Fertility Road Issue 03
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EUROPE'S NO.1 FERTILITY MAGAZINE<br />
ISSUE <strong>03</strong> | NOVEMBER / DECEMBER 2010 £3.95/€4.95<br />
YOUR PATH TO PARENTHOOD<br />
WWW.FERTILITYROAD.COM<br />
FERTILITY ON ICE<br />
Social egg freezing<br />
- exclusive report<br />
ZITA<br />
WEST<br />
EXCLUSIVE<br />
READER<br />
Q&A<br />
IT'S MY LIFE<br />
Pregnancy,<br />
prying eyes and<br />
snooping glances<br />
Think<br />
Twice<br />
Celine Dion's IVF twin elation<br />
ISSUE <strong>03</strong><br />
WWW.FERTILITYROAD.COM<br />
TONI WESCHLER FERTILITY ON THE WEB CHINESE MEDICINE
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FERTILITY ROAD<br />
CONTENTS<br />
In this issue...<br />
42<br />
18<br />
30<br />
24<br />
13 THINK TWICE<br />
The story of Celine Dion's IVF success<br />
18 IT'S MY LIFE<br />
Pregnancy, prying eyes and snooping glances<br />
24 UNCHARTED TERRITORY<br />
Celebrated author and renowned expert Toni Weschler<br />
speaks exclusively about the changing face of fertility<br />
30 FERTILITY ON ICE<br />
Social egg freezing – the legal, emotional and<br />
sociological boundaries explored<br />
34 MAN ALIVE<br />
The growing voice of male same-sex couples<br />
looking to fulfil their family ambitions<br />
42 WORLDWIDE WEB OF FERTILITY<br />
How the internet has altered our emotional<br />
understanding of pregnancy and fertility<br />
54 EXPERT WITNESS: ZITA WEST<br />
The UK's leading fertility expert answers your<br />
questions in her regular <strong>Fertility</strong> <strong>Road</strong> Q&A<br />
ALSO IN THIS ISSUE:<br />
FERTILITY ROAD GUIDES:<br />
Law, Finance, Reflexology<br />
SCIENCE:<br />
Sperm DNA Fragmentation – latest research<br />
EXTRAS:<br />
<strong>Fertility</strong> Finds, Books, Letter From The Heart<br />
www.fertilityroad.com<br />
<strong>03</strong>
The Zita West<br />
Clinic<br />
The The Zita West Clinic is is the the<br />
UK’s largest integrated<br />
clinic for for reproductive<br />
health, combining<br />
the the latest medical<br />
thinking with expert<br />
complementary treatments.<br />
Each year, our our specialist team of of doctors,<br />
midwives, nutritional therapists and and<br />
complementary practitioners help help hundreds<br />
of of couples to to get get pregnant, both both naturally and and<br />
through assisted means - - most of of whom have tried<br />
previously for for months and and years without success.<br />
We We also also help help many more, who who are are going through IVF, IVF, to to<br />
improve their chances of of success through expert preparation<br />
and and support.<br />
<strong>Fertility</strong>, conception, pregnancy and and birth are are whole-body<br />
events and and an an integrated approach to to preparing for for them can, can,<br />
we we believe, pay pay dividends, helping to to improve not not just just your your<br />
fertility, but but your your pregnancy and and the the long long term health and and<br />
potential of of your your baby too. too.<br />
How we can help:<br />
• • Just Just decided to to try? try?<br />
Boost your your fertility and and improve your your pregnancy<br />
• • Want to to know how how fertile you you are? are?<br />
Take Take our our tailor-made fertility MOT MOT<br />
• • Finding it it difficult to to get get pregnant?<br />
Identify and and help help resolve your your problem<br />
• • Planning on on having IVF? IVF?<br />
Help Help increase your your chances of of success<br />
• • If If IVF IVF fails fails<br />
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• • Suffering from recurrent miscarriage?<br />
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Services we we offer:<br />
• • Gynaecology • • Nutrition • • Counselling<br />
• • Midwifery • • Acupuncture • • Massage<br />
• • Embryology • • Hypnotherapy • • Fitness<br />
Zita Zita West Clinics Ltd Ltd<br />
37 37 Manchester Street, London W1U W1U 7LJ 7LJ<br />
Tel Tel 0207 0207 224 224 0017 0017 Fax Fax 0207 0207 224 224 0062<br />
www.zitawest.com<br />
TO TO MAKE AN AN APPOINTMENT: 020 7224 0017<br />
Top foods to eat to<br />
boost your fertility!<br />
A healthy weight and well-balanced diet for both<br />
men and women before you conceive will boost<br />
your fertility, ensure you are at the best of your<br />
health during pregnancy and make sure that you<br />
have the energy you will need when your baby<br />
finally arrives.<br />
Laura McLoughlin,<br />
Tesco Diets Nutritionist<br />
What’s important?<br />
Folate<br />
Why? Helps prevent neural tube defects in your developing<br />
baby. Foods: A 400mcg daily folic acid supplement, leafy<br />
green veg, beans and citrus fruits.<br />
Iron<br />
Why? Boots your iron stores to prepare for increased iron<br />
needs during pregnancy. Foods: Red meat, pulses, dried<br />
fruits and leafy green vegetables.<br />
Vitamin C<br />
Why? Improves iron absorption in your stomach and boosts<br />
immunity. Foods: Citrus fruits, kiwi fruits, berries, peppers<br />
and leafy green vegetables.<br />
Calcium<br />
Why? Essential for your baby’s development and helps to<br />
protects mother’s bones. Foods: Dairy, leafy green veg, dried<br />
fruit, sesame seeds, beans and chickpeas.<br />
Alcohol<br />
Cutting it out will boost fertility, remove any alcohol related<br />
risks when you do get pregnant and limit your intake of<br />
“empty” calories for a healthy weight.<br />
Special Offer for <strong>Fertility</strong> Readers! 2 weeks<br />
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A<br />
2<br />
D<br />
w
ISSUE <strong>03</strong> | NOVEMBER / DECEMBER 2010 £3.95/€4.95<br />
ISSUE <strong>03</strong><br />
WWW.FERTILITYROAD.COM<br />
FERTILITY ROAD<br />
CONTRIBUTORS<br />
Introducing the <strong>Fertility</strong> <strong>Road</strong> panel of journalists and experts…<br />
EUROPE'S NO.1 FERTILITY MAGAZINE<br />
YOUR PATH TO PARENTHOOD<br />
ZITA<br />
WEST<br />
EXCLUSIVE<br />
READER<br />
Q&A<br />
Think<br />
Twice<br />
Celine Dion's IVF twin elation<br />
WWW.FERTILITYROAD.COM<br />
FERTILITY ON ICE<br />
Social egg freezing<br />
- exclusive report<br />
IT'S MY LIFE<br />
Pregnancy,<br />
prying eyes and<br />
snooping glances<br />
Welcome to the new issue of <strong>Fertility</strong> <strong>Road</strong>, Europe's number one<br />
fertility magazine. It's about that time again when we begin to think<br />
of what we want the year ahead to provide, and for many of us the<br />
gift of bringing a new face into the world is undoubtedly the greatest<br />
of them all. For some, the journey is straightforward; for others,<br />
drawn out, plus physically and emotionally taxing. But at whatever<br />
point you are at, there is advice, assistance, knowledge and, more<br />
than that, genuine empathy... in the pages of this magazine and<br />
across thousands of other sources. The subject of fertility pools<br />
compassion and belief like nothing else, and we hope the coming<br />
months bring for you happiness, contentment and optimism.<br />
In the meantime, enjoy the magazine... James Evans, Managing Editor<br />
TONI WESCHLER FERTILITY ON THE WEB CHINESE MEDICINE<br />
ISSUE <strong>03</strong> - NOVEMBER / DECEMBER 2010<br />
Group Publishers:<br />
Jeff Crockett, Giorgio Severi<br />
Business Advisor:<br />
Alessandro Severi<br />
Managing Editor:<br />
James Evans<br />
Contributors:<br />
Kelly Rose Bradford, Hazel Davis,<br />
Carrie Dunn, Olivia Gordon, Andy Greeves,<br />
Siobhan O’Neill, Johanna Payton, Zita West<br />
Art Editor:<br />
Damian Browning<br />
Interim Sales Manager:<br />
Ms. J Watson<br />
European Sales:<br />
Susan Calatayud, Pier Minole<br />
Public Relations:<br />
Edith Collins<br />
Legal Advisor:<br />
W Burson & Co.<br />
Client Liason Officer:<br />
Debbie Hanson<br />
Printed by:<br />
ACORN printing<br />
Advertising Enquiries:<br />
sales@fertilityroad.com<br />
Contact details:<br />
<strong>Fertility</strong> <strong>Road</strong> Magazine<br />
Suite 318, Building 50,<br />
Argyll <strong>Road</strong>, London SE18 6PP<br />
Tel: 020 8316 8923<br />
Email: info@fertilityroad.com<br />
www.fertility-road.com<br />
Follow us on Twitter<br />
www.twitter.com/fertilityroad<br />
OUR WRITERS...<br />
OUR EXPERT...<br />
Zita West is a renowned expert in her field, having successfully assisted<br />
thousands of couples through the trials and challenges of conception.<br />
Zita writes exclusively for <strong>Fertility</strong> <strong>Road</strong>, answering an array of reader<br />
questions and concerns, imparting the kind of knowledge that sees her<br />
regarded as the UK’s leading light in pregnancy and fertility.<br />
Hazel Davis lives with her partner and two dogs in West Yorkshire. She writes<br />
on a variety of topics for The Guardian, The Independent, Daily Mail, Financial<br />
Times, Practical Parenting, Early Years and the music press. She has a particular<br />
interest in lesbian and gay parenting and fertility issues and sings in a choir.<br />
Andy Greeves is based in Dorset and works as Marketing & PR Officer for<br />
the Bournemouth-based Anglo-European College of Chiropractic. His interest<br />
in fertility issues stems from his mother Janet, who is alternative medicine<br />
practitioner, so Andy has heard many happy pregnancy stories as a result!<br />
Siobhan O’Neill is a mum to five-year-old Una and 11-month Aoife. As a writer<br />
she specialises in features about parenting, health and nutrition. As a mum she<br />
specialises in cuddles, snotty noses and messy dinner times. She has written on<br />
the rollercoaster that is parenthood and pre-parenthood for a variety of titles.<br />
Johanna Payton is a journalist, author and broadcaster who has been writing<br />
about fertility, pregnancy and parenting since her son, Eliott, was born six years<br />
ago. Her features have been published everywhere from Grazia to Maternity &<br />
Infant magazines. She has conducted interviews whilst changing nappies!<br />
Kelly Rose Bradford is a writer for the Daily Mail and Daily Express, and a<br />
specialist in parenting and family matters. A huge fan of babies, home-birthing<br />
and cloth nappies, she does not however weave lentils or hug trees. Kelly is<br />
mum to seven-year-old William.<br />
Carrie Dunn is a freelance journalist who has written for publications including<br />
The Times, The Guardian, The Independent, Cosmopolitan and Pregnancy Baby<br />
and You. When she’s not writing, she will be found at the theatre, at the<br />
cricket, or playing World of Warcraft!<br />
Olivia Gordon is a freelance journalist writing regularly on issues that affect<br />
women. A fertility charting obsessive and self-confessed POAS-aholic who is<br />
in awe of the amazing facts of life, she and her husband (and their two cats)<br />
are currently expecting their first baby.<br />
www.fertilityroad.com<br />
05
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FERTILITY ROAD<br />
NEWS<br />
The latest developments from the fertility world<br />
£5.5m FERTILITY CENTRE<br />
OPENS IN LIVERPOOL<br />
The biggest fertility centre in the UK has<br />
unveiled a new, state-of-the-art extension.<br />
The Hewitt Centre for Reproductive Medicine at Liverpool Women’s<br />
Hospital opened the new £5.5million unit in October, which includes<br />
a laboratory, sperm bank, egg freezing equipment and dedicated<br />
recovery services. The new facility is good news for both NHS and<br />
private patients, both of whom are able to use its facilities.<br />
The family of the centre’s founder – pioneering fertility doctor<br />
Jon Hewitt – were present at the launch of the new extension. Hewitt<br />
established the specialist clinic in 1989 but sadly died of lung cancer<br />
aged 47 in 2002. Jon’s wife Jenny said she was delighted that the<br />
new extension would “allow his good work changing lives to continue.”<br />
Jon had previously worked at the UK’s first ever fertility clinic – Bourn Hall in Cambridgeshire. It was on moving to Liverpool in<br />
1985 to work as a consultant at the Royal Liverpool Hospital that Hewitt realised there was the need for designated fertility clinics<br />
to be set up across the UK and went about creating the first in the North West of England. The pioneering Hewitt Centre has<br />
come a long way since its formation. Back in 1989, a team of three doctors carried out 100 cycles of IVF every year at the Royal<br />
Liverpool Hospital. Now over 2,000 treatments are performed and the Hewitt Centre employs over 75 members of staff.<br />
The new extension cements the Hewitt Centre’s status as the busiest provider of NHS fertility services in the country, and speaking at<br />
its launch, Director of Clinic Charles Kingsland commented: “I am delighted with the outcome and the work done over the last three<br />
years to deliver such a magnificent facility. It is such a relaxed, comfortable atmosphere, and that is what we wanted to create.”<br />
The Human Fertilisation and Embryology Authority (HFEA)<br />
has produced a guide for men, focused on addressing a<br />
dramatic fall in male fertility over recent years.<br />
COOL<br />
IT<br />
BOYS!<br />
It reveals that as many as one in five healthy young men aged between 18 and<br />
25 in the UK have an abnormal sperm count and in ‘primary infertility’, namely<br />
failure to achieve pregnancy after at least a year of unprotected sex. It also<br />
details how 40% of infertility cases result through problems with the man.<br />
Scientists agree that the testes should be a couple of degrees cooler than<br />
the rest of the body to help boost sperm production. Simple recommendations<br />
outlined in the guide include avoiding excessively hot showers, and saunas,<br />
whilst avoiding tight fitting underwear that may risk damaging sperm.<br />
HFEA also say that men should drink no more than the national alcohol<br />
recommended limit – 21 units a week – to avoid compromising their reproductive<br />
health. It is clinically proven that excessive alcohol consumption (and<br />
the use of illicit drugs) damages sperm production.<br />
The causes of male fertility problems are vast and include obstructive<br />
problems (blockage in sperm-carrying tubes), testicular injury and disease,<br />
varicocele, medical disorders which reduce fertility, not to mention environmental<br />
toxins/radiation and genetic disorders. Research has even shown<br />
that too many hours of cycling can have a detrimental effect on sperm levels<br />
– so men may want to consider ‘saddling up’ less often!<br />
At a recent European fertility conference, Professor Niels Skakkebaek of<br />
the University of Copenhagen, likened declining levels of male fertility to the<br />
rise of global warming in terms of its threat to the future global population.<br />
www.fertilityroad.com<br />
07
FERTILITY ROAD<br />
NEWS<br />
The latest developments from the fertility world<br />
IVF<br />
VERSE<br />
SOME<br />
INSPIRATIONAL<br />
QUOTES...<br />
“OBESITY DOUBLES<br />
RISK OF MISCARRIAGE”<br />
A recent study has found that women who are overweight or obese are more<br />
likely to experience a miscarriage following IVF treatment than those with a<br />
healthy BMI (Body Mass Index).<br />
The medical records of 318 women who had been patients at the assisted<br />
conception unit of Guy’s and St Thomas’ Hospital in London between January<br />
2006 and December 2009 were examined. The women were divided into two<br />
groups – those who have a healthy BMI of between 18.5 and 24.9, and those who<br />
were 25 and above.<br />
The report, delivered at a recent European fertility conference, stated that there<br />
was a miscarriage rate of 22% among women with a healthy BMI compared with<br />
a 33% miscarriage rate for overweight women. The findings echo the results of<br />
research carried out at London’s St Mary’s Hospital two years ago. The general<br />
risk of miscarriage was found to be raised by a staggering 73% in women with a<br />
BMI of 30 or above in the St Mary’s study.<br />
Obesity has long been proven to cause or exacerbate health conditions including<br />
heart disease, hypertension and diabetes. Strong evidence also exists that women<br />
who are overweight or obese are far more likely to experience fertility problems.<br />
Obesity results in the increased production of oestrogen, and this hormonal<br />
imbalance in turn interferes with ovulation, which is the basis of successful conception.<br />
Women who are overweight are also less likely to respond to fertility treatment<br />
because excess weight can prevent proper absorption of drugs used in IVF.<br />
One of the world’s leading medical journals, The Lancet, reported in 2007 that<br />
the number of couples seeking IVF treatment could double in the next decade if<br />
obesity levels in the Western World continue to rise. The report pointed to the<br />
rise of polycystic ovary syndrome (PCOS), which affects one in 15 women<br />
worldwide and occurs commonly in overweight women, as being ‘the tip of the<br />
iceberg’ in terms of future infertility problems.<br />
Adult obesity rates have nearly quadrupled in the UK over the past 25 years<br />
and two-thirds of adults are now overweight, of which nearly a quarter are ‘obese’.<br />
“There will always be a<br />
next step, you just have<br />
to be willing to take it!”<br />
– Danni Hutt<br />
“When you feel like giving up,<br />
remember why you held on<br />
for so long in the first place.”<br />
– Unknown<br />
“IVF makes you take a deep<br />
breath and say: ‘Let’s get<br />
through the next couple of<br />
weeks, let’s hope it all sticks.’”<br />
– Jo Joyner<br />
“If one dream should fall<br />
and break into a thousand<br />
pieces, never be afraid to<br />
pick one of those pieces<br />
up and begin again.”<br />
– Flavia Weedn<br />
“Forget about all the reasons<br />
why something may not<br />
work. You only need to find<br />
one good reason why it will.”<br />
– Dr. Robert Anthony<br />
“Staying calm through IVF<br />
is the most important thing.”<br />
– Nancy Sorrell<br />
“Hope sees the invisible,<br />
feels the intangible and<br />
achieves the impossible.”<br />
– Unknown<br />
“We’d use IVF. It’s not<br />
a big deal any more.<br />
Children are such a joy.”<br />
– John Travolta<br />
08 fertility road | november - december
FERTILITY ROAD<br />
NEWS<br />
The latest developments from the fertility world<br />
TOP HONOUR<br />
FOR IVF PIONEER<br />
Professor Robert Edwards has been awarded the<br />
2010 Nobel Prize for his groundbreaking work in<br />
the field of reproductive medicine.<br />
Professor Edwards has been at the forefront of developments<br />
into overcoming infertility for over six decades<br />
and played a key role in the realisation of IVF treatment.<br />
It was Edwards and the late Patrick Steptoe, a gynaecologic<br />
surgeon, who created IVF technology in which egg cells are<br />
fertilised outside the body and then implanted in the womb. The<br />
efforts of Edwards and Steptoe famously led to the birth of the world’s<br />
first ‘test tube’ baby – Louise Brown (pictured with Edwards) in 1978.<br />
Professor Edwards, who is a Cambridge-based physiologist, once<br />
said that “the most important thing in life is having a child” and<br />
that “nothing is more special that a child.” Since the birth of<br />
Brown, over three million babies have come into the world as<br />
a result of IVF and other assisted reproductive techniques.<br />
Edward’s Nobel citation says his work into infertility has made<br />
it possible to treat a medical condition which affects more than<br />
10% of couples worldwide. The Nobel committee added that IVF<br />
is a safe and effective therapy which sees 20-30% of fertilised eggs<br />
through the technique resulting in the birth of a child. Long-term<br />
studies have also shown that IVF children are as healthy as<br />
children born through natural conception.<br />
Robert Edwards was born in Manchester in 1925 and served<br />
his country during the Second World War. He later went on to<br />
study biology at the University of Wales, Bangor, and Edinburgh<br />
University. Edwards obtained a PhD in<br />
1955, producing a thesis on embryonal<br />
development in mice before becoming a<br />
staff scientist at the National Institute for<br />
Medical Research in London in 1958. It<br />
was here that he began his research into<br />
the human fertility process.<br />
From 1963, Edwards worked as a<br />
lecturer and researcher at Cambridge<br />
University, where he is currently professor<br />
emeritus. It was also in the early 1960s<br />
that he and Patrick Steptoe founded<br />
Bourn Hall Clinic – the world’s very first<br />
dedicated fertility clinic. He served as<br />
the clinic’s Research Director for much of<br />
his professional career. In later life,<br />
Edwards also edited several leading<br />
scientific journals in the area of fertility.<br />
Mike McNamee, Chief Executive at<br />
Bourn Hall, Cambridge, paid tribute to<br />
Edwards on the award of the prestigious<br />
Nobel Prize, commenting:<br />
“Bob Edwards is one of our greatest<br />
scientists. His inspirational work in the<br />
early 1960s led to a breakthrough that<br />
has enhanced the lives of millions of<br />
people worldwide.<br />
‘”He is held in great affection by<br />
everyone who has worked with him and<br />
was treated by him. I am really pleased<br />
that my great mentor, colleague and<br />
friend has been recognised in this way.”<br />
McNamee’s views were shared by Martin Johnson, Professor of<br />
Reproductive Sciences at the University of Cambridge, who told<br />
The Daily Telegraph:<br />
“I am absolutely delighted. This is long overdue. Bob’s work<br />
has always been controversial but he has never shrunk from<br />
confronting that controversy.<br />
“He was a real visionary, and always ahead of his time on<br />
so many issues – not just IVF – also on pre-implantation genetic<br />
diagnosis in the 1960s, stem cells in the 1970s, and the whole<br />
process of thinking ethically.<br />
“He is also an amazing human being – warm and generous. He<br />
was shocked when the MRC accused him of behaving unethically<br />
because everything he has done was based on a very clear set of<br />
humanist and ethical principles. It has taken 20 or 30 years for<br />
some people to catch up with him.”<br />
Louise Brown, who owes her very existence to Edwards, released<br />
a statement which read:<br />
“It’s fantastic news. Myself and my mother are so glad that one<br />
of the pioneers of IVF has been given the recognition he deserves.<br />
We hold Bob in great affection and are delighted to send our<br />
personal congratulations to him and his family.”<br />
Over 1,000 IVF babies have been born at Bourn Hall since Louise.<br />
10 fertility road | november - december
FERTILITY ROAD<br />
NEWS<br />
POLLUTION<br />
THREAT TO<br />
FERTILITY<br />
Bourn Hall<br />
Clinic<br />
first choice<br />
for IVF<br />
Often described as a sanctuary for people with<br />
difficulties conceiving, Bourn Hall Clinic made history<br />
by being the first in the world to offer IVF. In the last<br />
30 years more than 10,000 babies have been born as<br />
a result of our pioneering fertility treatment.<br />
Research in the USA has found a link between air<br />
pollutants and IVF failures.<br />
The case results of over 7,000 women who underwent<br />
IVF in various hospitals across the States between<br />
2000 and 2007 were recently analysed and published in the journal<br />
Human Reproduction. The findings were that women exposed to<br />
greater air pollution had a lower chance of IVF success.<br />
High levels of nitrogen dioxide (NO2), produced mainly by<br />
vehicle exhaust fumes, were constantly linked to lower odds of<br />
IVF success. Where NO2 levels were higher than average, either<br />
at the patients’ house or IVF clinic, chances of having a baby<br />
dipped. Of the whole study group, 36% of the women had a baby<br />
following their first round of IVF treatment. Of those women,<br />
only 20% from the group where high NO2 levels were found had<br />
a successful course of IVF.<br />
Dr Duanping Liao, a Professor of Epidemiology at Penn State<br />
College of Medicine, Pennsylvania, and who pioneered the study,<br />
commented:<br />
“Numerous studies have consistently shown a relationship<br />
between air pollution and human health, ranging from mortality,<br />
cardiovascular disease and other chronic conditions.<br />
“In the process of searching for the mechanisms responsible for<br />
the above associations, we, and others, have reported significant<br />
links between air pollution and inflammation and increased<br />
blood clotting... These intermediate factors are also associated<br />
with reproductive health.”<br />
Despite the findings, Dr Liao stressed that women who are<br />
pregnant or planning on becoming pregnant either naturally<br />
or through IVF “shouldn’t panic”. While the study points to an<br />
association between air pollution and IVF outcomes, it does not<br />
prove cause and effect. Liao also reported the effects of air<br />
pollution on IVF failures to be “subtle”.<br />
Individual Treatment<br />
Today we offer bespoke fertility treatment to both NHS and<br />
private patients. Our success rates and individual care are second<br />
to none and we have a reputation for treating particularly difficult<br />
fertility issues, achieving excellent results against the odds. At<br />
Bourn Hall every patient’s journey is unique and you can be<br />
confident we will put you first at every step.<br />
Egg and Sperm Donation and Sharing<br />
We’re one of the few clinics with our own banks of donated<br />
sperm and embryos and we encourage healthy men and<br />
women to consider altruistic sperm and egg donation for which<br />
we reimburse expenses. We also run highly successful egg<br />
sharing and sperm sharing programmes where eligible patients<br />
can have a free cycle of IVF treatment in return for their<br />
participation.<br />
We have two dedicated fertility clinics in Bourn,<br />
only 20 minutes from Cambridge, and in<br />
Colchester in Essex.<br />
www.bourn-hall-clinic.co.uk
FERTILITY ROAD<br />
NEWS<br />
The latest developments from the fertility world<br />
PCOS POLL REVEALED<br />
A poll on specialist PCOS website Verity has provided some interesting<br />
findings into what women really fear about the disorder. PCOS (short for<br />
Polycystic Ovary Syndrome) is one of the most common female endocrine<br />
disorders affecting approximately 5-10% of women of reproductive age,<br />
and is thought to be one of the leading causes of female infertility.<br />
And whilst it would be assumed that the greatest worry resulting out<br />
of PCOS would be an inability to conceive, the poll threw up some startling<br />
results, with only 58% of women listing that as their first concern.<br />
For a further 30%, the worries were of a more cosmetic nature, with<br />
11% concerned about facial hair growth and 19% worried about permanent<br />
weight gain. A further 5% listed their hair falling out as the leading fear.<br />
PCOS is treatable, but cannot be cured. It affects women in the<br />
UK and worldwide, and if not properly managed can lead to health<br />
problems in later life.<br />
For more information on the poll and PCOS in general, head to<br />
www.verity-pcos.org.uk<br />
THE<br />
FERTILITY<br />
SHOW<br />
Remember to catch The <strong>Fertility</strong><br />
Show at London Olympia on<br />
November 5 and 6. Backed<br />
by Infertility Network UK, the<br />
show provides a dedicated and<br />
discrete environment in which<br />
to learn about fertility, explore<br />
your options with experienced<br />
and sympathetic professionals,<br />
as well as finding out how to<br />
give yourself the best chance<br />
of conceiving.<br />
For more information, head to<br />
www.thefertilityshow.co.uk<br />
SOUTH AFRICA’S<br />
DONATION BOOM<br />
Egg donation is truly a global phenomena,<br />
with the realisation of this rarely seen better<br />
than in South Africa.<br />
A country whose society has so frequently struggled with the<br />
less savoury elements of human interaction has reinvented<br />
itself as a dedicated and devoted base for those looking to<br />
conceive with the help of others.<br />
The speed of the country’s ascent into the top rankings of<br />
global egg donators has been incredible, and in a year when<br />
South Africa has been heralded for their hosting of the world’s<br />
largest football tournament, it’s clear that in the agencies and<br />
clinics there is a similar legacy of success being created.<br />
Jenny Currie, founder of the baby2mom Egg Donation<br />
Agency, believes South Africa’s interest is in line with the new<br />
values of community that the country stands for in 2010.<br />
“Benefits of pursuing egg donation services in South Africa<br />
are many and include the top quality affordable fertility<br />
treatments in South Africa. The absence of any egg donor<br />
registry and legislative restrictions empowers recipients with<br />
the decision of whether to disclose the egg donation aspect<br />
of conception. That anonymity aspect ensures that the rights<br />
and responsibilities of egg donors end with the egg retrieval.<br />
“In addition, the scenic beauty encourages a relaxed<br />
atmosphere and opportunity to explore and enjoy whilst<br />
having egg donor fertility treatment. And because of the<br />
advantageous exchange rate for foreigners to South Africa,<br />
egg donation offers a highly affordable effective option to<br />
conception through anonymous egg donation.”<br />
Jenny, who founded baby2mom in 2007 in response to<br />
a community of growing infertility-requiring third parties to<br />
aid conception, is personally involved in every egg donation<br />
program. She believes that egg donation is a fundamentally<br />
personal initiation, and that the decision to accept a specific<br />
egg donor profile is a hugely intimate one.<br />
“We offer immediate access to an extensive live online<br />
egg donor database, the largest in South Africa. It has enabled<br />
us to gather vast experience in the facilitation of hundreds<br />
of egg donation treatments, with an unbiased assistance that<br />
is never held back by waiting lists or non-availability of donors,<br />
no matter what race groups are requested.<br />
“It is important for service to be<br />
at the forefront, so we also offer<br />
immediate response to queries, and<br />
assist with travel arrangements<br />
and excursions. We feel it is this<br />
and more that is guiding people<br />
to South Africa.”<br />
For more information, head to<br />
www.baby2mom.co.za<br />
12 fertility road | november - december
FERTILITY ROAD<br />
CELEB NEWS<br />
<strong>Fertility</strong> news amongst the flashbulbs<br />
THINK<br />
TWICE<br />
After many gruelling rounds of IVF, singer Celine<br />
Dion has given birth to twins, and declared<br />
herself “thrilled” at adding to her family.<br />
The two boys, Nelson and<br />
Eddy, were born prematurely<br />
by Caesarean section in Florida<br />
on October 23.<br />
The singer, 42, already had a nine-yearold<br />
son, Rene-Charles, with husband and<br />
manager Rene Angelil, but the couple<br />
have been trying to add to their family<br />
for many years.<br />
She had been admitted to hospital earlier<br />
in the week so that the pregnancy could be<br />
monitored more closely by her doctors.<br />
Her husband was there during the birth,<br />
and told reporters shortly after announcing<br />
the news: “I cut the cord, it was instant<br />
love. I would do anything for them. I love<br />
them so much.”<br />
Celine has recently had six rounds of IVF,<br />
having frozen embryos inserted into her<br />
womb and miscarrying three times before<br />
this successful pregnancy, but the couple<br />
began IVF in 1999 to conceive their first<br />
child after Angelil’s treatment for throat<br />
cancer. Doctors say they were “extremely<br />
lucky” to become pregnant with Rene<br />
Charles on their first IVF try 10 years ago,<br />
leading Dion to refer to her eldest son as<br />
“our miracle baby”.<br />
Celine has previously spoken openly about<br />
her experience of the procedures, and her<br />
struggles to administer the necessary daily<br />
hormone injections to her thighs - “I give<br />
the shots (of fertility drugs) to myself. My<br />
thighs are bruised and numb and full of<br />
lumps from the long needles that go deep<br />
into the muscle. I don’t want people saying,<br />
‘Oh, poor Celine,’ but it does take a lot<br />
out of me.”<br />
The recurrent miscarriages have also<br />
taken their toll, with the singer saying: “I<br />
feel like I’ve been pregnant more than a<br />
year. I never gave up. But I can tell you that<br />
it was physically and mentally exhausting.”<br />
She has also been very aware of the<br />
potential risks to her as an older mother,<br />
saying: “We believed in trying one more<br />
time. If the doctor had told me that my<br />
body was too tired, I would have given up.”<br />
The couple have talked about their<br />
worries waiting for news of whether a cycle<br />
of IVF has worked, with Angelil saying:<br />
“We go crazy waiting for the results. It’s like<br />
waiting for the lotto, but it’s bigger than that<br />
- imagine. It’s the biggest news you can get.”<br />
As one of 13 children, Celine has always<br />
wanted a big family, and has found the<br />
successive disappointments tough to cope<br />
with. She said: “Sometimes I just suddenly<br />
burst into tears for no reason. Rene and I<br />
want this so much and we go crazy waiting<br />
for the results. As a girl who grew up with<br />
13 siblings, I found it hard.”<br />
Last August it was reported that Celine<br />
was pregnant, but it was confirmed in<br />
November 2009 that the pregnancy had<br />
resulted in a miscarriage.<br />
She later said that she had not wanted<br />
to announce the miscarriage immediately,<br />
explaining: “They said that I was pregnant,<br />
and a couple of days after, we were not<br />
pregnant again.<br />
“We didn’t want to feel like we were<br />
playing yo-yo – ‘I’m pregnant. I’m not pregnant.<br />
I’m pregnant. I’m not pregnant.’ So<br />
we didn’t want to do this thing. But we did<br />
have a miscarriage.”<br />
Since then, she has also talked about<br />
receiving the news that the cycle had failed,<br />
recalling: “Rene answered the phone and<br />
when I saw the tears running down his<br />
face, I knew it wasn’t the news we have<br />
been longing for. You do everything right<br />
and you’re careful and you rest and then...<br />
the disappointment hits you like a wave.<br />
But I swear, I’ll keep trying until it works.”<br />
On announcing the news this time round,<br />
Angelil declared: “We’re ecstatic. Celine is<br />
just hoping for a healthy pregnancy. She<br />
was hoping for one baby and the news that<br />
we are having two is a double blessing.”<br />
Unsurprisingly, the couple were concerned<br />
about this pregnancy too, and looked<br />
forward to the regular medical check-ups.<br />
“My doctor had to constantly reassure me,”<br />
Celine admitted. “Each week I had sonograms.<br />
I heard their heartbeats.”<br />
She relaxed as much as possible, reducing<br />
her heavy concert workload. “I do almost<br />
nothing,” she said. “If you tell me I have<br />
to stay in bed, I will stay in bed until the babies<br />
are born. To bring them into the world,<br />
there’s nothing more important than that.”<br />
Thankfully, she now has her wish...<br />
www.fertilityroad.com<br />
13
FERTILITY ROAD<br />
CELEB NEWS<br />
<strong>Fertility</strong> news amongst the flashbulbs<br />
TURNING<br />
TEARS INTO<br />
DREAMS<br />
COME TRUE<br />
When your body refuses to<br />
cooperate, and no matter<br />
how many fertility treatments<br />
or IVF attempts<br />
you try you simply cannot fall pregnant, it<br />
can be devastating. The realisation that you<br />
will never bear children no matter how<br />
desperately you want to is extremely hard to<br />
come to terms with. Inevitably there will be a<br />
period of grieving, a sense of loss, followed<br />
by a gradual grudging acceptance.<br />
But it’s important to remember that<br />
being unable to carry a baby yourself does<br />
not mean the end to your dreams of having a<br />
family, because other options like adoption<br />
or surrogacy can be just as rewarding.<br />
Regular readers of <strong>Fertility</strong> <strong>Road</strong> will<br />
remember our celebrity interview with<br />
Sinitta in the last issue, when she recounted<br />
the terrible ordeal she endured in a bid to<br />
have her own children. And she described<br />
how quickly and easily she bonded with<br />
her adopted children and how much she<br />
adores them. She said, “My path through<br />
fertility didn’t end the way I expected it<br />
to, but this will be the case for millions of<br />
other people out there. We all go in with<br />
hopes and dreams, and sometimes our<br />
wishes aren’t granted. But I am proof<br />
enough that there is another way if, at the<br />
end of the long road, you haven’t reached<br />
the destination you expected.”<br />
Celebrity adoption has been much in<br />
the headlines of late, thanks to stars like<br />
Angelina and Madonna’s widely publicised<br />
adoption of children from third world<br />
countries. But, as admirable as that is, less<br />
well known are the stories of celebrities<br />
who adopted or chose surrogacy because<br />
of their own fertility issues.<br />
Hugh Jackman, the Australian star of<br />
Wolverine and The X-Men, and his wife<br />
Deborra-Lee Furness, adopted two children<br />
when their plans for natural conception<br />
didn’t turn out the way they’d hoped.<br />
Hugh said they’d always planned to adopt<br />
a child, but only after the two children they<br />
expected Deborra-Lee would carry. In an<br />
interview he said, “We still wanted to adopt.<br />
That was our plan: we’ll have two and<br />
we’ll adopt one. Anyway we didn’t have<br />
children. We tried and that was tough. But<br />
Jamie Lee Curtis<br />
the moment Oscar arrived, it just felt like<br />
he was always meant to come that way.<br />
I forget he’s adopted; he’s just my son.”<br />
Hugh and Deborra-Lee were present at<br />
Oscar’s birth in 2000, having formed a<br />
good relationship with his American birth<br />
mother. “It was exhilarating. I remember<br />
tears running out of my eyes in the<br />
happiest possible fashion,” said Jackman.<br />
The couple later adopted Ava in 2005,<br />
also from America, mainly because Australian<br />
adoption is so difficult. This was<br />
after their own share of heartbreak over<br />
failed IVF attempts and miscarriages.<br />
Jackman said, “We’d been told by a<br />
naturopath that you’ve got to make love<br />
every day for a 10-day period. I never<br />
thought I’d get to the point where I was<br />
like, ‘Deb, can I have a break?’ It’s very hard<br />
with IVF, there are a lot of emotions. We did<br />
have a couple of miscarriages as well and<br />
those are very tough. When we adopted, all<br />
that seemed to melt away instantly.”<br />
The pair now campaign for a change to<br />
the Australian adoption laws to make it<br />
easier for couples to undertake the process.<br />
Jamie Lee Curtis and husband Christopher<br />
Guest also chose to adopt following fertility<br />
issues. Although she is private about her<br />
life, Jamie Lee has spoken a few times<br />
about it saying, “Adoption was the only<br />
way for us to have a family. It becomes the<br />
only viable option for you. If you want to<br />
be a family, that’s how you’re going to be it.<br />
I don’t think you feel like a family until the<br />
child is born.”<br />
Jamie Lee has been anxious to break<br />
down some of the barriers and taboos that<br />
sometimes accompany adoption. She and<br />
Christopher opted for an open adoption<br />
with each of their children – Annie and<br />
Tom – and she has written a story book for<br />
young children about adoption, called Tell<br />
Me Again About The Night I Was Born.<br />
But she is keen to keep her children’s<br />
lives out of the public eye and says she will<br />
not campaign around adoption until<br />
they’re much older. But she has admitted,<br />
“The only disappointment I’ll talk about<br />
publicly in terms of not going through<br />
childbirth was missing the unbelievable<br />
love and affection you get from the world<br />
around you, and the delicacy with which<br />
people treat women who are about to give<br />
birth. I have participated in this lovefest<br />
14 fertility road | november - december
WORDS | SIOBHAN O’NEILL<br />
with many, many women. But when you’re<br />
an adoptive mother, no-one knows that<br />
you’re about to become a mother. No-one<br />
understands that you’re going through the<br />
exact same fears about the health of the<br />
child, about your ability to be a parent, about<br />
the changes in your life and marriage, the<br />
changes with your other child, the financial<br />
restraints, the ‘Do I have enough room in<br />
my house?’.<br />
“While every pregnant woman has nine<br />
months to deal with that, adoptive mothers<br />
often have no time. That’s a small price<br />
to pay for the joy of being a mother, but it<br />
is a significant one, and one I’ve never<br />
talked about.”<br />
Whilst apparently less frequently observed<br />
in this country – perhaps because the laws<br />
were changed only as recently as 2009 – in<br />
the United States surrogacy seems a more<br />
popular choice for those struggling to<br />
conceive or carry a baby themselves, and<br />
many celebrity couples have gone down<br />
this route.<br />
There can be complicated legal issues, and<br />
some states – like New York – do not permit<br />
hiring a surrogate mother. Nevertheless<br />
Kelsey Grammer, of Frasier fame, and his<br />
wife Camille, became successful parents<br />
via surrogacy, as did Grammer’s co-star<br />
Peri Gilpin who now has two daughters by<br />
surrogate following seven years trying to<br />
conceive, including failed IVF attempts.<br />
There are two options for surrogacy. One,<br />
where the surrogate is the genetic mother<br />
of the child, but more preferred by celebrities<br />
seems to be where the surrogate is implanted<br />
with the parents’ own embryo. Actress<br />
Angela Bassett and her husband Courtney<br />
B Vance became parents to their own twins<br />
following seven years of failed IVF, thanks<br />
to a surrogate mother.<br />
Angela said, “I was devastated when it<br />
didn’t happen. I had to remain hopeful and<br />
resilient and say, ‘Okay, let’s do it again.’”<br />
When a friend told her about her surrogate<br />
pregnancy Angela’s ears pricked. “She<br />
began to tell me about the idea of surrogacy.<br />
The more we learned about it, the<br />
more we began to think that perhaps<br />
this was an answer for us,” she said.<br />
The birth was a dream come true for<br />
Angela who described the moment<br />
saying, “Just standing there together,<br />
holding each other, with the<br />
Angela Bassett and Courtney B.<br />
Vance with children Bronwyn<br />
Golden and Slater Josiah<br />
Sarah Jessica Parker and Matthew Broderick<br />
with son James Wilkie and daughters<br />
Marion Loretta Elwell and Tabitha Hodge<br />
realisation that this is the moment that<br />
we’ve been working toward, praying for.”<br />
Most recently, Sex and the City actress<br />
Sarah Jessica Parker and her husband Matthew<br />
Broderick welcomed their new twins<br />
to the world thanks to a surrogate mum.<br />
Speaking before the birth Sarah Jessica<br />
said, “I’m excited, I’m really grateful. I feel<br />
really fortunate.”<br />
Admitting they’d had fertility problems<br />
and had considered adoption as well as<br />
surrogacy, Sarah Jessica said, “We’ve been<br />
trying to expand our family for a number<br />
of years and we actually have explored a<br />
variety of ways of doing so. I tried and tried<br />
and tried to get pregnant, but it just was not<br />
meant to be, the conventional way. I would<br />
give birth as often as I could, if I could. I<br />
couldn’t pretend otherwise. It would be odd<br />
to have made this choice if I was able to have<br />
successful pregnancies since my son’s birth.”<br />
And anyone in any doubt about how<br />
special a surrogate birth can be need only<br />
listen to Sarah Jessica’s description of it.<br />
“It’s as if everything else disappears for a<br />
moment, and the world goes silent and – I<br />
can’t explain it except to say that nothing<br />
else existed. The notion of meeting your<br />
children instead of giving birth to them is<br />
something best described as suspended<br />
animation. I don’t remember anything but<br />
the blanket on the bed that they were lying<br />
on and my husband’s face and their faces<br />
and my son’s. It’s literally as if sound is<br />
sucked from the room. It’s so different, and<br />
equally extraordinary.”<br />
www.fertilityroad.com<br />
15
FERTILITY ROAD<br />
FERTILITY FINDS<br />
The latest gadgets, gismos, applications and supplements…<br />
Conceive Plus<br />
Conceive Plus is a unique and scientifically formulated gel designed to help you conceive.<br />
Its exclusive formulation creates a conception friendly environment that assists your<br />
path to pregnancy by maintaining and facilitating male sperm viability and motility.<br />
It is the only lubricant that includes calcium and magnesium ions that help keep<br />
cells as healthy as possible. These ions are present in all bodily fluids and are essential<br />
for cell viability and the process of fertilisation.<br />
And it’s really easy to use as well. Just apply a small amount prior to or during<br />
intercourse and re-apply as required.<br />
Scientifically designed to be free of harmful inhibitors such as EDTA,<br />
Conceive Plus does not contain certain complex sugars that may<br />
potentially interfere with the fertilisation process.<br />
Price £14.99 - available exclusively at Boots stores nationwide<br />
and www.boots.com. To find out more information regarding<br />
the science behind Conceive Plus, visit www.conceiveplus.co.uk.<br />
PRODUCT<br />
OF THE<br />
MONTH<br />
Sanatogen<br />
- Mother To Be Omega 3<br />
Vitamin experts Sanatogen continue<br />
to produce supplements that are<br />
expertly tailored to meeting the<br />
needs of prospective parents, and in<br />
Sanatogen Mother To Be they have<br />
created a formula that can be taken<br />
right from the first day you decide<br />
you want to start a family. A Father To<br />
Be version is available also, and both<br />
options are suitable to continue taking<br />
throughout your pregnancy making it<br />
easy to look after yourself.<br />
FitFlop<br />
FitFlop footwear is biomechanically<br />
engineered to help tone and tighten<br />
your leg muscles while you walk.<br />
They can provide relief from plantar<br />
fasciitis, heel spurs, chronic back pain,<br />
sciatica, osteoarthritis, RLS, scoliosis<br />
and degenerative disc disease. And in<br />
terms of fertility, we all know that losing<br />
weight, staying in shape and exercising<br />
more is the single best thing when it<br />
comes to reproductive health.<br />
FitFlop footwear is approved by the<br />
American Podiatric Medical Association.<br />
Cyclotest Baby<br />
- RDO Medical<br />
RDO Medical are now taking orders for<br />
their amazing symptom-thermal fertility<br />
monitor, Cyclotest Baby.<br />
By just making a few observations<br />
regarding waking temperature (BBT)<br />
and menstruation dates, Cyclotest Baby<br />
can reliably identify ovulation, and with<br />
it, the optimum time to have intercourse<br />
for conception. It learns about your cycle<br />
and shows the whole fertility window<br />
for the coming month, and all data can<br />
be downloaded and shared with your<br />
doctor or fertility specialist.<br />
RRP £10.99 – from all good chemists<br />
Prices start from £30.00 – www.fitflop.com<br />
Price £169 – www.buycyclotestbaby.co.uk<br />
16 fertility road | november - december
FERTILITY ROAD | Origin International <strong>Fertility</strong> Centre<br />
INTELLIGENT PROFILE<br />
ORIGINAL<br />
AND<br />
INDIA’S<br />
FINEST...<br />
There are many clinics around the world offering low<br />
cost, high quality treatment with good success rates,<br />
but a major part of travelling abroad so as to breathe<br />
life into your fertility dreams is about connecting with<br />
those you will trust and confide in on such an emotional journey.<br />
The Origin International <strong>Fertility</strong> Centre, based near Mumbai,<br />
already has a reputation for clinical excellence, offering a vast<br />
range of services from IVF, egg donation, surrogacy and sperm<br />
banking, through to embryo donation, laser hatching, blastocyst<br />
transfer and vasectomy/tubectomy reversal. But outside of the<br />
scientific achievements that have led Origin to be rated in the top<br />
15 clinics worldwide, this family-based operation prides itself on<br />
a quality of care that far outperforms the norm.<br />
It’s a benefit aided by using the expertise and experience of<br />
British doctors within the practice, but additionally through the<br />
knowledge of leading specialists such as Dr Sandeep Mane.<br />
“When I completed my training at the Royal College in London<br />
I realised I was equipped with skills that would find use 7,000<br />
miles away in my homeland. It was then I decided to return to<br />
India to set up The Origin International <strong>Fertility</strong> Centre. I had the<br />
drive and the qualifications to realise this ambition, and I have<br />
trained over 15,000 doctors across the world.”<br />
Having trained in the UK, the irony of Dr Mane returning to<br />
Mumbai to treat British patients is not one that is lost, but the<br />
simple facts are that treatment abroad has become a fantastically<br />
cost-effective way for couples to realise their ambitions of starting<br />
or extending their family.<br />
And a family operation The Origin International <strong>Fertility</strong> Centre<br />
is with Sandeep’s wife, Dr Rajashree Mane, a key figure and pillar<br />
of strength at the centre. Her feminine insight, communication<br />
and counselling skills and specialist knowledge provide the<br />
perfect backdrop that transforms a medical research centre into a<br />
friendly, caring treatment facility.<br />
And the vision of the practice has always been clear – to offer<br />
quality care to patients, to impart professional and communication<br />
skills to doctors, to conduct research to improve healthcare for<br />
women and, in general, to create opportunities to serve society.<br />
It is a thorough blueprint that spells out a passion for expert<br />
diagnosis and treatment, combined with a backdrop of stress<br />
management sessions and relaxation therapies such as meditation<br />
and yoga. It means that those who visit the 10,000-sq ft Origin<br />
<strong>Fertility</strong> do so to undertake treatment that offers an overall body<br />
and mind cleansing process.<br />
The jewel in Dr Sandeep Mane’s crown of achievements is his<br />
nomination for the Bharat Jyoti Award in 2008, which places him<br />
on a pedestal as other luminaries in his field such as Mother<br />
Theresa, while the clinic has also been profiled on BBC world<br />
news as one of the fastest growing clinic in surrogacy services.<br />
But at their heart, the aims remain simple, even with over<br />
1,000 operations having been performed in the first two years<br />
since the clinic opened.<br />
“Our work is different to that of others, because we are always<br />
looking to treat the mind along with the body,” Sandeep Mane<br />
continues. “We have many unhappy couples arrive having gone<br />
through various stages of what can be a painful process. Some<br />
come with a very defeatist attitude and having lost all confidence<br />
that their childlessness is something that can be cured. But with<br />
care, understanding, sensitivity, and some of the world’s leading<br />
technology, The Origin International <strong>Fertility</strong> Centre really is<br />
making dreams come true.”<br />
For more information email info@theoriginfertility.com or<br />
head for The Origin International <strong>Fertility</strong> Centre’s website at<br />
www.theoriginfertility.com<br />
www.fertilityroad.com<br />
17
FEATURE | it’s my life<br />
WORDS | KELLY ROSE BRADFORD<br />
IT’S MY<br />
LIFE<br />
Why the most intimate and private of life<br />
experiences can often result in being the most<br />
public, and with traumatic consequences...<br />
For some couples, it can barely seem like the ink is<br />
dry on the wedding certificate, or the emulsion is<br />
put on the walls of their first home, before people<br />
start asking those questions:<br />
“When are we going to hear the patter of tiny feet?”<br />
“Ooh, you’ll be making a baby announcement soon, no doubt!”<br />
And, for those who already have a baby, the constant ‘so<br />
when are you going to try for number two’ comments.<br />
A woman’s fertility and baby-making prowess is, it seems,<br />
of great interest – and not only to family and friends, but<br />
complete strangers too.<br />
“I was sitting in the doctors’ surgery, ironically waiting to<br />
have a chat about the fact I hadn’t fallen pregnant after six<br />
months of trying,” says Katie, 34, “and there was a screaming<br />
baby wriggling and arching its back in a pushchair opposite<br />
me. An old lady who lives in my road who happened to be<br />
sitting next to me nudged me in the ribs and said ‘You’ve got<br />
the right idea, not having babies! Bet you’re glad, aren’t you?’<br />
“I found myself welling up – obviously she wasn’t to know<br />
why I was there, but it made me so angry that people just<br />
say what they like to women about pregnancy and children<br />
– you’d never say to someone, ‘Oh I bet you’re glad you<br />
haven’t got cancer’ or something. It’s just so rude.”<br />
“It’s insensitive and intrusive,” says Michelle, 30. “I’d only<br />
been with my partner for 18 months when people started<br />
quizzing us about starting a family – I thought it was really<br />
overstepping the mark – not only given that the relationship<br />
was fairly new, but also because I’ve got PCOS (Polycystic<br />
Ovary Syndrome) and didn’t even know if I could conceive. I<br />
hate the fact that women’s fertility seems to be public property.”<br />
Mum of one Laura, now 40, agrees. Having eventually<br />
gained a son after years of trying, she found people’s constant<br />
questions about ‘number two’ hard to take:<br />
“It took five years to have our son, Jacob. In that time I had<br />
load of tests, but they never found anything actually wrong. It<br />
just wasn’t happening. And then, after Jacob was born, number<br />
two didn’t happen either. We tried for a couple of years, but<br />
didn’t really put our hearts into it as it had just been too draining<br />
going through years of negative tests before having Jacob.”<br />
This did not stop friends and family’s incessant questioning<br />
though, something that Laura and her husband Nick found<br />
very difficult to cope with.<br />
18 fertility road | november - december
“I think the worst one was the mother, who I did not<br />
know, turning to my son when he was about four-anda-half<br />
and saying ‘Tell your mummy to give you a<br />
brother or sister’. I was livid. Even now I can’t believe<br />
she did that. It was so utterly appalling. I just turned<br />
to her and said, rather coldly but calmly, that really I<br />
would love to have another child but since it took five<br />
years to have Jacob, it was highly unlikely I would.”<br />
Mel, 38, and her partner Paul, 40, decided to keep<br />
their second attempt at IVF a secret after enduring endless comments<br />
from people the first time round:<br />
“I actually had some older family members telling me they<br />
‘didn’t believe in IVF’,” Mel recalls. “That they thought it was<br />
playing God. Then there were those who questioned the amount<br />
of money we were spending. People were actually pretty awful<br />
throughout the whole procedure. What really annoyed me though<br />
was the fact my cousin announced her pregnancy whilst we were<br />
in the midst of treatment and I constantly had to hear every last<br />
detail of her antenatal appointments and scans – no-one showed<br />
any kind of tact or diplomacy despite knowing I was injecting<br />
every day and waiting to have eggs harvested. It was horrible.”<br />
No-one showed any kind of tact<br />
or diplomacy despite knowing I was<br />
injecting every day and waiting to<br />
have eggs harvested. It was horrible.<br />
For Sophie, 25, the constant questioning about babies so soon<br />
after her wedding became too much to bear that she and her<br />
husband decided to stop trying for a family:<br />
“I would say we actually faced criticism, more than just questioning,”<br />
she says, “Firstly, directly after the wedding, we were<br />
under enormous pressure. Then, when we finally had to say, well<br />
actually, we’re not going to have any, another barrage of questions<br />
and opinions.”<br />
Sophie and her husband reached the heartbreaking decision to<br />
stop trying for a baby after they failed to conceive.<br />
“Literally as soon as we were married our family and friends<br />
began asking when the kids would come along - how many »<br />
www.fertilityroad.com<br />
19
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FEATURE | it’s my life<br />
we were going to be trying for, when<br />
we were going to start. At that point<br />
we didn’t even have anywhere to<br />
live, so the idea of children was the<br />
last thing on our minds. To their<br />
faces we laughed off their constant<br />
questions, but deep down it did annoy me that they expected<br />
such a personal decision to be discussed in the same breath as<br />
what we were having for dinner. Even if we decided to have<br />
children, we certainly wouldn’t discuss it with anyone else.<br />
“When we did start trying for a family we didn’t tell anyone.<br />
We continued to laugh off all the questions, without actually<br />
confirming that we were trying. We attempted to conceive for<br />
a year but nothing happened. Before this we had decided that<br />
we would only give it a year - if we didn’t fall pregnant in that<br />
time, then it was not a big deal. And when nothing did happen<br />
we made the decision not to have children at all.”<br />
When Sophie went on to admit to curious relations and pals<br />
that she and Dan had decided not to have children, she faced a<br />
further barrage of questions and comments:<br />
“When people found out we’d tried for a year most of them<br />
immediately said – and these are their exact words - ‘Is Dan<br />
a Jaffa?’. That infuriated me so much. We didn’t have any<br />
fertility problems that we knew of, but if we had been told that<br />
for some reason we couldn’t have children it would have been<br />
very hurtful. It was made worse when one friend suggested I<br />
make an appointment with a fertility doctor and considered<br />
IVF. I was only 22 at the time!”<br />
Once you make the decision to conceive,<br />
it’s so exciting that you want to get going right<br />
away. When I stopped using contraception<br />
a year ago I was actually expecting to get<br />
pregnant within the week!<br />
Sophie has also found people are critical to the point of<br />
rudeness about her decision to stop trying:<br />
“We regularly receive comments like ‘you’re not being what a<br />
woman should be [as in be a wife and mother]’ and ‘you’ll get<br />
to 35 and want children. Then what happens if you still can’t?’<br />
“Our choice about children is a decision that we made<br />
together, yet I feel for people who can’t have babies for one<br />
reason or another and don’t want the whole world knowing<br />
their fertility issues, as they receive unfair judgement. I feel<br />
children and fertility is such an emotive subject, yet people<br />
believe that questioning others’ decisions relentlessly is okay<br />
and the norm.”<br />
Hannah, 33, also despairs of other people’s insensitive<br />
comments. She and her husband Rodney have been trying for<br />
a baby for a year. She feels people do not understand the pure<br />
heartbreak women go through when they realise yet another<br />
month of ‘trying’ has not resulted in pregnancy:<br />
“Once you make the decision to conceive, it’s so exciting that<br />
you want to get going right away,” she says. “When I stopped<br />
using contraception a year ago I was actually expecting to get<br />
pregnant within the week! It was a complete shock to get my<br />
period at the end of that month. I even felt pregnant before »<br />
www.fertilityroad.com<br />
21
FEATURE | it’s my life<br />
SO WHAT<br />
CAN BE<br />
DONE?<br />
How can you best fend off well-meaning<br />
(or otherwise) comments from friends<br />
(and strangers). Parenting expert Sue<br />
Atkins, who has counselled many mums<br />
and dads through fertility treatment and<br />
pregnancy, offers the following advice:<br />
I am determined to be a<br />
mum again, I am 37, not 57, and<br />
there are options open to me.<br />
And frankly, whether it upsets<br />
people or not, I have totally come<br />
to the conclusion that I don’t<br />
need a relationship or a man<br />
in my life full-time to do it.<br />
then. The next one was even worse. The awful thing is when you<br />
have friends who know you’re trying and you say you have period<br />
pains and they say ‘oh but it could be pregnancy cramps’ it makes<br />
it so much worse. You start to treat period symptoms as pregnancy<br />
symptoms and that exacerbates the shock.”<br />
And sometimes the attitudes go further than the pure<br />
biological side of getting pregnant. Sarah is 37 and mum to a<br />
seven-year-old daughter. When her relationship broke up last year,<br />
she confided in her mum that she would love to have another child.<br />
“I was furious when she said to me ‘well, you’ve closed the<br />
door on that part of your life now, haven’t you?’! It seemed such<br />
a heartless thing to say. I was close to tears and said I was<br />
considering using donor sperm or even adopting if I didn’t meet<br />
a new partner very soon. She was absolutely horrified and just<br />
sat there looking at me as if I were mad! She actually said ‘I’ve<br />
never heard anything so ridiculous in my life’.<br />
“In the end I had to pretend I was joking, else we would have<br />
fallen out over it. It’s so sad though that I can’t discuss with<br />
my own mum my need and desire to have another baby, but<br />
she really does see me as being too old and indeed, too single<br />
now, and so the subject, as far as she’s concerned, is closed. It<br />
most certainly isn’t for me though. I am determined to be a mum<br />
again, I am 37, not 57, and there are options open to me. And<br />
frankly, whether it upsets people or not, I have totally come to the<br />
conclusion that I don’t need a relationship or a man in my life<br />
full-time to do it.’<br />
• 1. Why aren’t you starting a family yet?<br />
People presume things all the time in life and rarely mean to hurt<br />
when they ask this question. I think it helps to spend a little time<br />
just pondering your reply and I encourage the people I work with<br />
to jot down their ‘stock answer’. It can be different for different<br />
people – one response for work colleagues and general acquaintances;<br />
a different, deeper answer for family and friends and people who<br />
really know you. From clarity you get confidence.<br />
• 2. Wild Confidence – You’ll be FINE!<br />
It’s very helpful to stay relaxed and positive during this process<br />
and to learn to be in a balanced emotional state. You can achieve<br />
this through meditating, gentle exercise or saying a positive<br />
affirmation – like “I am grounded, centred and positive.”<br />
The emotional rollercoaster of IVF and fertility treatment is<br />
tough enough without wildly exaggerated hopes or fears. So it<br />
helps to stay grounded, positive, relaxed and focussed on being<br />
happy throughout the process whilst also learning to adopt the<br />
attitude of gratitude for all the good things in your life. This helps<br />
you to filter life through the positive and will help you to feel more<br />
balanced and in control of your life.<br />
• 3. “You can always adopt”... “Not meant to be”<br />
It helps to see life from the perspective of other well-meaning<br />
friends and family. One simple exercise I do is to stand on a piece<br />
of paper with your friend/family/partner’s name on it and assess<br />
what you see from there, hear what you hear and feel how you<br />
feel from your friend/family/partner’s perspective.<br />
This helps you to see life from your friend’s, mother-in-law’s,<br />
or sister’s point of view. This exercise helps you to focus on their<br />
intention in this remark; usually it is to help you cope with the<br />
possibility of disappointment.<br />
• 4. It’s my life<br />
The journey of fertility is a very private and individual experience<br />
for each person, as well as for each couple. I think it’s helpful to<br />
remember that one size really doesn’t fit all during this process,<br />
and people only have to be confided in on a ‘need to know’ basis.<br />
You choose who you give a ‘stock’ answer to, and who you share<br />
your inner most thoughts with.<br />
For more information and advice from Sue Atkins please visit<br />
www.positive-parents.com<br />
22 fertility road | november - december
INTERVIEW | Toni Weschler<br />
words | Olivia Gordon<br />
© Annie Marie Musselman / www.anniemusselman.com<br />
24 fertility road | november - december
She is a fertility expert who has transformed the way millions of<br />
Americans think about their bodies. Across a generation’s span,<br />
where science and technology has left remarkable, dazzling<br />
imprints on fertility, Toni Weschler’s impact has been profound.<br />
Profiled now alongside the modern greats of reproductive<br />
communication, she gives an exclusive interview to<br />
<strong>Fertility</strong> <strong>Road</strong> magazine...<br />
TEACHER:<br />
TONI<br />
Sadly, a modern education still leaves women<br />
in the dark about their own bodies. We now<br />
have a generation of women in their 30s and<br />
40s who were taught nothing whatsoever<br />
about their fertility and have not the slightest clue<br />
about how the female reproductive system works.<br />
Essential facts every woman should know - for example<br />
that it’s possible to predict your next period if you know<br />
when you ovulated because the luteal (post-ovulation)<br />
phase has a consistent length in each woman, while<br />
the follicular (pre-ovulation) phase varies each cycle; or<br />
that cervical mucus with an ‘egg white’ appearance is a<br />
healthy sign of high fertility - were simply not included<br />
in our school ‘sex education’ lessons.<br />
Women today have left conceiving much later, and<br />
when we finally stop taking the pill to get pregnant, we<br />
suddenly realise we know nothing about our natural<br />
cycles. Tragically, we usually only come to understand<br />
our own biology at a late stage - when often, the time<br />
pressures are starting to become unbearable.<br />
In this era when women want to know as much as<br />
possible about their bodies, the new science of fertility<br />
awareness, made available with the advent of the<br />
digital thermometer in the 1970s, is more popular than<br />
ever. Our mothers are mystified to see our carefully<br />
plotted graphs. “It was so different in the 70s,” Suzanne,<br />
a 69-year-old writer, recalls. “We were vaguely aware<br />
the middle of the month was fertile, but getting pregnant<br />
just happened; we didn’t try.”<br />
But women trying to conceive today are older than ever<br />
before, desperate for knowledge so we can understand our<br />
natural cycles and maximise our chances of conceiving,<br />
fast - which is why modern women are getting hooked<br />
on the fertility awareness movement, the bible of which<br />
is the super-selling book Taking Charge of Your <strong>Fertility</strong><br />
by American Toni Weschler. Published in 1995, the book<br />
was the first to explain - in amazing detail - how to get<br />
pregnant by monitoring and recording on a chart the<br />
body’s daily fertility signs, including waking temperature,<br />
which rises after ovulation; cervical fluid (dry in infertile<br />
times of the month, increasingly creamy and then like egg<br />
white as you approach ovulation); and cervical position.<br />
And although these facts are now all over the internet<br />
and other fertility books, the fact remains that TCOYF<br />
explains them in the most comprehensive and authoritative<br />
detail - it’s still the biggest and the best manual for understanding<br />
your fertility. The book is currently ranked at<br />
number three out of the nearly 19 million published<br />
books sold on Amazon.com when it comes to customer<br />
ratings (trumped only by two Harry Potter novels). But<br />
that’s not down to marketing or publicity - TCOYF remains<br />
an underground, word-of-mouth fertility phenomenon. »<br />
www.fertilityroad.com<br />
25
INTERVIEW | Toni Weschler<br />
Women who read TCOYF<br />
felt cheated to discover that they<br />
had been taking the pill with all<br />
its side effects for years without<br />
knowing that, by charting, they<br />
could reasonably safely have sex<br />
at infertile times of the month.<br />
© Chris Scredon / iStockphoto.com<br />
Usually what happens is that when a woman starts ‘trying’, a<br />
clued-up friend who’s been trying for a while shows her some<br />
fertility charts, and asks incredulously if she’s never heard of<br />
‘Toni’. That’s Toni Weschler, she explains, a cult figure to women<br />
trying to conceive.<br />
As an undergraduate studying Psychology, Weschler found<br />
herself running to the gynaecologist every month - like many<br />
women, she felt ashamed and concerned about the white<br />
discharge that returned again and again and wondered what<br />
was wrong with her. “It wasn’t until years later, in the mid-<br />
1980s, when I was told this was a normal fertility sign that<br />
occurs before ovulation, that I had my light-bulb moment,”<br />
Weschler, now 54, recalls.<br />
“Oh my God - all those years I thought I was dirty, when I was<br />
completely healthy and my body was doing exactly what it was<br />
meant to do and showing me signs telling me what was going on<br />
inside. And this made me so mad. I thought, it is unacceptable that<br />
in today’s times, women have no clue how their bodies work.<br />
I wanted to yell it out to every woman: there is a world of<br />
knowledge in your body.”<br />
Weschler achieved a Master’s degree in Public Health and tried<br />
to raise awareness among doctors - but, she recalls, they wrongly<br />
equated fertility awareness with the entirely discredited rhythm<br />
method, with which it has nothing in common – “it was humiliating<br />
and made me even angrier”, Weschler says. With no other options,<br />
she set up fertility awareness seminars for couples in her living<br />
room in the late 1980s, then wrote TCOYF.<br />
A tidal wave of responses came from thousands of women from<br />
all over the world, who flooded (and still flood) Weschler’s PO<br />
Box with letters – “I can’t even count how many”, she says, “all of<br />
them saying ‘This book has changed my life - why wasn’t I taught<br />
this stuff as a teenager, instead of whether to wear sanitary pads<br />
with wings or not?’’’.<br />
Women who read the book felt cheated to discover that they<br />
had been taking the pill with all its side effects for years without<br />
knowing that, by charting, they could reasonably safely have sex<br />
at infertile times of the month. And that they had been trying to<br />
get pregnant without taking into account, for instance, that they<br />
had an abnormally short luteal phase which didn’t allow for implantation.<br />
Thus, that they weren’t producing enough fertile cervical<br />
mucus to allow semen to travel towards the egg. Or that<br />
they weren’t ovulating at all - facts which charting clearly shows.<br />
Yet in both the UK and US, many doctors still don’t take<br />
fertility awareness seriously - or are even uneducated enough to<br />
believe that every woman ovulates on day 14 of her cycle. The<br />
official advice for conception from the NHS website, indeed, is<br />
to have sex throughout the month, with no need to time intercourse<br />
to ovulation (which, it says, ‘usually happens about 14<br />
days after the first day of your last period’). Given that many<br />
women ovulate early or late, and know thanks to charting »<br />
www.fertilityroad.com<br />
27
INTERVIEW | Toni Weschler<br />
or ovulation tests when they are fertile, this advice<br />
seems dismissive and dumbed down.<br />
“Doctors insult women who chart to get pregnant by<br />
rolling their eyes,” notes Weschler. “Yet no doctor can<br />
know a woman’s body better than she does.”<br />
The charting pioneer, who lives in Seattle, believes that<br />
it’s still the case that not enough of us are fertility-aware,<br />
and this could well be at the root of struggles to conceive,<br />
ironically despite all the high-tech options now on offer. The<br />
low-tech, DIY methods of fertility charting are, Weschler<br />
feels, by contrast a simple and reliable knowledge base.<br />
“Of all of the fertility treatments developed in the past<br />
few decades, IVF has undoubtedly helped more couples<br />
than any other, which is extraordinary. But its appeal as<br />
the end-all, be-all, is also insidious,” she says.<br />
“I have major concerns about women being put through<br />
this incredibly expensive and invasive procedure when they<br />
have not been taught the most fundamental information<br />
necessary to achieve pregnancy: the <strong>Fertility</strong> Awareness<br />
Method. By charting their cycles, they may be able to conceive<br />
on their own by simply learning how to identify their<br />
most fertile phase, or potential problems that can be easily<br />
rectified before moving onto something as invasive as IVF.”<br />
So at what point should fertility charting take second<br />
place to medical treatment like IVF? “If a couple is officially<br />
diagnosed with a physical problem such as blocked tubes,<br />
then no amount of charting is going to help them to conceive,”<br />
says Weschler. “But in most other cases, charting<br />
works beautifully in conjunction with fertility treatments<br />
to help the couple take control of their medical management,<br />
rather than feeling like it is all being done to them.<br />
“Ultimately, if a couple has actively timed intercourse<br />
perfectly for at least 4-6 cycles (for women 35 and over)<br />
or 6-8 cycles (for women younger than 35), then it is<br />
time to seek medical treatment. But the operative phrase<br />
here is ‘timed perfectly’. That means that they know her<br />
cycle so well that they know if she is ovulating altogether<br />
and they have consistently timed intercourse around ovulation.”<br />
Some women can’t be bothered with charting (“It just makes<br />
me think ‘maths’’’, says Sophie, a 32-year-old photographer, in<br />
horror), and the average man would rather eat his own fist than<br />
check out his wife’s chart. But the practice appeals enormously to<br />
women who like to have a plan.<br />
Still, taking your temperature can too easily become the focal<br />
point of each day. You irrationally find yourself looking at<br />
your chart every few hours in case it tells you you’re pregnant, or<br />
worrying over signs and symptoms.<br />
Weschler stresses that charting should be about seeing “the<br />
big picture, not obsessing over one single temperature or letting<br />
your life get consumed by minutiae.” Still merrily ovulating, and<br />
charting on paper, she sees charting, when done right, as a worthy<br />
object of one’s attention and pride. “I’ve been charting 28 years and<br />
my charts are a thing of beauty - I love showing them to people! Seeing<br />
the patterns of what a woman’s body does is a fascinating privilege.<br />
Still, at a certain point, you do have to get on with everyday life.”<br />
So if she could give one piece of advice to a couple wanting a<br />
baby, what would it be? “It would be to focus on her cervical<br />
fluid,” says Weschler. “She should try to have intercourse every<br />
Doctors insult women who chart<br />
to get pregnant by rolling their eyes,<br />
yet no doctor can know a woman’s<br />
body better than she does.<br />
day that she has wet, slippery cervical fluid at her vaginal<br />
opening - or every other day if the man’s sperm count is low.”<br />
Of course, fertility awareness doesn’t end with pregnancy<br />
achievement. It is an invaluable tool for women dealing with troublesome<br />
or irregular periods, PMS or menopause, and can be used<br />
as a form of natural birth control. Weschler’s second book, Cycle<br />
Savvy, educates teenage girls about the female reproductive system.<br />
Hopefully, with her influence, the next generation of women<br />
will grow up with a greater understanding of their bodies.<br />
Taking Charge of Your <strong>Fertility</strong> by<br />
Toni Weschler is published by Vermilion<br />
at £20; however this British edition<br />
of 20<strong>03</strong> has not been revised like<br />
the American one over the years,<br />
and Weschler, who is currently busy<br />
revising another American edition due<br />
in 2012, recommends British readers<br />
buy the more up-to-date American<br />
version published by Collins in 2006<br />
(available from Amazon.com from $8).<br />
28 fertility road | november - december
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For 25 years these fertility monitors have been a great success<br />
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objects on the bedside tables of satisfied women. In a report by the<br />
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Cyclotest fertility monitors were judged to be the most reliable<br />
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The sharp rise in the numbers of people suffering from infertility<br />
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the practice of observing the natural symptoms of fertility of the<br />
female body.<br />
That both contraception and pregnancies can be planned is based<br />
on the fact that the monitors analyse a woman’s cycle data and pinpoint<br />
her fertility window, her ovulation and infertile phases. This is<br />
achieved using a combination of the classic temperature method to<br />
identify subtle changes of Basal Body Temperature (BBT) associated<br />
with ovulation and additional observations of fertility symptoms.<br />
This process of determining the cycle data – known as the<br />
symptothermal method – is safe, natural and effective. The fertility<br />
monitor is extremely easy to use: directly upon waking, you take<br />
your temperature inside your mouth with the integrated thermometer.<br />
The highly sensitive sensor picks up even the slightest<br />
INTELLIGENT PROFILE<br />
temperature fluctuations. To increase the monitor’s<br />
effectiveness, you can input a further<br />
indicator of fertility once a month. Different<br />
options are available, varying depending on<br />
the time they take and the complexity of the<br />
procedure involved.<br />
Firstly, you can use the values of the ovulation<br />
hormone LH (luteinising hormone), which<br />
can be detected with additional ovulation tests.<br />
Or you can use observation of the cervical<br />
mucus consistency and the extent to which the<br />
neck of the uterus is open as an indicator of<br />
the body’s readiness to facilitate or prevent<br />
pregnancy. It is extremely easy to input these<br />
observations using buttons on the monitor.<br />
Cyclotest Baby has a very clear LCD display<br />
which shows your current cycle and its fertility<br />
window. Knowing the 6-8 days every month<br />
when intercourse could result in pregnancy<br />
makes Cyclotest Baby a great natural contraceptive<br />
choice. By abstaining or using barrier<br />
contraceptives during their fertility window,<br />
women avoid having to take the pill and all of<br />
the risks and problems which accompany it.<br />
What works for contraception can be turned<br />
around and also applied to pregnancy planning.<br />
When it’s time to plan for a baby there’s<br />
no need to wait months on end for the pill to<br />
be flushed from the body and hormone levels to stabilize. In fact<br />
Cyclotest Baby already knows when you’re fertile and when you’re<br />
ovulating so you can get to work straight away!<br />
It should be remembered that intercourse during a woman’s<br />
fertility window still isn’t a guarantee for conception as there are<br />
many other factors, some which are completely out of your control.<br />
Cyclotest Baby is recording your Basal Body Temperature (BBT),<br />
your menstruation dates, any LH hormone or cervical mucus observations<br />
which you make and charting it all in its software. In the<br />
case of needing to consult a fertility specialist this data is a goldmine<br />
which can speed up diagnosis of a huge range of fertility issues in a<br />
woman even during IVF treatment. Cyclotest Baby comes with a CD<br />
and USB cable for downloading all of that data and printing it out in<br />
a fertility chart which any fertility specialist will be familiar with. It<br />
has been scientifically proven that, by using Cyclotest Baby, couples<br />
who have been trying unsuccessfully to have a baby succeed in getting<br />
pregnant much faster and more safely than if they were to take<br />
highly burdensome hormone treatments.<br />
Getting pregnant with Cyclotest Baby is child’s play – and<br />
healthy too!<br />
Cyclotest Baby is available for<br />
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in the UK and Ireland. For more<br />
information about Cyclotest Baby<br />
call 0208 1331 700 or visit<br />
www.get-pregnant-cyclotest.co.uk<br />
www.fertilityroad.com<br />
29
FEATURE | fertility on ice<br />
FERTILITY<br />
ON<br />
Three years ago, two major UK fertility clinics launched a ‘social egg freezing<br />
service’, creating widespread controversy. Johanna Payton investigates<br />
whether women who ‘invest their eggs in the bank’ are still causing a stir.<br />
Healthy women putting their biological clocks on hold<br />
has polarised opinion. When the Bridge <strong>Fertility</strong><br />
Centre and Care <strong>Fertility</strong> launched their social egg<br />
freezing programmes in 2007, they were hailed<br />
as liberating independent women - and simultaneously vilified<br />
for facilitating the ethically reprehensible whim of middle class<br />
careerists with money to burn.<br />
Historically, the process had been undertaken for medical<br />
reasons; women who were undergoing chemotherapy, which can<br />
temporarily or permanently damage fertility, were most likely<br />
to freeze their eggs. Healthy women who wanted children, but<br />
wished to pursue a career or stable relationship first, did not have<br />
access to the service. The success rates of the technology were<br />
deemed too low; doctors worried that fertile women could allow<br />
their chance of natural conception to slip away, then discover<br />
that their ‘defrosted’ eggs were not viable.<br />
But new freezing techniques with higher success rates emerged.<br />
Vitrification, where water from the eggs is removed and they are<br />
flash-frozen, was introduced. Clinics claimed that vitrified eggs<br />
could emerge from years in storage in almost the same condition<br />
as when they were released from the ovaries. In Japan, where<br />
vitrification techniques were developed, scientists showed that<br />
90-95% of eggs could survive the freezing method, compared<br />
with 50-60% using conventional methods.<br />
As a result, HFEA figures showed that 78 UK women chose to<br />
freeze their eggs for non-medical reasons in 2007, up from 33<br />
in 2006. Today, over 40 UK clinics offer egg freezing services for<br />
lifestyle rather than medical reasons and several hundred British<br />
women have put their eggs on ice to date. Eggs can remain frozen<br />
for a maximum of 55 years subject to the patient’s consent and<br />
maintaining a financial agreement with the clinic for storage.<br />
Although the procedure is becoming widespread, the ethical<br />
and medical debate rages on. In 2009, the Royal College of<br />
Obstetricians and Gynaecologists and the British <strong>Fertility</strong> Society<br />
released a joint statement expressing serious concerns about<br />
freezing eggs for non-medical reasons. They said the success rate<br />
for pregnancies involving frozen eggs was low, and that the<br />
babies may be less healthy than those from fresh eggs.<br />
Quoted in The Guardian at the time of the statement, Bill Ledger,<br />
professor of obstetrics and gynaecology at Sheffield University<br />
and a member of the Human Fertilisation and Embryology<br />
Authority, said: “We should be very careful about performing<br />
30 fertility road | november - december
words | Johanna Payton<br />
medical procedures on healthy people. The<br />
group I worry about are women who are<br />
healthy and want to have kids, but do it<br />
later. The image that’s portrayed [of egg<br />
freezing] is that a woman in her late 20s or<br />
early 30s can establish a relationship 10 or<br />
15 years later and then take the eggs out of<br />
the freezer, fertilise them with the partner’s<br />
sperm and have the baby. That’s the dream.<br />
“The central issue is that it doesn’t work very well. By egg<br />
freezing for social reasons, they are taking a huge gamble for<br />
their future.”<br />
But in spite of the warnings, and the cost - around £5,000<br />
- women continue to seek the procedure. Dr. Alan Thornhill,<br />
scientific director at the London Bridge <strong>Fertility</strong>, Gynaecology and<br />
Genetics Centre, says “people are grown-ups and should make<br />
their own decisions”, but adds that egg freezing technology is still<br />
developing and there are drawbacks to consider. “Most laboratories<br />
can offer this service,” he says, “but women should be aware<br />
that apart from embryo transfer, the process is the same as IVF,<br />
including ovarian stimulation. No punches should be pulled from<br />
explaining this.”<br />
Although any risks to a woman’s health are minimal, Thornhill<br />
agrees that the effectiveness of egg freezing is still debatable. He<br />
says that while success rates are primarily governed by the age of<br />
the woman (the average age of social egg freezers in 2007 was<br />
37), there is also some manipulation of the egg involved.<br />
I doubt that most of these women<br />
will ever return. In many cases, social<br />
freezing really is an insurance policy and<br />
these women find their own solution.<br />
“When we collect eggs, they’re coated in granulosa cells, which<br />
are beneficial to the egg,” he explains. “We strip off those cells to<br />
access the egg and determine whether or not it will mature. It<br />
could be detrimental to the egg not to have those cells around for<br />
longer and, in the future, we may store eggs in their cumulous<br />
cells, so they’re more natural.<br />
“Another issue is the number of eggs we can freeze,” he adds.<br />
“At the moment, the standard is to freeze eggs at the second<br />
metaphase, when they’re ready for fertilisation. How many eggs<br />
are at this stage depends on an individual body’s response to the<br />
stimulation. It can be disappointing for clients to discover that,<br />
from a good haul of eggs, only a handful can actually be frozen.”<br />
Dr. Thornhill agrees that conceiving a baby naturally is always<br />
preferable to IVF, when a woman has a choice, because there is<br />
a higher chance of success.<br />
He also says that freezing embryos rather than eggs, if a woman<br />
has a partner but is trying to store her fertility for the future,<br />
is advisable - but there may be additional legal and ethical »<br />
www.fertilityroad.com<br />
31
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FEATURE | fertility on ice<br />
of their fertility potential, including ovarian<br />
reserve.”<br />
Dr. Thornhill agrees that a fertility<br />
assessment can be a major factor in helping<br />
women decide if social egg freezing is<br />
right for them. “<strong>Fertility</strong> screening gives<br />
women a clear idea of where their fertility<br />
is right now. We had a patient in her 20s<br />
who had her life mapped out - but finding<br />
out she had a low ovarian reserve changed<br />
her plans. She opted for immediate IVF<br />
and had a baby. It was a very positive<br />
outcome for her.<br />
“More women talk to us about egg<br />
freezing than actually go through with it.<br />
Some get a clean bill of health and<br />
because their mind has been put at rest,<br />
they no longer feel the need to freeze their<br />
eggs. Even if they don’t have the freezing<br />
done, they leave with an awareness of<br />
their fertility, which is a gap in most<br />
people’s knowledge.”<br />
While some women stop at a fertility<br />
screening, Thornhill says that over 100<br />
women have had their eggs frozen at Bridge<br />
for social reasons. As yet, none have come<br />
back to use them. “I doubt that most of these<br />
dilemmas to face. “If either partner doesn’t<br />
want the embryos to be used, there is a<br />
cooling off period, but after that, they<br />
can’t be transferred,” he says. “People may<br />
also find it harder to throw embryos away<br />
if they can’t use them. However, they’ve<br />
still made a big investment, financially<br />
and emotionally, by freezing their eggs.”<br />
Gosia Heeley is resident counsellor at<br />
the London <strong>Fertility</strong> Centre (LFC). She says<br />
that social egg freezers are increasingly<br />
informed and have undertaken a huge<br />
amount of research prior to making their<br />
decision. “Most women I meet are either<br />
delaying motherhood because of their<br />
career or they haven’t found the right<br />
partner and are concerned about their age<br />
and the quality of their eggs,” she says.<br />
“It’s important to have choices open to you<br />
throughout life, and I’m behind social egg<br />
freezing as a treatment option. However, it’s<br />
crucial that the implications are fully considered<br />
prior to treatment being undertaken.<br />
“Patients wishing to invest in egg freezing<br />
at LFC, whether social or medical, receive<br />
counselling. We look at the implications<br />
of the patient’s decision, which includes<br />
motivation, understanding the process and<br />
legalities, and the implications relevant to<br />
their personal life and future.”<br />
The image that’s portrayed [of egg<br />
freezing] is that a woman in her late 20s<br />
or early 30s can establish a relationship<br />
10 or 15 years later. That’s the dream.<br />
Heeley says that different clinics follow<br />
different protocols and counselling sessions<br />
vary, but presses home the reality that<br />
every woman interested in freezing her<br />
eggs needs to consider how they will feel<br />
if their eggs do not prove to be viable<br />
when they are ready to try for a child.<br />
“The worry is that women put all of their<br />
fertility hope and aspirations into the<br />
frozen eggs,” she says. “Women need clear,<br />
realistic boundaries and limits when<br />
considering whether to proceed with this as<br />
an insurance policy. If the eggs do not result<br />
in a viable pregnancy, the women will have<br />
to face a multi-layered grieving process.<br />
“Social egg freezing can be a realistic<br />
and successful treatment option for some,<br />
but not all, women,” she adds. “Before<br />
they make their decision, they should<br />
have a consultation with a clinician who<br />
will discuss their options and inform them<br />
women will ever return. In many cases,<br />
social freezing really is an insurance policy<br />
and these women find their own solution.<br />
“But women who make the decision to<br />
freeze their eggs are driven in a different<br />
way to other patients, and that’s interesting<br />
in itself. Studies may be done, and it would<br />
be fascinating to know more about the<br />
motivations of social egg freezers and<br />
whether they really consider it to be a<br />
guarantee – which it isn’t. In my experience,<br />
they want to do everything they can to<br />
protect their fertility and they don’t want<br />
to have any regrets. The balancing act for<br />
us is to respect their right to treatment,<br />
whilst being honest about their chances<br />
of success.<br />
“These women may still cause controversy,<br />
but investing so much time, money<br />
and energy for the future certainly shows<br />
how seriously they take their fertility.”<br />
www.fertilityroad.com<br />
33
FEATURE | same-sex parenting
WORDS | HAZEL DAVIS<br />
Our series of features on same-sex<br />
parenting this time looks at the industry<br />
from the perspective of gay couples.<br />
Are men really afforded the same<br />
privileges as women, and what are<br />
the attitudes surrounding fathers?<br />
MAN<br />
ALIVE<br />
© BananaStock<br />
It’s every woman’s right to have a child, correct? But<br />
what about when you’ve dreamed of being a father<br />
ever since you can remember?<br />
Back in April, the law changed to allow gay male<br />
couples to have both their names on a child’s birth certificate.<br />
Prior to this, only heterosexual couples were allowed to do<br />
this. The law change meant that same-sex couples could<br />
finally be recognised as official parents.<br />
So you’re finally allowed. Hurrah. But how do you get to<br />
that joyous day?<br />
The landscape for gay men and child-rearing is muddy<br />
as you might expect. Society accepts that women have<br />
‘the right’ to have children but does it hold the same view<br />
for men? And what are the options for men who want to<br />
reproduce without being in a relationship with a woman?<br />
You can, of course, pass on your genes by donating<br />
sperm without taking any parental responsibility, or you<br />
could opt to co-parent with a single woman, gay woman or<br />
consenting couple.<br />
You can also donate to an unknown person through a<br />
fertility clinic but the law change in 2005 means that your<br />
biological child can trace its biological father when it’s 18.<br />
Some gay men donate to friends or through a connection<br />
service such as Pride Angel or Gay Family Web. Gay Family<br />
Web was set up to provide couples with connections to<br />
suitable donors, to offer access to equipment and testing, as<br />
well as providing a discussion forum. There are 500 women<br />
registered and just under 200 donors in the UK, though<br />
there are plans to go international.<br />
Pride Angels is a site dedicated to connecting sperm<br />
donors, egg donors and co-parents. The free-registration<br />
site also specialises in health screening advice, fertility law<br />
support, artificial insemination and fertility products.<br />
Same-sex couples have been allowed to legally adopt in<br />
the UK since 2002, but surrogacy is usually the preferable<br />
option for gay men who wish to become full-time parents.<br />
In surrogacy, a woman carries the baby using her own eggs<br />
or those of another egg donor.<br />
The new law states that provided a court is satisfied that<br />
two men are in a stable relationship, that no fees – beyond<br />
expenses – are paid to the surrogate mother and that it is in<br />
the child’s best interest, then it will award a parental order<br />
for a birth certificate to be drawn up with both men named as<br />
parents and therefore legal guardians. This makes it much<br />
easier for gay men to father their own children naturally,<br />
meaning that adoption is not the only option.<br />
Special provision was also made for gay couples who could<br />
not previously apply so that those with existing surrogate<br />
children born before April 6, 2010, were given until October 5,<br />
2010 to apply.<br />
Though surrogacy in the UK is legal, the UK system<br />
means that if the surrogate decides that they have »<br />
www.fertilityroad.com<br />
35
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FEATURE | same-sex parenting<br />
changed their mind, they can keep the baby after<br />
it is born. Therefore it’s imperative to seek legal<br />
advice if you’re planning on going down the<br />
surrogacy route.<br />
Barrie and Tony Drewett-Barlow are probably the world’s most<br />
famous gay fathers. They made history in July this year when they<br />
were jointly registered as fathers at the christening of their fourth<br />
and fifth children.<br />
The couple now have the family they always dreamed of<br />
together. But getting there has been no cakewalk. The process<br />
started at a young age for Barrie. He told his parents he was gay at<br />
the age of 14. His mother was not upset at his sexuality, but more<br />
that his life wouldn’t involve children. He met Tony at 19 and when<br />
one of their friends entered into a co-parenting situation with a<br />
lesbian friend they started thinking about having children.<br />
“It was always there in the background,” he says, “but we didn’t<br />
really want to co-parent. We didn’t want to be part-time parents.”<br />
And because of that there was a financial pressure. “As a gay man<br />
you have to be in a position to be a father,” says Barrie, “you don’t<br />
suddenly get a girl pregnant when you’re a gay man. You have to<br />
prepare and plan.”<br />
In 1994 the couple made an application to their local council to<br />
adopt a child. They went through the whole process, interviewing the<br />
couple’s relatives. In the end the council refused their application<br />
As a gay man you have to be in a<br />
position to be a father, you don’t suddenly<br />
get a girl pregnant when you’re a gay<br />
man. You have to prepare and plan.<br />
but said they would consider an application for a child with<br />
severe learning difficulties. Says Barrie, “They made it so hard for<br />
us but we said, ‘yes, ok’ and played their game.”<br />
The couple were offered, says Barrie, the worst cases possible:<br />
“They were finding severely disabled children just to try and put us<br />
off but we went back to the panel with glowing reports.” And still they<br />
said no. At the time explains Barrie, there was no real recourse to this<br />
so they went through what Barrie calls a period of mourning: “We<br />
just thought there was no way we could have children of our own.”<br />
But one day Barrie was messing around on the internet and<br />
came across some surrogacy sites and it snowballed from there.<br />
“In those days it was quite new,” he says, “and many of the agencies<br />
I found (in the US) explicitly said they wouldn’t help homosexuals.”<br />
At this time Barrie and Tony had sold a couple of businesses and<br />
were doing well financially and, “after weeks of nagging Tony”<br />
they went to LA. They found an agency which catered for gay men<br />
and they set about choosing an egg donor and surrogate.<br />
It was quite a straightforward process says Barrie. “The director<br />
showed a catalogue of egg donors and we pulled out eight or so<br />
that we liked from around 50.” The second one they saw they »<br />
www.fertilityroad.com<br />
37
FEATURE | same-sex parenting<br />
The application for a parental order must be made within six months<br />
of the birth. There are no extensions on this and taking legal advice<br />
late could make the process lengthier. If the parental application<br />
is not made, then it might be possible to get a residence order,<br />
though obviously this is less desirable. The intended parents also<br />
need to satisfy the court that the child’s home is with both parents.<br />
One of the partners needs to be domiciled in the UK.<br />
Commercial surrogacy is illegal so the expenses process must be<br />
navigated carefully. The court has to authorise all expenses paid<br />
and these include things like medical bills and insurance and<br />
nothing which implies the buying of a child. This is authorised at<br />
the end of the case so the intended parents need to make sure they<br />
handle the process correctly from the start or risk losing the<br />
parental order. There is always the risk that the expenses could be<br />
unauthorised and this is particularly worrisome if the parents have<br />
gone to a country (India, for example) where what’s construed as<br />
an excessive amount may differ. And in these cases, the court has<br />
to be happy that it’s not sanctioning something illegal.<br />
And once you’ve sorted the above, you’re faced with the possibility<br />
that the surrogate can change her mind. Under English family law,<br />
the surrogate remains the mother until the parental order is<br />
obtained. She can change her mind at any point up to this. Moreover, if<br />
she is married, her husband has to give consent as he is legally the<br />
father. However, the surrogate’s consent is invalid unless it’s given<br />
within six weeks after the birth. Pre-natal consent is disregarded.<br />
This is, of course, very stressful for the intended parents as<br />
the birth mother could changed her mind at any time. “It doesn’t<br />
fell in love with and she ended up being the<br />
biological mother of three of their five children. Barrie<br />
explains, “We picked her for her personality and her<br />
views on life. She was very in tune with us.”<br />
But the second time round it was a different matter.<br />
Says Barrie, candidly, “We just found someone amazingly<br />
good looking. The first time we went into it we<br />
wanted to study people and suss them out but then<br />
we realised that our children are a product of us and<br />
the egg donor and surrogate are only responsible for<br />
their living and breathing.”<br />
Barrie and Tony’s children know all about their egg<br />
donors and surrogate mothers and they are in touch on a weekly<br />
basis. “We have always been honest,” he says, “we’re so high-profile,<br />
how could we not be?”<br />
Tony and Barrie now have the family they always wanted but<br />
it’s not always easy. “We had no responsibilities and loads of cash,”<br />
he says. “Because of that, it was easy for us, but I get letters from<br />
people all the time who’ve been refused treatment. It can be heartbreaking.”<br />
Even while the couple were going through their first<br />
failed IVF attempts, both of Barrie’s sisters announced they were<br />
pregnant. He says, “It’s just devastating.”<br />
The surrogacy process can be a legal minefield, says John Randle<br />
of law firm Lester Aldridge, which specialises in fertility cases.<br />
Now gay men can apply for a parental order, says Randle,<br />
it’s crucial to get legal advice early on. “There are quite a lot of<br />
conditions the intended parents have to satisfy before they are<br />
granted the parental order.”<br />
Firstly, they have to prove a biological link to the child, which is<br />
easy enough. Then they have to satisfy the court that they are either<br />
civil partners or two people living in an “enduring family relationship”.<br />
Surrogacy is definitely now more<br />
open to more people, and things are<br />
changing, in fact the whole dynamic<br />
has changed. There are hundreds<br />
of same-sex families in the UK and<br />
thousands around the world now.<br />
happen a lot”, says Randle, “but I did come across a case the other<br />
day where the surrogate appeared to be having second thoughts.”<br />
Barrie and Tony were trailblazers, though he says they never<br />
set out to be. “Surrogacy is definitely now more open to more<br />
people,” says Barrie, “and things are changing, in fact the whole<br />
dynamic has changed. There are hundreds of same-sex families<br />
in the UK and thousands around the world now.”<br />
For qualified information and advice on same-sex parenting why<br />
not head to www.prideangel.com. Founded by scientists Erika<br />
and Karen, Pride Angel is an independent connection service,<br />
committed to helping single, lesbian, gay and infertile couples<br />
become parents through donor conception and co-parenting.<br />
GayFamilyWeb.co.uk link to donors from all over the UK, whilst<br />
also giving sperm donors access to people who need them. The site<br />
has only been online for a couple of years, but using the creators’<br />
personal experience as a guide, aims to provide a straightforward<br />
and easy-to-follow service with support and advice at its heart.<br />
38 fertility road | november - december
FERTILITY ROAD | California <strong>Fertility</strong> Partners<br />
INTELLIGENT PROFILE<br />
A PARTNERSHIP<br />
THAT COUNTS...<br />
For many, the prospect of travelling abroad to combine the<br />
promise of raising a family with the opportunity to relax<br />
is an exciting one. And with the first considerations<br />
always being quality, care and professionalism, many<br />
believe that the US offers something that cannot be found elsewhere.<br />
Certainly, when you have a clinic that boasts 25 years experience<br />
yet is based in the sun-drenched, fashionable and fantastically<br />
cultural city of Los Angeles, it is a combination that is really<br />
quite unique.<br />
To enable a couple to truly envelop themselves in a life-changing<br />
trip means slipping into an environment that heightens the senses,<br />
offers a distraction from the scientific and emotional stresses, and<br />
provides an experience that is truly one to remember.<br />
With that in mind, California <strong>Fertility</strong> Partners firmly believe that<br />
they have cracked the combination code. It’s a clinic that undertakes<br />
extensive surrogacy and egg donor options, and one that has<br />
always focused attention on the lesbian and gay parenting market,<br />
calling upon experience at the highest level of family planning.<br />
For Dr. Guy Ringler, one of the co-partners of the practice, and<br />
recipient of the American <strong>Fertility</strong> Association’s Visionary Award<br />
for 2010, believes the clinic’s Los Angeles base represents something<br />
rather special.<br />
“Patients arriving in Los Angeles from around the globe will find<br />
an exciting cosmopolitan city with something to offer everyone.<br />
From the mountains to the seashore, the area provides a physically<br />
beautiful landscape, the finest in art, music, shopping, restaurants,<br />
and a creative community filled with passionate people from many<br />
diverse backgrounds.<br />
“But it’s our longstanding reputation for excellence and a<br />
commitment to providing high quality care in a personalised and<br />
caring environment that makes us stand out. In short, it’s important<br />
to work with people who care about you and<br />
your success. We do that, always.”<br />
Dr. Ringler’s attention to detail and commitment<br />
to providing the highest quality of care possible<br />
results in some of the highest pregnancy rates<br />
possible today. Factors such as the young age of<br />
egg donors, closely monitored ovarian stimulation,<br />
thorough screening of gestational carriers,<br />
excellent culture conditions, and meticulously<br />
conducted embryo transfers all contribute to his<br />
high level of success.<br />
It’s thanks to this that Dr. Ringler has been<br />
able to help gay patients from around the world<br />
achieve their dream of having children through<br />
his care.<br />
“The acceptance of gay parenting in our society<br />
continues to improve,” he continues. “Twenty<br />
years ago the path to parenthood for gay men<br />
was uncharted and there were few resources<br />
available to help individuals find their way.<br />
“Today, thanks to the work of many dedicated<br />
professionals in the fields of reproductive law,<br />
reproductive medicine, and support organisations,<br />
there are established treatment protocols and<br />
legal foundations to allow all individuals the<br />
opportunity to build families.”<br />
Dr. Ringler and his colleagues work with<br />
some of the finest egg donor, sperm donor, and<br />
surrogacy agencies in the United States. All candidates undergo<br />
extensive medical, psychological and genetic screenings before<br />
treatment calendars are planned.<br />
That’s why California <strong>Fertility</strong> Partners has been one of the<br />
leading centres for reproductive medical care in the United States<br />
for over 25 years. And it explains too why the base’s physicians<br />
and scientists are internationally recognised for their expertise,<br />
not to mention a reputation for providing the highest quality and<br />
personalised care.<br />
Guy continues, “As societal acceptance evolves, the demand for<br />
high quality reproductive care by gay men and women increases in<br />
the United States and around the world. All patients at California<br />
<strong>Fertility</strong> Partners find an atmosphere of warmth and caring from<br />
their initial visit until graduation to their obstetrician.<br />
“Each patient is assigned to their own specially trained nurse to<br />
help guide them through the treatment process and to assist in<br />
communication between all parties. An organised team of caring<br />
professionals at all levels helps to ensure the finest care and the<br />
best treatment outcome.<br />
“At California <strong>Fertility</strong> Partners all exams and procedures are performed<br />
by your physician, not a technician or someone unfamiliar<br />
with your case. This sets us apart from other centres and allows for<br />
greater attention to detail and continuity of care. It’s this edge,<br />
along with a fantastic outer environment, that really makes us a<br />
perfect choice for couples.”<br />
To find out more, call California <strong>Fertility</strong> Partners on 001 310 828<br />
4008, contact Dr. Ringler directly at GRingler@aol.com or head to<br />
www.californiafertilitypartners.com<br />
www.fertilityroad.com<br />
39
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FERTILITY ROAD | Oregon Reproductive Medicine<br />
INTELLIGENT PROFILE<br />
UNITED<br />
STATES<br />
OF<br />
DONORS<br />
One of the most eminent infertility centres in the United<br />
States is experiencing a new following - European<br />
gay couples wanting to have a baby.<br />
Oregon Reproductive Medicine, located on the<br />
West coast in Portland, has nearly unmatched pregnancy success<br />
rates, likely the reason that same sex couples are choosing to start<br />
or grow their families at the Northwest centre.<br />
Oregon Reproductive Medicine’s four physicians, all specialists<br />
in reproductive endocrinology, work with patients from all over<br />
the globe in their well-known donor egg programme.<br />
“About half of our patients who want to have a baby via<br />
donor egg are from outside Portland,” Brandon J. Bankowski,<br />
MD, MPH, says.<br />
While Oregon is a popular tourist destination for international<br />
travellers, Bankowski believes that patients are coming to Portland<br />
for one reason, and it isn’t to see the Pacific Ocean!<br />
“They want success. That’s patients’ number one priority<br />
regardless of where they live in the world. And in their research<br />
about success rates, IVF, donor egg and gestational surrogacy<br />
programmes, they find Oregon Reproductive Medicine,” John S.<br />
Hesla, MD, says.<br />
The most recent data available from the US government shows<br />
that donor egg pregnancy success rates at Oregon Reproductive<br />
Medicine are nearly 80%, placing them near the top of all US<br />
infertility centres.<br />
European gay couples, often unable to proceed with using a<br />
donor’s eggs and surrogate in their home countries, are more and<br />
more looking to the United States for options. In the past, many<br />
patients selected centres in New York City and Boston because of<br />
their proximity to Europe. But today it’s common for these future<br />
dads to look closer at the data available through www.SART.com and<br />
base their selection on where they are most likely to have success.<br />
“It is a big decision to proceed with using a donor and working<br />
with a surrogate in the United States. So it’s imperative that patients<br />
do their homework and select a practice that is most likely to make<br />
their dream come true, and at a cost they can afford,” Jonathan<br />
Kipp, marketing director at Oregon Reproductive Medicine, says.<br />
Oregon Reproductive Medicine’s costs are often appealing to gay<br />
and straight European patients. The centre’s price plans are typically<br />
lower than infertility centres in larger US cities. Compensation for<br />
egg donors and surrogates also tends to be more affordable in<br />
smaller US cities, Kipp says.<br />
Some gay couples visiting Portland to become parents are<br />
nervous at first. After all, they are not only about to become<br />
parents but they are in a foreign country.<br />
“But they soon realise that being at Oregon Reproductive<br />
Medicine in Portland, Oregon, is about the best place they could be<br />
to move forward with their dream of a baby,” Kipp says. “We are<br />
confident that they’ll fall in love with Portland while they experience<br />
our unmatched personalised care.”<br />
Portland, home to a sizeable gay population including many<br />
couples with children, is considered one of the most gay-friendly<br />
cities in the US.<br />
“We are always happy to welcome our European patients,” Hesla<br />
says. “We not only have the opportunity to introduce them to an<br />
amazing part of the United States, but we get to watch their<br />
biggest dream come true. It doesn’t get better than that.”<br />
If you would like additional information about Oregon<br />
Reproductive Medicine’s services, or are interested in<br />
scheduling an appointment, contact:<br />
2222 NW Lovejoy. St., Suite 304, Portland, Oregon USA 97210<br />
Phone: 877-567-4994 or 5<strong>03</strong>-274-4994<br />
www.oregonreproductivemedicine.com<br />
www.fertilityroad.com<br />
41
FEATURE | worldwide web of fertility<br />
WORLDWIDE<br />
WEB OF<br />
How the greatest communication tool ever invented is helping<br />
strangers fulfil the farthest reaching fertility ambitions...<br />
OMG, DH and I DTD last night cos my I<br />
POAS and CBFM was on PK - the LH<br />
surge was super-strong - but I don’t think<br />
I’ve O’d - this AM my temp’s still 97.3 and<br />
I’ve still got tons of EWCM. How’m I gonna get DH to<br />
BD again tonight? And I’m so worried about my LP<br />
only being 8 days last cycle - do you think I have a<br />
chance of a BFP this month? Babydust!’*<br />
If you know exactly what this means - and perhaps<br />
you’ve even got a response in mind - chances are<br />
you’ve spent time on an online fertility forum.<br />
From fertilityfriend.com to peeonastick.com, twoweekwait.com,<br />
babyandbump.com and of course fertilityroad.com,<br />
the rise of fertility discussion forums on<br />
the internet has created a vast new world in which<br />
women trying for a baby are charting their fertility<br />
signs online, sharing information and trying to support<br />
one another, all talking in the language of fertility. As<br />
any poster on a fertility chatroom knows, nothing is ever<br />
‘TMI’. Posters tell one another things their partners<br />
and closest friends don’t know.<br />
Take, for instance, in-gender.com, a site for women<br />
aiming to ‘sway’ for a girl or boy, who use the forum to<br />
debate DIY techniques. On the ‘extreme swaying’<br />
board, a woman asked recently: “Can I add a calcium<br />
citrate tab to lime douche? Has anyone ever tried<br />
this?” Half-an-hour later, the first of 16 replies came:<br />
“I was doing this but you have to let it sit in the lime<br />
until it is completely dissolved. Also the pH of the<br />
solution will go up after adding the calcium so you<br />
have to adjust it accordingly. I found using the liquid<br />
calcium was much better though.”<br />
We’re living through an information revolution when<br />
it comes to fertility. This means that women trying<br />
to conceive are increasingly like walking, talking<br />
reproductive biology textbooks, sharing in-depthknowledge<br />
gleaned from the internet on, for example,<br />
the signs of low and high oestrogen and progesterone.<br />
After all, with GP appointments lasting just 10 minutes<br />
and long waiting lists or high costs to see specialists,<br />
who wouldn’t turn to the internet?<br />
“Trying to conceive can be an extreme emotional rollercoaster,<br />
with the highs each month of ‘this could be it’<br />
and the lows of ‘it didn’t work,’” says 44-year-old publicist<br />
Katrina Power of her struggle to conceive her second<br />
child. “Talking on a forum with other people in similar<br />
circumstances can be a sanity saver, as you support one<br />
another, provide advice, share tips and delight in »<br />
*Translation: “Oh my God, my darling husband and I did the deed last night because when I peed on a test<br />
stick, my Clearblue <strong>Fertility</strong> Monitor told me I was at the peak of my fertility - the luteinising hormone surge was<br />
super strong, but I don’t think I’ve ovulated - this morning I’m still at a typical pre-ovulation temperature of 97.3F<br />
and I’ve still got tons of highly fertile egg white cervical mucus. How am I going to get my husband to have sex<br />
again tonight? And I’m so worried about my luteal [post-ovulatory] phase being so short last cycle - do you think<br />
I have a chance of a big fat positive pregnancy test this month? Good luck with the baby-making, everyone!”<br />
42 fertility road | november - december
WORDS | OLIVIA GORDON<br />
We’re living through an<br />
information revolution when it<br />
comes to fertility. This means that<br />
women trying to conceive are<br />
increasingly like walking, talking<br />
reproductive biology textbooks,<br />
sharing in-depth knowledge<br />
gleaned from the internet.<br />
www.fertilityroad.com<br />
43
FEATURE | worldwide web of fertility<br />
In real life, these women reveal themselves<br />
to be lawyers, doctors, army wives, teachers,<br />
engineers, policewomen and stay at home<br />
mothers, living in America, England, Europe,<br />
Africa, the Middle East - all of them sharing<br />
an insatiable hunger for knowledge about<br />
their own reproductive abilities and pregnancy<br />
chances. It’s a fascinating all-female world, and<br />
close friendships often arise.<br />
And frequently, the advice on fertility sites<br />
goes much further than that given by scientists.<br />
Take the legendary site peeonastick.com. A<br />
‘comprehensive collection of home pregnancy<br />
test and ovulation predictor test information<br />
and images’, this die-hard site catalogues the<br />
sensitivity of tests (officially versus anecdotally),<br />
has a wealth of unbelievably detailed information<br />
on how tests work scientifically, which goes far<br />
beyond what manufacturers think women need<br />
to know, and even publishes random experiments<br />
the author has done, for example, using breast<br />
milk instead of urine on a pregnancy test.<br />
It’s surely the best of times for any woman<br />
wanting to know more about fertility, but could<br />
there also be a risk of information overload and<br />
each other’s success stories. It has the<br />
advantage of being anonymous, and means<br />
you can be completely honest about what<br />
you’re going through, without sharing too<br />
much with real life friends.”<br />
Justine Roberts, co-founder of mumsnet.<br />
com, agrees. “Our TTC (trying to conceive)<br />
discussion boards are one of the busiest<br />
parts of Mumsnet. Out there in the real<br />
world, it can be hard to find people who are in the same situation<br />
as you but, each month on Mumsnet, a new load of people<br />
aiming for a BFP (big fat positive) join a discussion thread<br />
together and find somewhere safe and supportive to vent<br />
their frustrations, sharing at the same time information about<br />
what’s worked for them during the ups and downs of trying to<br />
have a baby.”<br />
On fertility site message boards, women have posted signatures<br />
which express their desperation to conceive, perhaps even at a<br />
certain time and a certain gender (‘swaying for blue in September<br />
2011’) or their memories of babies lost in miscarriage (‘Jay: 10<br />
weeks in my womb; forever in my heart’). They have cartoon<br />
‘tickers’ which show other posters where they are in their cycle:<br />
the 30 days might be illustrated by a long, winding road, and the<br />
point they are at by an egg hatching, or a cradle.<br />
It’s a strange new world, light years away from the whispered<br />
conversations women had only a generation ago when, without<br />
the internet, infertility was something discussed discretely with<br />
your doctor and closest friends, and there were only a few books<br />
to guide you. On fertilityfriend.com, each woman’s cycle graphs<br />
are added to a vast ‘chart gallery’ where women can ‘overlay’<br />
their own chart with others’, or search for others who have<br />
similar charts to them (right down to intercourse pattern and pre<br />
and post ovulatory temperatures) and got pregnant.<br />
It’s surely the best of times for any<br />
woman wanting to know more about<br />
fertility, but could there also be a risk of<br />
information overload and old wives’ tales?<br />
old wives’ tales? Online posters hotly debate the possible fertility<br />
benefits of everything from drinking grapefruit juice to increase<br />
cervical mucus, to using an ‘instead cup’ to hold semen close to<br />
the cervix. But who can you trust? There’s very little advice<br />
available online from appropriately qualified doctors, and even<br />
when you do take the trouble to sift through all the sites written<br />
by amateurs to find those written by medical professionals, the<br />
information you find often conflicts with that from another site.<br />
Too much ‘fertility surfing’ can also lead to an unhelpful level<br />
of preoccupation that takes over hours of the day, every day.<br />
Surrounded by online friends who are equally obsessed, it’s easy<br />
to lose your sense of perspective to a point where if someone<br />
asks you what day it is, your first thought is ‘seven dpo [days post<br />
ovulation]’.<br />
Jane’s story (not her real name) illustrates both sides of the<br />
coin. She and her partner were trying artificial insemination at<br />
home. “It didn’t cross my mind at first to ask my GP how to do it,”<br />
she says – “I was too embarrassed!”<br />
It was much easier to search for information online - she found<br />
some encouraging success stories and bought a kit containing<br />
some syringes, sample pots and instructions. It was only after three<br />
months of unsuccessfully following the instructions that Jane<br />
found the courage to ask her GP if this could really work - and<br />
he explained that the instructions in the kit were incorrect. »<br />
© Yuri Arcurs / iStockphoto.com<br />
44 fertility road | november - december
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FEATURE | worldwide web of fertility<br />
FERTILITY<br />
ON THE<br />
WEB<br />
We’ve toured around the virtual<br />
world to showcase some of the<br />
best websites out there offering<br />
advice on all matters of fertility:<br />
• www.fertilityroad.com<br />
Our online supplement to the magazine you<br />
have in front of you. With additional features,<br />
comment pieces, forums, and up-to-theminute<br />
news.<br />
• www.fertilityfriend.com<br />
The internet can give us in-depth<br />
fertility education from others who have<br />
been there - often far more practical than<br />
impersonal advice in a book, and with an<br />
eye-opening international perspective.<br />
Renowned for its charting software<br />
that enables prospective mothers to plot<br />
accurately their fertile point in the month.<br />
Ad free, and free to join.<br />
• www.peeonastick.com<br />
A comprehensive collection of home pregnancy<br />
test and ovulation predictor kit information<br />
and images. The perfect back-up for home<br />
scientists!<br />
© Yuri Arcurs / iStockphoto.com<br />
“The kit had advised us to leave the<br />
semen to liquefy for 20 minutes in a<br />
sample pot before inserting it, but the<br />
GP stressed that as sperm die quickly, it<br />
should be kept warm and inserted as<br />
quickly as possible. He was completely<br />
matter of fact and supportive and even<br />
demonstrated how to release the syringe<br />
properly”, says Jane.<br />
Following the doctor’s advice, she and<br />
her partner conceived on her next fertile<br />
cycle. But the internet did also prove<br />
invaluable to her. At the last minute, she<br />
asked some fellow posters on a home<br />
insemination board who had conceived<br />
that way some questions: how long to<br />
leave the syringe in for, whether to orgasm<br />
after insemination, whether to lie on her<br />
back or turn over? Their candid answers,<br />
Jane feels, also helped her achieve success<br />
- and precisely what had worked for<br />
others was something her GP could not<br />
have told her.<br />
The internet can give us in-depth<br />
fertility education from others who have<br />
been there - often far more practical than<br />
impersonal advice in a book, and with<br />
an eye-opening international perspective.<br />
But equally, when we take advice from<br />
a site on the worldwide web, we are<br />
entrusting our health to strangers, many<br />
of whom are completely misinformed,<br />
and none of whom know our health or<br />
bear any responsibility towards us.<br />
The consequences, if you are desperate<br />
enough to follow a medically unqualified<br />
person’s advice to try a certain pill or<br />
potion, for example, can potentially be<br />
extremely dangerous.<br />
On balance, it is always advisable to<br />
take professional, personalised medical<br />
advice over that on any website, which is<br />
likely to be overly generalised, out-ofdate,<br />
or simply inaccurate. The information<br />
and opinions on websites suggest<br />
certain things are ‘normal’ and others<br />
not, which can be very frightening,<br />
whereas a doctor will often dismiss these<br />
fears as irrelevant. Most of the time,<br />
the doctor is right, but - and here’s<br />
what’s good about the worldwide web of<br />
fertility - there are also times when<br />
people who have been in your shoes really<br />
do know best.<br />
• www.twoweekwait.com<br />
The internet’s widest resource of clues,<br />
signs and symptoms, all user-submitted<br />
and in every part designed to help you<br />
understand the clues you body offers.<br />
• www.in-gender.com<br />
A brilliant resource for those looking to improve<br />
the odds of getting a certain gender, whilst<br />
dealing with the range of post-birth emotions.<br />
• www.mumsnet.com <br />
A prolific and mammoth resource, relevant<br />
along the whole timeline, from those looking<br />
to conceive to others adapting to the patter<br />
of not-so-tiny feet.<br />
www.fertilityroad.com<br />
47
FERTILITY ROAD<br />
GUIDES/LAW<br />
Helping you plan for every stage of your journey...<br />
HAVING A<br />
FAMILY BY<br />
ADOPTION<br />
by Naomi Angell of<br />
Osbornes solicitors<br />
Adoption can offer an opportunity<br />
for parenthood to families who might<br />
otherwise be childless. At the same<br />
time it can give a child who faces<br />
growing up in care without their own<br />
family a loving and permanent family.<br />
Adoption in the 21st Century<br />
With the availability of abortion, contraception and society’s<br />
acceptance of single motherhood, young babies are now rarely<br />
relinquished for adoption particularly as compared to the situation<br />
50 years ago. The traditional adoptive family has also changed as<br />
reforms in adoption law mean that not only married couples but<br />
also single people, unmarried and same sex couples can adopt.<br />
There are also many children within the care system in need of<br />
adoptive families. For many of these children in care, the promise<br />
of a fulfilled and successful life reduces the longer they remain in<br />
care. But adoption has been proved to give them what every child<br />
needs to grow up successfully into adulthood.<br />
Before the new Adoption and Children Act 2002 came into<br />
force, even after a child had been placed for adoption with a family,<br />
there was no certainty that either the family or the child would<br />
have a smooth passage through the court system to the making of<br />
an adoption order. Birth parents were able to withdraw consent<br />
to the adoption right up to the Court room door or contest the<br />
adoption despite the fact that the Court had already decided,<br />
months or even years earlier, that the parents would not be able<br />
to care for their child. It was consequently always a worrying and<br />
very stressful process.<br />
The Adoption and Children Act 2002 brought in a much higher<br />
degree of certainty so that once a child has been placed with<br />
a prospective adoptive family, an adoption order will almost<br />
definitely be made. The birth parents now have very limited ability<br />
to intervene, as their opportunity to do so is much earlier on in<br />
the process, when the child was first taken into care.<br />
With virtually all the uncertainty removed, the adoptive family<br />
can now devote themselves to getting to know the new member of<br />
their family and giving the child the secure and loving permanent<br />
family that has until then been denied to them.<br />
First Steps to Adopting<br />
A family interested in adoption is likely to start their journey by<br />
contacting their local authority adoption unit or by responding to<br />
a local authority advert seeking adoptive families for the children<br />
in their care or for a specific child available for adoption.<br />
Many of the children will be sibling groups, children with<br />
special needs or children with troubled early childhoods. The<br />
young babies available for adoption may well have been removed<br />
from parents with drug or alcohol problems.<br />
This might sound a daunting prospect. However thorough<br />
adoption preparation and social work support means that many<br />
families who originally might have doubted their ability to parent<br />
other than a very young child to whom they are biologically<br />
related, find that they have untapped skills and enthusiasm for<br />
this different type of parenting.<br />
What is important is that an adoptive family is able to meet<br />
the needs of the individual child and consequently, prospective<br />
adopters must be assessed by an adoption agency as to whether<br />
they are suitable to adopt the children available for adoption.<br />
The assessment or home study process is a thorough investigation<br />
by a social worker which includes looking at the family’s<br />
background, values, aspirations for their adopted child and their<br />
ability to meet the needs of children who are within the care system.<br />
The home study report will be considered by the adoption agency’s<br />
adoption panel, which the family are encouraged to attend to<br />
answer any outstanding questions.<br />
Again, families can feel daunted by the prospect and feel it<br />
unfair that they must undertake this process for adoption when, if<br />
they were able to have their own children, no outside body would<br />
be involved in deciding whether they would be suitable parents.<br />
This alone can dissuade families from considering adoption.<br />
However, families who have been through the assessment<br />
process frequently report how interesting and constructive they<br />
have found it, giving them many skills for bringing up their future<br />
children and an understanding of parenthood, which would be<br />
helpful for any family and not just for adopters.<br />
Once assessed as suitable adopters, the adoption agency will<br />
then help the family find the right child for them.<br />
48 fertility road | november - december
Supporting Adoptive Parents through<br />
the Adoption and Beyond<br />
The Adoption and Children Act 2002 has also brought in an<br />
adoption support package to help the adoptive family in meeting<br />
their adopted child’s needs. This may be in the form of a payment<br />
of a regular adoption allowance which opens the door to adoption<br />
to families of all means. The adoption support package can also<br />
include the provision of professional advice and support with<br />
birth family contact.<br />
Continuing contact between a child and their birth family is<br />
another change encouraged by the 2002 Act. For older children who<br />
have continuing relationships with their birth families, birth family<br />
contact may well be important. Contact may be ‘direct’ contact with<br />
regular or occasional meetings with birth family members, or indirect<br />
by the exchange of letters and photographs through the adoption<br />
agency’s letterbox contact service. If contact with birth parents is not<br />
thought to be in the child’s best interests, there may be the possibility<br />
of contact between a child and their siblings or grandparents.<br />
During the adoption assessment, prospective adopters will learn<br />
how they can provide a settled secure home to children and where<br />
this is considered to be in the child’s best interest, plus how to manage<br />
some form of contact for the child with their birth families.<br />
Many adoptive families bear witness to the joy and satisfaction<br />
that adoption has brought to both the children and adults involved.<br />
It provides an opportunity of family life to children who<br />
would not otherwise have had it and puts the adults on a journey<br />
to parenthood which may be different than that originally<br />
planned but one which may in many ways, be more fulfilling.<br />
Naomi Angell specialises in children’s law and has particular<br />
expertise in international and domestic adoption, children’s<br />
cases with an immigration interface, child protection and<br />
alternative reproduction cases, such as surrogacy.<br />
She chairs the adoption panel of a national adoption agency<br />
and has been closely involved in the parliamentary process<br />
of the recent new adoption legislation. She is a Consultant<br />
at Osbornes and qualified as a solicitor in 1973.<br />
Contact her by email naomiangell@osbornes.net or call<br />
020 7485 8811 or visit www.osbornes.net<br />
Delhi IVF <strong>Fertility</strong> and Research Centre, was one<br />
of the first test-tube baby clinics established in<br />
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a state-of-the-art comprehensive facility providing<br />
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Alternative Family Law<br />
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At MFP we understand all that it is to be a new parent with all<br />
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person at a time to suit you (before or after baby comes), just contact us below or via<br />
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FERTILITY ROAD<br />
GUIDES/ FINANCE<br />
Helping you plan for every stage of your journey...<br />
PUTTING A PRICE<br />
ON SOMETHING<br />
PRICELESS...<br />
© Rosemarie Gearhart / iStockphoto.com<br />
Much is often said about the cost of having children,<br />
and by that, the assumption is made that it’s<br />
the price of nappies, nursery, schooling fees,<br />
PlayStations and university textbooks that counts.<br />
But for many couples, some of the biggest costs come before<br />
birth – a long time before. And though IVF success rates are on the<br />
rise, it is an expense which, ultimately, may not even yield that<br />
very special and individual reward that parents the world over crave.<br />
Assisted Reproduction Therapy (ART) remains at the forefront of<br />
modern science, and with that insight comes a reflective price tag.<br />
Indeed, cost is often marked as the governing factor in the type<br />
and design of infertility treatments that couples undertake, with<br />
a typical IVF cycle costing, on average, £6,300, and the expense<br />
of fertility hormones adding a further £2,500 onto that total.<br />
When it comes to budgeting for such treatments, very few can.<br />
And in fairness, very few ever would have had the foresight to. After<br />
all, fertility problems, (barring hereditary clues) are very rarely<br />
consequences that a couple would have put money to one side for.<br />
Yet given the considerable costs involved, not to mention the<br />
financial constraints of a weak economic situation, more and<br />
more experts are warning that couples must consider seriously<br />
(and budget accordingly) when it comes to seeking private<br />
fertility treatment.<br />
Thankfully, the UK market is well equipped to advise, with the<br />
first point of contact being a fertility specialist. The time to visit<br />
one is when attempts to fall pregnant have proved unsuccessful<br />
after a year for couples under 35, six months for those over 35,<br />
and any length of time for those over 40.<br />
The fertility specialist will, first and foremost, discuss cost, isolating<br />
potential treatment plans whilst charting realistic financial facts<br />
that will mean that, when your little bundle of joy does arrive into<br />
the world, he or she isn’t instantly saddled with a legacy of credit<br />
card debt that you’ll still be paying off when they reach adulthood.<br />
Seeing a reproductive endocrinologist (an expert in hormones)<br />
will also help you save time and money, as well as going some way<br />
to helping alleviate stress, worry, nerves and indecision – factors<br />
that some experts believe can muddy the progress of even quite<br />
straightforward IVF processes.<br />
While many couples will dip into reserves or borrow in order to<br />
fund fertility treatment, it’s worth checking your health insurance<br />
terms to see if your provider caters for infertility. Only one in four<br />
cover ART methods, though rather more will at least fund early<br />
investigations into diagnostic infertility tests.<br />
It’s also worth checking out companies who offer paybacks,<br />
guarantees and refunds if fertility treatment proves unsuccessful,<br />
while participation in clinical trials can also provide a wellmonitored<br />
if slightly unconventional (and by no means worry-free)<br />
process by which prospective couples can potentially save tens of<br />
thousands of pounds.<br />
As with anything, your best point of reference for all initial fertility<br />
funding discussions is your primary care physician or obstetriciangynaecologist,<br />
whereby they will recommend options and refer you.<br />
And always be certain to use friends, reference items and the world’s<br />
biggest resource for information and advice – the internet – when<br />
judging and assessing what you feel is the best option for you.<br />
Support is always at hand in so many different guises, and with<br />
the stress of fertility woes coupled with a financial backdrop that<br />
will seem more terrifying with every cycle, there will come a time<br />
when you will undoubtedly need it. But use it and make the most<br />
out of it, because the rewards are truly priceless.<br />
www.fertilityroad.com<br />
51
FERTILITY ROAD | Rosjurconsulting<br />
INTELLIGENT PROFILE<br />
FROM<br />
RUSSIA<br />
WITH<br />
LOVE<br />
Konstantin Svitnev from Family and<br />
Reproductive Law Firm Rosjurconsulting<br />
talks to <strong>Fertility</strong> <strong>Road</strong> about Surrogacy<br />
and fertiltiy treatments in Russia<br />
With changing laws in the anonymity of donor<br />
eggs in the UK, parents-to-be are seeking further<br />
afield for their dreams to come true. Russia offers<br />
one of the most advantageous approaches towards<br />
reproduction in Europe, allowing the possibility of parenthood<br />
to everybody.<br />
The legal situation around assisted reproductive treatment in<br />
Russia is very favourable as well where surrogacy, gamete and<br />
embryo donation are all without restrictions.<br />
Konstantin Svitnev is the General Manager of Rosjurconsulting,<br />
the first Russian and International Family and Reproductive Law<br />
firm in the Russian Federation, and is also the founder of the<br />
Reproductive Law and Ethics Research Centre based in Moscow.<br />
His main involvement, since 1991, has been in reproductive law<br />
and the legal challenges and controversies in the area of assisted<br />
human reproduction.<br />
He explains that “In Russia, marital status is irrelevant, single<br />
women and married couples are treated the same; the same<br />
refers to single men too…”<br />
“A birth certificate is issued to the names of the intended<br />
parents, and the surrogate’s name is never mentioned”<br />
In light of this, single women and men can also become parents<br />
through surrogacy in Russia as they also allow the one parents<br />
name on the birth certificate, as this is the only country in Europe<br />
where this is legal.<br />
“Single intended parents regardless of their age,<br />
sex or sexual orientation can implement their right<br />
for parenthood through surrogacy in Russia”<br />
In Russia foreigners have the same rights for<br />
assisted reproduction as Russians, so parents-to-be<br />
will automatically obtain a Russian birth certificate<br />
with their names on and can leave for home<br />
within 3 days of the child’s birth.<br />
At Rosjurconsulting they believe that everyone<br />
has the right to have a child, and that has been<br />
their policy for 7 consecutive years.<br />
As Konstantin Svitnev explains;<br />
“The right to procreate should not depend on<br />
gender, family, age or sexuality. It is a natural right<br />
of any person. Refusing to allow childless people to<br />
become parents means refusing to treat them equally<br />
and is an example of selective discrimination.”<br />
Travelling for treatment is almost a given in<br />
many cases and liberal legislation makes Russia<br />
very attractive for reproductive tourists looking for<br />
interventions that are not available in their home<br />
countries. Prospective parents go to Russia when<br />
surrogacy is considered, because of marital status (single men and<br />
women) or advanced age. Costs play a big part of the process, and<br />
in Russia, remain lower than in the EU or US.<br />
Russia has no waiting lists for their clients for both surrogacy<br />
and egg donation. Any successful surrogacy program requires<br />
cooperation between qualified doctors, professional lawyers and<br />
experienced managers. Working with the Vita Nova IVF clinic in<br />
Moscow, Rosjurconsulting offers an all inclusive surrogacy package<br />
covering all medical and organizational services upto the child’s<br />
birth when the parents can leave for home with their new born.<br />
Rosjurconsulting are the first to introduce a 'Baby Guarantee<br />
plan, in which the surrogacy program will be continued until the<br />
live birth without extra charge regardless of number of IVF and<br />
embryo transfer attempts – even in the case of spontaneous<br />
abortion, still pregnancy or still birth. Money is always an issue<br />
and intended parents should know the exact amount they are<br />
going to be spending from the start.<br />
Russia is also one of the very few countries where posthumous<br />
surrogacy can be implemented, by which mothers who have lost<br />
their sons are allowed to have grandchildren.<br />
For more information head to www.jurconsult.ru/en<br />
FIRST IVF CLINIC IN RUSSIA SPECIALIZED IN<br />
SURROGACY AND EGG DONATION (INDIVIDUAL<br />
AND ANONYMOUS) FOR INTERNATIONAL CLIENTS.<br />
Couples and Single intended parents<br />
All-inclusive packages<br />
Baby-Guaranteed plan<br />
Legal protection<br />
No waiting list<br />
English-speaking staff<br />
www.vitanovaclinic.ru<br />
4 Bulvar Generala Karbysheva, 123154 Moscow, Russia • Tel: +7-926-823-23-04<br />
e-mail: info@vitanovaclinic.ru • Skype: vitanovaclinic • Follow @vitanovaclinic on Twitter
FERTILITY ROAD<br />
GUIDES/REFLEXOLOGY<br />
Helping you plan for every stage of your journey...<br />
TREADING<br />
A NEW<br />
PATH OF<br />
FERTILITY...<br />
© MorePixels / iStockphoto.com<br />
If a word ends in ‘ology’ there’s a good chance that at some<br />
point, and in some way, its science has been linked to that of<br />
fertility. Patients will pursue the dream of having a family<br />
with the same veracity as specialists seeking to unravel the<br />
secrets of the human body, but should reflexology be added to the<br />
list of alternative remedies that hold their own when it comes to<br />
providing trusted routes to parenthood?<br />
Maybe so. An increasing number of women are claiming significant<br />
results having experimented with this popular type of foot<br />
massage - a technique and approach that dates way back to the<br />
ancient Egyptians and Chinese, and one that uses pressure points<br />
on the feet (and hands), in doing so unblocking channels and freeing<br />
up the flow of positive vibes around the body.<br />
Scientific investigations remain disparate, but the theory is that<br />
the sole of the foot, in particular, acts as a map for the inner workings<br />
of the body. It therefore follows that particular points on the foot,<br />
if manipulated in a skilled and knowledgeable way, can send<br />
therapeutic, repairing vibes to the brain regarding a woman’s egg<br />
production, correcting imbalances and freeing up energy pathways.<br />
Unlike other assisting techniques, there is no evidence whatsoever<br />
that reflexology interferes negatively with any processes either before<br />
or during pregnancy. Some reflexologists will refuse patients<br />
in their first trimester, though this is thought to be for the reason of<br />
protecting against adverse publicity that might errantly be linked<br />
to the therapy in the event of miscarriage.<br />
Instead, reflexology is best viewed as an exercise – something that<br />
can be built up gradually to suit an individual’s taste and demands.<br />
Renowned therapist Lynne Morgan was recently quoted as<br />
saying: “Reflexology is very successful in the treatment of a wide<br />
variety of pregnancy discomforts and conditions. It can be used for<br />
relaxation and pain relief, and research has shown that women<br />
who have regular reflexology treatments during pregnancy have<br />
far shorter labours than those who don’t.”<br />
In addition, research leans heavily towards the idea that reflexology<br />
is excellent for maintaining or increasing milk supply, as well<br />
as helping with postnatal depressing and general relaxation.<br />
And the good news for those looking to explore more about<br />
reflexology is that the technique’s reputation is very much being<br />
endorsed by the NHS, with many healthcare professionals<br />
recognising its incredible benefits.<br />
Some maternity units have their own reflexologists either working<br />
within the practice or accessible through it, so try asking your<br />
midwife if she knows of any that your local Trust uses.<br />
So what are the scientific numbers that have pushed this<br />
relaxation art right forward into the consciousness of potential<br />
participants? Well, the Association of Reflexologists recently<br />
gathered feedback from their members, finding that over 50% of<br />
clients seeking reflexology in connection with conception found<br />
themselves pregnant within six months.<br />
Of course, these figures are very difficult to quantify. A certain<br />
proportion of that number would have fallen pregnant anyway,<br />
while others will state that it is the calming effect or faith created<br />
by and placed in reflexology that actually creates better conditions<br />
with which to conceive, rather than the technique itself.<br />
But reflexology has as worthy a place on the market as any of<br />
the other alternative remedies, and given that it takes the form of<br />
such a simple, non-intrusive process, its popularity is only<br />
expected to increase.<br />
www.fertilityroad.com 53
Q&A | zita west<br />
EXPERT<br />
WITNESS<br />
WITH<br />
ZITA WEST<br />
Once again, our leading fertility expert Zita West<br />
has taken the time to answer questions sent in<br />
by readers through the <strong>Fertility</strong> <strong>Road</strong> website.<br />
If you would like Zita’s advice on a fertility matter,<br />
please log your question at www.fertilityroad.com<br />
or email in to info@fertilityroad.com.<br />
QMy doctor has recommended I start using a<br />
drug called Clomiphene. I’ve had irregular<br />
cycles and unexplained infertility for a while,<br />
and she feels we could get some positive results on<br />
both of those fronts by using the drug, but I’ve been<br />
made aware of some side effects. I already suffer from<br />
vertigo, could Clomiphene make it worse?<br />
– Lisa-Marie Brossard , Nottingham<br />
A<br />
Clomiphene is usually used as a first line treatment<br />
for women with irregular cycles, and also<br />
if your progesterone level is low – your specialist<br />
will have investigated this with tests.<br />
Ideally you should be monitored while on Clomid to<br />
check that you are responding to the dose that you were<br />
given. This dose may be increased depending on how<br />
you respond.<br />
There are side effects with Clomid, and if you suffer<br />
from vertigo it is worth discussing this with your doctor<br />
first. As with all drugs and side effects, some people get<br />
them and some don’t. For most women taking Clomid,<br />
the side effects do improve after a few weeks.<br />
54 fertility road | november - december
QI’ve just married the love of my life. I am 33 and in<br />
good health, yet he is more than twice my age. So<br />
much of fertility seems to be from the perspective of<br />
the woman, but in this instance, should I be worried that the<br />
quantity and quality of my husband’s sperm may be a cause<br />
for some anxious times ahead in terms of getting pregnant?<br />
– Sandeep Margat, Ramsgate<br />
A<br />
You don’t state if you want to start trying for a baby straight<br />
away. If you are, it is worth having regular sex at least 2-3<br />
times a week for the next 4-6 months and seeing what<br />
happens before testing your partner. For every test there is a result,<br />
and through my experience this can send you into a real panic if the<br />
slightest thing is out of the normal range, which in turn can put a<br />
lot of stress on a newly married relationship.<br />
Many things affect male fertility so it’s best if he does not<br />
smoke, does not drink alcohol to excess and eats a well balanced<br />
diet. Male fertility does decline somewhat with age and many<br />
men will benefit from taking a male fertility supplement. If it is<br />
discovered that he has a fertility problem, there are many things<br />
that can be done in terms of assisted fertility.<br />
QWould having sex twice a day during my ‘window’<br />
have any real greater effect on my chances of getting<br />
pregnant than having sex just once a day? Thanks.<br />
– Angela Edwards, Grantham<br />
A<br />
Having sex once a day is more than enough. Twice a day<br />
can put a lot of pressure on your partner. Healthy sperm<br />
can live for 3-5 days inside you, so aim to have sex at<br />
least 3 times a week to ensure that there is plenty of sperm in the<br />
fallopian tube ready to meet the egg once it’s released. A healthy<br />
diet and lifestyle is very important also as this can have an impact<br />
on the quality of the egg and sperm.<br />
YOUR<br />
BIG DAY<br />
THE MOST POPULAR<br />
DAY FOR A BABY TO<br />
ARRIVE IS A WEDNESDAY<br />
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AND THE LEAST<br />
POPULAR DAY?<br />
SUNDAY!<br />
QWe have researched what we believe to be two<br />
excellent IVF clinics in India. We like the idea of<br />
combining our pursuit of a family with a relaxing<br />
trip, and I’ve always wanted to visit Asia, but are there<br />
guarantees over technical knowledge and proficiency, and<br />
are we being too ambitious when a clinic closer to home<br />
may be a less stressful venture?<br />
– Jonathan Welton, Skye<br />
A<br />
The idea of going overseas to combine your pursuit of<br />
a family with a relaxing trip sounds nice in theory but<br />
in practice can prove very different. Cultural differences,<br />
language barriers and expectations can be incredibly stressful to<br />
some, while in others the challenge is something that takes<br />
them out of their normal state, and therefore takes the attention<br />
away from the task in hand. Personally, I believe couples are<br />
better off having a holiday and focusing on IVF separately at<br />
home, but it really does depend on who you are and what type<br />
of person you are. We are all different and we all enjoy different<br />
challenges and experiences.<br />
Zita West has given specialist fertility<br />
and pregnancy advice for over 25 years, as<br />
a midwife, an acupuncturist, a nutritional<br />
advisor and as an author and consultant.<br />
She has also written numerous books on fertility<br />
and pregnancy, with her latest title - Zita West’s Guide<br />
to <strong>Fertility</strong> and Assisted Conception - now available.<br />
For more information on Zita, her London clinic or books,<br />
visit www.zitawest.com<br />
MORE<br />
ABOUT<br />
ZITA<br />
WEST<br />
© Jacob Wackerhausen / iStockphoto.com<br />
www.fertilityroad.com<br />
55
FERTILITY ROAD<br />
GUIDES/ACUPUNCTURE<br />
Helping you plan for every stage of your journey...<br />
Yvonne Darnell, so-named<br />
‘The Baby Whisperer’, looks<br />
at acupuncture’s increasing<br />
place in the world of fertility...<br />
There are few alternative remedies that split opinion<br />
in quite the way that acupuncture does. One of the<br />
oldest and most practised forms of traditional Chinese<br />
Medicine, it tends to provide determined schools of<br />
thought in one direction or another. One camp sidelines it as a<br />
holistic adventure without significant scientific backing, while in<br />
other quarters it brings together in complete form the complexion<br />
of systems that form a person’s physiology.<br />
It is certainly the uniting of complex physical and emotional<br />
states that brought record numbers to acupuncture last year,<br />
a good percentage of whom were looking for answers to their<br />
fertility conundrums.<br />
For Yvonne Darnell, the Sussex-based acupuncturist, who has<br />
been widely profiled and celebrated in the national press, acupuncture’s<br />
power is without question. She has already helped over<br />
100 couples achieve their fertility dreams, intervening at a point<br />
where science had told them to turn their backs on the chances of<br />
producing a family by conventional methods.<br />
“People ask me to define acupuncture, and the best description<br />
I can offer is that it presents a natural path down which the body<br />
can heal itself. It is a drug-free solution that is cleansing and<br />
thorough – so thorough that the practitioner’s aim is to identify and<br />
treat not just the symptoms of the problem, but the cause as well.”<br />
Acupuncture’s history goes back thousands of years, and it is a<br />
credit to its resilience throughout times of massive change in<br />
terms of medical and scientific advancements, that it remains as<br />
highly regarded now as ever before. Its secret of longevity may<br />
well be in its versatility.<br />
That’s because no matter what the ailment, acupuncture technique<br />
and application remains much the same, with deep principles of<br />
treating the individual as a whole.<br />
“Acupuncture serves such a wide range, but every person who<br />
comes to see me is unique, and the treatment given will reflect<br />
this,” Yvonne continues. “If several people turned up with a named<br />
condition - for example PCOS (polycystic ovary syndrome), something<br />
which has become very common - the severity of it and the<br />
Acupuncture as a whole can<br />
be a complementary treatment<br />
to many ailments, but the specifics<br />
of how it is used vary widely.<br />
imbalances it produces will vary from person to person. The<br />
responsibility is therefore that the diagnosis and point selection<br />
will differ depending on what other underlying issues there are.<br />
“Acupuncture as a whole can be a complementary treatment to<br />
many ailments, but the specifics of how it is used vary widely.”<br />
Its flexibility works too in terms of where along the fertility<br />
timeline the woman (and indeed man) are. It is known to<br />
encompass unexplained infertility, pre-conception care and<br />
assisted conception support, plus low sperm parameters, PCOS,<br />
endometriosis, ovulation issues, menstrual cycle irregularities<br />
and recurrent miscarriage.<br />
© Jacob Wackerhausen / iStockphoto.com<br />
56 fertility road | november - december
“Treatments, if working alongside assisted conception<br />
cycles, are recommended at certain times to support<br />
the different phases of the drugs being given. And<br />
acupuncture shouldn’t be mistaken for a treatment<br />
used to assist only in getting pregnant. Its benefits<br />
last throughout the gestation period, and beyond.<br />
“For acupuncturists, it is the pregnancy itself that<br />
dictates the level of treatment and when those treatments<br />
happen, but the benefits are vast. This delicate,<br />
beautiful time can also be plagued with discomfort<br />
and malaise which can be very frustrating. At a time<br />
when most medications can’t be taken, acupuncture<br />
can bring great relief. Morning sickness, headache<br />
and threatened miscarriage are physical symptoms<br />
often supported, while emotionally, it helps with the<br />
anxiety first time mums go through at various points.”<br />
It is clear that attitudes to acupuncture have<br />
progressed over the years. Even in its very use, it<br />
has transformed from a preventative measure to<br />
something used to cure.<br />
“We now live in a society of trying to mend things<br />
once they are broken,” Yvonne continues. “I think<br />
therefore it only follows that acupuncture’s role has<br />
altered over the years, but as practitioners we’re<br />
keen to change those views back. We look after our<br />
cars by having them serviced regularly, giving them<br />
oil and water to keep them working, yet we seem to<br />
forget to do these key things for ourselves.<br />
“And science has really been behind acupuncture’s<br />
recent resurgence. There have been several studies<br />
undertaken and published in the British Medical<br />
journal, most of which were extremely positive.<br />
“There are always important distinctions to be<br />
made though, because we are keen to emphasise the<br />
fact that acupuncture is often intended as a complementary<br />
benefit. Western medicine and research<br />
is invaluable and can help in cases (for example if<br />
someone has blocked, scarred fallopian tubes) that<br />
acupuncture alone cannot, but where fertility is<br />
concerned there seem to be no definitive answers.<br />
So many people come to me diagnosed with unexplained infertility,<br />
and there must be some explanation. Acupuncture has, on many<br />
occasions, succeeded where other methods have failed, but there<br />
is a long way to go to prevent the growing fertility problems for<br />
all involved.<br />
“But we are certainly in a good place now. I think a lot of recent<br />
interest probably comes from increasing public awareness about<br />
its benefits, either through the media or from working more<br />
closely with Western medical professionals and their understanding<br />
and acceptance. We are all nervous of the unknown, but those<br />
who try acupuncture generally feel so good they wish they had<br />
discovered it earlier.”<br />
And many acupuncturists will charge as little as £50 for an<br />
initial consultation. Naturally, prices of treatment vary according<br />
to areas and the knowledge base of the practitioner. And as with<br />
most things in life, you’re likely to pay more for a specialist based<br />
on their background and experience.<br />
“I think for those looking to take a step towards acupuncture<br />
for the first time, the relationship with the practitioner is of great<br />
I think for those looking to take<br />
a step towards acupuncture for the<br />
first time, the relationship with the<br />
practitioner is of great importance.<br />
importance,” Yvonne says. “After all, no matter what we do in<br />
life, we all need to feel confident in someone’s ability, and be<br />
able trust them.<br />
“This is especially the case where fertility issues are concerned<br />
as it involves discussing the most intimate part our lives. I would<br />
recommend that anyone planning treatment should contact the<br />
British Acupuncture Council to get a list of practitioners in their<br />
area. Ask what experience they have working with fertility, their<br />
success rates, how they could help with their particular problems,<br />
and what to expect from their first visit. This will give a good<br />
sense of who is right for them.”<br />
For more information<br />
about Unity <strong>Fertility</strong>,<br />
contact Yvonne on<br />
01444 235400 or visit<br />
www.unityfertility.co.uk<br />
Fo<br />
Un<br />
Yv<br />
vis<br />
uk<br />
www.fertilityroad.com<br />
57
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IVF – ICSI treatment - IVF is a procedure being performed since<br />
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58 fertility road | november - december
SCIENCE | sperm dna fragmentation<br />
SPERM DNA<br />
FRAGMENTATION<br />
By Dr Preben Christensen,<br />
from SPZ Lab in Denmark<br />
© Sebastian Kaulitzki / shutterstock.com<br />
Recently, there has been increased<br />
emphasis on the evaluation of<br />
sperm quality. Much of this has<br />
been due a growing realisation<br />
that a sperm or semen test is actually of<br />
limited value.<br />
Sperm, in essence, act as little more<br />
than vehicles by which DNA is carried<br />
from the male to the female egg. Only<br />
very few make it to their goal, and along<br />
the way a potentially damaging process is<br />
undertaken, where the protein blocks<br />
designed to protect the sperm can very often<br />
fail, leaving DNA susceptible to damage<br />
and at risk of becoming fragmented.<br />
There have been significant recent studies<br />
into DNA fragmentation, and I have outlined<br />
below the latest findings into an area of<br />
fertility previous not given the attention it<br />
perhaps deserves.<br />
Historically, infertility has been a problem<br />
that was believed to originate solely from<br />
the woman. About 300 years ago, people<br />
were pretty sure that “what father does<br />
is always right!” The Dutchman Nicolas<br />
Hartsoecker was one of the first to look at<br />
a sperm sample under the microscope. He<br />
drew a ‘Homunculus’, a small child in the<br />
head of the sperm cell, and the belief was<br />
that anything produced by the man would<br />
have to be perfect.<br />
This example tells us that one of our<br />
problems when trying to understand new<br />
research is our entire perception of the<br />
problem! Thus, approximately 75% of all<br />
women believe that it can only be the<br />
woman that is the problem when a fertilised<br />
egg does not implant in the uterus.<br />
And that is despite the fact that nowadays<br />
most men are aware of the fact that<br />
sperm quality can be a problem. Indeed, in<br />
approximately every fourth childless couple,<br />
the reason for the involuntary childlessness<br />
is DNA fragmentation in the sperm cells.<br />
The vast majority of these men have<br />
normal sperm quality, the problem being<br />
that you cannot see when the genome (the<br />
DNA) is not packed properly in the sperm<br />
cell. The concentration of sperm cells can<br />
be fine, they are swimming properly and<br />
can easily fertilise the egg. However, the<br />
fertilised egg is still doomed to perish. The<br />
reason for this is that the genome from the<br />
sperm cell has been damaged (fragmented)<br />
during the long journey to the egg. The<br />
egg might be able to carry out small<br />
repairs of the sperm cell’s DNA, but major<br />
damage is fatal for the further development<br />
of the egg. In other words, the woman’s<br />
eggs might be perfectly fine – but with a<br />
fragmented genome in the sperm cells, the<br />
fertilisation will not result in a viable foetus.<br />
The most extensive study carried out<br />
so far regarding the significance of DNA<br />
fragmentation in sperm cells was conducted<br />
by Mona Bungum at Malmø University<br />
Hospital and was published in 2007 in the<br />
journal Human Reproduction. The study<br />
was based on 998 treatment cycles, where<br />
the couples received either IUI, IVF or ICSI<br />
Historically, infertility has been a problem that<br />
was believed to originate solely from the woman.<br />
About 300 years ago, people were pretty sure<br />
that “what father does is always right!”<br />
treatment. Mona showed that the DNA<br />
fragmentation index (DFI) was above 25 for<br />
approximately 27% of the infertile couples<br />
in her study. At this level itz is basically<br />
impossible to get the wished-for child<br />
through IUI treatment. For approximately<br />
5% of the couples, the DFI was above 50.<br />
At this level, IVF treatment will not have<br />
the desired result either. In other words,<br />
this is a very frequent problem.<br />
It’s also something of a hidden problem,<br />
because when the fertilised egg starts<br />
splitting, the first breaks take place without<br />
any influence from the genome of the sperm<br />
cell. Not until there are eight cells does the<br />
egg start drawing on information from the<br />
sperm cell.<br />
»<br />
www.fertilityroad.com<br />
59
SCIENCE | sperm dna fragmentation<br />
The process of developing a small child lasts through the first three<br />
months of the pregnancy, and during that period the process can be<br />
likened to reading a small manual: ‘How to make a baby’, if you will.<br />
Half the pages of this manual come from the egg and the other half<br />
come from the sperm cell. The manual might have 300 pages, and<br />
all pages have to be intact in order to get the desired result. But<br />
what if page 28 or 268 has been torn (fragmented)? What happens<br />
then? The answer is that if page 28 is damaged, the development of<br />
the egg stops early in the process. The egg might have looked fine<br />
when the fertility specialist inserted it in the uterus, but after a short<br />
while, the development stalls, and the egg does not implant. Thus,<br />
in some cases, DNA fragmentation in the sperm cells can be the<br />
reason that biochemical pregnancy is achieved and then later lost.<br />
By the same logical process, if page 268 in the manual is damaged,<br />
the DNA fragmentation will result in an abortion later in the pregnancy.<br />
Damage to the genome does not always result in the development<br />
of the egg stalling. In some cases, the egg can repair the damage<br />
to the DNA of the sperm cell, but much new research indicates<br />
that faults are not always repaired properly. This means that<br />
some children can be born with genetic damage caused by DNA<br />
fragmentation in the sperm cells - for example, disorders such as<br />
autism or schizophrenia.<br />
Of course, we are all constantly made aware of the fact that the<br />
biological clock is ticking for women, while conversely, the story<br />
of Charlie Chaplin and others becoming fathers at an advanced<br />
ages are common. However, recent research shows that the biological<br />
clock does also apply to men.<br />
A group of American researchers under the leadership of Andrew<br />
Wyrobek discovered in 2006 that if the man is 48-years-old or<br />
older, there is a 50% likelihood that he can no longer fertilise a<br />
woman. The group of researchers found out that this is, amongst<br />
other things, caused by DNA fragmentation in the sperm cells,<br />
which increases as the man gets older. It therefore cannot be ruled<br />
out that a man who has produced children in a previous relationship<br />
is now infertile due to DNA fragmentation of his sperm cells.<br />
The fact that the same man apparently has a normal sperm<br />
quality and quantity, and the fact that the woman has achieved<br />
a biochemical pregnancy, do not exclude the reality that the<br />
problem exists in the sperm.<br />
When Nicolas Hartsoecker looked under the microscope in<br />
1695, he was sure that all fertility problems must be caused by the<br />
woman, but we know now that the situation is somewhat different.<br />
More than 300 years later, the reason for involuntary childlessness<br />
can just as often be found in the man as in the woman.<br />
And we shouldn’t be surprised. The sperm cell is, after all, up there<br />
with the most fragile cell in the entire human body. If the genome is<br />
packed poorly and is damaged (the reasons for which can be found<br />
on the right in the fact box), the sperm cell is most likely doomed.<br />
There is a lot of progress in DNA fragmentation research involving<br />
sperm cells at the moment, and even though it seems that men<br />
are not what they used to be, there is some underlying good news.<br />
In many cases, the packing of the genome can be improved if<br />
the cause is treated. Where this cause is and how it comes about<br />
requires greater investigation, but we know it takes at least three<br />
months before any advancement can be detected.<br />
Although definite progress for patients is slow, research in<br />
this field within the labs continues at great speed, and there is<br />
considerable promise that the years to come will offer a new<br />
world of information and optimism.<br />
Facts regarding reasons for<br />
genome in sperm cells being<br />
packed poorly, resulting in the<br />
possibility of DNA fragmentation:<br />
THE PHYSICIAN CAN EXAMINE AND<br />
TREAT YOU FOR THE FOLLOWING:<br />
Leukocytospermia:<br />
High white blood cell count in the sperm.<br />
Diabetes:<br />
Diabetes or pre-diabetes (hyperinsulinaemia).<br />
Varicocele:<br />
Abnormal enlargement of the veins from the testicles.<br />
WHAT CAN YOU DO?<br />
Temperature:<br />
The normal temperature of the scrotum is 33.3ºC and can be<br />
increased for many reasons. Avoid hot baths or spa. Avoid tight<br />
underwear and pants. Place the portable computer on the table<br />
instead of on your lap. Turn down the heat in the car seat. High<br />
fever, for example in connection with flu, can also cause problems.<br />
Smoking:<br />
Quit smoking, if you can.<br />
Overweight:<br />
Maintain a healthy diet. Weight loss is a good idea if your BMI is<br />
above 25. Changes in the diet can also reduce hyperinsulinaemia<br />
and result in better packing of the genome in the sperm cells.<br />
Medicine:<br />
Many medicines cause problems. If you are taking medicine,<br />
you should inform your fertility specialist of this. Cholesterolreducing<br />
medicine, stomach ulcer remedies and antidepressants<br />
have a well-known negative effect. Regarding many types of<br />
medicine, we currently do not know whether they affect the<br />
packing of the genome in the sperm cells.<br />
Mobile phone:<br />
Radiation from mobile phones causes problems. When you<br />
have it on you, it should be in your breast pocket and not<br />
your trouser pocket.<br />
WHAT IS DIFFICULT TO CHANGE?<br />
Age:<br />
Already having had children unfortunately provides no<br />
guarantees that problems won’t come about in future.<br />
The environment:<br />
Air pollution, pesticides plus various chemicals can cause<br />
problems. Always adhere to safety precautions when dealing<br />
with chemicals and pesticides. Remember to rinse vegetables<br />
and wipe off fruit.<br />
60 fertility road | november - december
FERTILITY ROAD | |IRTSA<br />
NEW SCIENCE<br />
REPRODUCTIVE<br />
OPTIONS FOR<br />
HIV-POSTIVE<br />
PARENTS<br />
By Lyudmyla Smahina, CEO<br />
of International Reproductive<br />
Technologies Support Agency.<br />
The Invention of antiretroviral therapy has allowed<br />
HIV-infected people to enjoy an active lifestyle for a<br />
longer time and think about having children. Up-to-date<br />
reproductive medicine has also highlighted this group<br />
of patients. On top of that, long-awaited parenthood is now<br />
possible not only for HIV-positive couples (one partner infected)<br />
but for concordant parents (both partners infected) as well.<br />
For an infected man, insemination or IVF with a donor sperm<br />
is considered the safest. However, there is a problem of legal<br />
limitations imposed on such practices in many European countries.<br />
Also, it is often more intolerable for a man to recognize the absence<br />
of genetic relation to a child than it is for a woman. If to consider<br />
adoption as an alternative option then HIV infection complicates<br />
the procedure or in some cases can make it absolutely impossible.<br />
Other more reasonable ways tend to include various methods of<br />
artificial fertilization depending on the reproductive health of a<br />
couple. These cover intrauterine insemination (IUI), in-vitro fertilization<br />
(IVF) or ICSI. The latter two methods are considered more<br />
efficient as they eliminate close contact between an egg and a sperm.<br />
Techniques for sperm clean-up represent distinctive feature of<br />
the programmes. First inseminations using cleaned sperm cells<br />
were performed in Italy (1989) and Germany (1991). From 1991<br />
to 20<strong>03</strong> application of these methods gave birth to 500 children.<br />
Sperm washing is a term used to describe the process of cleaning<br />
masculine germ cells from the virus as it is only the surface of the<br />
sperm and not the sperm itself that is affected. Research has shown<br />
that virus infects only plasma sperm, core cells and immobile<br />
sperm cells. Mobile vital sperm cells are not infected. To detect<br />
such sperm cells, sperm Is mixed with a special liquid with<br />
high density. Then, it is divided into three elements and place<br />
into a medical centrifuge. Adding salt solution results in the<br />
emerging of active sperm cells on the surface which is then taken for<br />
fertilization preceded by tests on the presence of the virus applying<br />
high-sensitive methods (sensitivity threshold is 10 pattern/ml).<br />
However, there is a possibility that HIV content in the material<br />
can be lower than the sensitivity threshold. Therefore, one can<br />
not guarantee that this method is 100% safe.<br />
Unfortunately, the sperm washing method is not accessible in every<br />
country. In Great Britain, there are only a few clinics that deal with<br />
this, while France has recently approved the right of HIV-infected<br />
people for IVF. The same law has been introduced in Italy<br />
and Spain as well. In Germany this service is even included in<br />
medical insurance while in Sweden it is completely controlled<br />
and sponsored by the government.<br />
As far as a HIV positive woman is concerned, there is a chance<br />
of a so-called vertical virus transference from mother to a child<br />
which is possible during pregnancy child delivery, and breast<br />
feeding. In 25-40% of such cases HIV is transferred during gestation.<br />
This becomes possible because of vulnerability of the placental<br />
barrier in the result of which the virus can penetrate from<br />
the mothers blood into that if the child.<br />
According to the World Health Organisation a chance of vertical<br />
transference amounts to 20-30%. Under conditions of special<br />
nursing and feeding with milk mixtures the risk decreases to<br />
2-5%. Less continual delivery as well as C-section operations are<br />
also recommended for such obstetric patients.<br />
Thus, the success of the programme depends on three factors:<br />
antiretrovirus therapy, planned cesarean operation and artificial<br />
feeding. However, such medical services are normally difficult to<br />
receive. Many European medical centers offer IVF services only<br />
for those couples where a man is an infected person. Significant<br />
challenges are also faced by concordant couples.<br />
It would be appropriate to note ethical, psychological and social<br />
aspects of implementation and outcomes of highly mentioned<br />
reproductive programs. Many people are curious how living with<br />
one or two HIV-positive parents can influence the child. There<br />
is no doubt that such couples will be very careful in their daily<br />
routine doing their best to avoid any chance of infection.<br />
For more information about<br />
IRTSA’s services, please contact:<br />
Phone: +38 (044) 223-51-13<br />
E-mail: info@irtsa.com.ua<br />
www.irtsa.com.ua/en<br />
www.fertilityroad.com<br />
61
READER STORY | letter from the heart<br />
LETTER<br />
FROM<br />
THE HEART:<br />
JANET’S<br />
STORY<br />
‘‘<br />
This month, Janet Murray, an<br />
Education Journalist based in<br />
Kent, speaks about her journey<br />
towards motherhood, and the<br />
challenges thereafter...<br />
I<br />
always wanted a big family, so when I got married to my<br />
husband Ed in 20<strong>03</strong>, we started trying for children straight<br />
away. I’d just turned 30 and it never crossed my mind I<br />
might have trouble conceiving.<br />
When I hadn’t fallen pregnant after a year, I went to see my GP,<br />
who did some routine blood tests. He rang a few days later to say<br />
the tests had shown my liver wasn’t functioning normally and he<br />
was going to refer me to a consultant.<br />
After a painful liver biopsy, I learned I had a condition called<br />
Autoimmune Hepatitis, a disease in which the body attacks the<br />
liver and causes it to become inflamed. Left untreated, the condition<br />
can lead to liver failure.<br />
Although in my case, the disease was in the early stages - which<br />
is why I hadn’t experienced any symptoms - I would have to stay<br />
on medication for life. While it wouldn’t be impossible for me to<br />
fall pregnant, my consultant explained that fertility problems<br />
were common in women with liver disease.<br />
While I was relieved my condition had been diagnosed at an early<br />
stage, I was devastated that I might not be able to fall pregnant<br />
naturally. Then, just as I was coming to terms with the news, I was<br />
rushed into hospital with pancreatitis, a potentially life-threatening<br />
condition in which the pancreas becomes inflamed, after developing<br />
an allergic reaction to the drugs I was on. Physically, I recovered<br />
quickly, but emotionally I felt drained. I couldn’t help wondering<br />
what else life could throw at me.<br />
However, in July 2004 I received the news I’d been hoping for. I<br />
was pregnant. But 11 weeks into the pregnancy, I started to bleed.<br />
My GP referred me for a scan and the sonographer confirmed the<br />
baby had stopped growing, at just eight weeks gestation.<br />
Nothing could have prepared me for the misery of miscarriage.<br />
I knew of friends and colleagues who had experienced it, but like<br />
many people, I was ignorant. I thought it was something you ‘got<br />
over’ like a bad bout of flu or a minor operation.<br />
She could experience<br />
any number of complications<br />
from a collapsed lung to a<br />
brain haemorrhage.<br />
I didn’t venture out of the house for weeks. And when I could<br />
finally face the world, I felt I was going to burst into tears at any<br />
moment. It was months before I was back to my old self.<br />
In April 2005, I found out I was pregnant again. Although I was<br />
delighted, I was scared something would go wrong. But my worries<br />
began to ease when we saw our baby bouncing away on the screen<br />
at my 12-week scan.<br />
But At 28 weeks, my waters broke. I was taken, by ambulance, to<br />
Kings College Hospital in south London, where I was given steroid<br />
injections to delay the labour. Doctors explained that I would have<br />
to stay in hospital until the baby was born and that every extra day<br />
of pregnancy would give my baby a better chance of survival.<br />
62 fertility road | november - december
ISSUE <strong>03</strong> | NOVEMBER / DECEMBER 2010 £3.95/€4.95<br />
ISSUE <strong>03</strong><br />
WWW.FERTILITYROAD.COM<br />
My daughter Katy was born five days later, weighing just<br />
two-and-a-half pounds. She was immediately transferred to the<br />
intensive care ward. Doctors explained that although she was in<br />
good shape, the next 48 hours would be critical, and she could<br />
experience any number of complications from a collapsed lung<br />
to a brain haemorrhage.<br />
When I first saw her, about six hours later, she seemed so frail<br />
and vulnerable lying in her incubator with wires coming out of<br />
every part of her body. When I’d thought about bringing my<br />
baby into the world, I’d imagined me proudly pushing her<br />
around her new pram. Instead, I was staring at her through a<br />
plastic box and having to ask permission to hold my own child.<br />
But as the weeks went by, Katy got stronger, and in December,<br />
nearly 12 weeks after her birth, we finally took her home.<br />
In May 2006, when Katy was just eight months old, I discovered<br />
I was pregnant again. I was shocked, but also delighted. Surely<br />
we deserved some luck this time around?<br />
But a few days later, I started to bleed. My GP ran blood tests,<br />
which showed low levels of the pregnancy hormone HCG, which<br />
suggested the pregnancy was failing. I resigned myself to<br />
another miscarriage.<br />
Weeks later, I was still bleeding and, although I couldn’t put<br />
my finger on it, something just didn’t feel right. I went back to<br />
my GP who referred me for a scan, which showed it was an ectopic<br />
pregnancy, a life-threatening condition in which the foetus<br />
implants outside of the womb. If it ruptures, as is common with<br />
the condition, it can cause massive internal bleeding.<br />
I was prepared for theatre immediately and investigative surgery<br />
showed I had a rare type of ectopic pregnancy, known as<br />
‘cornual,’ where the foetus implants in the junction between the<br />
womb and fallopian tubes.<br />
The surgeon explained that removing a pregnancy from this area<br />
carries a high risk of catastrophic internal bleeding and performing<br />
a full hysterectomy would be the only way to remove the pregnancy<br />
safely. To avoid this, I could take a drug call Methotrexate,<br />
under close observation, to try and ‘dissolve’ the pregnancy.<br />
Faced with the prospect of a hysterectomy at 31, I opted for<br />
the drugs. It took several months and endless trips back and<br />
forth to the hospital, but in late August I finally got the ‘all clear.’<br />
After a miscarriage and premature baby, it seemed like bad luck,<br />
but doctors reassured me both my fallopian tubes were intact<br />
and I would still be able to fall pregnant in the future.<br />
But four years later, my friends were onto their second and<br />
even third babies, and I still hadn’t fallen pregnant again. I went<br />
back to my GP, who referred me for tests.<br />
Earlier this year, a hysterosalpingogram showed that one of<br />
my tubes was blocked. I am now waiting for a hysteroscopy, but<br />
my consultant thinks it is likely that the ectopic pregnancy has<br />
caused tubal damage and scarring.<br />
I am 36 now and with only one tube working. Combine that<br />
factor with an autoimmune disease that affects my fertility, and<br />
we realise that IVF may well be our only option. And given my<br />
previous history, there is a big question mark over whether I<br />
could carry a baby to term.<br />
People are usually quite sympathetic to women who can’t<br />
conceive a first baby. But when you can’t conceive a second,<br />
people can be quite dismissive. I’ve lost count of the number of<br />
people who have said to me ‘well at least you’ve got one.’<br />
My daughter is five now and has no long lasting problems as a<br />
result of her prematurity. We feel so grateful to have her, but it<br />
doesn’t ease the longing for a second baby.<br />
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FERTILITY ROAD<br />
BOOKS<br />
Our review of the latest fertility titles…<br />
Frozen<br />
- Mike Butcher<br />
BAAF Books, £7.95<br />
The journey through ‘Frozen’ can be detailed<br />
quite succinctly within the opening few<br />
pages. In the introduction we’re introduced<br />
to Mike Butcher, a prolific writer and editor<br />
through such titles as Judge Dredd, Red Dwarf<br />
and 2000AD. I’m fearful of what may follow...<br />
Then, on the opening page, there’s an<br />
email from Mike’s wife, Lesley, to a friend,<br />
dating back some years, in which she writes:<br />
“Mike is getting really stressed with this<br />
course of IVF. I’ve never seen him like this<br />
before... People don’t think much of how<br />
much it hurts the men, they only think of<br />
the women.”<br />
It’s a profound contrast, because it speaks<br />
volumes of how IVF affects everyone,<br />
enveloping all before them in its hope, be<br />
that well placed or misplaced. Comic book<br />
aficionado or nuclear scientist, the subject<br />
is as pertinent to one man as it is another,<br />
and this journey details the highs, the lows,<br />
and the promise of future smiles.<br />
‘Frozen’ proves that when IVF goes wrong<br />
- not only with life-changing, but potentially<br />
life-ending consequences – there are still<br />
answers, even to the most painful of<br />
questions. And the results are emotional...<br />
Making Babies<br />
- Theresa Miller<br />
Available at Amazon.co.uk<br />
How many couples going through the<br />
process of baby-making ever feel they are<br />
truly in control? Of course, part of the thrill<br />
can be knowing that you are not, but for all<br />
those tackling the more stressful footnotes<br />
of fertility, ‘Fertile Thinking’ is an excellent<br />
guide, one that wrestles back control and<br />
empowers those wishing to call the shots.<br />
Renowned expert Anya Sizer and author<br />
Cat Dean team up to produce a unique,<br />
practical guide, specifically aimed at women<br />
experiencing difficulties. The premise here<br />
is not on advice, support and counselling,<br />
more in being able to remove those going<br />
through the process from the hard and fast<br />
facts – a journey from diagnosis of infertility<br />
to a place where they can feel happier and<br />
more in control of their lives.<br />
Many are of the opinion that unless a<br />
fertility book offers some radical new<br />
blueprint or slant, then it’s much like the<br />
one that has gone before, but this title really<br />
is aiming at the everlasting psychological<br />
imprint that the subject makes on us. The<br />
question is whether that imprint becomes<br />
a scar to be hidden away or an elegant<br />
graceful tattoo to be celebrated.<br />
Fertile Thinking<br />
- Anya Sizer and Cat Dean<br />
Infinite Ideas, £10.99<br />
Away from the clinics and doctors’ surgeries,<br />
Theresa Miller is a successful TV producer,<br />
but her battles with creating babies have<br />
tempted her away from the small screen<br />
and into the pages of a debut book. This is<br />
a touching and emotive passage through<br />
IVF, bringing together 14 brave and heartfelt<br />
journeys that sway the reader from<br />
laughter to tears.<br />
Because this isn’t one story, nor a scientific<br />
matter-of-fact insight into the world of IVF,<br />
there’s so much to be taken out of this. In<br />
essence, Theresa has crafted a range of<br />
real-life case studies, processes that will<br />
touch the widest range of readers. From<br />
those involved in IVF, those considering it,<br />
families desperate to understand exactly<br />
what is happening without wishing to pry,<br />
and even doctors and health professionals<br />
looking to get a greater steer on just what<br />
it’s like being a patient, it’s a prolific book<br />
that converses beautifully.<br />
It draws no boundaries between heterosexual<br />
and same-sex couples, and Theresa<br />
links everything with a rich compassion<br />
that makes this a worthy addition to current<br />
crop of excellent fertility titles on the market.<br />
WIN!<br />
We have copies of the above titles to give away to 15 lucky winners, drawn at random.<br />
To enter, simply email your name and contact number to competitions@fertilityroad.com,<br />
stating your top two preferences of books. Entry closes on 24 December 2010.<br />
www.fertilityroad.com 65
FERTILITY ROAD |<br />
not forgotten<br />
THE DIONNE QUINTUPLETS were five identical sisters<br />
born on May 28, 1934, in Ontario, Canada. Emilie and Marie<br />
shared an embryonic sac, as did Annette and Yvonne, while<br />
Cecile shared one with a sixth foetus, which died. Curiously,<br />
those paired together bonded closely post-birth.<br />
But the story of the sisters is a sad one. Cecile died<br />
after an epileptic seizure, aged 20, while 14 years later a<br />
blood clot accounted for Marie.<br />
Long before, when the quintuplets were just four<br />
months old, the Canadian government, led by Mitchell<br />
Hepburn, took custody of the children under the premise<br />
that parents Oliva and Elzire were unfit to care for them.<br />
This created outcry, particularly when the five girls<br />
were courted for significant press interest, which in turn<br />
provoked a flood of tourist interest. Between 1936 and<br />
1943, almost three million people walked through the<br />
observation gallery where the sisters were kept.<br />
Custody was handed back to the parents in 1948,<br />
and exactly 50 years later, the government reached<br />
settlement with the three surviving sisters for what<br />
was deemed exploitation of minors. Yvonne died in<br />
2001, leaving remaining sisters Annette and Cecile.<br />
Neither this publication nor its contents constitute an explicit endorsement by Vibration Media, or by LRN Media, of the products or services mentioned in advertising or editorial content. The editorial<br />
content in this publication does not necessarily represent policies or recommendations of Vibration Media or LRN Media. This publication is not intended to be exhaustive. While every effort has been<br />
made to ensure accuracy, neither Vibraton Media nor LRN Media shall have any liability for errors or omissions. Readers who have questions should consult their healthcare providers or other competent<br />
sources of information and guidance. © All copyright Vibration Media unless otherwise stated. Reproduction in whole or in part without written permission is strictly prohibited.<br />
66 fertility road | november - december
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