Managing your mindset for fertility and IVF

One thing we see so often in the clinic for women going through IVF or with struggling with fertility issues is a sense of uncertainty which they are trying to manage. While it may be true that conception is much more than just egg-meets-sperm, and that lifestyle and mindset make a huge difference, it’s much easier said than done to “relax and it will happen!”

At the Zita West Clinic, our resident hypnotherapist, Maureen Kiely, offers hypnotherapy at the clinic to help, as well as Skype sessions to manage your mindset in preparation for IVF or natural conception.

What is hypnotherapy?
It isn’t as scary as it sounds! If you’re having a session in person at the clinic, Maureen uses her voice to get you into a deep, relaxed state and teaches you how to do that too at home. If you have a Skype session then you will be taught self-help techniques to use day-to-day to help manage your mind.

What can hypnotherapy do to help?
If you’re struggling to cope with past experiences that have affected your fertility, or you’ve had many IVF cycles and are losing hope, one of the first things Maureen will do is to help acknowledge the past, set it to one side and help you get by day-to-day without it affecting your life as it has been. Whether with hypnosis or through her mind-management strategies, Maureen will help you become more optimistic and positive within your everyday life to enable you to look forward with hope rather than fear.

How does hypnotherapy link with fertility?
While there are many benefits to hypnotherapy generally, at the Zita West Clinic we have a focus on fertility and IVF, which means Maureen can give very specific places for you to take your thoughts and

feelings in relation to your own personal fertility issues. Maureen has helped many of our clients to enter a more positive place with visualisations and strategies to overcome the anxiety and worry around IVF failures and fertility struggles.

How many sessions will I need?
This can vary between clients, but one of the most important things about a session here is that you have strategies to take away with you. Maureen will teach you self-hypnosis which means that if you wake up in the middle of the night, you’ll have your own techniques to help calm your mind and soothe your thoughts. Some clients like to see or speak to Maureen regularly, whereas others prefer to check in when they need it.

 

For more information about a hypnotherapy session with Maureen, either in person or via Skype, please call 0808 196 4060

Is the IVF process harder if I have PCOS?

Here at the Zita West Clinic, up to 15% of the women we see have Polycystic Ovarian Syndrome (PCOS), and it can be an upsetting condition to face.

Women with PCOS produce imbalanced levels of hormonal secretions in their ovaries, so instead of stimulating one follicle to produce one mature egg during their cycle, numerous follicles are inappropriately stimulated but can’t mature, so form tiny cysts. This then further disrupts any hormonal secretions, and without the right hormonal environment, the possibility of fertilisation and implantation are reduced.

As there is no real clear-cut reason for PCOS, it is easy to feel like you have no control over your own body or hormones if you are diagnosed. But it is important to remember that it is manageable, and it does not at all mean that you have no chance of getting pregnant.

Normally we have the same good results with PCOS patients that we have with all patients, however one of the additional risks is an increased risk of hyperstimulation as a result of the IVF process. In order to assess this risk, we always monitor the ovarian reserve of the patient by assessing the number of follicles the patient has before starting the IVF process. This is very important as this will dictate the tailored and specific dose regimen for the patient, which is helpful to prevent and to control the risk of developing hyperstimulation during IVF.

If you have PCOS and would like to speak to someone about your IVF options, please call us on 0808 1964060.

Supporting – not boosting – your immune system

We are learning new things everyday about the Coronavirus, and so many blogs are talking about boosting your immune system, but you don’t want to boost your immune system, you need to strengthen and support it for the long term. So let’s first look at what weakens immunity, what happens if you have any auto immune disorders and having underlying medical conditions.

Lifestyle factors such as lack of sleep, poor diet, alcohol and cigarettes leads to weaker gut immunity. Chronic stress and anxiety over a period of time (which many women will go through on their fertility journeys) also affect gut health and therefore immunity. But it’s very important not to panic and feel in control, and there are certain things that you can do to protect yourself and ensure your immune system is functioning as optimally as possible which is so important now more than ever.

Your immune system is a network of cells, organs, proteins and antibodies that work to protect you against bacteria, viruses and parasites. Whilst we usually only think of our immune system when we feel ill, it’s actually working every day to keep us safe.

If you are looking to strengthen your immunity, the best way is through a combined approach. These tips are in no way prescriptive, nor a magic bullet to health, but are simply a gentle nudge in a better direction…

Reduce stress
Modern medicine has come to appreciate the closely linked relationship of mind and body and reducing stress is an important way of strengthening your immune system. Although it is difficult to define, as what may appear to be a stressful situation for one person is not for another, but what is known both from anecdotal evidence and published studies is that sustained neuronal activities, such as experiencing prolonged psychological and emotional stresses, negatively impact the immunological state.

When you are feeling stressed or anxious, the body releases cortisol. In short spurts, cortisol can boost your immunity by limiting inflammation, however, over longer periods cortisol can lead to a decrease of the body’s lymphocytes – the white blood cells that help fight off infection – and the lower your lymphocyte level, the more at risk you are to catch viruses.

Stress reduction strategies not only give your mind a break, but they can also relieve the pressure on your immune system. You can take steps to reduce short-term and long-term stress through things like meditation – for 10 to 15 minutes a day – or yoga and now, more than ever, while we can’t control what is going on around us, it is important to try and take control over the situations we can, which includes our internal environments, in order to help support and strengthen the immune system.

Breathe…it sounds so simple but it is! Getting into balanced breathing will put your body into parasympathetic mode and will evoke a relaxation response and reduce cortisol levels. The hard thing for women to make is time, but this is the one thing we may all have soon so make time to practice.

Sleep
While more sleep won’t necessarily make us invincible, lack of sleep almost immediately tips our immune system into imbalance. A single night of poor sleep leads to a decrease of up to 70% of our natural killer cells – our first line of defence against viruses. Other research shows that people who sleep for six hours a night or less are four times more likely to catch a cold when exposed to the virus, compared with those who spend more than seven hours a night sleep. A good night’s sleep pays dividends, as it helps the body produce antibodies, which benefit the immune system and to better fight infections.

Reduce alcohol intake
Alcohol affects the way health gut microbes interact with the immune system and also disrupts the gut barrier, allowing more bacteria to pass into the blood. In addition, it also interferes with the chemical signals from white blood cells called cytokines, which can cause an autoimmune response if produced in larger than normal quantities, or an immune system deficiency in cases when these levels are decreased. Alcohol consumption also disrupts normal T-cell function, leaving someone at greater risk of bacterial and viral infection. A single episode of binge drinking can result in an immune weakness against exposure to illness within the first 24-hours of initial consumption.

Gut health
Research has shown that there is a significant amount of interaction between the body’s immune system and bacteria in the gut. Beneficial gut bacteria species have been demonstrated to impact both the innate (present from birth) and acquired immune systems, so it’s important to focus on optimising your gut health, strengthening the gut lining and re-inoculating (re-populating your gut with bacteria by eating prebiotic and probiotic rich foods). In turn, this will then help promote a strong immune system. Fortunately, this can be achieved by eating a variety of different foods, rich in different species of bacteria – all of which promote a healthy gut lining, microbiome and consequently a healthy immune system. In fact, 80% of immune cells are present in the gut and the gut microbiome is becoming recognised as more and more important for immune health.

What I am taking and recommending at the moment 

Good nutrients
Eating nourishing foods rich in certain vitamins and minerals may help your immune system

Support

  • Vitamin C. I’m a huge fan of Vitamin C and it’s my first go to product if I feel I’m coming down with something. It not only helps the production of white blood cells may help protect the body against infection, it also helps these white blood cells function more effectively while protecting them from damage by potentially harmful molecules. While we cannot produce our own, the good news is that there are a number of foods rich in this vital nutrient, such as oranges, grapefruits, tangerines, strawberries, peppers, spinach, kale and broccoli.
  • Vitamin D. All of our clients have Vitamin D tests and we are able to recommended dosages for them based on their results. Many are Vitamin D deficient which is linked to so many underlying medical conditions, and it is the workhorse of the immune system. Low levels of Vitamin D have been associated with the worsening of autoimmune diseases, as well as with frequent infections, colds and flu. In addition, studies have shown that taking Vitamin D may help reduces the risk of developing a respiratory infection.
  • Curcumin (the orange-yellow component of turmeric). This is known for its anti-inflammatory and antiviral properties and is an age old recommendation for its effects. The thought is, if you can reduce the amount of active free radicals in the body, you will see a boost in your immune system function. While studies on some antioxidant supplements are inconclusive at best, turmeric’s main active, curcumin, demonstrates strong disease-fighting potential. The way curcumin behaves as an anti-inflammatory, in itself, makes it an excellent therapeutic agent for immunity. It’s the capability to double as an antioxidant that gives us extra incentive to squeeze more turmeric into our daily regimen.
  • Omega 3 fatty acids. These are incredibly important, as they have many powerful health benefits. In addition to helping prevent disease by reducing inflammation, DHA-rich fish oil also helps enhance the function of immune B cells.

What is natural modified IVF?

Dr Vivienne Hall is a medical consultant at the Zita West Fertility Clinic and has been doing IVF for more than 30 years. I have really enjoyed learning about reproductive immunology, the treatment of recurrent miscarriage and early pregnancy loss since joining the clinic and in return for that I have brought another speciality to the clinic and that is the treatment of women with critically low egg reserves. This treatment is called Natural Modified IVF and it is mostly appropriate for women of any age who have a low egg number.

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 DR VIVIENNE HALL CALL: 0808 196 4060

 

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.

To date, there have not been enough live births in the UK to be able to satisfactorily assess the success rate of egg freezing, but early indications suggest it is between 30 – 50%. For the best chance of success, it is better to freeze your eggs in your early 30s, however, I understand that this is hard for many women, as you may not be ready to undergo the procedure at that point in your life.

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 only be stored for 10 years
UK regulation only permits eggs to be frozen for 10 years. There is the possibility of obtaining an extension for up to 55 years, but only if you are able to demonstrate that you have become prematurely infertile. However, it is important to understand that if you experience normal age-related fertility decline then you won’t be considered prematurely infertile and would not be able to extend the storage period of your eggs.

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.

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.