Fertility Healthy Living

Lifestyle has a major impact on our general health, including our fertility. The things we eat and the way in which we cope with stressful situations have a long-term impact on our health. Therefore trying to eat a healthy and balanced diet along with keeping active will be a positive step in improving fertility performance. At RHG we believe that being healthy before starting fertility treatment helps to achieve a successful pregnancy outcome.

Our fertility is affected by many factors. We have no influence on some of them, including for instance on some diseases. Hormonal imbalance and autoimmune disorders, endometriosis or fallopian tube obstruction in women are barriers to conceiving a child, which have to be overcome with the help of fertility treatment. However, we do have an influence on many other things. If you are planning to start a family, here are some useful suggestions:

Keep to a healthy weight

You will feel better and be healthier if you can achieve a healthy weight. Bear in mind that any deviations from normal weight may have a negative impact on fertility. Excessive dieting is also not beneficial to our health. Inappropriate body weight results in ovulatory disturbance and lower quality of semen, which impairs the chances of pregnancy.

Choose foods that will nourish you

Make a list of the things that you eat during the week. Think about what might be helpful to cut out of your diet and what healthier meals and snacks you could eat instead. Choosing foods rich in antioxidants, which help to protect the egg and sperm from free radicals and healthy fats will be helpful. Taking a good quality fertility supplement containing vitamins such as vitamin E, vitamin D, selenium, zinc, vitamin B and vitamin C is important too. Fertility vitamin products for women will contain folic acid, which prevents nervous system defects in the foetus.

A good night’s sleep

Try to have a good sleep routine and this will help you feel rested even during busy times. Sleep effectively regenerates your body and helps reduce stress. When you are tired it is also more tempting to reach for sugary quick fixes or caffeinated drinks, sending blood sugar levels up and down throughout the day.

Managing stress

High stress may make it more difficult to conceive. Finding the right techniques for you to help you unwind is important. Whatever is right for you, try to make time to fit them into your diary.

Keep active

Regular exercise not only makes you less prone to diseases but also improves performance and strengthens your immune system. It helps you maintain a healthy weight and can help reduce stress. Finding something you enjoy doing with a partner or with friends makes it more likely for you to commit to it.

Avoid stimulants

Refined sugars, alcohol and caffeine are best kept to a minimum or cut out completely for optimum health. Cut down gradually and you will find that your habits have changed. Once you start to feel better for the changes they will be easier to stick to.

Egg Freezing

RHG’s Clinical Director Luciano Nardo suggests that egg freezing using the vitrification method should be an option to consider for all women under 35 in order to help preserve their own fertility.

“Whilst it is established that elective egg freezing doesn’t guarantee pregnancy outcome, it can increase the chances of a woman being able to conceive her own biological child later on in life. Age is closely linked with the number and quality of eggs, therefore the probabilities of having a successful egg freezing cycle are higher in women younger than 35.”

Ovaries do not continue to function infinitely. Fertility naturally decreases with age and unfortunately it cannot be restored. Typically you need twice as many eggs to produce a single baby at age 39 than you would at age 29. Fertility can also be directly impacted by some forms of cancer treatment, including chemotherapy and radiotherapy.

For these reasons fertility preservation is becoming increasingly important.

Research suggests that more and more women are leaving it later before deciding to start a family. There are many understandable reasons for this, whether it be financial position, enjoying a successful career, finding the right person, or getting on the property ladder. Once the ‘time is right’ many women and couples find that they struggle to become pregnant. Whilst you  cannot always plan for every eventuality in life, you can protect your future fertility by freezing your eggs whilst they are still at optimum quality – ideally before you reach the age of 35 –  and potentially undergo either conventional IVF or ICSI treatment in the future.

At RHG we offer a comprehensive fertility preservation programme. We have the latest technologies and the multidisciplinary expertise to assist you through the fertility preservation journey.

If you would like to talk to us about freezing your eggs or fertility preservation, please contact us on 01925 202180 or email us at info@reproductivehealthgroup.co.uk

Fertility Treatments Quick Guide

There are several different fertility treatments available and a treatment that is suitable for one patient may not be suitable for another. Equally each treatment may provide a greater chance of success depending on a patient’s circumstances.

Here is a quick guide to the fertility treatments we currently offer here at RHG and when they are typically used:

IVF

What is IVF?

IVF treatment is the process by which eggs are retrieved from the ovaries and fertilised with sperm to create embryos. At the optimum time, the embryos are replaced back into the womb to hopefully form a successful pregnancy.

When would IVF typically be used?

  • The patient has been diagnosed with unexplained infertility
  • The patient may have blocked fallopian tubes
  • A male partners fertility problems are not severe enough to warrant ICSI treatment
  • Fertility drugs or IUI treatment were not successful
  • Frozen sperm is being used
  • Frozen eggs or donated eggs are being used

ICSI

What is ICSI?

Intracytoplasmic sperm injection (ICSI) treatment is used in nearly half of all IVF treatments and the most successful form of treatment for men who are infertile. ICSI differs from IVF in that the embryologist selects a single sperm to be injected directly into an egg, bypassing the natural fertilisation process.

When would ICSI typically be used?

ICSI is typically used when there is a problem or potential problem with the sperm to be used in an IVF cycle. It may be used in cases of:

  • Abnormal sperm parameters (low sperm count, low sperm morphology and/or motility)
  • Previous history of failed fertilisation with conventional IVF
  • Previous history of abnormal fertilisation as it occurs in cases of gestational trophoblastic disease
  • Sperm which has been surgically retrieved

IMSI

What is IMSI?

Similar to ICSI, IMSI (intracytoplasmic morphologically selected sperm) treatment also involves inserting sperm directly into the egg, the only difference between the two procedures being the way that the sperm is selected. A high powered lens is used to observe the sperm in greater detail with the aim of improving the chance of pregnancy. The IMSI microscope can magnify up to 6000 times allowing the embryologist to see potential abnormalities in the head of the sperm.

When would IMSI typically be used?

  • A high number of abnormal sperm are found in a semen analysis
  • Repeated unsuccessful ICSI cycles
  • History of recurrent miscarriages
  • Poor quality embryos formed in previous cycles

IUI

What is IUI?

IUI (intrauterine insemination) is a relatively simple treatment which involves inserting prepared sperm into the uterus around the time of ovulation. The sperm is prepared by separating fast moving sperm from more sluggish sperm to ensure the best quality sperm is inserted. IUI can be performed with either a male partner’s sperm or donor sperm.

When would IUI typically be used?

IUI may be used in the following circumstances:

  • Couples who have been trying for less than 2 years with no specific fertility issue.
  • Couples who have problems with sex such as impotence, premature ejaculation, vaginismus etc.
  • Couples in whom the woman’s cervical mucus is altered in amount and texture for the sperm to pass through.
  • Where the woman has mild/ minimal endometriosis.
  • Women undergoing insemination with donor sperm.
The role of antioxidants in male infertility

Whilst several causes of male infertility have been recognised, in the majority of men the precise mechanism remains unknown. Many studies of such idiopathic cases at the molecular level have highlighted the significant role of “Oxidative Stress”.

This entails a state of imbalance between reactive oxygen species (ROS), aka “free radicals”, and antioxidants as an established factor in male infertility. Sperm are particularly vulnerable to DNA damage and accelerated cell death.

Antioxidants exhibit a beneficial effect in reversing sperm dysfunction. Supplementation may include the Vitamins C, E and B9 (Folic Acid), the trace elements Zinc and Selenium and the substances Carnitine, Coenzyme Q10 and N-Acetyl Cysteine. They have been shown to:

  • improve semen parameters (concentration, motility and morphology)
  • reduce sperm DNA fragmentation
  • improve clinical pregnancy rates
  • improve live birth rates

However, the heterogeneous nature of various studies, including the use of different antioxidants at different concentrations and in different combinations, hamper our ability to implement an ideal treatment modality. Proper diagnosis and treatment are difficult.  Antioxidants must be chosen so that they work in synergy and with some selectivity for the male reproductive tract. Overdoses and self-medication with antioxidant formulations that use random ingredients and dosages may be counterproductive and impair fertility. At RHG, we provide advice on when and how to use supplement combinations.

Eight things to ask your fertility clinic

1. How does the clinic decide which treatments to choose?

Through a thorough consultation with the individual or couple involved, including examining medical and reproductive histories, and by carrying out relevant tests and investigations, your consultant will be able to identify which course of treatment is the right one for you.

View RHG’s range of  fertility assessment packages here.

2. What tests will I have to have?

There are a number of tests that you can expect to have as your consultant looks to identify what may be causing any fertility issues. An initial fertility assessment on either one or both partners in the relationship can help to ensure any issue is dealt with without paying for needless treatment if a simpler or more cost-effective solution can be found.

3. Does the clinic work with patients to ensure the treatment for them is the most suitable?

Some fertility clinics are simply IVF clinics, with this being the treatment option offered to all patients. However, this may not be the best option for everyone. At RHG we will only recommend the best care pathway once we have carried out all the appropriate investigations.

4. What treatments are available?

There are a variety of treatments available, from IVF (In vitro fertilisation), where eggs and sperm are brought together outside the womb in a laboratory, to IUI (intrauterine insemination). For IVF treatment, there are also a number of different techniques, such as ICSI (intracytoplasmic sperm injection) and IMSI (intracytoplasmic morphologically selected sperm injection).

5. What success rates does the clinic have?

Before you start out, you want to know that you have chosen a clinic that has high success rates in helping people to achieve their goal and become successfully pregnant.

View RHG’s latest success rates here.

6. What are the costs involved?

You can view our clear and transparent fertility price list here.

7. Are women with specific conditions accepted at the clinic?

If you are affected by a specific issue, you may find that not all clinics are able to offer you treatment. At RHG we are able to treat all gynaecological and infertility conditions under one roof at our Cheshire based Centre for Reproductive Health.

8. What makes the clinic different to the others?

In our case, it is our dedicated integrated fertility and women’s health hospital, one of the first ever in the UK. Every detail was designed by our consultants and embryologists, using their extensive experience to ensure that our patients receive the best possible care, using the very latest technology in a state of the art environment.

If you would like to organise a fertility consultation with us to discuss any of the above, or additional questions you may have, please do contact us on 01925 202180 or email us at info@reproductivehealthgroup.co.uk

What happens during a typical IVF journey?

The journey through an IVF treatment can be quite a daunting process, so we are here to help guide you through every step, ensuring that you feel happy that the treatment is the right way forward for you.

Initial IVF consultation

In the very first stage of your IVF journey, you will meet your consultant who will discuss everything from your medical history to which treatment would be best suited to your personal needs. Your treatment plan will be individually tailored to you, based on factors such as age, results of any tests undertaken and outcome of any previous treatment. More importantly, your consultant will be able to answer any questions you have.

Meeting your specialist nurse

Following the initial consultation and once agreement is made on how to proceed, you’ll meet with a specialist nurse who will help you go through all of the legal consent forms and your plan of treatment, as well as instructing you on how to administer the daily dose of stimulation medication and answering any other questions you may have.  You will also have access to our experienced fertility counsellors should you need any additional support  at any time before, during or after your treatment.

Ovary stimulation

The next stage is to stimulate the ovaries, which is monitored by a number of blood tests and ultrasound scans. We will assess your response to the stimulation medication by the number and size of follicles being produced in the ovaries, where the eggs will eventually be developed. An injection will then be administered to stimulate the final maturation of your eggs once the decision has been made that the optimal number and size of follicles have been produced.

Egg retrieval

The retrieval of eggs will usually happen around 36 hours after the last injection, and will take place in the theatre, usually whilst you’re sedated. A needle will be guided by ultrasound through your vaginal wall into the ovaries to withdraw fluid from each follicle. This is the easiest and safest approach. A number of tubes containing the collected fluid are taken to the embryology lab where an embryologist examines every tube under a microscope to identify the eggs.

Fertilisation

The collected eggs are cultured in an incubator in optimised conditions until the eggs are ready to be inseminated with the sperm provided either by your partner, or by a donor. The following morning, the embryologist will check to see how many eggs have been successfully fertilised and will contact you by phone with the news. Over the following few days, the developing embryos are carefully checked and at the most appropriate time, we’ll make arrangements for your embryo transfer.

Embryo transfer

At the time of your embryo transfer, the embryologist will discuss with you the quality and number of embryos and whether any would be suitable for freezing for use in the future. The transfer will take place back in the procedure room, but usually requires no sedation or anaesthetic. The embryos, once selected, will be transferred using a special catheter, a fine plastic tube which is inserted through the cervix and into the womb.

Once the procedure has been completed, you will be discharged home and advised to wait for at least two weeks before taking a pregnancy test to see if the transfer was successful. This can be the hardest part of the process but we suggest you carry on life as normally as possible.  After the pregnancy test has been taken, we will either carry out an ultrasound scan or we will organise an appointment for you to discuss the next steps.

Fertility treatments for single women

If you missed our live webinar for solo mums, catch up on it here to listen to RHG’s Professor Nardo and fertility coach Mel Johnson who has been through this journey herself chat about fertility options for anyone considering solo motherhood, answering questions on both the medical and the practical and emotional aspects.

You can also hear details of how you can book a free mini consultation with Professor Nardo to explore your individual options in more detail and about courses that Mel runs for anyone thinking of taking this route to becoming a mum.

Explaining Unexplained Infertility - Podcast

What does a diagnosis of ‘unexplained infertility’ really mean? Does more advanced testing available now mean that a cause can be found for subfertility that would have been labelled ‘unexplained’ in the past? What part do emotional factors play in subfertility?

RHG’s Clinical Director Professor Nardo was recently invited to talk about these issues with Natalie Silverman of ‘The Fertility Podcast’ and Kate Davies of ‘Your Fertility Journey’.

The discussion was also broadcast on UK Health Radio:

 

How to plan your egg donation cycle - Webinar

Are you considering an IVF cycle with egg donation but have some questions you would like answering?

Our webinar on ‘How to plan your egg donation cycle’ recorded in conjunction with Dr Maria Arque of Fertty International and fertility coaches Andreia Trigo and Mel Johnson, who are both part of our Patient Support Partners programme, can help with some of the most common queries:

Fertility Nutrition (preconception advice)

When we spend so much of our early life trying not to get pregnant, it is natural to assume that getting pregnant will be a piece of cake – but that is not always the case. Around 1 in 6 couples struggle to conceive – ‘struggling to conceive’ is defined as 12 month of unprotected sex with no pregnancy.

Advice you often hear when trying to conceive is ‘relax and it’ll happen’ and although there may be an element of truth to that statement, it is not the whole picture.

Fertility can depend on many factors –  physical, environmental and emotional. Couples often spend years planning weddings, buying houses, building careers and relationships and yet we often expect pregnancy to just happen.

It is ideal to do some preconception preparation before conceiving and I will generally recommend at least 3 months of preparation prior to conceive as 3-months is the amount of time it takes for new sperm to form and for eggs to mature.

If you are feeling anxious about your fertility, the below 6 steps might help you:

  1. Get a basic fertility MOT. That means gents go for a sperm test and ladies track your period and ovulation to ensure they are regular and get some of your basic hormones tested on day 3 of your cycle (FSH, LH, oestradiol, prolactin and testosterone). Then find a practitioner who can support you with the interpretation of these results.

    Then regardless of the above results, the below nutritional and lifestyle advice can support everyone:

  2. Ensure you have complex carbs (wild rice, oats, root vegetables, quinoa, buckwheat, legumes, lentils, spelt pasta and bread), protein (meat, fish, eggs, nuts, seeds and nuts), healthy fats (avocado, olive oil, olives, nuts, seeds) with each meal.
  3. Eat 5 portions of vegetables and 2 portions of fruit a day – preferably organic.
  4. Get rid of hormone disrupting plastics in your life. Replace plastic water bottles with glass. Replace plastic Tupperware with glass.
  5. Stop smoking, reduce sugar and refine (beige) carbs, stop drinking alcohol and reduce caffeine as much as possible.
  6. Make sure you ladies are taking a good quality pre-natal that includes folate (much better than folic acid). Brands for different budgets, include; Together Prenatal, Cytoplan prenatal and Optimal prenatal.

Rosie Tadman is a registered Nutritional Therapist (CNHC and BANT registered) and specialises in fertility, pregnancy and postpartum Nutrition.

She is also one of our RHG Patient Support Partners.

To view Rosie’s profile and contact details please see here.