Fertility Road Magazine 46 - September/October 2018

SUPPORTING EACH OTHER THROUGH INFERTILITY • FOOD PORN 

FERTILITY JOURNEYS UPDATE • THE ART OF MALE FERTILITY TESTING 

FertilityRoad 

ONE SECRET 

TO SHIFT 

YOUR ENERGY 

Learn how to balance 

your positive energy. 

SEPTEMBER/OCTOBER 2018 

NATURAL 

APPROACHES 

TO HELPING 

ENDOMETRIOSIS 

The emotional 

strain of trying 

to get pregnant 

SUCCESS 

RATES 

EGG FREEZING 

Is it a fertility 

insurance policy? 

The recommendations for 

reducing your stress levels 

IT’S ME OR 

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FertilityRoad ISSUE 46 fertilityroad fertilityroadmag 

Contents 

LEGAL 

08 EGG FREEZING 

Is it a fertility insurance policy? 

BODY 

MIND 

22 STRESS & FERTILITY 

The infertility roller coaster can 

be a stressful journey. 

26 One secret you need 

to know to shift your 

fertility energy 

HINT... It takes more than 

positive thoughts. 

FERTILITY 

JOURNEYS 

38 IVF SPAIN 

Claire & David discuss their 

recent visit and embryo transfer. 

40 REDIA IVF & MEDITERRANEAN 

FERTILITY INSTITUTE 

Meet Kirstie & Christopher 

who are preparing for their visit 

to Greece. 

42 OREGON REPRODUCTIVE 

MEDICINE 

Heather & Brandon are starting 

their their third trimester of 

Heather’s pregnancy. 

FERTILITY 

360 

44 THE VALUE OF SUCCESS RATES 

Understand success rates and 

help keep your surrogacy 

journey on track. 

56 ITS ME OR THE BABY 

The struggle to start a family 

can put a strain on the best of 

relationships. 

10 FOOD PORN 

Do men need to be aware of what 

they are eating? 

14 NATURAL APPROACHES TO 

ENDOMETRIOSIS 

With endometriosis affecting 10- 

15% of women can a more natural 

approach help? 

30 THE EMOTIONAL STRAIN OF 

TRYING TO GET PREGNANT 

Why reducing stress levels can 

have a positive outcome for you. 

34 CONCEIVE PLUS 

MEN ONLY 

60 SUPPORTING EACH OTHER 

THROUGH INFERTILITY 

Some helpful advice for men on 

supporting their partner. 

18 WHY WEIGHT CAN MATTER 

Being over or underweight can 

affect your chances of getting 

pregnant. 

04 | fertilityroad.com 

| fertilityroadmag | follow us @fertilityroad

Contributors 

The people who made this issue happen… 

Michelle Mulliss BSc (Hons) 

MBAcC 

Michelle specialises in natural and 

assisted fertility and provides a unique 

approach of integrated medicine. 

Liz Bottrill 

Liz Bottrill is a Partner in the Family 

Law Team at Laytons Solicitors with 

over 25 years’ experience in the 

field. She has a particular interest 

and expertise in the law relating to 

children and fertility. 

Cassie Everett 

Cassie has practised Homeopathy 

for the last 11 years, first in London 

and now in Bristol. 

Bryan Woodward 

Bryan is co-editor of the book 

‘Male Infertility: Sperm Diagnosis, 

Management and Delivery’ which 

covers all aspect of male fertility for 

professionals and patients. 

Colette Assor 

Colette is a fertility acupuncturist 

with 20 years clinical experience. 

A’ndrea Reiter 

A’ndrea is a Reiki Master and 

Holistic Fertility Specialist. 

Sarah Banks 

Sarah is a Fertility coach and 

mentor who works with fertility 

professionals to enhance their 

patient experience and success rates. 

Dr Jodie Peacock ND 

Jodie is a Naturopathic doctor 

in Canada who runs the online 

program, Enhance Fertility 

Bootcamp. 

Craig Reisser 

Craig is a father through donor egg 

surrogacy and IVF. Craig works with 

Oregon Reproductive Medicine, 

the clinic that helped him become a 

father, to help other intended parents 

building their families. 

Kathy Payne 

Kathy is a women’s health coach 

online and in Norwich UK, offering 

bespoke programmes for women 

and couples, as well as online classes 

and courses. 

Russell Davis 

Russell is a fertility coach 

supporting couples on their journey. 

FertilityRoad 

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PJ Jarvis-Mack 

pj@fertilityroad.com 

Managing Editor 

Tone Jarvis-Mack 

tone@fertilityroad.com 

Art Editor 

Richard Porter 

Ad Sales 

Tone Jarvis-Mack 

tone@fertilityroad.com 

020 7183 9882 

Accounts Manager 

Lynsey Jackman 

lynsey@fertilityroad.com 

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FR News & Views 

FERTILITY APP NATURAL 

CYCLES HAS BEEN TOLD TO 

STOP CLAIMING IT IS A ‘HIGHLY 

ACCURATE’ CONTRACEPTIVE 

THE APP CLAIMS TO SHOW YOU WHEN YOU CAN HAVE 

SEX *WITHOUT* GETTING PREGNANT BUT THERE’S 

CONTROVERSY OVER ITS EFFECTIVENESS. 

Natural Cycles, the fertility app, will no longer 

be allowed to claim it is a "highly accurate" and 

"clinically tested alternative to birth control" 

by the Advertising Standards Authority (ASA). 

The ASA has banned a Facebook ad which 

made the claims on the grounds they were 

“misleading” and has told Natural Cycles not to 

repeat them. 

The ASA received three complaints about the 

ad, which was shown in July 2017 and read: 

“Natural Cycles is a highly accurate, certified, 

contraceptive app that adapts to every woman’s 

unique menstrual cycle. Sign up to get to know 

your body and prevent pregnancies naturally.” 

It also claimed the app was a “clinically tested 

alternative to birth control methods”. 

Natural Cycles said the claims were based 

on clinical studies. It said when a person 

used the app exactly as instructed it had 99% 

effectiveness. But the ASA pointed out that the 

app requires users to input accurate information 

including hormone levels – which could lead 

to errors – and said that taking into account 

“imperfect” use of the app brought it to around 

91.7% effectiveness in preventing pregnancy. 

While some feel it has revolutionised 

contraception by freeing women from needing 

to take hormonal contraception, there have 

been widely-reported concerns over the 

accuracy of the app. In Stockholm, 37 women 

reportedly fell pregnant while using it. 

“We told Natural Cycles not to state or imply 

that the app was a highly accurate method 

of contraception and to take care not to 

exaggerate the efficacy of the app in preventing 

pregnancies,” the ASA said. 

The Family Planning Association also expressed 

concerns about the app. A spokeswoman said: 

“The use of the word ‘certified’ suggests that 

there is independent evidence supporting these 

claims, whereas in fact the only evidence is 

from the company itself. It has amassed a vast 

database, which is very interesting, but that is 

not the same as verified independent evidence. 

“Many other apps focus on getting to know your own 

body, but Natural Cycles is specifically targeting itself 

as a contraceptive, which is concerning.” 

Bekki Burbidge, Deputy Chief Executive at FPA 

aded that while apps are incredibly popular, 

they’re also “fairly unregulated” and it can be 

hard “to sort the good, evidence and researchbased 

apps from the bad”. 

She said: “Fertility apps can be particularly 

helpful for planning a pregnancy, but we’re 

still cautious about using them to prevent 

a pregnancy without initial support from a 

trained fertility awareness teacher. A teacher 

can support you while you learn to track your 

cycle and can help you understand the things 

that can make fertility awareness less effective. 

Things like travel, alcohol, stress or just not 

having enough sleep, can all affect temperature 

readings for apps like Natural Cycles. 

“At the moment there’s not enough 

independent evidence available about the 

reliability and effectiveness of apps. To use 

fertility awareness as effective contraception, 

whether you’re using an app or not, you need 

to be motivated and understand the advantages 

and disadvantages, especially the things that 

can make it less effective.” 

“Natural Cycles has been independently evaluated 

and cleared by regulators in Europe and the US 

based on clinical evidence demonstrating its 

effectiveness as a method of contraception.” 



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The book starts with a familiar account of how the 

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Following unfruitful visits to unsympathetic GP’s 

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A chance visit to a Chinese herbalist sorted out 

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Next up a partner to fill the ‘baby shaped void’ 

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There follows an intense period in the story 

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An open mind, a favourable physical response and of 

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The book is a good read for anyone embarking 

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main things I took from it was the fact that those 

of us on the journey have been increasingly 

educated and empowered about fertility and our 

own bodies. Increased access to educational and 

medical information; treatment options and 

holistic support have strengthened our arm – our 

fertility destiny, or a large part of it, is moving 

slowly into our own hands. We are empowered 

patients and our fertility options are to a large 

degree considered and ultimately decided by us. 

Osborn sums this up perfectly. Whilst accepting 

she did not always receive the responses she desired 

from her consultants, nurses and GP she appreciated 

all their help and guidance in hindsight. 

However, as a final caveat she says; 

“There is a wealth of information ‘out there’ so you 

also need to consider how you feel and what is right 

for you. Knowledge is power and even if it doesn’t 

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'Against the Odds: A journey through the 

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Infertility, IVF and 

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Ask the average lay 

person about the 

prospect of reading 

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miscarriage and no 

doubt it wouldn't be top of their Christmas 

list. If, however, you are one of the increasing 

numbers of people affected by infertility it is 

very likely that you will want to consume as 

much information, advice and sign posting as 

you can possibly grab hold of. 

Many people who find themselves in the fertility 

wilderness wonder where to turn first. There are 

a mountain of online and hard copy resources, 

guides, podcasts, vlogs and blogs to access but at a 

time of vulnerability, confusion and even panic it 

is difficult to know where to start. 

‘Infertility, IVF and Miscarriage – The Simple 

Truth’ by Dr Sean Watermeyer successfully opens 

the debate for those struggling to conceive and 

offers a step by step guide to IVF and examines the 

causes of infertility, investigations, treatment and 

miscarriage. As a Consultant Gynaecologist and 

Obstetrician, Watermeyer combines his extensive 

knowledge, practical application and quite obvious 

clinical success in this short, snappy, jargon free 

and sometimes light hearted guide – and before 

you say anything, why can’t we laugh in the face of 

infertility sometimes?! 

The guide is extremely comprehensive and 

Watermeyer discusses every point of the fertility 

journey from when to seek advice; the female and 

male physiological perspective; investigations 

and treatments including ‘add ons’; miscarriage 

through to the consideration of lifestyle, 

complementary and medical interventions to 

improve the chances of a successful pregnancy. 

In the world of fertility information which is 

so diverse and fragmented Watermeyer offers 

bite sized chapters each with a clear aim and a 

very useful, ’So the message is..’ section which 

summarises the main elements of each chapter. 

Using anonymous case studies of real patients’ 

Dr Watermeyer achieves his goal of delivering 

a refreshing, insightful and clear guide for the 

general public. 

For anyone who is starting or at the early stages of 

their fertility journey this guide is a must. It will 

equip you with the information and knowledge to 

enable you to take an active and empowered role in 

your own journey. In Dr Watermeyer’s own words, 

“Don’t be fobbed off”- use this guide to learn more 

about your particular situation, options and choices 

and use it to direct your own journey. 

‘The Simple Truth’ is much more than a guide 

– it is a blueprint for your future and I would 

wholeheartedly recommend it. 

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Dr Sean Watermeyer is available from 

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LEGAL 

EXPERT: Liz Bottrill 

EGG FREEZING: 

IS IT A FERTILITY INSURANCE POLICY? 

"Should I freeze my eggs" is a question many 

women consider and for many different 

reasons. Perhaps they have not found the right 

partner or they are at a particular stage in 

their life when they are simply not ready for 

a child, but at the same time, do not wish to 

miss the opportunity of producing and storing 

eggs before their biological clock gets the best 

of them, or before the quality of their eggs 

degrade making it harder to become pregnant 

in the future. 

With many clinics offering egg freezing to 

their patients, the procedure has transformed 

from one only undertaken if there is a medical 

need (perhaps before embarking on a course 

of treatment which is likely to affect fertility) 

to what has been termed by some as a fertility 

‘insurance policy’ allowing women the 

opportunity to take steps now in an attempt to 

preserve their fertility just in case they are unable 

to produce viable eggs in the future. However, the 

value of that ‘insurance policy’ continues to be 

a matter for debate with wildly varying quoted 

success rates, which remain relatively low, and at 

a not unsubstantial cost. Yet many take the view 

that a backup plan is better than nothing at all, 

even if it offers no guarantees. 

However, the decision to freeze is only the first 

of many decisions to be taken which can have 

significant consequences in the future. For 

example, should the egg be frozen on its own, or 

should it be frozen as a fertilised embryo? The 

embryo is thought to be more robust than the egg 

increasing the prospects that it would survive the 

freezing process but comes with less flexibility 

to meet changes in the woman’s circumstances. 

The genetic makeup of an embryo is set by the 

choice of sperm used to create it (whether known 

or through anonymous donor sperm) and cannot 

be changed if, for example, the woman meets a 

new partner before she is ready to have children. 

Furthermore, if a woman and her partner 

separate before the embryo is implanted and the 

partner withdraws his consent for the embryo to 

be stored or used, it may have to be destroyed. 

The decision of when to freeze the eggs is also 

an important one. From a medical perspective, 

the advice seems to be to freeze early on rather 

than waiting till you are in your mid to late 30s 

and 40s and using egg freezing as a last-ditch 

attempt to preserve fertility. Whilst this may 

well be sound medical advice, there can be legal 

ramifications. That is because in the UK, it is 

only possible to store eggs for a maximum of 10 

years after which they must be destroyed. The 

only exception to that rule is if the woman, or 

in the case of freezing embryos, her partner, are 

or are likely to become prematurely infertile. In 

that case, if the correct steps are taken before the 

10 year time limit expires, the time for storage 

can be extended. 

The choices that freezing offers are undoubtedly 

beneficial – but in making decisions about what 

and when to freeze guidance should be taken from 

both your medical and legal team. As with all 

forms of insurance, a full assessment of the risks 

and the possible future consequences is needed to 

ensure the choice you finally make is the one most 

likely to provide you with the best outcome in 

your particular circumstances in the future. 

Liz Bottrill is a Partner in the Family Law 

Team at Laytons Solicitors with over 25 years’ 

experience in the field. She has a particular 

interest and expertise in the law relating to 

children and fertility. 



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BODY 

EXPERT: Michelle Mulliss 

FOOD PORN 

It’s a Man’s World 

Parenthood is something that not just the 

mother needs to get ready for; dads need to be 

prepared too. Infertility is on the rise in our 

modern world. According to statistics, there has 

been almost a 20-30% rise in infertility in the 

last five years. 

In men, the quality of semen is the main reason 

of failing to impregnate the partner with 35% of 

male infertility issues are due to low sperm count 

and motility. 

Common reasons for male infertility are low 

sperm concentration (oligospermia), poor 

sperm motility (asthenospermia), and abnormal 

sperm morphology (teratospermia). The exact 

reason for the decline in semen quality is 

not clear, but environmental, nutritional, 

socioeconomic and other factors are starting to 

come into focus, but what can you do to help 

improve your sperm health? 

Stock up on fruits and vegetables: A study 

conducted by the Harvard University found that 

eating yellow and orange coloured vegetables 

and fruits had a profound effect on the health 

of the sperm. Yellow and orange colour in fruits 

and vegetables have an abundant amount of 

“carotenoids” including beta carotene which is 

converted to Vitamin A in the body. It is one of the 

most potent antioxidants. Sweet Potato and melon 

were found to improve both the quantity and 

quality of sperms while red vegetables particularly 

tomatoes, which contains lycopene, improved the 

quantity of abnormally shaped sperms by 8-10%. 

Break on the processed food: Processed and take 

away fast foods are known to be detrimental to 

our health. A young men’s study carried out at 

the University of Rochester took a group that 

was fed a diet high in processed and red meat, 

refined grains, fast foods, high energy drinks 

and fast food. Another group were put on a 

healthy diet of chicken, fish, fruits, vegetables, 

whole grains and legume beans. It was no 

surprise that those on the healthy diet had 

better sperm motility which has been supported 

by various studies of the positive role of diets 

high in whole grains, legumes, fruits vegetables 

and fatty acids on sperm health and fertility. 

Manage the cholesterol: We have seen 

that couples with a high levels of 

cholesterol take longer to conceive. 

A study published in the Journal 

of Clinical Endocrinology & 

Metabolism concluded that 

couples or either of the partner 

with high cholesterol found it difficult to 

conceive as compared to other couples. So, ensure 

to get in those fibres, whole fruits and lean plant 

proteins into your daily diet and keep a check on 

your lipid profile. 

Ditch saturated fats: Saturated fats do not only 

have an adverse effect on your heart and waist 

line but are also major contributory factors for 

low sperm count. Studies have suggested that 

even a 5% increase in saturated fat intake could 

result in a decrease in sperm count. 

Protect against oxidative stress (OS): OS is 

directly related to cellular damage which 

is caused by free radicals known as reactive 

oxygen species (ROS). Small amounts of ROS 

are needed for functioning of the sperms, 

however when their number increases, and 

our antioxidant defences are overwhelmed 

impacting on the quality of sperm. 

Weight in check 

Obesity is a health target for the NHS, 

and research has shown that obesity 

has an impact on reproductive health 

with reducing sperm concentration 

and delaying conception. Increased 



BODY 

BMI is also associated with decreased levels of 

testosterone and an increase in oestrogens – causing 

low sperm counts and infertility. 

Nutrition can be a minefield when it 

comes to fertility which to some can be 

overwhelming with the marketing of 

supplements. It’s important to reiterate 

that to maintain health, a varied 

and balanced diet is key. However, 

certain nutrients have been shown 

to increase sperm count, motility 

and quality which include; 

Vitamins 

Vitamin A deficiencies have been 

linked to sluggish sperm and motility 

issues. Eat plenty of red peppers, oats, 

carrots, dried apricots, sweet potatoes, spinach 

and broccoli to give you a vitamin A boost. 

Vitamin C, found in good amounts in 

strawberries, asparagus, fruit and yellow veggies, 

has a positive effect on sperm viability and 

motility (the swimming ability of sperm). 

Vitamins C, E and B12 are also great antioxidants 

that can help boost sperm production and 

motility by fighting harmful free radicals. 

Minerals 

Inadequate levels of zinc can cause lowered 

sperm counts. Natural sources of this 

mineral can be found in oysters, 

eggs, turkey, seafood, pumpkin 

seeds, liver, beef, oats, lamb, 

yoghurt, nuts and barley. 

Selenium is also thought 

to be beneficial to sperm 

motility and health. 

You can get it by eating 

Brazil nuts, red meat, 

cottage cheese, poultry 

and eggs. If you don’t think 

you are getting enough zinc 

or selenium, a multivitamin may 

help. However, be sure to stick within 

the recommended dose, as high levels of both 

these minerals can become toxic. 

Fatty Acids 

Studies have shown that fertile men’s sperm tend 

to contain greater amounts of polyunsaturated 

fats (many unsaturated fats), specifically omega-3 

and omega-6 fatty acids, than that of infertile men. 

They’re found in walnuts, chia seeds, omega-3 

supplements like krill oil but can be found in oily 

fish like anchovies, sardines and salmon. 

Folic Acid 

It is well known now that 

women should take folic 

acid when preparing for 

pregnancy. This I believe 

should be extended to men 

as I see in clinic which is 

also supported with recent 

research that some men 

who have been taking dietary 

supplements containing folic 

acid in combination with zinc have 

experienced increases in sperm counts of as 

much as 70% and research suggests that men with 

low folic acid levels tend to have more sperm cells 

with chromosomal (genetic) abnormalities. Keep 

your levels up by eating leafy green veggies, whole 

grain foods, avocados, beans and fruit. 

Lycopene 

Lycopene, has been shown to help increase sperm 

count and can be found in tomatoes, carrots, 

watermelons and paw paw fruit. 

Water 

Many of us get caught up with such busy lifestyles 

that water intake can be forgotten. However, 

drinking plenty of water throughout the day you 

can counteract dehydration, which is one of the 

main factors associated with low semen volume. 

Food Porn 

Cooking and presenting 

food that is not 

only appealing but 

tastes great can be 

challenging, and 

many couples often 

ask for advice on 

how to cook the foods 

recommended in my 

clinics. It was through 

this concept and my love 

of cooking I created Fertile 

Foods cooking workshops. These 

workshops help encourage the understanding of 

nutrition in all areas of reproductive health and 

have helped couples embrace nutrition to add 

splash of fun in the pan. 



BODY 

Here are some recipes to help boost sperm and 

most of all taste great. 

Persian Pomegranate Chicken 

Try this tasty recipe with walnuts and 

pomegranate which are great for sperm health. 

Walnuts are bursting with essential omega-3 fatty 

acids and antioxidants to help in boosting sperm 

volume and production by increasing blood flow 

to the testicles. Whilst the delicious pomegranate 

fruit is known as a powerful food that helps in 

increasing sperm count and improves semen 

quality. It is full of antioxidants that help in 

fighting against free radicals in the blood stream. 

Ingredients 

• 1 to 2 large yellow onions, chopped, (3 cups) 

• 2 Tbsp unsalted butter 

• 3 Tbsp olive oil 

• 5 Tbsp pomegranate molasses (simmer 1 cup 

of pomegranate juice until it reduces to 5 Tbsp 

of syrup) 

• 1/2lb walnut halves (about 2 cups) 

• 2 lbs boneless skinless chicken thighs and/or 

breasts, trimmed of excess fat, cut into medium 

size pieces, patted dry and salted 

• 2 cups chicken stock 

• 2 Tbsp plus 2 teaspoons of sugar 

• 1/2 teaspoon turmeric 

• 1/4 teaspoon cinnamon 

• 1/4 teaspoon ground nutmeg 

• 1/4 teaspoon ground black pepper 

• Salt 

• 1/2 cup fresh pomegranate arils for garnish (optional) 

Method 

You can toast the walnuts in one of two ways. You 

can either spread them out in a single layer in a 

large skillet, and toast them on medium high heat, 

stirring frequently until lightly toasted, OR you 

can spread them out in a single layer in a baking 

rimmed baking sheet, and toast at 350°F in the 

oven for 8 to 10 minutes. 

In either case, once toasted, remove from heat and 

allow to cool. Once cool enough to handle, pulse in 

a food processor or blender until finely ground. 

In a large pan, heat 1 tablespoon of butter and 2 

tablespoon of olive oil over medium-high heat. 

When the butter has melted, pat the chicken pieces 

dry again and place the chicken pieces in the pan, 

working in batches if necessary to not crowd the pan, 

and cook until golden brown on all sides. Sprinkle 

the chicken with salt while they are cooking. 

Remove the chicken from the pan, set aside. Add a 

tablespoon of butter and a tablespoon of oil to the 

pan. Lower the heat to medium low. Add chopped 

onions to the pan and sauté until translucent, 

stirring on occasion to release the browned bits 

from the bottom of the pan. 

Return the chicken pieces to the pan with the 

onions. Pour 2 cups of chicken stock over the 

chicken and onions. Bring to a boil, reduce to a 

simmer, cover and simmer gently for 30 minutes. 

Stir in the ground walnuts, pomegranate molasses, 

sugar, and spices. Cover and cook on very low 

heat for 1 hour, stirring every 20 minutes or so to 

prevent the walnuts from sticking to the bottom 

of the pan. 

Remove from heat and adjust sugar/salt to taste. At 

this point the chicken should be fall apart tender. 



BODY 

Ginseng Chicken 

Ginseng has been known for its health benefits 

and is a powerful herb known for improving 

male fertility by increasing the number of 

sperms, sex drive and also enhances the sexual 

performance. It also helps in fighting erectile 

dysfunction, increasing semen volume and 

sperm production. 

Garlic contains a chemical compound called 

allicin, that helps in improving the flow of 

blood to the genitals and boosts the strength 

and endurance of the sperm. They are also 

power-packed with selenium and vitamin B6 

which helps in preventing sperm damage and 

hormone regulation. 

This recipe combines ginseng and garlic in this 

tasty chicken ginseng broth soup. 

Ingredients 

• 4 cups boiling water 

• 5 oz Korean red ginseng tea 

• 2 small chickens (poussin) or Cornish hens, 

(about 2lb each) 

• 4 large cloves garlic 

• 15 goji berries 

• 3 pieces dried Korean red ginseng (optional) 

• 2 cooked chestnuts, peeled (optional) 

• 1 cup uncooked sweet rice 

• 2 pinches dried chili threads 

• Handful fresh pea shoots 

• 1 tablespoon roasted sesame oil 

• 1 teaspoon black sesame seeds 

• Sea salt 

• Freshly ground black pepper 

Method 

Brew the ginseng tea by mixing together 

the boiling water and the ginseng tea until 

dissolved. Set aside. Rinse the chickens with 

cold water. Place 2 of the garlic cloves, goji 

berries, 1 piece of ginseng, a chestnut, and 2 

tablespoons of rice into the cavity of each bird. 

Skewer each closed with a toothpick. Place the 

remaining rice in a double layer piece of muslin 

or cheesecloth with of the remaining ginseng 

and date. Tie the cloth closed tightly but leave 

a little bit of extra space for the rice to expand. 

Place the chickens and rice bag into a large wide 

heavy-bottomed pot. Cover with the tea, and 

top off with water to cover, if necessary. Bring 

to a boil over high heat. Reduce the heat and 

simmer, occasionally skimming away any fat 

that comes to the surface, until cooked through, 

about 2 hours. 

When done, the chickens should be very soft 

and fall apart easily when tugged at. Carefully 

transfer the chickens to two bowls and divide 

the broth between them. Top the chickens 

with chili threads, garnish with pea shoots, 

and a sprinkle of black sesame seeds. Drizzle 

with sesame oil. Unwrap the rice package in a 

separate bowl and sprinkle with black sesame 

seeds, if you like. Serve with salt and pepper on 

the side. 

Should you want to know more about how 

you can improve your fertile health with 

food, visit michellemulliss.com or email 

info@michellemulliss.com 



BODY 

EXPERT: 

Dr Jodie Peacock BSc, ND 

Naturopathic doctor - The Root of Health 

Founder of Enhance Fertility Bootcamp program enhancefertilitybootcamp.com 

NATURAL APPROACHES TO 

HELPING ENDOMETRIOSIS 

Endometriosis is a common condition affecting 

between 10-15% of women. It is a condition where 

the cells that should only be found within your 

uterine lining migrate and are found in other 

areas within your abdominal cavity. The growth 

of these cells outside the uterus can cause a host 

of different symptoms depending on the location 

the tissue is growing on. These cells respond the 

same way as your normal endometrial tissue 

to hormone stimulation. This means that they 

grow and bleed in the same cyclical pattern as the 

tissue in your uterus. This internal bleeding can 

lead to areas of scar tissue development, regions 

of inflammation and pain. 

Symptoms of endometriosis will vary from 

women to women but can include painful and 

heavy periods, painful intercourse, pain with 

urination or bowel movements, low energy and 

concerns with fertility. It is thought that up 

to 60% of women with fertility concerns have 

some degree of endometriosis. The diagnosis of 

endometriosis can be quite difficult and the only 

way to get a true diagnosis is by doing a surgical 

procedure called laparoscopy. 

The precise cause of endometriosis is still yet to 

be determined. There appears to be an increase in 

immune activity in the uterus, with a correlation 

between supressed immune functions and an 

increased number and size of lesions. There is a type 

of immune cell called a natural killer cell. These 

cells help to keep abnormal cells in check and are 

suppressed in some women with endometriosis. 

A different immune cell called macrophages also 

plays a role in endometriosis. Macrophages have 

a job to clean up any general debris. There is an 

increase in macrophage activity seen in the uterus 

of women with endometriosis. This may lead to 

a women’s body identifying sperm as foreign and 

therefore contributing to infertility. In 

terms of fertility, endometriosis 

can lead to scarring on 

fallopian tubes, adhesions 

and unruptured follicles in 

the ovaries are often seen. 

What are the 

risk factors 

for developing 

endometriosis? 

The most common risk factor is 

genetic. If your mother has endometriosis 

there is an 8% higher chance of you having it 

and about a 5% higher chance if your sister has 

endometriosis. Women with shorter periods 

and women with more frequent periods (with 

shorter time in between) have a higher risk. 

From a lifestyle standpoint, low activity levels 

from a young age, high fat diets and the use 

of intrauterine devices (IUDs) have all been 

demonstrated to increase the risk. From a 

It is thought that 

up to 60% of women 

with fertility concerns 

have some degree of 

endometriosis 

hormonal standpoint, having elevated or 

unbalanced levels of estrogen have been shown 

to make symptoms worse. 

Your liver has the task of breaking down 

hormones including your estrogens. This 

includes both your natural estrogens, synthetic 

estrogens (medications) as well as 

environmental toxins that can 

mimic estrogens. As the 

liver breaks down 80- 

90% of your estrogens, 

optimizing its ability 

to function will help 

support your treatment. 

Your liver metabolizes 

estrogen by attaching 

it to glucuronic acid and 

excreting the combo into 

your intestinal system for 

removal. The health of your 

intestinal flora is imperative to your 

body being able to eliminate the estrogen. If 

you have an abundance of healthy bacteria in 

your gut, you can rid your liver of the estrogen 

it has just worked to detoxify. If, however, you 

have an abundance of unhealthy bacteria, they 

can break the bond between the estrogen and 

glucuronic acid and allow the estrogen to be 

reabsorbed into your blood stream. Your liver 

then must work double time to get rid of this 

same estrogen again. 



BODY 

As you can see endometriosis is a complex multifactorial 

condition. To minimize symptoms and 

further growth we need to address the health 

of your liver, intestines, immune function and 

estrogen balance. 

Where to begin? 

1. Nutrition and diet will play 

a huge role in managing 

endometriosis. 

High fibre foods can provide significant benefit 

by helping support the healthy bacteria in the 

gut and crowd out the harmful ones. Increasing 

fibre by focusing on vegetables, legumes and 

beans can help improve digestion as well as reduce 

inflammation which will help reduce pain levels. 

Reducing the amount of red meats in your 

diet. Red meats, when consumed, release a 

substance called arachidonic acid that promotes 

inflammation contributing to pain levels. 

Including plant-based protein sources such 

as soy, nuts, seeds, beans or legumes in your 

meals, will assist your body in lowering levels of 

inflammation. You can also look to substitute 

fish for meats, as fish contains a type of fatty acid 

called omega 3s that work to reduce inflammation. 

Limit your caffeine intake. Women who have 

less than the equivalent caffeine of about 6 

cups of coffee per month had on average 40% 

improvement in symptoms compared to women 

who consumed over this amount. There is 

approximately 120mg of caffeine in a cup of 

coffee, so keeping total intake under 7g is optimal. 

Some patients I find do significantly better with 

eliminating caffeine entirely from their diet. Try it 

for one full cycle and see if you notice a difference. 

Or as another option I find for some women even 

it they stop for the week before their period this 

can have a positive impact. 

Focus on including more liver supporting foods 

and herbs. The family of vegetables known as 

brassicas includes broccoli, cauliflower, kale, 

brussel sprouts, cabbage, bok choy and turnips. 

These vegetables contain a nutrient called 

indole-3-carbinol or I3C. I3C helps the liver to 

metabolise estrogens, so can be helpful to assist 

in the balance of estrogen in the body. Root 

vegetables such as beets, sweet potatoes, radishes, 

and artichokes are very nourishing for the liver 

to also assist in overall function. In general, 

making sure you are getting a minimum of 5 

servings of vegetables per day will go a long way 

to ensuring you are getting adequate fibre and 

nutrients to support detoxification. 

2. Supporting your stress and 

nervous system. 

When your body is under higher levels of 

constant stress your adrenal gland makes more 

of a hormone called cortisol. The body uses your 

progesterone to make cortisol, so with higher 

stress levels your progesterone levels can drop 

leaving the ratio of estrogen to progesterone 

imbalanced. This allows for higher levels of 

estrogen that can stimulate endometrial tissue. 

As well contributing to pain in endometrial 

tissues, this can also affect the length of a 

women’s cycle and the heaviness of period 

flow. Elevated levels of cortisol can also have a 

negative impact on immune function which also 

isn’t helpful when it comes to endometriosis. 

There are several ways to help your body 

regulate stress more effectively. One is to add 

(or continue) regular daily exercise. Doing any 

type of activity that you enjoy is fine. This could 

range from walking, biking, dancing, swimming 

or weights and classes at the gym. 

Breathing properly is also critically important to 

keeping cortisol levels in a good range. Doing either 

diaphragm or yoga breathing each day, helps keep 

your body in its relaxation nervous system. 



BODY 

3. Reducing exposure to 

estrogenic or hormone 

disrupting toxins. 

Hormone disrupting toxins will have the largest 

impact on hormonal based concerns such as 

endometriosis as well an on overall fertility and 

reproductive health. Some examples of common 

places we will find these chemicals include lotions, 

makeup, soaps, cleaning products, food storage 

containers, water supply. The Environmental 

Working Group (EWG) published a list of the 12 

top hormone disrupting chemicals and includes: 

1. Bisphenol- A (BPA) 

2. Dioxin 

3. Atrazine 

4. Phthalates 

5. Perchlorate 

6. Fire retardants 

7. Lead 

8. Mercury 

9. Arsenic 

10. Per fluorinated chemicals (PFCs) 

11. Organophosphate pesticides 

12. Glycol ethers 

We know we have exposure to the majority of 

these chemicals on a daily basis. Some are easier to 

avoid than others. This list is not meant to make 

you panic but to begin to draw awareness to the 

exposures that we can control. 

Why are these types of toxins so problematic? 

Some of the hormone disrupting toxins will bind 

to the same receptors that your hormones bind to. 

This means your body can think you have more 

or less circulating hormones than you actually 

do. Some hormone disrupting chemicals will 

increase the amounts of hormones your body 

High fibre 

foods can provide 

significant benefit 

by helping support the 

healthy bacteria in the 

gut and crowd out the 

harmful ones 

secretes, others will decrease 

amounts, and some will 

even mimic the function 

of the hormones. As your 

body’s levels of certain 

hormones change, this 

can lead to changes in 

the menstrual cycle, 

immune function and 

how your body responds 

to stress. Some of these 

chemicals, for example phalates, 

link directly to endometriosis. 

Toxins are ubiquitous in our environment, so 

we are never going to be able to get away from 

exposure. We can however do things to minimize 

exposure and encourage the body to eliminate and 

excrete the toxins instead of storing them. One 

of the best ways to encourage toxins from your 

body is through sweating. This can be done either 

through exercise or the use of saunas. 

Visit ewg.org for more information on where to 

find these toxins and ways to reduce exposures. 

Optimizing your digestion and liver function 

are two of the most important ways to not only 

improve your endometriosis but also to optimize 

your overall health. There are also other nutrients 

and herbal medicines that can be used to assist 

with pain so please speak to your Naturopathic 

doctor or other health provider to see what makes 

the most sense for you. 



BODY 



BODY 

Why Weight 

Can Matter 

It’s Best to Lose Weight 

Before Trying For a Baby 

EXPERT: Kathy Payne 

It's best to manage weight at a healthy level 

when planning a baby, either naturally or via 

IVF. It's also best to do it before trying to fall 

pregnant. That's because being overweight 

or underweight can affect fertility. Let's talk 

about weight management for fertility. 

Weight Can Affect Hormones 

Women’s hormones need to be in balance for 

a regular and healthy menstrual cycle. Being 

overweight or underweight risks hormone 

imbalances and we start to notice signs, like cycle 

irregularities and fertility challenges. 

Fertility and Being Overweight 

Some studies show that overweight women 

are more likely to encounter fertility issues. 

Generally speaking, the more overweight we are, 

the higher the risk of problems. This is simply 

because overweight women tend to have more 

fat cells, than those women who are classed as 

normal weight. 

Fat cells produce oestrogen; it’s not just our ovaries! 

Because fat cells produce oestrogen, overweight 

women are at higher risk of what’s commonly 

called “oestrogen dominance”. Oestrogen 

dominance means too much oestrogen in 

relation to progesterone i.e. a hormone 

imbalance. Oestrogen dominance can impact 

cycle health, ovulation and fertility. 

Some common signs of too much oestrogen/ not 

enough progesterone include: 

• Brain fog and memory issues 

• Mood swings, irritability and depression 

• Sleeplessness 

• Tiredness 

• Hormonal migraines and other headaches 

• Hair loss 

• Thyroid problems 

• Cold hands and feet 

• Sore and tender breasts 

• Abdominal bloating 

• Weight gain and slower metabolism 

• Low libido 

• Period problems 

• Endometriosis 

• Fibroids 

• Infertility and miscarriage 

Fertility and Being Underweight 

Being underweight can also be a factor to consider 

when you’re planning a baby. Underweight 

women tend to have a lower percentage body fat 

than women classed as normal weight. 

Women need a certain amount of body fat to 

ensure hormone balance and ovulation. If we’re 



BODY 

underweight, our bodies “think” there 

are not enough fat stores for pregnancy, so we 

are less likely to conceive and run higher risk 

of miscarriage. 

It’s not only the underweight who should watch 

out however, it’s possible for a woman to be 

average or even above average weight, but still 

have a low body fat percentage. As an example, 

let’s look at female elite athletes or women who 

exercise a lot and hard. Their low body fat and 

high muscle percentage can cause their periods to 

become irregular or even stop altogether. 

BMI is only one measure of weight and health. 

It’s a useful indicator but it’s not the only 

measurement to consider because it doesn’t 

show us the fat/muscle make-up of our bodies. 

It’s possible to measure that and I’ve found that 

many gyms have machines to measure fat/muscle; 

alternatively you could ask your doctor instead. 

Accepted reference ranges suggest that underweight 

is a BMI lower than 20. Normal BMI is 20-15. 

Overweight is a BMI of 25-30. Obese is a BMI of 30- 

40 and morbidly obese is over a BMI 40. 

If weight is a factor for you, there are some things 

I suggest before trying to conceive. 

Here are some suggestions: 

Tips for Managing Weight 

It's best not to go on a weight loss diet when 

you're trying to conceive. 

Sorry, but it much better to lose excess 

weight first and then try for a baby. 

Many of my clients, ask me 

why. The imbalance is usually 

temporary and maintaining 

a healthy weight and eating 

healthily should rebalance 

any issues over time. 

Slimming diets - especially very 

restrictive ones - can cause periods to 

become irregular and ovulation to stop, 

because hormone levels drop. 

Wait until 3-4 months AFTER losing weight 

to start trying for a baby, if you can. 

Weight can be a 

fertility factor for 

women, because it 

impacts hormone 

balance 

I know this can sound like a very long wait when 

you really want a baby. I suggest this as a precaution 

when time is on a woman’s side. Sometimes nutrient 

levels - including all the really key fertility fuelling 

nutrients - can be lower after a slimming diet. 

I therefore recommend boosting nutrient levels 

if you’ve been on a slimming diet. 

In my clinic, I use hair mineral tests from a 

respected Laboratory to help couples 

identify any mineral deficiencies 

and also exposure to toxic metals 

which also impact fertility. 

I work out what foods and 

supplements they may need, 

based on those test results. 

No faddy diets, please. 

That’s because you risk robbing your 

body of nutrients, including the ones 

needed for fertility and a healthy pregnancy and 

bouncing baby. It is best to gradually lose weight 

through a healthy, varied and balance diet. And 

that includes plenty of healthy fats! 



BODY 

It doesn’t include “diet” or lite products. They 

can be packed with health and hormone harming 

chemicals, sugar or artificial sweeteners. In fact, 

the basics of a fertility friendly diet will help you 

lose weight. 

1-2lbs a week is a steady, healthy and brilliant 

weight loss. 

The aim is to lose weight to become a healthy 

weight for fertility, not skinny-down as much 

as you possibly can. Even losing a small amount 

of weight can make a big difference to general 

health and fertility. 

The basics of a fertility friendly diet 

1. Balance blood sugar by having good quality 

protein with every meal and snack. Good 

protein sources include nuts, seeds, legumes, 

eggs, fish, poultry, meat, dairy. For other 

fertility-protecting reasons, go easy on the 

red meat and cow’s dairy. Eat breakfast and 

another two good meals. Only snack if you’re 

really hungry or feeling whoozy/hangry. 

2. Choose organic food as far as possible - 

certainly for any meat or poultry, dairy and 

the “dirty dozen” veggies and fruits. See the 

EWG’s list of the worst pesticide residue 

covered veggies and fruits. ewg.org/foodnews/ 

dirty_dozen_list.php 

3. Eat a rainbow and plenty of vegetables and 

fruits - much more veggies than fruits and 

include leafy greens. Have at least seven 

portions of veggies and fruits daily. Yes, SEVEN. 

4. Eat good fats - nuts, seeds, avocados, oily fish, 

extra virgin olive oil, coconut oil, grass-fed 

butter and ghee and grass-fed red meat. Reduce 

saturated fats from factory farmed meats 

and trans fats from processed, packaged and 

takeaway foods. 

5. Choose unrefined carbs for fibre and nutrition 

- brown rice, quinoa, chia seed, oats, rye, spelt, 

buckwheat, legumes, starchy veggies and if you 

have wheat eat sparingly and have wholegrain. 

You need LOTS of fibre for digestive 

and hormonal health. 

6. Avoid - or vastly reduce 

- caffeine, alcohol, 

sugar and artificial 

sweeteners, processed 

and refined foods. 

Don't start binge 

eating sugary or 

junk food to gain any 

weight. 

Please don’t start binge eating 

pasties, shovelling in chocolate 

and crisps or troughing takeaways! 

They are simply NOT fertility-fuelling foods. 

Eat more nutritious, calorie-dense foods - nuts 

and seeds, avocado, eggs, brown rice, oily fish and 

healthy fats and oils. Increase your number of 

healthy snacks as well. 

CROWD IN healthy foods to lose weight. 

I know that losing or gaining weight is not 

always straightforward and habits can be tough 

to break. In my clinic, some people have seemed 

daunted. I start with the simple practice of 

crowding in what you do want and to crowd out 

what you don’t want. 

Slimming diets 

- especially very 

restrictive ones - can 

cause periods to become 

irregular and ovulation to 

stop, because hormone 

levels drop. 

As an example, if you’re trying to cut down on 

sugar, crowd in more protein and soon you’ll be 

eating more protein, feel fuller for longer and 

less likely to be eating a doughnut at elevenses. 

Give it a go and see how it works for you. 

If you have a male partner, check his weight too 

Men’s weight matters too. Being overweight can 

affect male fertility. It’s been linked 

to poor sperm quantity and 

quality. One of my mantras 

is it takes two to tango 

and two to make a baby. 

Both women and 

men should tackle 

weight issues as part 

of their preconception 

care plan. 

Weight and BMI can 

affect chances of getting 

pregnant - that’s women 

and men. 

I work with women and couples who 

want babies. Sometimes those people are 

struggling to conceive. I suggest food and lifestyle 

changes tailored for them and I practice natural 

therapies to support them 

And I know that sometimes people feel a little 

daunted and wonder how they’ll stick with my 

new suggestions. Of course, it’s easier when 

you’re working with someone to support and 

encourage you, but for everyone I’d say it’s 

a matter of giving yourself the best chance 

you can of natural conception or IVF success. 

And maximising your chances of a healthy 

pregnancy and happy, bouncing baby, through 

your diet and lifestyle choices. 

It’s about taking control of all the fertility factors 

that you can control and that includes weight 

and BMI. 

Love, Kathy x 

Kathy Payne is a Booster of Fertility, Balancer 

of Hormones and Soother of Modern Life 

Madness, naturally. She is a women’s health 

coach online and in Norwich UK, offering 

bespoke programmes for women and couples, 

as well as online classes and courses. 

If you’d like to protect, nurture and boost 

your fertility naturally, sign up for her 

weekly newsletter and occasional offers with 

this link. As a FREE GIFT you will receive 

the popular, online course 7 Steps to Boost 

Fertility http://bit.ly/7Steps-FertilityRoad 



BODY 

Olympia London 3 - 4 November 

Book 

tickets 

now 

The UK’s biggest fertility event 

Find out more at fertilityshow.co.uk 



MIND 



MIND 

STRESS & 

FERTILITY 

EXPERT: Colette Assor 

Our clinic is seeing an increased number of 

women with a diagnosis of unexplained infertility. 

Tests and scan results come back as normal, 

but women are still struggling to conceive. The 

infertility roller coaster can be a stressful journey. 

What is unexplained infertility? 

Unexplained infertility is diagnosed when a 

couple has been unsuccessfully trying to conceive 

for 12 months or more and all investigations 

have ruled out all other known explanations. 

Living with a medically unexplained diagnosis can 

be both a relief and a cause of anxiety for patients. 

On one hand, your specialists have effectively ruled 

out several undesirable causes for your symptoms 

but on the other hand, you are still living with those 

symptoms. For couples who have been diagnosed 

with unexplained infertility, this can be particularly 

frustrating as it gives you no explanation as to why 

you’re struggling to start a family. 

How Specialists Reach a Diagnosis 

of Unexplained Infertility 

There are many causes and risk factors related to 

infertility and your doctor will explore all of these 

pathways when making a diagnosis. In general, 

infertility can be defined as the inability to get 

pregnant, carry a pregnancy to term and deliver a baby. 

Male Infertility Tests 

For male infertility specialists will look at 

factors that include: 

• sperm size, shape, number and mobility 

• the presence of varicoceles (enlarged veins in 

the scrotum) 

• blockages of sperm-carrying ducts 

• the presence of infections, cancer and STIs 

• hormonal imbalances 

• risk factors such as excessive weight, smoking, 

alcohol and drug abuse and a history of 

fertility disorders 

Female Infertility Tests 

To diagnose female infertility your specialist 

may look for: 

• polycystic ovarian syndrome 

• premature ovarian failure 

• blocked or damaged fallopian tubes 

• the presence of polyps or fibroids in the uterus 

• endometriosis 

• an abnormally shaped uterus 

• period irregularity and irregular menstrual 

cycle length 

• weight gain, facial hair growth and lifestyle factors 



MIND 

Is Stress Affecting Your Fertility? 

The journey through infertility can be a 

stressful path, how much do we know about the 

impact of stress on fertility? 

There has been ongoing debate within the 

scientific community about whether stress may 

influence fertility and pregnancy outcomes. 

Doctors are once more looking at the idea that 

stress may actually play a role in infertility 

problems. Studies are focusing more on the 

physiological effects of stress and how they may 

play a role in conception. In the UK 25 % of 

couples have been diagnosed with unexplained 

infertility. For these couples the effects of stress 

can be most profound. 

Whilst there is not enough data to draw a 

clear conclusion, what is apparent is that when 

stress reduction techniques are employed 

something happens in some women that allows 

them to get pregnant when they were not able to 

previously conceive. 

What is Stress? 

Stress is a normal psychological and 

physiological reaction to changes in 

someone’s environment. 

When most people talk about stress, 

however, they are usually referring to 

chronic and/or negative forms of stress, 

such as having too many demands at work, 

relationships or the death of a loved one. 

People experiencing chronic stress may 

feel that they are unable to handle daily 

life tasks, have limited-to-no control over 

the direction of their life or more easily 

become angry or irritated. This type of 

chronic stress can negatively affect a 

person’s short-term and long-term health. 

When Stress Can Lead to Trouble 

Getting Pregnant 

Stress can lead to toward unhealthy behaviours 

and non-fertility friendly lifestyles. For 

example, when you’re stressed out, you may: 

• Sleep too much or sleep too little 

• Give into emotional eating or not eat right. 

• Not find enough time for exercise or push 

yourself to exercise too hard 

• Drink one too many alcoholic drinks 

• Smoke, or, if you quit smoking, start smoking again 



MIND 

• Drink too much coffee, especially if you’re 

sleep deprived 

• Lose interest in having sex 

How Stress, Sleep, and Fertility 

Are Connected 

If your work schedule or 

lifestyle leads to late 

nights with early wakeup 

calls, the constant 

lack of sleep can affect 

your body, and hence, 

affect your fertility. 

Research has shown 

that people who get less 

than five hours of sleep 

are more likely to suffer 

from obesity, and obesity can 

lead to fertility problems. 

How Stress and Emotional 

Eating May be harming 

your Fertility 

When people are stressed, they tend to eat in 

less than healthy ways. Constant stress has been 

shown to lead to weight gain, and weight gain 

and obesity have in turn been linked to fertility 

problems. Just as eating too much junk food or 

being overweight can cause fertility problems, 

weighing too little or not eating enough can 

affect your reproductive potential. 

Work out Mindfully 

Getting a healthy amount of exercise can 

help lower stress and lead to a 

healthier body. It is important 

to exercise. However, the type, 

frequency and intensity 

of exercise is variable 

dependent on age, lifestyle 

and most importantly 

stress levels. Mindful 

exercise is best, i.e., 

listening to your body. A 

slow gentle walk has amazing 

health benefits and will aid 

body systems. Gentle walking in 

nature at least 30 minutes per day will 

benefit health and well being. 

When Stress Gets in the Way of 

Sex and Fertility 

Sex can be a stress reliever, something to relax 

with at the end of a long day. However, crazy work 

Stress can hamper 

ovulation. No amount 

of sperm will make a 

difference if the woman’s 

body hasn’t released 

an egg 

schedules, not to mention feeling exhausted, can 

make it difficult to find time for sex 

A stress-filled life can also lower your libido, so you 

might not be in the mood often. It seems logical to 

say that if you want to get pregnant, you need to 

have sex. Some couples are too stressed 

to have sex and do not have sex 

enough during ovulation to 

get pregnant. 

Hormone mixup 

– Stress 

impact on 

ovulation 

Stress can hamper ovulation. 

No amount of sperm will make 

a difference if the woman’s body 

hasn’t released an egg. A woman’s body is 

involved in a constant monthly dance of hormones, 

for which ovulation is key to conception. 

When a woman is stressed, other hormones 

are released in the brain, which can disrupt the 

hormone cycle. 

Without ovulation, any eager sperm that arrives 

on the scene will find no egg to fertilise. 

How does stress impact on the 

reproductive system? 

Everyone experiences stress, and for many it’s 

not an enjoyable experience. It isn’t inherently 

bad, although research suggests that depending 

on the type and timing of the stressor (i.e. the 

reason for stress) it can cause changes 

to a person’s menstrual cycle. 

Recent research tells us 

that stress boosts levels of 

stress hormones, such as 

adrenaline, cortisol, which 

can inhibit the release of 

the body’s main hormone, 

GnRH (gonadotropin 

releasing hormone), which is 

responsible for the release of sex 

hormones. Subsequently this may 

suppress ovulation in women, reduce 

sperm count in men and lower libido in both 

women and men. 

Any disruption to GnRH may cause insufficient 

release of hormones from the pituitary gland 

which can cause their target organs to no longer 

work as they once did and in extreme cases, 

atrophy over time and no longer function. 

Stress impact on Sperm Quality 

Although mechanisms are not fully understood, 

there is a link between anxiety and sperm 

quality. A recent research study of 29,914 

participants found that psychological stress 

lowers sperm concentration and progressive 

motility and increases the amount of abnormal 

forms of sperm. 

How does stress impact on IVF? 

An area that has received growing interest 

in recent years is the potential role that 

psychological stress may play in determining 

in vitro fertilisation (IVF) treatment outcomes. 

At least anecdotally, many infertile women 

and health care professionals alike believe that 

the experience of stress may play an important 

role in the difficulties that infertile patients 

face, and thus may be a contributing factor in 

determining the eventual outcome of IVF. 

Research in this area is mixed, one study 

showed that elevated levels of stress hormones 

measured in hair were associated with a third 

less chance of conceiving. 

These facts are very important to consider if you 

have been trying to conceive without success. It 

also shows that stress relief should be a part of 

every couple’s conception plan even if they are 

going through IVF. 

Colette Assor Lic Ac MBAcC is a fertility 

acupuncturist with 20 years clinical 

experience. Colette runs Acupuncture Works 

clinics in Hendon & Finchley North London. 

acupunctureworkslondon.co.uk 



MIND 



MIND 

EXPERT: A’ndrea Reiter 

One secret you need 

to know to shift your 

fertility energy 

Energy is a term that is becoming a little more 

comfortable for people. But other than maybe 

The Secret, they don't have much experience 

with it, much less how to control it. From 

everything we initially learn about the Law of 

Attraction and positivity, we think we need to 

just say positive things and focus on it all the 

time and then the baby materializes. But that's 

not the case. 

Like energy attracts like energy. So, the Universe 

is responding with a match to the energy that we 

are putting out. Unfortunately, it can be tricky 

to catch when we are truly being being positive, 

versus being in need and lack (which brings more 

need and lack). 

When it comes to energy, the more weight 

we put on a situation, the heavier it is. Even 

though we are focused on being a mother 

because it’s a great thing and we really want 

it; when we make one area of our lives seem 

heavier and harder than others, the Universe 

has to bring a match to that and things stay 

heavier and harder. The cycle just keeps 

repeating because our brain is taking our past 

experience with that area, and chucking it into 

the future. The brain assumes that because it’s 

always been hard, it always will be, and so the 

cycle repeats. The energy doesn’t change, so we 

are met with more of the same. 

Here’s the exciting thing though: 

The energy in all areas of your life is the same. 

I know it feels like they’re different, but they’re 

not. It’s a self-made construct to say, “Money is 

more difficult than relationships,” or “Fertility 

is harder than career.” We give different areas of 

our lives different names, but it is essentially our 

energy and what we are aligned or not aligned 

with. Fertility may be blue frosting, Career may 

be yellow frosting, and Relationships may be red 

frosting; but it’s all buttercream frosting in the 

end- just tinted to look different. As long as we 

think fertility is harder it will be, thanks to the 

Law of Attraction, but once you realize it’s the 

same as other areas and treat it as such, things get 



MIND 

a whole lot easier. The brain can’t help but think, 

“But it IS difficult!” Again, what’s happening is 

your brain taking past experiences and assigning 

it to the future. It’s not a true statement on its 

own that, “Getting pregnant is hard,” but when 

we believe and expect it to be, that’s what we are 

met with a match to from the Universe. So, it 

seems like things just keep happening to prove 

your point, but it’s literally only because we are 

assigning weight and meaning to it. 

What do I mean by assigning meaning to it? The 

situation as it is, is not stressful. It’s when you 

make it mean something, that it’s stressful. So, it’s 

the thought- not the situation that’s causing you 

pain. For example, if you’re still getting a cycle 

and have at least one ovary and a uterus- you’re 

fine. It’s when you think it should have happened 

by now, or it’s not fair, or too late, that you stress 

yourself out. 

It’s a belief that fertility is harder than other areas 

in your life. From an energy perspective, it’s not. I 

know that can be tough to wrap our heads around 

sometimes, but it’s true. And it’s necessary to 

begin shifting your energy if you want to get out 

of the pattern. We must take some of the weight 

off of this idea of infertility so that it doesn’t feel 

so heavy energetically. It’s hard not to constantly 

focus on the lack and what’s going wrong with 

your fertility, but here are three simple things you 

can do to start shifting the tide. 

1) Make a list of why it could be easy to get 

pregnant. What DO you have going for you (ex: 

supportive spouse, taking care of self, regular cycle, 

had sex this month, etc.). We need to stop focusing 

on the problem, and focus on the solution and 

what feels good/capable. Why is it likely this could 

actually work? Feel into that daily. 

2) Pick relief. Sometimes it can be hard to make 

the energetic leap from fear of losing your dream, 

to “I’m pregnant!” So, relief is an emotion in the 

middle of those two, and once we can feel that, 

it’s easier for the brain to entertain the positive 

thoughts. What’s one thing that makes you feel 

relief about your current situation? What’s one 

thing YOU can do for yourself that makes you feel 

relief? Why in THIS moment right now, are you 

OK? (Because you are. I promise!) 

3) Look at other areas in your life where you’ve 

achieved something you never had before/didn’t 

know if you could. Remind yourself that energy in 

one area of your life isn’t different than another, 

so if you’ve achieved things in career, family, 

money, etc.; Then it is possible in this area as well. 

Write them down, close your eyes, put one hand 

on your solar plexus and say those things aloud 

daily. Make a list of all your victories because it 

makes you feel capable- and that’s the energy you 

need to make a human. 

A’ndrea is a Reiki Master and Holistic 

Fertility Specialist. She uses a combination 

of reiki, intuition and mindset coaching to 

move women through the emotional and 

physical blocks that are impeding them 

from conceiving naturally. Her book, How 

to Get Pregnant, Even When You’ve Tried 

Everything: A Mind-Body Guide to Fertility 

is available on Amazon and Llewellyn 

Worldwide. Though based in New York City, 

she helps clients all over the world achieve 

their dream of motherhood. 



MIND 

YOUR FAVOURITE 

FERTILITY MAGAZINE 

COLLECTION 

IN ONE PLACE 


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AmazonKindleHalfPageAdvert.indd 1 30/12/2016 10:10

MIND 

EXPERT: Cassie Everett 

THE EMOTIONAL 

STRAIN OF 

TRYING TO GET 

PREGNANT 

When I talk to my clients about how they 

are feeling, the immense emotional strain of 

trying to get pregnant is often a big topic of 

conversation. Sometimes it's hard to cope when 

you feel that something may be wrong with 

you. Perhaps you don't feel normal and are 

angry that you are finding something difficult 

that others seem to find easy. You may be 

experiencing grief from a previous miscarriage, 

or anxiety and worry about losing future 

pregnancies. You might feel left out when your 

friends and family are having children. 

Many of my clients speak about the injustice of 

seeing pregnant women and babies everywhere, 

as well as the hurtful words of people who mean 

well, but can be insensitive. 

For those of you who have decided to embark 

on IVF treatment, you will be coping with lots 

of tests and procedures, as well as the additional 

financial strain. 

It may be that stress is making it harder for you 

to conceive due to the effect of stress hormones 

on your reproductive system, so every monthly 

disappointment becomes a vicious cycle. This can 

lead to issues between partners, with the pressure 

to perform sexually in a scheduled and clinical 

way exacerbating an already strained relationship. 

However you are feeling, it’s important 

to remember that these feelings are 

understandable and natural, and that you are 

not alone. It’s also a good idea to try and reduce 

your general stress levels. Here are some of my 

top tips on how to do just that. 

RECOMMENDATIONS 

FOR REDUCING YOUR 

STRESS LEVELS 

Talk it through 

There are many things you can do to try and 

reduce your stress levels. Most important is 

having someone to talk to – maybe a friend 



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MIND 

or family member. If this makes you feel 

uncomfortable then you might like to consider 

counselling, attending a fertility support group 

or chatting anonymously on an online forum. 

This can help you feel less isolated 

and provide support. Remember 

that there are probably people 

you know going through 

the same thing as you. 

One in four couples have 

problems conceiving and 

finding other people who 

are experiencing the same 

as you can really help. 

Consider your own 

feelings 

It’s a good idea to avoid situations that upset 

you, and remember, don’t feel guilty about it! If 

you don’t want to go to a friend’s baby shower, 

don’t go. If you don’t want to go in to the baby 

shop, get a present online. Consider your own 

feelings and don’t put unnecessary pressure 

on yourself to do the so called ‘right thing’. Do 

what’s right for you. 

Do a stress audit 

Ask yourself if you have the right work/life 

balance. Are you working too much or taking 

on too much responsibility? Look at the 

different areas of stress in your life and think 

about whether any of these stresses can be 

reduced or removed, as the cumulative effect 

may be taking its toll on your fertility. The 

Many of my clients 

speak about the 

injustice of seeing 

pregnant women and 

babies everywhere 

more stress hormones are circulating 

round your body, the more disruption is 

caused to your reproductive hormones and 

hence your fertility. 

Do things you love – and 

look 

after yourself 

If you don’t have interests 

or hobbies, find something 

you love and do it. You 

should also build in 

daily relaxation to your 

schedule. This could be 

going for walks, doing yoga, 

visualisation, meditation or 

having a regular massage. Gentle 

exercise is also important. It helps alleviate 

anxiety and tension plus releases happy, calming 

hormones into your system. A good book that 

I often recommend my clients to read 

is, The Inside Out Revolution by 

Michael Neill as this helps us to 

see how our thoughts affect 

our feelings. Many of my 

clients feel that they will 

only be truly happy when 

they have a baby. This 

book really helps you 

to appreciate that it is 

you, and you alone that 

can create your happiness; 

no external influence can 

do that, not even a baby, even 

though it really looks like that! 

Above all, make sure you have some play 

time – schedule it in if you must, as it’s easy to 

forget the importance of fun while your life 

seems dominated by trying to conceive. Research 

has even shown that feelings of joy help us 

create more of the hormone DHEA in the body. 

DHEA is a luxury hormone, that means that 

the body can convert it into other hormones 

like Progesterone. As women age progesterone 

naturally declines and when women are stressed 

progesterone levels are often lower. Progesterone 

is THE pregnancy hormone and without enough 

of it we cannot hold a pregnancy, so any extra 

DHEA could make an important difference to 

your Progesterone levels. 

Invest in your relationship 

Remember that 

there are probably 

people you know going 

through the same 

thing as you 

As you know, many relationships suffer when 

fertility issues arise, so make time to focus on 

your relationship, and friendship, with 

your partner. This is a good time 

for romantic dinners and 

weekends away to help 

keep the spark alive. 

Be honest with 

yourself about your 

feelings 

Some of my clients 

write their thoughts 

and feelings down 

in a diary. This helps 

them release anxieties and 

frustrations without worrying 

that they are burdening someone else 

with them or being judged, and it’s a great way to 

free up some emotional space inside. 

Take a break 

If you feel like your fertility issues are taking 

over your life, why not take a break from trying 

for a few months to remove the issue and escape 

the vicious cycle for a while? Clear your head 

and allow your life, your relationship and your 

hormones to rebalance before you think about 

trying again. 

Use Australian Bush Flower Essences 

You might find the following combinations useful: 

• “Calm & Clear Essence” is great for relaxing 

and unwinding 

• “Dynamis Essence” is useful if you are feeling 

exhausted from stress and anxiety 

• “Relationship Essence” can help enhance the 

quality of intimate relationships 



MIND 

You can buy Australian Bush Flower Essences from 

a good health food store such as: revital.co.uk/ 

catalogsearch/result/?q=australian+bush+flower 

+essences 

Take as directed on the bottle. 

Put essential oils in the bath 

Not only is the very act of making time for 

a bath a great form of relaxation and creates 

‘me time’, but some essential oils can be used 

to induce a deeper sense of relaxation. A 

combination of rose, jasmine and neroli is 

ideal. These will help you to relieve stress and 

for women they will also enhance feminine 

qualities necessary for improving fertility. 

Alternatively, you can buy ready-made essential 

oil blends from nealsyardremedies.com 

which are more cost-effective than buying 

individual oils. 

Try homeopathic remedies 

The following homeopathic remedies can 

be taken for acute anxiety and emotional 

upsets. Select the remedy that most closely 

matches your thoughts and feelings. Buy it in 

30c potency from a pharmacy or health food 

store and take one pill when needed, up to a 

maximum of three a day for three days, leaving 

at least a week before repeating: 

• Arg Nit: for anticipatory anxiety, worrying 

about the baby during pregnancy or before 

doing a pregnancy test 

• Gelsemium: for anxiety especially after a 

shock or bad news e.g. from a miscarriage or 

diagnosis from the doctor 

• Ignatia: for the emotional roller coaster, 

feeling very tearful and even hysterical, 

embarrassed about emotions 

• Natrum Mur: for repeated grief and 

disappointment, want to be on your own, can’t 

cry any more 

• Pulsatilla: for feeling weepy all the time, don’t 

want to be alone, feel better after a good cry 

If your symptoms persist, always seek professional 

advice from a qualified homeopath. 

I really hope this has given you some useful 

suggestions as to how you can relax and destress, 

and cope with the emotional strain of 

trying to get pregnant. For more information 

on tailor-made natural solutions which could 

help you get pregnant please visit my website: 

cassieeverett.com or call on 07588 820 409. 



MIND 

Conceive Plus helping 

couples conceive naturally 

When it comes to getting pregnant the path can be challenging. 

There are many challenges faced by couples 

who want to get pregnant naturally to start, or 

extend their existing family. Busy lifestyles, 

careers, buying a home, as well as everyday 

health concerns such as lack of sleep, poor 

diet and lack of exercise can create emotional 

stress or stress on the body, either of which can 

negatively affect the chance of conception. 

Even the process of conception itself, the journey 

of the sperm to the egg is a complex feat of 

biology fraught with variables. Despite the stories 

we read of how easy it is to get pregnant (and for 

some it is) statistically a couple in their twenties 

has a 20 to 25 percent chance of pregnancy each 

month. By 30, the chance of becoming pregnant 

in a given month lowers to around 15 percent 

and by 35, the likelihood is can be as low as 10 

percent in any month. 

When pregnancy does not occur as planned many 

couples can stress unnecessarily especially if 

there is a lack of education or understanding of 

fertility, such as the fertility period, the process of 

ovulation and the days that conception can occur. 

Stress can also lead to or exacerbate vaginal 

dryness and as a result many trying to conceive 

couples experience a lack of natural fertile fluid 

(Cervical mucus). Cervical mucus plays an vital 

role in the process of conception by creating the 

optimal vaginal environment as well as facilitating 

the movement of sperm to the egg. Trying to 

conceive couples are 50% more likely than couples 

that are not trying to pregnant to experience 

Vaginal dryness and 75% couples experience 

vaginal dryness when trying to conceive. 

Vaginal dryness is a cause of subfertility yet 

many couples do not even notice or understand 

that this can be a barrier to natural conception, 

traditionally a regular personal lubricant is 

used however these have been shown to damage 

sperm, are the formulated with the wrong PH 

(to acid) and wrong osmolarity (to thick), either 

damaging or creating a barrier to sperm and 

should not be used. 

Studies also indicate that a man’s health affects 

his sperm in both quality and quantity, and low 

sperm counts and poor quality have a negative 

effect on the chance of conception. 

Conceive Plus is isotonic formulated with the 

optimal PH and osmolarity to mimic natural 

cervical mucus with the added benefit of Calcium 

and Magnesium ions essential to support 

sperm cell motility and viability. The patented 

Conceive Plus formula matches natural fertile 

fluids, supplements moisture to support the 

viability and motility of sperm, and bonding of 

the sperm to the egg. 

In independent studies Conceive Plus is shown 

to be compatible with sperm and egg making 

it the lubricant of choice for couples who are 

trying to conceive. 

Through an intimate understanding of personal 

lubricants, optimal vaginal health and fertility 

Sasmar’s team has developed the Conceive 

Plus range, a selection of products specially 

formulated for couples who have just started 

trying as well as those who have been trying to 

get pregnant for a while. 

The newest edition Conceive Plus Fertility Support 

contains essential nutrients that prepare the body 

for conception including zinc, folic acid, iron, 

multivitamins and antioxidants in two specialty 

formulations for men and women. 

See website for information and retailers. Always 

read the label. 

Available from Lloyds Pharmacy, 

Amazon & Chemists conceiveplus.com 



MIND 



FERTILITY JOURNEYS 2018 

TRIPLE YOUR CHANCES 

OF HAVING A BABY. 

FREE SKYPE WITH 

IVF SPECIALIST 

FREE USE OF TIME- 

LAPSE SYSTEM 

SURGICAL SPERM 

RETRIEVAL 

UK BASED CLIENTS 

SINCE 2006 

NETWORK OF 4 

CERTIFIED CLINICS 

STATE OF THE 

ART IVF LAB 


www.klinikkhausken.no 



FERTILITY 

JOURNEYS 2018 

Welcome back to the Fertility Journeys. 

We’re nearly at the end of another year and we’ve been busy working with our new 

couples and clinics making sure they are getting the support they need to start 

their fertility journeys. 

Herts & Essex Fertility Centre are contacting all of the couples who applied for the 

free IVF treatment and the 40 free fertility consultations. In the November issue 

we’ll be announcing the couples that have been selected. 

We welcome IVF Spain’s couple Claire and David who have already visited the IVF 

Spain team at their clinic in Alicante for the first embryo transfer. 

Redia IVF and Mediterranean Fertility Institute’s couple Kirstie and Christopher tell 

us about their journey so far as they prepare to travel to Greece in September for 

their treatment. 

Also Heather and Brandon who are working with our US partners Oregon 

Reproductive Medicine are expecting TWINS and Heather is in her third Trimester. 

We’re really looking forward to meeting the twins very soon. 

But we’re not stopping there as we have two new clinics joining us in September 

and November. 

Keep an eye out for our newsletter with the news. 

Good luck to all of our couples on their journeys. 




FERTILITY JOURNEYS: 

EGG DONATION WITH IVF SPAIN 

Exclusive 

Spanish 

Partner 

During the first week of August, Claire (42) and David (35), the winners of this year’s 

Fertility Journey, visited our clinic for their first embryo transfer. 

When we discovered that Claire didn’t have a single 

positive pregnancy test, we suggested to carry out an 

endometrial biopsy to analyse the sample by means 

of the ER Map® test (Endometrial Receptivity Map) 

in order for us to being able to accurately determine 

the receptivity of Claire’s endometrium during the 

window of implantation (the moment when the 

endometrial lining is receptive). 

”The test results showed that Claire’s endometrium 

was post-receptive, meaning that a transfer 

performed on day 5.5 of progesterone (like in 70% 

of cases) would not end up in a successful pregnancy” 

explains Dr Natalia Szlarb. 

They were pleased to share with us the emotion and 

joy created by their short stay in Spain; 

“We have spent some time in Alicante ahead of the 

transfer, relaxing in the area and preparing for our 

next visit to IVF Spain. Our experience with previous 

treatments with UK clinics has been very stressful 

but in Alicante, we have spent most of our time 

preparing for treatment by relaxing on the beach!” 

Claire and David arrived at IVF Spain after 

having been trying to get pregnant for 7 long 

years and 3 failed ICSI treatments with their 

own eggs. IVF Spain discovered that the embryos 

were of poor quality and that they had always 

been transferred on day 3 of their development 

with a bad morphology. In order to increase 

their chances of getting pregnant the clinic 

recommended an egg donation treatment, which 

greatly depends on matching the perfect donor 

to the patient. 

To protect both patients and donors, Spanish 

law requires that the donation process must be 

completely anonymous. In addition, donors 

must be in good condition and younger than 35. 

Dr Szlarb with 

2018 winners 

Claire and David 

Moreover, both donor and patient must share a 

phenotypical resemblance: hair and eye color, 

BMI, and so on. 

Claire and David were grateful that so many women in 

Spain were willing to donate their own eggs, enabling 

others less fortunate, the chance of forming a family. 

“We are really grateful that there are people willing 

to donate eggs. If we are being honest, it has taken a 

while for us to understand the Spanish anonymity 

rules for egg donors, but we have taken the time to 

consider this. It’s hard not having control or letting 

another person being in charge for something 

related to your baby. However, we even think now it 

is better that way, because the more you know, the 

more you want to know and we do prefer knowing 

nothing and leaving it in the clinic’s hands.” 

There are other factors, however, that are crucial 

to achieving a successful pregnancy such as the 

quality of the embryo and the microenvironment 

of the endometrial lining. This means that a 

successful pregnancy also depends on the successful 

communication between the embryo and end the 

endometrial lining. 

“Before coming to IVF Spain, we had never heard 

of an endometrial study or ER Map. The fact that 

the endometrial study analyses the best time to 

transfer the embryo could make a big difference to 

our treatment. We were really impressed with the 

accuracy of the test. Our ER Map test result was postreceptive 

and although this was initially a concern, 

we later came around to the view that knowing the 

best time to transfer the embryo would increase the 

chances of success, and this might have been the 

reason our other treatments in the UK had failed” - 

Claire and David. 

Another key aspect to achieve a successful pregnancy 

is the male factor. David suffers from teratospermia 

which implies that 96% of the ejaculate sperm cells 

have an abnormal morphology. Luckily, we were able 

to improve David’s sperm quality and fertilize the 

retrieved eggs. 

We now wish them the best of luck! 

Although it will not be until mid-September when 

the 2018 runner-ups Laura (41) and Ian (44) visit 

us in Alicante for their embryo transfer, they 

already talked about the differences between IVF 

Spain and former clinics. They were impressed at 

how extensively their case had been studied by our 

fertility specialists. 




Laura and Ian 

Immunologically speaking, finding a matching 

donor for Laura is certainly a challenging task, which 

is why IVF Spain suggested that we find out her KIR 

via a blood test. Ian was also tested for his HLA-C in 

order to determine whether the maternal – foetal 

interaction will be optimal or not. 

“I think the longer you have treatment the more 

difficult it becomes. When you begin there’s a 

naivety along the lines of, ‘we’ll have one, maybe 

two goes at IVF and have a baby in our arms’. 

After 7 treatments (and lots of add-ons) the 

feelings completely change. You feel terrified 

that it won’t work, and you’ll never become 

parents. You’re scared it will work and you’ll lose 

the baby again (Laura and Ian have experienced 

5 losses). 

You’re scared of physically going through the 

treatment as you’ve had so much. Each test and 

treatment creates fear – fear that it will hurt, be 

traumatizing, that it will give you more bad news. 

Then there’s the impact on your own mental 

health and emotional well-being. Can I handle 

this? What if the results say something’s wrong 

with me? Will I blame myself? It starts to really 

damage your mental health and well-being. 

Financially you start to feel that you’re risking 

everything, and it may not pay off. 

For us we have renewed hope with IVF Spain. We 

have undergone tests that we’ve never had before 

(ERA, NK biopsy and KIR). We have paid for 

lots of very expensive blood tests and drugs but 

never received this kind of analysis. So, we feel as 

though the treatment is now specifically for us. 

This creates more positivity, a feeling of being 

cared for and that maybe, just maybe, we’ll get to 

be parents. 

Plus, we’re now using donor eggs. The hope starts to 

soar and with that comes excitement. Hope is the 

only thing that keeps you going and overcoming the 

fears I mentioned. This opportunity with IVF Spain 

has given us hope that we thought we’d lost.” 

Laura is 41 years old and has already been through 

traumatic losses including an ectopic pregnancy. 

Due to this and to the fact that Laura suffers from 

trisomy 22 syndrome, our medical team at IVF 

Spain recommended an egg donation treatment to 

increase their chances. 

The couple is thankful for the egg donation process 

being anonymous, as otherwise it would be really 

difficult to find a donor: 

“For us, it’s taken some of the pressure away. I can’t 

imagine how difficult it would be to choose a donor 

ourselves. But putting your complete trust into 

someone else’s hands is hard. 

We’ve explored whether it would be better for 

our future child to know the donor. I think that’s 

something we’ll never know. But we hope that he/she 

will understand our decision to choose an anonymous 

donor. It would be good to know a little more about the 

heritage of the donor but then we also know that we 

often don’t even know our own heritage. We’ll make 

sure Spain is a key part of their story. 

It’s also really odd to not know who this person 

is. What they look like and personality. What’s 

motivating them to help us. One of the things I’ve 

been really consumed with is the gratitude you have 

for this person. I’d like to thank them but can’t. 

Anonymity means we have a chance to become 

parents. Without it there’d be a shortage of donors 

like there is in the UK. For us, this makes it a 

wonderful gift – a chance to hopefully find a donor 

that is perfectly matched to us genetically (due to the 

KIR tests) as well as in physical looks. 

I can’t stop thinking about what our future child will 

look like – but I think that’s quite normal” says Laura. 

Thanks to the KIR-HLA-C genotyping test it is 

possible to determine if the uterine KIR and the 

embryonic HLA-C will both be compatible. If so, 

the pregnancy will carry on successfully; if not, then 

the most probable outcome will be an unviable 

pregnancy and subsequent miscarriage. 

“We carried out the KIR-HLA-C genotyping and 

concluded that the patient had a KIR AA. It is 

known that KIR expressed by the natural killer 

cells present in the maternal part and the HLA 

presented by the trophoblastic cells together will 

influence the outcome of the pregnancy. With 

Laura’s KIR AA variant, the sperm would have to 

be HLA C1 C1 and the HLA of the donor should be 

as well HLA C1 C1; as her husband has a HLA C1 

C2 variant, we will treat her with a medication that 

reduces her immune-genetic reaction. We believe 

that not paying attention to this issue in the past 

is what may have caused the implantation to fail” 

suspects fertility specialist Dr Isabel Herrera. 

We tend to recommend a single embryo 

transfer, as it has been proven that on patients 

with an immunological profile such as Laura’s, 

a double embryo transfers would increase 

the immunogenetic reaction, hindering the 

achievement of a pregnancy” says Dr. Herrera. 

It is also known that these cases tend to have a 

higher risk of pre-eclampsia, late spontaneous 

abortion or miscarriage. 

Until their transfer day the couple will try to enjoy 

summer just as any other couple would; 

“I’ve tried to just carry on as normal. Remain 

healthy, take pre-conception vitamins. Reach out 

and get support through the Donor Conception 

Network in the UK and connect with other people 

going down the DE route via online forums. It’s 

quite isolating and scary so it’s important to reach 

out and not feel so alone. 

I’m trying to relax a little – not so easy with work but 

it’s a work in progress. I need to get that bit sorted 

now treatment is on the horizon.” 

Dr Isabelle Herrera 





OUR FERTILITY JOURNEY – 

KIRSTIE DOWNEY & CHRISTOPHER HANSON 

Around Christmas time of 2015, we met with 

the Sunday Life journalist in Belfast to discuss 

infertility and our journey towards finding an 

egg donor. We openly discussed our journey 

to date with the journalist and had some 

photographs taken for the newspaper. A few 

weeks later our story featured in the newspaper 

seeking an anonymous egg donor. 

In May 2016 we received a call from the Regional 

Fertility Centre at the Royal Victoria Hospital in 

Belfast. Allison McKee from the Centre informed us 

that an anonymous donor had come forward after 

seeing our advertisement and wished to donate her 

eggs to help us fulfil our dream of having a family. 

We thought it was amazing that we received this 

news less than 48 hours after we had got engaged. 

At 16 years old I was still waiting for my first 

period and was advised to visit my GP. After 

many blood tests, scans, and open key hole 

surgery I was diagnosed with premature ovarian 

failure. My consultant advised me at this young 

age that my only chances of ever conceiving a 

child would be through egg donation. I would be 

able to carry a child but unfortunately, I would 

have no eggs to conceive naturally. 

This was shattering news to receive at such 

a young age for me and my family. I did not 

really understand the implications of this 

condition and always held onto the hope that I 

would conceive children naturally. As the years 

progressed I gained a better understanding of 

my condition, but it only really started to sink in 

when I met my partner Chris in October 2012. 

I had spoken to Chris early on in our relationship 

about my condition and he was understanding 

and supportive; fully aware of the difficulties we 

might face to have our own family. Chris decided 

to get his sperm tested early on in our relationship 

to ensure he had good quality sperm for whenever 

we would go through fertility treatments. We were 

delighted when Chris’s results came back as normal 

and his GP advised that he had no fertility issues. 

Our fertility journey began in 

2015 at the Grove Wellbeing 

Centre in Belfast where 

we met Gillian about 

advertising for an egg 

donor. Gillian discussed 

during our appointment 

the possibility of doing 

an advertisement in the 

local Sunday Life newspaper 

in Northern Ireland. We 

were very open to this idea and 

received contact from the editor of 

the newspaper, Angela, very shortly after our 

appointment with Gillian. 

I had spoken to 

Chris early on in our 

relationship about my 

condition and he was 

understanding and 

supportive 

Chris & I would do anything to have a child and 

following the phone call with Allison I started to 

make some life changes. I changed my diet, ate 

healthy foods, took folic acid daily and started fertility 

acupuncture with Sharon Campbell, a renowned 

fertility acupuncturist in Northern Ireland. 

In July I received my medication to prepare my 

body for pregnancy. In subsequent appointments 

my bloods were normal, and my womb lining 

was thick for egg transfer. I was visiting Sharon 

once a week which I believed helped 

towards the thickening of my womb 

lining and helped my mental 

state during this emotional 

roller coaster. 

The day before the embryo 

transfer I received a call 

from the laboratory to 

inform me that 2 donor 

eggs had fertilised and they 

would be transferred the 

next morning. On 4th August 

our transfer took place and two 6 

cell embryos were transferred into my 

womb with no complications. Now it was the 2 

weeks wait before I took a pregnancy test. 




I took 2 weeks off work to give the embryo the 

best possible chance to implant and followed all 

guidelines given to me by the professionals. 

give anything to have our own child to love and 

protect and hopefully someday soon, with the help 

of yourselves, you can make our dreams come true. 

•Can we afford the travel & test costs? 

•Can we get the time off work? 

On 18th August we did our pregnancy test. Our 

dreams were shattered when the result came back 

negative, it was the worst feeling in the world. We 

had believed because we were so young we would 

have a better chance of a positive result. 

During and after the procedure we attended 

counselling and eventually came to terms with 

the negative result. This was our only free cycle 

of egg donation available here. 

We have been together now for 

nearly 6 years. We have built 

a loving home together. I am 

a full time childcare worker 

which has always been my 

passion. Chris is a full-time 

manager in Tesco. 

Despite all this, there is one 

thing missing from our lives 

and that is the dream of having a 

child. We are both young, fit, healthy, 

hardworking individuals and have so much 

love to give a child. I have a big family and have 

grown up with children my whole life. We are 

happy to share our story with others facing similar 

scenarios to demonstrate that wherever you are in 

your particular fertility journey there are always 

options – options to consider, and support to help 

you make the right decisions for you. We would 

We literally could 

not believe it and had to 

read the email numerous 

times in floods of happy 

tears to check this was 

actually real 

We received the email to say we were the lucky 

winners on 20th June. It is very difficult to put into 

words how we felt. To be the selected couple is very 

hard to believe and we count ourselves so lucky to 

have been given this amazing opportunity. 

We literally could not believe it and had to read the 

email numerous times in floods of happy tears to 

check this was actually real. Eventually we were able 

to write a response obviously accepting the 

offer. Finally, when the news had 

sunk in we started to ask ourselves 

questions about travelling to 

Greece and researching the 

clinic and island etc. 

Over the next 2 weeks 

we acted very quickly 

in getting all our tests 

together, sorting time off 

work, arranging flights & 

accommodation and getting 

the required medication. We went 

through a number of stumbling blocks. 

With the amazing Shirley supporting us via email 

we were able to sort everything very quickly and 

her advice was invaluable during this period. 

Despite all this we were naturally worried about 

travelling to Crete for this treatment. We asked 

ourselves many questions 

•Where will we stay in Crete? 

•Is my body going to respond to the medication? 

When we went through our free cycle of 

treatment with the NHS over here in Northern 

Ireland, the success rates were only 24%. To 

know that the success rate in Crete is almost 3 

times that gives us massive hope and we would 

obviously not be travelling to Crete and putting 

ourselves through all this if we didn’t think it 

was going to work. 

Everything is arranged, booked and paid for. I 

am currently on the Microgynon pill on my first 

cycle. My first uterus scan is on 20th August. We 

depart for Crete from Dublin on 12th September, 

we are staying for 2 weeks and are so excited to 

undergo the treatment and meet all the team in 

the Mediterranean Fertility Institute. A special 

mention must go to Shirley who has helped us 

out so much over the past few weeks with our 

endless questions and emails. She has made this 

experience a lot easier. 

We are both super excited and hopefully our 

story will encourage other young couples like 

ourselves to take the step of travelling abroad for 

treatment. It seems scary preparing to go abroad 

for treatment but with the help of your chosen 

clinic everything runs smoothly. 

We sincerely hope that the team in Crete can 

make our dream come true. It is impossible to 

put into words how much we want a baby and to 

be taking this step now in travelling abroad is 

so surreal. We never seen ourselves at 25 years 

old travelling to Crete for egg donation. At this 

moment in time and certainly in the foreseeable 

future there is no chance we would be able to 

afford the treatment anywhere, so this feels like 

our only hope of having a bundle of joy. 





DONOR EGG IVF WITH GENOMIC SCREENING... 

WITH OREGON REPRODUCTIVE MEDICINE 

After nearly ten years trying to build their family, Heather and Brandon are starting the 

third trimester of Heather’s pregnancy. Their 20-week scan has given them a good look 

at their baby girl and boy who are continuing to develop well. 

Heather writes… 

We’ve made it to the start of my third trimester 

and are all smiles right now! 

While nausea has continued to pay a significant 

role in my journey, anti-nausea medications 

have become my best friend. I‘ve been needing 

to take anti-nausea medication once every eight 

hours (three times a day) to help avoid constant 

vomiting. Food has become challenging. There are 

very few foods I enjoy with the exception of fruit, 

smoothies, lemonade and tart candy. 

Importantly though, the babies are doing well and 

both are maintaining an above average heart rate. I 

cannot feel them moving just yet but have been told 

by my doctors that they are actively moving and 

kicking each other. I was told that it is normal for 

them to kick each other in order to start developing 

basic capacity for their limbs. 

My daily routine is waking up, going to work, coming 

home to nap, eating take out - because the smell of 

food lingering in the house makes me nauseous -and 

heading back to sleep by 10:30 p.m. I will be honest 

that I have never felt so tired in my life. 

I do not feel at all in control of my own body and 

many of the basic tasks I used to do on a consistent 

basis seem impossible (washing clothes, tidying up 

the house, etc.). 

Brandon is doing a lot of the research that I am 

too tired to do. He sends me, on a consistent basis, 

helpful tips and bits of information and weekly 

“what to expect” updates. 

After much 

anticipation, our 

20-week ultrasound 

went well and it was 

amazing to see our 

babies right there in 

front of us. 




Through these updates we are following the size 

of each baby and what parts of the anatomy they 

are starting to develop at each stage. They are 

also helping us focus on the things we should 

start to prepare for so that we are properly pacing 

ourselves through this journey. 

As an example, we were given the suggestion of 

talking about how we will handle life after the birth, 

making sure I invest in flats for the remainder of 

my pregnancy and knowing the symptoms and 

risks of preeclampsia. 

After much anticipation, our 20-week ultrasound 

went well, and it was amazing to see our babies right 

there in front of us. Because we are having fraternal 

twins our ultrasound took more time to complete. 

Baby A is our girl and she is located closest to my 

waist. Baby B is our boy and he is higher up and 

above my belly button. 

Our baby girl has been diagnosed with a two-vessel 

umbilical cord instead of a three vessel cord. Our 

baby boy has a three-vessel umbilical cord and is 

the most active. 

Most babies’ umbilical cords have three blood vessels: 

one vein, which brings nutrients from the placenta 

to the baby, and two arteries that bring waste back 

to the placenta. But a two-vessel cord has just one 

vein and one artery — that’s why the condition is also 

referred to as having a single umbilical artery (SUA). 

It’s more common than you might think and is the 

most common abnormality of the umbilical cord. 

Our doctor informed us that in most cases, the 

one artery just makes up for what the missing one 

would do. However, there’s a slight increase in risk 

of growth problems and a minimal increase in risk 

of stillbirth. Our doctor has informed us that her 

weight is currently as should be expected and they 

will monitor our baby girl closely. 

I have been scheduled for several ultrasound 

follow-ups to ensure they are both doing well. Thus 

far, they are both flourishing and maintaining an 

above average weight. We are happy campers! 

We are currently in the process of making 

arrangements for a close to home babymoon with 

a car ride that will not exceed two and a half hours. 

Our goal is to stay close to home, enjoy a massage or 

two and have some time to lounge in a nice pool! 

In addition, we are awaiting the invitations for our 

upcoming baby shower which will take place around 

the corner from our house on the day of my birthday! 

We are excited to send out invitations in the 

coming days and share my birthday with one of the 

best gifts we have ever received. 

Dr Barbieri comments on Heather and Brandon's journey 

The 20-week scan is almost always a much anticipated point 

in every pregnancy. Not only is it an important milestone for 

being able to check on foetal development, but also modern 

ultrasound technology gives expecting parents a good peak at 

their growing babies. 

The precision of modern ultrasounds will have enabled the 

diagnosis at the 20-week scan of single umbilical artery (SUA) 

for Heather and Brandon’s baby girl. Heather is correct that 

SUA is the most common congenital abnormality of the 

umbilical cord. The cause of SAU is a not fully known and 

there is no scientific consensus on the incidence and clinical 

significance of SUA in twin compared to singleton pregnancies. 

Generally diagnosis of SUA is made during the third trimester. The earlier awareness of SUA for 

their baby girl will allow Heather’s OB/GYN to formulate a protocol for monitoring both babies’ 

development and managing Heather’s pregnancy. I am glad that Heather has a schedule for regular 

ultrasound monitoring. 

There is generally a growth in the size of the single artery for an affected baby near the start of the third 

trimester. Heather’s OB/GYN will be watching for this change, and their baby girl’s continued increase 

in weight and a strong heartbeat as key indicators of her healthy development. 

I am comforted to know that Heather’s OB/GYN has personal experience with twins. A twin pregnancy 

carries higher risks, so expertise with twin pregnancies and enhanced monitoring is called-for, even 

more so with the diagnosis of SUA for their baby girl. 

We are honoured to have been able to help Heather and Brandon and will be continuing to follow 

their journey closely. Along with them, we are counting the days now that they are in their third and 

final trimester. 



FERTILITY 360 

EXPERT: Craig Reisser 

THE 

VALUE 

OF 

SUCCESS 

RATES 

Understand Success Rates and Help 

Keep Your Surrogacy Journey on Track 



FERTILITY 360 

Craig Reisser, a parent via egg donation and 

surrogacy in the USA, shares some advice for 

intended parents on how to use success rates 

when planning your surrogacy journey. 

When it comes to choosing an IVF clinic a 

discussion of success rates is sure to be one of the 

key considerations. 

Success rates can be a notoriously complicated area 

for intended parents, not only because there can be 

so many factors that play a part in them, but also 

because clinics may report them in any number of 

ways. I certainly found this to be true when I was 

undertaking my own journey. 

Because your IVF clinic will play a pivotal role in 

shaping your journey, understanding how to make 

sure you are focussing on the right success rates 

for the specific IVF procedure you are planning, as 

well as how to apply them in a practical manner to 

your decision making is essential. 

In my view, your ideal goal with IVF should be 

to have the best chance of success and a healthy 

baby on your first attempt. Or in other words 

minimising the risk that you will have to repeat 

any aspect of the IVF process. This is the best way 

to keep your budget and timetable under control 

and your stress levels to a minimum. 

While my focus here is on IVF for a surrogacy 

journey, as this was my own personal experience, 

this same objective can apply equally to anyone 

undergoing IVF – whether using her own eggs or 

donor eggs, working with a surrogate or planning 

to carry the pregnancy herself. 

In an ideal world, first time success would mean 

two things. Firstly, only needing one egg retrieval 

and embryology cycle (including embryo testing 

if applicable) to obtain all the viable embryos 

that you will need to build your family. Secondly 

only needing a single embryo transfer for the live 

birth of a healthy baby. 

For many intended parents their actual IVF 

experience does not reflect this ideal and they 

may require more than one egg retrieval and 

embryology cycle and/or more than one embryo 

transfer to achieve their dream of a healthy baby. 

Each time that you need to repeat either of these 

steps in the IVF process there are real implications 

for you in terms of higher costs, a longer timetable, 

and added emotional stress. 

The real "value of success" is therefore that higher 

success rates can help you avoid costs, keep your 

timeline to a minimum, and your stress levels in check. 

Intended parents therefore need to know which 

success rates to focus on, how to apply them to make 

practical choices, and what they mean in terms of 

the likely number of times they will have to undergo 

each step of the IVF process to reach their goal. 

With this in mind, I focus on two key elements of 

the IVF process where achieving first time success 

can make a real difference in your journey: the 

egg retrieval and embryology cycle and the 

embryo transfer. These steps are distinct but 

intimately connected. 

My focus on these two aspects is not meant to 

diminish the importance of other elements of the 

IVF process that can play a part in having a healthy 

baby, such as genetic screening and the choice 

regarding the number of embryos to transfer, and 

which intended parents should also consider. 

Egg Retrieval and 

Embryology Cycle 

In my view, the real measure of success for an egg 

retrieval and embryology cycle is the number of 

viable embryos obtained, and whether this meets 

or exceeds the number that you can expect you 

may need. 

The number of viable embryos that you may need 

depends on how many children, over time, you 

hope to have multiplied by the number of transfers 

you can expect will be required to achieve a live 

birth. If you plan to transfer more than one embryo 

at a time then this needs to be factored in as well. 

It’s certainly true that you only need one viable 

embryo to have a child and success on the first 

embryo transfer can absolutely happen. However, 

the reality is that that embryo transfer success 

rates are not 100%. Therefore, there is a potential 

risk that you may need to repeat the egg retrieval 

and embryology cycle if you only have a single 

embryo at the end of this step in the IVF process. 

For example, if you hope for one child and can 

expect that you may need to undergo two transfers 

to achieve a live birth, then you will hope to have 

at least two viable embryos. If say however, you 

hope to also have a sibling in the future for your 

first child (and can expect that again you may 

need to undergo two transfers to achieve a live 

birth) then you will hope to have obtained at least 

four viable embryos from your egg retrieval and 

embryology cycle in order to minimise the risk of 

needing to repeat this step to create more embryos. 

The egg retrieval and embryology cycle is the most 

expensive part of the IVF process to have to repeat. 

It may represent some 75-80% percent of the IVF 

costs of a single successful journey. In addition to 

the medical costs you may incur for a repeat cycle, it 

you are using an egg donor there will also be donor 



FERTILITY 360 

compensation and potentially travel reimbursement, 

as well as possibly egg donor agency fees and 

screening costs that may need to be paid again. 

Depending on when this step would need to be 

repeated, and possible scheduling considerations, 

(e.g. egg donor availability) it could lengthen your 

timeline from a few to several months. 

Unfortunately, for intended parents, the public 

databases for clinic success rates (such as SART and 

the CDC in the USA) do not report the statistics, 

namely the average number of viable embryos 

that each cycle type has achieved at a clinic, which 

could help inform intended parents’ decisions. 

Though each cycle is unique and some factors 

cannot be controlled, IVF clinics should have this 

type of success data, particularly in the case of egg 

donor cycles. You should be sure to ask about this, 

as well as the factors that contribute to successful 

egg retrieval and embryology cycles, including 

stimulation and egg retrieval medical protocols, 

the quality of the embryology laboratory, and 

the role of ovarian reserve. This will help you in 

making decisions that may help you increase the 

chance of first time success. 

Embryo Transfer 

Beneficially for intended parents, the public 

databases for clinic success rates generally 

focus on the statistics that help them 

understand the chance of success with an 

individual embryo transfer. 

Live Birth Rate Per Transfer, is the relevant success 

rate to focus on as it represents your ultimate 

goal. Where more than one embryo has been 

transferred, a Live Birth Rate Per Transfer will 

refer to the birth of at least one child. 

Sometimes, clinics may instead quote Pregnancy 

Rate Per Transfer. This represents the percentage 

of embryo transfers that had an ongoing 

pregnancy when the rate was calculated. This is 

not the same as Live Birth Rate Per Transfer as 

some pregnancies that were ongoing when the 

success rate was calculated will not progress. As a 

result, this measure will be a few to several points 

higher than the one that matters most for you. 

Occasionally some clinics may report their 

success rates on a cumulative rather than a per 

transfer basis. Cumulative success rates calculated 

over multiple embryo transfers will be higher in 

comparison to per transfer success rates. 

Cumulative rates can be helpful if understood 

correctly, but intended parents may be confused 

in thinking that a Live Birth Rate presented on a 

cumulative basis is comparable to one presented 

on a per transfer basis. For example, a 67% Live 

Birth Rate Per Transfer will represent a much 

greater chance of success on the first transfer 

attempt (and therefore a lower cost and shorter 

timeframe) than a 67% Cumulative Live Birth 

Rate calculated over say three transfers. 

Generally speaking it takes more than one 

embryo transfer to achieve a live birth. So 

from a practical point of view you may want to 

translate the Live Birth Rate Per Transfer into 

an estimation of the number of embryo transfer 

attempts you may actually need in order to 

achieve a live birth. It is this number of expected 

embryo transfer attempts that will influence the 

number of viable embryos you should hope to 

obtain from your egg retrieval and embryology 

cycle. It will also impact how you plan your 

budget and timetable. 

If an embryo transfer needs to be repeated then 

this will add to your timeline and costs. Extra 

costs may include the transfer procedure itself 

and related medications, pre and post transfer 

monitoring, as well as other costs such as travel. 

You can estimate the potential number of embryo 

transfers you may need to achieve a live birth. Using 

the Live Birth Rate Per Transfer, you can calculate 

the cumulative probability that you will have a live 

birth within a certain number of transfers. 

In the example below, using a Live Birth Rate 

Per Transfer of 50%, intended parents would 

have a 88% chance of having a live birth within 

3 transfers. They may get lucky and have a live 

birth on the first or second transfer, and there 

still remains a small chance that they will not 

have been successful by the third transfer. This 

type of calculation can help intended parents 

plan for the possible implications to their budget 

and timeline of their IVF clinic’s success rate. 

46 | fertilityroad.com 


FERTILITY 360 

Indicative Added Costs of Having to Repeat an Embryo Transfer 

Live Birth Within n 

Embryo Transfers 

Cumulative Probability 

of Live Birth 1 

Indicative Added 

Months 2 Indicative Added Cost 3 

1 50% - 

2 75% +2-4 $3,000 – 5,000 

3 88% +4-8 $6,000 – 10,000 

4 94% +6-12 $9,000 – 15,000 

1. Based on the SART-reported US National Live Birth Rate Per Transfer in 2016 for all donor egg + surrogacy frozen embryo transfers. 

2. 2-4 months in an indicative period of time to prepare for and undergo a repeat embryo transfer. 

3. $3,000 – 5,000 is an indicative additional cost of elements associated with a repeat embryo transfer. If an additional egg retrieval 

and embryology cycle were needed these costs would be extra. 

Success the First Time 

In my family’s own journey, we found that this 

type of understating of success rates helpful. 

It focussed us on the factors that would help 

keep our journey on track, namely obtaining 

the highest number of viable embryos and 

minimising the number of required transfers. 

It also allowed us to plan our budget and 

timeline, accounting for the probability that 

we might have to repeat either step in the IVF 

process. Thankfully, we had the first-time 

success that we were hoping for and I believe 

that the decisions we made, armed with this 

understanding, played a big part in this. 

US IVF Success Rate Resources 

For those intended parents looking at IVF 

treatment in the USA, there are two online, 

public databases that contain national and 

individual US IVF clinic success rates - The US 

Society for Assisted Reproductive Technology 

(SART) at SART.org and the US Centers for 

Disease Control (CDC) at cdc.gov/art. 

SART has been recording US IVF clinic 

success rates since 1988. Additionally, since 

1992 all US IVF clinics have been mandated 

by the US government to report their success 

rate data to the CDC. SART membership is 

voluntary for US IVF clinics. About 80% of 

US IVF clinics are SART members and about 

95% of US IVF cycles are captured in the 

SART success rate database. 

Both SART and the CDC have now released 

the 2016 live birth success rates for US IVF 

procedures and this represents the most 

current US live birth success rates. The 2016 

data is available alongside the 2015 data for 

year-on-year comparisons. The 2017 live birth 

rate data will be known and reported in the 

Spring of 2019. 

The SART database allows for easy filtering 

by clinic for specific procedure types – 

surrogacy, egg donation, PGS/PGD testing, 

and more – as well as for the specific number 

of embryos transferred. 

Craig is a regular contributor to Fertility 

Road on third party reproduction. 

Look for his upcoming articles on egg 

donation and surrogacy in future issues 

of Fertility Road or contact him at 

oregonreproductivemedicine.com. 

This functionality is a real benefit for 

intended parents considering US IVF 

clinics as they can now search for live birth 

success rates for the exact procedure they 

are seeking to undergo by clinic, as well 

as US national averages for comparison. 

It also allows them to view consistently 

prepared and presented data and live birth 

success rates for every clinic they may be 

considering. It allows them to reference a 

clinic’s 2016 data to its 2015 results as well 

to national statistics for both periods. 



FERTILITY 360 



FERTILITY 360 

What Women Need To 

Know About Polycystic 

Ovary Syndrome 

By Michael Ah-Moye FRCOG, CEO and Consultant Gynaecologist 

What are polycystic ovaries? 

The term Polycystic ovaries was coined in the 

1930’s because it was thought that the ovaries 

contained many cysts, which was incorrect as 

the “cysts” are in fact just follicles. A follicle is 

where an egg develops. Polycystic ovaries are 

usually larger in size and contain more follicles 

than normal. 

What is polycystic ovary 

syndrome? 

It is important to know that having polycystic 

ovaries does not necessarily mean that the woman 

has Polycystic Ovary syndrome. Some women 

have polycystic ovaries without any symptoms. 

Only women manifesting symptoms are classified 

as having the syndrome. Studies show that 20 – 

25% of all women have polycystic ovaries, but less 

than 10% will have the syndrome. 

Polycystic ovary syndrome (known as PCOS) is, 

therefore, a common hormone disorder. It can 

cause a woman’s menstrual cycle to be longer 

than normal, be irregular and infrequent, and 

in severe forms, there may be no periods at all. 

PCOS can affect a woman’s ability to conceive 

and may affect her appearance with excess 

body and facial hair, acne and oily skin, and a 

tendency to be overweight. 

What causes PCOS? 

There is no known cause for PCOS and why some 

women develop it while others don’t. However, we 

do know that it often runs in the family, so there 

may be a genetic link to the condition. 

What are the symptoms of 

PCOS? 

•Irregular periods where there are longer gaps in 

between periods or no periods at all 

• Increase in facial and body hair known as 

hirsutism 

• Loss of hair on the head 

• Oily skin and acne 

• Problem with fertility 

• Overweight 

Most of the symptoms of PCOS are due to the 

abnormal hormone levels associated with the 

condition and can vary tremendously from 

woman to woman. The hormones that are 

abnormal, are raised levels of the male hormone 

testosterone and also insulin which is a hormone 

linked to diabetes. 

Women trying to fall pregnant may also face 

difficulties, due to ovulatory problems associated 

with PCOS. There also appears to be an increased 

risk of miscarriages. 

Mood swings and depression 

Women with PCOS are more likely to experience 

higher levels of depression and low self-esteem, 

caused both by the hormonal imbalances of the 

condition or by the symptoms it presents. If 

you are experiencing mood swings, do get help 

from your doctor for both your PCOS and your 

depression, even if it means a referral to a mental 

health specialist. 

Diagnosis 

As already mentioned some women with 

polycystic ovaries do not have the syndrome and 

therefore do not have any symptoms. Many are 

diagnosed when they seek help for their infertility. 

Others have symptoms but are unaware of what 

causes them. Symptoms to look out for: irregular, 

infrequent periods and an increase in facial or 

body hair. 

The best investigations to diagnose polycystic 

ovaries are ultrasound scan of the ovaries and 

hormone tests to check the levels of Anti- 

Mullerian Hormone (AMH) and testosterone. 

What are the long-term 

consequences of PCOS? 

Irregular periods can increase the risk of uterine 

cancer, acne can cause scarring, and weight can 

become harder to manage. Getting diagnosed and 

treated sooner rather than later is the best way to 

lower the risk of these problems. 

Insulin resistance and 

diabetes 

In PCOS the body responds less well to insulin 

which leads to a higher level of insulin and 

increased glucose level. Raised insulin may 

lead to irregular periods, weight gain, increased 

testosterone and fertility problems. It is estimated 

that 10-20% of women with PCOS go on to develop 

diabetes in later life. Furthermore, women with 

PCOS have an increased risk of diabetes if they are 

over 40 years old, have a family history of diabetes, 

have developed gestational diabetes in previous 

pregnancies and those who are obese. 



FERTILITY 360 

Cancer 

A very small number of PCOS women who have 

significantly fewer periods per year than normal 

are at risk of developing endometrial cancer due 

to the womb lining remaining thicker. There 

are means of reducing the risk which involve 

hormones and depends whether the woman is 

trying to conceive or not. 

Hypertension 

PCOS women are more prone to raised blood 

pressure which may be linked to obesity and 

insulin resistance. 

Snoring and drowsiness 

There appears to a link between PCOS and snoring 

leading to tiredness and drowsiness. 

What can be done to reduce 

the long-term consequences 

of PCOS? 

Diet and Weight loss 

A healthy lifestyle is important to help reduce the 

symptoms of PCOS. First of all, a healthy balanced 

diet is strongly advised. This should include 

plenty of fruits and vegetables and whole food 

e.g. wholemeal bread, brown rice and whole grain 

cereals, lean meat, fish and chicken. Consume less 

carbohydrates and salt, avoid alcohol and exercise 

regularly. 

If you are overweight it is advisable to lose weight. 

The benefits of losing weight are: 

• Lower risk of developing diabetes and insulin 

resistance 

• Lower risk of heart problems 

• Lower risk of cancer of the womb 

• Improving your fertility and the chance of 

pregnancy 

• Improve regularity of your periods 

• Improve skin condition with less acne and 

hirsutism 

• Less depression and mood swings 

It is important to note that losing a small amount 

of weight can make a significant difference to the 

symptoms of PCOS and at the same time make 

you healthier. 

Regular health checks 

Make sure you have your blood pressure and blood 

sugar checked by your GP regularly, at least once 

a year especially if you are overweight and have a 

family history of diabetes. 

How to get pregnant 

with PCOS? 

Most women with the milder form of PCOS do 

conceive naturally, though in general, it takes them 

longer to do so than average. On the other hand, 

women with the moderate to severe form of PCOS 

will have more difficulty conceiving naturally and 

often require help from fertility specialists. They 

have what is termed “ovulatory disorders.” 

For women with ovulatory disorders, the first 

line treatment is trying fertility tablets such as 

clomifene citrate which stimulates ovulation 

although the tablets themselves can reduce 

conception as they adversely affect the womb 

lining (endometrium) where embryos implant. 

This is why there is no benefit in taking fertility 

tablets if a woman is already ovulating on her own. 

An alternative is to use fertility injections which are 

more powerful and works differently to the tablets 

in that they do not affect the womb lining. There 

is, however, a higher risk of multiple births and 

requires ultrasound monitoring to reduce the risk. 

Another option is In-Vitro Fertilisation (IVF) 

should the above be unsuccessful. Whereas women 

with PCOS have a problem conceiving naturally, 

their chance of being successful through IVF is the 

same as other women without PCOS. 

It is pertinent to note that because women with 

PCOS have more follicles than normal, there 

is a tendency to produce more eggs during 

IVF leading to a condition known as Ovarian 

Hyperstimulation Syndrome (OHSS). 

Our fertility experts at Herts & Essex Fertility 

Centre have devised a protocol to treat PCOS 

patients with a special trigger to ripen the eggs. 

This is designed to reduce many times the risk of 

OHSS in patients with too many eggs, as opposed 

to the standard trigger which itself initiates the 

whole process of OHSS in those particular women. 

Finally, is there a cure 

for PCOS? 

Unfortunately, there is no cure for PCOS. 

Medical treatments are aimed to manage and 

reduce the symptoms or consequences of having 

PCOS. Medication alone has not been shown 

to be any better than healthy lifestyle changes 

(weight loss and exercise). Many women with PCOS 

successfully manage their symptoms and longterm 

health risks without medical intervention. 

They do this by eating a healthy diet, exercising 

regularly and maintaining a healthy lifestyle. 



FERTILITY 360 

MORE WAYS TO ENJOY 

YOUR FAVOURITE 

FERTILITY MAGAZINE 

fertilityroadsubscribe.co.uk 



FERTILITY 360 

Taking 

Time Out 

ALPHAZITA True Holistic Fertility 

Care and Fertility Retreats 



FERTILITY 360 

By adopting this 

holistic approach, 

couples can lay down 

the foundations, not just 

for conception but for 

healthy uncomplicated 

pregnancies 

A new series of articles looking at initiatives; 

innovation and development in international 

fertility begins with an exploration of 

AlphaZita, a new concept which uses a multidisciplinary 

approach to stimulate positive 

fertility health. 

Fertility Road’s Editor, Andrew Coutts went to 

hear a little more from the AlphaZita team. 

‘Wellness Tourism’ involves people who travel 

to follow activities that maintain or enhance 

their physical, Psychological and Physiological 

wellbeing. According to the Global Wellness 

Institute, the total expenditure from both 

international inbound and domestic 

tourists defined as ‘wellness tourists’ 

is expected to grow to $808 billion 

by 2020. They estimate that 

nearly 700 million trips that 

incorporated some aspect of 

wellness were made in the last 

year. International wellness is 

becoming big business. 

ALPHAZITA takes an innovative 

approach to wellness tourism and 

combines it with more traditional 

types of medical support which is provided 

by experts representing different countries and 

different specialisms. A team of acclaimed and 

experienced Doctors, Acupuncturists, Fertility 

Massage Therapists, Nutritionists and Fertility 

coaches have been brought together with the aim 

of promoting natural fertility and optimizing 

physically, emotionally and spiritually patients’ 

status during their fertility journey. 

The philosophy of AlphaZita is summed up by 

its founder, Dr Elias Tsakos, fertility specialist 

and Fellow of the Royal College of Obstetricians 

& Gynaecologists, “patients are treated 

individually by a team of Specialists in a unique 

and true holistic manner. Our aim is to educate, 

support, encourage and empower our patients in 

their fertility journey” 



FERTILITY 360 

Patients receive valuable 

treatments and consultations 

in a relaxed non-clinical 

environment and they increase 

their fertility awareness and 

their overall natural fertility. 

“A fertility retreat is an amazing experience; it’s an 

opportunity to come and meet Therapists bringing 

a fusion together of Complementary Medicine 

with Conventional Medicine. At the AlphaZita 

Fertility Retreats, patients have the opportunity to 

spend 2-3 days together with all the Therapists, all 

being one, all communicating, all connecting. It’s a 

life changing experience” added Miss Clare Blake, 

Fertility Massage Therapist and Founder of Fertility 

Massage Therapy. 

At AlphaZita you get a feeling that education, 

understanding, flexibility and mindfulness 

underpins much of what they do. Miss Gordana 

Petrovic, Fertility Acupuncturist points out, 

“the benefits of Holistic Fertility Coaching 

are multiple. Education is key for all 

Fertility patients and as long 

as patients know what 

therapies exist and what 

help is available, 

they will be more 

reassured and 

more relaxed. 

The AlphaZita 

programme 

provides a 

continuity of care 

of step of the way” 

What was refreshing 

to hear from the team 

was the belief that their 

intervention would help support 

and maintain good health prior, 

during and after patients’ fertility journey; 

“By adopting this holistic approach, couples can lay 

down the foundations, not just for conception but 

for healthy uncomplicated pregnancies. We care 

about every aspect of your physical and emotional 



FERTILITY 360 

help and as we teach you to improve balance in 

your body. Participants are aware that their general 

health improves alongside their fertility and they are 

encouraged to carry these benefits throughout life” - 

Miss Rosie Letts, Fertility & Pregnancy Nutritionist. 

From a patient’s point of view, I can see the very 

real benefits of access to diverse specialists in a 

safe and comfortable environment. It is the level 

of access which is not ordinarily available in 

clinics and one which is recognised by Dr Tsakos; 

“Fertility education, fertility awareness, 

pre-conception care and fertility coaching 

are important areas supported by substantial 

scientific evidence. During a technical and 

clinical appointment at a fertility clinic there is 

usually limited time, resources and expertise to 

explore vital areas of fertility care for everyone. 

As a fertility specialist, I often felt that I was 

failing my patients for being unable to address 

their stress levels, their nutrition, their emotions, 

their mindset and for strictly dealing with 

the medical part of their care. Most Medical 

specialties offer a multidisciplinary approach 

to their patients and it seems that Fertility care 

would perhaps be more complete, if it regularly 

embraced other disciplines as well, maintaining 

the wellbeing of the patient as the main focus.” 

Retreat participants from the UK, Europe and the 

US have benefitted from the events which have 

been hosted in 5-star resorts across Greece. The 

informal schedule on offer includes individual 

bespoke treatment sessions, lectures and group 

sessions. Post retreat, care and support is 

maintained via individually designed packages 

and the delivery team are available to respond to 

any medical, emotional and spiritual needs. 

The retreats are offered (attendance does cost) 

to single men and women; couples with (or 

without) fertility issues who wish to enhance 

their natural and/or assisted fertility. Females, 

males and couples with fertility issues who wish 

to enhance their natural and assisted fertility. 

Fertility professionals (Doctors, Nurses/Midwives, 

Acupuncturists, Massage Therapists, Nutritionists, 

Coaches, Councillors, Coordinators, Health Care 

Assistants, and Volunteers) who wish to familiarize 

themselves with holistic fertility care. A Certificate 

of attendance is offered if individual professionals 

wish to use their participation as CPD evidence. 

Feedback from those who have participated in the 

retreats is very positive with many agreeing that 

“the experience has been very different to what we 

have experienced so far”. Many others point out 

that the unique atmosphere created away from 

clinics allows them to take time out, to understand 

and appreciate their own fertility journey. The 

informality of the retreat allows unparalleled 

access to the specialist team and enables 

participants to forge relationships with others who 

our on the same journey – I am sure relationships 

that will last well beyond the AlphaZita retreat. 

On a personal level the benefits are tangible; 

patients receive valuable treatments and 

consultations in a relaxed non-clinical environment 

and they increase their fertility awareness and 

their overall natural fertility. Retreats can increase 

general physical and emotional wellbeing; lower 

stress levels and allow participants to stay focused 

while exploring all fertility options available, both 

conventional and complementary. 

AlphaZita seem to get it. Patients receive 

personalized care with respect and honesty, 

consistency and communication, understanding 

and trust. A unique true holistic retreat of 

fertility care. The retreat opportunity presents 

a life changing and life creating experience. The 

Fertility Retreat I believe, has a future and the 

AlphaZita blueprint is a good example to follow. 

The next AlphaZita Fertility retreat is 

scheduled for 11-14 October 2018, at 5 Star 

SaniResort.com, Greece. Limited places 

available on alphazita.com 



FERTILITY 360 



FERTILITY 360 

EXPERT: Russell Davis 

It’s Me or 

Baby 

Infertility can put a strain on the best of 

relationships. It is never something a couple 

expects to go through or can imagine how it 

will be when they start out. You can quickly 

go from deciding it's time to start trying for 

a baby to it impacting every area of your life, 

talking to clinics about treatments you never 

dreamed you would need and wonder how you 

got to this place. 

Over time, ‘Project Baby’ can become allconsuming. 

It can infiltrate all aspects of life. From 

lovemaking, the food you eat, whether or how 

much alcohol you drink, what social events you do 

or don’t go to and even the size of your friendship 

circle as more and more friends have children. As 

time goes by, the intensity can increase as the fear 

of time running out gets grows. 

Having a baby is supposed to come from a 

place of deep love and connection but can often 

become the source of a wedge between a couple. 

It can go from something that you expect would 

give such great joy to be the kill-joy. 



FERTILITY 360 

Sarah came to see me to help her be in the best 

place possible to get pregnant. However, she was 

frustrated her partner wasn’t making any effort. 

He didn’t seem to care how much he was drinking 

or whether he smoked or not even though there 

was a problem with his sperm quality. She said it’s 

like he’s given up, he can’t be bothered with it any 

more. This hurt her. She felt he didn’t care about 

her and them having a family together. 

What if one partner says ‘enough is enough’? 

What if it comes to the situation of being ‘me or 

baby’? Or more accurately me or Project Baby? 

Dealing with infertility can be tough enough on 

its own. Unfortunately, a study found that the 

pain of infertility can cause even more pain and 

heartache. Couples who didn’t have a baby after 

fertility treatment were more likely to break up. 

For the study, which was published in the journal 

Acta Obstetricia et Gynecologica Scandinavica, 

Danish researchers tracked 

47,515 women who were 

evaluated for infertility over 

12 years. After the 12-year 

follow-up period, it turns 

out that the women who 

didn’t have a child were up 

to three times more likely to 

have divorced or ended their 

relationship with the person they 

were with at the time of the study than 

the women who gave birth. 

This shows the need to ensure Project Baby doesn’t 

become the sole focus in the relationship at any 

time; open and honest communication and 

connection is the priority. This creates the glue 

and also keeps both parties on the same page. 

If one of you has had enough, the first thing 

to explore is what have they had enough of. I 

would suggest is not the idea of having a baby 

Over time, 

‘Project Baby’ 

can become allconsuming 

but the impact that it’s having 

on the relationship and life as 

a whole. 

They probably resent that 

Project Baby has crawled 

its way into every area of 

life with what appears to be 

negative consequences. The 

carefree fun-loving times have 

seemed to be replaced by regimes, 

timetables, rules about what you can or can’t 

eat, not being able to have a drink and a partner, 

who is more often than not, anxious, distressed 

or depressed. 

Do these experiences have to go with the 

territory? Is it possible to continue trying to 

have a baby as well as living life to the full in the 

now? Is it really ‘me or the baby’ or ‘me or the 

all-consuming, partner-imploding, fun-zapping 

Project Baby? 



FERTILITY 360 

If it is the former, then open and honest conversations 

need to take place about the future of the relationship 

and where your lives are going. Keep reading and you’ll 

find something to help you with that. 

If it is the latter, then I have some good news. 

It is possible to continue to explore having a 

baby without all the distress and for it to come 

all-consuming. In fact, you are more likely to be 

successful that way. 

Project Baby takes over when it is founded on 

fear. Fear of not being successful. Fear of not 

having what you think a baby will give you. I 

have asked many people what they think having 

a baby will give them. More often than not the 

answer is something like fulfilment, purpose 

or happiness. I genuinely believed we would be 

happier with a baby than without. 

This is living ‘outside-in’. This is thinking I’ll be 

happy when… or I’ll be happy if… people do this 

with all sorts of things. ‘I can relax and be happy 

when I have more money’. ‘I’m okay if people 

don’t think badly of me’. ‘I’m okay I’ve proved 

myself to be okay’. The thing is it’s just not true. 

Nothing has the power to make us feel anything. 

100% of our experience comes from thought. Our 

perception of the situation, not the situation itself. 

I was very much in this place. It wasn’t until the 

middle of our fertility journey I realised this 

was the case. I’d been like it all my life. I’ll be 

OK when I’ve proved to my parents I am good 

enough, then my teachers, then it 

became my employer. I was a 

people pleaser. It wasn’t until 

I let go of this and KNEW 

I was OK for who I was 

that I needed nothing 

to be OK, that I found 

peace of mind on 

our fertility journey. 

It wasn’t until we 

realised we could create 

a life that is inspiring 

and fulfilling with or 

without children than things 

happened for us, naturally 

against all odds. The underlying fear 

of not having a baby was impacting our fertility 

as well as day to day happiness in life. 

If you feel like this I recommend you look 

at exploring some therapy or counselling to 

help you let go of the fear of not having a 

baby. For you to know you are OK now, there’s 

nothing you need to be OK. The fear of not 

having a baby is usually fuelled by a fear of 

failure or fear of not being good enough or 

not deserving. The emotional roller coaster of 

infertility can shine a spotlight on these things. 

They are not really about having a baby but 

are contaminating your experience of trying 

to have a baby. Thee can create psychological 

blocks to getting pregnant. 

Whatever the specifics of the situation if 

one partner decides enough is enough there 

needs to be some open and honest dialogue in 

order to understand how each other feels; not 

what anyone thinks. Not to fix each other’s 

feelings or change their thinking about it. To 

understand how they feel. To get into their head 

and understand it from their perspective. Their 

perspective on whether you think it’s right or 

wrong. Too often we communicate to defend 

our position, to tell our partner where they 

are wrong if we feel criticised, to fix problems 

and make them feel better rather than to truly 

seek to understand them. To understand how 

they feel about things. Men are often a little 

rusty at communicating feelings but quick to 

fix problems and not hear what their partner is 

wanting them to hear, how they feel about it. 

I recommend you 

look at exploring some 

therapy or counselling 

to help you let go of the 

fear of not having a 

baby 

I suggest in this situation each person writes 

down how they feel about the situation. Not what 

they think, how they feel. This process can help 

men to be more aware of the feeling within them, 

especially if they keep the pen moving.. 

Writing can also help each other identify the 

feelings the other person is communicating. I 

found when I read something my wife had written 

it stopped me interrupting to fix the problem. It 

helped me focus on the feelings she wanted me to 

hear and understand. I would read it twice to make 

sure I’d really ‘heard’ them. 

Once you have both written 

how you feel about the 

situation you can take 

turns in talking about 

what each other has 

written. The listener/ 

reader can ask 

questions to ensure 

they’ve understood, 

what they think is 

being communicated. To 

understand what is meant 

behind the words. If someone 

says they feel angry what does that 

really mean? How angry? What’s that 

anger like? A word can mean different things to 

different people so it’s important to understand 

the experience behind the words that are being 

communicated. 

All too often we hear what we think we’ve heard 

and not really heard what was being said. This 

is about really understanding each other and 

where each other are at on this journey. It’s can 

be a long and tough journey. Sometimes people 

want to give up. Sometimes this is a passing 

experience, sometimes it goes deeper. 

Don’t jump to conclusions about what the other 

person is saying. Don’t make it into what you think 

it is or means. Listen. Seek to understand. From that 

place, there is no situation you cannot deal with. 

At the end of the day, whatever happens, you 

are going to be OK. Whatever happens. Our 

psychological well-being is within us. You may 

not feel OK at any time but underneath the 

emotional experience is a soul that’s got this and 

whatever happens covered. Emotions come and 

go, you cannot hold on to them forever even if 

you wanted to. 

Take a breath, come back to the here and now 

and seek to connect, understand and you may 

find it’s not what you think it is. 

Russell is a fertility coach supporting 

couples on their journey. You can contact 

him via his website thefertilemind.net 



MEN ONLY 

EXPERT: Sarah Banks 



MEN ONLY 

How fertility treatment may 

aect your partner 

Stress: Fertility treatment can amplify anything 

stressful in a couple’s life, and simple daily things 

can just be too much for your partner to handle 

at the minute. Try to be considerate to see if 

there is anything you can to do help take the 

weight off of her shoulders. 

Insecurities: Fertility treatment can intensify 

your partners sensitivities and triggers, making it 

difficult to be around babies and pregnant women 

(including family members). Be understanding 

and try not to question these emotions. 

Depression: It is extremely common for women 

to feel low and depressed while going through 

fertility treatment. Watch outs are: loss of appetite, 

inability to sleep, excess sleeping, eating a lot, 

and generally feeling very sad. If your partner is 

showing any of these signs you should encourage 

her to talk to her fertility specialist or a fertility 

counsellor (usually available through your clinic). 

ow can you support her 

through treatment 

There are four main ways you can support 

your partner: 

Emotional support (listening, empathising, hugs) 

Self-esteem support (telling her you love, admire 

and respect her) 

Informational support (doing research, asking 

questions) 

Practical support (take on responsibilities, 

planning logistics) 

motional Support e there 

for her 

One of the best things you can do during IVF 

treatment is to listen. Don’t try to fix it or suggest 

solutions. Just listen with empathy. She doesn’t 

expect you to make things better, she knows you 

can’t fix the problem. She just wants to know you 

hear her and that you sympathise. 

Sometimes just giving her a hug will help you 

show your support and make her feel loved. 

Holding her hand, letting her cry on your 

shoulder, and just being there (not on your 

phone) is all she needs. 

It may be difficult to know how to best help her, 

so ask her how she wants you to help her. All the 

hormones play havoc on the emotions and your 

partner may be fine one minute and floods of tears 

the next. Similarly, she may want to talk about 

everything one minute and the next not want to 

talk about anything to do with treatment. 

I know this makes it hard to know what to do for 

the best. Cut her some slack, she’s pumping herself 

full of hormones every day and ask her how she 

wants you to help her. She can tell you what she 

needs at that exact moment and you can help her. 



MEN ONLY 

Selfesteem support 

e her biggest cheerleader 

Your wife’s self-esteem may be suffering, and 

the indignities and side effects of IVF treatment 

don’t help. Try to keep any criticism and sarcasm 

to a minimum and think about whether it is wise 

to make jokes at inappropriate times (even if it is 

to lighten the mood). 

Compliment her on how she looks as she is likely 

to be feeling bloated and not her usual self – be 

genuine with your compliments so she believes 

you. Any little boosts to her 

confidence will put a smile 

on her face and make her 

day a bit brighter. 

t’s really 

important that you 

don’t blame each other 

for the fertility issues 

and don’t blame yourself 

you are in this as 

a team 

Show her you admire 

her for what she 

is going through, 

that you think she’s 

great and handling 

everything really well. 

Show her you love and 

appreciate her – it doesn’t 

have to be big gestures, 

something as simples as flowers, 

chocolates, a hug, or saying ‘I love you’, just to 

show you understand what she is going through 

physically and emotionally – trust me, she’ll thank 

you for it. 

nformational Support 

Do our esearch 

The man’s role in fertility treatments is different 

from his partners in that he will mainly play a 

support role as his partner does the physical side 

of treatment. You can help by doing research 

on treatment – clinics, add ons, side effects, the 

process, finances, payment plans – so you can 

support your partner through the process. 

Understanding the impact of treatment on your 

partner’s body and the way infertility in general 

makes her feel can help you support her better 

– it will show your partner that you are 

interested in her well-being. 

You can also research other 

lifestyle factors that may help 

with conception and feeling 

prepared for treatment. 

Look in to ways that you 

and your partner can relieve 

stress, nutritional advice and 

emotional support. 

ractical support 

rganise all the dull bits 

Between the stress and the physical effects of fertility 

treatment, your wife may be feeling more tired than 

usual, and all the hormones can cause some side 

effects such as nausea, fatigue and even pain. 

Taking on some of the day to day chores that you 

don’t normally do will ease the pressure on her 

and show that you appreciate that she is taking the 

brunt of the physical side of treatment. 

You could take on all the logistics and planning 

side of fertility treatment – timings of journeys, 

booking hotels, picking up medication. 

You could also offer practical support in terms of 

nutrition – buying healthy snacks and cutting out/ 

down alcohol as a support to her. 

It’s really important that you don’t blame each 

other for the fertility issues and don’t blame 

yourself – you are in this as a team, it is a joint 

issue that you will work through together. 

Supporting yourself through 

Fertility treatment 

We can’t get away from the fact that most of the 

pain of treatment is felt by women (physically and 

emotionally), but it is often forgotten that men 

experience emotional stress, they have to watch 

their partner go through the gruelling process of 

IVF, have to go through invasive procedures and 

they also long for the family they want to create. 

Many men feel hopeless during this period as there is 

nothing they can physically do to take the pain and 

stress off their wife. They empathise with how their 

wife is feeling, but they may also feel overwhelmed by 

the depth of their wife’s emotion and pain. 



MEN ONLY 

partner) a fertility professional (Counsellor, 

fertility Coach) or a support group where it is 

more anonymous. 

hink about the things you want 

to do and achieve 

Infertility and going through treatment can 

make you put plans you have on hold. Write a 

list of things you’ve always wanted to do and 

achieve and create a plan to start doing some of 

them. There may be time and money constraints 

around treatment, but it will give you a sense of 

achievement and something to focus on outside 

of treatment. 

Do things you enoy 

Men and women deal with 

the stress of infertility 

in very different ways, 

and it is important to 

remember that no way 

is right or wrong. Each 

person processes their 

pain in a way that works 

for them, and it’s important 

to find what works for you. 

Communication is so important 

in couples struggling with fertility, and 

honesty and openness can save marriages. 

Supporting your partner through IVF is so 

important, but it’s also really important to look 

after yourself through the process and get the 

support you need. 

There are lots of ways to help cope with infertility 

and IVF: 

ake control of the things you can 

Infertility can make you feel out of control of your 

life and your future, and when you go through IVF 

it can feel like the process is out of your control, 

with all the timings, hospital visits and medications. 

However, there are things that you can control; 

Lifestyle – you can make sure you are eating 

healthily, avoiding alcohol, reducing/stopping 

caffeine. These things are important for your body 

to be in the optimum state for sperm production, 

but you will also feel better in yourself. 

Mindset – you may feel that you don’t have 

any control over how you feel, but you do have 

full control. You can make a choice to be in the 

right mindset for going through treatment and 

supporting your partner. 

en and women 

deal with the stress of 

infertility in very dierent 

ways, and it is important to 

remember that no way is 

right or wrong. 

Practical – although a lot 

of the process is out of 

your control, control 

the things you can – 

research treatment so 

you can ask informed 

questions, research add on 

treatments, so you are clear 

on what you do/don’t want, 

organise logistics and plan 

treats around procedures to give 

you both something to look forward to. 

Don’t bottle it up 

Its normal to feel that you need to be a rock 

for your partner and that you can’t show your 

emotions, but it’s important that you address your 

feelings and have a way to cope. 

Everyone copes differently, and there is no right 

or wrong way, it’s just important to have an outlet 

for your feelings: 

Write in a journal – you can write freely without 

worry of someone reading it. Use it to scribble 

down your feelings, worries and frustrations. It 

can be quite therapeutic! 

Write a blog – this is a good way to talk through 

your feelings anonymously, and it may help 

others in the same situation if you choose to 

share it. 

alk it out 

You may find it difficult to talk about what 

you are going through and how you are feeling, 

but it’s important that your feelings are heard. 

There are lots of options for people you can talk 

to – either someone you know (friend, family, 

Plan things that you enjoy, so that infertility isn’t 

your only focus - gym, exercise, walking, reading, 

computer games, seeing friends. 

Spend time as a couple 

It’s really important to remember why you are 

together as a couple and spend quality time 

together. You need this, so you don’t feel the 

focus is only on having a baby and that you’re 

only needed for your swimmers. Spending time 

together gives you chance to talk openly if you 

want to about how you are both feeling and 

anything about treatment. 

Set time limits for how long you talk about the 

treatment and infertility, so your conversations 

don’t just revolve around trying for a baby. 

This can add to the stress and pressure in the 

relationship. Also set times when you don’t discuss 

it – for example if you’re out for a meal, so it gives 

you time to focus on the other good things in your 

life and each other. 

Remember to look after yourself and get the 

support you need, you will be better able to support 

your partner through treatment and both be in a 

better state as a couple to cope on this journey. 

Sarah Banks is a Fertility coach and mentor 

who works with fertility professionals to 

enhance their patient experience and success 

rates. She helps them understand how 

patients feel, the emotional support they need 

and helps implement support structures. 

She also works on a 1-to-1 basis with women 

struggling to conceive, to improve their 

emotional state and increase their chances of 

getting pregnant. 

For further information contact her on 

sarahsarahbanks.coach or via her website 

sarahbanks.coach. 



MEN ONLY 

A F 

A F 

TESTINGryan oodward 

is the erson esponsible at 

Fertility, a new fertility clinic in eicester 

specialising in male fertility, and lowtech 

fertility treatments such as and D. ryan 

is coeditor of the book ale nfertility 

Sperm Diagnosis, anagement and Delivery’ 

which covers all aspect of male fertility for 

professionals and patients. 



MEN ONLY 

EXPERT: Bryan Woodward 

When it comes to fertility problems, it is a 

sad fact that some GPs, will go gung-ho into 

investigating the female partner, whilst the 

male is often left on the side-lines with no 

investigations. As a result, he may watch whilst 

his wife has numerous blood tests to check her 

various hormone levels throughout 

her menstrual cycle; some 

women are even admitted 

to hospital to have their 

Fallopian tubes checked 

out, to ensure they 

aren't blocked, and 

this is all before the 

man has any questions 

raised about his 

fertility status 

Yet, nowadays, fertility 

problems are attributed more 

or less equally between the male 

and the female. Therefore, one of the first 

tests to perform for a couple who experience 

trouble conceiving is a semen test for the man. 

Please note, this is called a ‘semen test’, rather 

than a ‘sperm test’. Yes, we will be looking for 

sperm – after all we need to find sperm so that we 

know there is a chance of this cell fertilising an 

egg. However, a semen test is so much more than 

just looking for sperm, as I’ll explain later. 

To assess semen, the first step is to ask the man 

to produce a sample. For some, this is a simple 

process, over in less than 5 minutes. For others, 

this can be a source of great anxiety. Some men 

may not be able to masturbate, whilst for others 

the act of masturbation may be contrary to their 

religious belief or way of life. If this is the case, 

then condoms can be used, to obtain the semen 

sample by sexual intercourse. However, use of 

a condom can cause complications; firstly, it is 

important to check that the condom material 

is not toxic to sperm, and secondly, much 

t is a sad fact 

that some s, will go 

gungho into investigating 

the female partner, whilst 

the male is often left on 

the sidelines with no 

investigations. 

care is needed to ensure that the sample isn’t 

contaminated by any other cells during the 

withdrawal process, such as cells from the vagina, 

as these may affect the sperm. 

There is also the question of whether the man should 

produce the sample ‘on-site’ at the clinic, or whether 

he should produce it ‘off-site’, for example at home. 

Specialist fertility clinics usually have specific rooms 

for on-site production, although the quality of the 

room is variable. Oddly, the name for this room also 

varies, from the basic “Male production room” to the 

more Latin-sounding “Masturbatorium” (this word 

has made it into Google’s Wiktionary but has yet to 

be included in the Oxford English Dictionary!). 

There are many advantages to producing a 

semen sample on-site, since the environment 

and timing can be better controlled. Ideally the 

specimen container should be pre-warmed to body 

temperature (37C) and then placed into an incubator 

at the same temperature immediately after the 

sample is collected. Off-site production inevitably 

runs the risk of variations in temperature during the 

journey to the clinic (may be not so much 

in the recent summer heat-wave, but 

certainly in during the colder 

months. There is also the 

time-factor to consider: the 

semen needs to be analysed 

within 60 minutes of 

production, to ensure an 

accurate assessment of 

the swimming ability of 

any sperm. Many clinics 

will reject a semen sample if 

it arrives even 1 minute later, 

which can add to the stress for the 

man who produces ‘off-site’. 

Once the sample is safely in the andrology lab, the 

semen analysis can begin. The first test is to assess 

the colour, which optimally should be an opalescent 

grey. An opaquer sample may indicate a low sperm 

count, whereas a more yellow sample may indicate a 

possible infection, jaundice, or that the man may be 

taking some form of drugs. A reddish-brown colour 

usually indicates that red blood cells are present. In 

this case, it is essential to check how this might have 

been caused – was it by the masturbation process, 

or is the man’s natural ejaculate colour? If the latter, 

then further testing should be sought as soon as 

possible to rule out any internal problems with any 

of the reproductive system or the prostate. 

We then test the volume of the ejaculate. In 2010, 

the World Health Organisation (WHO) stated that 

the lower limit of fertility was a volume of 1.5ml. 

This means that if the volume of the sample is 

less than 1.5ml, then there could be a problem. If 

a man produces an ejaculate with a small volume 

or even no volume at all, then retro-ejaculation 

is a possibility. Retro-ejaculation is a condition 

where, at the point of orgasm, the semen passes 

backwards into the bladder rather than out of 

the penis. It should be noted that this is a rare 

condition, affecting 1% couples undergoing fertility 

investigations, and is more common in men who 

have had prostate surgery, suffer from diabetes, or 

take medication for high blood pressure. 

The next parameter to be tested is semen pH, a 

test of alkalinity and acidity. Semen is made up 

of secretions from various glands which support 

the sperm when it is deposited at the top of the 

vagina during intercourse. Secretions from the 

prostate are acidic, whilst those from other glands, 

such as the seminal vesicles, are more alkaline. If 

there is an obstruction or problem with any of the 

ducts, then this can affect the pH. Semen should be 

slightly alkaline (above pH7.2). However, sample pH 

increases with time from production, as the sample 

is exposed to air in the container. This is another 

reason why it is important to control the time from 

production to analysis. If the pH is too high, then 

this could indicate an infection, possibly due to 

decreased secretions from the prostate. 

The final test that is performed, before looking down 

the microscope, is the liquefaction and viscosity of 

the sample. The reason Mother Nature made semen 

viscous immediately after ejaculation, is to keep the 

semen within the vagina to allow the sperm to start 

swimming towards the egg. The medical term for the 

semen at this stage is a coagulum. If it wasn’t viscous 

coagulum, the semen would immediately fall out 

after intercourse! A normal sample should liquefy 

within 30-60 minutes, although liquefaction is often 

completed within 20 minutes. If a sample doesn’t 

liquefy after 60 minutes, this could compromise 

sperm motility, hence the importance of the test. 

At the same time as assessing liquefaction, the 

general consistency of the semen is also assessed 

for anything unusual, such as the presence of 

crystals. These could be caused by uric acid, but 

if crystals are present, regardless of the cause, 

then further investigation by a urologist is 

recommended, as ejaculation may also be painful. 

Once these ‘macroscopic’ tests (visual tests 

without use of a microscope) are complete, it is 

time to begin the ‘microscopic’ tests. 

he Shape of Sperm 

In fertile men, and even super-fertile sperm donors, 

the majority of sperm are not the correct shape. 

The WHO has put a lower limit of just 4% sperm 

needing to be the correct shape for fertility. The 

grading of each sperm follows strict criteria, and a 

full assessment requires the grading of at least 400 

sperm. Of particular importance is detecting if a 



MEN ONLY 

man just has ‘round-headed’ sperm. This indicates a 

condition called ‘globozoospermia’, whereby all the 

sperm lack a sperm cap on the top of the head called 

an ‘acrosome’. It is the acrosome that is essential 

for fertilisation, as this helps the sperm penetrate 

the egg. Even if there are lots of fast moving sperm, 

if the sperm are round-headed, then natural 

fertilisation is highly unlikely. 

he ovement of Sperm 

A sperm needs to swim forward to have a chance 

of fertilisation. If we consider the journey that 

the sperm has to make naturally, it is quite an 

ordeal. Firstly, it has to swim towards the cervix, 

then through the cervical mucus to enter the 

uterus. Many sperm are naturally filtered out 

at this point. The next journey is to find the 

Fallopian tube and swim through the ciliated 

cells that line this structure. Fertilisation takes 

place at the top of the Fallopian tube, where 

the ovulated egg is hopefully waiting. This 

progressive movement, termed ‘motility’ is 

essential. The WHO has put a lower limit of 32% 

for sperm moving progressively forward to be 

classed as fertile. 

Please note though, even if a sample has no 

moving sperm, it is still possible to achieve 

a pregnancy, provided the sperm are alive. 

There are various lab tests for sperm ‘vitality’. 

Once a sperm is checked to ensure it is alive, 

then the assisted conception technique called 

‘intracytoplasmic sperm injection’ (ICSI) will 

be needed to try to achieve fertilisation. The 

ICSI process is highly skilled, and involves an 

embryologist selecting the best-shaped living 

sperm (usually at a magnification of 600x), then 

carefully picked up into a needle, which has a tip 

size which is the tenth of the width of a human 

hair! The sperm is then carefully injected into 

the egg. 

he Sperm Concentration 

level of fragmentation 

in the sperm DNA, 

often called a ‘DNA 

Fragmentation Index’’ 

or ‘DFI’, which looks at 

the level of integrity of the 

genetic components within 

the sperm. Another test looks at 

the level of ‘Reactive Oxygen Species’ 

or ‘ROS’, which gives an indication of the 

amount of oxidative stress the sperm might be 

subjected to within the semen sample. 

hilst shape, motility 

and count are the three 

main microscopic tests 

of sperm, there are a 

multitude of other tests 

available. 

most scenarios. Like 

everything in biology, 

there are extremes. 

Some men produce a 

thick sample of semen 

that contains so many 

millions of sperm, that 

there are simply too many 

to be functional unless they can 

swim out of the seminal plasma as soon as 

possible. Other men produce a watery fluid, that 

is completely void of sperm. 

As a general rule, the sperm count is the number 

of sperm in the sample, expressed in millions 

per millilitre. The WHO sets a lower limit of 

15 million/ml for fertility. The actual test is 

again quite detailed, as a specialised microscope 

slide called a counting chamber is needed. This 

ensures a fixed volume of semen is held over a 

microscopic grid. The number of sperm in the 

grid are then counted to estimate the number of 

sperm present in the whole semen sample. 

Additional test for sperm 

Whilst shape, motility and count are the three main 

microscopic tests of sperm, there are a multitude 

of other tests available. These include assessing the 

However, caution should be considered when 

thinking of having these additional tests. They 

are usually only recommended once the results 

of a conventional semen analysis are known, and 

most likely after a repeat semen analysis has been 

performed to confirm the values of each tested 

parameter. Before embarking on additional tests, 

it is recommended that you ask your fertility 

specialist to explain what the value these test 

results will bring. This is also important if these 

tests come at an additional charge! 

n a personal note 

I have been looking at sperm for over a quarter 

of a century, so it is fair to say I have seen 

Provided the semen analysis is performed 

by a reputable clinic, then the results should 

be accurate and the staff should take time 

to explain exactly what each result for each 

parameter means. 

With the vast number of assisted conception 

treatments on offer, there is always a way 

forward to achieve a pregnancy. And for 

me, there is nothing better than to receive a 

call from a patient to tell me his partner is 

pregnant, even though he had a poor prognosis 

semen analysis. The couple will have been 

given the facts, but fertility has always been an 

enigmatic area of medicine - after all, it only 

takes one sperm to make it!

Fertility Road Magazine 46 - September/October 2018

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