Sperm injected into an egg

What is natural modified IVF?

What is natural modified IVF?

Often, patients will previously have had conventional IVF with high dose stimulation in an attempt to get more eggs from their ovaries and when this doesn’t work they could be told that their only option is egg donation. There is one other avenue to explore before we suggest egg donation and that is natural modified IVF. What we do is instead of giving huge doses of drugs to get one or two egg follicles, we can usually achieve the same result by using much lower doses of stimulation.

Why is it called natural modified IVF?

It is called natural modified IVF because you are only really supporting naturally recruited follicles which have occurred in a natural menstruation cycle. We will be supporting the growth of that natural follicle with a low dose of stimulation and adding in another drug that stops premature ovulation, so that we can collect the egg for you.

How do I know which stimulation is best for me?

Stimulation in these cycles only really starts on day five, rather than day two which is the case in conventional IVF. We obviously offer conventional IVF as well at the clinic and the decision is based entirely on the antral follicle count at the beginning of the cycle.

How do you optimise IVF success rates?

Optimising IVF success rates depends very much on a fantastic laboratory, the skills of the practitioners involved and also to a large degree on the preparation of the patient in terms of nutrition and supplements that she takes. Overall however, the success rates in IVF significantly correlates with the age of the woman. As we know, genetic changes occur in a woman’s eggs as they age and anything we can do to predict which embryo will be the successful one is obviously the most important thing that we can do and to this end we would strongly recommend that a lot of women have a pre-implantation genetic screening of their embryos if they are over 38 years old.

WHAT MAKES THE ZITA WEST CLINIC DIFFERENT?

The Zita West Fertility Clinic is the UK’s only clinic offering IVF treatment as well as preconception planning and natural fertility trouble-shooting, all under one roof.

Based in a relaxed and comfortable central London townhouse, it’s a long way away from the usual medicalised fertility centre environment and a wholly different experience from what you’ll find elsewhere.

Discover what makes us different

 

TO BOOK AN APPOINTMENT WITH US CALL: 0808 196 4060

 

egg freezing

What should I consider before egg freezing?

Increasingly, I see more and more women coming into the clinic wanting to freeze their eggs, particularly if they have reached their late thirties but don’t feel ready to have children, haven’t met the right partner or have been diagnosed with an illness such as cancer. While the techniques have greatly improved over the years with a process called vitrification, which helps make it easier to freeze eggs, there remains a number of factors for women to consider around preserving their eggs.

Here are seven key things that women should consider before freezing their eggs:

1. Understanding what’s involved starts with a consultation
The first, and potentially most important step before egg freezing is the consultation. If you are ready to proceed then you should see one of our doctors, so that they can not only plan your treatment but do blood tests as well, which will enable the doctor to assess your eggs reserves. This will help better understand how many eggs you are likely to produce and check your anti-mullerian hormone (AMH) level and also an antral-follicle count – the higher the egg reserve, or antral-follicle count, the better the chances of getting an adequate amount of eggs. It’s important to realise that a number of them will be lost during the thawing process, so if the count is low it will mean that you will have to do the procedure more than once in order to get the amount of eggs needed to increase your chances of getting pregnant. It is also important to understand that it is not just about the production of eggs, it is about ensuring we get mature eggs that are viable for freezing.

2. Age is key
Age is the biggest determining factor in the success of egg freezing. Typically, the younger the eggs, the more chromosomally normal they will be, while the older you are, there is an increasing chance there will be more chromosomally abnormal eggs and that you are likely to have a lower reserve. This therefore means you may have to undergo two or three cycles to get the amount needed and you will have to take into account the cost, as well as the emotional toll it may take on you.

Many of the women I see are aged around 39 or 40, which is often very late to freeze eggs because of the chances of egg reserves being lower and therefore the amount of eggs available to successfully freeze is also much lower.

Thousands of babies have now been born worldwide from treatment using previously frozen thawed mature eggs. The best success rates are from eggs frozen before a person is 35 years of age. When looking at success rates within the UK for treatments that have used frozen eggs, numbers tend to be quite low and the technology for egg freezing has also improved over the years which means older data isn’t likely to be a good indicator of current success rates.

For information on your chances of success when having treatment with your frozen eggs HFEA advise you look at success rates for fresh IVF cycles where patients have used their own eggs in their own age band. The HFEA considers these success rates to be more reliable as there are higher numbers of embryo transfers following treatment with fresh eggs compared to transfers using embryos created with previously frozen eggs.

You can find success rates for fresh IVF cycles where patients have used their own eggs here

3. How many eggs am I likely to get in an egg freezing cycle?
If you’re 37 or younger and have a normal ovarian reserve you’re likely to retrieve around 13 eggs per cycle. If you’re older than 38 however and have a low ovarian reserve, ideally you will want to freeze 20-30 eggs in order to achieve a baby and this is rarely possible in just one egg freeze cycle.

4. Eggs can be stored for 55 years

The law allows you to store eggs for use in treatment for up to 55 years but for storage to continue lawfully, you would need to renew your consent every 10 years.

5. Your future fertility
Choosing to freeze your eggs doesn’t have a detrimental effect on your future fertility and it doesn’t use up your eggs or exhaust your existing supply. However, it is important to bare in mind that although the procedure is a very safe one, it is not completely without risk.

6. It is similar to the IVF process
Many women I see are unaware of the fact that egg freezing involves going through a similar process to IVF in order to collect the eggs. To collect the eggs, your ovaries need to be stimulated, which involves injections and you will also have a number of scans to check how your follicles are growing. You produce lots of eggs in any one month during a natural cycle but only one egg is usually released, so for egg freezing the aim is to produce a larger number of eggs. When ready, you will then go to theatre and, under light sedation, the eggs are collected vaginally using ultrasound guidance.

Once collected, the eggs are assessed by the embryologist for suitability and any mature eggs are then frozen. Then, when you are ready to use your eggs, they are thawed very slowly and inseminated with sperm. Following fertilisation, the eggs develop into embryos and one is inserted into your uterus. Any remaining embryos can then be frozen and used at a later date.

7. Preparation is vital
I am a big believer in the importance of preparation on every level – mentally, physically and emotionally – prior to undergoing the egg freezing procedure to help improve the quality of your eggs. One of the most important ways a woman can prepare for egg freezing, is to ensure the specific nutritional requirements of an egg are being met. This means building nutrients into your diet or looking at supplements such as anti-oxidants and inositol where necessary, as they can really help in that preparation process and make sure you give yourself the best chance of success.

If you are considering egg freezing and would like to have an initial consultation with one of our experienced team members at our clinic in London, then call us on 0808 196 4060. You may also be interested in our Plan Ahead kit, which is designed to provide you with a better understanding of where you are now and what the next steps are that you should take.

Desk with keyboard, pen, notebook and glasses

Fertility treatment and work

How to deal with fertility issues at work

Something we see many of our clients struggling with throughout their cycles is how to deal with work as well as their fertility treatment. One of the challenges women face when going through IVF is to whether to tell their colleagues and bosses; some companies are very good, and of course all should be, but it can still be a difficult subject to raise.

Here are my tips when you’re going through fertility treatment while working:

  • It’s hard work doing IVF and working full time as it needs some preparation, especially in the first 10 days or so when you need to have scans and blood tests during the monitoring phase of your cycle. If you are able to take this time off then do, but understandably many won’t, so make sure you plan your diary carefully and allow time not only for the appointment, but factor in delays as appointments don’t always run to time and the last thing you want to be feeling on top of everything else, is stressed that you won’t be back in the office when you said you would be.
  • Focus on what you are doing, and don’t try to schedule in exercise or adding another long to do list at work to your already busy schedule!
  • Build your reserves, go to bed early and sleep as much as you can, use visualisation to make the world around you a calm, peaceful place. Before you embark on the cycle, ensure your bedroom feels like a calming sanctuary, so keep it as decluttered as possible so that when it comes to going to sleep, your mind and body feel as relaxed as they can.
  • Don’t take on any extra chaos at work or in your life, look after yourself first and foremost! We’ve got all those collegaues who we love dearly but who also can cause immense stress – try to stay away from these situations as much as you can while you’re going through IVF.
  • Nourish yourself, but do build in a few treats, it’s already a challenging enough time without feeling you can’t enjoy your favourite cake or chocolate bar. Although I would advise no alcohol during your IVF cycle I’m afraid.
  • Ask your partner for help to support you, and make sure you are there for him as well. This is something you’re going through together so make sure you look out for each other and talk through how you are both feeling. Friends, family and colleagues would also love to help, but many just don’t know what to say! Bring them in (if you want to) as sometimes it’s good to talk things through with an outsider. If you feel you need more support than this, hypnotherapy can really benefit you.
frosted window

Does Vitamin D affect my fertility?

This article from Dr Gillian Lockwood, Medical Director, CARE Fertility Tamworth, gives a great insight into the importance of Vitamin D for your fertility, and especially if the time of year makes a difference to your IVF cycle success.

Can the time of your IVF treatment influence the outcome – what can we do to boost rates all year round

Dr Gillian Lockwood, Medical Director, CARE Fertility Tamworth

Lambs, foals and fawns are born in the Spring because resources are better for their survival.  But what about human babies?  In fact there is quite marked birth seasonality in humans with peaks occurring earlier in the year the further north you get from the equator.  Finland’s birth peak is in late April while Jamaica’s is in November.  Research shows that the seasonality of births correlates with changes in local temperature and day length.

So what has this to do with IVF treatment?  I remember telling an Australian colleague that our pregnancy rates always seemed to be a little better during the summer holidays and he replied that their best rates were at Christmas time! So can the time you have your IVF treatment really influence the outcome and, if so, what can we do to boost rates all year round?

What affects fertilisation rates, implantation rates and pregnancy rates?

Several studies have found that fertilisation rates, implantation rates and pregnancy rates seemed to be associated with increased numbers of sunlight hours and one Belgian  study that looked at nearly 10,000 treatment cycles found that the weather the month before an IVF cycle seemed to affect the outcome, with more sun and less rain being associated with more pregnancies! Some studies didn’t find a correlation between seasons and IVF outcomes, but they were done in countries like Israel that have lots of sunshine all year round.

The link between sunshine and successful pregnancies may lie with Vitamin D.

How does Vitamin D affect fertility?

Your body needs Vitamin D to help absorb calcium which is critical for forming your bones and keeping them strong and healthy.  The two main kinds of vitamin D – D2 and D3 are found in foods like salmon, tuna and egg yolks and they are added to ‘fortify ‘ foods like milk and cereal.  When exposed to sunlight, your skin can manufacture its own Vitamin D.  After it’s absorbed through the skin or acquired from food or supplements, it gets stored in the body’s fat cells.  All types and sources of Vitamin D are equally good and since skin cancer (malignant melanoma associated with excess UVB exposure and sunburn) can be so devastating, it is safer to wear sunblock, cover up in strong sunlight and take a Vitamin D supplement.

Do levels of Vitamin D in my body affect my fertility?

Depending on diet (strict Vegans will definitely need vitamin supplements), skin colour (darker skins cannot manufacture Vitamin D so effectively in Northern latitudes), and health status (malabsorption syndromes or post gastric –band surgery interferes with absorption), up to 40% of the female population may be deficient in Vitamin D.  Because Vitamin D deficiency has been proven to affect fertility in other mammals, several research groups have investigated IVF outcome in women with different Vitamin D concentrations in their blood.

Is the chance of pregnancy affected by Vitamin D?

One study found a progressive decline in pregnancy rates with declining Vitamin D status in Caucasian but not Asian patients, and a study of 99 recipients of donor eggs of different ethnicities showed a significant decline in clinical pregnancy rate with declining Vitamin D levels. A well-designed Italian prospective study carried out in 2014 that included nearly 500 women undergoing IVF found that the chance of a clinical pregnancy for women with adequate Vitamin D levels was double that of women with low levels. Vitamin D supplementation is a simple and cheap intervention and at correct doses is free of side effects.  Also there is growing evidence that Vitamin D supplementation may improve birth outcome and reduce obstetric complications such as pre-eclampsia and gestational diabetes.

The take-home message is start taking Vitamin D along with Folic acid BEFORE you start trying for a baby and embarking on your fertility treatment. Go too www.zitawest.com/shop for our range of fertility supplements.

Original article posted at: www.carefertility.com/blog/in-the-bleak-midwinter-let-the-sun-shine-on-your-fertility-treatment/