Category: Reproductive Health Basics

For LGBTQIA+ individuals and couples, family forming is never straight forward. Luckily there are lots of fertility treatments and options out there. We’ve put together a list of the different options available, whether you’re looking to embark on family forming now or in the future.  Quick facts: IUI and IVF are popular fertility treatments for couples where both individuals are assigned female-at-birth (AFAB). Shared motherhood can also be an option for AFAB couples where both individuals can physically participate in the process. Surrogacy is another option where an individual offers to carry a baby for a couple or another person.  Adoption can be a hard but hugely rewarding process for those who don’t want to undergo fertility treatment. Sourcing sperm for fertility treatment There are three options for sourcing sperm in the UK:  A licenced sperm bank  A fertility clinic  From a consenting individual, you know personally If you source your sperm through a HFEA-licensed UK fertility clinic or sperm bank, your donor will have been vetted and their medical history checked. This includes infections such as HIV and hepatitis or a history of any genetic disorders.  The clinics will also be able to offer support and legal advice and each donor is only allowed to donate sperm to make up to 10 families.  If you’re planning on bypassing a licensed clinic or sperm bank and using donated sperm either from a known donor or another source, it’s recommended to ask the individual to carry out their own medical checks before donation. With using sperm from someone you know personally, there are legalities around who is the legal father of the child. It’s important to research this option thoroughly if this is a route you’re choosing to go down.  If you would like to use a known donor but would still like all the legal protections around parenthood, you will still be protected if you carry out the insemination at a clinic. Intra-uterine insemination (IUI)  Intra-uterine insemination (IUI), also known as artificial insemination, is a type of fertility treatment that involves injecting sperm into the uterus (womb) using a special syringe-like device called a catheter.  IUI is a commonly used fertility treatment for same-sex female couples, where one (or both) partners want to carry a child. For IUI, you’ll need to source some sperm—either through a licenced sperm bank or fertility clinic, or some couples opt to use a sperm donor that they know personally.  As long as you are ovulating regularly and have no issues with your Fallopian tubes you should be eligible for IUI.  However, IUI may not be recommended for you (or your partner) if you: Have blocked Fallopian tubes due to a pelvic infection or an underlying condition  Have decided you’d like to do shared motherhood (one partner’s eggs and the other partner carrying the pregnancy)  Have a low number of eggs (low ovarian reserve) Are in your late 30s or over 40 (with age the number of available good quality eggs naturally decreases, as do the chances of success, so IVF might be more appropriate) Couples have the choice for the insemination process to take place in a licensed clinic, or they may opt to do this in the comfort of their own home to save them money and time. But, there are some legal risks if you choose this second option. IUI is thought to be a less invasive and more natural process than IVF because it doesn’t involve as many medications. In vitro Fertilisation (IVF)  IVF is a fertility treatment where eggs are removed from the ovaries and fertilised with sperm in a lab. If an egg is successfully fertilised, the resulting embryo is transferred into the uterus.  IVF is another popular fertility treatment for same sex-female or gender-diverse couples and is one of the most common in the UK. Again, it requires a sperm donor which can be sourced from a licenced sperm bank, fertility clinic or someone you know personally.  IVF also forms part of the shared motherhood and surrogacy process. Shared Motherhood Otherwise known as Reciprocal IVF, shared motherhood is where eggs are collected from one partner, fertilised in a lab with donor sperm, and the resulting embryo is transferred to the other partner’s uterus for them to carry the baby.  Shared motherhood can be a great option for couples where both individuals have working female reproductive anatomy, allowing for both partners to be physically involved in the family-forming journey. Not all fertility clinics offer this treatment and eligibility depends on various factors such as your age, weight, lifestyle and medical history. Surrogacy Surrogacy is where an individual agrees to carry a child on behalf of another person or couple.  Traditional or partial surrogacy involves the surrogate’s eggs being fertilised using the sperm from someone within the couple, to create the biological link to one of them. This is often used by male same-sex couples looking to form a family.  Full or gestational surrogacy is when the eggs of the intended mother or a donor are used, and therefore, there is no genetic connection between the surrogate and the baby.  Whilst surrogacy is legal in the UK, it is an altruistic process. Essentially this means it is illegal for a surrogate to receive any monetary gain from helping you on your journey to parenthood, and it is even illegal to advertise seeking a surrogate. A surrogate can receive expenses.  There are a lot of other complicated legal issues to note about surrogacy. The most important is that the surrogate is the legal mother of the child when it’s born. This is even if the eggs and sperm used in the process are yours or were donated, and the carrier is not genetically related to the child.  The surrogate has rights over the child until you receive a parental order from the court – so of course, it is vital to choose someone you trust. For these reasons, it is common for a close friend or family member to carry […]

Hypothalamic amenorrhea (HA) is when your menstrual cycle and ovulation are interrupted due to the influence of the hypothalamus gland, located in the brain.  In this article we run through common symptoms, the causes and treatment options available. Quick facts: What causes hypothalamic amenorrhea? The hypothalamus is a small region of the brain that plays a crucial role in lots of important bodily functions. It controls the release of certain hormone and helps to regulate body temperature, sleep patterns, hunger and the menstrual cycle.  It is a commonly occurring condition in women with eating disorders, athletes or dancers or those with a low body mass index (BMI) Hypothalamic amenorrhea is caused specifically by issues in the functioning of the hypothalamus. The function of the hypothalamus can be disrupted by lots of different things, usually lifestyle factors.  Common disruptors include: Symptoms of hypothalamic amenorrhea Common symptoms include: What causes menstrual cycle disruption When you eat too little or exercise too much, the body perceives this as stress. This can lead to severe fluctuations in a hormone called gonadotropin-releasing hormone (GnRH). This is the main hormone regulated by the hypothalamus.  GnRH influences the production of other hormones, including those involved in the regulation of the menstrual cycle.  Follicle-stimulating hormone (FSH), needed to mature an egg each cycle and luteinising hormone (LH), needed for the release of the mature egg each cycle, can become disrupted as they both rely on GnRH.  FSH and LH, in turn, regulate oestrogen and progesterone production by the ovaries. Oestrogen helps the eggs to mature and progesterone prepares the uterus lining for a fertilised egg. Typically, a rise and fall in FSH, LH, oestrogen and progesterone is what controls the menstrual cycle. If a disruption happens at the hypothalamic level, the hormonal cascade is affected, resulting in low FSH, LH and oestrogen. Essentially, this is just your body trying to protect you. It’s putting your basic energy needs ahead of your reproductive health, which is why your periods become irregular. How can hypothalamic amenorrhea be diagnosed? It is usually a “diagnosis of exclusion,” which requires healthcare providers to rule out other conditions that could be interrupting the menstrual cycle. Your doctor may consider the following blood hormone tests to base their diagnosis on:  GnRH levels are tested to analyse the function of the hypothalamus, with a low GnRH result being indicative of a dysfunctional hypothalamus. Low levels of FSH, LH and E2, may also indicate hypothalamic amenorrhea.  High levels of prolactin can also lead to irregular or absent periods. Testosterone levels are analysed to eliminate the possibility of hyperandrogenism (high androgen levels) and Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS). Thyroid-stimulating hormone is analysed to rule out the influence of thyroid gland disorders. Human chorionic gonadotropin is purely tested to confirm or eliminate the possibility of pregnancy influencing your periods. Hypothalamic amenorrhea treatments If you’ve received a diagnosis of hypothalamic amenorrhea, your pathway to care and treatment options will usually be tailored according to the cause. Healthy lifestyle habits, diet and exercise routine modifications can help improve your symptoms, and make them more manageable. If you think you may be experiencing any of the symptoms above, reach out to us.  Hertility can help you with your initial hormone testing, along with a comprehensive Doctor-written report analysing your results. We can also support you with any onward care or treatments you may need, including tele-consultations with specialists.  Resources:

Folic acid is a vital preconception supplement. But what makes folic acid so important? How and when should you be taking it? We’ve broken down everything you need to know about folic acid for preconception care. Read on to get clued up. Quick facts: What is folic acid?  Folic acid is the man-made version of the vitamin folate, a form of vitamin B9. It is used by our bodies to make new cells and is needed to support the rapid growth of foetal tissues and organs in early pregnancy.  Unfortunately, our bodies do not store folic acid, which is why we must get our supply from certain foods and supplements. Why is folic acid important for pre-conception and pregnancy? Folic acid is important in helping your unborn child’s brain, skull and spinal cord to develop properly. It reduces the risk of potential neural tube defects, such as spina bifida, by 70%.  Whilst spina bifida is not that common, it can create significant problems for its sufferers that affect everyday life. These include problems with mobility and movement, bladder and bowel problems and learning difficulties.  Folic acid is also used to: When should you start taking folic acid? The advised amount of folic acid to take daily is 400mcg. However, some people may need a higher dose if they have a higher risk of having a pregnancy affected by neural tube defects.  You may have a higher risk if:  In these cases, your doctor will be able to advise the correct dosage you should be consuming to keep your child protected. Which foods contain natural forms of folic acid? You can also find the natural form of folic acid or folate, in certain foods. Introducing these to your diet will increase your folate levels: However, the amount of folic acid in these foods is often not enough to provide your baby with the best protection, so it is important to add the tablet form to your daily routine too. Understanding preconception nutrition If you’re looking for some help understanding your preconception or pregnancy nutrition, you can book a call with one of our Fertility Nutritionists.  Our nutritionists will work with you and recommend a personalised nutrition plan for your specific fertility goals, taking into consideration your medical history and lifestyle. Get in touch today if we can help.