Knowledge Centre

IVF can be a highly effective fertility treatment for some people, but it doesn’t guarantee a successful pregnancy. Here we cover what the IVF process entails, who could benefit from it and things to consider if you’re thinking about undergoing a cycle.  Quick facts: What is IVF? In-vitro fertilisation (IVF) is a fertility treatment for those who can’t or don’t wish to conceive naturally. It’s one of the most common fertility treatments in the UK, with as many as 50,000 people undergoing IVF in the UK each year.  IVF involves removing eggs from the ovaries, attempting to fertilise them with sperm in a lab and then transplanting any successfully fertilised eggs (embryos) into the uterus. This is called an IVF cycle. It’s an invasive procedure and doesn’t guarantee a successful pregnancy.  Whether or not it’s right for you will depend on a range of personal and medical factors, as well as carefully considering the IVF cycle process. Fresh cycle vs frozen cycle IVF cycles can be fresh or frozen. Once an egg has been successfully fertilised by a sperm in the lab, it creates an embryo. This embryo is then typically incubated in the lab for 3-5 days.  In a fresh cycle, it will then be transferred to the uterus. In a frozen cycle, the embryo will be frozen at this point and transferred to the uterus at another time. This might be done if your uterus isn’t prepared to receive an embryo, or if you had several embryos that were successfully fertilised, they will be frozen, rather than transferring more than 1 at time, which is associated with multiple pregnancies (expecting two or more babies from a pregnancy). Who is IVF for? IVF can benefit lots of different types of people. Some instances where IVF may be explored could be: What happens in an IVF cycle? There are four key stages involved in an IVF cycle—ovulation stimulation, egg retrieval, egg fertilisation and embryo transfer. The entire process may take between 4 to 6 weeks but will vary and depend on you. Ovulation stimulation Firstly, you’ll take a course of fertility medication to stimulate your ovaries to mature multiple eggs. Usually in one menstrual cycle, you’ll only release one egg for ovulation. But this medication stimulates many eggs to mature.  During this time you’ll need to go to the clinic regularly for ultrasounds and blood tests to analyse your progress. The simulation period generally lasts for around 10 days.  Egg retrieval and sperm collection Once your eggs are mature, you’ll undergo a retrieval procedure. Egg retrieval is carried out under ultrasound guidance, where a small transvaginal needle is used to suck follicular fluid  that contains your mature eggs, out of your ovaries. You’ll have the option to have the procedure done under general anaesthetic or mild sedation. Whilst your eggs are being retrieved, your partner or sperm donor will be required to go into the clinic and produce sperm cells which will be used to fertilise your eggs, unless your partner or donor sperm has previously been frozen. Egg fertilisation During the fertilisation step, your eggs and the sperm will be combined in a lab. The goal is for the sperm cells to break into and enter your egg cells where an embryo will be formed.  There are multiple techniques in which your eggs can be fertilised. One technique is called conventional IVF which involves placing the mature eggs in a petri dish full of sperm. Another technique is called intracytoplasmic sperm injection (ICSI), where one sperm cell is selected based on morphology and injected directly into your egg cell. The technique used depends on the sperm, clinic and whether or not you have attempted conventional IVF successfully or not before.   Embryo transfer If you undergo a fresh cycle, any successful embryos will be transferred 2-5 days later. If you have a frozen cycle, you will be given medication to prepare the uterus lining and depending on your progress, your doctor will determine a transfer date.  However, this doesn’t guarantee a pregnancy. The embryo will still need to successfully implant to your uterus. You will be given a pregnancy test roughly 2 weeks later, which can confirm whether or not the IVF process has been successful.  The process for an embryo to grow into a healthy baby and undergo live birth is a very complicated and precise journey. A certain number of chromosomes, which is our genetic information in the form of our DNA, is required for an embryo to develop into a baby.  The test that is used to understand and analyse the number of chromosomes in the embryo before implantation is called Pre-implantation Genetic Screening. However, many other screening techniques can be used too depending on your clinic. Is only one embryo transferred? If more than one egg is fertilised, your doctor will choose one to transfer, based on trying to assure the maximum possibility of a pregnancy. There are multiple criteria that the clinics use to determine this, including:  Sometimes you will be given the option to transfer more than one embryo. This may increase your chances of developing multiple pregnancies but again, doesn’t guarantee a pregnancy. Can you get IVF on the NHS? The NHS provides full funding for IVF for those who: Whether or not you are eligible for IVF under the NHS also depends on where you live as different trusts have different requirements and funding availability. You must discuss thoroughly with your gynaecologist or GP and if you are not eligible, there are many private clinics available for IVF treatments.  The cost for 1 cycle of treatment is roughly £5,000. This depends on the clinic you choose and the treatment protocol you follow.  How effective is IVF? Yes, IVF can be an effective fertility treatment and many women can successfully become pregnant and give birth to healthy babies via IVF. The success rate depends on a range of factors, including age, medical history, sperm quality and success rates of your clinic.  As younger women […]

We’re all sold the ideal of perfect skin by skin care companies. But sometimes the cause of our breakouts is more than skin deep. So how do we know if our skin troubles are hormone-related? Read on to find out. Quick facts: What is hormonal acne? Hormonal acne is acne or breakouts that are related to hormonal fluctuations or imbalances.  Typically hormonal acne is found on the lower face, cheeks and jawline chest, neck, shoulders and back. Hormonal acne can affect people of all ages. Whilst it’s common during puberty when lots of hormonal changes are occurring, it can also be common as an adult, especially for women and people who menstruate, due to hormonal fluctuations throughout the menstrual cycle. What causes hormonal acne? Your skin has many small glands, called sebaceous glands, that produce an oily substance called sebum. Sebum helps keep your skin supple, smooth and healthy.  These glands also have receptors for our sex hormones, particularly androgens like testosterone, and oestrogen. Both of these hormones stimulate the production of sebum. When excess sebum is produced, this buildup causes visibly oilier skin and can clog the pores, resulting in inflammation and acne breakouts. Hormonal acne and androgens When our bodies produce excess amounts of androgens, it can cause hormonal acne and other skin problems. If androgen levels are higher than normal, there is more androgen binding to the sebaceous gland receptors, promoting more sebum production.  There can be lots of reasons for elevated androgens. A common cause is Polycystic Ovary Syndrome (PCOS). Those who experience PCOS are more likely to experience excess androgen-related symptoms like acne, excessive facial and body hair growth (hirsutism) and skin darkening.  Trans and non-binary people who begin taking testosterone as part of their transition journey may also notice acne breakouts because of raised androgen levels. Hormonal acne and oestrogen Sebum production is also influenced by the menstrual cycle, specifically by the hormone oestrogen.  Oestrogen fluctuates throughout the menstrual cycle. It’s at its lowest level during your period and gradually rises to a peak at ovulation, around the mid-point in your cycle. Although the impact of oestrogen on the sebaceous glands is not fully known, it has been shown to suppress sebum production at high levels. Therefore when your oestrogen levels are higher, generally your skin will be clearer. This is why lots of people experience hormonal acne flare-ups just before or during their periods when oestrogen levels are low.  Oestrogen is also associated with increased collagen production, skin thickness, skin hydration and wound healing—which all contribute to clear-looking, healthy skin. After menopause, your oestrogen drops. Some people find that this drop causes hormonal acne and may also leave their skin dry, itchy and saggy. For some individuals, HRT to reduce the symptoms of menopause can also cause hormonal acne. How to treat hormonal acne? If you think you suspect you’re suffering from hormonal acne, there a number of treatments you can explore.  Firstly, if you’re not already, begin tracking when you have flare-ups and your periods. You can do this with a period tracking app or just using a calendar. This will help you to understand when in your cycle you’re getting flare-ups and whether it could be due to hormonal fluctuations during your cycle.  Testing your hormones will be able to give you answers as to whether you have raised androgen levels. Our advanced hormone and fertility test can help you identify any hormonal imbalances.  There are topical treatments available that can help with flare-ups, as well as some contraceptives like the combined pill that has anti-androgenic properties. Lifestyle changes like diet, exercise, stress and alcohol reduction can also have a significant impact.  If you’re struggling with your skin, don’t suffer in silence. Reach out to us and get on a plan to find the root cause of your skin issues. References:  

The menstrual cycle is an incredibly important process that governs female fertility and can be a signifier of your overall health. The menstrual cycle is made up of two separate cycles that each run from bleed to bleed. Here’s everything you need to know, from your period to the proliferative phase.  Quick facts: The Menstrual Cycle: More Than Just Your Period When we talk about the menstrual cycle, periods often steal the spotlight. But did you know that your period is just one small part of a much bigger process? Cultural stigmas, taboos, and limited sex education have left many people with gaps in their knowledge about the menstrual cycle. However, understanding your cycle is essential—not just for fertility but also for overall health because it’s intimately linked to your overall health. It can easily be influenced by other factors such as stress, diet, weight fluctuations, exercise, sleep, illness and medications. The American College of Obstetricians and Gynecologists (ACOG) has now classified the menstrual cycle as a vital sign—putting it right up there with your heart rate and blood pressure. So yeah, your menstrual cycle is a big deal. Period. What is the menstrual cycle?  The menstrual cycle starts on the first day of your period and ends on the first day of your next period. It is broken down into 2 main cycles, the ovarian cycle (happens in the ovaries) and the uterine cycle (prepares the uterus for pregnancy). Both of these cycles happen in tandem and are carefully regulated by your incredible cycling hormones—oestrogen, progesterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH). What happens during the ovarian cycle? During the ovarian cycle, one of your ovaries will develop an egg which will be released mid-cycle, during ovulation. The ovarian cycle includes three main phases, the follicular phase, ovulation and the luteal phase. Let’s look at each phase in detail. The follicular phase Day 1 of your period is counted as day 1 of your menstrual cycle—it’s also when the follicular phase begins.  For most people, this phase lasts around 10-16 days, ending mid-cycle, around ovulation. (although this can vary from cycle to cycle and person to person). Changes to the length of your follicular phase are usually the main reason why your cycle length may vary from month to month.  During the follicular phase, a few immature eggs in one of your ovaries are selected and begin to mature. The follicular phase kicks off when gonadotrophin-releasing hormone (GnRH) is made from your brain, which promotes the release of follicle-stimulating hormone (FSH).  FSH stimulates your follicles—little sacs in your ovaries containing immature eggs, and a few selected follicles will begin to grow and mature. As these follicles grow, they make oestrogen—the main female sex hormone.  Thanks to the rise in oestrogen, generally, this time in your cycle you’ll likely be feeling your best, most confident, sexy and unstoppable. However, not all of the follicles make it. Only one follicle will be picked as the chosen one for that month and the others will stop maturing. This chosen one is called the dominant follicle and will be prepped for release during ovulation. Ovulation Oestrogen gradually increases during the follicular phase and peaks around the middle of the cycle. This triggers the brain to make a hormone called luteinising hormone (LH).  A sudden rise in LH levels triggers ovulation, which is when the now mature egg will be released from the ovary.  Ovulation takes place 12-36 hours after the onset of the LH surge. The released egg will travel through the fallopian tubes, where it will wait in hopes of being fertilised by a sperm.   Ovulation usually happens around the middle of your cycle, if you’re having regular periods. This is usually estimated to be around day 14 of your cycle, but this is based on the assumption that everyone has a 28-day cycle, which is not always the case. Menstrual cycles vary in length and ovulation usually happens 10 to 16 days before the start of your next menstrual cycle. Your fertile window is the 5 days leading up to ovulation and the day of ovulation itself. This is when you’ll be most likely to conceive.  If you’re trying to conceive,, there are a few things you can use to track ovulation.  The luteal phase The luteal phase of the menstrual cycle lasts from the day after ovulation until the day before your next period. It lasts about 14 days. During this time, your progesterone levels rise, which causes the glands in the lining of your uterus to thicken. You might wonder why this is so crucial. If the egg released during ovulation was fertilised by a sperm, then it may travel down the Fallopian tubes and implant into the lining of the wall of your uterus. It helps if the lining of the walls of your uterus are thick and ready to provide nutrients so your fertilised egg can attach firmly and grow.  However, if you don’t conceive i does not happen, a drop in both progesterone and oestrogen levels triggering your period causes the lining of your uterus to break down, shed, and leave your body in the form of your period.  Your period marks the start of a new cycle, and your body goes through this whole process all over again.  This is also the point in your cycle when PMS (premenstrual syndrome) symptoms start to appear. Everyones symptoms are different and can vary from month to month, but the most common symptoms of PMS include: What happens during the uterine cycle? The uterine cycle happens alongside the ovarian cycle and involves all of the changes happening in the endometrium as it prepares to welcome in a fertilised egg.  The menstrual phase  This is when you’re menstruating or having your period. Your endometrium builds up during your cycle. But if no pregnancy occurs, falling oestrogen and progesterone just before your period will trigger the breakdown of the endometrium, because it’s no longer needed to support a pregnancy.  Your endometrium is shed along […]

PMS and PMDD can both occur during the luteal phase of the menstrual cycle. But what is the difference between PMS and PMDD and what are the treatments available? Read on to find out.  Quick facts: What is Premenstrual Syndrome (PMS)? Premenstrual Syndrome (PMS) refers to a group of physical, emotional, and behavioural symptoms that occur in the days or weeks leading up to your period. For many people, PMS is a familiar but manageable part of the menstrual cycle, with up to 90% of women and people who menstruate experiencing it at some point.  PMS can vary from person to person, with some people just experiencing mild symptoms, with others suffering from more extreme symptoms that can affect their daily lives. What are the most common symptoms of PMS? There are a combination of physical and mental symptoms that can be associated with PMS. Some of the most common symptoms include: What is PMDD? Premenstrual Dysphoric Disorder (PMDD) is a cyclical hormone-based mood disorder. that affects mood, behaviour, and physical wellbeing in the days leading up to your period. While PMS exists on a spectrum, PMDD sits at the most severe end. What makes PMDD distinct is not just the symptoms themselves, but how disruptive they can be. People often describe feeling like a completely different version of themselves in the second half of their cycle, with changes that affect their ability to work, maintain relationships, or carry out daily routines.  These symptoms follow a clear cyclical pattern, typically emerging after ovulation, intensifying in the week before a period, and easing shortly after menstruation begins. This predictable timing is one of the most important clinical clues and one of the reasons PMDD is often misunderstood or missed altogether. PMDD is estimated to affect up to 5.5% of the population in the UK who menstruate, which adds up to over a million. That is 1 in 20  people. What Are the Main Symptoms of PMDD? PMDD can present a wide range of emotional, physical, and cognitive symptoms.  The main symptoms of PMDD include severe mood swings, irritability or anger, anxiety, depression, and difficulty concentrating. Many people also experience physical symptoms such as fatigue, bloating, sleep disturbances, and appetite changes. Symptoms occur in the luteal phase  or premenstrual phase of the menstrual cycle and subside within a few days of menstruation due to the brain’s sensitivity to the natural rise and fall of progesterone and oestrogen. Recognising these patterns is key to understanding whether what you’re experiencing could be PMDD. 🌪 Emotional & Mood Changes  🧠 Cognitive & Psychological 🛌 Physical & Sensory Symptoms In the most severe cases of PMDD, some people may experience suicidal ideation or suicidal thoughts. If you need urgent help for your mental health you can contact the Samaritans 24/7 helpline, or Mind’s crisis resources. What Does PMDD Actually Feel Like? PMDD is often characterised by a shift in emotional and psychological state that can feel difficult to control or explain. Unlike PMS, where symptoms may feel uncomfortable but manageable, PMDD can feel overwhelming and, at times, debilitating. Many people report intense mood changes, including persistent low mood, anxiety, irritability, or a sense of being emotionally overwhelmed. There can be a loss of interest in things that would usually bring enjoyment, alongside difficulty concentrating or making decisions. For some, these changes are accompanied by intrusive or distressing thoughts, and in more severe cases, feelings of hopelessness or suicidal ideation, which is why PMDD is recognised as a serious medical condition. Importantly, these symptoms are cyclical. They tend to resolve once the period starts, sometimes quite suddenly, which can make the contrast between phases of the cycle feel even more pronounced. It’s also important to note that PMDD can occur even in people who do not bleed regularly. For example, individuals using a hormonal coil or those who have had a hysterectomy but still have functioning ovaries may still experience PMDD symptoms, as hormonal cycling continues. What Causes PMDD?  PMDD is often misunderstood as a hormonal imbalance, but current research suggests something more nuanced. Most people with PMDD have hormone levels that fall within the typical range. Instead, the condition appears to be driven by an increased sensitivity in the brain to the normal hormonal changes especially linked to oestrogen and progesterone that occur across the menstrual cycle, particularly after ovulation.  There is also evidence to suggest a genetic component. Individuals with PMDD are more likely to have a family history of the condition, as well as mood disorders such as depression or anxiety.Variations in genes involved in hormone regulation and serotonin signalling may increase susceptibility, helping to explain why some people experience more severe reactions to hormonal shifts than others. Emerging research and lived experience also point towards a potential link between PMDD and neurodiversity. Some neurodivergent individuals, including those who are autistic, report more intense or difficult-to-manage symptoms. This may be related to differences in how the nervous system processes stress, sensory input, and emotional change. It is important to note that neurodiversity does not cause PMDD, but it may influence how symptoms are experienced and perceived. Stress is another key factor. Chronic stress can disrupt the body’s hormonal and neurological balance, particularly through its effects on cortisol, the primary stress hormone. This may amplify sensitivity to normal hormonal fluctuations and worsen the emotional and physical symptoms associated with PMDD.  Mental health history also plays an important role. Individuals with a history of trauma, anxiety, or depression may be more vulnerable to PMDD, and symptoms can often overlap or intensify during certain phases of the cycle. This does not mean PMDD is purely psychological, but rather that it sits at the intersection of hormonal and mental health processes. Beyond the brain and hormones, there is growing interest in the role of inflammation. Some studies have found elevated inflammatory markers in people with PMDD, suggesting that inflammation may interact with hormonal sensitivity and contribute to symptoms such as fatigue, low mood, and brain fog. Nutritional […]

Annie Coleridge, CEO of Alva Health, shares her story of getting a PCOS and dermoid cyst diagnosis. Erratic periods I’ve always had a feeling something wasn’t quite right with my hormones. Nothing major, but something a little skew-whiff.  Since I was a teenager I’ve had erratic periods. They’re on the light side, making me one of the lucky ones, but sometimes they won’t come for months.  Once, just after my final exams at university, my period didn’t come for about 9 months. I’ve always been a normal weight and was eating ok (albeit a bit stressed about exams) but 9 months seemed excessive…  So did the endless doctor’s appointments checking that I wasn’t pregnant or having a flare of an autoimmune condition I had previously. That was my early 20s. My mid-twenties passed with little change to that pattern, to be honest. Months and months without a period, then they’d just restart again.  I tried to track my periods, but I didn’t have the monthly reminders to help me remember. So I just put up with a mild, low-level, background kind of anxiety about my reproductive health.  Weirdly, although I understand contraception pretty well, it made me reluctant to go on any hormonal birth control. I just didn’t want to mess with these hormones which seemed in such fine balance. And anyway, it didn’t bother me that much. Testing my hormones Then I started working at a health tech company, which really highlighted to me that knowledge is power when it comes to your body. Finally, it clicked – I really should check if my hormones are balanced.  I knew that wouldn’t hold all the answers to my period woes… but it seemed like a very interesting place to start.  When I got my first test back I had high testosterone and low oestrogen – which was not what I expected… I knew that raised testosterone suggested PCOS but I also knew I didn’t have the typical symptoms. Beyond the messed up periods and the raised testosterone, I just didn’t have much else that was typical for PCOS. Or at least I thought I didn’t.  What I knew about PCOS was that it usually causes heavy periods, excessive hair growth, insulin sensitivity and weight gain. I didn’t struggle with those. I had light, irregular periods and bad mood swings. But that was it.  So… I ignored my first few sets of results, for about a year. I’d had abnormally high cortisol results at the same time, so as ever I just sort of put it all down to stress. Maybe my periods were just super super super sensitive to stress. A sudden change Then my periods suddenly got incredibly heavy. I thought it might be a sign of something really serious so I went to a doctor. I don’t hate the doctors at all, but I do find the process often quite inconvenient. It just doesn’t fit in with my life. Despite having recent blood tests, the doctors made me take another test and told me I had PCOS. That was it. A single phone call. Just the test results and a simple conclusion. Nothing else on the matter,  no follow-up information.  Doctor Google and my mum (an actual doctor) helped me learn that there are loads of different types of PCOS. Turns out whilst some people get the more ‘classic’ PCOS symptoms it’s actually a hugely varied condition. PCOS diagnosis – what else? But this new diagnosis didn’t explain the sudden changes in my periods. Or at least I didn’t think it did. I was pretty confused to be honest. So I went back to my GP and they said I could have an ultrasound.  The process of finding out I had a dermoid cyst involved an initially inconclusive scan – where the sonographer simply told me that I had ‘some sort of mass.  Four weeks later, another scan followed. This time they told me that the mass was probably a ‘ benign cyst’. The probably in that sentence didn’t fill me with confidence. So I went to my GP to ask what next? What next was a very long wait to see an NHS gynaecologist.  Now, let me say that although I felt pretty horrific after my various appointments I am staunchly pro the NHS. They gave me a certain first diagnosis – PCOS – and a probable second one – a benign cyst.  I did feel a little lost though. Suddenly my fertility (not something I’d thought about being 28 years old at the time and in a very new relationship) felt uncertain. I’m not even sure I want kids but that feeling was very unsettling. Knowledge is power To get a quicker second diagnosis I went and got a private scan. I’m very lucky they could confirm it was a dermoid cyst that was not cancer.  They could also see the characteristic ‘string of pearls’ appearance around my ovaries that suggested PCOS. It was a relief to be able to see what was going on in my ovaries, although they didn’t look in the best shape I must say.  I feel so fortunate to have been able to quickly access answers but it took me years to take control of my reproductive health. Even though it’s not perfect – nothing ever is and it’s much better to know Written by Annie Coleridge, CEO Alva Health If like Annie, you’re experiencing irregular and erratic periods, it could be a sign of a hormonal imbalance. Our at-home hormone tests can help you get to the root of your period problems. Our team of experts include PCOS specialists that can help you to manage your PCOS symptoms.

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: Sourcing sperm for fertility treatment There are three options for sourcing sperm in the UK:  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: 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 a child on behalf of the couple. If you are looking for more information, please visit the Human Fertilisation and Embryology Authority (the regulatory body for fertility treatment in the UK) website or Surrogacy UK. Coparenting Co-parenting is a pathway some LGBTQIA+ couples are now choosing to go down. It usually involves two or more people who are not in a romantic relationship deciding to raise a child together. For example, a lesbian couple chooses to have a biological child with a gay male and agrees to raise the child collectively.  They can choose to opt for fertility treatment such as IUI or IVF for this depending on age, medical history and sperm quality. Although this is something that has been going on for years, the rise of the internet has caused a shift in the way prospective co-parents may look for partners. If you are choosing to go down this path, it’s important to understand […]

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  Polycystic Ovary Syndrome (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.   

In this article, we’ll explore how fertility treatments can affect your mental health. We’ll discuss the ups and downs and tips for taking care of your emotional wellbeing. Quick facts: Understanding the emotional side of fertility treatment  Sometimes, the road to parenthood is not as straightforward as we may initially think. If you’ve struggled to conceive naturally, don’t want to, or can’t, fertility treatments can be a great option.  But they can come with a huge range of emotional challenges, that are often lost in the conversation centring around all of the physical aspects of the procedures.  According to recent studies, up to 30% of people seeking fertility assistance report symptoms of anxiety and depression, while nearly 40% grapple with elevated stress levels. Fertility treatments like egg freezing and IVF are often described as ‘emotional rollercoasters’, with moments of joy and love, and moments of sadness, uncertainty and fear.  The anticipation of each treatment cycle, uncertainty of outcome and the financial burdens can all take a toll on mental health. Many individuals and couples going through fertility treatments may feel isolated or like they’re carrying the burden alone, which can exacerbate feelings of loneliness. Some individuals may also feel pressure to conceive within a certain timeframe, adding to the stress. This pressure can come from societal expectations, family, or personal goals. Here we lay out some tips for looking after your mental health during treatment as well as some proactive ways to deal with the prospect of failed treatment. Tips for looking after your mental health during fertility treatment Everyone deals with stress differently and it’s important to find a method that works for you, as well as understanding your triggers. Some of these methods may work for you.  Get as much information as possible about your treatment  Understanding the fertility treatment process can significantly reduce anxiety. Research the steps involved and make sure you know exactly what will happen at each stage. Prepare a list of questions for consultations with your doctor or specialist to clarify any doubts or worries. Knowing what to expect can make the process feel less daunting, allowing you to feel more in control of your journey. Don’t make it the only topic of conversation  While sharing your feelings and concerns with your partner is crucial, it’s essential not to let fertility worries or discussions about your treatment dominate every conversation. Taking breaks to discuss non-fertility-related topics, especially if you’re going through this process with a partner can provide relief and maintain emotional connections with your loved ones.  Lean into your family and friends Your support network is invaluable during fertility treatment. Lean on family and friends who are empathetic and understanding. Share your experiences, but also make time for enjoyable activities together that can take your mind off things. These connections can offer emotional support and a sense of normalcy. Consider fertility counselling Fertility counselling can offer a safe space to explore your emotions and concerns with a mental health professional. These experts can guide you through the emotional challenges of fertility treatment, providing valuable coping strategies and emotional support. You can book an online appointment with one of our fertility counsellors at any time.  Identify your triggers Take time to understand how stress affects you personally. Recognise your personal triggers and signs of stress, such as irritability, sleep disturbances, or physical tension. Once identified, develop a toolbox of coping strategies that work for you. This may include relaxation techniques, journaling, exercise or talking to a friend. Practice mindfulness Mindfulness techniques, like deep breathing, meditation, or progressive muscle relaxation, can help you stay grounded during the emotional turbulence of fertility treatment. Regular practice can reduce anxiety and increase your overall sense of well-being. Keep active and don’t isolate  Maintaining physical activity and staying engaged in enjoyable activities can positively impact your mood. Exercise releases endorphins, which can help alleviate stress. Additionally, avoid isolating yourself during treatment. Maintain social connections to provide emotional support and prevent feelings of loneliness. Avoid any other big life changes The fertility treatment journey itself is a significant life event that can be emotionally taxing. Avoid introducing additional stressors, like moving to a new home or starting a new job, during this period if possible. Staying in a familiar environment and maintaining your established routine can provide stability and reduce anxiety. Join a support group Support from friends and family can also be vital, but it’s important to remember that not everyone will understand the emotional complexity of fertility struggles. Joining a support group can allow you to connect with other people going through the same struggles. There are lots of online groups available or in-person group counselling-based sessions. Waiting for your pregnancy test result The two-week wait, that agonising period between embryo transfer and the pregnancy test, is often one of the most emotionally challenging phases of fertility treatment. It’s a time marked by heightened uncertainty and anxiety, as the long-anticipated results of your efforts hang in the balance.  Try to plan ahead for activities and distractions that can help take your mind off the uncertainty. Having a plan in place can provide a sense of control over your time and emotions during this period. Keep a schedule of daily activities, work commitments, or outings with friends and family. Consider engaging in hobbies you enjoy, reading a good book, or taking up mindfulness and relaxation techniques. It can be beneficial to focus on tasks and experiences that bring you joy and fulfilment. Remember that a busy mind has less space for worries. Lean on your support network during this challenging time. Share your feelings and concerns with loved ones, as they can provide invaluable emotional support. Whether it’s a shoulder to lean on, a listening ear, or a comforting presence, friends and family can help alleviate some of the anxiety and loneliness you may be feeling. Don’t hesitate to communicate your needs to them. Facing the prospect of a failed fertility treatment Experiencing a failed fertility treatment can be emotionally devastating. It’s a moment […]

Fertility preservation methods can be a great way for people to put having kids on hold, or preserve their fertility if they need to for medical reasons. Here we go through the main procedures available to women and those assigned female-at-birth. Quick facts: What is fertility preservation? Fertility preservation involves freezing your eggs, embryos, reproductive tissues or sperm, so they can be used in the future and you can hopefully have a biological family. For women or those assigned female-at-birth, there are a few different fertility preservation methods available. Which one is right for you will depend on your age, medical history and personal fertility goals.  Each method involves removing either eggs or tissues, freezing and storing them in liquid nitrogen—a process called cryopreservation. When you are ready to use them, they can be thawed and used to help you conceive.  These processes are all designed to help those at risk of potential infertility or to assist those who can’t conceive naturally. Who might use fertility preservation? There are lots of different reasons why someone may undergo fertility preservation. Generally, the reasons can be categorised as either medical or social preservation.  In the UK as of July 2022, you can store your eggs for 55 years for both medical and social reasons, as long as you renew your consent every 10 years. Medical fertility preservation Medical fertility preservation is for anyone undergoing fertility preservation for medical reasons. This could include possibly losing their ability to conceive naturally because of impending medical treatment. Reproductive health conditions Some reproductive health conditions such as Premature Ovarian Insufficiency (POI) and early menopause can affect fertility. Additionally, conditions such as endometriosis or fibroids might require surgery around the pelvic organs to manage it, your doctor may suggest fertility preservation before this in case there is a risk of damage to the ovary. Cancer Certain cancers and cancer treatment, including chemotherapy and radiotherapy (especially targeting the pelvic organs), or surgeries impacting the ovaries, can impact our fertility. Egg freezing may be suggested on a case-by-case basis for those who are looking to have children post-cancer treatment. Gender-affirming care If you’re undergoing gender-affirming care, you might want to preserve your fertility before starting hormone therapy or having reconstructive surgery. Although anyone with or undergoing the above may still be able to get pregnant naturally, there might be a risk of impacting their ovarian reserve, which may make it difficult to conceive. This is why considering fertility preservation is recommended before starting therapy.  Social fertility preservation Social fertility preservation is when you freeze your eggs or embryos for ‘social’ reasons. This can include if we are worried about our natural fertility decline with age, but we aren’t quite ready to have children yet. Or if we aren’t sure if we want children at all, but would like to keep our options open for the future.  As we age, our egg quantity and quality decline. This can make getting (and sometimes, staying) pregnant more difficult. Age, also increases the risk of pregnancy-related complications, like miscarriage, genetic disorders in the baby and gestational diabetes, especially after our mid to late 30s. In our early to mid-20s, we are at our most fertile—but there’s still only a 25–30% chance of us getting pregnant each cycle. This gradually reduces during our 30s to around 5% by age 40.  What are the different types of fertility preservation? Fertility-preservation options for women and AFAB people include egg freezing, embryo freezing, ovarian tissue cryopreservation, ovarian transposition and gonadal shielding. Egg freezing (Oocyte cryopreservation):  Egg freezing is a medical procedure which can help us to plan for our future fertility. It’s what’s known as a ‘fertility preservation method’, or scientifically speaking, ‘oocyte cryopreservation’. Egg freezing involves taking medicine to encourage the growth of the eggs in our ovaries, which will then be collected during a short surgical procedure. Viable eggs will be frozen and stored in liquid nitrogen (-196°C). They do not decline in quality—like they would do if they remained in your ovaries as you age.  These eggs can be thawed at a later date whenever you are ready to start a family through fertility treatment. This whole process is what’s called an ‘egg freezing cycle’.  Technically, you can freeze your eggs at any age before menopause, but eggs retrieved in your 20s and early 30s usually result in better outcomes than those in your late 30s and 40s. This is largely to do with the quality of the eggs at the time they are retrieved, as generally, our eggs begin to decline more rapidly from 35 onwards. Embryo cryopreservation (embryo freezing) This is a procedure that involves removing eggs from the ovaries, fertilising them with either a partner or donor sperm to create embryos and then freezing the resulting embryos for future use. Embryo cryopreservation would usually require an in-vitro fertilisation (IVF) cycle.  The egg retrieval process is similar to the one used in egg freezing. Once retrieved the eggs will be analysed in the lab by an embryologist and then fertilised with sperm from your partner or donor once. They are then placed into an incubator to allow the resulting fertilised egg (embryo) to develop.  The embryos are then frozen and stored in liquid nitrogen. Once you are ready to conceive, the embryo will be thawed, cultured and will be transferred to the uterus.  The number of embryos transferred is dependent on your age, the quality of the embryo(s) and if you have had failed IVF cycles in the past. It’s generally preferred to transfer just one embryo because this reduces the chances of complications associated with multiple pregnancies.  If you have good-quality embryos left over at this stage, you can opt to freeze them for future cycles, discard them or donate them to someone else. Sometimes, if a sufficient number of embryos are not collected in one cycle, your doctor will recommend another cycle. Ovarian tissue cryopreservation Ovarian tissue cryopreservation is the only fertility preservation option to help younger people who have not gone […]