To Freeze or Not to Freeze… Good Question

By: Dr. Ed Coats Egg freezing is now readily available in IVF clinics across the UK. The concept of ‘freezing eggs’ has been discussed in the media and widely debated by fertility experts around the world. Freezing technology has advanced so much that it is now possible for a woman to reliably preserve her fertility for the future. Fertility preservation is an important subject for women to understand and the possibilities it offers them. Making the decision to freeze eggs could have significant future consequences, so we try here to distil the facts from the hype. There are a number of reasons why a woman will choose to freeze her eggs. Studies suggest that the majority of women currently choosing to freeze their eggs are highly educated, single women over 35 years of age. They will often have researched the subject before engaging with a fertility clinic for a consultation to discuss their options for treatment. It is an emotional journey for most balancing optimism and…
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The American Society for Reproductive Medicine Scientific Congress & Expo

By: Dr. Ed Coats This week ‘Total Fertility’ have been at The American Society for Reproductive Medicine Scientific Congress & Expo in Philadelphia. This year’s meeting celebrates 75 years of science, innovation and history. More than 40 years after the birth of Louise Brown, the world’s first IVF baby, this expansive area of medicine continues to test the boundaries of what is known and what is possible. This Congress brings together experts from around the world to present the latest ideas and concepts in IVF and reproductive health. The quality of scientific papers in the areas of endometrial preparation, stimulation regimens and fertility preservation demonstrate that there is still much to discover. Our November Research Update brings you some of the highlights. By: Dr. Ed Coats                                   …
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Add-ons Don’t Always Add Up

‘Add-ons’ are additional treatment options that a patient may choose to add to their IVF cycle to increase their chances of success. IVF clinics have been offering treatment ‘add-ons’ to patients undertaking IVF cycles for years. The efficacy of ‘add-ons’ though has been widely debated in recent years. The HFEA now uses a handy “traffic light rating” system to warn patients about the levels of evidence supporting the use of these additional treatments. By: Dr. Ed Coats The fertility industry is growing rapidly and ‘add-ons’ are often adopted by clinics before rigorous research has truly determined their worth. This is a difficult area for patients and clinics alike. Patients are often willing to try the latest techniques if that may help them reach their goal and achieve a pregnancy. Clinics need to remain in touch and up-to-date offering the latest technology in the fast moving world of assisted conception. This is where the water can get a little murky, as not every ‘add-…
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Total Fertility will be at The Fertility Show London

The Total Fertility team will be in attendance at this years Fertility Show London in November. The UK's biggest fertility show, it is attended by prospective patients and clinics alike from across the UK and Europe. The Fertility Show London 1 - 3 November 2019 Kensington Olympia Stand D13 Pop by the stand anytime over the weekend. Opening Times: Friday 1st: 4pm - 7.30pm Saturday 2nd: 10.30am to 5.30pm Sunday 3rd: 10.30am to 4pm
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Optimising Sperm for IVF

“Make your swimmers into winners” By: Dr. Ed Coats 30% of couples who have been unsuccessful with natural conception will discover that sperm quality has been suboptimal. This news can come as quite a shock, especially if the focus has been on the woman’s fertility up to that point. Sperm develops in the testicles in a system of tiny tubes (seminiferous tubules). The sperm then moves to the sperm ducts (vas deferens). Seminal fluid (white in colour) is secreted from the seminal and prostate glands mixing with sperm to create semen, which is ejaculated. There are a number of points along this pathway where something can go wrong. The testicles are instructed to produce sperm by hormones released from the central brain. If a problem occurs with these hormones or the testicles themselves then sperm may not develop. A blockage can occur in the sperm ducts preventing the ejaculation of normal semen. In the majority of cases there are in fact no problems here but semen qual…
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Baby of a Cancer Patient Who Froze her Eggs is Born in Malaga

This is the first case registered in the Reproductive Unite of Gutenberg Centre (URE Centro Gutenberg) , located in Málaga, Spain. A woman, who was 37 years old when she suffered breast cancer, vitrified her eggs before receiving chemotherapy treatment. Seven years later, after the disease has passed, this woman has been able to be a mother thanks to the work of the doctors of URE Centro Gutenberg. This has been possible, because the frozen eggs were inseminated with spermatozoa of her partner, and then this patient was implanted with the embryos to achieve a pregnancy. Now, at the age of 44, she is the mother of a two-month-old baby whose gestation has been carried on normally. Egg freezing or vitrification is a technique for preserving fertility, which consists of stimulating woman's ovaries through a hormonal treatment, through ovarian puncture in the operating room. The mature eggs are then vitrified (quick freezing) and kept in benches intended for the pu…
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Recent Research: July 2019

Tablet Study The TABLET study is a powerful research trial that has just recently published its findings in the New England Journal of Medicine. This study recruited almost 20,000 patients from 49different hospital sites and fertility clinics across the UK. The study attempts to answer the question as to whether ThyroidPeroxidase (TPO) Antibodies in the blood affect the chances of having a live baby when patients don’t have any symptoms of thyroid disease. Specifically the study looked at whether patients without thyroid disease symptoms, but found to have a raised TPO antibody level in the blood, actually had a reduced chance of having a live birth. Previously a few studies had suggested a small dose of Levothyroxine, a drug commonly used to correct thyroid problems, might increase the chances of having a live baby in these patients. We now know that this is not true. Study Findings: The study showed that if patients were found to have high levels of TPO antibodies in th…
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Top 10 Tips When Choosing a Fertility Clinic

Location, location, location…. Always factor in a clinic’s proximity to your home or work. You will need to attend the clinic on a number of occasions through your treatment. Appointments are frequently scheduled early in the day so check your journey time to avoid added stress Parking What parking options do you have once you arrive at the clinic. Is there ample parking or will you have to drive in circles looking for a space to park. This just adds extra stress when trying to get to your appointments Emergency 24/7 cover It is important to have access to some friendly advice sometimes. Does your clinic of choice offer an out of hours emergency advice line for you during treatment cycles. Cost The costs of fertility treatment can be vast. If you are self-funding your treatment this website helps you to compare different prices of treatment, whilst at the same time considering the location of each clinic. Prices do vary across UK clinics. Suc…
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Eggs and Supplements. Unscrambling the Evidence

Eggs, Fertility & Supplements By: Dr. Ed Coats Let’s get to the heart of a question frequently asked by women, “Will taking supplements really make a difference to my eggs and my IVF treatment?”. This is a simple question that sadly doesn’t have an easy answer. So if you feel that supplements are a minefield then you are not alone. There is so much information on the web today driven by powerful marketing campaigns across social media, fertility forums and media platforms that it can become confusing. The supplements market in IVF is complex and not always well understood by clinicians. Unscrambling the evidence for selecting supplements to optimise ‘egg quality’ requires a logical and scientific approach. Rarely does a ‘one size fits all’ strategy work in fertility or in life, so beware of the response “this is just what we do in our clinic”. It is crucial to take the woman’s age, ovarian reserve, body mass index, medical health and previous IVF performance into …
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Do IVF clinics take advantage of older women?

THE HFEA (Human Fertilisation and Embryology Authority), a non-departmental public body of the Department of Health in the UK have come out and said that some fertility clinics are exploiting the desperation of older women to conceive. In an interview with the Daily Telegraph the chairwoman of the HFEA, Sally Cheshire, said a number of private clinics were using "selective success rates" to target older women. Since 2004 the number of women undergoing fertility treatment in their 40s has doubled to 10,835 in 2017. The chairwoman said all UK clinics need to be "transparent" about the costs involved in IVF treatments, as well as the chances of success. This is something that Total Fertility is striving to assist with by providing the base costs of popular treatments and success rates sourced directly from the HFEA of fertility clinics across the UK.
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Monkey gives hope to boys post cancer treatment

Incredibly researchers at University of Pittsburgh School of Medicine have found a possible solution to infertility in boys post cancer treatment. Using monkeys, they found that harvesting the testes of pre-pubescent male monkeys before making them infertile, cryogenically freezing the testes, thawing and grafting a small piece of the testes under the skin of the monkey leading to testosterone production: “during the 8- to 12-month observation period, grafts grew and produced testosterone. Complete spermatogenesis was confirmed in all grafts at the time of recovery. Graft-derived sperm were competent to fertilize rhesus oocytes, leading to preimplantation embryo development, pregnancy, and the birth of a healthy female baby.” There were issues however, most significantly being that although fertilisation of 138 eggs with sperm occurred, only 11 embryos developed enough to be viable options and of those, only one developed all the way to birth – Baby Grady. Although …
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Semi-Identical Twins in Australia for First Time

Two four year old siblings in Brisbane Australia have become only the second case of being semi-identical twins. The sister and brother share all their mother's DNA but only a section of their father's as reported in the New England Journal of Medicine. Genetic testing was used to first identify that the two were sesquizygotic. According to Professor Nicholas Fisk, who looked after the mother and semi-idenitcal twins at Royal Brisbane & Women's Hospital said:- “It is likely the mother’s egg was fertilised simultaneously by two of the father’s sperm before dividing,” he said. “The mother’s ultrasound at six weeks showed a single placenta and positioning of amniotic sacs that indicated she was expecting identical twins. “However, an ultrasound at 14 weeks showed the twins were male and female, which is not possible for identical twins.” Read more on The Queensland University of Technology Website  
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