Does anyone know a good fertility consultant?

[ceebeebee]

Not for me (just in case Mr Ceebeebee reads this and has heart attack....) Need to find a local (ish) specialist who does private work - not IVF at this stage, just investigative and possibly clomid therapy. Feel free to PM me if you'd rather not post publicly!

[bumpy]

http://www.emmacannon.co.uk

http://www.thefertilitysupportcompany.co.uk/Index.aspx

[dulwich22]

Have you considered acupuncture? There is evidence to support that it works and is definitely less invasive than some western alternatives. Check out Hilary Grandon's website, she works at the Natural Family Health Center on Lordship Lane and fertility is one of the things she specialises in. She offers free telephone consultations so you could call her and have a chat about how it works. http://www.acupuncturehil.co.uk

[The Nappy Lady]

These people come highly recommended via a friend;

http://www.argc.co.uk/

We went for a meeting with them after our recurrent miscarriages, but didn't pursue it for various reasons.

It is incredibly expensive, but they have fantastic success rates.

Our friends used it for IUI, which is less stressful, invasive, or expensive than IVF and may well be worth looking at. It worked for them, and they went on to have 2 more children unaided...so to speak, despite all the problems having their first.

IUI is not well known, and rarely offered on the NHS I think, had never heard of it until they went through the process.

Good luck to your friend. If they want to speak to me about the experience they are very welcome, and I'm sure my friend who had the IUI would also be more than happy to do the same. Just PM me.

xx

[annaj]

IUI is available for NHS-funded patients, but it's not offered as much because it's only useful for certain types of infertility and is far less successful than IVF.

Just one word of warning about looking at success rates, particularly for private clinics, who are, after all, trying to sell themselves. This might seem really picky, but it's actually really important and the doctor in me can't help wanting to point it out...

Lots of clinics publish their "Clinical Pregnancy" rate, which, depending on their definitions, may mean positive pregnancy test or foetal heart seen on scan. It's not the same as the "Live Birth" rate, which, obviously, is the one that matters. The clinic linked above, which may be excellent, I don't know, give very high clinical pregnancy rates, compared with other centres, but doesn't say what their live birth rates are. To get a full picture of any centre you need to know their live birth rate and their exclusion criteria for treatment - a centre may have an excellent success rate, because it only accepts patients who have a good chance of success.

[chantelle]

Colin Davis - 02076 167753 - works out of Harley Street.

ACU at Guys Hospital is also good and does both NHS and private funding.

[new mother]

Ok.

As Anna says, "live birth rate" is the generally accepted standard and for ARGC not to quote it is strange, particularly as I understand that they DO have quite good LBR.

If anyone's interested, the London clinics - Lister, UCH, ARGC, are generally good but very dear. ARGC is in a slightly different bucket in that it's extraordinarily expensive and, by Taranissi's admission, deals in controversial therapies. Their main claim to fame is with the very sad issue of recurrent mcs, especially the utter tragedy of late mcs, and the idea is that they have special immune treatments that will overcome some women's "rejection" of the implanting or growing embryo. Now, this is certainly an issue for a few women, but only a few. Spend ?20 first on Dr Beer's book "Is your body baby friendly?" and see if it resonates.

I cannot emphasise enough that you need a clinic that is specialist in YOUR issue and YOUR age-group. If that is eg male factor, ARGC isn't immediately indicated. If you've had recurrent mcs, tried aspirin, tried a steroid such as high dosage prednisolone to dampen the purported anti embryo reaction, all with no success, it might be worth trying ARGC and its (controversial and in some cases unlicensed) therapies.

As a general point, a sizeable number of couples nowadays present with so called "unexplained infertility" ie no male issues, no blocked tubes, the women ovulates per a progesterone test at 7 post ovulation of >30 pmol (watch units used), a decent number of embryos are fertilised and the max implanted but...no fertilisation follows. If you have unexplained, you will TEND to be older and might have a low day 3 antral follicle count (AFC). THis leads us to think that ageing eggs and lower supply, ie deteriorating chromosome counts, result in the body naturally rejecting a flawed the embryos.

Now, if this is the case, what can you do to icnrease the odds? Well, it is my strong belief that success needs numbers. THat is, you need to have as many embryos trying to implant each cycle as possible as a surprisingly high % will be flawed. eg many women will find in an IVF cycle that they produce eg 10 eggs, none of which is good. (As a separate issue, query whether AMH blood tests measure quality of eggs accurately or not. Polycystic women will have very high AMH but often poor egg quality.) So, for older women where egg quality is likely to be an issue, at the very least, I'd be looking for a clinic that will automatically put back the max number of embryos ie 2 up to 40 and 3 over 40.

Ask about criteria for treatment, as Anna says. Eg I've heard that UCH gets good results but certainly used to require a certain AFC of maturing eggs before the IVF cycle would continue. In this way, the denominator of their stats is contained and their stats improve. Lister doesn't have these criteria as far as I know but has other drawbacks.

I'd look to use any free NHS goes that you have where-ever you can and then, if you're paying, maybe try UCH or the Lister. You may as well get the best but take them as much detail - and I mean very intricate stuff if you can get hold of it - and all your results from the prev treatment so they can learn from it.

Try the HFEA website for complete sets of clincs results.

Hope this is helpful and very best of luck to anyone embarking on a treatment.

[Bellenden Belle]

new mother Wrote:

So, for older women where

> egg quality is likely to be an issue, at the very

> least, I'd be looking for a clinic that will

> automatically put back the max number of embryos

> ie 2 up to 40 and 3 over 40.

>

This is probably not the place to begin this debate. But actually evidence shows that it can be safer to put one egg back rather than two.

http://www.timesonline.co.uk/tol/news/science/article1913144.ece

http://www.bjog.org/details/news/587797/IVF_twins_face_greater_risk_of_neonatal_complications.html

At Guys Hospital I attended an information evening which explained why they pursued wherever possible a "one embryo replaced at a time policy." I must say the evidence was very convincing. There are other options - including frozen embryos - which are viewed as safer options.

[new mother]

BB, Did you read my post? Perhaps I wasn't clear and my mind assumed things. I am talking about older women or anyone with poorer egg quality than average. This type of woman needs to play the odds. That means putting back more embryos.

[As a digression, why do you think there is an increased maximum for the over 40s at all? Why do you think the USA rates for older women are so much better than here? (Answer: higher nos of embryos inserted)]

With younger women or anyone with a high likelihood of success at IVF, clearly there are more issues associated with carrying multiples to term than singletons. (BB, this is what your studies are on. SET - single embryo transfer.)

As regards FET (frozen), the reasoning behind this being "safer" - which is a misleading term - is that the embryo is put back during a normal cycle ie not one where high levels of oestrogen have been generated by the IVF stimulatory drugs. There is thinking that using a more "normal" uterine environment is better. I don't buy that in the main as I think it mostly boils down to egg quality. Older women will be unusual to be doing many FETs as they don't generate many successful embryos at blastocyst - day 5 - stage.

In summary, those with low ovarian reserve will be happy to get one embryo implanting and the challenge is to "find" that one and put it back.

[Bellenden Belle]

Your points are pertinent new mother (I did indeed read your post) and as I said previously, this is probably not the best place to begin a debate.

BUT I just wanted to clarify that there is evidence to suggest putting one embryo back can be a preferable option, and the least riskiest for the child and I do think that must be consideration. It's not just about "playing the odds" is it?

Also - FET - frozen embryo transfers - can take place with the help of IVF stimulatory drugs, indeed they are recommended to increase success rates.

To return to the OP's original request for help - a wealth of information can be found here:

http://www.fertilityfriends.co.uk/

[Curmudgeon]

If your friend gets a private consulation I would suggest

1) charting for at least 3 months before seeing them - write down when period starts, when you have sex, when you ovulate (ovulation predictor kits or charting) and take this along

2) getting GP to do initial sperm and blood tests - say you will fund any treatment required but that GP should do initial tests

If consultant then recommends clomid get them to write to GP and get GP to write prescription - it's a bloody cheap pill as it's been around for so long

[The Nappy Lady]

Good advice from Curmudgeon, BUT despite already having these tests, when we went to ARGC they still ran them all again (and charged for them) - results much the same as those we brought with us! It is hard to refuse when you are there for help, if that makes sense.

I know ARGC has had some negative press, but it is worth noting that there are two clinics, and the one that was carrying out some contraversial therapies is not the one on Wimpole Street (and in any case, the charges against Taranassi's other clinic were dropped completely).

Re research - my friends did a LOT of very thorough research before deciding where to go for help, and ultimately decided ARGC was the best option for them, and it worked first time, whether because they really are the best clinic (as their research suggested), or because they simply got lucky, who knows? They have nothing but praise for the entire process they went through.

We trusted them enough to follow the same route, but in the end didn't feel the treatments available were likely enough to bring about a good result (given our specific issues), and given that we already had 1 child (so much luckier than most in the waiting room that day), and the amount of money we'd have to commit we decided to walk away. For me it was the moment I finally accepted there would be no 2nd child....and interestingly, 10 months later along came our beautiful 2nd baby girl. For me this rather backs up the age old theory that stress has a huge impact on pregnancy, and despite not feeling stressed about what we'd gone though there was clearly a lot of underlying angst. Once I mentally walked away from it all we had a successful pregnancy, for which I will always be so thankful, and amazed.

From my brief expereince; I would say is that there are a lot of hidden costs - consulation is only the start, cost of various tests, cost of drugs etc. so ask lots of questions before you get sucked in so to speak. An initial consultation was, IIRC about ?200 (?50 to register, the rest on the day), and that is just to have a 20 minute conversation. Plus the cost of the tests we had, another ?50-?100 I think. Discussion about me having some sort of dye test to check my remaining fallopian tube was open - ?500 plus (hard to recall)? At that point (in tears), I realised it was all going to be too much - on many levels. This was what I 'needed' before even getting started on any actual fertility treatment.

Also, sitting in the waiting room, I've never experienced an atmosphere like it. This sounds melodramatic, and I don't mean it to be, but the despair really was almost tangible in the room. It was painful just being there, and of course being aware that others around you were going through some really difficult stuff. There was also good stuff - photos of all the children that have been born thank's to the work of the clinic, lovely, kind and very gentle staff....but the thing that has remained with me is the atmosphere of the waiting room. I share this because I hadn't really thought about it in advance, and knowing might have helped.

It is such a difficult and emotional subject, and no price can be put on having a baby. It is definitely worth exploring all the options. I do agree with other posts that it is vital to get the right treatment for your specific problem, but you also have to temper that with the fact that around 80% of infertility is undiagnosed I believe (medics on here please correct me if this % is incorrect, I am having to trawl my memory banks from 3+ years ago, and it is a subject I have rather tried to forget/move on from to a certain extent). So, as in my case, if you can't find what is 'broken' it is very difficult to fix it.....

[Bellenden Belle]

Molly - that's a very honest and thoughtful post - I'm really pleased it had a happy ending.

I went through IVF (unsuccessfully) a few years back and I do recognise your description of the waiting room....it was one of those situations where people just didn't seem to talk to each other and there was lots of tension in the room.

It's one of the reasons I posted the link to fertility friends above. It's one of those forums that is littered with annoying avatars; cutesy quotes; and endless counters. BUT if you can cut through that there is some fantastic support there. In particular there are London meet ups arranged - 10 to 12 girls having dinner and a chat together - which were both enjoyable and vital for keeping me fairly sane. It can put a lot of pressure on a relationship if it's just the two of you sharing that journey - it's really useful to have another place to go to to let off steam and ask "so how's it going for you?" And yes there were lots of cases of people not being successful, but rather than despair I felt a huge sense of collective hope so that each success story you cared about and shared.

[Smiler]

With fertility issues there're so many difficult decisions to be made, e.g. when to consult a doctor / who to see (and whether NHS or private) / what tests / treatments to have / whether to try alternative therapies etc. etc.

Having experienced some problems (but over the moon to now have two children) I second the recommendations for fertility friends and similar sites, e.g. Mumsnet, Baby and Bump. Dulwich library has quite a lot of books on fertility stuff, including Dr Foster's guide to clinics. The Human Fertilisation and Embryology Authority website has useful info, including on what questions to ask.

Really feel for anyone struggling with this.

[latestarter41]

Just thought I would post to let people know that I've just called Mr Davis secretary. He isn't at the London Clinic, he works at the Princess Grace Hospital now, just off Harley Street. The number is 020 7034 5000 if anyone else might need it. An initial appointment with him costs ?200, which goes up if you need blood tests or scans. He sounds very good, apparently we would only have to wait about 2 weeks to see him at the moment

[The Nappy Lady]

Good luck latestarter, plenty of us on here will be rooting for you.

Xx

[chantelle]

good luck late starter! I felt in very capable hands with him. I went on to have my IVF at Guys but I saw him for clomid monitoring and stimulated IUI.

[Smiler]

Am reviving this thread as a close friend is having fertility problems and am after any more tips for private doctors for fertility tests. She is 33 her partner is 42 and sperm tests have come back abnormal. Ttc for 2 years, made lots of lifestyle changes, had a pregnancy after 18 months but miscarried :'(

They have had an appointment with a specialist through the nhs, but feel fobbed off, were basically told to keep trying and take vitamins, and sperm stuff and possible treatment options weren't explained. Also that having conceived and miscarried meant they'd have to wait another 2 years for referral for ivf and that if further (optional) sperm analysis in 6 months showed improvement, this would also put them down the list. The consultant also sounds like a stereotypical doc with no interpersonal skills, made comments like "why haven't you tried vitamins, you can get the, in sainsbury's!" and when when my friend got upset about the waiting and uncertainty and cried, said that there was no need to be "overemotional" about it.

Am really upset for her. Any tips would be appreciated (she doesn't live in ed and doesn't know am posting).

[Jules20]

.

[nylonmeals]

I would second the poster who recommended the forums on the website Fertility Friends http://www.fertilityfriends.co.uk/forum/index.php Hugely helpful to me a few years ago when we were having similar fertility issues and meeting similar sounding type medical specialists. In the end they found out that I had a quite huge fibroid that was preventing us from conceiving, but it took a long long time before I was given an ultra sound scan that basically found it. Once that was removed we conceived straight away and are expecting baby 2 next week. I had never heard of fibroids before, but that might be something that your friend might ask her consultant about. Good luck, there can be happy endings to fertility issues!