Egg freezing: How I made an Agonising Decision over my Fertility

Early in 2014, I set myself a challenge: to decide whether or not to freeze my   eggs.

I was 42, single and childless. But I had a great life. How much did I really   want to change it by having a baby? Would I ever meet a suitable partner?   Did I really want to be an older mother?

How desperate was I to be a mother anyway?

As I researched the subject, I realised that it would make a fascinating   documentary topic for Al Jazeera, where I work. After all, it’s a pretty hot   topic, with companies such as  Apple and Facebook offering to pay for female employees to freeze their eggs.

To be honest, when I started out, I didn’t envisage myself being quite so much   at the centre of it.

But, as the film progressed, it became clear that my own journey was key to   unlocking what the experience of weighing-up egg freezing is really like.

Exploring a personal subject in front of a crew and a potential audience of millions isn’t easy. Especially when I was used to being the one filming, not being filmed.

And you can’t get much more personal than fertility. I had to face up to some big truths on camera.

But I’m not the only woman asking herself these types of questions.

Nor am I the only woman in her early 40s, single and childless. On the   contrary, as I and the producer, Lynn Ferguson, researched the film – which   airs tonight – it became clear that I am part of a growing trend.

Three times as many women are having children in their forties, as in my mother’s generation. One in five women in Britain and the US are childless   in comparison to one in 10 a generation ago. For women born in the 1970s,   like me, that could be as high as one in 4. I am in fact a good example of “women these days”.

It was clear – this is what the film needed to be about.

The assumption is that childless women have focused on themselves and their   careers, instead of family. Sure, work can play a part, but it’s far from   being the whole story.

Many women are childless by circumstance, not by choice. There can be all   sorts of reasons – not meeting a suitable partner in time, ambivalence about   having children until it is too late, being unaware of how rapidly fertility   declines, not having the funds, not feeling ready to have a child and so on.

I had been pretty ambivalent about whether or not I wanted to have children.   My life was fulfilling and interesting. I loved my work – making   documentaries around the world. It was a life full of adventure and I didn’t   feel any void. I’d had some good relationships with men but none of them had   worked out in the long-term.

By the age of 42, however, the thought of never having children was preying on   my mind. As I met consultants who told me the stark facts about fertility at   my “advanced maternal age” I began to have sleepless nights.

The fact that I myself might never have a family was something I had to face   up to in front of the documentary crew. Not easy.

But, inspired by the women I met during filming, I believed that a personal   and honest exploration of the subject was the best way of helping others in a similar situation to myself.

I also hoped that my journey through the subject might be benefit younger   women, too. In today’s super busy, high-pressure world – when there are so   many demands on our time and so many option – I would encourage every woman   to really think about whether, when and how she wants to have children,   before the age of 35.

This is when fertility first starts to drop.

As I looked at fertility forums online and read the stories of childless   women, or women struggling to start a family, I was deeply affected by the   huge amounts of desperation and pain. The grief of childlessness can be   particularly difficult to deal with, because it can be an intensely lonely   experience. It is rarely publicly acknowledged or discussed. I wanted the   film to raise at least some awareness of this issue.

Although I’d never felt desperate to have a child, hearing the experiences of   other women made me realise that I might feel a huge gap if I didn’t have   one. The possibility of prolonging my fertility through egg-freezing became   increasingly attractive. It might buy me some time to meet the right man.   Wouldn’t I regret passing up this opportunity?

But was it worth spending so much money (around £9,500 in the UK), on   something that consultants told me only had a 10 per cent rate of success at   my age?

I was helped out of this dilemma by two things. I live in Istanbul, a short   plane ride away from Cyprus, where good treatment comes relatively cheap.   And I was told by doctors that I was a good candidate because my ovaries   were in above average shape for my years.

And so, in the end, after weeks of agonising, I decided to go ahead and freeze   my eggs. The documentary also follows me through that process.

Time will tell whether I will ever use them. And if I do? Who knows, maybe   there will be a second film in the offing.

By Amanda Burrell, Al Jazeera English

http://www.telegraph.co.uk/women/womens-life/11272565/Egg-freezing-How-I-made-the-painful-decision-over-my-fertility-on-TV.html

Motherhood on Ice: Why I Chose to Freeze My Eggs

In the weeks leading up to this I’d been talking to people including doctors and women who’d frozen their eggs to help me make up my mind.  I’d also been making a documentary about the process for Al Jazeera English.

My decision wasn’t an easy one, particularly given my age.  I feel as energetic as I always have done, and I still imagine that I have heaps of time ahead of me to live out all my dreams. So it was bit of a shock to learn from fertility consultants that a woman’s ‘advanced maternal age’ starts at 37.  That makes me, at 43, practically ancient.  Not only are my eggs running out, but the ones left are likely to be poor quality, with an 80% chance of being chromosomally abnormal.

I’ve never been desperate to have children. I was, rather, ambivalent about them, choosing a life of adventure, making films around the world, living abroad, rather than settling down and starting a family.   But in the course of exploring whether egg freezing was for me or not I realized that, while I knew I could continue to have a happy life without children, the prospect of a childless future wasn’t one I was ready to accept.  Egg freezing was the only viable option for me as a single woman who didn’t want to use donor sperm or bring up a child alone.

More and more women these days are, like me, leaving it late in the day to have or even think about having children. I went to Cambridge to meet academic Irenee Daly who had researched why this is.  She found that the pressure to have a good career plays a part, as do economic constraints and a misunderstanding of fertility, fed by media stories of older celebrities having babies.   Ambivalence about having children is common largely, Irene thought, because ‘Life is too busy to have time to feel broody’. Many women assumed they would be mothers but wanted to have packed in lots before then – a great career, travel, finding the right man, marrying and living with him a few years before conceiving.

Women’s social and career clocks, it seems, are clashing with their biological ones.   The result is that today, three times as many women are having children in their forties in Britain, as in my mother’s generation.  1 out of 5 women in Britain and US are childless in comparison to 1 in 10 back then.

I wondered if I should give up gracefully and accept that I was never to be mother.  But I was encouraged not to by tests which showed that my ovaries were in good shape.  “Like a woman 10 years younger” exclaimed my doctor.  This, plus the fact that good and relatively cheap treatment was available in Cyprus, a 90 minute flight from my home in Istanbul were two of the main factors prompting me to decide to freeze.

Contrary to warnings, I didn’t find the medical process too difficult.   The hormones I needed to take to prepare me for collection didn’t affect me too badly, beyond one tearful morning and a clumsy afternoon, which left me with a few less glasses and a cracked laptop screen.  After collection I was a bit sore in my right side but otherwise fine physically.

There was, however, one thing that was difficult to handle. The doctors had expected over 10 mature eggs to be collected, but only 5 were. 10 is the minimum that I had been advised were needed in order to make a future IVF cycle worthwhile.  I had to accept that a second collection was necessary.   And that my ovaries, however well they had shown up in previous tests, really were 43.

I’d embarked upon freezing with my eyes wide open, knowing that it wasn’t the insurance policy it is so often sold as, particularly for a woman of my age.  Even so, getting only five eggs was disappointing.    There could be several reasons for this – a younger woman might get less eggs on a particular month – but I couldn’t help feeling that it must have had something to do with my age.  I suddenly felt old.  We are all living longer but fertility is still as short as it ever was and I am coming to the end of mine.

My frozen eggs, however, may prove to be my way of prolonging it.  I have just started taking hormones to prepare me for the second collection.  Once that is over, however many eggs are collected, then I will at least feel satisfied that I’ve done all I can in my current circumstances.

Amanda Burrell

Manager, In House Productions,  Al Jazeera English Turkey

http://www.huffingtonpost.co.uk/amanda-burrell/freezing-eggs-pregnancy_b_6286724.html

Mixed reaction to Apple egg freezing offer

By Catherine Shanahan, Irish Examiner

Apple has become the latest Silicon Valley giant to appear to make it easier for women to focus on their careers and delay having children. From next January, it will follow in the steps of Facebook by offering to fund the cost of egg freezing procedures, which can cost up to €10,000 plus €500 per year to store the eggs.

Apple also operates an adoption assistance programme where it reimburses eligible expenses associated with the legal adoption of a child.

“We want to empower women at Apple to do the best work of their lives as they care for loved ones and raise their families,” an Apple spokesperson said in an email.

However reaction to the offer is mixed, with some questioning Apple’s motivation.

Dr John Waterstone, medical director at the Waterstone Clinic, said his concern was that egg freezing was not tremendously successful. He said research published in international journal Fertility and Sterility in 2013 showed the chance of a woman having a baby after having eggs frozen at age 25 was 31.5%. That reduced to 19.3% when the women was aged 35 at the time of the procedure.

“Offering to pay for egg freezing is almost encouraging women to delay having babies even further,” he said.

“Egg freezing is not a perfect science and there is a big chance the eggs won’t work. It is completely different to freezing sperm which is very robust and freezes well. Perhaps a more responsible approach would be to make it easier for women to have kids younger by allowing them take more time off and having more family-friendly policies.”

The medical director at Beacon CARE Fertility in Dublin, Dr Ahmed Omar, said they were seeing “more and more Irish women” enquiring about the option of egg freezing with the hope of preserving their future fertility.

“A barrier to preservation in the past has been financial, so the fact that employers are now considering funding employees as a benefit is very interesting and could open opportunities for more women,” he said.

Beacon egg freezing costs €3,000, which includes one year freezing and after that, €500 storage per year.

Exactly what’s involved in putting your fertility on ice?

By Rowena Walsh, Irish Independent

When it comes to job perks, freezing your eggs may not be quite the treat you were planning to enjoy come bonus time. But it’s the latest on offer for female employees at tech giants Apple and Facebook, who are already receive lavish with healthy and wellness benefits to encourage loyalty.

The idea is that women who want to put their careers first no longer have to sacrifice having children. Fertility treatment is seen to ‘level the playing field’ for female employees, which is something that Facebook’s Sheryl Sandberg has long campaigned for.

But whatever about seeming to empower women, there is something fundamentally creepy about your employer becoming involved in your fertility.

Egg freezing allows a woman to have her eggs extracted and stored. They can then be planted into her uterus at a later time, meaning that she can delay getting pregnant. It is becoming increasingly popular among Irish women.

“Seeing so many people going through IVF and ultimately not being able to have children made me think about freezing my eggs. I think of it as an insurance policy,” says Aoife (not her real name).

“I am in a relationship now, but it’s early days and I don’t want children right now. It’s not the right time for me,” says the 29-year-old office worker.

“I haven’t discussed it with my partner, it was a decision I made before I met him, but I have spoken to my friends. Some of them are in the same boat and they are also thinking doing it.

“Although I don’t know anyone who has had the procedure, there doesn’t seem to be any downside. If it saves you going through a lot of stress and an ordeal later in life, why wouldn’t you do it. It is expensive, but it’s good value compared with going through a lot of fertility treatments when I’m older. I know it isn’t a guarantee, but it does take the pressure off.

Dr Ahmed Omar of Beacon CARE Fertility, a clinic offering social egg-freezing in Ireland, is seeing many more women like Aoife, who are willing to pay a fertility insurance policy. It is one way to deal with the insidious ticking of our biological clocks, as well as the doom-mongering about the fertility cliff women hit when they reach 35. Beacon CARE Fertility charges €3,000 for the process, which includes freezing for the first year, and a €500 annual fee for storage after that. There is an extra charge for additional cycles.

Social egg-freezing is a relatively new concept in Ireland. Beacon CARE Fertility started offering the procedure a couple of years ago and they are currently doing two or three treatments per month. Of the women who come in for a consultation, between 70 and 80pc go through with the procedure. “There are many reasons why women may want to freeze their eggs,” says Dr Omar, “and sometimes it simply just isn’t appropriate or possible to have babies at the most fertile age.”

When they’re born, girls have two million eggs, a figure which drops to about 400,000 by the time we reach reproductive age and when a women reaches her 35th birthday, about 95pc of her ovarian reserves gone. Matters are further complicated by the fact that the quality of her eggs has diminished too, so becoming pregnant naturally can be a struggle.

In Dr Omar’s experience, there are three main groups of women who are interested.

The majority either want to establish their careers before having a baby or haven’t met the right man yet and are worried that it might be too late by the time they do.

Others are concerned about their family history of premature menopause or ovarian cancer and may be thinking of having their ovaries removed. A smaller group work in a hazardous situations, for example in a chemical factory or around pesticides.

Martina Kelly, the clinical director of the Clane Fertility Clinic, says that when they first offered the procedure, it will mainly taken up by single women focused on their career, but their clientele is now more varied, including those who are still in education – sometimes families will make provision for that, this is a very typical scenario in the US – to those who always wanted a family and wish to optimise their potential whatever their background.

Meanwhile Dr Omar says that it takes courage to go through the treatment and “there is no guarantee that frozen eggs will result in a successful future pregnancy”.

The collected eggs are put through a process of flash-freezing or ‘vitrification’. This has had a major impact in the success of egg freezing. According to Dr Omar, previously the process involved slow-freezing of eggs, and the results weren’t great – between 2 and 10pc based on a study because of this mechanism. It caused crystals to form in the eggs, which damaged them.

“In a few years, the number of women having the treatment will be much higher and the chances of achieving a baby thanks to frozen eggs will be much higher. One day, there will be no difference between a woman who freezes her eggs at 35 and one who uses her eggs fresh at the same age.

“Hundreds of babies have now been born worldwide using previously frozen, thawed mature eggs. Using advanced techniques, the average success rates using frozen eggs continue to increase at Beacon CARE Fertility and its UK sister clinics, and is now at 39.5pc per attempt.”

However, to date, only a single patient at the Irish clinic has used her frozen eggs. The 37-year-old had left 13 eggs in storage for a year, and so far has not given birth.

Egg freezing is certainly not a panacea for those worried about their fertility, a view strongly felt by Dr John Waterstone, medical director of Waterstone Clinic

“No Irish fertility unit has yet frozen an egg, thawed it, fertilised it and produced a successful pregnancy,” he says, adding that, theoretically egg freezing makes a lot of sense, but there’s a gulf between theory and practice, particularly with regard to the success rates of the technology.

“There are no guarantees in reproductive medicine, and the data from the US is not encouraging with regard to the success of a woman having frozen her eggs, even repeatedly, would have a baby as a result. There is maybe a 19pc chance.”

Dr Waterstone believes social egg-freezing encourages women to put off having babies, and “at the present stage of technology, I couldn’t advocate getting it done in Ireland or England. They haven’t achieved proven high success rates because it hasn’t been used a lot in egg donation. Go to the US or Spain, or a place where they freeze eggs a lot as part of the egg donation process.” This enables them to perfect their techniques freezing and thawing them in a short time frame to find out if the process really works.

As more women like Aoife opt for a fertility insurance policy, Dr Omar points out that some who do freeze their eggs will never need them.

“It’s a safety plan. They might be the right person in the next year or two and go on to get pregnant naturally.”

So, what’s involved?

It begins with a thorough medical consultation and a woman’s ovarian reserves are checked through an AMH blood test. Dr Omar is insistent that it is imperative that women must be very informed in order to manage expectations before they go through the procedure.

After a woman turns 40, her ovarian reserves will be quite low, and the risk of chromosomal abnormalities, such as Down syndrome, and miscarriage are higher. The process involves a woman injecting themselves with ovulation stimulants on a daily basis for two weeks prior to the egg collection and getting scanned every three to four days.

Everyone’s ovarian reserves are different and the quantity and quality of eggs will differ depending on the person.

The process of egg retrieval involves conscious sedation and it’s done by trans-vaginal ultrasound. A small needle is passed into the follicles and the solution is sucked into the test tube. This is then passed on to the embryologist who look at them under a microscope to see if an egg has been retrieved. If so, they will assess whether they are mature enough – normally 80-90pc will be, however. The eggs are then flash-frozen in a process of vitrification. When a woman decides to use her eggs, sperm is injected into them and they are fertilised to become embryos. The strongest one or two are then implanted into the woman, and it is hoped that pregnancy will result.

5 Foods That May Hurt Male Fertility

Guys, you’ve heard the standard advice for protecting your swimmers: Don’t wear tight undies. Keep your laptop far from, well, your lap. Stop smoking ASAP. But there may be an even easier way to shield your sperm —  watch what you eat. “We’ve noticed that fertility has been decreasing over the past several decades. And guys want advice to improve upon matters,” said Dr. Ryan Terlecki, director of the Men’s Health Clinic for the Wake Forest University Department of Urology. “Most guys have never even heard that anything in their diet could impact sperm count.”

But the truth is, an emerging body of research suggests that the foods you pile on your plate may play a role in the number of sperm you have (count), whether they’re normally shaped (morphology), and how well they move (motility).

How that does that play out in the bedroom? “Sperm count is, of course, important, because if it’s not there, you’re not going to [biologically] father a kid,” said Dr Paul Turek, president of the Society for Male Reproduction and Urology. “And I think sperm motility is more important than sperm count.” Although morphology is less firmly linked to fertility, it has been shown in a number of studies to influence reproductive success, said Audrey Gaskins, who researches nutrition and fertility at the Harvard School of Public Health.

Although the research is still new, one thing is clear: The foods that may pose a threat to male fertility are many of the same dietary culprits behind things such as Type 2 Diabetes and heart disease. That means you’d be smart to avoid them, regardless of whether you plan to make a baby any time soon. The following foods might get in the way of fatherhood:

Processed Meats

Sure, meat is considered the ultimate man food — but if you eat the wrong kind, your sperm could be compromised. In a 2014 Harvard study, men who consumed the most processed meat — hamburgers, hot dogs, salami, bologna, bacon — had 23 percent fewer normal sperm than guys who ate it sparingly. In another 2014 study, published in the journal Epidemiology, the same researchers found that eating processed meat was associated with lower sperm count.

Interestingly, saturated fat intake — which has previously been blamed for poor sperm quality — wasn’t the nutritional connection. “We didn’t find a link with unprocessed red meat, so it seems to be something that happens in the processing that is detrimental to sperm quality,” Gaskins told Yahoo Health.

One possibility: Processed meats tend to house more hormonal residues than other meats, which could have potential reproductive consequences. “In the U.S., we allow more hormones to be administered to our cattle [than in the European Union],” she said. “So this is definitely one possible mechanism.”

Eat this instead: Want to boost your swimmers? Look to the sea: The same Harvard scientists found that men who eat lots of fish have, on average, a 51 percent higher sperm count than those who barely eat any. This link was strongest for dark meat fish, like salmon or tuna, although white meat fish, such as cod and halibut, had a positive effect, too.

“Dark meat fish have higher levels of omega-3 fatty acids,” which have been previously shown to boost healthy sperm, said Gaskins. The extra dose of vitamin D in dark-meat fish may also be a factor.

Full-fat dairy 

Whole milk may leave you with a fraction of the healthy sperm you should have. Young guys who eat at least two servings of full-fat dairy — especially cheese and whole milk — per day tend to have fewer motile sperm, according to a 2013 study in Human Reproduction. Don’t blame the cows, though: Pesticides and other chemical contaminants in the environment, which are attracted to the fat in dairy, may be what leads to subpar sperm, the scientists say.

Eat this instead: You don’t have to ditch dairy altogether. Just switch your focus to the low-fat kind: Men who consume a couple servings of low-fat dairy — especially 1% or 2% milk — per day have 33 percent higher sperm counts and more motile sperm than those who eat little or no low-fat dairy, a 2014 study in Fertility and Sterility found.

One explanation: Low-fat milk may boost levels of insulin growth factor-1, a hormone thought to aid the cells that help produce sperm, the scientists say. “It’s not always the sperm themselves [that are affected],” said Terlecki. “Sometimes, it’s the supporting cells — those that create testosterone to nurture sperm development, and cells that guide the sperm toward maturation. We see those cells affected a lot, in terms of compounds that come from the diet.”

Non-organic produce

That fresh spinach may come with a side of pesticides — and your sperm could be the first casualty: In a study presented at the 2014 American Society for Reproductive Medicine Annual Meeting, which took place this week, men who consumed the most pesticide residues through produce had 64 percent fewer normal sperm and 70 percent fewer motile sperm than guys who took in the least.

Pesticides may throw your hormonal balance out of whack, which can interfere with your body’s production of sperm, said Gaskins. “We’re concerned about low chronic exposure, day after day at a low dose,” she said. “Our body slowly becomes unable to deal with these low-level impacts over time. This slowly leads to destruction.”

Eat this instead: We’d never suggest you eliminate produce from your diet — but you may want to consider shelling out the cash for organic fruits and vegetables, especially when it comes to these pesticide-laden picks: apples, strawberries, grapes, celery, peaches, spinach, sweet bell peppers, nectarines (imported), cucumbers, and cherry tomatoes. A 2014 Environmental Working Group study showed that these 10 fruits and vegetables have the highest pesticide load.

Alcohol

You booze, you lose — sperm, that is. Drinking alcohol may have a negative impact on sperm concentration and motility, according to a 2012 Brazilian study of men seeking fertility treatments. Why? Downing copious amounts of alcohol may lead to total-body oxidative stress, which is a key cause of male infertility, the researchers say. But one drink probably isn’t a problem: “In moderation, alcohol intake seems to have no effect on semen quality,” Gaskins said. However, as a new Danish study found, modest but habitual alcohol intake — slightly less than a bottle of wine per week — may compromise sperm quality.

Drink this instead: An occasional beer probably won’t do your body any harm, but if you’re constantly sipping on something (besides water), make it pomegranate juice. In a Turkish study, male rats given pomegranate juice on a daily basis experienced a boost in sperm count and motility. The purple juice is a rich source of antioxidants, like vitamin C, and although this was an animal study, past research has linked a high intake of antioxidants in men to better semen quality. “Men who eat a healthier diet with higher antioxidants — particularly from natural foods, as opposed to supplements — tend to have higher motility,” noted Gaskins.

Soda

Here’s yet another reason to kick the can: In a new study of 189 healthy young men, published in Human Reproduction, regularly drinking sugar-sweetened drinks — slightly more than a serving per day — was linked to poorer sperm motility. (Interestingly, this connection was strongest among lean men.) Sipping on sugary beverages — soda, sports drinks, sweet tea — boosts your odds of insulin resistance, which in turn leads to oxidative stress that can damage your sperm, the scientists say.

Eat this instead: If you need a shot of sugar, make it the kind found in fruit — not soda. In the Brazilian study, the fruit was positively related to sperm quality, although, keep in mind, you should go organic whenever possible (or give your fruit a good scrubbing before eating it).

Shame and stigma still attached to infertility

By Catherine Shanahan, Irish Examiner

Helen Browne said infertility, which affects one in six people, was “still isolating, still stigmatising” especially for those living in rural areas where the issue was “not so much taboo” as “not discussed”.

“People are OK, generally speaking, about talking to their families and close friends, but not so much outside that circle,” said Ms Browne. “It can be very stressful for people if they are trying to conceal it from work colleagues. They end up sneaking out to clinic appointments and are very nervous about being seen going into the treatment clinic.”

Cork woman June Shannon, 43, who has endured four failed cycles of IVF treatment since 2009, said her experience was that people simply did not “stop to think”.

“In my experience, people were not deliberately nasty or stigmatising, but you are excluded from a lot of things if you are childless,” she said.

Ms Shannon, who will address NISIG’s annual conference at the Hilton Dublin Airport tomorrow, said she believed childless women — whether by choice or through infertility — were excluded from a lot of things in society.

“If you look at women’s magazines, so much of the focus is on women and their babies and their care, articles like ‘How to get my baby to sleep’,” Ms Shannon said. “It is such a wonderful thing to have a baby and I understand why children are the focus of so many articles but it just seems to be everywhere.”

Medical director at the Waterstone Clinic, John Waterstone, who will also address the conference, said media coverage of fertility treatments meant it was becoming “more normalised”. Last week, the media reported the first baby born from a transplanted womb.

Dr Waterstone will give a talk at tomorrow’s conference on pre-implantation genetic screening (PGS) and diagnosis (PGD).

PGD is generally the diagnosis of a single gene defect in the embryo for couples who have a single gene mutation and want to ensure their offspring will not carry the disease.

PGS involves screening for chromosomal abnormalities.

The NISIG conference, which gets underway at 9.30am, will also explore egg donation options and legal issues around surrogacy. Separately, an open information day will take place in the Kingsley Hotel in Cork on Sunday, organised by the CFC, for people unable to make the Dublin conference.

Patient Information Seminar

This patient information seminar will give practical advice to couples on how to maximise their chances of conception and will explain the different treatment options available. As part of the seminar, there will be a series of short and informative talks from the clinic’s specialist team of gynaecologists, scientists, fertility nurse specialists and counsellor.

The information seminar will begin at 9.30am with a talk entitled ‘Understanding your fertility’, presented by Dr. Minna Geisler.  Medical Director, Dr. Waterstone, will provide an overview of the fertility treatments and options and new techniques available at the group’s clinics. Head of Laboratory Service, Dr. Tim Dineen will discuss male fertility tests and treatments and couples will also have an opportunity to meet leading embryologist, Jayne Flanagan. There will be an opportunity for questions and answers throughout the seminar.

“We understand how intimidating it can be to seek fertility advice,” says Dr. John Waterstone, Medical Director of the group. “Our hope is that through this informal fertility seminar, men and women will feel more comfortable about taking that important next step. Our expert team of fertility specialists will explain treatment options, what the process entails and answer any queries couples might have.”

Dr. Waterstone explains that fertility difficulties can affect as many as one in five couples in Ireland: “Sometimes difficulties can relate to something as simple as lifestyle, which can be addressed and resolved easily. Other couples may need fertility treatment in order to conceive. Earlier this year we opened two new fertility outreach clinics in Limerick and Waterford and we are delighted to extend our services to people throughout Munster. Assisted reproductive services are evolving and when the best medical and nursing care is combined with the latest scientific innovation and developments, notable success rates can be achieved.”

National Infertility Support and Information Group Conference 2014

This year’s NISIG conference is taking place at the Hilton Dublin Airport on October 11th from 9am to 5pm and will address aspects of fertility and infertility in males and females.

NISIG are pleased to announce that Fertility expert Dr George Ndukwe, who is one of the most experienced fertility specialists in Europe, will be at the conference to discuss Auto immune Issues. Dr George is the Medical Director and IVF consultant at ZWAF (Zita West Assisted Fertility Clinic). Dr John Waterstone, Waterstone Clinic, will discuss Pre Implantation Genetic Diagnosis.

Helen Browne, co-founder and chairperson of NISIG states‘1 in 6 people in Ireland experience fertility issues, the aim of this conference is to provide support and information to everyone who experience such issues. At the conference NISIG will not only just listen and provide support in addition national and international experts will be on hand to provide direction and the best advice and information.

Topics to be presented at the conference include:

  • A General Landscape on Infertility
  • Psychological Implications of Infertility
  • Anti-mullerian Hormone Fertility Testing
  • Pre-implantation Genetic Diagnosis
  • Auto immune Issues – recurrent miscarriages and numerous failed IVF treatment
  • The latest developments in the fertility world such as endometrial scratching and embryo glue
  • Optimising IVF Outcomes
  • Genetic Screening in IVF
  • Talking and Telling for parents of donor children

Workshops will be held in the afternoon from 2pm to 5pm providing advice and support to people who have fertility issues. Allocated break off rooms will be available to meet the experts.  This conference is also a great opportunity for individuals to meet other people who are and have gone through similar situations; NISIG encourages all people attending to discuss and exchange the stories of their journeys. A complete list of work-shops will be made available on www.nisig.ie in advance of the conference. Register your interest by e mailing [email protected] or visit NISIG’s website at www.nisig.ie. Tickets available from www.eventbrite.ie

NISIG hold monthly support groups throughout the country offering advice, information and guidance for both men and women who are suffering from fertility issues.

Top 10 ways your man can boost his fertility

Infertility is most commonly associated with women, but around one third of  infertility cases are down to a problem with the man, with another third being  down to a problem with both partners.

Recent studies have suggested that male fertility problems are on the rise. A  major French study published a year ago found that average sperm counts fell by  one-third between 1989 and 2005. 

The researchers at the Institut de Veille Sanitaire in St Maurice tested  samples from 26,000 men. 

At the beginning of the study, the average sperm count for a 35-year-old  man was 73.6 million sperm per millilitre; by 2005, it had dropped to 49.4  million per ml. Anything below 20 million per ml is considered low.

Luckily, there are some simple lifestyle changes you can persuade your man to  make today to help increase your chances of getting pregnant.

Here Valentine Akande, fertility expert at Spire The Glen Hospital Bristol,  shares his advice:

Stop smoking. “This is always a good idea, but it  really is crucial if you are struggling to conceive, or if your partner has a  low sperm count or issues with the mobility or morphology of his sperm. Smoking  contains hundreds of chemicals which can prevent fertilisation of the egg and  therefore reduce the chances of conception. Whether he does it cold turkey or  uses nicotine replacement therapy, it’s time to pack in the fags.”

Cut back on booze. “The link between alcohol and male  infertility is clear. If your partner wants his swimmers to be in tip top shape,  he must cut right down on alcohol. It affects sperm production and lower  testosterone levels which impacts fertility”.

Keep cool. “The testicles are on the outside of the  male body for a reason- to keep them cool. Overheating from hot baths or tight  pants can reduce sperm function. Your man should opt for showers and loose  fitting boxer shorts instead.”

Exercise in moderation. “You might think that the more  physically fit your partner is the better, but that is not always the case.  Overdoing it in the gym or doing any kind of exercise to excess can actually  impair your fertility, rather than help it. That’s because too much exercise can  affect sperm production. It’s still important to exercise, just keep it in  moderation.”

Avoid long distance cycling. “Riding a bicycle for long  distances or competitively can have significant detrimental effects on sperm  function particularly with tight underwear. As such this should be  avoided if you are experiencing difficulties conceiving.”

Lose weight. “Carrying excess pounds not only affects  how you look and feel, but can also impact your fertility. Obesity creates an  excess of oestrogen (the female sex hormone) and a lowering of testosterone,  which reduces sperm count. Being overweight can also reduce your man’s libido  which has obvious implications on trying to conceive.”

Get your vitamins. “A healthy diet plays a key part in  optimising your fertility. Zinc is particularly important as it ‘activates’  sperm and helps them swim towards the egg. To ensure you get a good range of  essential fertility vitamins, eat lots of leafy greens and a range of nuts and  seeds. If there are deficiencies in your partner’s diet, additional antioxidants  and vitamins such as vit C, folic acid and selenium can be beneficial for sperm  function.”

Cut back on caffeine. “Small amounts of caffeine do not  appear to adversely affect fertility, but if you partner drinks cups of coffee  all day long then cutting back is definitely worth considering. He should stick  to no more than two or three cups of coffee a day.”

Talk to your GP. “If getting pregnant takes you more  than a year (or more than six months if your partner is over 35) then it is  worth a visit to your GP to arrange some basic fertility testing. This is less  invasive for the man and will usually involve simple blood tests and a sperm  analysis. It might sound daunting but the sooner you know if anything is wrong,  the sooner you can take steps to help.”

Know your partner’s fertile window. “You have a period  of up to five or six days before the day of ovulation when you are able to  conceive. Timing sex within these days is absolutely crucial in order to  conceive. If you are unsure when you ovulate, ovulation predictor kits (which  can be bought over the counter) can help.”

by Taryn Davies for www.femalefirst.co.uk

IVF ‘Success’ is a live birth, not pregnancy

Some of the figures quoted in the article seem overly optimistic – as does reporting on IVF at times – and this may be because it is not clear what the denominator is. For example, the statement that “pregnancy rates are fairly stable (30-35%) for each embryo transferred up to the age of 30, but fall to 20% by 40 and are only 5% by 45” warrants examination.

IVF treatment involves a number of steps: fertility drugs to develop a number of eggs; retrieving the eggs; adding sperm to the eggs in the hope that embryos develop; and finally an embryo transfer (ET) procedure where an embryo is placed in the uterus in the hope that it will implant and grow into a baby. Unfortunately, there is a risk that things go wrong in each of these steps. The woman might not respond to the fertility drugs, eggs may not be recovered and live birth embryos may not develop or implant. Even if the embryo does implant and a pregnancy is established, there is also still a risk of miscarriage.

So when we hear IVF success rate figures we need to ask if the rate is per started treatment cycle, per egg collection or per woman who reaches the stage of embryo transfer. Also, “pregnancy rate” is not the same as live birth rate because some pregnancies are lost.

‘Success’ is a live birth, not pregnancy

To illustrate the point here are the most recent 2011 statistics about IVF success in Australia and New Zealand:

In that year 40,696 treatment cycles were started. Of these, 37,259 continued to the egg collection stage and 31,053 to the embryo transfer stage. As a result, 9,100 pregnancies were established and there were 6,928 births. So, if “success” is quoted as pregnancies per embryo transfer, the figure is 29%. If on the other hand it is quoted as the chance of a live birth per started cycle, this drops to 17%.

While 17% is a pretty grim figure it is the only honest way of reporting chance of success because what people want and expect when they start an IVF cycle is a live birth.

Then there is the impact that the woman’s age has on IVF success. The older the woman is the greater the risk at each stage that things won’t go to plan. In 2011 the chance of a live birth per started treatment cycle was 25.3% for women aged 30-34 but only 6.6% for women aged 40-44 and a dismal 1.2% for women aged 45 or older. So, while fertility doesn’t “drop off a cliff” at 35, the chance of conceiving (spontaneously and with IVF) and having a complication-free pregnancy and a healthy baby steadily declines after age 35 and after age 40 chances are slim.

Of all the women who had IVF in Australia and New Zealand in 2011, 26.5% were aged 40 or older, up from 22.8% in 2007. This means that for one in four women who start IVF, the chance of having a baby is around 6% each time they try. Or, put the other way around, 94 out of 100 attempts will not result in the birth of a baby.

But the belief that IVF can help overcome age-related infertility is widespread and evident in the IVF data: while only 4.3% of women who gave birth in 2011 were aged over 40, 26.5% of those seeking assisted reproductive technology (ART), which includes IVF, were age 40 or over, which shows that women over 40 who are unable to conceive spontaneously seek ART presumably hoping it will help.

Women and men deserve good information about the factors that affect fertility to allow them to make informed and timely decisions about childbearing – and this includes accessible, evidence-based information about the modifiable factors that affect fertility and what people can do to improve their chance of achieving their childbearing aspirations. And while IVF has helped countless couples have children, it’s important that those who decide to try IVF are given honest and realistic information about the chance of the treatment working for them.

Waterstone Clinic’s success rates are benchmarked against the best in the UK and USA where reporting of results is mandatory and birth rates are transparent. CFC uses ‘Live Birth’ rate as the measure of success.

By Karin Hammarberg, Monash University