Who should consider fertility preservation? More people than you may realise.-image

Who should consider fertility preservation? More people than you may realise.

We created Hertility to give women a way to proactively track their fertility, but the last thing we want to do is panic people who aren’t in a position to have babies just yet or scaremonger people into starting a family when they’re not ready. Cue: fertility preservation, as explained by our trusted partner clinic, The Evewell.  Quick Facts: Fertility preservation is not just for single women; it’s relevant to anyone who is not yet ready to start a family regardless of their relationship status. You can freeze eggs, or embryos (fertilised eggs) with either a partner or donor sperm. Fertility preservation is also a form of ‘Strategic family planning’, a way to work towards building the family you want before you get pregnant with your first child. Let’s talk about something very topical right now: fertility preservation. You’ve probably heard about it in the context of egg freezing, almost always in relation to single women, but in reality, it’s something that may be relevant to many more of us than we think.   Emma Whitney, Director of Embryology and Genetics at The Evewell in London (and @emmatheembryologist on Instagram), is passionate about helping people understand the available steps they can take today, so they can have options to build and complete their family in the future. In this article, she will take you through some of the science as well as the groups of people who are or should be thinking about fertility preservation. To speak to a member of our nursing team about The Evewell Clinic and how to access services contact referrals@hertilityhealth.com.  Our team will be able to book in your appointment and provide insights into pricing and next steps.  Firstly, what is fertility preservation? Fertility preservation is when we collect eggs and then we can either freeze them at this point (the well-documented egg freezing option) or create embryos by fertilising them with either partner or donor sperm and freeze those instead. We work with patients to help them make the best choice for them. Talking about freezing eggs or embryos is something I speak to patients about every single day and we can help patients decide which option is best for them depending on their family goals. What is so frustrating is that many people have not considered fertility preservation because they didn’t understand it related to them or could have supported them in creating their future family. So could fertility preservation be relevant to you?  I’m in a committed relationship but we’re not ready to start a family yet… I see it all the time, for people in their 30s, the pressure to settle down and start a family can intensify, particularly if they’re in long-term relationships. But for some people now is just not the right time. It may be career commitments, financial concerns or simply still having things on the “list” they want to do or achieve before they become parents. What’s interesting is that people in committed relationships may just feel fertility preservation isn’t relevant to them because it’s all about egg freezing for single women. By explaining that it’s not just eggs that can be frozen, but embryos too, it’s a bit of a lightbulb moment as they realise this is quite literally, a way to press pause and start a family when they’re ready. And for those of you thinking: I’m not sure I want to freeze embryos with the person I’m with right now, you can freeze both eggs and embryos, giving yourself even more options for who you want to start a family with. We’ve been trying to conceive but it’s harder than we thought… When people are trying to have a baby, the focus understandably is getting pregnant as quickly as possible, and little thought is given to what will happen when you want to have baby two and beyond. As more people are starting their family later in life, it can be harder than they thought. Some find it takes more time or they need medical support. What’s frustrating is that we often see patients in The Evewell who are now two to three years older than they were when they had their first baby and now it’s considerably harder to achieve a second pregnancy. If I know people want more than one child, I always talk to them about ‘strategic family planning’; making sure we aren’t just focused on baby number one, but how we can help them plan for the family they dreamed of. This is when embryo freezing – before the first pregnancy – can be a really useful option. We call it ‘strategic family planning’ because it’s a strategic approach that really can make the difference between needing more invasive, exhaustive and expensive treatments later down the line, when you’re – inevitably – a couple of years older, with older eggs (and with a toddler running around!) I’m single and I may want a family in the future…. Single people in their 20s and  30s are understandably confused and feeling overwhelmed. On the one hand, they understand the harsh fact that females are born with all the eggs they’re ever going to have, and, as much as science and technology have improved almost all areas of our lives, we haven’t been able to stop a female from losing her eggs, or those eggs ageing. But they’re also being bombarded by press articles telling them that egg freezing is not the solution. Just this month, Tory MP mother of three Miriam Cates told women they should not consider egg freezing and that if they wanted to be parents, to have babies “sooner rather than later”. It’s this kind of attitude that is really distressing. I see this all the time in the clinic because women who haven’t met their life partner and who don’t want to parent alone, feel like they’re left with no choice and they may never become a parent. Egg freezing of course doesn’t guarantee that one day someone […]

How to Boost Fertility Naturally in Your 30s-image

How to Boost Fertility Naturally in Your 30s

Age is a big factor when it comes to fertility, but on the whole, people are having children much later than previous generations—some well into their 30s. If you’re looking for advice on how to boost your fertility naturally in your 30s, there are several things you can do. Read on to find out.  Quick facts: Fertility in your 30s Age is a big factor when it comes to fertility and we’ve all heard of the infamous biological clock. In other (more scientific) words, your biological clock refers to your ovarian reserve.  This is the number of eggs you have left and equally as importantly, the quality of your remaining eggs. Both of these factors unfortunately decline over time, significantly so after your mid-30s.  That’s not to say that you can’t have a very healthy and even easy pregnancy in your 30s, it’s just worth bearing in mind that as you get older, it becomes more difficult to get pregnant and to keep the pregnancy. Luckily there are many different types of fertility treatments, like egg freezing and IVF, which can help those who have more difficulty conceiving naturally.  When you’re trying to conceive in your 30s, whether you’re using fertility treatments or trying to get pregnant naturally, every little helps. Your lifestyle choices, nutrition, menstrual cycle awareness and mental health can play a crucial role in your fertility journey in your 30s, and at any age. Let’s take a look at some of the key lifestyle factors and medical factors that can help you on your journey. Medical considerations and check-ups Boosting fertility naturally in your 30s begins with a proactive understanding of your reproductive health. Regular medical check-ups, including hormone and fertility testing, can help you to understand if any underlying conditions may be affecting your reproductive health and help you address any potential hurdles to pregnancy. Lots of healthcare providers recommend only visiting a fertility specialist if you’ve been trying to get pregnant for a year without success, but you don’t need to wait that long.  While some couples have no trouble conceiving, 1 in 6 heterosexual couples face fertility struggles. Knowing your body from the inside out means you can seek support and advice faster with all the facts, should you need it. When it comes to getting pregnant in your 30s, timing is everything. By taking charge of your reproductive health through regular check-ups and fertility screenings, you equip yourself with the knowledge needed to optimise your chances of a successful pregnancy.  You may also want to consider getting a pelvic ultrasound scan to give you your definitive Antral Follicle Count (AFC). This gives you a clear and accurate picture of your remaining ovarian reserve Lifestyle changes to boost fertility Despite common misconceptions, you can implement lots of lifestyle changes to help support your fertility and reproductive health. While some aspects of fertility are out of our control, there are actions you can take to improve your chances of getting pregnant in your 30s, with and without fertility treatments. Lifestyle changes can help to boost your fertility naturally. Choosing a well-balanced and nutritionally rich diet, doing regular physical exercise, managing your stress and getting enough sleep can all support your fertility. Physical exercise to boost fertility Getting at least 150 minutes of physical exercise a week is important for supporting overall health—physical and mental.  Broken down, that could look like five 30-minute workouts, a week. This can be anything from a brisk walk to a gym session, yoga, swimming—or any kind of movement that’s right for you.  30-60 minutes of physical exercise per day was shown to reduce the risk of anovulatory infertility (infertility due to an ovulation disorder). Exercise not only balances your hormones, but it can boost your mood, help you manage stress and support your energy. However, being underweight, or doing vigorous physical exercise (more than 60 minutes a day) combined with eating in a calorie deficit, can negatively impact your fertility. This can have a knock-on effect on your hormones, which can lead to irregular periods and ovulation. Your menstrual cycle relies on a delicate hormone balance, and if your weight is too low or too high can throw them out of sync affecting your chance of conceiving. Stress management strategies for fertility Stress can also throw your hormones off balance, causing irregular periods and ovulation. It might also affect your desire to get intimate and reduce your sex drive.   Manage stress to boost fertility in your 30s by identifying coping strategies that work for you. You could try relaxation techniques like breathwork, yoga, meditation and mindfulness to help you relax.  If you find that self-help measures are not helping out, you can always consider seeking professional help.  The connection between sleep and fertility It’s recommended to get between 7-10 hours of sleep every night regardless of your health concerns. Sleep is associated with better health outcomes all round, including reproductive health.  So, how does sleep affect our fertility? A lack of sleep can cause your circadian rhythm (responsible for your sleep-wake cycle) to become dysregulated. This can cause knock on affects for your hormones and in turn your menstrual cycle and fertility.  One study revealed that in a survey of nurses of reproductive age, 53% reported menstrual cycle changes while engaging in shift work. To get a healthy sleep routine, try switching all screens off two hours before bedtime, and have a wind-down routine which could include a hot bath, calming tea, stretching or bedtime yoga. Try to stick to a schedule by going to bed and waking up around the same time each day, so your sleep-wake cycle is regulated. It’s usually easier to fall asleep when it’s quiet, dark and cool, but test different sleep environments to see which works best for you. Morning sunlight is proven to improve your ability to sleep too. Exposure to sunlight in the first hour of waking for 10-30 minutes a day, and in the afternoon as the sun is setting, […]

10 Fertility Myths You Need to Know-image

10 Fertility Myths You Need to Know

Myths are everywhere when it comes to reproductive health and fertility. But how can we dispel fact from fiction? Here we’ve broken down some of the most prevalent fertility myths and swapped in the facts. Read on to find out.  Quick facts: What are the most common fertility myths? Fertility myths are everywhere. This is in part due to the lack of education and awareness surrounding reproductive health, exacerbated by today’s age of online misinformation.  From questions around age and gender to addressing whether contraception or lifestyle factors can really cause infertility, we’ve broken down some of the most common myths and corrected them with evidence-based facts.   Let’s get into it… Myth 1: Infertility only affects people over 35  Age is the most important factor in determining female fertility. This is because we are born with all the eggs we will ever have. As you get older, the number and quality of your eggs will decline.  As you approach your mid-30s the rate of decline increases which makes it more likely that you might experience difficulty getting pregnant.   However, this doesn’t mean that you can’t experience fertility issues before that. There are causes of infertility that can happen at any age, like PCOS, endometriosis, pelvic inflammatory disease, fibroids, and cancer treatments like chemotherapy and radiotherapy exposure. If you’re under 35 and have been trying to conceive for a year with no success, you should seek medical advice. You should also seek help after 6 months if you’ve been trying to conceive and are over 35 or have an underlying health condition.  Myth 2: Infertility only affects women and those assigned-female-at-birth This is simply not true. About one-third of infertility cases are due to male factors, another third have inconclusive or unknown causes, and the remaining third are due to female factors.  There are a variety of reasons that can cause male infertility such as poor sperm quality, number, and erectile dysfunction which can cause issues when trying to get pregnant. While male fertility isn’t limited by age (and some men can father children well into their 60s and 70s), it doesn’t mean that male fertility is limitless. Myth 3: Male fertility doesn’t decline with age Just like female egg quality, sperm quality declines with age. There’s an increased risk of miscarriage, birth defects and autism with increased paternal age.  Hormonal changes can affect male fertility, affecting sperm production, mobility and motility. This is essentially the ability for sperm to move and swim towards the egg.  Myth 4: Infertility won’t be a concern if you’ve already been pregnant Unfortunately, even if you have had one or more children previously without any issues, you still might struggle to conceive or give birth in the future. If you are struggling to conceive after having a child, this is called secondary infertility and affects approximately 10% of people. Secondary infertility can be caused by factors such as age, complications from a previous pregnancy, medical treatment or damage to your reproductive organs.  If you’ve been trying to conceive again for some time without success, seek medical advice. Myth 5: Irregular periods mean you’re infertile  Irregular periods are common, but it’s possible to become pregnant even if you have them.  Lots of factors impact the regularity of your periods and menstrual cycle. Stress, sleep disruptions, changes to your exercise routine, medication and more can impact your hormonal balance. Irregular periods can mean irregular ovulation, which can make trying to conceive difficult because it is more difficult to know when your fertile window is. In this way, irregular periods can impact fertility.  Irregular periods, coupled with heavy, painful or infrequent periods (if they happen more than 35 days apart), can be a sign there’s something else going on. If this is the case, it’s worth getting a hormone and fertility test to understand if there might be any underlying hormonal issues that might be causing your symptoms. Myth 6: Long-term contraception will negatively impact your fertility The idea that hormonal contraception will cause infertility is a very common misconception, but thankfully it’s not true. Whether you’re on the pill, have an implant, an IUD (the coil) or the injection, the evidence suggests that there is no permanent impact on your fertility. Depending on the type, your use of hormonal contraception may temporarily suppress your ovarian reserve. It can take several months for both your ovarian reserve and periods to return to what is normal for you.  For example, if you’ve been on the pill, it could take 2-3 cycles for things to return to normal. If you were on the Depo injection, it might take up to 8-12 months. This is because it takes time for your hormones to get back to baseline. So, whilst there is no evidence to suggest that hormonal contraception can impact fertility in the long term, it’s worth knowing your body may need time to get back to normal when planning future pregnancies. Myth 7: Your lifestyle doesn’t matter because it’s all about sex  For conception to occur, sperm must meet the egg to become fertilised. So for those conceiving in a heterosexual relationship, this means you need to have sex at the right time—after you’ve ovulated. But this is not the only factor that impacts fertility. Leading a healthy lifestyle including exercising in moderation, eating a healthy, balanced diet, keeping stress to a minimum and avoiding or limiting alcohol and smoking may shorten the time it takes to get pregnant. If you need personalised diet recommendations to support fertility, you can speak with one of our fertility nutritionists. Myth 8: The more sex you have, the better your chances of conceiving Your fertile window exists only around ovulation—in the 6 days leading up to ovulation, the day of ovulation, and the day after.  This is because of the limited lifespan of both your eggs and sperm. Your egg will only survive about 2-24 hours after ovulation if not fertilised, while sperm can survive in the genital tract for up to […]

Fibroids 101: Signs, Symptoms and Treatments-image

Fibroids 101: Signs, Symptoms and Treatments

Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime. But what are fibroids, how do we look out for symptoms and what are the treatments if we’re diagnosed? Read on to find out.  Quick facts: What are fibroids? Uterine fibroids are benign or non-cancerous growths in and around the uterus, or womb. They are made up of fibrous muscle tissue and are extremely common. Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime (1). Your risk of developing a fibroid increases with age and if you: Where do fibroids grow? Fibroids can vary in size and you may have one or multiple fibroids. They can develop as singular fibroids or as clusters. There are three different types of fibroid, depending on where in the body they grow: Signs and symptoms of fibroids Not all people who develop fibroids experience symptoms. Most are actually asymptomatic and have no symptoms at all. Only approximately 1 in 3 people with fibroids will experience symptoms. The symptoms of fibroids can include: What causes fibroids?  Unfortunately, like many reproductive health conditions, the exact cause of fibroids is unknown. What we do know though, is they’re affected by oestrogen and progesterone—two hormones important for regulating the menstrual cycle. After menopause, when oestrogen and progesterone levels drop, fibroids tend to shrink (3). How are fibroids diagnosed? To diagnose fibroids you’ll need a pelvic ultrasound scan. Usually, your doctor will discuss any symptoms you’ve been experiencing with you first. Then they’ll carry out an abdominal examination to look for any areas of tenderness or masses in your abdomen, before referring you for a scan.  The ultrasound will look at your reproductive organs including your uterus, Fallopian tubes, ovaries and general pelvic area. This can be done either transvaginally (through the vagina) or transabdominally (looking at your uterus through your abdomen). A scan is the only way to definitively diagnose fibroids and to determine their size and location. You may also be offered a blood test to screen for iron deficiency anaemia, which is a condition that can occur as a result of heavy bleeding.  Because lots of people with fibroids don’t experience symptoms, often fibroids are found coincidentally. This could be during an ultrasound for a pregnancy or another suspected condition. Black women have an increased risk of developing fibroids Black women are three times more likely to develop fibroids than white women. They’re also more likely to be diagnosed with fibroids at a younger age, have a longer duration of symptoms and have larger, more rapidly growing fibroids. Although the increased risk of fibroids in Black women is known, there’s been little research conducted to understand why this is. Some research suggests genetics, such as Vitamin D deficiency in Black women (4) could be a link. Other research has suggested certain environmental factors could be linked. These include exposure to chemical relaxers, used for afro-textured hair, which have been linked to a higher risk of developing fibroids (5). Will fibroids affect my fertility? Some fibroids can cause problems with fertility (6). This largely depends on their size and where they are located.  Fibroids can affect the structure of the uterus and its surrounding organs. Meaning they can prevent sperm from fertilising an egg or prevent an embryo from implanting. However, lots of people with fibroids do not have any difficulties getting pregnant. How are fibroids treated?  Treatment for fibroids depends on:  If you have fibroids that are not causing symptoms and aren’t likely to affect your fertility, then generally no treatment is required. But if you begin to experience any new symptoms, it is really important to go back to the doctor to have a check-up.  The treatment methods for fibroids can be broken down into non-surgical and surgical methods. Non-surgical methods If you commonly experience heavy periods as a result of your fibroids, you may be given medications such as tranexamic acid. This is a medication which breaks down blood clots in the womb. You may also be given anti-inflammatory medications, like ibuprofen or an oral medication called Ryeqo. The combined oral contraceptive pill and hormonal IUD can also be prescribed to help you have lighter, less painful periods.  As well as treating heavy periods directly, you may also be given a gonadotrophin-releasing hormone (GnRH) analogue. This is to try and shrink your fibroids and is also commonly prescribed before any surgical treatment.  GnRH analogues work by reducing your levels of oestrogen. Low levels of oestrogen can lead to several other long-term complications, so this method can only be used for a short period.If you have larger fibroids, you may be offered a procedure called Uterine Artery Embolisation. This is used to block the arteries which supply blood to the fibroids. If you have smaller fibroids, you may also be offered a procedure which removes the lining of the womb called Endometrial Ablation. Surgical methods There are various surgical techniques which can be used to treat fibroids. Surgery can be explored if medical treatments don’t work for you or aren’t suitable in the long term.  You may be offered one of the following surgical treatments for fibroids:  What type of procedure is most suitable for you depends on the location, size and number of your fibroids. Each varies in terms of invasiveness, risks and its potential effect on fertility. Some people’s fibroids may grow back after surgery, known as ‘recurrence’.  Suspect you may have fibroids? As the symptoms mentioned above are commonly experienced in various types of pelvic issues, they may be linked to other causes apart from fibroids.  If you’re suffering from painful periods or any of the above symptoms, it’s important to get your hormones tested, to rule out a hormonal cause. This, alongside a pelvic ultrasound scan, can help you get to the bottom of symptoms and get a recommended care plan based on your biology.  If you’ve been diagnosed with fibroids, you can also talk to our team of […]

Research News: Fertility Preservation Outcome Study in Cancer Patients-image

Research News: Fertility Preservation Outcome Study in Cancer Patients

Recent research conducted by some of our Hertility Team, led by one of our co-founders Dr Natalie Getreu, has been published in the Fertility and Sterility Journal. Fertility can be affected by cancer and cancer treatment to such an extent that women may have reduced family planning options once they’ve completed their treatment. Although, records of the success of fertility preservation methods in cancer patients are not routinely collected by hospitals, fertility clinics or researchers. Instead, when it comes to egg and embryo freezing, clinicians routinely use success rates from patients that have undergone fertility preservation for social reasons as opposed to medical reasons. Therefore, our research team aimed to look into pregnancy outcomes in cancer survivors who had used their frozen tissues to provide more up-to-date and relevant information for these patients. Check your fertility The results revealed that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. At Hertility we are so proud to not only offer new and different care pathways for women but also to be home to so many amazing researchers. So we thought in this article we would take you through the research, and the findings and explain them to you. After all – knowledge is power! First up, let’s recap on fertility preservation…. We’ve already published an article that covers all the different types of fertility preservation for people with ovaries but here is a brief sum up: There are both medical and social reasons to undergo fertility preservation.  Medical fertility preservation means preserving parts of your fertility in people who might lose their ability to reproduce due to upcoming medical treatment, for example, cancer patients about to undergo chemotherapy/radiotherapy or people undergoing gender reassignment surgery, or for some who have an autoimmune condition that want to protect their fertility. Whereas, social fertility preservation is when you are opting to freeze your eggs because of social and age-related factors. There are several different fertility preservation methods, some of which include: Egg freezing – This is what it says on the tin: collecting your egg cells and putting them on ice for later use. Embryo freezing – This process involves fertilising your collected egg with IVF using either donor’s or your partner’s sperm and then the resulting embryo is frozen until you are ready to use it. Ovarian tissue cryopreservation – This method is created mostly for younger patients who have not yet gone through puberty and are therefore not able to fully mature their egg cells. Tissue containing immature eggs is cut from their ovaries and is preserved in a tissue bank until the tissue can be re-implanted and used at a later stage, however, this is not routinely used for the general population. There are more fertility preservation options but in this study, researchers only included cancer patients who had undergone oocyte, embryo or ovarian tissue cryopreservation (freezing) What did this study do? Researchers followed cancer patients that had both fertility preservation and then had fertility-damaging cancer treatment (gonadotoxic therapy) who were now looking to start a family using their cryopreserved oocyte, embryo or ovarian tissue. The main outcomes this research looked at were if there were clinical pregnancies (clinical signs of the foetus can be either seen or heard), miscarriages (pregnancy loss) and live birth (completed pregnancies that result in a live birth). What were the results? This study found that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. (In science it’s all about whether a difference is significant or not!).  Also high clinical pregnancy rates and live birth rates were observed in all techniques. They also found that freezing ovarian tissue results in significantly less miscarriages than embryo freezing, which is interesting and is something to further investigate! What do these results mean? Like anything in science, there are limitations in the study and this research does report some limitations since it was an early analysis. However, this is a really important and interesting starting point in this area of research and for cancer-related fertility preservation.Researchers hope that this study helps to establish better reporting of outcomes in cancer patients and will encourage clinicians to use appropriate statistics and information to counsel women who find themselves facing a cancer diagnosis on their chances of biological motherhood. If you fancy having a read of the article yourself, have a look here! At Hertility, we are dedicated to revolutionising women’s healthcare, whether that be through improving care pathways, helping women receive answers about their bodies through our at-home tests or contributing to the Women’s Health research. It’s all part of our mission for a #ReproductiveRevolution.

Egg Freezing Process: What is it and is it Right For Me?-image

Egg Freezing Process: What is it and is it Right For Me?

Egg freezing is a fairly new procedure, allowing you to preserve your fertility. But what exactly is egg freezing and what does the egg freezing process entail? Read on to find out. Quick facts: Egg freezing There’s no doubt about it, egg freezing has become a biology buzzword. And with good reason too.  Egg freezing can be a great option for many people, including those of us who want to become parents one day but aren’t quite ready to take the plunge just yet. Or those who have a reproductive health condition that could affect their fertility.  But what exactly is egg freezing? And how do we know if it could be right for us? Before we jump into the egg freezing process, let’s quickly recap on why we even need egg freezing in the first place. What is your ovarian reserve? As people with ovaries, we’re born with all the eggs we’ll ever have—known as our ovarian reserve. Unlike men, who produce sperm throughout their life, women have a limited supply of eggs.  We are all born with around 1-2 million eggs but by the time we hit puberty, we have around 300,000 left and this slowly declines as we get older. This decline increases more sharply post the mid-30s. Unfortunately, as we age, both the quality and quantity of our eggs decline (cheers biological clock). This means that as we get older, we stop ovulating as consistently and the eggs we do release aren’t quite the spring chickens they once were. So, as we age and our ovarian reserve declines, getting pregnant naturally also becomes harder. What is egg freezing? Egg freezing is what’s known as a ‘fertility preservation method’ that quite literally involves putting your eggs on ice for later use. Egg freezing involves using fertility medication which stimulates your ovaries to produce multiple mature eggs. Those eggs are then removed from your ovaries and frozen and stored in a laboratory, until you’re ready to use them. Eggs are frozen in what’s known as an ‘egg freezing cycle’. You may want to do multiple rounds to increase your chances of retrieving a larger batch of healthy eggs.  How many eggs can you freeze in one cycle? The number of eggs you can freeze in one cycle depends on how many eggs you’ve got left, how well you respond to the fertility medication and how successful the retrieval is.  Some retrievals will, unfortunately, yield no eggs that are suitable for freezing. Whilst in others, you may be able to retrieve dozens of eggs.  The whole process is what’s called an ‘egg freezing cycle’. We will explain each stage in detail below. It’s important to note that egg freezing is not a fail-proof method and its success relies on healthy eggs. The egg freezing process Step one: Blood tests and scans First things first, you’ll undergo several different blood tests to check your reproductive hormone levels as well as testing for infections like HIV, hepatitis B and hepatitis C.  Testing your Anti-Müllerian Hormone (AMH) levels can also give you a good initial indication of your ovarian reserve and how viable egg freezing is for you. You will also have a pelvic ultrasound scan to assess your ovarian reserve better by having a look at the number of follicles in your ovaries, known as the antral follicle count (AFC) i.e. an estimate of your egg count.  This step is also essential for deciding if this process is right for you and whether you have enough eggs to successfully do an egg freezing cycle.  Step two: Ovarian stimulation Depending on the results of your blood work and scan, your doctor will work out the best protocol, dosage of medication and how many cycles you might need.  You’ll be given fertility medication that will stimulate your ovaries. Your ovaries usually mature and ovulate only one egg during each menstrual cycle, but this medication encourages them to mature more eggs so multiple eggs to be retrieved.  During this simulation period, which is usually around two weeks, you’ll need to attend pelvic ultrasound scans and take blood tests regularly to monitor the growth of the follicles which house your eggs.  When your doctor thinks your eggs are ready, you’ll be given a ‘trigger injection’ which matures your eggs fully, readying them for collection. The timing of this injection is important and the egg retrieval usually happens 36 hours afterwards. Step three: Egg retrieval It’s time to collect those eggs. You’ll undergo a minor egg retrieval surgery performed under general anaesthesia or sedation. A long, thin ultrasound-guided needle is inserted via your vagina to retrieve your eggs.  You can go home after an hour or two of the procedure. Some people do return to work the next day, while others also rest the day following the retrieval. You might feel slight pain or discomfort and notice some spotting after the procedure. Your doctor will guide you on aftercare. Step four: Freezing, storing and thawing Once your eggs have been collected, they’re passed onto an embryologist who checks they’re all good to go. They will then freeze (cryopreserve) your eggs in a method called vitrification. Your frozen eggs will be stored in your fertility clinic to be later thawed whenever you’re ready to use them. What happens when I’m ready to use my eggs? When you’re ready, your frozen eggs will be thawed, fertilised with sperm, either from your partner or a donor if needed, and allowed to develop into embryos in the lab before being transferred into your uterus via a thin, flexible catheter.  Sometimes people may opt to undergo add on testing such as genetic testing of the embryos before they are transferred to select the best quality embryo. This is not a required step, may not be recommended for everyone and may have an additional cost. Who is egg freezing for? Technically, anyone with ovaries. There are many, many reasons why we might decide to freeze our eggs. Maybe we’re worried about […]

How to support LGBTQ+ employees-image

How to support LGBTQ+ employees

Deciding to start a family is never an easy process, but for some employees who identify as part of the LGBTQ+ community, their journey to parenthood might need some more support.  Being a 21st-century employer means establishing an inclusive, progressive and supportive work environment to attract and retain employees. A 2017 study by Mercer found that 33% of UK respondents do not offer equal benefits to LGBTQ+  employees because they do not know how to implement such a benefit!  Here are some ways to provide support to your LGBTQ+ employees in their fertility journeys Partner with experts like Hertility to raise awareness about the advances in fertility treatments such as IVF (in vitro fertilisation), IUI (intrauterine insemination), surrogacy, etc., that made it possible for LGBTQ+ couples to have biologically related children. Refer your employee to resources like Hertility that may help them understand the basics of all things reproductive health will make them more confident in their reproductive journeys. Gender-affirming treatments can impact fertility, and therefore, many require fertility preservation, such as banking eggs, sperm or embryos before medical transition. With the number of NHS-funded cycles declining rapidly, LGBTQ+ couples have to fulfil extensive criteria before being eligible for a funded cycle, because of which,  many are opting for private treatment, where the average cost per cycle can be about £5,000, varying significantly depending on the treatment options chosen and the clinic (HFEA). Listen to feedback from employees,  ask them what they would want to feel more supported in their choices and try to develop policies around them. Establishing fertility benefits policies – covering proactive fertility testing, fertility treatment or egg freezing costs or providing low-interest loans – can help align your interests with your employees, supporting their individual journeys to parenthood, facilitating equality, diversity and inclusion. If you have existing family planning and health benefit policies, revisit the language and clauses to ensure LGBTQ+ employees are eligible for the equal benefits to support them as they embark on their parenthood journey, whether that be through fertility treatment, surrogacy, adoption, or parental leave. Hertility can help train your staff on all things related to policies.  About Hertility Health Hertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer with a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website. Trusted resources:https://www.imercer.com/uploads/dmi/2017_lgbt_sample.pdfhttps://www.bpas.org/media/3484/bpas-fertility-investigation-nhs-funded-fertility-care-for-female-same-sex-couples.pdf    

Understanding the Causes of Infertility-image

Understanding the Causes of Infertility

For many, the journey to parenthood can be a challenging process, both physically and emotionally. We’re here to help you understand the different causes of infertility, and the options available for those who need support. Quick facts: What is infertility? Infertility is defined as not being able to conceive after one year (or longer) of trying. This could be despite having regular unprotected sex with a partner, or trying using methods like artificial insemination (IUI).  There are 2 types of infertility: In the UK, as many as 1 in 7 heterosexual couples experience infertility, yet the causes are sometimes preventative, or treatable.  Causes of infertility  There can be many different reasons why you might struggle to conceive. This can include structural fertility issues, ovulation problems, underlying health conditions and hormonal imbalances. Let’s take a look at each. Ovulation issues  Anovulation, also known as the inability to ovulate, is the most common cause of infertility. Ovulation is when a mature egg is released from one of your ovaries, each month, during your menstrual cycle. The egg travels into the Fallopian tube, where it prepares to be fertilised by a sperm, before then travelling down the tube to the uterus.  When trying to conceive, ovulation is a crucial event, with the 5 days before ovulation and ovulation day itself often referred to as your ‘fertile window’.This is the time of the month when you’ll be most likely to get pregnant.  Research suggests that as many as 25% of infertility cases are caused by anovulation. Anovulation can be caused by: Another possible explanation is a problem with the egg maturation process. This means that an “immature” egg may be released from your ovaries when it is not quite ready and unable to fertilise. Underlying health conditions Polycystic ovary syndrome (PCOS) PCOS is the most common underlying condition affecting fertility. PCOS affects as many as 1 in 10 people with ovaries.  People with PCOS produce higher levels of androgen hormones, like testosterone. This can disrupt your menstrual cycle, ovulation, and balance of cycling hormones—like oestrogen, follicle-stimulating hormone and luteinising hormone (LH). As PCOS is still under-researched and misunderstood, many people are left undiagnosed and are unaware they have it until they are actively trying to conceive. This is why it’s a good idea to check in on your hormones before you start your conception journey.  Primary ovarian insufficiency (POI)  POI is when the ovaries stop working properly before the age of 40. POI is far less common than PCOS, affecting only 1 in 100 women younger than 40. Your ovaries produce oestrogen and progesterone—two cycling hormones responsible for the regulation of your menstrual cycle. When their function is disrupted, ovulation can also become disrupted or stop completely.  People with POI also have a lower ovarian reserve, meaning fewer eggs for their age. Without a sufficient amount of eggs and the correct level of hormones needed to regulate your cycle, the possibility of conceiving is reduced considerably. According to the National Infertility Association, POI can be caused by genetics, autoimmune factors, induced by chemo or radiotherapy, or it can have an unknown cause. Uterine fibroids Uterine fibroids are noncancerous tumours that affect as many as 25% of people with a uterus. They can cause symptoms such as heavy periods, intermenstrual bleeding, and pelvic pain. In some cases, depending on the location in which they grow, and whether they affect the shape of the uterus or cervix, fibroids can also cause infertility.  This is because they can block the fallopian tubes, stopping eggs from meeting sperm, or reaching the uterus for implantation. They can also get in the way of implantation if they are near the inner lining of the womb.  Despite being less common than other causes of infertility, around 5-10% of infertile women and those assigned female-at-birth are found to have uterine fibroids, with their instance being much more common in Black women.  Endometriosis Endometriosis is a common reproductive health condition that affects around 1 in 10 women and people assigned female-at-birth. With endometriosis, tissue similar to the tissue that makes up the lining of the womb starts to grow in other places, such as the ovaries and the fallopian tubes, causing lesions and scarring.   This can cause several life-altering symptoms, such as painful and heavy periods, pain during or after intercourse and pelvic pain. It is also another common cause of infertility, with research suggesting it is present in around 20-50% of infertility cases. The exact link between endometriosis and infertility is unknown. However, some theories suggest that lesions and scarring can cause structural problems with the reproductive organs and chemical changes in the lining of the uterus. Structural infertility  Structural infertility is a problem with the anatomical structure of the reproductive organs. This can include blockages, structural damage or abnormal growth in the fallopian tubes, uterus or ovaries.  Structural issues with the ovaries or fallopian tubes can prevent eggs from being released from the ovaries or stop them from moving through the fallopian tubes to reach a sperm for fertilisation.   Additionally, if the structure of your uterus is abnormal or damaged, it may prevent eggs from implanting into the endometrium (uterus lining). This is needed to create a healthy embryo and pregnancy.  Structural infertility problems can also be caused by scarring from surgery, infections, injuries, or endometriosis.  Also, the growth of noncancerous tissues such as uterine polyps on the lining of the uterus, can cause blockages. Polyps occur when additional tissue grows on your uterus. However, sometimes tissue grows elsewhere in your reproductive system potentially blocking your fallopian tubes and preventing pregnancy.  Implantation failure Other possible explanations of implantation failure are: Infections and auto-immune disorders  Untreated sexually transmitted infections (STIs) may have serious consequences for your fertility. STIs like chlamydia or gonorrhoea can cause scarring and blocking of your Fallopian tubes.  Additionally, if syphilis is left to develop, it can cause stillbirth. There are also other forms of infections of the cervix with human papillomavirus (HPV) that could cause infertility. It’s […]