Genetic screening in IVF explained

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A new study has been published in the Journal of Clinical Medicine, exploring the benefits of genetic testing for IVF-created embryos in women over 35.

Conducted by a research team from King’s College London, King’s College Hospital and King’s Fertility, this was the first study of its kind to look specifically at women aged 35 plus, and found that genetic screening of embryos could help women aged 35-42 successfully conceive in a shorter timeframe.

Although the sample size was too small to be considered statistically significant, the positive difference in cumulative live birth rate in those women who underwent genetic screening was large enough (72% compared to 52% in the control group) that the researchers believe the study merits a larger, multi-centre trial.

This could be exciting news for the IVF community, but genetic screening is not suitable for everyone, so here at Aria we’ve put together a list of FAQs to help you decide if it’s right for you.

What is genetic screening?

Genetic screening is a process that allows embryologists to check embryos that have been created through IVF for genetic and/or chromosomal abnormalities.

There are three different types of embryo screening:

PGT-A (aneuploidy testing)

This is the most common form of embryo screening and is looking for a genetic disorder called Aneuploidy. This is a condition that results in cells with either too many or too few chromosomes, potentially leading to life-limiting conditions such as Edward Syndrome or Patau Syndrome, and increasing the risk of miscarriage. During PGT-A screening, any embryos with more or less than the standard 46 chromosomes are not considered for transfer to the uterus.

PGT-M (monogenic testing)

Monogenic means single gene, so this test is looking for disorders associated with a single gene. PGT-M looks for specific genes carried by one or both parents, that might indicate genetic disorders like sickle cell anaemia or cystic fibrosis. Only embryos that are free of this specific gene would be transferred.

PGT-SR (structural rearrangements)

PGT-SR is looking for structural issues in the chromosomes, like segments that have been inverted, duplicated or are missing. Ensuring only embryos without these structural issues are implanted in the womb reduces the risk of failed implantation, miscarriage, birth defects or developmental issues.

How is genetic screening carried out?

The process is similar for all types of embryo screening:

  1. First, the embryos are created through IVF
  2. When the embryos reach five to six days old, a few cells are taken from the outer layer of each embryo
  3. The embryo is then frozen for the four to six weeks it takes for genetic testing to take place
  4. The cells that have been removed from the embryos are taken for genetic analysis
  5. Embryos that have been identified as healthy, without any genetic abnormalities, are then transferred to the uterus
  6. The usual IVF process continues

Who is suitable for genetic screening in IVF?

This process is not suitable for everyone. If you are younger than 35 and have no known risk factors, this could be an unnecessary additional step in the process. However, genetic screening can potentially help you achieve a viable pregnancy faster if:

  • You are over 35 – the older you are, the higher the risk of chromosomal abnormalities
  • You have a history of repeated miscarriage – some genetic disorders can increase the risk of miscarriage
  • You or your partner has a family history of genetic disorders
  • You are experiencing unexplained infertility or have undergone several failed IVF cycles

If you would like to know more about genetic screening in IVF and find out whether it might be helpful for you, one of our team will be happy to talk you through the process. Please contact us to make an appointment.

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Managing the endometriosis patient through their fertility journey

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In the UK, it is estimated that one in 10 women of reproductive age is affected by endometriosis, translating to roughly 1.5 million women. Trustee of The Endometriosis Foundation and executive committee member of the British Fertility Society, Ms Srividya Seshadri has recently co-authored an exploration of endometriosis management for IVF patients.

Published in the specialist journal The Obstetrician and Gynaecologist, this seemed an opportune moment to give a more patient-focused rundown on the intricacies of fertility treatment for endometriosis patients.

Endometriosis and fertility

Endometriosis is a painful condition that is characterised by the growth of womb-like tissue outside of the uterus. Because this tissue cannot exit the body in the usual way – through menstrual bleeding – this leads to the formation of scar tissue, causing obstruction and pain in the pelvic region.

Although there is some association between endometriosis and fertility problems, the condition does not necessarily cause infertility, and some women with very severe endometriosis have been able to conceive naturally. However, studies have suggested that roughly 25% to 50% of infertile women have endometriosis, and about 30% to 50% of women with endometriosis are infertile.

The exact reason for this is not yet fully understood, but in some cases, it may be linked to the formation of scar tissue, causing distortion of the abdominal organs, or even creating a blockage in the fallopian tubes, preventing eggs from being released. Other possible reasons are that the associated inflammation reduces egg quality or disrupts implantation.

Can IVF help with fertility issues related to endometriosis?

The short answer is, yes. By extracting eggs directly from the ovaries, IVF treatment can circumvent many endometriosis-related fertility problems, and success rates among IVF patients with endometriosis are reassuringly high. However, there may be some adjustments to the standard IVF protocol that are necessary for patients with endometriosis.

Pre-IVF evaluation of symptoms

Before undergoing fertility treatment, it is necessary to assess the severity of the endometriosis symptoms and the impact it is having on your reproductive organs and ovarian reserves. This may include MRI or ultrasound scans.

Surgery to remove endometrial lesions

Although there is evidence to show that surgical treatment of endometriosis can be beneficial for the success of IVF, there is a risk that the surgery itself can diminish ovarian reserves, so currently this is only recommended for patients with severe lesions that block access for egg retrieval.

Hormone therapy and GnRH agonists

Historically, patients with endometriosis have been prescribed a prolonged (3-6 month) period of treatment with GnRH agonists and hormone therapy to treat the symptoms of endometriosis before IVF. However, evidence for the benefits of this on the success of fertility treatment is minimal, and it is now only recommended for patients who have undergone surgical removal of lesions, to prevent the recurrence of endometriosis symptoms.

Whilst all technologically assisted fertility treatments are available to patients with endometriosis, IVF has the strongest evidence base to support its use.

Endometriosis and pregnancy

Patients are often concerned about the impact that endometriosis will have on pregnancy, if they can conceive. The good news is that generally, the pain associated with endometriosis improves during pregnancy – although there are some exceptions to this rule, and it is likely to return soon after giving birth.

There are also some increased risks associated with endometriosis in pregnancy – the risk of miscarriage rises from 1 in 5 to 1 in 4, and patients with endometriosis are more than twice as likely to experience an ectopic pregnancy as those without the condition – although the risk is still very minimal.

When you undergo fertility treatment with Aria, we will always offer the treatment with the best evidence base for you, and monitor your fertility journey every step of the way, so you can rest assured you’re in the best possible hands.

For more information, please get in touch with us.

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Understanding shared motherhood

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Shared motherhood – also known as reciprocal IVF – is a treatment that allows female same-sex couples to both take an active role in the experience of conceiving and carrying a child. Many women arrive at our clinic uncertain about how the process works, so here we answer some of your Shared Motherhood FAQs to help you gain a deeper understanding of the procedure.

Who can benefit from shared motherhood?

Shared motherhood is predominantly a treatment for female same-sex couples who want to have a child that feels as close as possible to being the biological offspring of both mothers.
How can a child have two biological mothers?

The idea of shared motherhood is that the eggs are harvested from one partner, with the fertilised embryos implanted in the other, so that in effect one mother conceives the child, while the other carries it to term and gives birth to it.

How does the process differ from standard IVF?

Just like in IVF for heterosexual couples, both partners are fully involved in the process. The difference with shared motherhood is that the sperm will always come from a donor, and the egg will be harvested from the non-carrying partner

What steps does the shared motherhood procedure follow?

Once you and your partner have had a thorough consultation at your chosen clinic, and have undergone the various tests and scans necessary, the consultant will advise on which partner is best suited for which role – for example if one partner has a higher ovarian reserve, they may be recommended as the “egg donor”, while the other partner would be the carrier.

Once a sperm donor has been selected (this can be from a sperm bank, or can be someone you know), the partner who is donating the eggs will begin medication to stimulate egg production, and will undergo regular check-ups and hormone injections to ensure everything goes to plan.

When the doctor is happy that the time is approaching to harvest the eggs, the carrying partner will begin a course of medication to help prepare the womb for pregnancy.

The eggs will be harvested once they have reached the appropriate point of maturity, and will then be fertilised with the chosen donor’s sperm and left to grow into embryos, before being implanted into the carrying partner’s womb.

What is the success rate of shared motherhood?

As with all fertility treatment, success rates can be dependent on the age of the eggs and of the women involved. However, as the sperm used always comes from a donor, this eliminates many of the sperm quality issues associated with standard IVF, meaning success rates can be higher. Some clinics report a success rate as high as 85% in women under the age of 35

Are there any legal implications of shared motherhood?

If you are not married or in a civil partnership, it is important to be aware that only the carrying partner will be considered a legal parent once the child is born. However, the clinic can guide you through the process of filling out paperwork before your treatment takes place, to ensure you are both considered legal parents, and remove any additional stress in those first few weeks of motherhood.

If you have any questions about shared motherhood that aren’t answered here, or would like to book a consultation with one of our fertility specialists, please contact us.

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The blend of human expertise and AI in IVF

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Have you ever wondered how technology is transforming the world of IVF? At Aria, we combine human expertise with the power of artificial intelligence (AI) to help create families.

Embryologists are the unsung heroes of the IVF process, but their human ‘AI’ does not develop overnight. Their keen eyes and skilled hands result from years of experience, which allow them to make judgments based on a multitude of knowledge points derived from their extensive training and practice.

The role of AI in IVF: enhancing decision-making

In our lab, AI is not just a tool but a trusted partner. AI is used to analyse imaging data – pictures and videos of the precious cells that we hope will become a success story one day. This data is processed to generate scores that help us assess quality.

When evaluating AI algorithms, and there are lots of them nowadays, we ask critical questions: How large and diverse was the dataset used? What type of microscopes or images were involved? Was the data static or dynamic, 2D or 3D? What is the accuracy of the predictions? Are they developed to predict pregnancy chances, live birth rates, or genetic makeup?

These questions ensure that the AI tools we integrate are reliable. Ultimately, the embryologist makes the final decision, guided by both the AI’s recommendations and their expertise.

Aria’s own studies

AI’s role in the fertility lab has been much in the media spotlight. UK researchers recently published a study in Nature Communications that explored which follicle sizes were associated with improved rates of retrieving mature eggs, resulting in babies being born.

The scientists at Imperial College London used ‘Explainable AI’ techniques – a type of AI that allows humans to understand how it works – to analyse retrospective data on more than 19,000 patients who had completed IVF treatment.

One of the challenges with AI is the ‘black box’ nature of many algorithms. This means that while AI can provide scores and recommendations, the reasoning behind these decisions is not always clear.

At Aria, as scientists, we are committed to understanding AI processes. For instance, we used an AI tool to assess single-sperm motility variables related to ICSI practices but went a step further and looked for biological reasons (in this case, sperm maturation properties) to support the ranking we were given.

We tested AI systems designed to predict the genetic makeup of embryos and their chances of implantation. How? Because we use time-lapse technology, we collect thousands of images, providing a comprehensive view of development. The AI can then analyse these images in a single second, identifying patterns and making predictions that would be impossible for a human to do in such a short time. But are these, on their own, better? The jury’s still out.

“Something key is to understand why an embryo is deemed good by AI,” says Aria’s Senior Clinical Embryologist and Laboratory Manager Dr Xavier. “This knowledge will help us refine our processes and make IVF more efficient.”

While AI offers tremendous benefits, it also raises ethical and practical considerations. We ensure that the AI tools we use are reliable, maintaining a balance between human expertise and technological support. This approach guarantees that our patients receive the best possible care.

Founding director of Aria Mr Stuart Lavery concurs. A well-respected member of the global human fertility community with over 20 years’ experience providing fertility care and support, he believes, “AI represents an amazing opportunity that could impact on improving laboratory results, optimising clinical decision making and enhancing our patient’s experience.

“There is no doubt that its potential will be best realised not by replacing doctors and scientists but by supporting their decision making.”

AI systems have run quietly in the background from the start, always ready to provide an immediate second opinion. They are our copilots, enhancing our decision-making process and ensuring that every choice we make is backed by the best possible data and insights.

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What’s the difference between IVF and IUI?

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Different methods of assisted conception have come under the spotlight recently as Democrat vice-presidential candidate Tim Walz speaks out about his family’s struggle with fertility.

Walz and his wife have been open about their “journey with IVF” but were then forced to clarify that they had relied on a different process known as intrauterine insemination, or IUI.

It is common for patients to conflate the two under the umbrella of ‘IVF’, but what’s the difference?

What is IUI?

During intrauterine insemination, or IUI, sperm is placed directly into the uterus. This increases the chance of the sperm reaching the egg as it reduces the distance it must travel.

Furthermore, the semen is separated from the seminal fluid before it is injected, significantly increasing the number of sperm in the uterus compared to through intercourse.

If you have irregular ovulation, we can use fertility drugs in combination with IUI.

How is IUI performed?

The sperm sample is injected through a fine catheter into the uterus at the time you are ovulating. The patient may be prescribed fertility medication to stimulate egg production.

The procedure is relatively quick and painless. In preparing for the IUI procedure, you will visit the clinic to monitor the eggs’ development before ovulation.

Who is IUI suitable for?

IUI may be recommended for:

  • Couples with unexplained infertility, often as a first-line treatment
  • Mild male factor infertility, such as low sperm count, sperm motility, or other mild sperm abnormalities
  • Cervical factor infertility as IUI bypasses the cervix
  • Use of donor sperm
  • Male and female conditions that make full penetrative sex difficult, such as vaginismus or erectile

What is IVF?

IVF or in-vitro fertilisation involves fertilising the egg with a sperm outside the body. Embryos are developed in the laboratory before they are transferred to the uterus, where they will hopefully implant successfully and lead to a full-term pregnancy.

IVF maximises the chance of fertilisation, and we can use embryo selection techniques, including time-lapse monitoring and preimplantation genetic screening, to choose the embryo with the highest potential for pregnancy.

How is IVF performed?

IVF involves several steps. First, ovarian stimulation medication produces multiple eggs in one cycle. These are then retrieved through a minor surgical procedure performed in our Marylebone fertility clinic. Our embryologists then fertilise the eggs with sperm in our lab to create embryos.

The embryos are carefully monitored for a few days before the healthiest ones are selected. At this stage, they can either be frozen, or one or two are transferred to the uterus, with the rest frozen for possible use later.

The IVF process involves several visits to the clinic over four weeks for monitoring, egg collection and transfer.

Who is IVF suitable for?

IVF is suitable for the following fertility patients:

  • Couples with infertility issues
  • Same-sex couples wishing to use donor eggs, sperm or embryos
  • Single individuals using donor eggs or sperm to conceive
  • Patients with ovulation disorders such as PCOS (polycystic ovary syndrome)
  • Individuals with genetic disorders as embryos can be screened before implantation
  • For fertility preservation as IVF can be used to freeze embryos, eggs, or sperm for future use

Regarding success rates, there are many factors to consider, such as age and underlying fertility issues. Typically, IVF has higher success rates, but IUI can be a viable option for couples with minor fertility issues as a first-line treatment.

During your fertility consultation, our experts can thoroughly explain each procedure’s benefits and drawbacks and advise you on the most appropriate treatment option.

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Recurrent implantation failure explained

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Repeated embryo implantation failures pose a challenge for women and couples who wish to start a family, as well as for fertility experts. It is estimated that between 70% and 75% of embryos created, either through natural conception or via IVF, fail at some stage in their development before implantation occurs.   

There are many reasons why an embryo doesn’t attach or implant, and fertility expert Ms Srividya Seshadri explains how we investigate repeated implantation failure (RIF) at Aria.

Q: What is the definition of recurrent implantation failure?

There are numerous medical definitions in the literature of recurrent implantation failure or repeated failed IVF cycles, but generally, it is defined as two unsuccessful transfers of two good-quality embryos.

Q: What are the causes of recurrent implantation failure?

There are multiple causes of recurrent unsuccessful IVF cycles. I segregate them into two main parts. Is it the embryo, or is it the womb itself that’s resulting in an unsuccessful cycle?

Let’s look at the embryo. We all need to remember that the embryo is formed in the laboratory. I believe the success of any fertility clinic is largely dependent on the lab. Aria has a bespoke laboratory with cutting-edge technology and highly skilled embryologists that have the patient’s success at heart.

Then, there is the endometrium, or the lining of the womb. Multiple factors can result in a failed or unsuccessful IVF cycle, and one of them could be endometrial receptivity. Are we getting the timing right of the transfer, and is there any delay in the receptivity window that’s resulted in the unsuccessful cycle?

Or could it be selectivity that the lining doesn’t seem to recognise this beautifully normal, good-quality embryo? Could other anatomical factors, such as fibroids, endometriosis or hydro-salpinges, which means water in the tubes, interfere with success rates?

Q: How soon can we try again after a failed IVF cycle?

Regarding how long it takes to wait before you start again, I always advise couples that it is an individual choice. I’ve had patients who have struggled with the side effects of drugs from their previous cycle and who are emotionally drained. Do not let medicine dictate to you when you need to start.

In essence, though, once you’ve had a withdrawal bleed after an unsuccessful cycle, you can start the transfer process immediately. However, I always tell my patients that we need to find out why something has not worked out before we rush into another transfer because, quite often, this will result in another unfortunately unsuccessful cycle.

Q: What tests are required after an unsuccessful IVF cycle?

The tests that must be performed after an unsuccessful IVF cycle depend on the individual couple’s history. I could list pages and pages of tests that we could order, but are they all necessary?

The tests could include thrombophilia, which checks whether you have an inherent capacity to overclot rather than underclot, which may be easily treated with heparin injections before and during treatment.

Or should you check to see if the lining has an infection from a previous loss or any previous operations you have undergone?

Is immune testing necessary? Absent evidence does not mean the absence of evidence. We all believe immunology plays a role in kidney, heart, gut issues, and even early dementia. But, when it comes to reproduction, everybody gets very nervous. Please look on the UK’s fertility regulator website for more information or discuss this with one of the consultants at Aria.

A detailed history, evaluation, and discussion with your consultant to discuss all possible causes and necessary tests are essential stages of managing recurrent implantation failure. Contact us to arrange a consultation.

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Reciprocal IVF: What should my partner and I consider?

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Emily Patrick and Kerry Osborn recently made UK history by being the first to give birth to each other’s babies in a process known as simultaneous reciprocal IVF. Ezra was conceived using Emily’s fertilised egg and carried by Kerry, while Elvis, born just a few weeks earlier, was carried by Emily using Kerry’s egg. The same sperm donor fertilised both eggs.

What is reciprocal IVF?

Reciprocal IVF is also referred to as shared motherhood, co-maternity, shared parenthood or intra-partner egg donation. It is a fertility treatment option that allows both partners in a same-sex female relationship to participate in the experience of conception and pregnancy.

If you choose to undergo reciprocal IVF, eggs are collected from one partner and fertilised in our lab using donor sperm. The most suitable embryo is then chosen for transfer into the other partner. Considerations include:

Choosing which partner will be the donor and which will be the carrier

At the beginning of your journey, both you and your partner will undergo a fertility check. The partner donating her eggs should have a good ovarian reserve, which is assessed by an ultrasound scan showing the number of follicles on each ovary, the small fluid-filled sacs that can potentially release an egg. Blood tests are also performed to measure certain hormones, such as anti-müllerian hormone (AMH). Low AMH levels can indicate a low ovarian reserve.

A pelvic ultrasound scan will also be performed to check the health of your and your partner’s uterus to facilitate a successful implantation.

These factors can highlight who is most suitable to be the donor or carry the pregnancy. However, if both of you have no fertility issues, it is up to you to make a personal choice, and we can provide you with our expertise and support when making that decision.

Understanding the risks

Neither role is free of risk as you’ll both be taking fertility medications, and both may experience side effects. Then, one partner will be going through pregnancy and childbirth.

As in the case of Emily Patrick and Kerry Osborn, if you are undergoing simultaneous or concurrent reciprocal IVF, then this may also mean unforeseen challenges as you may have very different experiences of pregnancy and childbirth.

Choosing the right sperm donor 

You can either use sperm from a known donor or from a sperm bank. At Aria, we provide the facility for sperm donors to donate their sperm on a known basis to either a friend, family member or someone else known to them.

We also work with several established sperm banks and can help advise and support you through the process. We will also inform you on when you should order donor sperm in advance of your treatment.

Understanding the legal implications

Understanding the legal implications of using a sperm donor and reciprocal IVF is vital. For example, if you and your partner are married, you are both the legal parents to the child born. However, you must consent to legal parenthood if you are not married before receiving treatment.

If you use sperm through a sperm bank, there are strict regulations regarding donors. A sperm donor can request confirmation of the number of children born, inducing gender and year of birth, but otherwise, the identity of the child and mother will remain anonymous. The donor will have no legal or financial rights or obligations in relation to the child. At the age of 18, your child will have the right to basic information about their sperm donor if they wish.

Using a known donor can be more complicated, so it is vital to obtain legal advice and consider a donor agreement. While they are not legally binding, they record the intentions of all involved.

Our team is here to answer any questions you may have and support you through the process of reciprocal IVF.

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The cost of IVF

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A recent article in The Times has focused on the ‘hidden costs of IVF’ and claimed that unexpected charges mean the eventual bill for fertility treatment may be many thousands of pounds more than a clinic’s advertised prices.

In February 2020, the Competition and Markets Authority (CMA) was asked to investigate fertility clinic pricing following consumer feedback. They raised concerns that some clinics provided unclear price information.

The next step was to explore the feasibility of developing a standard approach for a package price for a single cycle of IVF so patients could meaningfully compare clinics.

“The CMA has investigated this and found it is unfortunately not as simple as regulating supermarket pricing,” Aria Clinic Director Rob Smith explains. “Every fertility treatment is unique, and there are so many variables: the medical history of both individuals if you’re treating a couple, the scans or tests required, the medication dosage, whether fresh or frozen embryos are being transferred, or what different treatment add-ons are used.

“There’s no average price because there’s no such thing as an average patient.”

The value of treatment add-ons

The investigation by The Times found that an IVF treatment costs 50% more than advertised at a quarter of private clinics, based on data by Fertility Mapper, a review platform for fertility clinics. Additional costs not included in the initial quote frequently included blood tests, embryo freezing and scans.

Thirty-nine per cent did not include blood test monitoring, which can cost £150-200 for each test.

“Some clinics monitor the life out of patient – sometimes once or twice a day – and throughout an IVF treatment, this can quickly run into the thousands. If you’re not expecting it, this will be a huge shock,” Rob explains. “We make it very clear to patients at Aria that we don’t include the monitoring of bloods in their costs because actually very few patients require it. For those that do require more monitoring, we inform them of this at the very beginning of the treatment and make a small additional charges for these.  Charging for these tests on an ad-hoc basis prevents us from increasing the IVF treatment cost for everyone.”

Another cause for concern was treatment add-ons. When IVF was first invented, the process was collecting the egg, fertilising it and then transplanting an embryo back. This remains the basic IVF cycle. Since then, several refinements to the process have been developed, such as genetic testing or time-lapse imaging of the embryos.

These treatment add-ons are all additional costs, and it is true that there is currently not enough clinical evidence to prove that they are effective at improving treatment results. “At Aria we believe that treatment add-ons can improve the eventual outcome for some patients,” argues Rob, “which is why we offer them. But they are only applicable to certain patients.

“If you have unsuccessfully undergone multiple rounds of IVF, then it is vital that your clinic attempts to boost the chances of a successful treatment by utilising these advances in technology and techniques. We always discuss these options beforehand and make sure patients make an informed decision about their treatment.

“However, if you are under 38 and embarking on your first round of IVF, then genetic testing, for example, is just not required. Unfortunately, some clinics try to recommend these treatment add-ons when unnecessary.”

The Aria ethos

“We set up Aria because we wanted to create something unique in the industry,” Rob explains. “We aim to be as transparent and clear on costs as possible from the outset. We do not advertise a headline ‘from’ price on our website, and we include our complete pricing guide with every treatment clearly listed.

“After the initial consultation with one of our fertility experts, the doctor will send a list of what is required to our patient care team. They then provide the patient with a bespoke quote that includes exactly what is included in the treatment package.”

“Another thing that I think is quite unique is that you pay for a package and there are no surprises afterwards. It happened to me, at other clinics, to pay for packages and then to have to pay for countless ‘non-included’ extras. For example, ‘the first scan is not included’. You probably would not expect the medicines to be included but the scans? At Aria you pay once, and no further surprises.”

“If the patient wishes to discuss any aspect of the quote, they can come into the clinic and go through it line by line with one of the team.

“We are always striving to improve our patient experience, and gathering feedback is vital to this process,” continues Rob. “In our most recent data collected, almost 88% of our patients reported that they had paid exactly what they had expected.”

Call +44 (0) 203 263 6025 to speak to one of our team about fertility treatment costs at Aria Clinic.

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Can you improve egg health for IVF?

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In vitro fertilisation is a challenging time as it’s both emotionally and physically demanding, and one way to prepare for IVF is to focus on the potential benefits of improving egg quality or ovarian function through lifestyle changes, such as nutrition.

Leading fertility nutritionist Melanie Brown believes nutrition can help improve fertility.

“Women are constantly being told nothing can improve the quality of their eggs. And while we are all born with the eggs we shall ever have in our lifetimes, the environment in which those eggs mature is fundamental to their quality, so this assertion is not strictly true.

“There are many reasons why someone’s egg quality or ovarian function might not be optimal and can be positively influenced.

“We know that smoking damages egg quality, so conversely, I believe that nutrition and other lifestyle changes could also help to improve egg quality. If you can do something that adversely affects egg health, it shows they are not immune to their environment.”

IVF vs a normal menstrual cycle

During a normal menstrual cycle, many follicles containing immature egg cells or oocytes will develop and grow when your body releases a follicle-stimulating hormone called FSH.

Typically, one standout follicle grows faster than all the others, known as the dominant follicle. It sends a signal to decrease the amount of FSH being produced, which causes the other follicles to cease developing, leaving only the one dominant follicle to continue growing and the egg inside to mature.

In an IVF cycle, however, the goal is to grow multiple follicles simultaneously, a process that does not occur in a natural cycle.

“I often say to my patients, if you look at the progress of an IVF cycle as a flow chart, you can see how important it is to ensure you are as well prepared as possible,” Melanie explains. “You might have 18 follicles, which release 14 eggs, 10 of which are mature eggs, from which eight go on to be fertilised, six then go through to day three, and maybe two become day 5 blastocysts.”

Preparing for IVF with nutrition

“I can also advise patients on all the fertility-improving strategies out there on the internet – milk or no milk, soya or no soya, is DHEA right for you, how do I use melatonin?

Fertility Nutritionist“There’s an ever-running argument about milk consumption during IVF. Many nutritionists think milk is the devil’s work as it’s very inflammatory and can be a factor in everything from acne to polycystic ovaries. And I certainly think that’s true for those that suffer from certain conditions.

“But, if you don’t suffer from those conditions, I think there’s quite an argument for consuming milk in an IVF cycle. Milk is meant to grow baby animals and full-fat milk is full of growth factors and growth-promoting nutrients.

“Iron takes oxygen to our cells, so if you are even slightly anaemic, then it means you’re not getting enough oxygen to your ovaries. Yet, many people might be entering an IVF cycle with mild anaemia – if you have undiagnosed endometriosis, very heavy periods or have a vegetarian or vegan diet.

“A protein-rich diet is essential to support multiple follicle growth during an IVF cycle. Protein makes up the building blocks for every cell in our bodies, including our sperm and eggs. So ensuring you have the right amount of protein is essential.

“I see maximising ovarian function and potentially improving egg quality before IVF, as a ‘project’ – usually three months will do it.”

For more advice on anything fertility and nutrition-related, see Mel’s website: melaniebrownnutrition.com. Call +44 (0) 203 263 6025 or email us at admin@ariafertility.co.uk for advice on preparing for IVF.

For more information on the individual practitioners and organisations offering support, advice, and information to those undergoing fertility treatment, please visit our Support Hub.

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Patients asked to give their view on proposed changes to ‘inflexible’ fertility law

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The Human Fertilisation and Embryology Authority (HFEA) has opened a patient consultation process regarding proposed changes to UK fertility laws which they say are inflexible and not reflective of modern fertility practice.

The Human Fertilisation & Embryology Act (HFE Act), the law that currently governs fertility treatment and embryo research in the UK is over 30 years old. The HFEA believe that it no longer accurately reflects the medical and scientific innovations and changes in societal expectation that have occurred over the subsequent decades. They recommend sweeping reforms, proposing to put patients at the heart of fertility law.

Julia Chain, Chair of the Human Fertilisation & Embryology Authority (HFEA), explains: “Much of the fertility law has stood the test of time remarkably well but modern fertility practice, emerging possibilities in research that could benefit patients and the changing expectations of donors and of families, are not reflected in the sector’s 30-year-old law.

“With input from an expert advisory group, we have identified where the law needs to be modernised in the interests of patients and their families. This includes providing more up to date powers for inspecting and regulating fertility clinics in the interests of patients and greater choice around donor anonymity. However, it’s important to note that any decision to update the law is for the Government and ultimately Parliament to decide.”

Fertility law changes being considered

  • Changes to HFEA’s regulatory powers so they can more rapidly impose conditions, suspend all, or part of a service for a specific period of time, or impose financial penalties where there have been serious non-compliances
  • Extending HFEA’s powers to address fertility services outside licensed fertility clinics
  • Changing current access to donor information, including providing parental and donor choice where they can opt for anonymity until age 18 (as now) or identifiable information on request after the birth of a child.
  • Allowing automatic record-sharing between fertility clinics and GPs to ensure safer patient care.
  • Encouraging innovation by allowing the HFEA to authorise trials for low-risk new practices.

HFEA also plan to future proof the law to ensure it is better able to respond to scientific developments and speed up potential new treatment options for patients.

Since the Human Fertilisation and Embryology Act was established in 1990, fertility care in the UK has changed rapidly and currently around 60,000 patients use fertility services every year and approximately 60% of them will pay for their own treatment.

The HFEA consultation opened on 28 February and will run for six weeks on the regulator’s website. It will submit its recommendations for law changes to the Department for Health and Social Care by the end of the year.

For more information and to share your views, Fertility Network UK are holding a webinar on the HFEA’s proposed changes to fertility law with Peter Thompson from the HFEA. The webinar will explain more about this consultation process, what the proposed changes mean to patients and how patients can get involved.

You can register here: Webinar – Why Changes To Fertility Regulations Matter To You | Fertility Network

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