Nutritional health does play a role in conception and pregnancy, yet there is so much conflicting advice online for those trying for a baby naturally, couples struggling with infertility or individuals experiencing health conditions that affect their fertility.

A fertility dietician can provide clear, personalised nutritional advice with regard to fertility, pregnancy and gynaecological concerns. The benefits can be wide ranging, including:

• Optimising the chance of conception
• Helping to regulate ovulation
• Can improve egg and sperm health
• May reduce the risk of miscarriage
• May improve success rate of fertility treatments
• Reduce pregnancy-related risk factors

Often just the act of focusing on diet can be good for allaying anxiety as the patient can feel they are being proactive at a time when so much is beyond their control.

Alex Ballard (@alextalksdiet), a Band 7 specialist fertility dietitian in the NHS, specialises in preconception nutrition and works with Aria Fertility, helping patients with general enquiries about fertility and nutrition and how that links to fertility treatment or any other health conditions.

“I have been interested in the link between fertility and nutrition since I trained to be a dietician seven years ago as I had family members that were going through fertility treatment and friends that had been recently diagnosed with conditions such as PCOS and endometriosis.”

Unfortunately, it is often challenging to access this support through the NHS. “In seven years of working in the NHS, I have never had a patient referred to me who’s trying to conceive although I know there’s many that would benefit from it.

Support and advice from a fertility nutritionist can be accessed at any point in their journey, but Alex points out that there is optimal time to embark on any changes to lifestyle habits if you’re about to commence fertility treatment.

“If people are motivated then I can help at any stage in their fertility journey but there is a three-month cycle for eggs and sperm to mature to the point that they are ready for fertilisation so any changes you make consistently for 12 weeks or more is likely to have a really beneficial impact both on their fertility and then, hopefully, their pregnancy.”

Patients that could benefit from fertility nutrition advice

 “I see both couples and individuals and have three main types of clients,” fertility dietician Alex explains. “People at the beginning of their fertility journey are often looking for more general advice on a diet that is protective of fertility and foetal development.

“The second type of client has been trying to conceive for a long time and is about to start fertility treatment and wants advice specific for that.

“And, finally, I have many clients who have existing health conditions which are impacting their fertility, and which can be better managed through diet. This includes POCS, endometriosis, coeliac, Crohn’s, diabetes, or nutritional deficiencies.”

How does a fertility dietician work?

Although there is a lot of information available online, Alex finds patients are often overwhelmed and her role is to provide practical advice and workable plans that fit in with modern, busy lives.

“I’m always led by the client. The goal is always realistic, sustainable, and important to them. Just because I think something would be highly beneficial to them, if they don’t agree then it’s not going to be a sustainable change.

“I’m not going to send someone away with a long list of changes for them to implement. It’s more likely to be, let’s make one or two realistic goals and then touch base in a month or so and see how things are going.”

Final advice: variety and moderation are key!

“There are definitely foods that we know are particularly rich in nutrients and good for fertility, but the danger is that you can then fixate on some foods and not get enough of the other nutrients we need. I also advise patients not to be too extreme; never eliminate a specific food group, as every one has a purpose.”

We work closely with a wide range of practitioners to provide support throughout your fertility journey – click here to visit our Support Hub.

This month is Stress Awareness Month which has been held every April for the last thirty years, yet events over the last two years have made this event even more essential. Anxieties over COVID and the impact of lockdowns have all taken a toll on our mental health. Multiple studies have shown a major increase in the number of adults reporting symptoms of anxiety, depression, and insomnia.

For those undergoing IVF, however, this has been an even more stressful time, with cancelled appointments, delayed procedures and worries about how the pandemic would impact their fertility treatment. We take a look at where stress, diet and fertility intersect.

Stress and the body

There are many factors that are stressful for mind and body – external pressures such as your job or family responsibilities and internal influences such as our diet or how body is functioning.

Stress affects our body in a myriad of ways: it increases blood pressure levels, spikes our blood sugar, releases stress hormones, and speeds up our heart as we enter a flight or fight response. The problem is that the pressure of modern-day living means we’re continually in a state of full alert.

Diet and fertility stress

A well-balanced diet can help us combat the physiological changes caused by stress. Much of the focus is on stabilising our blood sugar levels.

Prioritising protein: when the body is chronically stressed, it demands protein as that slows down release of sugar into the blood stream and the best sources are lean meat, fish, eggs, beans, pulses, nuts and seeds.

Time your intake: eating regular, well-balanced meals are the key to maintaining energy levels and your mood while staving off tiredness.

Fight the easy fix: highly refined foods such as white bread, pasta, sweets, cereals, as well many tinned or processed products, are full of added, hidden sugars that cause a spike in blood sugar levels.

Avoid emotional eating: try not to reach for food when you’re feeling stressed as it diverts blood flow away from your digestive system and it will probably just leave you feeling bloated and uncomfortable.

Alex Ballard (@alextalksdiet), a Band 7 specialist fertility dietitian in the NHS, specialises in preconception nutrition and works with Aria Fertility, helping patients with general enquiries about fertility and nutrition and how that links to fertility treatment or any other health conditions

“A Mediterranean diet is specifically good for mood; one with oily fish, lots of fruit and veg, nuts and seeds, and whole grains. But I find that just the act of focusing on diet and taking control can also be good for allaying anxiety as the patient is being proactive about improving their own health.”

We work closely with a wide range of practitioners to provide support throughout your fertility journey – click here to visit our Support Hub.

The IVF laboratory is a key component to the beating heart of any fertility clinic – it is here where human fertilisation occurs, sparking the creation of embryos and the beginning of life.

With the perfect integration of three highly specialised areas (andrology, embryology and preimplantation genetics), Aria provides a focused and individualised approached to optimising the IVF laboratory environment and managing the most complex of infertility issues.

Led by Laboratory Manager, Xavier Vinals Gonzalez, the scientific team has enhanced embryology processes to deliver high success rates, with a constant focus on patient care and experience as core to the laboratory values.

Digitalised environment

We understand how important it is for us to be able to deliver the best results possible. In doing so, laboratory activities we recognise the importance of an environment with minimised carbon footprint. We recognise the synergies and benefits which can be derived from a fully digitalised environment, such as electronic witnessing (traceability) which eliminates the risk of errors.

Digital traceability is incorporated across each specific stage of the IVF pathway:

• Egg collection & preparation
• Sperm collection & preparation
• Fertilisation
• Embryo culture
• Embryo transfer
• Cryopreservation

Taking sperm processing as an example, conventional preparations have 14 associated steps and 32 failure modes – potential risks to a sample or errors in the process, such as sample mismatch and impairment of sperm function. In Aria’s digital ecosystem, each stage in the process is associated with an electronic tag containing three identifiers for each sample allowing for full traceability. Furthermore, electronic data gets routinely checked in order to test and improve the workflow and efficiency in the laboratory.

Integrating new technologies

IVF is a constantly evolving field, which requires continuous careful assessment of emerging solutions by doctors and scientists. In order to evaluate the incorporation of innovations into the laboratory, a systematic decision strategy which accounts for effectiveness and risk is always followed.

Last year, Aria cryostorage facilities was the first clinic worldwide to introduce a novel monitoring technology. With the aid of such equipment, Francisca Mora, ESHRE certified clinical Embryologist at Aria, developed a study analysing cryokinetic variables, which helped to validate the integrity and lifetime of cryostorage tanks adding a unique high-security level and cryosurveillance to our stored samples.

Aria’s Laboratories have always welcomed advances in the field of IVF, where technology can bring standardisation and precision while enhancing normal functions of eggs, sperm and embryos. Based on the use of microfluidic devices for sperm preparation, embryologist Kimberley Hill, showed a reduced operational risk and improved laboratory workflow. Such devices use the natural properties of sperm to ‘swim up’ (rheotaxis), whilst reducing the associated steps in the process.

Currently, Aria Laboratories continue to evaluate the efficacy of non-invasive genetic testing, 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.

Rigorous quality control

Correct functioning of equipment is imperative for maintaining the functions of eggs, sperm and embryos. Temperature, gas and humidity sensors are distributed along the equipment in the laboratory and monitored 24/7. Should any anomaly be detected, different sensors will trigger an alarm and inform the Embryology Team, which can connect remotely and troubleshoot rapidly.

This digital surveillance system is tested against our weekly manual quality control checks to ensure correct performance. Annually, Aria Laboratories have a planned shut-down where all pieces of equipment are analysed, calibrated and tested; providing us with the reassurance our equipment is functional and we continue to offer a premium quality service with the best results.

Research and development

The importance of research and development activities is well embedded in our daily work and philosophy. Journal clubs and quality review meetings are organised between departments to track new practices and developments in the field. It is key for us to be able to provide an individualised and exceptional experience to our patients, which requires managing each case independently.

Within the embryology department, Miriam Alvarez’s interest resides in reviewing literature and research with a goal of potential adaptation of the laboratory procedures for cases of autoimmune disorders to maximise the chances of success when embarking on the IVF journey.

Aria Laboratories are proud to be able to provide an excellent and evidence-based approach to infertility cases, which would not be possible without the cohesive integration with the clinical, nursing & patient support teams.

To find out more about our work, call +44 (0) 203 263 6025 to arrange a consultation.

When you embark on your fertility journey, you may have seen the term ‘a holistic approach to fertility treatment’ and be unsure what it means.

At Aria Fertility Clinic, we offer cutting-edge scientific solutions to infertility; our medical team is led by highly experienced fertility and gynaecology specialists and backed by the latest technology incorporated in our IVF laboratory. Yet we recognise that emotional, mental, and physical factors can all play a role in your experience, and we work closely with leading complementary practitioners and counsellors.

Recently, we spoke to Emma Cannon, a fertility and women’s health expert, registered acupuncturist, founder of the Emma Cannon Clinic, and a mentor and speaker in fertility matters. She explains how she supports men and women who are contemplating or undergoing fertility treatment.

“Covid has added a layer of stress to fertility treatment. I gave a talk recently to IVF doctors and nurses and discussed what fertility treatment needs to look like in 2022 and safety is primary. By this, I mean not just physical safety during the Covid pandemic, but the importance of providing emotional safety for patients.

“There was a lot of talk when we went into lockdown that there would be a baby boom, and this seemed very unlikely. Fear does not induce good fertility. So, it’s important that people feel safe. If you’re not going to get this from external sources, it is something that must be cultivated internally and that is how I help patients.”

Infertility and past trauma

“If you have formed a belief in your childhood that you’re not good enough, you spend your whole life trying to compensate – by getting good grades in school, doing well at university, or getting a great job.

“Everything you do dispels this belief buried deep down that you’re not good enough. But suddenly, after being successful all your life, you experience difficulties in conceiving. Sometimes it’s the first time my patients may have failed at anything their whole life.

“Very quickly they go into a trauma response and these old belief systems get triggered. I work with patients so they aren’t in this fight or flight mode.”

Women and the self-blame of infertility

“Most people tend to catastrophise, and they often make the situation worse by the meaning they attach to it. This can be particularly true for women who are much quicker to say what’s wrong with me.

“By the time they reach the IVF clinic, they are often convinced that there is something really wrong with them. What I tried to do is unravel their past so they can come to fertility treatment from a fresh place rather than projecting onto the future.

“Typically, I will see the individual or couple for an initial consultation via Zoom. Often, I may refer them to a fertility clinic that would be a good fit for them and then we create a holistic programme for them. I have two acupuncturists that offer pop-up clinics in central London and our emotional support sessions are carried out via Zoom. Generally, I work with them individually at that point.

“I can’t cure their fertility issues, which is the role of IVF or other fertility treatments, but I can give them back their trust in the fertility process.”

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

Infertility and its treatment can affect all aspects of people’s life and can cause frustration, anxiety, depression, guilt, and feelings of worthlessness.

In a 2016 study into the impact of fertility treatment carried out by Fertility Network UK, respondents felt on average sad, frustrated, and worried nearly all the time and 42% experienced suicidal feelings as a result of fertility problems and/or the treatment they are undergoing. The study also found that 70% reported some detrimental impact on their relationship.

The Human Fertilisation and Embryology Authority (HFEA), the UK’s fertility regulator  acknowledge the importance of counselling being attended before you donate eggs, sperm or embryos or have treatment with donated eggs, sperm, embryo. It is a mandatory requirement that fertility clinics offer access to counselling when embarking on any fertility treatment.

At Aria, we work closely with Senior Fertility Counsellor Tracey Sainsbury who provides implications counselling for individuals and couples around all fertility issues. Implications counselling aims explore the psychological as well as the social, legal, and ethical implications around your treatment.

“I am not a tick box type of counsellor – I like to take my patients on a journey,” Tracey explains. “And every person’s journey is different – usually because experiences from the past can be triggered.” It’s estimated that 80 to 90% of people undergoing fertility treatment experience anxiety and depression.”

Managing the emotional rollercoaster of IVF

The IVF process can be a highly emotional time for both the individual and the couple, marked by highs and lows and alternating feelings of excitement, hope, disappointment or uncertainty.

“Often people have a fantasy around how they had hoped to conceive, it rarely includes assisted conception. There can be a grief response to the loss of fantasy around embracing assisted conception, even when they are keen to get started.” Tracey clarifies. “For couples, they will usually have put life on hold, telling themselves I’ll stay in this job because of maternity leave or we won’t book that holiday because we may be pregnant.”

“For women, in particular, we live in a prenatal world and suddenly everyone around them seems to be pregnant and that can feel persecutory. Then, they arrive in clinic and they are hopeful but maybe annoyed that they even have to be there in the first place. They may also feel relief because someone else is now going to take charge.

“Fertility treatment can be very traumatising and the thing with trauma is that we can be retraumatised. So, anything relating to family, hopes, dreams can bring up past trauma even from a very long time ago.”

Managing stress during your fertility treatment

“Sometimes the greatest risk to mental health is social media as it promotes this sense that you should be zen-like and positive, but fertility treatment is very stressful, Tracey explains. “So, we say be stressed but learn how to manage it well.”

Tracey promotes patient autonomy and there is no prescribed amount of fertility counselling that she recommends. For some patients this can be an initial appointment to discuss strategies for managing any stress you experience during your treatment journey. However, fertility treatment can bring to the surface long-buried trauma and emotions or put pressure on relationships and some patients – either as couples or individuals – may have weekly sessions throughout the many weeks and months that they undergo treatment.

Tracey offers a reduced fee for counselling appointments for people exploring or progressing fertility treatment with Aria. The cost is £50 per appointment, appointments are always provided online via Zoom or Teams and last around 50-60 minutes. Patients do not have to register with her private practice, and she has access to their notes, so she is aware of their fertility journey so far.

Call +44 (0) 203 263 6025 to find out more about the support we can offer at Aria Clinic.