Well, I thought it had this morning, the 1st of April, but it seems to be threatening rain at the moment now we’re mid-way through the day. I guess that’s Spring for you. Very unreliable. The clocks have gone forwards and everything feels wrong - hungry at the wrong time, sleepy at the wrong time and awake at the wrong time. Still, I’m sure we’ll adjust given a few days and will be on an even keel until we have to undo it all again in October.
Time does seem to be flying and, we know from experience, that for fertility patients, Time does play awful tricks. Goes too fast when you want it to be slow and too slow when you need it to speed up. So much patience is required. We admire everyone who is trying to conceive, which ever and how ever you’re doing it because, ultimately, it is a numbers game and, even though you can and should do everything within your means to increase your chances of success - nutrition, acupuncture, IVF, Chlomid,abdominal massage and everything else that is on offer - there is still an element of chance involved and that’s just Evolution’s fault.
Nature hasn’t been that kind to us from a fertility point of view. Unlike rabbits who, apparently, have something called reflex ovulation (which means a female rabbit ovulates in response to ‘externally derived stimulus, ie a male rabbit doing his thing), humans have to wait for the twelve times per year (on average) when this happens. But that still means twelve chances for things to go right and they can, they do and they will. This is Spring remember, a time of new beginnings and growth. So let’s remember that the rain is here to nourish the ground, the sun’s here to warm us all up (at last!) and the wind …. well, not quite sure about the wind but I’m sure it’s good for something! Enjoy.
A lovely patient has got back to us after a couple of years with the testimonial she wrote and forgot to send. Always lovely to hear back from you all at any time. So here it is:
After struggling to conceive with our first baby and being on the waiting list at the ERF to help conceive another, I found acupuncture really helpful for easing some of the frustration. The sessions were very relaxing and I would have continued with more, but after two sessions I found out I was pregnant! Would definitely recommend acupuncture to anybody exasperated with trying to conceive.
Once again, a lovely bit of feedback from a happy patient - now 35 weeks pregnant. It’s so nice for us to hear from you and find out how you are getting on, whether pregnant or not because so much is shared between us in fertility/acupuncture sessions.
I genuinely think that the acupuncture you gave me made all the difference to me successfully conceiving through IVF, and I’m very grateful. I also found the sessions really therapeutic just from the point of view of chatting and hearing about other women’s experiences, in addition to the acupuncture itself. I’ll certainly be back to see you when we’re thinking of using our remaining two embryos.
This patient also went on to say how she was very happy to share her feedback with you all.
You certainly helped me enormously, and I would like to see other women benefit.
Do let us know if you’ve been to see us but we haven’t caught up in a while. We always like to know how everyone is doing.
I know it’s not quite November but for fertility patients this time in the run up to Christmas is fraught with additional tensions. Mainly this is due to IVF clinics closing down for ‘deep cleaning’ and being on reduced staff over the Christmas break. There is a need to arrange for embryo transfers to take place before this happens or to be in the down regulation phase of the drug protocol which allows two weeks without too much intervention by the clinic.
Given that women (and humans in general) are not machines, our cycles don’t always start when they’re ‘supposed’ to or at a time that would be convenient. We know this whether or not we’re going through IVF or even trying to conceive. I’m sure we’ve all had a rogue period start on the day of a sports event or on holiday, just when it’s not wanted and not expected.
It’s difficult, as a practitioner, not to get wound up at the expectations of IVF clinics for women’s bodies to conform to their schedules but I reluctantly admit that they have to work to some sort of timetable. But it does translate as an added pressure on the woman who feels that her body is not working as it should and she’s doing something wrong. Girls, we are not robots!!!
The other problem with Christmas is the social pressure to drink alcohol. It’s amazing how difficult it is at this time of year, with the parties and social gatherings starting, to avoid sneaky appraising looks as soon as someone says they don’t want a drink. I think this is changing now with more people cutting down and choosing to go without alcohol but it’s still the norm to have at least one drink at a party and is almost impossible to say no without it drawing attention.
The dilemma then is what to say when people ask. Some women get away with clutching one glass of wine for the whole evening, putting it down when they get the chance or pouring the contents away and filling the glass with water. I think it’s valid to just say “I’m cutting down” and people should be mature enough to accept that but in reality, and this is worse with old friends where our friendships are often based on youthful wild nights out, it still raises eyebrows and knowing silences.
The fact is that, unless someone has experienced their own difficulties conceiving, they will probably not be able to understand where you’re coming from. Most couple trying to conceive don’t want to share what they’re going through with even the closest friends so sometimes we just have to lie or deceive in order to get through this intensely social time over Christmas.
Don’t despair though. It will pass. And there’s nothing wrong with turning down invitations and staying at home and relaxing anyway. We all deserve time off from the hustle and bustle and the pressures of appearing to be overtaken with Christmas spirit. Give yourself permission to chill out at home instead with bed socks, hot water bottle and a mug of hot chocolate!
We are so happy when our patients take the time to say thank you. We know how busy life is - especially with fertility/ivf appointments on top of everything else. We are very grateful when people find the space to get in touch so thank you to everyone who does. It really makes our day!
This comes from a recent lovely email:
I just wanted to say how grateful I am to you for the support that your treatment has been over the last couple of months. Having that little bit of breathing space in a calm and relaxing environment, and not having to pretend to be fine with the ups and downs (!) of the whole process, definitely helped me on this first bit of the journey towards eventual motherhood.
There have been a couple of articles recently about the HFEA's decision to curtail 'expensive add-ons'.
This is not an IVF consultant!
We do admire what the HFEA are trying to do. They are safeguarding the patient from being exploited which is vital, but we are very much on the side of the patient having a choice. Not all procedures have strong evidence, yet, for altering success rates but that doesn't mean they don't or won't work and (as long as they do no harm) the more we learn the better for everyone. Our patients are generally very well informed and not easily led. They've done their research and they know what they want. We don't see that taking choice away from them will make their paths any easier.
Not only that, but the Press paints an incorrect picture of innocent and ignorant couples being led down dark alleys by unscrupulous Mr Burns-type private consultants who are only after money. This is not at all accurate on two fronts.
First it assumes that couples can't make their own wise decisions. That's not what we see in real life.
Secondly it makes out all private fertility consultants to be profit orientated manipulators which is also incorrect. The consultants we work with in Edinburgh and Glasgow will only offer patients what they really think might help them and are careful with procedures that have limited testing or marginal effects on success rates.
Often consultants have to work hard to guide couples away from unnecessary testing or procedures which have no proven impact. They have to carefully tread a path between the often desperate needs of patients vs the limited scientific evidence for various procedures. They have to decide whether or not to support a patient who wants to try something new and is well-informed about the potential outcomes, in the knowledge that a determined patient will often seek these procedures or tests somewhere else.
After all, we certainly don't know everything about fertility and we probably never will. Drugs that are 'guaranteed' to stimulate follicles sometimes aren't effective; endometrial lining doesn't always respond to hormonal input - we are not robots after all - so if something has no or minimal side-effects and may have a positive impact then why not try it?
Our bone of contention with private or self-funded IVF clinics is how quickly couples are referred for IVF. We often see patients who have irregular cycles and are missing their fertile window, with low semen analysis results or with undiagnosed hypothyroid, endometriosis or PCOS. All of these have a negative impact on fertility and should be rectified before going down the route of IVF.
We applaud patients who take their fertility health into their own hands. Couples should be encouraged to investigate options and make solid, results-based decisions on where to go for treatment and what treatments to ask for and the consultants as well as experienced and well-informed health practitioners like ourselves should be on hand to guide and support them in these choices.
I realise I am writing this the day after International Women's Day which, to me, adds poignancy to the subject in hand because what I want to write about is a wider women's issue. This has been a long-brewing blog, brought to a head when reading 'No, Millenial Women are Not Failing at Fertility' in the Huffington Post this morning. It's not supposed to be a rant (although it may come across like one!) but a contemplation on the situation of hundreds of women who come through our clinic.
When I attend fertility conferences or read fertility-related articles it strikes me, over and over, how often women are blamed for the status of sub-fertility or infertility in couples. When the (usually, but not exclusively male) consultant stands up and says "Women are choosing to leave it later to start trying to conceive", I really want to shout out and question their use of the word 'choice'. Because, having worked with couples over the last 18 years for fertility-related issues, I know that most women in their late 30's and early 40's would have far rather have chosen to try to conceive earlier if a) they'd had a willing partner and 2) they had financial and employer support to do so.
Blaming women for making the 'wrong' choice is neither useful nor beneficial. First of all, women shouldn't have to make a choice at all, between fulfilling employment and child-care. The excellent author, Caitlin Moran, has a simple measuring tool for assessing life/style choices (wearing make-up, high shoes, worrying about our weight, being 'nice' etc etc) and that is, ask yourself, "are men doing it?". The answer is usually "no". Certainly no one is standing up at fertility conferences and saying "men are leaving it too late to settle down and have children". The onus, as always, falls on the women's shoulders.
But this isn't an 'anti-man' article and it's not just consultants and statisticians who are doing the blaming. I am very aware, because I see it all the time, that women find it easier to take responsibility for low fertility or infertility on themselves, even when the cause is decisively Male Factor. Fertility is a male and female issue equally but women assume the burden of blame readily and often without questioning.
Currently I have a female patient whose male partner is opting not to complete a semen analysis. This is not uncommon. He is not being 'blamed' for his choice. Instead, she is finding all sorts of ways to make it easier for him: choosing with great care the time to bring up the subject. She is taking on the responsibility for their fertility problems. Would a frank calling out of the subject with her partner help more? I don't know. She has endometriosis so is seeing it as 'her' problem and yet a semen analysis is still vital to the cause and if he wants children, which he says he does, then surely one small pain-free test (though admittedly one fraught with potential for embarrassment) isn't too big an ordeal?
There is so much that could be done to change this culture of blame, starting with improved fertility education. It is incredible how little people know about falling fertility rates associated with age and believe that IVF will solve all issues. We regularly see couples in their 40's expecting conception to occur easily and quickly, disappointed when nothing has happened after 3 months. Maybe if both and men and women had a more realistic idea about the fragility of human fertility we would be in a better position to make earlier decisions and encounter fewer problems.
Instead of blaming women for 'choosing' their jobs over childbearing, governments could be supporting women to have children earlier. Because, let's face it, it is an either or. The difficulties of trying to work and look after more than one child quickly becomes obvious and it's usually (but not always, I know) the woman who jacks in her job.
Instead of making women & couples more dependent on medical intervention later in life, let's put funds into affordable child-care and legislate so that women aren't penalised economically for being the ones who do the child-bearing and most of the subsequent child care (most men in the UK still don't use their allotted paternity leave allowance).
But most of all, let's stop the use of blame as a shaming tool. Women are up against it where fertility is concerned. Our bodies are built to conceive and carry a pregnancy much earlier than society allows. 'Early' pregnancies are frowned upon and life is hard enough as a working mother, let alone as an older working mother. Whether it's your GP, your partner, your consultant or friends who imply that it's a woman's fault when things don't go to plan, fertility is a human issue, not just a woman's issue and we need to start calling this out.
So next time I'm at a conference and a fertility consultant glibly apportions blame to women and, specifically, older women, I am going to speak up instead of sitting in the audience fuming to myself but staying silent. Women have incredible bodies and strong minds, we are resilient and resourceful, let's not let that be taken away from us.