IVF treatment, or whether having children is even realistic compared to their income.

In an ideal world, kicking off fertility treatment, for instance, would be funded by savings. With something like IVF those savings may only take you so far, and there will always be instances in life where we spend more than we have because the need is so great.

But let’s put that to one side and think most specifically about budgeting, either in terms of being able to gather those savings together in advance of a project, or when, we hope, there is another mouth to feed (and to finance).

The truth is most of us are appalling budgeters and that comes from quite an interesting place – we all know what we earn, but we don’t know what we spend and we struggle to balance a see-sawing budget without making inaccurate and unrealistic assumptions.

So when we look at our spending across the month we judge it on what we’d typically pay for something. But there’s a huge chunk left out. Why? Because the average family in the UK spends £600 on Christmas, or £50 a month; they buy a new sofa every three or four years for maybe £1,000; they buy a television that is £500; they go on holiday in the summer etcetera. And none of this is factored into the monthly spend, but it should be.

So, the real deficit that people have in their spending comes about as a result of failing to factor in the irregular bits every now and again. My advice therefore would be to factor in £50 a month for Christmas, £50 a month for big one-offs, £50 a month for a holiday. Only after doing that will your budget truly balance.

But most people don’t do that and all those additional expenditures are the stuff we never count, which is why far too many people spend more than they earn. And it’s easy to see if that’s happening to you. If you’ve got savings and they’re disappearing, you’re spending more than you earn. If you’ve not got savings and you’re building up debt, you’re spending more than you earn – in which case, go and do a budget.

Well, that’s great and now we have the knowledge; but the question then becomes what you then do and how you manage it? Now, the way I suggest people manage their money is a system which I call ‘piggybanking’. It’s literally this – once you know what you’re going to spend your money on, you then have to accept you’re going to live within your means by using little pots or little accounts. So, let’s say you have your ‘standard bills’ account, which is all the regular stuff you need to pay each month. You have you ‘family account’, your ‘holidays account’. Each month, when you get paid, you siphon the right amount of money into the each account.

So for each of those piggybanks, when it comes to going on holiday what most people say is, “Oh, I don’t want to spend too much…” They’ll only want to save £500 and then they see an £800 holiday and then say: “I’ll have the £800 one! I’m sure I’ll manage somehow.” But this way, you look at that holidays account, or the family account, and it’ll say you have £422 in it. If you’re spending more than £422, you cannot afford it. So you have to cut your cloth accordingly. Many people swear by this technique because, honestly, it works.”

“In an ideal world, kicking off fertility treatment would be funded by savings”

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[column md=”6″]Martin Lewis

Martin Lewis – Money Saving Expert

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Expert Witness

Interview With Fertility Expert Toni Weschler

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Toni Weschler Fertility Expert

She is a fertility expert who has transformed the way millions of Americans think about their bodies. Across a generation’s span, where science and technology has left remarkable, dazzling imprints on fertility, Toni Weschler’s impact has been profound.

Profiled now alongside the modern greats of reproductive communication, she gives an exclusive interview to Fertility Road magazine…

Sadly, a modern education still leaves women in the dark about their own bodies. We now have a generation of women in their 30s and 40s who were taught nothing whatsoever about their fertility and have not the slightest clue about how the female reproductive system works.

Essential facts every woman should know – for example that it’s possible to predict your next period if you know when you ovulated because the luteal (post-ovulation) phase has a consistent length in each woman, while the follicular (pre-ovulation) phase varies each cycle; or that cervical mucus with an ‘egg white’ appearance is a healthy sign of high fertility – were simply not included in our school ‘sex education’ lessons.

Women today have left conceiving much later, and when we finally stop taking the pill to get pregnant, we suddenly realise we know nothing about our natural cycles. Tragically, we usually only come to understand our own biology at a late stage – when often, the time pressures are starting to become unbearable.

In this era when women want to know as much as possible about their bodies, the new science of fertility awareness, made available with the advent of the digital thermometer in the 1970s, is more popular than ever. Our mothers are mystified to see our carefully plotted graphs. “It was so different in the 70s,” Suzanne, a 69-year-old writer, recalls. “We were vaguely aware the middle of the month was fertile, but getting pregnant just happened; we didn’t try.”

But women trying to conceive today are older than ever before, desperate for knowledge so we can understand our natural cycles and maximise our chances of conceiving, fast – which is why modern women are getting hooked on the fertility awareness movement, the bible of which is the super-selling book Taking Charge of Your Fertility by American Toni Weschler. Published in 1995, the book was the first to explain – in amazing detail – how to get pregnant by monitoring and recording on a chart the body’s daily fertility signs, including waking temperature, which rises after ovulation; cervical fluid (dry in infertile times of the month, increasingly creamy and then like egg white as you approach ovulation); and cervical position.

And although these facts are now all over the internet and other fertility books, the fact remains that TCOYF explains them in the most comprehensive and authoritative detail – it’s still the biggest and the best manual for understanding your fertility. The book is currently ranked at number three out of the nearly 19 million published books sold on Amazon.com when it comes to customer ratings (trumped only by two Harry Potter novels). But that’s not down to marketing or publicity – TCOYF remains an underground, word-of-mouth fertility phenomenon.

Usually what happens is that when a woman starts ‘trying’, a clued-up friend who’s been trying for a while shows her some fertility charts, and asks incredulously if she’s never heard of ‘Toni’. That’s Toni Weschler, she explains, a cult figure to women trying to conceive.

As an undergraduate studying Psychology, Weschler found herself running to the gynaecologist every month – like many women, she felt ashamed and concerned about the white discharge that returned again and again and wondered what was wrong with her. “It wasn’t until years later, in the mid- 1980s, when I was told this was a normal fertility sign that occurs before ovulation, that I had my light-bulb moment,” Weschler, now 54, recalls.

“Oh my God – all those years I thought I was dirty, when I was completely healthy and my body was doing exactly what it was meant to do and showing me signs telling me what was going on inside. And this made me so mad. I thought, it is unacceptable that in today’s times, women have no clue how their bodies work. I wanted to yell it out to every woman: there is a world of knowledge in your body.”

Weschler achieved a Master’s degree in Public Health and tried to raise awareness among doctors – but, she recalls, they wrongly equated fertility awareness with the entirely discredited rhythm method, with which it has nothing in common – “it was humiliating and made me even angrier”, Weschler says. With no other options, she set up fertility awareness seminars for couples in her living room in the late 1980s, then wrote TCOYF.

A tidal wave of responses came from thousands of women from all over the world, who flooded (and still flood) Weschler’s PO Box with letters – “I can’t even count how many”, she says, “all of them saying ‘This book has changed my life – why wasn’t I taught this stuff as a teenager, instead of whether to wear sanitary pads with wings or not?’’’.

Women who read the book felt cheated to discover that they had been taking the pill with all its side effects for years without knowing that, by charting, they could reasonably safely have sex at infertile times of the month. And that they had been trying to get pregnant without taking into account, for instance, that they had an abnormally short luteal phase which didn’t allow for implantation.

Thus, that they weren’t producing enough fertile cervical mucus to allow semen to travel towards the egg. Or that they weren’t ovulating at all – facts which charting clearly shows.

Yet in both the UK and US, many doctors still don’t take fertility awareness seriously – or are even uneducated enough to  believe that every woman ovulates on day 14 of her cycle. The official advice for conception from the NHS website, indeed, is to have sex throughout the month, with no need to time intercourse to ovulation (which, it says, ‘usually happens about 14 days after the fi rst day of your last period’). Given that many women ovulate early or late, and know thanks to charting or ovulation tests when they are fertile, this advice seems dismissive and dumbed down.

“Doctors insult women who chart to get pregnant by rolling their eyes,” notes Weschler. “Yet no doctor can know a woman’s body better than she does.”

The charting pioneer, who lives in Seattle, believes that it’s still the case that not enough of us are fertility-aware, and this could well be at the root of struggles to conceive, ironically despite all the high-tech options now on offer. The low-tech, DIY methods of fertility charting are, Weschler feels, by contrast a simple and reliable knowledge base. “Of all of the fertility treatments developed in the past few decades, IVF has undoubtedly helped more couples than any other, which is extraordinary. But its appeal as the end-all, be-all, is also insidious,” she says.

“I have major concerns about women being put through this incredibly expensive and invasive procedure when they have not been taught the most fundamental information necessary to achieve pregnancy: the Fertility Awareness Method. By charting their cycles, they may be able to conceive on their own by simply learning how to identify their most fertile phase, or potential problems that can be easily rectified before moving onto something as invasive as IVF.”

So at what point should fertility charting take second place to medical treatment like IVF? “If a couple is officially diagnosed with a physical problem such as blocked tubes, then no amount of charting is going to help them to conceive,” says Weschler. “But in most other cases, charting works beautifully in conjunction with fertility treatments to help the couple take control of their medical management, rather than feeling like it is all being done to them.

“Ultimately, if a couple has actively timed intercourse perfectly for at least 4-6 cycles (for women 35 and over) or 6-8 cycles (for women younger than 35), then it is time to seek medical treatment. But the operative phrase here is ‘timed perfectly’. That means that they know her cycle so well that they know if she is ovulating altogether and they have consistently timed intercourse around ovulation.”

Some women can’t be bothered with charting (“It just makes me think ‘maths’’’, says Sophie, a 32-year-old photographer, in horror), and the average man would rather eat his own first than check out his wife’s chart. But the practice appeals enormously to women who like to have a plan.

Still, taking your temperature can too easily become the focal point of each day. You irrationally find yourself looking at your chart every few hours in case it tells you you’re pregnant, or worrying over signs and symptoms.

Weschler stresses that charting should be about seeing “the big picture, not obsessing over one single temperature or letting your life get consumed by minutiae.” Still merrily ovulating, and charting on paper, she sees charting, when done right, as a worthy object of one’s attention and pride. “I’ve been charting 28 years and my charts are a thing of beauty – I love showing them to people! Seeing the patterns of what a woman’s body does is a fascinating privilege. Still, at a certain point, you do have to get on with everyday life.”

So if she could give one piece of advice to a couple wanting a baby, what would it be? “It would be to focus on her cervical fluid,” says Weschler. “She should try to have intercourse every day that she has wet, slippery cervical fluid at her vaginal opening – or every other day if the man’s sperm count is low.”

Of course, fertility awareness doesn’t end with pregnancy achievement. It is an invaluable tool for women dealing with troublesome or irregular periods, PMS or menopause, and can be used as a form of natural birth control. Weschler’s second book, Cycle Savvy, educates teenage girls about the female reproductive system.

Hopefully, with her influence, the next generation of women will grow up with a greater understanding of their bodies.

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