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Itâs episode 2 of the relaunched Fertility Podcast and it has been amazing hearing what you think of our new sound. This week weâre talking about what to eat when youâre trying to conceive. It can be so overwhelming, and we want to make it easy for you to understand all you need to know.
We speak to Ro Huntriss who is a registered fertility dietician to give you the most up-to-date chat we can on what to eat.
Previously on the podcast, weâve spoken to a fair few people who know what theyâre talking about when it comes to fertility and nutrition and we'll add some other episodes you might want to check out below, but dieticians work slightly differently. Their focus is very much on evidence-based practice and their training to become a dietician involves clinical placements and training to support people with co-existing medical conditions. The way they work is to follow the medical model such as doctors, nurses, and pharmacists, etc.
Where do you start with nutrition when trying to conceive?
Ro recommends that you consider your own diet and look at the changes that you feel will make your diet healthier. Keeping a food diary is a great thing to do and can give you a really good picture on what kind of foods youâre eating and where you might need to make some changes.
How can I improve my egg health?
It takes around 3 months to influence the health of the egg and some of the nutrients to include are folate (folic acid) - to help reduce the risk of neural tube defect but also help to improve egg development and quality. Omega 3 - in oily fish or as a supplement can play a huge part in improving egg quality. Antioxidants â from fruits, veg, whole grains, nuts, seeds and even meat.
How can I improve Sperm health?
Ro also shares with us her recommendations for sperm health and how a Mediterranean diet and antioxidants are particularly useful such as vitamin C, E, Zinc, Selenium and folate.
Plus, we get the low down on whether you should go gluten and dairy-free â Ro makes it really clear that unless youâre a diagnosed coeliac, it is not recommended to be gluten-free to support fertility as there is no evidence to suggest that this is necessary. Wholegrain is an important part of our diet and needs to be included. If youâre worried you might be intolerant to gluten, ask your GP for a test before removing it out from your diet to be sure. With regards to dairy Ro doesnât recommend cutting it out unless necessary and if you do, make sure you get your plant-based dairy alternatives in.
We frequently talk about the importance of weight when trying to conceive and probably focus more on being overweight, however being underweight is also a consideration when it comes to fertility. Having a low BMI can cause irregular cycles and therefore ovulatory disorders. Ro recommends that if youâre underweight include olive oil, nuts, seeds and avocado in your diet.
Is it sensible to follow a vegan diet when trying to conceive? Ro says yes but encourages you to have a review with a dietician or nutritionist if youâre struggling to conceive. What about restrictive diets? Ro discourages this as these low-calorie diets are so restrictive and research shows that people that follow these diets donât get the best outcomes.
Weâll be catching up with Ro in the very near future to chat about preparing for IVF but in the meantime, you can find more about Ro here:
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THE FERTILITY PODCAST IS BACK WITH A NEW SOUND, A NEW RESIDENT EXPERT BUT THE SAME MISSION.
Weâre so pleased to be back with you, having taken some time to really work out what the best future plan for The Fertility Podcast is, and itâs to clearly guide you along the way to pregnancy. Weâre going through all that we think could help and sharing previous episodes to make sure you can really get stuck in. We canât guarantee you a baby, nobody can.
But we can promise you information you can trust and a lovely community to come and be a part of.
Our first episode back is talking about what we wished weâd know before starting to conceive. To be honest itâs what we should have been taught in school.
Those teenage years and when youâre in your early 20âs can be pretty worrying if you have unprotected sex. Itâs drummed into us NOT to get pregnant and what you should do to avoid getting pregnant. Sadly for so many of us, we never realised as we were never told, that our fertility is so finite.
That is what weâre here to do. Kate is SO passionate about empowering women to understand their cycle and the pair of us are talking through what you need to be thinking about.
Research shows that time to conception is reduced with fertility awareness knowledge so for the next few weeks weâre talking cycles and diets.
In this episode, we discuss how best to monitor your cycle with the different methods available and in particular what works and what doesnât!
Weâll be talking soon with a brilliant new app available to help you that has worked with women all around the globe. We also want to be very clear on the language we use as one of Kateâs pet hates is the fact that a normal cycle is often referred to as a 28 days cycle and that you ovulate on day 14.
FACT - Womenâs cycles vary hugely and can still be normal when shorter or longer than 28 days. We want to dispel this myth once and for all.
Itâs also so important that if you are trying to get pregnant in a heterosexual couple both of you understand about fertility health. Since this podcast launched in 2015 we have talked a lot about menâs fertile health and weâll be revisiting it again, donât you worry. The good thing is there is much more awareness today about the issue, then there was 7 years ago, but it needs to be taken seriously. We discuss the issue of protein shake use and how they can affect sperm health, as can smoking, recreational drugs and too much alcohol. It's so important that if you are in a couple you both take responsibility for this and get yourselves in the best place possible to improve your chances of conceiving. Men need to realise that infertility issues are 50/50 male to female.
Weâll be talking over the coming weeks about optimising your fertility and be sure to join us to carry on this conversation in our closed facebook group where you can also submit questions to Dr James our expert for next time.
Make sure you head over to our Instagramme for details of our fab giveaway happening for launch week only. Closes Friday 26th Feb 11.59pm.
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Episodi mancanti?
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Thanks to our episode sponsor Pharmasure who create the nutritional supplement Impryl, which enables your body to maintain its natural metabolic balance and so ensures the very best chance of pregnancy - to find out more visit fertilityfamily.co.uk
In this montage, youâll hear from Emma Cox from Endometriosis UK about how the diagnosis of endometriosis, which all too often goes undetected for 7 years, can be made. Hear the full episode.
Plus we want to make sure you know how you can improve your Gut health and what you can do to aid your fertility as we speak to Dr. Cecilia Kitic the founder of The IVF Project and Dr. Sue Reed who is a Dietician and microbiologist. Hear the full episode.
We also spoke with Fertility Nutritionist Melanie Brown about the importance of sleep and your fertility, and how you can improve your sleep hygiene. You can listen to this episode here.
My lovely co-host Kate explains what we need to make sure are thinking about with our menstrual cycle which you can hear in full here.
And when it comes to PCOS, we spoke with Kym Campbell about how PCOS affected her family building and what she did to overcome that. Have a listen to the full episode here.
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We are delighted to welcome Professor Joyce Harper to this week's podcast. Joyce is a Professor of Reproductive Science at the Institute of Womenâs Health at University College London and Director of the Centre for Human Reproduction. Joyce has an incredible amount of knowledge when it comes to womenâs health.
With over 30 years of experience working in the field of fertility awareness education, she is so passionate.
Finally, Joyce has had the time to finish a book, she started writing 4 years ago Joyce covering the whole of a womanâs lifespan from menarche to menopause.
You can imagine how fascinating it is going to be. It comes out next year and is described as
"The only guide you'll ever need to understand how your body works, from the menstrual cycle to the menopause: no myths, no misinformation, no scare stories - just scientific evidence that shines a light on the facts you need to know. "
Finally, the book we all wish we'd read earlier.
Joyce hopes that her book and all the information it contains will help men and women have a greater understanding of their fertility so that they may avoid needing assisted conception.
A powerhouse when it comes to research, Joyce has recently completed a study on fertility apps and found that the majority, used a calendar method using just cycle lengths which gives us very little information and using natural fertility indicators such as BBT, cervical mucus, cervix, and OPKâs (note not always reliable for women with PCOS).
She tells us about a new method that used carbon dioxide to measure fertility - fascinating eh.
We talk about how useful, but equally how misleading, social media can be when it comes to fertility information and perpetuating myths. The book looks at the scientific information and gives women the bottom line and the evidence they need. She is concerned that women can be very vulnerable when they trying to conceive and can be sucked in by bold claims on for example alternative therapies.
Joyce has been recently auditing the IVF clinic website and the IVF Add ons they offer. She found that many clinics in the UK are charging thousands of pounds for unproven treatments and that bold claims are made for many IVF Add ons, such as PGT-A, assisted hatching, and time-lapse imaging. Worryingly, it seems that the clinics are telling patients to ignore the evidence. Joyce has found it hard standing up to her colleagues on this contentious issue but is determined to get this information out to patients through her book.
Joyce talks about the Fertility Education Initiative that aims to get fertility education out to all. This initiative has now become international and all of their campaignings have, at last, got the word âfertilityâ on the school curriculum. More work needs to be done to reach a younger community on the platforms they use.
Are we seeing a shift in Fertility education? Whilst there is so much great work being done, Joyce thinks weâre still in a bubble and hardly scratching the surface.
Please share this episode with as many people as you think may benefit from it. Letâs use our âbubbleâ to reach other âbubblesâ and get talking about fertility awareness.
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Do you know where to find reliable information about your fertility? Today we speak to Matt Prior a Fertility Consultant Gynaecologist in Reproductive medicine at Newcastle Fertility Centre.
As well as working at Newcastle Fertility Centre, Matt works with Kate providing consultations for Dr. Fertility. Matt is passionate about patient information and on a mission to improve the quality of patient information, founded The Big Fertility Project.
Matt talks about the different types of information available to fertility patients, whether this is patient information leaflets, patients sharing their stories, information via fertility influencers, commercial information from clinics, and other organizations and media information. Mattâs ambition is to bring this information together in a collaboration between patients and professionals to produce better quality information than we have currently available.
Matt shared with us the research he undertook into miscarriage research â The Miscarriage Priority Partnership this identified the top 10 aspects that should be researched in miscarriage. This research involved a collaboration between patients and professionals to establish what aspects were most important to patients.
Matt aims to find good sources of information and present it in a more accessible and engaging way that is more appealing to patients. We talk about the rise of fertility social media influencers and how whilst they share fantastic information and break down barriers, sometimes this information can be biased if influencers are promoting products and caution is needed.
We talk about the benefits of patients sharing their stories, but it is important to be mindful that because someone may have had a negative (or positive) experience of, for example, a procedure, it doesnât mean to say that it will always be this way for you.
If youâre interested in getting involved with The Big Fertility Project and sharing your story â get in touch via the links below.
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In this episode weâre back with Dr. Malu Consultant in Sexual Health and Clinical Director of Clarewell Clinics based in Birmingham and Leicester, talking more about STIs and fertility.
Have you been to an STI test? How comfortable would you feel about going to an STI clinic? Does this fill you with dread?
Dr. Malu explains exactly what a hydrosalpinx is. Itâs something you may have heard about or may have had diagnosed on a scan, but the name doesnât exactly explain whatâs in the tin! Hydrosalpinx refers to a fallopian tube that is blocked with âwateryâ fluid and is typically caused by infection.
Erectile Dysfunction can have a huge impact on fertility, especially when it comes to the stress of TTC and performance anxiety. Kate asks how frequently is ED due to psychological issues and how much is in relation to physical aspects? Dr. Malu tells us that in young men, ED is predominantly due to psychological issues and also lifestyle such as alcohol intake, etc, but in older men, it may be a mixture of both the physical and psychological aspects.
Over the years with all the advances in drug treatments for HIV, men and women can now live perfectly normal lives with HIV, but what are the implications for TTC with an HIV diagnosis? Dr. Malu explains how well HIV can now be managed and that if one partner is being treated effectively and the virus is undetectable then the risks of passing on HIV to a partner are virtually zero. Similarly, if a woman becomes pregnant the risks of passing the infection to the baby are virtual zero. However, if an individual is not diagnosed and does not use a condom, then the risks of passing the infection to a partner are high, and passing the infection to the baby is 30-50%.
As a final note, Dr. Malu encourages all men and women who are trying to conceive to seek advice about STIs. Get empowered and take a test. You can take a look here for more information on the different STIs weâve chatted about.
For even more online support with your fertility and exclusive content, become a Patreon today for just ÂŁ11 a month, you'll get access to more Q&As with Kate and me more regularly as well as Q&As with our expert guests.
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In this episode of our Later Years series, we focus on a real-life fertility story and welcome TV personality and model Rhian Sugden to the show.
Rhian and her husband, Coronation Street actor Oliver Mellor have been together for 8 years and a year ago after fertility tests, Rhian was told the devastating news that her ovarian reserve was very low and she would need IVF. At the time of recording, she was about to start her 3rd round of IVF. Rhian has been advised to consider a donor egg, but at the moment, she just wants to give it one more try - an emotion that weâre sure is familiar with many of you.
Both Rhian and her husband are in the public eye, and their journey so far has been all about living this experience publicly. Itâs been a rocky road so far. Unfortunately, Rhian has experienced some negative comments and has been trolled on social media, but equally, Rhian has found support from women in similar situations, on Instagram, through sharing all she is going through.
During Rhianâs IVF treatment she started to notice a strange side effect â an increase in freckles! Rhianâs IVF medication caused hyperpigmentation of her skin. Hyperpigmentation is not well researched, but women do report this side effect and it is quite likely the false âmenopausal stateâ that IVF meds propel you into, could be the reason why this occurs for some women.
Rhian has looked into whatâs involved with donor eggs. We chat about epigenetics and how it is possible for a woman to influence the genetic make-up of the donor egg once in utero. Rhian now feels really positive about this option and is no longer fearful of considering this option to create her family should she need to.
Sadly, since recording Rhian let us know that her 3rd IVF failed. Rhian and Oliver are very much in our thoughts and we did make sure Rhian was happy for us to still publish our conversation, which she gave us her blessing.
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Have you thought about freezing your eggs?
Welcome to our final episode of The Later Years Series. We're hoping to bring you one final episode of 2020 just before Christmas and weâre very much hoping that the two of us can get together to record in person - Covid restrictions permitting!
This week weâre talking egg freezing with Catherine Hendy author, yoga teacher, and co-founder of Elanza Wellness, and Sophia Money-Coutts journalist and creator of the podcast Freezing Time.
So, you might have reached 35 or over and youâre thinking what next?
Catherine did after her marriage broke down at the age of 32 and found that there were so many presumptions about a life - childfree. This made her interested in finding out more and eventually made the decision to freeze her eggs.
Sophia has recently frozen her eggs and shared her egg freezing journey in her fantastically funny, informative, and emotional podcast. It is a must-listen if youâre considering freezing your eggs or even if youâre about to embark on your first round of IVF.
Catherine wanted to find out about the misconceptions of egg freezing and the questions women want to know. She found that the common questions were women considering if theyâre the right age, the pros and cons, how much egg freezing costs.
We ask for Sophia and Catherineâs opinion on fertility MOT testing. Sophia found the test really useful as it helped her with decision-making going forward. Catherine made the decision to go to a clinic to have the hormone test along with the antral follicle count scan to provide more in-depth information.
Sophia talks about the importance of feeling really comfortable with your choice of clinic and doctor. She recommends attending clinic open evenings to help you make a decision on which clinic. Sophia decided on the Lister Clinic and (in her words) the âlovely Dr. Jamesâ.
Natalie asks whether they considered freezing embryos as well as eggs. Sophia felt that this decision was rather rushed and didnât want to âpanic buy spermâ, so in the end made the decision to not freeze embryos on this occasion but doesnât rule it out for the future. Catherine was only 32 when she froze her eggs and felt as though she had enough time to meet a partner. Therefore, freezing embryos was not really on her radar at that time.
Finally, we chat about how they both feel about their decision to freeze their eggs in a Covid world. Sophia says her overriding feelings are relief, positivity, and gratefulness. She still is questioning whether or not she feels broody yet but after a year of Covid, sheâs looking forward to a bit of traveling before making any more decisions. Catherine on the other hand, two days after freezing her eggs met the partner she now lives with, so time will tellâŠ.
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In this latest episode of The Fertility Podcast, we continue to focus on 'The Later Years'.
We're in conversation with Lucy Lines, an embryologist based in Australia. Lucy worked as a clinical embryologist for many years and following redundancy made the decision to take a different path and founded Two Lines Fertility.
It's always fascinating hearing from an embryologist and Lucy explained how early on in her career, she had to sit a personality test to see if she was the right person to take on the role. She explains how it takes a certain type of person to become an embryologist.
Just as we are, Lucy is also passionate about fertility education and talked about a recent patient that had been trying to conceive naturally and with IVF for over a year with no success. She explained how it became evident that this couple had very little knowledge of their cycle and when the woman ovulated.
Lucy was shocked that no one, had anyone talked to her about the signs of ovulation!
This is something that frustrates both Kate and Lucy - that women and couples arenât given this vital information, especially as research shows fertility awareness education reduces time to conception.
Lucy uses her years of experience to advise patients on the ins and outs of embryology and what it really means when an embryo is 3 cells on day 2 or 6 cells on day 3.
She helps couples understand the science behind it so they can make informed decisions. Lucy also explains the importance of carefully searching for information and guidance on the internet and always using Google Scholar for evidence-based information.
If you've ever wanted to understand the differences between egg quality and egg health, then Lucy does it perfectly.
'Egg quality is the genetic stuff and the things we canât change like eye color, height, etc. Egg health, on the other hand, is the stuff we can change â such as improving egg health by healthy lifestyle choices and the right supplementation for you. '
Lucy recommends spending 90-120 days before conception by concentrating on these aspects to give yourself the best chances.
Like our recent guest Professor Joyce Harper, Lucy is passionate about raising awareness of your future fertile self with children and their parents. She shares an example of young people seeing their parents use synthetic fragrances and beauty products, or heating food in plastic containers, and how these chemicals are endocrine disrupters and disrupt the fine balance of both male and female hormones.
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In the 3rd episode of our Early Years Series we chat with an old friend and colleague of Kateâs Dr. Manoj Malu who is a Consultant in Sexual Health and Clinical Director of Clarewell Clinics based in Birmingham and Leicester.
When did you last consider your sexual health? Was it something that you thought more about in your 20s but since settling down itâs not even been a passing thought? Todayâs episode might just get you thinking againâŠâŠ.
Meet Dr. Malu we chat about the general awareness of STIs and how these infections can impact your fertility. He tells us the less common infections such as Syphilis are on the rise and explains what really is bacterial vaginosis. Dr. Malu discusses how pelvic inflammatory disease can have a devastating impact on your fertility and raises the issue of a little-known infection called mycoplasma genitalium. This infection is very common, as common as chlamydia, but it is not routinely tested for in the majority of clinics!
On the podcast, we frequently talk about how there needs to be more joined-up working among fertility doctors and urologists/andrologists, etc and Dr. Malu adds to this further discussing the importance of adding comprehensive STI investigations and examination to the mix.
Tune in next week to hear more from Dr. Malu when he talks about what on earth is a hydrosalpinx, erectile dysfunction, and the amazing advances in HIV treatment. In the meantime, you can take a look here for more information on the different STIs weâve chatted about, including mycoplasma genitalium.
For even more online support with your fertility and exclusive content, become a Patreon today for just ÂŁ11 a month, you'll get access to more Q&A's with Kate and me more regularly as well as Q&As with our expert guests.
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What is the Freedom Fertility Formula?
Meet Dany Griffiths. Dany is my coach and mentor in the training I have been doing over the last year to become a Freedom Fertility Specialist. Drum rollâŠ..I have now graduated and hopefully will make an awesome Freedom Fertility Specialist.
Dany is passionate about the emotional impact of fertility, which came about initially from her desire to support her best friend using Hypno-fertility. Dany found she had a huge interest in emotional well-being and developed the Freedom Fertility Formula to help women get to a place of strength, where they have the ability to cope with the rollercoaster of their fertility journey.
Becoming a Freedom Fertility Formula Specialist
Dany teaches her trainees to firstly listen so that the womanâs voice and pain are heard. She then provides strategies to support them to move forward and work on the mind-body connection. She recognizes that the one thing that women struggling with infertility wants - is the ability to cope with the day-to-day.
The Emotion Module of the Freedom Fertility Formula
This module focuses on understanding your emotions and taking the right action, using your feelings, to guide you. Dany believes that taking the time to consider your feelings, consciously, means that you can then move forward in the best possible way.
Dany talks about positivity and the importance of adding back joy into your life to help them avoid putting life on hold. Maintaining an even keel, acknowledging the bad days, and having a duvet day is absolutely fine.
Imagining your Goal
At the start of the Freedom Fertility formula course, Dany very much encourages her clients and trainees to focus on the individual rather than the end goal of a baby. However, towards the end of the Freedom Fertility Formula the conversation turns to the desire to have a baby. At this point and in a safe and secure space, Dany encourages women to fully embrace what it is they want and connect fully with this desire. This can be difficult and challenging for both the specialist and client, but Dany views this as the pathway to healing.
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We're talking periods, STIs, fertility education, miscarriage, and where to get the information you can trust when thinking about your future fertility.
Make sure you subscribe so you don't miss an episode, plus you can now sign up to become a Patreon of The Fertility Podcast. You'll be getting even more support from Kate and Natalie every month with a live get-together, have a say in who is interviewed on the podcast, and also get to chat live with experts.
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Continuing our series of The Early Years we chat with Amone Gbedamah co-founder of We Are The Hood, a brand new journal for girls aged between 8-14, aiming to change the way young girls experience puberty. Amone and co-founder Maria Purcellâs mission is to remove the secrecy, stigma, and taboo surrounding periods and replace this with knowledge, empowerment, and ultimatelyâŠ.. celebration.
As women, we can probably all remember the day we got our first period. The secrecy, and often the anxiety, that having your first period induces! Who do you tell? What do you do? Pads or tampons? Itâs a minefield.
Why is it that being educated about periods at school, is often shrouded in secrecy and shame? The girls are removed from the boys for these discussions, further increasing the shame felt by young girls. This first experience needs to change and this is exactly what Amone and Maria are on a mission to do.
Amone tells us how the inspiration to create the journal came about and gives us a tantalizing insight into the structure of the journal. The co-founders were careful to ensure that the journal is educational â covering the basics such as anatomy, periods, nutrition, myth-busting, and also advice on the different types of sanitary protection available. However, they also wanted to provide the opportunity for creativity, mood, and period tracking, as well as real-life stories from inspirational women.
The journal also includes an all-important guide for parents, which will hopefully help parents to feel more comfortable talking about periods with their daughters. Kate is well aware that some parents prefer not to openly discuss these issues with their children, fearing that this knowledge can have negative connotations, and asks Amone if they have come across any negativity from parents.
The journal is available as a hard copy and as a digital copy. Parents can preview the content before purchasing the book, by purchasing the digital content to look through this first before deciding to share it with their daughter.
Excitingly, going forward, We Are The Hood has plans to create journals for other age groups, ultimately spanning the lifespan of the woman.
The journal is available to purchase via their website - but also on amazon, Etsy and Instagram.
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This week on the podcast weâre talking poo!
Well to be exactâŠâŠ.gut health and your fertility. Meet Dr. Cecilia Kitic the founder of The IVF Project and Dr. Sue Reed who is a Dietician and microbiologist. Both ladies join us from Australia.
How to eat for good fertility
Sue tells us how infertility can be associated with an unhealthy gut, particularly increased inflammation and low diversity of bacteria in the gut. She recommends focusing on good whole foods and steering clear of refined and processed foods.
Whole grains are hugely important for a healthy fertility diet. They contain all our essential nutrients, antioxidants, and prebiotic fiber. Examples are whole grain pieces of bread, brown rice, and even popcorn! Sue recommends 48gs of whole grains per day. For PCOS focus on the low glycaemic index carbs.
Cecilia says that it doesnât have to be expensive to ensure youâre getting the right good quality foods. Both Cecilia and Sue help their clients in buying the right food to optimize their fertility.
Sue says even eating frozen veg and fruit is a great way to get all your nutrients in. These foods are frozen very quickly after being picked and therefore contain an abundance of our essential nutrients. Meal planners or batch cooking is another way of keeping costs down.
What about dairy?
Sue encourages her clients to eat dairy as it is chock full of all the vitamins, minerals, and the all-important calcium, that you would miss out on if you excluded this in your diet.
How can you find out about your gut health?
Itâs easy to get your gut tested by doing a simple poo test. Our feces are actually really complex but by testing you can easily see whatâs in there but equally whatâs not.
Sperm health and the gut
Cecilia explains that if your gut is healthy and you have a good bacterial diversity then testosterone is at an optimum level. However, a poor diet can reduce this diversity and be damaging to sperm health.
To supplement or not to supplement?
Sue feels that many women go overboard on supplements and that vitamins and minerals from our food is the best option. Clearly all women should take folic acid and vitamin D, and also Omega 3 if they donât generally get this from eating oily fish.
The benefits of exercise over-supplementation
Cecilia firmly believes that exercise should always be used to improve energy and vitality as opposed to supplements. Exercise is the best anti-inflammatory and this is especially important for women with PCOS and to help reduce DNA damage of the egg and sperm.
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It's Fertility Week in the UK, and throughout the week the TTC community are talking about the many different ways we are affected when dealing with infertility.
Fertility Network UK the leading fertility support charity is focusing today on Mental Health using the hashtag MentalMatters and a former guest on this podcast Kelly Da Silva is sharing her experiences of being childless not by choice. Kelly spoke to Kate and me in a previous episode about feeling at peace with the situation and you can hear her conversation be sure to visit FNUK's website to find out more about what's happening this week.
The Agora JournalsIn the fertility podcast world today I'm sharing an exclusive episode which is part of a new podcast series I have made called The Agora Journals - conversations about empowering the freedom of reproductive choice for everyone, featuring a wide range of individuals and couples on their road to parenthood with wisdom, compassion and honesty.
This first episode is a conversation with Carole Gilling-Smith. Medical Director of The Agora Gynaecology and Fertility Centre in Hove, East Sussex. The clinic specialises in diagnosing and treating the causes of infertility and welcomes people from all walks of life to support alternative parenting.
The clinic offers specialised programmes for same-sex couples and single women who wish to conceive using donor sperm. Carol talked about how she set up her clinic Agora in Surrey as a desire to create the perfect clinic to experience for patients and is interested in fertility education and believes strongly that we should be educating young people about fertility in schools but also for people in their 20s before they start thinking about making a family. She works with the LGBTQ community to help them in the different ways that can make a family and importantly get the communication right with this group of patients.
Fertility preservation and the LGBTQ communityis a key part of the clinic's work and Carol highlights that at the time when an individual is considering transitioning, is generally not the time that they are also considering their fertility? It is important to start having these discussions and consider fertility preservation before commencing hormone treatment, to avoid later regrets.
Carole explains the fertility preservation care and processes that transgender individuals receive at the Agora and that the Agora are very sensitive to their specific concerns. The Agora Clinic is leading the way in Fertility Care for the Trans community and actively celebrates alternative families. More clinics are beginning to open their doors to this community. We talk about the support that The Agora offers individuals and couples in terms of counselling and other resources they share with patients on how and when to discuss their stories with their children. Carole recommends that these discussions start with their child from a young age.
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Professor Adam Balen talked through the new PCOS guidelines, with regards to diet and also the issues around Clomid, explaining he prefers to use Letrozole. One of the most common misconceptions he says he still hears is women who have been told they won't get pregnant because they have PCOS.
When it comes to being overweight it, most women can improve their fertility by a 5-10% reduction in body weight.
Adam talked about how a lot of women end up having IVF when they have PCOS and don't need it. He spoke about Ovulation Induction kits as well as explaining more about a Laparoscopy and thankfully we've moved on from Ovarian drilling - which you will also hear him and Kate discuss.
Adam also talked about the downside of Metformin being used by women with PCOS and he explained how GPs don't understand what PCOS is and mistakenly think you have to have severe symptoms however we recognize it is a spectrum. You don't need all of them just 2 - such as menstrual disturbance and the Rotterdam Criteria
We also touched on the ethical issues - which we will aim to discuss more in a future episode.
Things to consider: PCOS runs in the family - 1st-degree relatives so there's a 50% of your mother's sister's daughter having it. Talk to your sister. Get screened.
We need to understand normal! Adam mentioned the videos from Fertility Forum which you can view here
You can also watch some animations from the Fertility Education Initiative here
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Meet Amy Bennie, Trustee and Chair of the Daisy Network. Daisy Network is a charity dedicated to providing information and support to women diagnosed with Premature Ovarian Insufficiency.
We discussed what is Premature Ovarian Insufficiency (POI) - a term used to describe where the ovaries stop working before the age of natural menopause. Some women with POI can be as young teenagers. Daisy provides support and medical advice, local support but also aims to raise awareness among medical professionals.
Sadly POI occurs in 1:100 under 40, 1:1000 under 30, and 1:10,000 under 20, however other women may also be diagnosed following cancer treatments for example.
It can be difficult to diagnose POI and may be incorrectly diagnosed initially. Symptoms include periods not starting as a teenager, periods stopping, noticing menopause symptoms such as mood swings, night sweats, anxiety, tiredness, etc. Diagnosis is obtained by taking an FSH Blood sample and repeat 4 weeks apart
Like fertility, POI or menopause is not routinely discussed in schools, and therefore there is a lack of awareness. Treatments for POI include HRT or the Combined Oral Contraceptive pill. HRT replaces the estrogen that is lacking and helps to protect bone density.
Daisy offers a variety of different support networks such as medical support, local support for meet-ups, and connecting with other women suffering from POI, a Private Facebook group. Daisy also has an annual conference called Daisy Day.
Daisy Network aims to be the first point of call for women who are diagnosed and encourage early referral from medical professionals once diagnosed.
Women who are diagnosed with POI are more likely to conceive with egg donation and IVF. All the Daisy Network team are volunteers. The charity fundraises through their annual conference and by members who do fundraising events such as climbing Kilimanjaro and 100k walks. The majority of POI is spontaneous but it can be hereditary and therefore this makes it difficult to detect and more research is needed to understand POI more.
HRT and breast cancer risk â for POI HRT replaces hormone levels that have been lost and does not increase the levels and shouldnât increase the risk of breast cancer. Most recent studies did not consider POI and therefore do not relate to a woman suffering from POI.
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Henrietta Norton talked about how even as early as seven years old she was experiencing digestive issues and tiredness. Her periods were dreadful and as we hear all too often she just accepted this was how it was going to be.
It wasn't until her early 20âs that she went to a nutritionist and had a light bulb moment as it was at this point that she understood how much our food and lifestyle can affect our hormone balance
Henrietta spoke about how she was diagnosed with all sorts of different conditions and each time, the common theme was extreme menstrual pain
In her work as a nutritional therapist and in her talk at The Fertility Show, Henrietta will be speaking explaining how important it is to realize, not what to cut out but that it's about what you need to put in. She describes how we are an interconnected web of systems and how you canât treat one without looking at the others.
We also spoke about 'Stress and mindfulness' and how whilst they can often be seen as buzz terms in today's society, stress can be more than running around, working hard as it means different things to diff people.
Henrietta talks about the 'window of preconception health' and how important this is. She explained how 'Preconception is a hugely energetically hungry process' which I thought was such an insightful thing to share and something that a lot of us probably don't realize.
She explained how if you donât have enough of the nutrients to support your mitochondria you will be feeling really tired. We also spoke about how Fertility preservation starts when we start menstruating
You will hear tips on where to start regarding supplementation and how Omega 3 is really important for Men and Women. For the man as well as it increased mobility and motility
You will also hear from Dr. Sandeep Mane who has set up Origin International Fertility Center in India. He was in charge of surgical skills training at the Royal College, London where he trained numerous doctors from all over the world. Dr. Mane has set up a clinic and will be speaking about the emphasis he puts on the mind and spiritual approach in his clinic. How important it is for patients to understand what is going on with them, to know what treatments and tests they have had previously and why they didn't work.
He wants to ensure people are able to cope with every stage of their treatment, so works with the mind as well as the scientific processes needed from assisted reproduction in his practice. His talk will be explaining more about his work and how he believes this approach is a significant part of the future of fertility treatment.
To get tickets to The Fertility Show and to find out the full speech schedule click here
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Do you know how to chart your cycle?
Meet Author Toni Weschler, who wrote her epic manual Taking Charge of Your Fertility over 20 years ago as she wanted to help women understand how to chart their cycles. She wanted to teach the fertility awareness method and educated women that cervical fluid is to the woman what seminal fluid is to the man
Toni spoke to me about how she got into working in women's health and when she started writing her book it became the most intellectually challenging thing she has done taking her five years to research and write, as it was for three different audiences.
Toni explained she wanted to speak to practitioners, people who are trying to get pregnant, and people who are trying to avoid getting pregnant and how that caused quite a headache with the language she would use. For example, if a woman or a couple was reading the book to understand more about natural birth control when I was discussing when a woman was fertile or infertile..Iâd say it was unsafe. But if a woman was trying to get pregnant, that wasnât a very helpful term, also for PCOS - itâs treated differently depending on whether you are trying to get pregnant or avoid pregnancyâŠ
Toni has also written a book called 'Cycle Savvy' - the smart teenage guide to mysteries of your body which is about being empowered and savvy about your cycle and once you understand everything about it you can use that information for a myriad of situations.
Her aim for that book is that she wants every teenager to come away with the power within their own body to utilize the information to make decisions eg. use natural birth control or use this information for pregnancy achievement and not go through years of infertility...
Toni spoke about her mixed feelings about fertility apps expressing concern if any woman uses an app when they only fill in when they get their period and the app tells them when they will be fertile, she said to ditch them!
She talked about the estrogen surge and how it's important to understand that once your temperature rises itâs too late and that the most imp thing to observe is your cervical fluid, which should be a slippery and clear type of substance. However, the exception of this is women with PCOS due to irregular cycles.
Toni explained how her book came out just before the internet took off and my number was in the yellow pages and she had a woman called to say thanks for all that she had done and had Toni see the messages on the 'Message boards'.Toni had no idea what the woman was talking about, as and I had to have her explain that people had been posting comments.
The email was barely a thing - so her PO box was flooded with letters, with every single woman saying I canât believe I didnât know this sooner⊠how is it my doctor didnât tell me this.
This is the episode I mentioned in my chat with Toni, where the lovely Amber aka Preggars Kitchen reviewed her book and explained how much it changed her life
To win my copy of Toni's book visit my Instagram for details
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Understanding your genes
Meet Angela Heap, a Nutritional Therapist who is working in fertility having come to it from her own experience of PCOS and Prolactinoma as she found she wasnât helped by conventional medicine.
Angela grew up in Hong Kong, had a very healthy lifestyle came back to the UK at 18, and started to experience migraine, it was at this point in her life she started to pay more attention to what was going on in her body.
She started to look into genetics and found out she had some of the genes such as insulin mutation genes that would predispose her to PCOS. She also has a family history of glaucoma
Angela has spoken around the world on her studies and in 2013 talking about it, in the US
and discovered people like Amy Yaskos and Dr. Ben Lynch - epigenetic and nutrigenomics and she started looking into it more. Angela explained how you can change things but only if they are expressed.
We spoke about the tests you can do yourself such as 23andme
and she explained how when you do these types of tests, itâs worth going through them with someone who understands, as you can get quite scared about them. The test is telling you a predisposition, itâs not saying you're actually going to get a certain disease.
She also explained how Google heavily invested in 23andme and is very interesting, which is something I didnât realize. Itâs important to understand the time frame involved when trying to make lifestyle changes and Angela explained
âI always say this when I speak to people - it's about a long preparation period. You wouldn't do a marathon without all the training, you wouldn't just jump into that... It's exactly the same for preparing for a baby because it's your family line. It's not just that one baby you're trying to get because you want to complete your family it's your family line and it's quite important to make them as healthy as you possibly can".
Angela has worked with people with egg health and has had some great results working with people with IVF to the point that the fertility consultant has asked the patient what they have been doing as they had expected the patient's eggs to have degenerated.
âWhat you do prior to conception is the most consequential thing you can doâ
Angela has also been invited to Parliament to discuss Micronutrients related to how in the UK theyâre going to be fortifying folic acid. She also explains about the MTHFR gene and how we ingest folate and it doesnât just get into the cell it has to be broken down
15 or 25% have the MTHFR gene, so itâs not just a straightforward case of taking folic acid when you are trying to conceive. She has specific opinions about off-the-shelf preconception supplements. "Going along to Boots or Superdrug and just picking up, you know standard prenatal's isn't the way forward. Any medical professional would say "I'm not just going to assume - let's test and find out" and that's exactly the point I'm coming to at. Let's look at some of your genes and see if there's some variance there that may be causing some issues and then we can have that conversationâ.
Angelaâs advice is to always look at people who are specialists in fertility who have been trained in nutrition as she says there are a lot of doctors and nurses on Instagram who hasnât been trained, giving advice on supplements, and they havenât been trained. Work with someone who knows what they are talking seek out professionals who are functionally trained. For more information on Angela, You can follow her on Instagram here
Angela made reference to the following people and organizations:
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