When Your Friend Is Going Through Fertility Treatment This Is What To Do

Mary McAuliffe, fertility nurse specialist and head of clinical services at Waterstone Clinic shares her tips on how to really help someone through this difficult time.

“We often find that women and couples don’t even want to tell their family and friends about their treatment, so it can be a very difficult and isolating time for them. If they have chosen to confide in you, they haven’t taken that decision lightly so it’s really important to make sure you are communicating with them in the right way. Men and women’s emotional response to fertility struggles are very different, and you might find they prefer to confide in a family member or a close friend than burdening their partner with their hopes and fears. The ways in which they need support might not necessarily be the way you think is right. You might want to discuss it all; they might want to escape it all and see a funny movie. Get in tune with the signs they are giving you and respond in the right way with the right type of support.”

My top tips:

1. Don’t tell them to “relax about it” – people who have chosen to go down the route of IVF have done so because they are facing significant challenges on the way to realising their dream of having a baby. Telling them to relax could be taken to belittle the issues they are trying to overcome.

2. Don’t ignore the Elephant In The Room or try to minimise the problem – much like not telling them to relax, completely ignoring the issue or dismissing it if it is raised is also not supportive. If they bring it up, listen and give encouragement. Unless they have expressly said they do not want to talk about it, ask a general question about how things are going so that they know you are interested and feel comfortable chatting about it.

3. Don’t ask every day if there any updates or news. And never ask, “are you pregnant?”

4. Never say ‘There are worse things that could happen” – to the person going through it, it’s the biggest challenge they have had to face.

5. Ask how you can help and support them on their journey – ask if there’s anything you can do that might help. Maybe they need a lift to an appointment, or maybe you could offer to make them dinner following an appointment. Offer your help and let them know you are genuine about it.

6. Be a cause for distraction – they will very likely need time out and something fun to look forward to so they can take their mind off it all for a few hours. Be their companion for a gig, or a spa visit or even just treat them to popcorn and the cinema.

7. Be aware of other people’s behaviour in their presence and be ready to protect them from preying or awkward questions.

8. Support their decision to stop treatments – making the decision to stop is an extremely difficult one, let them know you support them all the way and you know they did the right thing for them.

9. On testing day – don’t contact them looking for an update, whether it is good or bad news, they will need time to digest the information. Do, however, let them know in advance that you are at the end of the phone and there for them.

10. Encourage them to have a date-night with their partner; they may need to switch off for a few hours and have fun together as a couple.

11. Don’t limit communication to just texting or calling, visit them and arrange to go for a walk, or a coffee – sometimes just having company can make a difference. Physical support such as a hug or an arm around their shoulder can also provide comfort.

12. Be realistic with them and don’t be overly positive about their treatment if they have told you their chance of success is less than 20 per cent.

Soft Drinks may be Reducing Your chances of Getting Pregnant

Women who regularly consume soft drinks may be reducing their chances of getting pregnant, according to new research.

A study of 524 patients found a link between artificial sweeteners, such as those used in “diet” sodas, and lower fertility rates, while use of sugar in soft drinks and added to coffee was associated with poorer quality of eggs and embryos.

One of Britain’s leading fertility experts last night described the findings as “highly significant”, and warned women not to underestimate the effects of food additives on their likelihood of conception.

Other scientists, however, have said the lower pregnancy rates may have been driven by obesity, which is already a known negative factor, rather than the sugar or its synthetic equivalent per se.

Artificial sweeteners, such as saccharin and sucralose, are chemical substances that many people choose over sugar because they are low-calorie or calorie-free.

In the study, which will be presented today at the American Society for Reproductive Medicine congress in Salt Lake City, a batch of women who were undergoing IVF treatment were interviewed by nutritionists about the foods they consumed, as well soft and hot drinks.

The finding, showed that reduced rates of pregnancy was most closely associated with consumption of soft drinks made with artificial sweeteners, as well as coffee with added artificial sweeteners.

Meanwhile the use of sugar in soft drinks and coffee was associated with a poorer quality of egg, which can be a factor in likelihood of getting pregnant.

Unsweetened coffee, however, had no effect on egg quality or pregnancy chances, said the researchers from the Federal University of Sao Paulo.

Professor Adam Balen, Chairman of the British Fertility Society, said: “This is a very interesting study that suggests the false promise of artificial sweeteners that are found in soft drinks and added to drinks, such as coffee, may have a significant effect on the quality and fertility of woman’s eggs and this may further impact on the chances of conception.

“These findings are highly significant to our population.

“There should be more scrutiny of food additives and better information available to the public and, in particular, those wishing to conceive.”

However, a spokesman for the British Dietetic Association said the study made no effort to distinguish the effect on fertility outcomes of the bodyweight of the women in the trail from the impact of artificial sweeteners and sugar in their diets.

Professor Sir Colin Berry, Emeritus Professor of Pathology at Queen Mary University London, also cautioned about drawing inferences on wider reproductive outcomes from the experience of IVF patients.

When you should start seeking fertility help?

With so much media coverage of celebrities seeking fertility treatment and documenting their IVF journeys, the anxiety around trying to conceive when nothing is happening can become amplified for women and couples.

If you and your partner have made the decision to have a baby, it’s good to know when you should and when you shouldn’t become concerned if that blue line is not appearing.

When not to be concerned

If you are younger than 35, have regular periods, no family history of fertility issues or early menopause, and no underlying issues such as Polycystic Ovary Syndrome or endometriosis, then there is no need to worry if you have been trying for less than six months. I would always recommend when someone is trying to conceive, that they keep a menstrual diary to track their cycle, so you have a good understanding of your pattern and know when you are ovulating.

If you find yourself anxious even if everything appears normal, then to alleviate stress I would suggest you (and your partner) avail of a simple and cost-effective fertility assessment. This will either reassure you that all is well, or inform you of an underlying issue, which you can take steps to correct. At our clinics we offer a self-referral fertility assessment service, My Fertility Check, which is a quick and straightforward test.

When to know it’s time to seek fertility help

If you are under 35 and have been trying without success for 12 months and there is no history of early menopause or known fertility issues with you or your partner, then it may be a good time to consider seeking help.

If you are over 35 and unsuccessful after six months, you should take action and make an appointment with a fertility specialist. Age is the single greatest factor affecting a woman’s fertility, which goes into decline at a faster rate after the age of 35.

It is more difficult for women over this age to become pregnant, even with assisted reproductive technology. The earlier an issue is identified, the sooner we can address it with you. Remember, one in six couples will struggle when trying for a pregnancy, so you are not alone.

 Don’t forget the male factor

Of course, fertility issues also affect men. In fact in 30% of cases, a male factor is the reason why a couple has been unable to conceive, while in a further 10% of cases it is a combination of both male and female difficulties. So, if your partner has undescended testicles, had mumps when he was younger, or had any injuries to his testicular area, it would be a good idea to have an early assessment to ensure all is well, and if not, treatment is available to help you achieve your goal.

Advances in reproductive technology for men now mean that there are simple, effective and non-invasive procedures which can be very successful in overcoming some problems.

Private IVF clinics offer ‘discredited’ €1,000 test

Private fertility clinics are selling Irish couples €1,000 blood tests despite experts warning that there is no proof that the procedure improves the chances of having a baby.

The test is sold by Beacon Care and Sims fertility clinics. It is part of a reproductive immunology procedure offered to women who have had multiple miscarriages after rounds of IVF.

Both Beacon Care and Sims, two of the biggest private fertility clinics in the country, offer immunology testing and treatment for “natural killer” cells, which is one of the most controversial areas of reproductive medicine, according to a leading Irish fertility doctor.

The so-called Chicago test costs €1,000 plus a consultation fee. The blood is sent to the US city to be examined to see if the woman’s immune system is attacking embryos and causing miscarriages. If elevated levels of the killer cells are found the woman can be prescribed drugs to suppress her immune system, which can cost thousands of euros per dose. This is usually after multiple rounds of IVF treatment costing an average of €4,500 per cycle.

Researchers and fertility authorities have said that testing blood for such cells is not useful. When contacted by The Times yesterday, the medical director of Sims said that the clinic would likely withdraw the test in the near future.

The Human Fertilisation and Embryology Authority, the UK regulator, has said that the theory behind reproductive immunology has been “widely discredited and there is no evidence that immunosuppressive therapies can improve your chances of getting pregnant”.

It said that there was not enough evidence to support the effect of the killer cells in the uterus and that “safety and efficacy questions surrounding the use of immune therapies in IVF remain unanswered”.

Mary Wingfield, clinical director of the Merrion Fertility Clinic, which is linked to the National Maternity Hospital, said that she agreed with the UK regulator’s warnings about natural killer cells and that the commercially available tests were “extremely variable and unsatisfactory”.

“Until satisfactory evidence becomes available, testing for and treating presumed immune and [natural killer] cell dysfunction in women with reproductive problems should only be done as part of clinical studies and trials,” Professor Wingfield wrote in her book The Fertility Handbook.

The government has agreed to draft new legislation to offer financial assistance to couples struggling to conceive. The law would also establish an independent body to oversee the sector.

John Kennedy, medical director at Sims, said that the Chicago blood test was no longer routinely sold at its Dublin and Cork clinics and that a biopsy was now recommended to test for killer cells. He said that demand for the test was patient-led.

“It is something we are considering withdrawing but we offer it because if we don’t people will just go abroad or to another clinic,” he said.

Dr Kennedy said there was some evidence for reproductive immunology but the limits were explained to any couple treated at Sims. He added: “Across modern medicine there is a huge swathe of things that are done with limited evidence for them.” He said patients were told that there was no certainty that any treatment would work.

Ahmed Omar, clinical director of Beacon Care, said that the Chicago test was one of a number of investigations offered to patients who had suffered repeated IVF failures or miscarriages.

“We counsel them that immune testing may only be beneficial for women that other causes for treatment failure or pregnancy loss have been excluded. We explain that elevation in natural killer cells is one of many risk factors but due to the complexity of human embryo implantation it is difficult to be certain about what is a single cause for treatment failure,” he said.

Dr Omar said that there was “a general acceptance of the role of immune issues in some cases of [IVF] failure and miscarriages” but that there was a lack of randomised control trials to assess the benefits of the treatments available.

Ref: https://www.thetimes.co.uk/article/private-ivf-clinics-offer-discredited-1-000-test-gc6hf5pkc

 

13 myths you need to know about fertility

There are so many considerations involved in becoming pregnant, including age, weight, timing and lifestyle. With a myriad of myths surrounding the process, we debunk just a few of the untruths about fertility, and fertility treatment.

1 GETTING PREGNANT IS EASY

Many of us spend our youth avoiding pregnancy but find that when we do want a baby, getting pregnant can take time. In fact, one in six couples will have difficulties conceiving. We recommend women aged 35 and older try no longer than six months before seeking help, and that women younger than 35 try for 12 months, and if they have a condition that makes it difficult to become pregnant, to seek help sooner.

2 INFERTILITY IS A FEMALE PROBLEM

Fertility problems can be complex because there are so many factors involved in getting pregnant. A simple way of looking at it is that for one-third of couples, the issue is related to the female. For another third, the issue is related to the male and for a further third, both partners have a fertility problem. It is also important to say that in some cases there is no obvious cause identified, known as unexplained subfertility. It can be helpful to have some basic tests that may be reassuring.

3 CONCEIVING AFTER THE PILL WILL TAKE A WHILE

A history of taking the pill, or the amount of time you have been on the pill, does not affect your chances of conceiving. Equally, being on the pill does not conserve your eggs. Once you stop the pill, you begin to ovulate again and, if you time it right, you can get pregnant.

4 HAVE SEX WHEN YOU OVULATE

Sperm can survive in fertile cervical mucus for up to five days, so having sex in the days leading up to ovulation boosts your chances of conception. Therefore, having sex before ovulation will ensure there is plenty of sperm available. Ovulation-predictor kits help you identify the surge in the hormone LH that occurs 24-36 hours prior to the egg being released, but they are not always accurate so it helps to understand your own fertile window – five days leading up to ovulation and the 12-24 hours after.

5 LIFTING LEGS IN THE AIR AFTER SEX

Healthy sperm number in the millions and are speedy swimmers, programmed to travel through the cervix and uterus into the fallopian tube when the egg is released. Maintaining certain positions during or after sex does not help nor does it hinder this process.

6 WAIT FOR YOUR TEMPERATURE TO RISE

Using Basal Body Temperature (BBT) can be helpful as a tool to understand your cycle and identify when you normally ovulate by seeing a pattern emerge. The temperature rise only occurs after the egg has been released. If you wait until then to have sex, you have reduced your window of opportunity to mere hours (the egg will only live for 12-24 hours).

7 IVF IS THE ONLY OPTION

This is not true. There are several other fertility treatments available, depending on your particular situation. Your reproductive medicine consultant will select the treatment that is most appropriate to your situation. Some couples simply need advice on lifestyle, timing intercourse, or, simply more time for pregnancy to happen naturally.

8 I ALREADY HAVE A CHILD, SO THERE’S NO PROBLEM

Increasing numbers of women are suffering from secondary infertility. Even if your first pregnancy was natural and happened easily, sometimes, becoming pregnant a second time can prove difficult. As you are older than the first time you got pregnant, egg numbers may be lower and egg quality may be poorer. If you are over 35 and trying for more than six months, we advise an assessment by a fertility specialist.

9 WITH IVF, YOU CAN GET PREGNANT AT ANY AGE

With so many celebrities having babies in their late 40s, there is a belief a woman can have fertility treatment at any age with her own eggs to achieve pregnancy. This unfortunately is not the case. The CDC in the United States has extremely reliable data on success rates of assisted reproductive technology. The chance of one completed cycle producing a live birth is 40-50pc under age 35, 20-25pc at age 38-40, and 4-5pc over age 42.

10 WEIGHT MAKES NO DIFFERENCE

Being underweight or overweight can have a negative impact on fertility, for both men and women. If you are actively trying for a baby, calculate your BMI. Aim for a healthy weight; with a BMI between 20 and 24.9. Optimising your weight will help regulate your menstrual cycle, increase your chances of conceiving, and reduce the risk of pregnancy complications.

11 EXERCISE HAS NO IMPACT

Maintaining a healthy lifestyle is very important; however, excessive exercise can be detrimental in some circumstances. For some men with sperm problems, it may be best to avoid vigorous exercise that may overheat the testes (eg. excessive cycling). Excessive exercise can also disturb a woman’s reproductive cycle, making it more difficult to get pregnant. Certainly, do not give up exercise entirely as it is important for mental and physical wellbeing, but moderation is key.

12 STRESS MAKES NO IMPACT

Stress and its impact on fertility is difficult to quantify, but managing stress is important. Try going for a swim or a walk or using relaxation methods like yoga or mindfulness. For some women, severe stress may delay ovulation, resulting in irregular cycles and making it more difficult to conceive.

13 ONLY WOMEN NEED FOLIC ACID

Women should take folic acid (400mcg) while trying to conceive, as well as during pregnancy. For men with sperm abnormalities, folic acid is prescribed as there is evidence it can improve sperm health. Vitamin D is also recommended as evidence shows that most Irish people are low in this supplement.

â–  Dr Minna Geisler is a consultant in reproductive medicine at Waterstone Clinic. Waterstone Clinic is a leading fertility specialist with clinics nationwide, and has a state-of-the-art national centre of fertility excellence at Lotamore House in Cork. For more information, see waterstoneclinic.ie

http://www.independent.ie/life/health-wellbeing/health-features/13-myths-you-need-to-know-about-fertility-36091862.html

Delivery rates in IVF are affected by the age of the male partner

Geneva, 3 July 2017: Men, unlike women, do not have a menopause or a predictable and detectable decline in their fertility. Female age is thus the dominant factor in predicting (or explaining) a couple’s chance of conception, whether natural or assisted.

A few studies have found that the chance of natural conception can be affected by the age of the male partner, particularly in the genetic health of sperm cells, but the celebrity examples of Charlie Chaplin or Luciano Pavarotti have kept alive the notion that male fertility goes on forever.

Now, a new study from the USA in IVF couples shows quite clearly that live birth outcome is clearly affected by the age of the male partner and that in certain younger female age groups, where the effect of age is less potent, the chances of live birth can be appreciably reduced by the man’s increasing age. “Our study found an independent effect of male age on the cumulative incidence of live birth,” said investigator Dr Laura Dodge from Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA. Dr Dodge will present the study’s results on Tuesday at the 33rd Annual Meeting of ESHRE in Geneva.

The study was an analysis of all IVF cycles performed at a large IVF centre in the Boston region between 2000 and 2014, a total of almost 19,000 cycles performed in 7753 couples. The female partners in these cycles were stratified according to four age bands: under 30, 30-35 years, 35-40 years, and 40-42. Men were stratified into these same four age bands, with an additional band of 42 and over.

As expected, the cumulative live birth rate (measured from up to six cycles of treatment) was lowest in those couples where the female partner was in the 40-42 age band, and in this group the age of the male partner had no impact, demonstrating the dominant detrimental effect of female age. However, within the other bands of female age, the cumulative incidence of live birth was significantly affected by male partner age and was found to decline as the man grew older.

For example, in couples with a female partner aged under 30, a male partner aged 40-42 was associated with a significantly lower cumulative birth rate (46%) than a male partner aged 30-35 (73%). Similarly, in couples with a female partner aged 35-40 years live birth rates were higher with a younger than with an older male partner.

“Generally,” explained Dr Dodge, “we saw no significant decline in cumulative live birth when women had a male partner the same age or younger. However, women aged 35-40 did significantly benefit from having a male partner who is under age 30, in that they see a nearly 30% relative improvement in cumulative incidence of live birth when compared to women whose partner is 30-35 – from 54% to 70%.

“Where we see significant decreases in the cumulative incidence of live birth is among women with male partners in the older age bands. For women age 30-35 having a partner who is older than they are is associated with approximately 11% relative decreases in cumulative incidence of live birth – from 70% to 64% – when compared to having a male partner within their same age band.”

Commenting on the results, Dr Dodge noted that in natural conceptions increasing male age is associated with a decreased incidence of pregnancy, increased time to pregnancy, and increased risk of miscarriage. The mechanisms, she added, are unclear but may include impaired semen parameters, increased DNA damage in sperm, and epigenetic alterations in sperm that affect fertilisation, implantation, or embryo development.

“However,” said Dr Dodge, “both the results of this study and prior work show that female age has a larger effect on fertility than male age. While the effect of female age on fertility is overwhelmingly due to increased rates of chromosomal abnormality, the proposed mechanisms in the effect of male age on pregnancy are more subtle. When we looked at the effect of female age alone, we saw a 46% relative decrease from ages under 30 to 40-42, but when we looked at male age alone, we saw a 20% relative decrease over the same age span.”

Can men with younger female partners do anything to compensate for this age effect in IVF? “It’s hard to say without knowing the precise mechanisms involved,” said Dr Dodge. “Most preconception advice for men focuses on semen quality, though studies suggest that this likely cannot fully ameliorate the effects of male reproductive ageing. So in the absence of clear evidence of the mechanisms, the best preconception advice we can offer is to maintain a healthy lifestyle.”

This is the first study to calculate the cumulative incidence of live birth while jointly stratifying on multiple bands of both male and female age, allowing calculation of both male and female age simultaneously.

Abstract O-178, Tuesday 4 July 2017
The impact of male partner age on cumulative incidence of live birth following in vitro fertilization

* “Cumulative live birth rate” refers to the chance of delivery of a live infant after one or more cycles of treatment. This is today acknowledged as the most realistic measure of success, and a reflection of everyday treatment outcome.

Male partner age: the story so far
1. Studies on age-related infertility have concentrated on the female partner. For example, the classic study by Habbema et al on when to start building a family integrated female age only into its model (Habbema JD, Eijkemans MJ, Leridon H, te Velde ER. Realizing a desired family size: when should couples start? Hum Reprod 2015; 30: 2215-21). These results showed that couples hoping for a one-child family should start trying to conceive when the female partner is 35 years old or younger, with IVF as an acceptable option, for two children the latest starting age would be 31 years, and for three children 28 years.
2. A large population study in the UK found that conception (natural) during a 12-month period was 30% less likely for men aged over 40 than for men younger than 30. There have been several explanations for this age-related decline in fertility – notably, a decline in sperm concentration (sperm count) and quality, and an increase in DNA fragmentation. Increasing male age is also associated with a greater incidence of medical conditions, which may affect fertility.

For further information on the details of this press release, contact:
Christine Bauquis at ESHRE
Mobile: +32 (0)499 25 80 46
E-mail: [email protected]

Numbers travelling for donor egg fertility treatment up by 50%

Fertility specialists here have seen a 50% increase over the past five years in the number of couples travelling abroad for donor egg treatment.

Every year more than 1,000 Irish couples undergo donor egg treatment, mainly due to the increase in the number of women waiting longer to have treatment.

In 2006 the Irish-owned Waterstone Clinic, previously known as the Cork Fertility Clinic, was the first clinic in Ireland to commence an in-house egg donation programme.

The in-house egg donation programme is for patients who have a known egg donor, such as a sister or a friend, and for generous donations from women to help couples.

Between eight and 12 couples take part in the in-house programme every year. The clinic also facilitates around 200 couples who travel abroad every year for donor egg treatment.

Waterstone Clinic’s dedicated egg donation co-ordinator, Eilís McCarthy, manages support services for couples going abroad for treatment and the in-house egg donation programme.

Ms McCarthy said egg donation was permitted in Ireland, but medical guidelines prohibited the payment of donors.

Asked about the success rate of egg donation, Ms McCarthy said they would expect about 50% of couples to become pregnant on their first attempt.

Waterstone Clinic hosts a free patient information seminar on egg donation with American Clinic, Shady Grove Fertility, on Saturday, April 29 at Cork Fertility in Lotamore House, one of Waterstone’s four centres throughout the country.

Shady Grove Fertility’s Dr Gilbert Mottla will attend the seminar and will speak about the collaborative international programme that enables Waterstone Clinic’s patients to avail of Shady Grove Fertility’s extensive donor egg database — the largest in the US. The groundwork for all treatments is carried out in Ireland before the couple travels to Shady Grove Fertility in Washington.

By Evelyn Ring
Irish Examiner Reporter

http://www.irishexaminer.com/ireland/numbers-travelling-for-donor-egg-fertility-treatment-up-by-50-447901.html

National Fertility Clinic opens in Cork

Irish-owned Waterstone Clinic, formerly known as Cork Fertility Centre, has opened a state-of-the-art national centre of excellence at Lotamore House in Cork. The 13,000 sq ft advanced fertility unit is a major architectural and technological achievement and features a world-class laboratory with the latest embryology technology. The new development has also brought a significant boost to employment in Cork, with staff numbers at the clinic increasing by 30% to 55.

Speaking about the new centre at Lotamore House, Medical Director of Waterstone Clinic, Dr John Waterstone said: “We have been at the forefront of reproductive medicine in Ireland for 15 years and our facility in Cork reflects our achievements and ambitions as a national reproductive health care provider of the highest calibre. We believe we have created the most advanced fertility unit in the country which will allow us to provide an even better service for our patients.

“We have endeavoured to make a visit to Lotamore House as stress-free as possible for patients, with generous parking, spacious waiting areas and an interior design that maximises privacy.”

The comprehensive range of treatments at Waterstone Clinic include IVF, ICSI, surgical sperm retrieval including MicroTese, sperm donation, egg donation, PGD and Pre-Implantation Genetic Screening (PGS).

“Most clinics in Ireland using time-lapse technology charge patients extra for the service. This practice reflects a trend towards increasing and undesirable commercialisation of assisted reproduction. I have long campaigned for regulation to combat the financial exploitation of vulnerable patients through expensive add-on investigations and treatments. Until such guidelines are in place, it is the responsibility of fertility clinics across the country to self-regulate and deliver honest advice and ethical management,” Dr. Waterstone added.

http://www.independent.ie/regionals/corkman/news/national-fertility-clinic-opens-in-cork-35515745.html

15 ways to become fertility aware in 2017

For many people the New Year can be a time to embrace new beginnings and focus on where you are and where you want to be.Whether actively trying for a baby or planning a family at a later stage in life, reproductive health is hugely important for both men and women. Simple things like lifestyle choices, exercise habits and medical history all play an important role in fertility. Here are 15 ways to become fertility aware.

1. Educate yourself about the link between age and fertility. Fertility is age related and knowing how your fertility changes with age is so important, especially for women. Women’s fertility rate begins to decline from age 32, with a more pronounced decline from 35 and a sharp decline from 40 onwards. Men’s sperm can start declining in quantity and quality from 40 years. The key to fulfilling your desire to have a family is to take charge of your reproductive health and plan accordingly.

2. Maintain a healthy weight. Being underweight or overweight can have a negative impact on fertility for both men and women. If you are actively trying for baby, it’s a good idea to calculate your BMI. Aim for a healthy weight; a BMI of between 20 and 24.9 is ideal. Optimising your weight will help regulate your menstrual cycle and increase your chances of conceiving.  The key message is to get active and engage in an exercise that you enjoy

3. Eat a healthy and balanced diet. It’s as important for your fertility health as for your physical health. Maintain a balanced diet with plenty of fresh fruit and veg., avoid processed foods, junk food and fizzy drinks and reduce your caffeine intake as much as possible.  Omega 3 essential fatty acids found in fish oils and good-quality flaxseed oils are not only recommended for healthy cell development, but also play an important role during pregnancy

4. Quit smoking. As well as being beneficial for your overall health, research shows that it takes longer for smokers than non-smokers to become pregnant. Smoking can cause damage to the ovaries and fallopian tubes and alter the hormone levels required for pregnancy. Smoking also increases the risk of miscarriage within the first 12 weeks of pregnancy. Men who smoke have a lower sperm count that those who don’t and there is some association with increased sperm DNA damage.

5. Reduce alcohol intake. Heavy alcohol intake in men has been linked to reduced testosterone production and reduced sperm quality. It has also been linked to ovulatory problems in women. It is not known how much alcohol you need to drink before fertility is affected, so it is best to reduce alcohol intake or try to cut it out completely while trying to conceive.

6. Folic acid. Women should start taking 400mcg folic acid before trying to conceive and during the first three months of pregnancy. Folate is an essential ingredient in cell division and a baby starts out as a single cell that divides again and again. It can also be beneficial for men to take folic acid while trying to conceive. Taking a folic acid supplement can help improve sperm quality and reduce sperm abnormalities.  Foods rich in folic acid include spinach, brussels sprouts, asparagus and avocado

7. Up your supplements. Increase your Vitamin D intake; this is important for bone health and also for normal embryo development. Vitamin C and CoQ10 are beneficial for healthy egg and sperm development.

8. Understand your fertile period – especially after time on the pill.  Take note of your menstrual cycle; keep a record so that you have a good understanding of your cycle length. For example, when women stop taking the contraceptive pill, it can take a while for menstruation to regulate. so it is especially important to stay tuned into any changes. Usually, ovulation occurs on day 14 of a 28 day cycle, so your best chance of becoming pregnant is between day 12 and day 16, sometimes known as the fertile window.

9. Chat to your Mum. Ask your mum when she started the menopause as this can give you a good indication of when you may expect to start. If your Mum had early menopause, then you should be aware that this may narrow your fertility window.

10. Get to grips with your medical history. For women who have had surgery for problems such as appendicitis or removal of an ovarian cyst, becoming pregnant can be more challenging as the surgery can sometimes cause blockages in the fallopian tubes. If you have had any medical concerns, or have a history of a sexually transmitted disease, book yourself in for a quick fertility assessment to see if there are any issues you may need to address. Men who have had surgery for undescended testes, have had mumps (this can affect sperm production) or trauma to the groin region, should seek an early fertility assessment.

11. Keep it cool. It is important not to overheat sperm. Avoid resting laptops on your lap, using heated car seats and keeping your mobile phone in your pocket. Avoid wearing too-tight underwear or jeans for prolonged periods.

12. Don’t over-exercise. If you are trying to conceive, avoid vigorous exercise or long cycles as these activities can compress or potentially overheat the testicles.  Also avoid hot baths, saunas and Jacuzzis as they can temporarily decrease sperm production.

13. Get amorous. New research from Indiana University suggests that the more times a woman has intercourse outside of her fertile window, the more her immune system is primed for pregnancy when she has intercourse while ovulating. While this research is novel (September 2015), it is recommended to have intercourse two to three times per week when trying to conceive. Take care of your relationship, communicate with one another and remember to have sex for fun!

14. Don’t stress out. Take time out to listen to relaxing music, meet with friends or download apps for mindfulness to keep those stress levels in check.

15. Take a positive approach, book a fertility assessment. It’s becoming ever more convenient to have a fertility assessment. Ensure that you always discuss your results with a fertility expert.

Whats the reality of going it alone through sperm donation?

Cork woman Maria O’Sullivan (41) is the mother of two children conceived through a sperm donor, Zavier (5) and Aurora (20 months). Her eldest daughter, Freya (all pictured), who was conceived naturally, had just turned nine when she decided to look into sperm donation.

Despite massive changes in Irish society in recent decades, most young women still envisage a future where they will meet Mr Right, get married and have children (not necessarily in that order). However, more and more women who have not met a potential life partner by a certain age and whose biological clocks are ticking louder every year, are now opting to go it alone through donor conception.

Angela O’Mahony, counsellor at Waterstone Clinic, says most of the single heterosexual women she meets who are considering sperm or egg donation have had a long desire to have a child, but have either not met anybody or were in a long-term relationship that did not work out.

“It’s a decision that does raise a lot of ethical and emotional issues for some people, the greatest of which is very much around the implications for the child into the future. Science has made so many amazing advances, but it also throws up challenges on so many levels.

“Counselling is an invitation to explore some of these complexities and challenges, to facilitate the woman making a decision that feels right for her and her potential child,” she says.

Once a woman has made the decision to go ahead and try for a baby through donor conception, the next major challenge facing her is whether to go for an identifiable (known) or anonymous donor. There are no sperm donation facilities in Ireland, so most Irish fertility clinics use sperm banks in Denmark where the law allows for donors to be identifiable, which means a child could contact their donor at the age of 18 if they chose to do so.

Dr John Waterstone, medical director of Waterstone Clinic, says that while the number of single heterosexual women attending the clinic for donor conception is small, it is increasing. Three-quarters of women in this situation who attend his clinic are over the age of 37, and all clients considering donor conception at the clinic must undergo free mandatory counselling in advance of treatment.

“The donation co-ordinator then sits down with the client and goes through the list of available donors. Some donors will provide an extended profile with more information on their background, maybe a baby photo and even a voice clip, which is more expensive than a basic profile.

“Once a client chooses her donor, she needs to decide how much sperm to import. If she is planning to extend her family in the future, she might bring in more sperm so that all siblings come from the same donor,” he explains.

The sperm is deep frozen and imported in straws, one straw containing one unit of sperm. The cost varies depending on the number of straws purchased and whether the donor is anonymous or identifiable. For example, four straws from an open donor will cost about €3,350, and four straws from a closed donor will cost about €1,900.

Clients can opt for intrauterine insemination (IUI), a simple procedure that involves placing the donor sperm inside the uterus to facilitate fertilisation, or in vitro fertilisation (IVF), a more invasive procedure that involves combining the egg and donor sperm in a laboratory dish and transferring the embryo to the uterus. IVF is much more successful, particularly for women in their later 30s, but also about four times more expensive than IUI. The typical cost of one cycle in an Irish clinic is about €750, while the cost of a cycle of IVF is about €4,250.

Maria’s story

Cork woman Maria O’Sullivan (41) is the mother of two children, Zavier (5) and Aurora (20 months), conceived through a sperm donor. Her eldest daughter, Freya, who was conceived naturally, had just turned nine when she decided to look into sperm donation. She had been been in a relationship with a man who already had children, and did not want anymore. With the support of her GP, she decided to go ahead with treatment at Waterstone Clinic Clinic.

“I opted for an open donor as I wanted my child to have the choice of contacting the donor when he or she was 18. I had a choice of five donors and chose somebody I felt I would have sparked with if I was to meet him. It was like a blind date without actually meeting the person.”

After only one cycle of IUI, Maria was fortunate to get pregnant and her son Zavier was born at home in October 2010. She had some sperm from the same donor frozen at the clinic and, four years later, she decided to try for another baby. Aurora was conceived in March 2014, again through IUI and born at home in December that year.

“Freya is now a teenager and Zavier is starting school in September. Aurora is just a dote; she really completes our family. I had been parenting Freya on my own from the start so I knew I would be able to cope. I don’t have a lot of family around, but you make your own family. I have made great friends and have great support, it’s true that it takes a village.”

Maria has always been very open about how Zavier and Aurora were conceived and talked about it with Freya before they came.

A former kindergarten teacher, Maria is now at home with her children full-time. She also finds the time to volunteer as a doula, supporting other women through pregnancy, and with Le Leche League.

“I do worry about the financial side of things. I’m renting and the rental sector is a bit crazy at the moment, but I tell people not to let finances stop you from having a baby. There’s not much you need in the first couple of years, apart from your arms and boobs. I would definitely recommend sperm donation to other women. You can have a relationship any time in your life, but you can’t have babies any time. I’m so glad I had my babies, they’re amazing.”

Alison’s story

Alison (40) had been in a long-term relationship on and off with a man who had been married before and had two teenage boys. He had always been honest about the fact that he did not want any children, but she was convinced she would change his mind.

“I was 36 heading for 37 and the pressure was building. I went to the US for work, and was involved in a very serious head-on collision. That was a wake-up call for me. I loved the guy, but he was not prepared to have more children so we split up. It was a difficult decision but the right one.”

Six months after the breakup, Alison made the big decision to try for a baby alone through sperm donation. Two close female friends encouraged her on her journey, while her mother and sister attended appointments and supported her along the way.

“I was 37 heading for 38 when I made the decision. I had a voice constantly in the back of my mind saying you can’t not be a mum and that voice got louder every year. My friends and brother were on their way down the traditional life path of marriage and children that I had always thought I would follow. My family were not staunch supporters of my decision at the beginning but, to be fair to my parents, their concern was coming from the right place. They knew how hard it was raising kids with two parents, let alone one.”

Alison was referred by her GP to the Clane Fertility Clinic (since acquired by Instituto Marques). It took two rounds of IUI and one round of IVF before she became pregnant with her daughter Katy, now two years and 10 months old.

She is open about how she had Katy and intends to be open with her daughter in the future. For now, she explains to Katy how every family is different and while she doesn’t have a daddy, she has a mummy who loves her very much.

“Katy is not three yet but she says “Mammy, I have no Daddy” She sees the dads collecting other children from her childminder’s house. She has my dad and brother as male role models and if the right person comes into our lives, I would like him to adopt Katy, but I would need to be 150 per cent sure about him.”

A communications manager, Alison has a busy career and, as the sole provider for her little family, bears all the responsibilities for her daughter’s care. There is nobody to help her in the middle of the night when Katy is sick, nobody to help her with drop-offs and collections and it’s simply not an option for her to be sick herself.

Despite all of the challenges though, she says the decision to have Katy was the best she ever made and she will never forget the day her daughter was put into her arms for the first time and describes motherhood as “incredibly rewarding”.

As an administrator for the Single Mums by Choice and Single Mums By Choice in Waiting private Facebook groups, Alison explains that the groups are strictly for women either trying to or who have conceived through sperm donation. Anybody who wants to join can send a request via email to [email protected] which will be reviewed by the administrators. Members of the group come from all over Ireland, but are mainly concentrated in the Dublin area and they meet up for regular coffee mornings and days out.

Counsellor Angela O’Mahony says one of the biggest challenges for women considering donor conception tends to be about how to deal sensitively with questions from their child about the identity and whereabouts of the donor.

She encourages women to look for as much non-identifiable information as possible to help give their child a better sense of who the donor is, such as what kind of music they like or whether they are into football. This may also help the child to identify where his /her particular interest or talent originated.

“Women who opt for sperm donation on their own often have made a safe and conscious choice about how to have their baby. The sharing of the genetic narrative with a child is part of that decision-making process. While this can be daunting for some, keeping it age appropriate and honest tends to work well for most mothers,” O’Mahony.

Michelle McDonagh

http://www.irishtimes.com/life-and-style/health-family/parenting/what-s-the-reality-of-going-it-alone-through-sperm-donation-1.2768318