your great life

The Fertility Focus Telesummit is back for 2012

Sarah Holland's Fertility Focus Telesummit launches on the 12th of March. I spoke at last year's Telesummit, and listened to every one of the other speakers, so I believe I can vouch for this worthwhile event. Click here for more information about how you can register for the Telesummit.

This is how it works. The Telesummit is an amazing “virtual event.” It will feature fertility experts from around the world sharing their knowledge and insights on a wide range of fertility subjects. You can listen in to all the information-packed presentations either online or over the phone every day of the Telesummit, starting on March 12th.

Grab your place now to attend this exciting event for free and get fully informed about what you can do to improve your chances of having a baby. Click here for details of all the expert presentations, each covering a different aspect of infertility and all offering great advice, ideas and solutions to help you move further towards becoming a parent.

Careless lab error could destroy a couple's baby hopes

The Daily Mail has reported that a fertility clinic in South Wales has accidentally destroyed a batch of 10 exceptional quality donor eggs belonging to a couple that had been trying to conceive for 7 years. The eggs had been donated by the woman's sister after previous IVF using her own eggs failed. The couple, in their mid-30's, were devastated to learn of the accident by telephone when they returned home from the clinic. All of the eggs had been stored in the same pipette, which was broken when a clinic employee knocked it against a microscope.

Simple human error? Just one of those very unlucky things? Apparently this is not a one-time incident that has cost a patient dearly. The HFEA is reportedly very concerned about the standard of care at the clinic, which also recently destroyed sperm stored by cancer patients for future use. Legal proceedings are being brought against the clinic by the couple involved, who are also calling for a rigorous investigation to prevent this happening to others. The question remains whether the HFEA, the regulatory authority for IVF and other fertility treatment in the UK, is in fact able to effect changes when there is a pattern of poor standards of care and service? Voicing concern is clearly insufficient. It would be understandable if the donor in this case is unwilling to put herself through the hormone treatment and egg retrieval process a second time as a result of this blunder, but perhaps her love and generosity of spirit will prevail. I can only hope that the couple involved finds a new fertility clinic in which they can build trust.

Someone's been a bit too generous

One man; 17 families. No, he's not a bigamist. One British man has reportedly donated sperm to 17 couples, breaching HFEA regulations that limit donation to a maximum of 10 couples, according to The Sunday Times. Does it matter? Actually, yes. The Human Fertilisation and Embryology Authority regulations are in place to prevent the possibility that half-siblings could unknowingly meet and become involved in sexual relationships, thereby potentially parenting children with genetic risks.

In a large country like the United States, with a population of approximately 300 million, the distribution of donated sperm to multiple beneficiaries is not such a big risk. (See my post on Sperm Donor 150, who has 14 known biological children fathered through sperm donation, spread out across the United States.) However, the HFEA has determined that these regulations are necessary in a country like the United Kingdom, which only has about 60 million residents in a relatively small geographical area. Alan Doran, the chief executive of the regulatory authority, admitted this week that others have breached the maximum as well. He announced a crackdown, assuring that the HFEA would be warning fertility clinics that they risk losing their license if they continue to break the rules.

This isn't the first time that we have read about fertility clinics flouting the HFEA guidelines. I'm not sure whether this is simply a case of inadequate monitoring or the inability to follow through and actually impose sanctions. In the case of sperm donation, the risks to offspring could be both physical and emotional. It is important to consider the psychological ramifications to donor-conceived children, who may suffer adversely from discovering that they are one of dozens of siblings born to different families.

I would like to see the HFEA get some teeth. Fertility clinics are profit centres and cannot be expected or trusted to be wholly self-regulating. Since payment of donors is not allowed and sperm donors can only receive fairly minimal expenses for travel expenses and loss of earnings, up to £250 per time, the cost to the clinic is negligible. However, this may also be the reason that men do not come forward to donate sperm, hence the temptation to use the same donor over and over again. There are no regulations regarding how many children each of the 10 permitted families can have via sperm donation, so this one man could have fathered dozens of children who may never know about each other. Those who donated sperm, eggs or embryos after 1 April 2005 are, by law, identifiable, however, this will only happen if the donor-conceived children request their donor’s name and last known address, once they reach the age of 18. It's up to the regulatory authority to put in place as many safeguards as possible. It's also up to them to make sure they are being used.

con·san·guin·i·ty (knsn-gwn-t, -sng-)

n. pl. con·san·guin·i·ties

1. Relationship by blood or by a common ancestor.

2. A close affinity or connection.

"Consanguinity is an important legal concept in that the laws of many jurisdictions consider consanguinity as a factor in deciding whether two individuals may be married." http://en.wikipedia.org/wiki/Consanguinity

I love happy endings: A fertility fairy tale come true

Once upon a time, a young woman from Oxfordshire experienced premature ovarian failure at the age of 24 and thought she could never have children. She told her partner that it might be best for them to part, but he pledged his undying love for her and together, they went on a quest for a solution. They appealed to the local PCT for help, but were turned away on the basis of their age. When they thought all hope was lost, not one, but two, heroes came along to offer them a solution. Claire's sister offered to donate her eggs to the couple and a private hospital offered to perform the IVF procedure for free. The Cousins now have 2 children. The end.

Okay, so that's the fairy tale, with a damsel in distress, a villain, a heroine and the knight in shining armour, but the real story isn't far off. Claire Cousins tried to conceive for 2 years before being diagnosed with premature ovarian failure in 2009. She was told that the only way that she could conceive would be with donor eggs and IVF, however, when she and her husband Gary applied for the treatment through their local Primary Care Trust in Oxfordshire, they were turned down. While the general NHS guidelines permit funding of IVF for women between the ages of 23 and 39, Oxfordshire PCT restricted funding to those between the ages of 35 and 38 on the grounds of their budget. Despite the support of their GP and local MP, their appeals were turned down. The PCT later decided to expand its offering to women from the age of 30, but this still did not help the Cousins. They didn't have the £5,500 it would have cost to pay for the treatment privately.

Nearly three years on, and the Cousins are now a family of four. After some publicity, a private hospital stepped in and offered Claire the fertility treatment for free. Claire and Gary were able to have two children with the use of her sister's donated eggs.

This is just one case that demonstrates the uneven-handedness with which NHS funds are doled out by the various PCTs in the postcode lottery. While the PCTs must use some criteria in their decision-making, shouldn't there be space for them to apply them on an individual basis and make exceptions? Using strict criteria such as a specific age range does not always work, as demonstrated by the Cousins' case. Isn't it just like bureaucrats to tell a 24 year old that she is too young for IVF on the NHS, when she has already hit menopause and has no hope of having children without IVF? (Most women will go through menopause after the age of 45.) This wasn't about a lifestyle choice or misuse of funds, but of necessity. The system and those who run it are merely made to look foolish by these cases of thoughtless application of rules.

Stepmums can be denied NHS fertility treatment

This morning on The Wright Stuff, presenter Matthew Wright posed the question whether stepmums should be denied IVF treatment because they have (someone else's) children in their life. This isn't the first time I have heard of this. There have been occasions in the past when Primary Care Trusts (PCT) have denied fertility treatment to women whose husbands already had a child, albeit with another woman, or who have had children themselves in previous relationships. It's an example of bureaucratic policy making that doesn't take into account the human experience of the people it is meant to serve.

Susi Henson, a 33-year old woman has been denied IVF because her partner has a 20-year old son from a previous relationship who she has never even met.  This seems like blind adherance to a rule that does not take into account her medical condition, Polycystic Ovary Syndrome, that prevents her from conceiving. The Nottinghamshire County PCT has ignored the true facts surrounding this woman's childless status, in favour of a view that this is not a "childless couple."  However, in no way could Susi Henson ever be considered to have had the opportunity to parent her partner's child, considering that he is only 13 years younger than she is and lives in Wales. 

Some of the points made by Wright and his guests, including Anne Diamond, concerned the limited NHS budget, whether everyone has a right to have children, whether everyone who needs IVF should be able to access it free and how many cycles of IVF should be alotted per patient. There will always be controversy, as long as individual PCTs can use their own criteria for eligibility. For instance, Wright mentioned that about one-third of PCTs will allow patients who are smokers to access IVF, even though smoking is known to inhibit conception, raise the chances of miscarriage and impact upon the health of the foetus during pregnancy and after birth. It is, perhaps, the uneven and confusing allocation of fertility treatment that galls people the most. 

A caller to the programme, Katie, was also denied IVF which she needed due to blocked fallopian tubes because her partner had adult children.  She eventually managed to save the money for private treatment and is now the mother of a 5-month old baby, but considers the financial hardship it caused to be unfair.  Susi Henson phoned in to the show to say that she has received a lot of public support, as well as a phone call from one of the policy-makers who has promised to review her case and the PCT's policies on IVF treatment. However, the policies are only reviewed in April each year. Matthew Wright emphasized the inadequacy of this offer, pointing out that the delay of nearly a year could negatively impact upon Henson's chance of conceiving, as age is an essential aspect of a woman's fertility.

Even if a woman is the stepmother to her partner's young children, and partially responsible for their upbringing, should she be denied the ability to have her own children? By definition, those children have, or had, a mother already. Step-parenting can be difficult and is not always loving or even cooperative, depending upon the degree of amicability between the estranged parents of the children involved, custodial arrangements and other emotional factors. While step-parenting may fulfil some women's needs, others will never see it as an adequate replacement for the experience of giving birth to, raising and loving her own children. Further, it is entirely natural for a couple to want to create a family of their own.

If a woman meets all other criteria for fertility treatment on the NHS, and it is deemed medically necessary in order for her to conceive, it seems cruel and unjust to deny her that chance. Most women have no inkling of their infertility until they have begun trying to conceive, therefore, they will not had the chance to take it into account when agreeing to marry someone who already has children from a previous relationship.  Ironically, they may have had an easier time accessing NHS treatment is they were single, as many PCT's will allow IVF to single women.  This is symbolic of the incoherence and uneven-handedness of the present policies existing across the UK. If we are to ensure a fair allocation of NHS funds for fertility treatment, wouldn't it be better to look at the people concerned and make more individual decisions? Matthew Wright thinks an IVF ombudsman could work. I like the idea of individual, people-centred decision making, but I imagine I can already hear cries of alarm about the cost involved in that: how many IVF procedures could have been paid for with the salary of the ombudsmen?   

Are your hormones behaving badly?

For those of you who live locally, I have information about a natural health seminar taking place next week at the Riverside Health & Racquets Club in Northwood.

Are your hormones behaving badly? Did you know that what you eat can have an impact on how you feel? There is much you can do to help yourself feel better, without taking medication. If you suffer from PMS or are struggling through the menopause, attend Linda Munster's talk at the Riverside Club on Thursday 7th July either 10-12 noon or 7.30-9.30 pm.

Find out how eating the right foods can help balance your hormones...naturally. Cost 10 pounds. Booking is essential, so if you are interested, please contact:

Linda Munster Nutrition Consultant / zest4life Weight Loss coach  01923 842601

[email protected]

www.zest4life.com

Bringing multiple births down

Sometimes the number of young twins I notice seems remarkable compared to the relative rarity of twins I knew from my own childhood. Double, and even triple, buggies seem to be everywhere. Both of my children have twin friends, and know a few others. Twins do run in families, usually a genetic predisposition from the mother's side. They are also more likely to occur in women of African descent. However, there are two additional reasons for the increase in twin births in the past 2 decades:

• First, women have been having children later than in previous generations. Twins occur more frequently as the mother's age rises at the conception of her children.
• Secondly, the increase in IVF and the implanting of more than one embryo per cycle has resulted in more twin births.

However, news reports this week have revealed that twin births are declining in the UK now.

You may wonder what difference it makes if women are having twins rather than single births. After all, it still has the novelty factor. Some parents may prefer to have twins and not go through a second pregnancy and birth experience, especially if it would involve another round of IVF. For convenience and cost, it might make sense. However, there are several disadvantages to multiple births that should be considered.

The Human Fertilisation and Embryology Authority (HFEA) considers multiple births the "single biggest risk of fertility treatment." The increased risks of multiple births, according to the HFEA, include:

• miscarriage and other pregnancy complications
• premature and/or low birth weight
• neonatal mortality: 19/1,000 deaths within the first month of life for multiple babies, compared to 3/1,000 live births for single babies
• cerebral palsy: HFEA quote 6.2/1,000 live births for twins compared to 1.7/1,000 live births for single babies
• of newborns requiring special neonatal care
• maternal pregnancy-induced high blood pressure (hypertension), pre-eclampsia, pregnancy diabetes, assisted or interventional delivery (e.g., a caesarean), and mortality.

Its aim has been to reduce that risk by encouraging the transfer of single, rather than multiple, embryos per cycle. The program is having a swift and definitive impact on the trend of multiple births. The first target level set in 2009/2010, required that fertility clinics have a rate of no more than 24% multiple births from assisted reproduction techniques. For 2010/2011, the target was lowered to 20%, and in April 2011 the target has been set to 15%, which UK clinics are expected to meet by this time next year. The ultimate aim is a multiple birth rate of no more than 10% each year.

So, what does this mean for you if you are currently trying to conceive? If you are having fertility treatment in the UK, are under the age of 35 and considered to have a high chance of successful conception, you may find your clinic unwilling to transfer multiple embryos. Up to the age of 40, the HFEA restricts transfer to 2 embryos. From age 40, the group which is least assured of success with IVF, a woman may elect to have up to 3 embryos transferred. Any additional embryos created in vitro can be frozen and used later.

If you require more information about elective Single Embryo Transfer (eSET), a good source of information is the One at a Time website, which is dedicated to "better outcomes from fertility treatment." The site includes information about the guidelines, best practice, the risks of multiple pregnancies and what is involved in carrying, giving birth to and raising twins and triplets.

Additional sources:

Elective Single Embryo Transfer: Guidelines for Practice British Fertility Society and Association of Clinical Embryologists - http://informahealthcare.com/doi/abs/10.1080/14647270802302629

Decline in multiple birth rate from IVF -http://www.nhs.uk/news/2011/05May/Pages/decline-in-multiple-birth-rate-from-IVF.aspx

Preparing for multiplebirths - http://kidshealth.org/parent/pregnancy_center/preparing_parenthood/multiple_births.html

What's on TV?

It's possible that you are feeling as bereft on weeknights these days as I am over the end of Masterchef and, dare I say it, Embarrassing Bodies. While I enjoy having it on while I'm preparing dinner, Great British Menu doesn't have the same sense of drama as Masterchef, the kitchen isn't as swish and the chefs/restaurant critics/judges lack the personality to make you want to watch every episode. For the first time, my daughter and I couldn't call a winner this year on Masterchef, finding merit in all 3 candidates (Tim, Tom and Sara).

On the opposite end of the spectrum, nothing comes close to the wierd, unattractive and, frankly, yucky aspects of our health and bodily welfare on Embarrassing Bodies, presented by the very likeable Dr Christian, Dr Pixie and Dr Dawn. While I sometimes have to watch with my hands over my eyes, I'm fascinated by the untreated conditions that people keep secret for years, only to show millions of TV viewers, including growths, excessive body hair, "moobs," fungi, bowel disorders and skin conditions. I would go for the privacy of an appointment with my GP any day over sharing en masse. Is it that people don't have confidence in their own doctor, but are comforted and emboldened by the approachable bedside manner of EB's 3 medical presenters?

I've learned quite a bit of quasi-medical information which will hopefully stand me in good stead over the years, including preventive care (not the UK's strong suit) but what fascinates me is the link between bodily function, appearance and self-esteem. What causes people to keep their conditions hidden, to their own detriment? Some have lived 10 - 20 years with discomfort, pain, bad odours, inconvenience and embarrassment that could have been cleared up if they had sought help. Others, unfortunately, didn't receive the best help when they did inquire and didn't seek a second opinion until now. Fear of what the offending body part might mean to their health is a factor, for sure. Shame also plays a big part. Some of the visitors to the Embarrassing Bodies Clinic visibly blossom after treatment; a huge weight lifted off their shoulders. My husband leaves the living room in despair when he realizes that I won't change channels for love or money. If you live in the UK and haven't seen an episode of Embarrassing Bodies (is that possible?) or if you want information about an aspect of your own health or body, go to http://www.channel4embarrassingillnesses.com.

Good news then, that this week there is some worthwhile TV viewing this week. Ha! I laugh, because it all comes at once. On Thursday, May 5th, you can pin your hopes on one of the remaining 5 contestants on American Idol (ITV2, 7:30 - 9 pm), marvel at how pretty judge Jennifer Lopez is, how gentle and sweet judge and former Aerosmith band member Steven Tyler is and wonder what Simon Cowel thinks of Season 11, the first without his input. If you prefer something more educational and fertility health-related, the alternative is 'Is Breast Best?' on BBC3 at 8 pm, exploring the debate over breast-feeding. I may have to do some channel-hopping!

Another dilemma at 9 pm that evening. 'Inside the Human Body,' on BBC1, promises us a view of the moment of conception and the sequence of events leading to birth. I'm hoping that they handle this subject well, because the more information people have about their fertility health, the better prepared they will be when they approach conception and pregnancy themselves. At the same time, on ITV1, is 'Long Lost Family.' This is the emotional tearjerker of the reality show season, reuniting long-lost siblings, adopted children with their birth parents, etc... It's lovely. I like a happy ending and they do it well. Hopefully, you know how to record a program (unlike me) and won't miss either. Happy viewing.

The loneliest girl: What desperation led a pregnant teen to give birth and leave her baby in a hotel room?

This morning's news brought a tragic story about a newborn baby found dead in a hotel in Hounslow, West London. Police have traced the mother; a 15-year old Canadian girl who had been visiting the UK on a school trip. She gave birth without anyone knowing that she was even pregnant, and returned home to Canada. Had anyone known, she surely would not have been allowed to travel to the UK at 40 weeks pregnant by her parents, the school or the airline. It isn't known yet whether the baby was born alive. I spoke to Jayson Mansaray, the presenter of the Lunch Show at hayes.fm radio, this morning about why a young woman would go to these lengths and how teens can access help if they think they may be pregnant.

It may be difficult to believe that a woman could go through 9 months of pregnancy without anyone knowing about it, but it does happen occasionally. Presumably, she knew that she was pregnant, but hid it well by gaining a small amount of weight, already being overweight when she conceived or wearing very loose clothing. The question is why she felt she needed to go through this alone. We can only speculate that she may have:

• feared the judgment of her parents, peers, teachers and neighbours for being sexually active and/or pregnant;
• not understood much about pregnancy and feared the changes in her body;
• worried that she would be excluded from school, a job, a sports team or a social group;
• been in complete denial that the pregnancy would result in the birth of a baby;
• feared the responsibility of having a baby; or
• feared the withdrawal of love and support from her parents or other family members.

It's understandable that a pregnant teen would feel scared, isolated, confused and overwhelmed. However, the danger associated with secrecy about the pregnancy is that she would not get the help she needs and which is available to her. The primary concern is for the pregnant teen's health and wellbeing. She needs to know, as quickly as possible, whether she is pregnant and how far into the pregnancy she is. Depending upon whether she decides to continue in the pregnancy or to terminate, she needs advice about how to proceed. She, or her partner, may also need emotional support and help with her decision-making. They can access help, confidentially, through helplines and walk-in, young people's, sexual health clinics.

Nationally, a great UK resource is the Ask Brook website.  Young people, under the age of 25, can access information and advice regarding their sexuality, body image, sexual health, contraception, pregnancy, sexually transmitted diseases (STD's) and termination of pregnancy. Additionally, there is a free, confidential Ask Brook Helpline, which operates 9 am - 7 pm, Monday - Friday:  0808 802 1234, and a confidential text service: 07717 989 023, which charges a standard SMS rate. Both the website and the advisors on the helpline can provide information about all the services that are available to a young person in their own area.

Locally, KISS is the name for the NHS sexual health services for young people up to the age of 25 in and around Hounslow. For more information about where you can go to access free and confidential pregnancy testing, advice and other health services, go to: KISS Young People's Clinics – Sexual Health Hounslow. (You do not have to live in Hounslow to use this service.)

An unexpected pregnancy may seem very overwhelming, but if you are in that position, it's important that you know:

• There are no stupid questions;
• The sooner you ask those questions that you have, the more you will understand and the better equipped you will be;
• If you are pregnant, the earlier you know, the more choice you will have about how to handle it (prior to 24 weeks for abortion);
• You will get the right medical advice and treatment for yourself and/or the baby at the right time;
• Telling someone confidentially on the helpline or at a KISS centre may make it easier for you to tell an adult who is closer to you, like a parent;
• The help is there for you...you are not alone.

A Bonus for You as part of the Fertility Focus Telesummit

Welcome to Your Great Life, and especially today to those visiting from IComLeavWe.  I'm all set for presenting my session at the 2nd Fertility Focus Telesummit tomorrow. I have just listened to Sarah Holland, the founder and host of the Telesummit, present her introduction and it got me even more excited for the week's events.  As I shared with you in the blog above, I'm speaking to you on how "Creating an Effective Support Network Can Make All the Difference When Trying to Conceive."

In order to help you create the best support network to fulfil your unique needs, I have a Worksheet which is available FREE.  Email me at [email protected] (you can click through on the Email Icon to the right), quoting #FFTS2011 in the subject box and you will receive the worksheet by reply email.  Please feel free to include in your email any questions you have about my presentation at the Telesummit, or about fertility coaching.

If you haven't registered yet, you will want to do it right away. The presentations are live, each speaker will try to take questions and recordings are available for free for 24 hours after each presentation, or you can choose to upgrade to get all 17 audio files emailed to you after the Telesummit. 2,700 people have already signed up! Click here to register for the Fertility Focus Telesummit FREE.