Knowledge Centre

Egg donation is a procedure where one individual donates their eggs to be used in someone else’s fertility treatment. In this article, we’ll explain who might benefit from egg donation, the process and how you can choose a donor.  Quick facts: What is egg donation? Egg donation is when a woman or person assigned female-at-birth, donate some of their eggs to someone else’s fertility treatment. It’s proven to be a successful option for people unable to get pregnant using their own eggs.  Sometimes eggs are donated to friends or family that are unable to get pregnant. More commonly, eggs are donated anonymously to help couples or individuals trying to conceive. Who might need an egg donor? There are lots of different reasons why someone may need to use an egg donor. Some of the reasons could include:  What is the egg donation process? The egg removal, fertilisation and embryo transfer procedures used in egg donation are the same as standard IVF treatment.  How to choose an egg donor The first step in choosing an egg donor is deciding if you want a known egg donor or not. You might prefer to use a friend or someone you know as an egg donor.  If this is the case, your egg donor will need to go through ovarian stimulation and egg retrieval at the clinic you’ve chosen for your treatment. It is more common for people to choose an unknown donor. Most clinics will have a list of donors you can choose from. Some clinics might have long waiting lists for donor eggs but you can shop around to find a clinic with shorter wait times if you’re keen to get started. Some clinics have special licences that allow them to offer the option of importing eggs from abroad. Your clinic can’t provide you with identifying information about your donor. However, the profile available is extensive and transparent enough to allow you to make an informed judgement on your donor’s character and personality as well as including an accurate physical description. The information available about your donor will include: To get an idea of your donor’s character and personality, most clinics will have a questionnaire and profile completed by your donor. This will include their interests, a brief personal history and why they chose to become a donor. Some donors chose to write a goodwill message at the time of their donation to any potential children. You won’t receive any information that could reveal the identity of your donor and they won’t receive any information about you or your child once they’re born. If you choose a donor through a licenced UK clinic, they will be subject to a strict screening process. This involves background family health checks, screening for inheritable genetic disorders and testing to rule out infectious diseases like HIV, syphilis, gonorrhoea, and hepatitis. If you choose to use a known donor, they are still subject to the same checks at the clinic. What are the laws on donor eggs? The Human Fertilisation and Embryology Authority (HEFA) oversees assisted human reproduction in the UK. There are several laws in place to regulate licensed fertility clinics and donor conception. It’s illegal in the UK to pay a donor for anything other than expenses. The donor’s expenses are usually covered by your overall treatment cost with the clinic but you can double-check this with your clinic if you’re unsure. Donors have no legal rights or responsibilities to any children born with their eggs. That means if you conceive by donor egg, your donor will not appear on your child’s birth certificate, they won’t have any rights over how your child is raised, and they’re not required to contribute financially to the upbringing of your child. In the UK, egg donation is anonymous at the time of donation. This means the egg donor and you, the recipient, won’t know each other’s identity. However, when a donor-conceived person turns 18 they have a legal right to know their donor.  This means that if you have a donor-conceived child, they can choose to learn identifying information about their donor once they turn 18. The donor does not however have legal rights, claims or responsibilities towards your child and will not be able to contact your child or your family.  You can learn more about the rules around releasing donor information and identity from the HFEA. Are there risks involved with donor conception? As with any medical procedure, there are risks with egg donation. There is some evidence that people who conceive with donor eggs are at a higher risk of some pregnancy complications, including higher blood pressure, small gestational size, early delivery, and caesarean section. Are there any support networks for egg donation? There are plenty of support networks for people who have already been through or are just beginning their donor conception journey. DefiningMum.com founder and donor mum, Beaky Kearns, started the Paths to Parenthood support network to help you from the beginning of your donor conception journey through to parenting your donor-conceived child.  Members have access to regular interactive webinars and live chats from other parents and experts. Here, you can share your experience, find support and chat to other members for advice. Including how to choose your donor.  The site is full of resources from webinar recordings, personal stories, tips and other recommended resources. Resources

Premature Ovarian Insufficiency (POI) is when the ovaries stop working normally before the age of 40. Getting a diagnosis can be worrying at first, but there are options available. Let’s take a look at what you need to know about POI including symptoms and treatments.  Quick facts: What is Premature Ovarian Insufficiency? In short, Premature Ovarian Insufficiency (POI) is when the ovaries stop functioning properly before the age of 40. It can significantly reduce your fertility.  This doesn’t always mean that you don’t have any eggs left in your ovaries or that you couldn’t carry a baby. It means your body is failing to mature eggs or to ovulate each month.You may have heard of Premature Ovarian Insufficiency (POI) being referred to as premature ovarian failure. It is also referred to as Primary Ovarian Insufficiency, gonadal dysgenesis, and hypergonadotropic hypogonadism. Premature Menopause Premature Menopause is when someone before the age of 40 experiences menopause. This means they will not have any more periods and are permanently no longer able to become pregnant.  This is different to POI, where although fertility becomes significantly reduced, there is a chance of spontaneous ovulation, and hence a period might still occur. Some people are still able to conceive spontaneously after their diagnosis. However, POI and Premature Menopause do share many of the same symptoms. What are the symptoms of POI ? POI symptoms are similar to menopause and low oestrogen. You’re likely to experience: Other than menopausal symptoms, loss of skin pigmentation caused by vitiligo or hyperpigmentation can accompany POI. As can hair loss caused by alopecia.  Fatigue, anxiety, and depression can also be common symptoms as a result of other symptoms or a diagnosis (3). If you’re missing your period for three or more months, it’s important to get your hormones tested to try and decipher what’s going on.  You can miss your periods for a number of reasons, including increased stress, changes to your diet or exercise routine. Some people might even like the idea of not getting a period every month, but sudden changes should always be investigated to check the cause of the change and rule out POI or something more serious. What causes POI ? Roughly 1 in 100 people will experience POI and it can affect people up to the age of 40, with some affected as early as their teens (4). But despite its prevalence, the causes, like for many female-reproductive health conditions, are still relatively unknown (2).  POI can happen spontaneously. However, there are a few known risk factors that may increase your risk of developing POI. These include: How is POI diagnosed? To receive a POI diagnosis, you’ll need to get a hormone test. High FSH (greater than 25) and low oestrogen levels, also seen at the onset of menopause, are indicators of POI. This is accompanied by absent, unpredictable or irregular periods for at least two consecutive months.  If POI is suspected, you might also be sent for an internal ultrasound to check your antral follicle count (AFC). Antral follicles are small fluid-filled sacs in your ovaries containing immature eggs. An AFC count is an indicator of the number of eggs you have left in your ovaries, also known as your ovarian reserve. What does POI mean for my overall health? POI can increase the risk of other illnesses or health problems if left untreated. People with untreated POI have an increased risk of developing heart disease and stroke.  Also, because oestrogen plays such an important role in bone health, low oestrogen seen in POI is known to lead to lower bone density, increased risk of bone fractures, and osteoporosis.  There is also evidence that lower oestrogen levels earlier in life can increase the risk of developing Alzheimer’s disease or dementia (3,4). If you have received a POI diagnosis, your doctor will likely recommend hormone therapy to you. This could be in the form of HRT or taking some form of hormonal contraception.  Hormone therapy can help to alleviate symptoms and reduce the risk of developing the associated conditions mentioned above. Does POI affect fertility? Often, yes, POI can reduce your fertility significantly. This can mean getting a diagnosis can be stressful and upsetting, particularly if you want to start or grow your family.  Although POI means your ovaries aren’t functioning properly, as many as 25% of people with POI do spontaneously ovulate. Another 10% do conceive and deliver after their diagnosis (5). If you are looking to get pregnant, there are treatment options available if you have POI—including In Vitro Fertilisation (IVF).  Egg donation is also an option for some people. POI is a condition that affects the ovaries, not the uterus. This means egg implantation and your ability to carry a pregnancy are not greatly affected by a POI. Think you might be experiencing POI symptoms? If you suspect POI symptoms, like irregular or absent periods, it’s important to get checked. Our at-home Hormone and Fertility Test can give you a better insight into your hormones and any symptoms you might be experiencing.  Our team of experts will help you understand whether your symptoms are related to POI or other underlying health conditions. We can also support you with follow-up fertility treatments and fast-track you to specialists for tailored care plans. References:

The vegan diet is often hailed as having many health benefits, but what about when it comes to our fertility? In this article, we’ll cover the benefits veganism can have for your conception journey and which nutritional deficiencies to be aware of with a plant-based diet.  Quick facts: What is a vegan diet? A vegan diet omits any produce derived from animals including meats, fish, dairy products, eggs and even honey. Vegans tend to eat lots of vegetables, fruit, beans, pulses, soya products, tempeh and sometimes meat alternatives.  Plant-based diets have become increasingly popular and ubiquitous in recent years. The Vegan Society estimates that the number of UK vegans has quadrupled over the last five years, with lots of people going either fully or partially vegan for health, environmental or animal welfare concerns.  As veganism grows in popularity, the range of vegan food substitutes has rapidly expanded. You’ll now find different varieties of plant-based milk and the fake meat industry has boomed. As such, adopting a vegan diet is now easier than ever, but will switching to a plant-based diet improve your health and fertility? Health benefits of a vegan diet A vegan diet has a multitude of health benefits. Vegans typically have lower BMI and are up to 78% less likely to develop type 2 diabetes. This is because plant-based foods are typically lower in sugars and fat.  Consequently, many people make the switch to a plant-based diet to lose excess weight. Indeed, studies show that individuals following a vegan diet lose more weight on average than those following calorie-restrictive diets. Veganism and fertility benefits Diet and lifestyle factors can greatly impact your fertility. Will veganism boost your fertility? No, not directly. But, that doesn’t mean there aren’t fertility benefits to a vegan diet.  The link between obesity and infertility is well-documented. Being overweight or obese not only makes you less likely to conceive but also increases the risk of miscarriage and pregnancy complications.  In this way, following a vegan diet may be beneficial if you are currently overweight and trying to conceive—helping you to reach a healthy pre-baby body weight.  In addition, following a vegan diet has been shown to decrease your risk of gestational diabetes. However, regardless of the diet you follow, it is important to ensure that you are obtaining all required nutrients when trying to conceive and then throughout pregnancy.  Veganism and fertility risks You can definitely follow a vegan diet and have a healthy pregnancy, but a vegan diet can put you at greater risk of some nutrient deficiencies which may impact your fertility. Whilst a vegan diet may be low-fat, a plant-based diet can increase the risk of certain nutrient deficiencies.  It’s important to remember that with the correct planning, supplementation and nutrition, these deficiencies can be avoided even with a vegan diet.  Iron deficiency Low iron intake can cause anaemia, a condition in which you have a lower-than-normal red blood cell count. As red blood cells are responsible for providing cells with oxygen, anaemia can cause fatigue, breathlessness and headaches, among other symptoms. Iron deficiency is common in pregnancy, even if you eat meat. However, vegans are at a much higher risk of anaemia. Whilst anaemia is detrimental to general health, the direct effects of iron deficiency on conception and fertility remain unclear.  However, anaemia has been shown to increase the risk of preterm birth and can also lead to developmental delays in the foetus. Anaemia can be easily treated by taking iron supplements. Vitamin B12 There is evidence that vitamin B12 deficiency can decrease your infertility and that, in severe cases, vitamin B12 deficiency can cause infertility. This infertility is normally temporary and can be resolved by taking vitamin B12 supplements.  In addition, vitamin B12 deficiency can also cause anaemia. Vitamin B12 is naturally found in animal products such as milk, eggs and meat, and is essential for metabolism. With the exception of fortified cereals, vitamin B12 is not found in plant-based foods and so vegans are often unable to obtain sufficient vitamin B12 from their diet. Therefore, to avoid health risks and maintain good reproductive health, it is really important that vegans take vitamin B12 supplements.   Vitamin D Whilst we obtain vitamin D from sunlight, it is also found in lots of animal products. As such, vegans can be at risk of vitamin D deficiency, particularly throughout the winter months. It’s generally recommended that everyone in the UK take a vitamin D supplement throughout the autumn and winter regardless of their diet or conception plans. The links between vitamin D deficiency and fertility are unclear and require further research. However, observational studies indicate that vitamin D deficiency is a risk marker for subfertility (not being able to conceive after a year of trying). Therefore, if you are following a vegan diet whilst trying to conceive, it is worthwhile taking vitamin D supplements. Deciding if a vegan diet is right for you Switching to a plant-based diet may seem daunting, but if you ensure you’re eating a balanced diet with the correct nutrition and supplements, there is little risk to a vegan diet whilst trying to conceive.  In fact, arguably, with the required vitamins and supplements, the preconception health benefits to a vegan diet are significant. A vegan diet won’t work for everyone, but if you want to get healthy before trying to conceive then it may be worth giving it a go. Even switching to a plant-based diet for a few meals a week has been shown to have health benefits. If you need some help with your diet and nutrition to switch to a plant-based diet, book a consultation with one of our fertility Nutritionists today. Resources:

For trans and non-binary people considering medical transition, it can be difficult to find the right information about how fertility can be impacted and what treatments are available. We sat down with Asher, who shared their story about embryo freezing, pre-medical transition. Quick facts: Fertility concerns for trans+ individuals Thoughts about fertility may seem very far away when you’re experiencing the distress of having a body that doesn’t align with your identity.  But for trans and non-binary people considering a physical transition, whether with hormone therapy or gender-affirming surgery, the decisions made before and throughout can have a lasting impact on fertility.  Trans healthcare can be incredibly hard to access, with waiting lists for NHS Gender Identity Clinics in the UK being an average of 10 years wait or more.  Educational resources and personal stories of transition can also be hard to find. So we sat down with Asher, who was willing to share their journey with egg freezing to preserve their fertility before transitioning.  Before we dive into Asher’s story and the important decisions people may need to make around preserving their fertility, let’s understand some important terminology: Now let’s meet Asher. After many challenging years of living with gender dysphoria, they were able to access gender-affirming care. Yet it wasn’t until diagnosis and the start of a physical transition, that Asher was made aware of the fertility implications they could face.  Did anyone along your journey recommend preserving your fertility before undergoing any treatment? I discovered the importance of this process at the same time I was about to begin physically transitioning — literally the same day I was diagnosed with gender dysphoria and recommended for Testosterone HRT (hormone replacement therapy).  What were your fears and how did you overcome them? At the point of discovering this, I had surpassed the tipping point of how long I could cope with the soul-destroying experience of suppressing who I am in order to live in a world that taught me I shouldn’t exist. Managing gender dysphoria and trying to present yourself as something you’re not is an always-on 24/7 painful mask and bodysuit that you can’t take off. By the time I broke through internal and external barriers and played the arduous waiting game to speak with a doctor, I didn’t want to live another second with that feeling. My whole being was exhausted, terrorised, neglected and desperate for relief. Hearing then that I should freeze my eggs if I ever want children in the future not only felt like an extra obstacle for something so seemingly distant and intangible. The experience itself also sounded like it would be even more painful than what I’d been living with, as it essentially sounded like it would take me in the opposite direction.  On top of that, the information felt impossible to make sense of and the whole process itself seemed daunting, uncertain and expensive. I’ve always known that if life permits I’d love to raise a child someday, but I was totally unable to connect to this purpose. After a few off-putting initial conversations and appointments and my own research, I didn’t think I would be able to cope and was about to walk away.  Luckily, this is when I was introduced to Hertility and thank goodness I was! Finally some humane guidance, clarity and crucially being seen and understood as a trans person. The whole process became a lot clearer and felt more manageable, and honestly, I started to feel inspired by the gift of being able to do this. Was it easier than you expected to freeze your embryos? Yes. Although it wasn’t exactly easy, the actual process wasn’t nearly as bad as I imagined, especially with triggering my dysphoria. I suffered most in the angst-ridden anticipation before speaking with Hertility! It’s all the unknowns and uncertainty that make things feel worse than they are when you just take things day by day. How did you feel once it was over? So happy and so grateful. At the offset, I couldn’t have fathomed how joyous it would feel to get through this and know I’d honoured the future parent in me. This feeling only served to enrich how amazing it felt to start my physical transition after. Do you think we need more awareness in the community about fertility preservation so people know their options prior to gender reassignment surgery?  Absolutely. I wish I had been more informed and sooner but there was no mention of it, and even when it was it was almost a side-note. Transitioning alone is not an easy, self-determined process so we need to be informed about everything to expect as early as possible to start preparing, mentally and practically.  Help with gender dysphoria and transition If like Asher you are living with gender dysphoria and are considering physically transitioning, it is important to understand the implications this may have on your fertility, should you want children in the future.  Loads of great organisations can help you with the medical, practical and emotional aspects of gender journey and transition including: 

After a 9 year battle with pain, Abbie finally got a diagnosis for endometriosis. This is Abbie’s story, detailing the ordeal she went through to finally get treatment for her pain.  Quick facts: Meet Abbie My name is Abbie (@cheerfullylive) and in May 2019 I was finally diagnosed with endometriosis after a 9-year battle with pain.  If you aren’t aware, endometriosis is a chronic and debilitating condition where cells similar to the ones in the lining of the womb are found elsewhere in the body like the ovaries and fallopian tubes.  In response to your hormones, these cells break down and bleed, similar to the lining of your womb. This can cause inflammation and symptoms like painful periods, as well as possible infertility, fatigue, bowel and bladder problems, as well as many other symptoms. This is my story with endometriosis, from pain to diagnosis and treatment. I hope it can help you if you suspect you may have endo symptoms, or just want to learn more about this condition. Living in pain I can remember distinctly the first time I had severe pain. It was about a year before I had my first period. It was absolutely terrifying and things only got worse from there. My periods started when I was 15 and month by month the pain gradually became more debilitating. It got to the point where I could no longer get out of bed or do normal activities.  I would miss school, university and even work, but my pain and symptoms were deemed ‘normal’ period pain. I was told repeatedly that ‘I just had a bad period’, ‘I had a low pain threshold and ‘it was just something I would have to endure as a woman’.  This was even when I was having fainting episodes and vomiting due to the excruciating pain I was getting between periods. Because it was doctors telling me this, I genuinely believed it was just ‘normal’ and put up for it for many years of my life. Years to diagnosis It was only when my pain became chronic in December 2018, that my health was investigated fully. After going back and forth to my GP, A&E, urology and gynaecology, I was sent for an MRI in April 2019.  After so many years of believing this pain was normal, I didn’t expect my MRI to come back with severe endometriosis adhesions all over, but it did.  I was immediately booked in for an appointment with an endometriosis specialist. He told me I had extensive endometriosis on the left side of my pelvis, my left ovary and my bowel (sigmoid colon). I was also told that it was highly likely I had endometriosis growing on my bladder, my kidneys and on the right side of my pelvis. But only this wouldn’t be known until I had surgery. Managing my endometriosis It’s been over a year since I was diagnosed and I’ve tried so many different things to help with managing endometriosis. I’ve gone from being on the combined pill to the mini pill to extra hormones on top of that.  I’ve come off those extra hormones, gone on the waiting list for excision surgery, have taken different painkillers, tried yoga, hot water bottles, a TENS machine and trialled sacral steroid injections!  It’s been a long, hard journey and there are still many difficult days, but I seem to have found a few things that have personally helped me along the road. Deciding to have an expert excision of my endometriosis I’m still waiting for a surgery date, but just being able to make this informed decision with my consultant made me feel empowered. It made me feel like I was able to have some control over my endometriosis and how much it affected my life.  Being on the mini pill This is something that has helped me, as I no longer have periods anymore, which reduces the debilitating monthly pain and anxiety that comes with it. However, I understand that hormones are a very personal choice and you have to do what’s right for YOUR body. Pain management  Investing in a decent hot water bottle and a heat pad, as well as a TENS machine has really helped me manage my everyday chronic pain. Looking ahead Despite the struggles I’ve faced and the pain I’ve had to endure whilst living with endometriosis, I’m very grateful for all the positive experiences that have come out of this journey.  I started up my own blog, enjoyed being creative on Instagram and found an incredible community of #EndoWarriors! A fellow Endo warrior and I wrote a powerful blog post on “What Endo Means To Me”. Thank you to Hertility for having me on their blog to share my journey with endometriosis! If you feel you may have endometriosis or are concerned about your symptoms, please reach out to someone and don’t suffer in silence. Whether that’s your GP, sexual health clinic, hospital or a company like Hertility who can help you get answers on your reproductive or gynaecological health. You can find me over on my blog at www.cheerfullylive.com or on Instagram at @cheerfullylive www.instagram.com/cheerfullylive. I’m always open to having a conversation around women’s/period health, pelvic pain or endometriosis! Let’s break down the stigma and have more of these conversations!

Ovulation tracking can be a great way of either avoiding or planning sex during your fertile window. There are lots of ovulation detection methods, each with varying degrees of reliability. Read on to find out which could be right for you. Quick facts: What is the fertile window? The fertile window is 6 days around the midpoint of your cycle when you ovulate. It includes the 5 days before ovulation and the day after.  Ovulation is when you release an egg from one of your ovaries, and it travels down the fallopian tube to the uterus where it hopes to reach a sperm and be fertilised.  If you have regular periods, it is a good sign that you are ovulating (releasing eggs), every month. Your egg is capable of being fertilised 12 to 24 hours after ovulation but sperm can survive in the female genital tract for up to five days. So it’s possible to get pregnant if you have sex in the days leading up to ovulation. Ovulation tracking methods Lots of people choose to track ovulation, either to avoid or to plan to have sex during their fertile window. There are a few different methods available to predict your fertile window each month, but not every method will work for everyone—so it’s useful to try a few to find your fit.  Cycle tracking Tracking your periods is a helpful starting point for finding your fertile window. If your cycle is like clockwork and lasts 28 days, the chances are you’ll ovulate halfway through your cycle on day 14. Everyone’s cycle is unique and often not 28 days. It’s important to keep track of how long your cycles last, how long your periods are and any symptoms along the way. Ovulation generally occurs 11 to 16 days before your next period but this can also vary from cycle to cycle. You can use cycle tracking apps, some of which will predict your fertile window based on your previous cycle data—but these are not always 100% accurate.  Ovulation detection kits Ovulation detection kits involve a pee stick, which you use when you’re around the time in your cycle when you’re approaching ovulation. Ovulation sticks are considered the best way to identify if you are ovulating  From the start of your cycle, your oestrogen levels will increase to thicken the lining of your womb in preparation for pregnancy. When oestrogen levels reach a certain point, it signals the release of luteinizing hormone (LH), which triggers ovulation. Although LH is always present at a low level, it significantly increases 24-36 hours before you ovulate, known as the LH surge, which is what the kits detect. Changes in cervical mucus  The consistency of your cervical mucus (discharge) changes throughout your menstrual cycle. Just before ovulation, your discharge becomes clear and stretchy, a bit like egg whites. This is to help the sperm swim through the cervix and towards the egg.  Although this can be a good indicator of when you’re nearing ovulation, remember the appearance of discharge can also be affected by many other factors. This includes infections, sex and medications, and can also naturally alter within each cycle. Basal body temperate tracking After you ovulate, your basal body temperature (BBT) increases by 0.4-1°C. It is unlikely you’ll be able to feel this change, but it can be monitored with an accurate thermometer.  To use this method effectively, you must take your BBT first thing every morning before getting up, to get an accurate reading.  Again, there are lots of things that can cause your resting temperature to vary, such as sleep changes, alcohol consumption and fighting off a cold. This means using temperature changes alone may not be the most reliable. It is also important to consider that this method will only tell you that you have ovulated and won’t be able to predict your fertile window ahead of time.  Changes in saliva Your saliva can also vary throughout your cycle. High levels of oestrogen just before ovulation can cause there to be more salt in your saliva, which can be tracked using a testing kit. A specific pattern is seen in the saliva at ovulation which is called “ferning”, but this can be quite difficult to identify.  Similar to BBT tracking, saliva testing is not always reliable, as it can be easily influenced by the things you eat and drink, so shouldn’t be used alone.  Ovulation pain  Ovarian pain, also known as Mittelschmerz, is a fairly common symptom experienced by around one in five people who menstruate. Ovulation pain can be caused by stretching of the sac of fluid which contains the egg (the follicle) during its development, or by ovulation itself (when the egg is released from the follicle).  This isn’t a reliable method of fertility tracking and isn’t usually recommended as it can also vary from cycle to cycle. If you’re experiencing pain that’s disrupting your daily activities, speak to a specialist about treatment or pain relief options. Understand your cycle As ovulation is controlled by your menstrual cycle hormones, testing your hormones can give you insights into whether you’re ovulating regularly or not.  If you’re experiencing any symptoms like irregular periods, long or short cycles, it’s a good idea to get your hormones tested to understand what’s going on with your cycle hormones.  Check out our at-home Hormone & Fertility tests to find out more. 

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 at-home hormone tests 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, our periods seem to get all the air time. But the menstrual cycle is far more than that, with our periods only making up a very small part of the whole monthly process. But thanks to cultural stigmas, taboos and limited sex education, it’s no surprise that many of us have grown up knowing very little about the ups and downs of our menstrual cycles.  Not only is your menstrual cycle super important for your fertility, but 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 is the bodily process that makes pregnancy possible. It involves a series of natural changes in hormone production that affect the uterus and ovaries.  Your cycle starts on the first day of your period (the first day you bleed) and ends on the first day of your next period. It’s made up of both the ovarian cycle, which affects the ovaries and regulates ovulation, and the uterine cycle, which affects the uterus. 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 selection of immature eggs in one of your ovaries begins to mature. One egg will reach full maturation and be prepped for release during ovulation. The follicular phase kicks off when gonadotrophin-releasing hormone (GnRH) is secreted 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 secrete 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. Time to schedule that date and promotion discussion.  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 produce a hormone called luteinising hormone (LH).  A sudden surge in LH levels triggers ovulation, which is when the now mature egg will be released from your ovary.  Ovulation takes place 28-36 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. The date of ovulation can fall anywhere between days 11 to 16 of your cycle. During ovulation, you are at your most fertile. 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, or using natural birth control methods, 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 and usually, this is the same in each cycle.  After you’ve ovulated, the empty follicle that released the egg will get converted into a structure called the corpus luteum. This will produce a hormone called progesterone, which is important for pregnancy, and small amounts of oestrogen.  Progesterone thickens the lining of your womb, called the endometrium, in preparation for a fertilised egg to implant into it. The endometrium helps to support the growth and development of an embryo. If a sperm-meet-egg moment happens and fertilisation occurs, the corpus luteum will keep growing until the placenta (this is the organ that develops to help the baby get its food and oxygen) can take over the job of producing progesterone.  However, if fertilisation does not happen, the corpus luteum will shrink causing a drop in both progesterone and oestrogen levels triggering your period. This is also the phase during which premenstrual syndrome (PMS) might rear its ugly head.  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 […]

PMS and PMDD can both occur during the luteal phase of the menstrual cycle. Common symptoms include mental health-related issues. But what is the difference between PMS and PMDD and what are the treatments available? Read on to find out. If you need urgent help for your mental health you can contact the Samaritans 24/7 helpline, or Mind’s crisis resources. Quick facts: What is Premenstrual Syndrome (PMS)? Premenstrual Syndrome (PMS) is a set of symptoms that people can experience in the weeks leading up to their period, known as the luteal phase of the menstrual cycle. PMS is super common, 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. PMS Symptoms There are a combination of physical and mental symptoms that can be associated with PMS. Some of the most common symptoms include: What’s the difference between PMS and PMDD? Premenstrual dysphoric disorder (PMDD) is similar to PMS, but more severe, with far more exaggerated mental health-related symptoms. PMDD can have a significant impact on your life, affecting work, social life, relationships and friendships. Around 3-8% of women and people who menstruate experience PMDD. Similarly, PMDD affects people the week or two before their period, with some people experiencing symptoms throughout this time and others just for a few days. Symptoms tend to improve once your period ends. PMDD symptoms Again, like PMS, symptoms of PMDD can be expansive. But common symptoms often include: 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 are the causes of PMS and PMDD? The exact causes are still not fully understood, but researchers believe that PMDD is caused by how sensitive your body is to changes in hormone levels. Recent research suggests that PMDD is associated with increased sensitivity to the normal hormonal changes that occur during your monthly menstrual cycle. There is research to suggest other possible causes for PMDD, as well as things that may make your PMDD worse. Some of these possible factors are: PMS and PMDD treatments Several medical and non-medical treatments can help to alleviate PMS and PMDD symptoms.  If you don’t already, tracking your symptoms and cycle to see if there’s a correlation between when your symptoms are appearing and where you’re at in your cycle can really help.  You can track your cycle using a cycle-tracking app, or simply keep a record of it on a calendar. Once you’ve deciphered any patterns with your symptoms appearing, it can become easier to anticipate when they’ll appear. This can allow you to have more control over planning your schedule around them and factoring in self-care.  You’ve heard it all before, but we’re telling you again—eating well, exercising regularly and reducing stress, is proven to have a positive impact on PMS symptoms and of course, your overall health.  Some prescription hormonal contraceptives have also been shown to improve PMDD and PMS symptoms. Hormonal contraception halts the ovulation process and those prescribed without taking a break will level the natural fluctuation of your hormones, helping to lessen your symptoms.  For the more severe cases of PMDD – cognitive behavioural therapy (CBT) is also considered an effective treatment.  If your experience of severe PMS or PMDD symptoms is regularly affecting your wellbeing, it can be extremely beneficial to talk to a professional. The idea of diagnosing a mental health disorder can be daunting, but it is the first and most important move in alleviating your suffering. Resources: