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.”

This year’s NISIG conference is taking place at the Hilton Dublin Airport on October 11^th 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.

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

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

by Deborah Condon 

The healthy baby girl, Bridget, was born on June 27 at Cork University Maternity Hospital (CUMH).

PGD allows people with a specific inherited condition the option of trying to avoid passing it on to their own children.

People who are candidates for PGD include carriers of single gene defects, such as cystic fibrosis (CF), the most common genetic disease in Ireland. Other candidates include people who themselves are affected by chromosomal disorders such as Duchenne muscular dystrophy, myotonic dystrophy, haemophilia A and fragile X syndrome.

The PGD technique involves generating a number of embryos via IVF (in vitro fertilisation). With IVF, a woman’s eggs are fertilised with sperm outside the body in a test tube and the resulting embryo is placed back inside her womb.

In the case of PGD, before the embryos are put into the womb, they are biopsied, which means one cell is carefully removed from each cell. These biopsied cells are then sent to the UK to be analysed.

Only those embryos that are diagnosed as being unaffected by the particular condition are selected for transfer into the womb of the woman.

Commenting on the birth, Dr John Waterstone, a consultant obstetrician at CUMH and medical director of the Waterstone Clinic who delivered the baby, described the birth as ‘an important milestone in Irish reproductive medicine’.

The parents of baby Bridget, Patrick Mullane and Lisa Cooke, opted for PGD as they were at risk of having a baby with CF.

PGD is ‘the most technically challenging treatment in assisted reproduction’, according to the Waterstone Clinic, which is one of only two Irish IVF units to have attempted it.

Also commenting on the birth, the centre’s head of research and development, Dr Xiao Zhang, said that they are ‘delighted’ with Bridget’s birth.

“It is the result of a lot of hard work over the past few years validating and perfecting the underlying laboratory processes,” he added.

http://www.irishhealth.com/article.html?id=23831

By Joe Leogue, Irish Indpendent

A HEALTHY baby girl has been born following revolutionary treatment that allows couples at risk of a specific inherited condition to avoid passing it on to their children. John Waterstone, consultant obstetrician at CUMH and medical director of Waterstone Clinic – who delivered Bridget – said she is the first arrival after pre-implantation genetic diagnosis (PGD) in Ireland. PGD allows couples at risk of a specific inherited condition to avoid passing it on to their children. Conception takes place through IVF treatment and embryos are tested for the condition before being transferred.

Dr Waterstone described the birth of Bridget to parents Lisa Cooke (24) and Patrick Mullane (33), from north Cork, as “an important milestone in Irish reproductive medicine”. Lisa and Patrick were at risk of having a baby with cystic fibrosis, the most common genetic disease in Ireland.

A spokesperson for the Waterstone Clinic said that PGD is the most technically challenging treatment in assisted reproduction and that the centre is one of only two Irish IVF units to have attempted it. Dr Xiao Zhang, head of research and development at Waterstone Clinic, said the embryos were frozen by means of ‘vitrification’ with Lisa returning later to have one embryo transferred into the uterus. “We are delighted by today’s success – it is the result of a lot of hard work over the past few years validating and perfecting the underlying laboratory processes,” Dr Zhang said.

http://www.independent.ie/irish-news/health/healthy-baby-bridget-makes-irish-medical-history-30408246.html#sthash.qdGM45NW.dpuf

Barry Roche, The Irish Times

The birth of the first baby in the Republic following a technique to screen embryos for genetic conditions such as cystic fibrosis prior to implantation has been hailed as a major milestone for Irish reproductive medicine.

Baby Bridget weighed in at a healthy 7lbs 9oz (3.4kg) at Cork University Maternity Hospital on June 27th when she was born to couple, Lisa Cooke and Patrick Mullane who were at risk of having a baby with Cystic Fibrosis, the most common genetic disease in Ireland.

Dr John Waterstone of the Waterstone Clinic, which carried out Pre-Implantation Genetic Diagnosis (PGD) on embryos belonging to the couple, explained that Bridget’s birth was a highly significant development for couples at risk of having a baby with CF.

“We are very pleased to announce the arrival of the first baby after PGD in Ireland – this is a fantastic day for Patrick and Lisa and an important milestone in Irish reproductive medicine,” said Dr Waterstone who is also a Consultant Obstetrician at CUMH.

One in 19 Irish adults is a carrier with the altered gene that causes Cystic Fibrosis and approximately one in 400 couples are at risk of having an affected baby but PGD offers couples the opportunity to have an embryo screened for the disease, he said.

“PGD allows couples at risk of a specific inherited condition to avoid passing it on to their children. Conception takes place through IVF treatment and embryos are tested for the condition before being transferred,” said Dr Waterstone

Head of Research and Development at the Waterstone Clinic, Dr Xiao Zhang explained that PGD, which costs €9,800, involves a laser assisted embryo biopsy to remove cells for genetic analysis and must be carried out with great precision.

Dr Zhang explained that following the biopsy procedure for Mr Mullane and Ms Cooke, the embryos were frozen by means of ‘vitrification’ with Ms Cooke returning later to have one embryo transferred into the uterus.

“We are delighted by today’s success; it is the result of a lot of hard work over the past few years validating and perfecting the underlying laboratory processes,” said Dr Zhang, adding that the Waterstone Clinic was one of only two Irish IVF units to have attempted PGD.

http://www.irishtimes.com/news/health/birth-of-first-baby-screened-for-cystic-fibrosis-a-milestone-1.1857015

The first birth following Pre-Implantation Genetic Diagnosis (PGD) carried out in Ireland has just been announced by Waterstone Clinic. A healthy baby girl was delivered safely at Cork University Maternity Hospital (CUMH) on Friday June 27th. Dr John Waterstone, Consultant Obstetrician at CUMH and Medical Director of Waterstone Clinic who delivered baby Bridget, said “we are pleased to announce the arrival of the first baby after PGD in Ireland; this is a fantastic day for Patrick and Lisa and an important milestone in Irish Reproductive Medicine”

PGD allows couples at risk of a specific inherited condition to avoid passing it on to their children. Conception takes place through IVF treatment and embryos are tested for the condition before being transferred. Waterstone Clinic’s PGD success involved a couple, Patrick Mullane and Lisa Cooke, who were at risk of having a baby with Cystic Fibrosis, the most common genetic disease in Ireland. One in 19 Irish adults is a carrier of the altered gene that causes Cystic Fibrosis and approximately one in four hundred couples are at risk of having an affected baby. Cystic Fibrosis is a debilitating, life-limiting condition, sometimes requiring heart/lung transplant.

PGD is the most technically challenging treatment in assisted reproduction and Waterstone Clinic is one of only two Irish IVF units to have attempted it. The laser assisted embryo biopsy required to remove cells for genetic analysis must be carried out with great precision. Successful PGD is only possible where a robust blastocyst culture system and an efficient embryo cryopreservation programme are already in place.

Dr Xiao Zhang, Head of Research and Development at Waterstone Clinic, whose expertise in the area was central to the introduction of PGD, explained that following the biopsy procedure for this couple, the embryos were frozen by means of ‘vitrification’ with Lisa returning later to have one embryo transferred into the uterus.

Dr Zhang says “we are delighted by today’s success; it is the result of a lot of hard work over the past few years validating and perfecting the underlying laboratory processes”.

Waterstone Clinic continues to lead the way in advancing reproductive medicine in Ireland by offering the latest in assisted conception technologies and achieving success rates comparable with the best in the UK and US.

In addition to the many health risks such as cancer and heart disease, smoking also directly affects fertility in both women and men. Before beginning fertility treatment we strongly advise you to give up smoking to significantly improve your chances of becoming pregnant (Practice Committee of the ASRM, 2008).

Effects of smoking on fertility in women:

• Smokers are 54% more likely to take 12 months or longer to become pregnant. (Practice Committee of the ASRM, 2008)
• Smoking can cause genetic abnormalities in developing eggs
• Smoking directly effects hormone production including oestrogen
• Menopause can occur 1 – 4 years earlier for smokers than non-smokers
• Smoking is responsible for increased risk of miscarriage within the first 12 weeks of pregnancy
• Smoking increases the risk of pregnancy complications, in particular pre- eclampsia and placental problems
• Smoking also causes a great health risk for babies. Babies born to smokers tend to have a lower birth weight than non-smokers. This can be as much as 200 – 250g lighter.
• Smoking is linked with damage to the DNA of sperm and thus poor quality sperm
• Smoking has been associated with poor sperm movement (Homan, Davies & Norman, 2007)
• Men who smoke have a lower sperm count than non-smokers.

Effects of smoking on fertility in men:

Remember: Passive smoking can be just as harmful to fertility so it is important that both partners give up smoking together!

Smoking and fertility treatment:

Not only does smoking affect natural fertility, there is a strong link between smoking and poor outcomes of fertility treatment (ESHRE, 2010).

Smokers may need to undergo nearly twice as many IVF cycles than non-smokers to achieve  a  pregnancy.

It is ideal for those who are thinking of starting a family or have been trying to conceive for a short time and would like an assessment of their reproductive health.

Prior to your appointment, you will be asked to complete a questionnaire to allow a thorough assessment of your reproductive health. As well as performing the necessary fertility tests, we aim to provide couples with advice on how to improve their chances of conceiving naturally.

If a fertility issue is identified, early investigation and management will be arranged.

What is involved in an early fertility assessment?

Semen Analysis- a detailed test carried out by one of our embryology/andrology specialists to identify if there are any sperm abnormalities

Female Hormone Profile- FSH, LH, oestradiol and a mid-luteal Progesterone level to assess the levels of female hormones and confirm ovulation

Anti-Mullerian Hormone (AMH) level- a blood test that can be performed at any time of the menstrual cycle and relates to a woman’s ovarian reserve (indicating the number of eggs left in the ovaries)

Pelvic Ultrasound and Antral Follicle Count- a detailed transvaginal ultrasound scan assessing the uterus and ovaries for any abnormalities and quantifying the number of follicles in each ovary (follicles contain immature eggs), indicating ovarian activity.

A 30 minute consultation with a fertility specialist where a full medical and fertility history will be taken and lifestyle factors will be addressed. Further investigation will be arranged where necessary and advice on increasing your chances of natural conception.

If you would like to arrange an early fertility assessment please contact 021-4624436 or email [email protected]