Embarking on fertility treatment can be overwhelming and stressful, so it helps to be prepared in terms of what to expect during your first fertility consultation and to know what questions you should ask.

Many patients we see at Aria Fertility have undergone treatment on the NHS or at other fertility clinics and so may have already undergone various tests and received a diagnosis. Some are at the start of their fertility journey or wish to learn more about fertility preservation options such as egg freezing. Whatever stage you are at, one of the most important considerations at your first consultation is whether you feel comfortable with your fertility specialist.

Your initial consultation will usually last 30 minutes, and you will be asked about your fertility journey up to this point, as well as in-depth questions on your medical and family history, either as an individual or for both you and your partner if you are attending as a couple.

This first visit will be the opportunity to get to know your fertility doctor and the clinic and for them to get to know you and it is essential you feel comfortable enough to ask questions.

3 questions to ask in your first fertility consultation

1. What diagnosis might explain why we haven’t been able to conceive?

Your doctor may not be able to tell you the exact cause of infertility at the first visit as we may need to arrange additional testing to help us determine the cause.

However, be aware that potentially one in five cases of fertility cannot be explained. Unexplained infertility is thought to affect 15% to 30% of couples and individuals and is when they have undergone all the appropriate tests and no cause is found. It is most likely to involve issues with egg or sperm quality or problems with the uterus or fallopian tubes that aren’t identifiable during normal fertility testing. Unexplained fertility can still be successfully treated with fertility drugs, IUI and IVF.

2. What treatments do you recommend for us and what are their potential success rates?

At Aria Fertility we offer several different treatment options. This could be fertility drugs as a standalone treatment or in combination with IUI or IVF. Your fertility doctor will be able to give you information on the success rates of the clinic and advice on how successful a particular treatment option is likely to be, taking into account your age and medical history.

3. How much does IVF treatment cost?

It can often be embarrassing to ask questions about cost, but fertility treatment is a significant investment. Once a treatment pathway is recommended by our doctors, our Patient Coordinator Team will provide you with a comprehensive breakdown of costs, including any add-ons or medication that have been discussed.

At Aria Fertility, we believe in 360 support. Once you’ve made the informed choice to proceed, our dedicated team, which is composed of your fertility specialist, fertility nurse and patient coordinator, will help you chart the course of your fertility treatment. You will also have the support of a fertility coach who can advise you on nutrition, lifestyle changes, and complementary medicine as a supplement to your medical care.

To arrange a consultation with Aria Fertility, call +44 (0) 203 263 6025.

Since the birth of the first baby conceived using in vitro fertilisation in the UK more than four decades ago there have been significant advances, but for many couples IVF remains an emotionally and physically challenging process that may not lead to conception.

Recently, much of the focus has been on the role that Artificial Intelligence (AI) can play in improving the current live birth rate per embryo transferred. This currently stands at 25% and 19% respectively for patients aged 35 to 37 and 38 to 39 according to the most recent figures from HFEA.

“Artificial Intelligence (AI) for gamete and embryo selection has marked the start of a new era in IVF and is here to stay,” explains Xavier Viñals Gonzalez, Aria’s Senior Clinical Embryologist and Laboratory Manager.

“We can now get a deeper level of information which was not available to embryologists before. AI systems are already key for research and development in the field of IVF and will certainly improve our understanding of egg and sperm quality and embryo development.”

AI and IVF

Artificial intelligence describes technology that mimics human cognitive capacity to make predictions based on evolving data. In the IVF lab, it can aid the embryologist to make a rapid and accurate assessment of the health of a gamete or embryo.

Artificial intelligence is used as extension to time lapse monitoring that takes images of embryos at intervals of ten minutes, allowing our embryologists to monitor every stage of embryo development.

AI systems can review a massive amount of data, far more than humans can process, including hundreds of images from each developing embryo. Some AI algorithms are trained to predict clinical pregnancy, others to unveil genetic make-up of the embryos.

By analysing thousands and thousands of these time lapse images and comparing those that go onto successful outcome to those that don’t, AI uses this data to grade the embryos with greatly improved accuracy.

This process is always overseen by our embryologists who review the selection process before implantation but, as Xavier explains, “the assistance of AI systems to daily laboratory workflow will offer patients outcome optimisation and provide better understanding of their chances along reproductive journey.”

A study published last year in the Journal of Assisted Reproduction and Genetics discussed how AI can be used as an essential component in a fertility clinic lab’s quality management system. It could provide “systemic, early detection of adverse outcomes, and identify clinically relevant shifts in pregnancy rates”.

Currently, Aria Laboratories continue to evaluate the efficacy of time-lapse parameters and artificial intelligence algorithms as predictors of embryo potential with the main focus on delivering high success rates to our patients, whilst minimising multiple pregnancy. To learn more about the use of AI in the Aria Fertility lab, call (0) 203 263 6025 to arrange a consultation.

In vitro fertilisation and other fertility treatments are an often-gruelling process, with a huge impact both physically and emotionally on both men and women. This experience is further compounded for women by discrimination in the workplace, according to a MP who is campaigning for new employee protection for women undergoing IVF.

The Conservative MP for Cities of London and Westminster Nickie Aiken wants to make it illegal for employers to side line or sack women who are trying to conceive through IVF and are having to take time off for fertility-related issues.

“Women are facing discrimination at work and even being forced out of their jobs because they haven’t got rights to take IVF treatment currently,” Aiken explains.

“It’s now come to the time that we’ve got to recognise IVF as a very, very important part of reproduction’ she says. “We’ve got an awful birth rate here in this country. We need to keep giving birth to children so that in 30 years’ time, they will be paying taxes, they will be our workers of the future.

“I would also like to see a legal requirement for employers to have a workplace fertility policy. I would like to see organisations introduce guidance on rights to time off work for treatment and miscarriage, flexible working, access to HR support and counselling on a confidential basis. This would help to improve workplace culture for workers looking to build a family through fertility treatment.”

Currently, legal safeguards against pregnancy-related discrimination only begin after implantation has taken place, so women often find themselves having to ‘hide’ the fact that they are undergoing IVF or try and arrange appointments outside of working hours, all of which will have an undeniable effect on stress levels.

Aiken will introduce a private member’s bill at the next parliamentary session to discuss IVF workplace discrimination.

The growth in fertility benefits

Although there is evidently a need to protect many women from IVF discrimination in the workplace, more and more companies are embracing the concept of extending fertility benefits to their employees.

Fertility benefits are proving a powerful way to attract and retain employees. In a survey carried out by Carrot Fertility, the leading global fertility benefits provider for employers, and The National Infertility Association, 88% of employees would even consider changing jobs for access to fertility benefits.

Aria Fertility is delighted to partner with Carrot Fertility to provide fertility care to their UK members.

The latest UK statistics show that that half of women are now childless at the age of thirty for the first time since records began in the 1920s. A report from the Office for National Statistics (ONS) has found that 50.1% born in 1990 were still child free by their thirtieth. This follows the long-term trend of people opting to have children in later life and a smaller family.

The most common age to have a child is now 31. This is in direct contrast to baby boomers, born in the late 1940s, who were 22 on average when they began their families.

An explosion in opportunities for studying at university and pursuing careers was the catalyst for this trend and modern pressures such as the rising cost of childbearing and job uncertainty are also impacting the decision to start a family. But, at what cost to fertility?

Age affects fertility for both men and women, but in women it is the single biggest factor in determining whether you can conceive and carry a baby successfully. Fertility gradually declines in the 30s, particularly after the age of 35. Even before menopause, the ability to conceive naturally is unlikely by 45.

A woman is born with all the eggs she will ever have; at birth that is approximately 1 million eggs but, during your reproductive lifetime, only 300 to 400 will be ovulated and as you age, your eggs age and the number and quality reduces over time.

The decreased quality increases the chance of miscarriages, ectopic pregnancies and chromosomal abnormalities and raises the pregnancy risks. As you get older, you may also have other medical conditions that could affect your fertility.

Fertility treatment in my 40s: what are my options?

IVF treatment with PGT-A: For women in their late 30s and 40s that wish to undergo fertility treatment with their own eggs, we recommend screening all suitable embryos which have reached the blastocyst stage of development (day 5 embryo) using pre-implantation genetic testing for aneuploidy (chromosomal errors).

State-of-the-art embryo selection technology: Time-lapse imaging continuously monitors the development of the embryo and uses artificial intelligence, based on their developmental pattern, to identify the embryos which have the highest chance of implantation in the uterus.

Egg donation: Increasingly, egg donation is becoming a more effective way of overcoming age-related infertility. An egg donor may be anonymous or known to you and egg donation treatment is very similar to a standard approach to IVF, expect you will not be required to undergo the ovarian stimulation phase of the treatment.

If you are over 40 and would like to understand more about your own fertility, the first step would be to arrange a consultation to meet with one of our Aria consultants.

At Aria Fertility Clinic, we recognise the importance of supporting your emotional, mental, and physical wellbeing during your fertility journey. Acupuncture is increasingly popular as a complementary therapy for those undergoing fertility treatment or managing hormonal conditions.

Acupuncture is an ancient tenet of traditional Chinese medicine whereby very fine needles are placed at strategic points on the head and body to release the flow of energy or chi. It is believed to be beneficial in the treatment of a wide range of health conditions, including fertility issues, by correcting energy imbalances in the body.

How does acupuncture aid in fertility treatment

Acupuncture can be used by both men and women during the fertility process. For men, it may prove beneficial when going through ICSI treatment. For women, it’s thought to have several benefits:

• Increasing blood flow: acupuncture can boost blood circulation to the ovaries and uterus
• Regulating hormones: acupuncture can improve menstrual regularity, restore ovulation patterns, and regulate the release of key hormones including follicle stimulating hormones. This can be highly beneficial for women suffering from PCOS
• Reducing stress: acupuncture releases the body’s endorphins which helps to relax patients undergoing fertility treatment. Patients often report they feel more ‘in control’ and proactive

Emma Cannon, a fertility and women’s health expert, is a registered acupuncturist and works with men and women who wish to optimise natural conception or support IVF.

“Most of the research into acupuncture and IVF has been focused on the pre- and post-embryo transfer stage,” Emma explains. “Clearly that’s because when you design a study everyone must be at the same stage to produce comparable data. The studies showed promising results, but they never went beyond it. So, I’m more interested in what acupuncture can do outside of embryo transfer.

“We use it for women whose endometrium has previously not reached the correct thickness and I might combine acupuncture with a nutritional programme. That can be very effective.”

Emma pointed to another area where they have had good results. “It can be common during an IVF cycle that the follicles do not evenly develop. By improving the blood flow to ovarian arteries, it can improve follicle development and help the other ovary catch up.”

In recent years, several studies have attempted to evaluate the benefit of acupuncture in alleviating infertility or as an adjunct to IVF or ICSI and while we have no conclusive evidence yet, a growing body of scientific research supports its efficacy as a complementary therapy.

What is indisputable, though, is that acupuncture has no adverse effects and anecdotally our patients report that it has been highly beneficial in relieving stress during their fertility journey.

To get in touch with Emma, please visit her website. For more information on the practitioners we work with, please visit our Support Hub.