Podcasts about hfea

In the last couple of weeks there have been a lot of reports across the media about IVF Add Ons and there being no benefit to them.The Human Fertilisation and Embryology Authority (HFEA) has issued a warning to those undergoing IVF about “unproven extras” (Add Ons) to increase their chances of having a baby.  These included acupuncture, nutrition, supplements, PGTA testing, microbiome tests, Time Lapse and Immunology amongst others.I am joined by the brilliant Emma Whitney to discuss the findings, how it has been reported in the media and unpick the details behind some of the headlines.We discuss:The role of the HFEA - a legally regulated entity that supports fertility clinics.How the media often misrepresents the findings of patient surveys.How Add-ons can vary significantly in their benefits and applications.How the language used in media can create confusion and fear among patients.Why Time-lapse technology provides valuable insights into embryo development.Why patient context is crucial in evaluating the effectiveness of add-ons.How a lack of scientific evidence is different unprovenThe problem of scientific studies in the complexities of fertilityHow the majority of clinics and practitioners are primarily focused on helping patients build families.For more information from Emma see her ⁠Instagram⁠ account and ⁠Website⁠For more information on scientific studies on acupuncture see The British Acupuncture Council Factsheet.Don't Tell Me To RELAX is sponsored by Acupips, quote RELAX for 20% discount.

We are discussing IVF Adds Ons this week with James Nicopoullos, clinical director at The Lister Fertility Clinic.We discusses the complexities and controversies surrounding IVF add-ons and how difficult it can to make decisions about whether to use or not alongside IVF treatments.We discuss:why IVF add-ons are optional extras that may not be necessary.How the HFEA's traffic light system categorizes treatments based on evidence.How not all add-ons are supported by strong evidence.Why individual circumstances dictate the need for specific add-ons.Why Sperm DNA testing is crucial for unexplained infertility cases.Why patients should be informed about the pros and cons of add-ons.Why communication between patients and clinics is essential.For more information on Add Ons please see the HFEA website.*** Fertility Nutritionist, Kirsty Harrison and I will be running a free "Optimise Your Egg Quality" workshop on Monday 17th March at 7. To join us live or get the replay ⁠⁠⁠register here.⁠⁠⁠ ***

To celebrate the release on Netflix of the new film about IVF 'Joy' this is an old episode of The Fertility Podcast, which Natalie produced in celebration of Louise Brown's 40th Birthday and the fact that at that point in time, over 300,000 babies have been born through IVF treatment with more than 1 million cycles having taken place. TheHFEA asked Natalie to make a podcast with them, so Natalie is in conversation with its chair Sally Cheshire and one of its Inspectors, a lady called Janet Kirkland MacHattie, who worked as a nurse at Bourne Hall in 1982, under Patrick Steptoe, Robert Edwards and Jean Purdy. In fact, it was during this conversation with Janet, that Natalie first learnt about Jean, and found herself feeling somewhat ashamed that she didn't know about her sooner!What was discussed: Sally Cheshire talked about how at the time the treatment was quite experimental and Louise Brown's parents were quite brave in putting themselves forward She explains how the Government and Parliament decided to investigate how treatment should be regulated and asked Mary Warnock to form a committee in 1984 to look at how infertility should be regulated. The law came into being in 1990 and the HFEA came to be in 1991. Sally talked about her role at the HFEA and what has changed over the last 40 years and the importance of the focus of its work being on the 70% of people who aren't successful with their treatment. The HFEA has a vital role, thinking about how emotional support can be improved in clinics because, as she explains 'We do know that even if you are pregnant after IVF there's a level of anxiety you carry with you". The importance of being medically, emotionally and financially equipped to try again when going through fertility treatment. Sally explained how 'We still feel a lot of media stories about fertility treatment are positive… very often, there's a lot of around celebrities with the example of Bridget Neilson who gave birth at 54. Are they being truthful about using donor eggs? Some of those stories give you a false impression." Janet explained how she went for the job at Bourn Hall, to join the nursing team - not really knowing what was involved and when she asked Patrick Steptoe his advice on a book she could read to learn more, his reply was 'My dear, they've not been written yetWhat the treatment process was like initially, with Ladies staying at Bourn Hall for ten day periods and how as they didn't have blood tests, the Ladies urine was tested every three hours to find out if they were ovulating.Janet talked about an interview Patrick Steptoe gave where he spoke about his vision for the future being "centres set up where people have been properly trained and this technique will be available to women all over the world" To compare clinics like for like, or rate your clinic visit the HFEA website Follow @YourFertilityNurse on InstagramFollow @TheFertilityPodcast on Instagram

Back to The Fertility Podcast archive for this episode to celebrate the release of the Netflix movie 'Joy' - Natalie has shared a conversation she had Connie Orbach about how she started her research to curate the British Science Museum's exhibition about the story of IVF.What was discussed: Connie herself admitted how she didn't realize how much content she would find in the archives from Leslie Brown, regarding the correspondence she received from all around the world.Connie talked about Jean Purdy who I've learned all about over the last couple of weeks and she is talked about as being IVF's forgotten pioneer, despite being written about by Patrick Steptoe and Robert Edwards as one of the three of them. Connie has written a really good blog here Jean was hired as a lab technician however she was tasked with managing the laboratory and in reality, she did much more. Jean Purdy was not just central to the running of the lab but also to the scientific work. Connie and I spoke about whether her gender meant she was taken less seriously by reporters? Possibly, seeing as she was recorded in the photos as being the 'midwife'. Was her role as a lab technician seen as unimportant next to that of the surgeon and the scientist? This is so ironic seeing as she is credited with first discovering the blastocyst embryo stage, one of the key breakthroughs in our understanding of an embryo's development.Whatever the reason, it was not for lack of trying from Edwards. He repeatedly emphasized Purdy's importance and unsuccessfully lobbied her name to be added to the commemorative plaque placed at the site of their original clinic. Read more in Connie's blog and here are some other articles that are written for the exhibitionSally Cheshire, chair of the HFEA has also written a blog for the exhibition. Martin Johnson discussing the challenges faced by Bob Edwards developing IVF. Gareth Downs on the male perspective: Bristol Archives wrote a blog recently about receiving the Lesley Brown ArchiveFollow @YourFertilityNurse on InstagramFollow @TheFertilityPodcast on Instagram

This week Kate is joined by Clinical Embryologist Victoria Wigley a.k.a @allaboutembryology, to take you on a whirlwind of an episode on, what is quite a confusing topic, Pre-implantation Genetic Testing for Aneuploidy (PGT-A). PGT-A was first used for those who had a family history of a condition, such as cystic fibrosis. PGT-A takes a look at the chromosomes that are in the cells of the embryo. Since we all have a set amount, PGT-A makes sure that there are no aneuploidies, or in other words - an abnormal amount of chromosomes.Victoria talks about why clinics started using PGT-A testing and she goes into detail on what's involved with this testing and how it is done. Kate and Victoria discuss the HFEA grading system, which currently grades PGT-A testing as ‘red', meaning that ‘there are potential safety concerns and/or, on balance, the findings from moderate/high quality evidence shows that PGT-A testing may reduce treatment effectiveness'. Victoria also discusses her concerns that patients are being offered PGT-A when they do not need it. Victoria tells Kate how she believes that all patients should know everything about what they are being offered, including the risks and hidden costs. She goes on to explain how many of her patients struggle to find the confidence to say ‘no' to their clinics, when being offered treatment that they don't necessarily think they need. Lastly, Victoria and Kate talk about the cost of PGT-A, what you need to consider and managing patients expectations.We are delighted that this episode is sponsored by a friend of the podcast - @onedaytests. One Day Tests is your one stop shop for ‘at home' fertility blood tests and more. SOCIALSYou can find Victoria on Facebook, Instagram and TikTok at All about Embryology (@allaboutembryology) • Instagram photos and videos And you check out her website Home | All About Embryology | Independent Advice and Support | UKYou can also listen back to a previous episode of the podcast all about the darker side of fertility treatments here - Navigating Private IVF & The Darker Side Of Fertility "Treatments" (thefertilitypodcast.com)

In this episode Nikki talks to Suzannah Lansdell about Public Dialogue.  Suzannah is a  freelance facilitator who also advises organisations on how to do public and stakeholder dialogue, particularly in the science and technology sector for Sciencewise.   They talk about Public Dialogue as a process bringing together members of the public with specialists and policy makers to discuss complex and controversial topics and gather public insights on the issues without necessarily coming to firm recommendations; “this is this is not a Focus Group. It's not kind of top of mind views. It's digging behind that”  How members of the public are engaged to take part; The role of a facilitator in Public Dialogue and how it's different from other types of facilitation; Some recent topics for Public Dialogue including Embryo Research, Future Flight and the role of Data; The experience of participants and how this differs from other consultative processes;  “one of the key things about Public Dialogue as you give people the time to kind of wrestle around the issue and think more deeply.”  How information is shared with participants, including striking a balance on the level of detail and the importance of including a diverse range of specialist perspectives; Evaluation in Public Dialogue and the focus on monitoring longer term impacts from the process; Suzannah's hopes and expectations for the future of Public Dialogue, becoming more embedded in policy making and democratic processes. A full transcript is below. Links Today's guest: Suzannah Lansdell on LinkedIn: linkedin.com/in/suzannah-lansdell-ab23a78 Today's subject  Sciencewise: https://sciencewise.org.uk/  Involve Resources: https://involve.org.uk/resources/knowledge-base/resources  Involve Methods: https://involve.org.uk/resources/methods   To find out more about Facilitation Stories and the IAF and the England and Wales Chapter:  Facilitation Stories website: https://facilitationstories.libsyn.com/  And to email us: podcast@iaf-englandwales.org  IAF England and Wales: https://www.iaf-world.org/site/chapters/england-wales   The Facilitation Stories Team:  Helene Jewell: https://www.linkedin.com/in/helenejewell/  Nikki Wilson:  https://www.linkedin.com/in/nicolawilson2/    Transcript N.W Hello, and welcome to Facilitation Stories brought to you by the England and Wales chapter of the International Association of Facilitators, also known as IAF. My name is Nikki Wilson (NW) and today I'm going to be talking to Suzannah Lansdell (SL) about public dialogue. So welcome, Suzannah.    S.L Thanks, Nikki, lovely to be here.    N.W Okay, so to start off with, could you tell us a little bit more about you and what you do.   S.L So I'm a freelance facilitator, I've been doing that for about 15 years or so. I started, and so how I got into it just as a bit of context, as it sort of helps a bit with the public dialogue is, I started working for an environment charity back in the 90s. And I was doing a lot of work then with businesses, convincing them that there were commercial implications around environment sustainability issues. But one part of that the charity had was also about consensus building, about how do you get different organisations to approach environment sustainability issues, that at that time in the 90s, were very kind of adversarial in a more kind of consensus based approach. And absolutely core to that was facilitation, as a way to, to break through that more adversarial approach. So then I started working a lot on that and I kind of cut my teeth on some of the big issues of the day, things like nuclear waste, oil disposal, oil infrastructure disposal, biotechnology. So some really kind of big issues where people were on opposing sides and a facilitative approach helped people to kind of have more constructive conversations and find a way through. So that's kind of where I cut my teeth. And then moving on, what I'm much more doing now is that I advise and I support organisations on how they do public and stakeholder dialogue, and particularly around public dialogue work for an organisation called Science wise, that looks at public dialogue around science and technology. But I also do some kind of keeping my oar in on the practice in terms of facilitating citizens assemblies, and other kind of processes involved with the public. And then a little spattering of training in facilitation and a little bit of kind of charity away days, but most of my work at the moment is around the kind of public dialogue in science and technology.   N.W Okay, great. And that was a very neat segue into today's topic, which is about public dialogue. So for listeners that aren't familiar with this term, what do we mean by public dialogue?   S.L I suppose in its simplest terms, it's a process where you've got members of the public coming together with specialists and policymakers and other stakeholders to deliberate and have conversations about usually kind of complex or controversial topics. And they do that over several hours, so this is not a focus group, it's not kind of Top of Mind views. It's digging behind that. So you give people a lot of time to think about the issues and to have conversations with those specialists, but also fellow participants. So probably people are maybe deliberating over 10 hours or a couple of weekends. It can be online, it can be face to face, it can be a bit of a mix of both. The key purpose is to get those insights from the public to feed into kind of a decision whether that be a policy or whether that be a strategy. And some people might have heard of the term of mini Publics, so it sort of fits within that frame of mini Publics. And we could talk a bit more about who's the public in this. The key difference that I see with public dialogue is that unlike, for example, citizens  juries or citizens assemblies, we don't usually ask people to come up with or vote on recommendations or come up with specific recommendations. It's much more that they're kind of invited to explore that issue and then there are insights that come from that, but it's not taking it to that kind of final this is what this group of people think and vote on.   N.W And so who would normally be the sort of Commissioner of the public dialogue who would bring those groups together?    S.L It would be a decision maker. So it'd be somebody that has some traction over that issue. It might be that they own the policy or that they own the strategy the public dialogue is feeding into. So that could be a government department, it could be a Research Council, it could be a regulator. So usually at that sort of level.   N.W And you touched on this a moment ago, but mini publics as it were, who normally would get involved in these, and how would they get involved?   S.L Yeah, so I think what's really important to know with public dialogue, or indeed any of those mini publics is that these are not public participants that choose to sign up, because they've seen it in their local paper or something, they are kind of randomly recruited to take part in this process. So what you're trying to do is to get a reflective group of the population to be part of these processes, and they're paid to attend. So you're getting over that slight bias that you might have, if you have a local meeting, for example, where just those people with the time and the inclination, and already with an interest in the topic turn up. So you're recruiting them kind of randomly, and that might be that they are approached on the street and it might be that they are approached through some kind of invitation. So usually, for example, on citizens assemblies, they're approached through a sortition approach, which is, you randomly receive an invitation through the post. Most public dialogues, it's recruited sort of on the street. And then you're looking for a kind of demographic, as I say, that kind of reflects the population, whether that be gender, whether that be where people are from, it might be things like whether the urban and rural split, it might be to do with the age profile, so that you've sort of got a little mini public in the room that you're having that conversation within.   N.W Have you got any examples of recent topics that you've seen covered in a public dialogue, just to bring that to life, I suppose.   S.L Well certainly. So the science wise work that I work on, it's, I mean, as you might expect, it's kind of around science and tech innovation, sorts of topics. So some of the recent ones have been things like embryo research, and where that goes in the future. Future flight technologies. So there's a whole new area of kind of innovation around future flight and what does the public think about where that might go? BioMed adaptation has been another one. Lots around kind of data, what do people think about data that is held on them or data that might be used? Where are the boundaries around that? And through things like genome editing in farmed animals, so a real range across that sort of science and tech space.    N.W So obviously, we've talked about the commissioners and the public involved in this, but this is facilitation stories. So what would you say the role of facilitators is in a public dialogue? And how, in your experience, is that different from other types of facilitation?   S.L So I suppose, obviously, there's the core basics of facilitation, that are the same, but I suppose, for me, the real the things that really stands out are that, absolutely, as with lots of other facilitation, your view on a topic has to really stand down you can't be seen to influence the process in one way or another. And when some of those topics they're very kind of emotive. Another thing is that because you've got a group of the public there, so I suppose those two things, you're likely to be part of a bigger team. So the number of participants involved in a public dialogue might be, it might be 30, but it may well be closer to sort of 100. So there's a team of facilitators, you've got a group on your table, say if you're just a table facilitator of seven or eight participants, and they're public participants who, it's not like if you were, say, working in with an organisation where you might have a bit of insight as to who's going to pop up on your table, you might have people there who are really not confident in speaking or, or who might have literacy challenges, or who might have English as a second language. So you've got to sort of adapt to that group of participants that you have, and work with them to build their confidence to express their views about the sorts of issues that are under consideration. And then I think this notion that you're part of a team of facilitators, you're all doing the sort of similar process on separate tables, and that is part of a bigger jigsaw piece. So you sort of got to manage how your group is responding to those questions and that plan that you've got, and knowing that you need to kind of get to an output for that specific section, because it fits together into the whole jigsaw piece of the whole process. So I think that that's an interesting dynamic. It's not like you're there and you're kind of controlling the whole space. Of course, I'm talking there about a table facilitator and then there's the kind of facilitator who's kind of orchestrating the whole piece as well. I mean it's fascinating working with the public, that's the bit that I just find so interesting is giving people the opportunity to have their voice heard in these issues and people love it. But as a facilitator kind of getting to the point where people are comfortable to do that is interesting.    N.W Yeah, I mean, I haven't mentioned as we've been talking, but I have facilitated in these environments. And I think one of the things that I always find so fascinating is that you can have a whole load of different groups essentially following the same framework and process and they will come out with completely different things, or they will respond to the materials in completely different ways. And you've got such a close comparison, because they're all in the room together with half an hour, or whatever it is, and I just find that fascinating, or I've done some where I've done the same process two nights in a row with different groups. And literally, it's nothing to do with how I facilitated it because I was the same person. But yeah, so interesting to see how different groups respond to the material.   S.L And sorry, I was just going to say. And also giving people the opportunity, because of course, you've got a mini public there. They, the participants themselves are meeting people that are from all sorts of different walks of life, and seeing how they reflect also on other people's contribution and how that adjusts their views. And again, that, for me, is one of the key things about public dialogue, as you give people the time to kind of wrestle around the issue and think more deeply.   N.W Yeah, absolutely. And again, I mean, we've touched on this a little bit, but obviously, this can often be about quite complex subject matter, you've given some examples at the beginning, and the participants will have varying degrees of prior knowledge. So obviously, giving them some information is one of the key things in this, what have you seen works particularly well, in how you present that information to people and perhaps not so well?    S.L So yeah, absolutely, you kind of have to give people enough information that they can deliberate on it, but not so much and that for me is the real critical point is that it's boiling it down into what is the appropriate level of detail, participants don't need to have a PhD in the topic. And they very quickly, participants really quickly kind of get to grips with what the topic is. So for me, the really crucial things is that you have to have specialists from a diversity of perspectives. So that participants can kind of reach into the corners of the issues and what the different kind of takes are on that. And I know most of the time it is done through some form of kind of presentation. But it's really important to pick your specialists well, that they can talk in an accessible way or brief them well to do that, and make sure that you know what it is that they're saying, that you get to look at their slides beforehand and make sure that it is accessible. It's not kind of reams and reams of really detailed stuff. But other ways in which the worst sorts of information imparting are where you have a really long, dense presentation. So that's designed out. You tend to give it in small bite sized, probably no more than 10 minute type of talks, you layer up the sort of information that you're giving to people so that they've got these sort of bite sized chunks, and they're hearing from different perspectives. But as well as hearing from different perspectives, you sometimes in public dialogues, you can also interview people before the dialogue and put that into provocation, kind of cards or animations or sort of pictorial scenarios so that people can access the information in different sorts of ways. What's really crucial is that they hear from different perspectives, they get a chance to sort of question and interrogate that, and it's not in a kind of overly complex way. So that's the real skill of who's designing the whole process, is making sure that we're hearing the right sort of information enough for participants to get to grips with it, but not so much that they're just listening to reams and reams of presentations, because that's not the point. The point is not to kind of come out with an educated public. The point is, is that we want to hear what participants kind of deliberations and insights on having known enough about the topic.   N.W yeah, and I suppose almost that instinctive reaction or whatever it is that they have picked out from a presentation that's most important for them is a valuable insight in the first place is that, actually what is it that they're taking away from all of the information they've been given?    S.L Yep. What's really nice is if you have the opportunity and the processes, which because they're run over a number of sessions you can often do this, is to ask participants also what might be missing or what they might have to revisit. And, again, if you've got a specialist sort of in the room, whether that's a virtual or real room, using them as a kind of resource to be able to pull on as well is really important.   N.W Yeah, I think that we perhaps haven't made that clear that quite often those experts will give a presentation but then they are still available to chip in, to answer questions, to clarify bits. So that's really interesting, too. Yeah. And again, so while it's not unique to public dialogue, I think something that a lot of the processes involve is a really kind of structured evaluation. So could you tell us a little bit more about that? And how it sort of fits in the overall process?   S.L Yeah, yeah and certainly for science wise public dialogue. So just actually, to really quickly scale back. So science wise supports government departments, research councils to do public dialogue and kind of mentor supports those organisations, but also provides some co-funding. So there's always an independent evaluation that sits alongside that public dialogue. And that both I think, quite uniquely, for this evaluation, it sits at the beginning, and it can give sort of formative input throughout the process as it's being designed. But also it produces a kind of summative evaluation at the end. So what is it that participants have felt? What is it that specialists have felt? So gathering all of that data like you might do, usually in a kind of evaluation. So it's more than just observing the sessions, doing a participant survey and reporting on that. And the other thing that I think is kind of really important is, again, certainly for science wise dialogues is that there's a sort of interim report when the dialogue report comes out. But then we go back or the evaluator goes back six months later, and says, right, what was the impact of this public dialogue? And that, to me, is really, really crucial so that you know where has it influenced? You said at the beginning, that this was going to be something that inputted into this policy, or that inputted into this strategy. Six months on what has happened? Have those impacts happened? Have other things happened that have been as a result of that public dialogue process?    N.W And I suppose with that in mind, have you got any examples of where you've seen really specific big changes that have come out of those that you can sort of share? So obviously, a lot of them are still in progress.   S.L Yeah, sure. Well, I suppose the one that quite often is, is quoted and this is going back a little way. I mean if you look at the science wise website, there's always the evaluation reports are up there as well. And they, certainly the more recent ones, kind of capture those impacts. So it might be that it's led to a whole raft of new social science research. But one of the ones particularly that's quoted is around something called mitochondrial transfer, and this was quite a controversial area of research. A public dialogue was held which helped inform. Then the recommendations of what was the human fertilisation embryology authority, the HFEA , who regulates all of that, and that then fed into changing the law on what was allowed in terms of this mitochondrial transfer. Whilst they would have done other stakeholder work, they would have listened to what experts thought about this, actually hearing about what the public thought, whether this was the right way to go, what were the sorts of limits? What were the red lines? What sort of conditions should be in place? Formed a really kind of core plank of then what that recommendation and ultimately, the kind of law change signifies. So it can have some big impacts and what I see a lot with public dialogue, and we'll kind of think about this into the future is, lots of government agencies, or any key decision making authority is really familiar with thinking about how they involve their kind of traditional stakeholders. But thinking about how they really hear from what the public thinks is a more tricky area for them to grapple with. So public dialogue provides one route in which they can really understand, what do the public think about this having had a bit more time to think about it. What drives their concerns or their hopes or their aspirations around this particular topic? And that, for me, is always the missing pieces, like, how are we hearing the public voice in this new development? Because it's not a given that that will always happen.    N.W And so, I suppose building on that then, are there particular trends or developments that you're seeing happening currently or on the horizon for public dialogue? Where do you think it could go?   S.L So I mean, I hope, and I think that there will be a move towards this. Rather than this being something that is a sort of almost optional add on, or specifically for some topics that are quite high profile, or kind of think that they might be controversial, but actually, it becomes a much more embedded part of both policy and strategy. So that rather than ‘Oh, crikey, we need to think about doing a public dialogue', but it's something that's just automatically built into the policy strategy development process for those topics. So it's not saying that it should be used in every circumstance, but that it's much more kind of part of the normal suite of tools that policy makers will be thinking about, that there's that check. Oh, hang on a minute, how are we thinking about public voice? Do we need to do a public dialogue? Do we need to do some other kinds of, you know , how are we going to get that public insight into the development of our policies? Doing public dialogue is about making better decisions by getting public insight into that process. I think the other thing that I would just say is that I think increasingly, whilst the approach is about making better decisions, better policies, I think it will become more clearly linked with sort of a democratic process that ultimately, certainly, if we're talking about science and tech, whether we're talking about climate change with, for example, citizens assemblies, on climate change,that these are things that are affecting people, participant people day to day. If there's a new science or tech development, it's helping us and a lot of that research is funded by the public. So where's the sort of right, almost for the public to have a more considered, say, in the development of those areas?   N.W And I think what you say there is interesting as well, because obviously a lot of this is technical information. But in the main, there are ways that people find it does relate to their day to day life in some way. And I think that's another quite important tool potentially, is making it feel like something that people have a grounding in their daily life,even if they don't know all of the technical details, isn't it? So they can deliberate with their own perspective on that?.   S.L Absolutely, I mean, those examples I gave before, they're about the food that we eat, or about the impact of climate on our infrastructure. They're about what we think is right, or how far science should go. If we're looking at AI, or we're looking at these exciting, but also fast developments that are happening in science and tech, there has to be, and this is why I talk about quite often with the people thinking about commissioning, it's got to align with social values. If it's really out of step with that, I think we saw that a lot with GM in the early 2000s, then people start getting really concerned about it. So what's right? What's wrong? Or how should it go? Where are the sorts of red lines? What are the sorts of conditions under which this technology should develop? could develop? shouldn't develop? Understanding that for a policymaker, or for strategies is kind of gold dust really.   N.W Excellent, well, I mean, it's all so fascinating, we could probably talk all day about it, but    S.L Just scratched the surface .   N.W Exactly. And with that in mind, if listeners want to find out more about public dialogue, what would you say the best places to look?   S.L So I would say there's two. Obviously, I've talked quite a lot about science wise, and sciencewise.org.uk is the website,there's a lot there about public dialogue, but also lots of reports from previous public dialogues. And then the other place that I always kind of point people towards is the involve website. So if you just Google involve, and particularly, I think it's involve.org.uk .Particularly their methods and Resource Bank section. So the methods obviously covers lots of methods, but their resource section there is super useful and that will also touch on things which we haven't delved into as much here, sort of citizens assemblies, citizens juries and other sorts of, kind of public participation processes.   N.W Right. And we can put those links in the show notes as well. And, and if listeners would like to find out more specifically about your work or get in touch with you, what would you suggest?   S.L Look me up on LinkedIn as a start. Okay, that's probably the easiest, easiest place really.   N.W Well, we'll put that in the show notes too. So thank you so much, Suzannah, for your time and your contribution today. It's been really interesting to chat to you.    S.L Thank you, Nikki.    N.W Thank you again. Have a lovely day. Bye.   Outro   So listeners, we've reached the end of another episode of facilitation stories, the community podcast, IAF England and Wales.   If you'd like to find out more about the IAF and how to get involved all of the links on our website, facilitationstories.com.  And to make sure you never miss an episode, why not subscribe to the show on whatever podcast app you use?    We're always on the lookout for new episode ideas. So is there a fabulous facilitator you think we should talk to or something interesting emerging in the world of facilitation you think listeners need to hear about send us an email at podcast@IAF-EnglandWales.org   We hope you'll join us again soon for more Facilitation Stories. Until then, thank you for listening  

Wir sind ein Community Podcast! Niemand bei uns verdient durch diesen Podcast Geld, es gibt keine Werbung, es wird nichts geschnitten und wir haben keine Ahnung. Wenn dir der Podcast trotzdem gefällt, freuen wir uns enorm über eine Bewertung und ein Abo! In ewiger Liebe

What does LGBT stand for, and how does this community experience pregnancy and birth differently in maternity care? I chat to Laura Rose Thorogood about the experiences of the LGBT community throughout pregnancy and birth. From language, inclusion and care, we chat about the changes that need to be made, and how healthcare providers and the public can educate themselves to be empathetic, kind, and inclusive. Laura-Rose is a married lesbian mother of four donor conceived children by IUI and IVF over twelve years.  She is both a Bio and Non Biological mother and has loved experience of operative birth, failed cycles, miscarriage, secondary infertility and birth trauma.  She is an LGBT+, Maternity and Fertility Activist, educator, writer, seasoned speaker, & campaigner. She is Founder of LGBT Mummies, supporting over 70,000 worldwide through guidance, community, support groups and events. Through Proud Foundations their educational arm, she lectures & trains midwives and healthcare professionals, educates and consults with organizations to be inclusive, & has worked with the Government, NHSE & DHSC making policy & law recommendations & has been invited into and presented in Parliament. She has multiple roles across NHSE, RCOG,UCL, HFEA, MMHA, Chair of the largest national MNVP, & creates change to create equity and equality for marginalised minority groups. She is also a Trustee for UK charity Fertility Network UK. 

Leading scientists are calling for a change in the law to help IVF patients donate unused embryos to biomedical research after a collapse in donations over the past 15 years. Emma Barnett talks to Professor of Reproductive Physiology at Cambridge University Kathy Niakan and Clare Ettinghausen from the UK's fertility regulator, the HFEA.The new play Glacier is a dark and poignant festive comedy. It follows three women who meet while wild swimming in their local lake one Christmas. They form an unofficial tradition, meeting each year to go for a swim and escape. Escape their responsibilities, life's stresses, and maybe most of all – their families. We hear from playwright, comedian and podcaster Alison Spittle, and actor Sophie Steer, who stars in the show.We take another look at the world of gymnastics following on from last year's damning Whyte review with labelled the British Gymanstics as "inept and dysfunctional". Since that time, not one complaint of abuse has been upheld by British Gymnastics' Independent Complaints Process – with every single case over the past three years collapsing. We talk to Claire Heafford from Gymnasts 4 Change about their campaign for a new procedures. As two teaching unions call for a pause in Ofsted inspections following the death of head teacher Ruth Perry, we talk to Paul Whiteman, the General Secretary of the teaching union the National Association of Head Teachers.Presenter: Emma Barnett Producer: Lisa Jenkinson Studio Manager: Tim Heffer

This week we are discussing genetic testing including karyotyping and PGT-A testing with Kathryn Hawes. Kathryn is a senior embryologist and genetic lead at the Lister clinic. And has kindly done talks for our community group and team of practitioners on the role of embryology in assisted conception. We discuss  What genetics are in embryology and their role is miscarriage What is karyotyping is and what the testing is What the implications are if issues are identified Who should consider this type of testing  PGT-A testing and it's rise in popularity What happens during PGT- A testing PGT-A and why it's still a red light on the HFEA  Who is this test recommended for How embryos are graded for transfer without PGT-A testing Stats for PGT-A tested embryo success rates Reasons why it PGT-A isn't always successful Costs for testing and where to go for further information If you'd like to hear more from Kathryn you can watch back her presentation for us in our Community Group.

The Human Fertilisation and Embryology Authority (HFEA) has launched a ratings system to let patients see which IVF add-ons are backed-up by evidence. Emma Barnett is joined by Professor Tim Child, chair of the HFEA's Scientific and Clinical Advances Advisory Committee, and Jessica Hepburn, who spent over £70,000 on unsuccessful fertility procedures. In October 2019, Coleen Rooney was concerned by articles appearing in newspapers that could only have come from stories on her private Instagram account. She laid a trap for the account she suspected of the leak, and then told the world ‘It was…Rebekah Vardy's account'. Rebekah Vardy, who continues to deny she was the source of those stories, sued Coleen for libel. In a radio exclusive, Coleen speaks to Emma about her side of the story, told in a new documentary: The Real Wagatha Story. Jazz/soul singer Mica Millar is performing as part of the London Jazz Festival in November. She joins Anita Rani to talk about her new album, Heaven Knows, which she wrote while recovering from a spinal injury during lockdown. Britain's long-awaited Online Safety Bill is days away from becoming law. Emma talks to legal expert Joshua Rozenburg about what will be in the act. She's also joined by Baroness Kidron, who has been very involved in getting the act through the Houses of Parliament, and Rashik Parmar, CEO of BCS, the chartered institute of IT, about the future of online safety. Are we becoming afraid of our phones? A recent survey suggest half of 12 to 26-year-olds don't answer the phone to their parents and a third of them feel awkward speaking on the phone generally. Emma speaks to Helen Thorn, a writer, podcaster and comedian and to 17-year-old Iona Cooke Mcintosh. Presenter: Anita Rani Producer: Lottie Garton

There has been a huge rise in the popularity in freezing eggs over the last 5 years. COVID is thought to be a huge factor that impacted this. Statistics show a rise of nearly 50% of enquiries into egg freezing since 2020. So what's it all about, what's involved and how does it work? To discuss this I am joined by Rebecca who is the Patient Services Manager at The Evewell. She is a registered midwife and has supported many people through their treatment. And she has recently frozen her own eggs, so shares both her professional and personal expriences. We discuss: What is egg freezing? Why do it How do you assess someone's fertility potential? Why an AMH assessment is relevant for egg collection How many eggs do you need to collect to give you reassurance for future proofing your family Why it is important to make these decisions on a case by case basis Packages v's cycle by cycle Average age/ age range for egg freezing  The importance of preparation What happens at the other end of the journey when you're ready to use your eggs The improvement in freezing technology and the impact of this on future success rates Rebecca's experience going through egg freezing Rebecca's top tips for people considering egg freezing The dream for regular reproductive health check ins  To find out more about egg freezing see the HFEA

Dr Lisa Cameron was the SNP MP for East Kilbride, Strathaven and Lesmahagow from 2015 until a week ago when she decided to join the Conservative Party. She has described the move as equivalent to leaving an abusive marriage. In her first radio interview since her defection, she joins Emma Barnett to discuss what led to her making this decision. Listeners who have been through IVF treatment will be familiar the extra – and often very expensive – add-on services that many clinics recommend. The Human Fertilisation and Embryology Authority (HFEA), the fertility regulator, has now launched a ratings system to let patients see which add-ons are backed-up by evidence. Strikingly, not one of them has been given the highest "green" rating. Professor Tim Child chairs the HFEA's Scientific and Clinical Advances Advisory Committee. Jessica Hepburn spent over £70,000 on unsuccessful fertility procedures and now campaigns about the fertility industry. They joined Emma to discuss. Three Little Birds is a new ITV series written by Lenny Henry which follows three women who emigrate from Jamaica to England in the 1950s - post-Windrush. The series is inspired by the stories of Lenny Henry's family who, although had positive experiences of being helped as new arrivals, also shared accounts of physical and racial abuse when they reached the UK. Saffron Coomber who plays ‘Chantrelle' and director Yero Timi Biu talk about the show. Julia Fox is an actor, artist and fashion icon, as famous for her breakout role in the film Uncut Gems as she is for her spectacular avant-garde fashion choices. She became tabloid fodder after a brief relationship with Kanye West. Her memoir Down the Drain describes a troubled childhood of sex, drugs and abusive relationships in Italy and New York. She tells Emma how her high-fashion image allows her to escape the male gaze. Presenter: Emma Barnett Producer: Lisa Jenkinson Studio Manager: Steve Greenwood.

Geneticist Professor Turi King shares her views on donor anonymity in response to the HFEA (Human Fertilisation & Embryology Authority) opening a consultation on UK fertility law.

In her new book, Womb - The Inside Story of Where We All Began, NHS midwife Leah Hazard seeks to explore the organ she describes as 'woefully under-researched and misunderstood'. She shares with Nuala what she has learnt from looking into the womb's past, present and possible future. There have been accusations of Russian soldiers using sexual violence as a weapon of war during the current conflict in Ukraine. Progress is being made to bring the perpetrators to justice, but it's slow. Nuala is joined by Anna Mykytenko, senior legal advisor to Global Rights Compliance; and Anna Orel, who works for the Andreev Foundation. The laws surrounding fertility treatment and embryo research in the UK have remained largely unchanged for 30 years. Today a new consultation being held by the Human Fertilisation and Embryology Authority (HFEA) opens. They want to hear from people who have been impacted by fertility treatment. Julia Chain, chair of the HFEA, joins Nuala. As awards season continues we want to know - who should win best performance by a jumper? Mark Darcey's reindeer jumper? Cameron Diaz's knitwear in The Holiday? Fashion journalist Naomi Pike talks to Woman's Hour about the most iconic knitwear in film - and we also hear from the creator of the most talked about jumpers of the moment. Delia Barry is 83 and personally knitted the jumpers you can see in the Oscar-nominated movie Banshees of Inisherin. She tells Nuala how she came to knit for films, and what it's like to be the woman behind the new ‘it' jumper. Presenter: Nuala McGovern Producer: Lucinda Montefiore

Hello! In today's episode, we're talking with Dagmar Tapon, a genetic counsellor and Jane Fisher, Director of Antenatal Results and Choices, about genetic counselling.We talk about the technical stuff, like the difference between genes and chromosomes, the limits to testing, options for future pregnancies, the emotional and mental load that both testing and coping can bring...and much more.Dagmar mentions the HFEA as a resource for statics about IVF in the UK:Human Fertilisation and Embryology Authority gives  impartial, accurate information about IVF, clinics and other fertility treatments from the UK government fertility regulator:https://www.hfea.gov.uk/Get in touch and let us know what you think. Social media: Instagram and Facebook @TimeToTalkTFMR and Twitter @TalkTFMREmail is TalkTFMR@yahoo.comThis episode is supported by Antenatal Results and Choices. For more information on how they support women and couples click here or call them on 0207 713 7486.

This is a timely episode as the https://www.hfea.gov.uk/ (HFEA )has just announced a change in the law for the storage of our frozen eggs, embryos, and sperms. From 1 July 2022, all patients can store their eggs, sperm, and embryos for their own treatment for up to 55 years, you just must make sure you provide consent every 10 years. Frozen Embryos are a topic that I do find quite triggering to be honest, as we didn't go on to use ours. We donated them to science which is something I have spoken about on this podcast before.  Frozen embryos cause a lot of anguish to fertility patients when they don't know if they can handle more treatment or if they can't afford it, but it feels so unfair not to hold on to this precious material. But then as the popularity of IVF continues to grow and become more aware of it and have more access to it and sadly need it, there ultimately becomes more and more embryos in storage. We speak to embryologist Giles Palmer about this issue  What was discussed:  The anguish having frozen embryos has on people  How it feels  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-1678597 (Reference to paper Giles wrote ) How each country has its own laws on the storage of embryos  The growing inventory of eggs and sperm around the world and every clinic is talking about  Storage fee that is attached  -how that is communicated with the patient  Compassionate transfer  Single embryo transfer, fertility preservation - all leading to a growing inventory 300% increase in embryos stored over 5 years  If you weren't pregnant 75% of patients go back for the embryos If they were pregnant to live birth 16% go back  Giles spoke about how a new Dewer bought every year  - to store the embryos and he had to kn0ck down a wall to store them. The problem for many clinics - problem do they store in-house or off-site at a bio depositary  How to deal with issues when storage time is up Can't store samples after consent is up Paper said 25% of samples - never be used  Embryos are yours to take elsewhere if you want to move them from your clinic  Seed Ships  SOCIALS: Follow us  We really want to hear your thoughts on whether this matters to you. Please email  info@thefertilitypodcast.com https://www.instagram.com/fertilitypoddy/ (Fertility Poddy) https://www.instagram.com/your_fertility_nurse/ (Kate ) Giles Palmer on https://www.instagram.com/international_ivf_initiative/ (Insta) Webinars - https://ivfmeeting.com/ (https://ivfmeeting.com/) HFEA on https://www.instagram.com/hfeaofficial/ (Insta)  https://www.hfea.gov.uk/about-us/news-and-press-releases/2022-news-and-press-releases/new-law-comes-into-force-giving-greater-flexibility-for-fertility-patients/ (HFEA press release )

In this episode of Behind the Scenes of IVF, we're looking at who owns the clinics, with there being more groups, more venture capitalists, and more private equity. What does this mean for you, the patient? How might it impact your decision-making? What might the benefits be? We're in conversation with James Nicopoullus, Medical Director at The Lister Fertility Clinic, Peter Reeselv - Founder and CEO of The Fertility Consultancy, and Griffin Jones founder of Fertility Bridge What was discussed:  How the HFEA is still in charge in the UK as the regulators VCs who have bought clinics as they see it as a good business prospect and will have a master plan to make money  - therefore there will be pressure, however word of mouth will always ensure the clinic is a success  How clinics must make it absolutely clear where the ownership is on their website  Finance packages are separate from the clinical decision making  Whether prices will change and become more regulated Where does the buck stop when something goes wrong  What is happening in Europe and how developments in the fertility space are changing because the pioneers are retiring so international networks can combine and offer more opportunities for patients. How fertility tourism is going.  How Sweden, Norway, and France are now enabling single women and same-sex couples able to have treatment, yet in Poland, this is the opposite   How consolidation should put more pressure on clinics to improve services  Shared best practice Networks enable clinics from different countries to  come together and share best practices and research  The global reach of IVF Private equity within the IVF sector How Branding has changed over the last 20 years  SOCIALS:    We really want to hear your thoughts on what helped you choose your clinic?. Please email  info@thefertilitypodcast.com https://www.instagram.com/fertilitypoddy/ (Fertility Poddy's Insta) https://www.instagram.com/your_fertility_nurse/ (Kate's Insta) https://www.linkedin.com/in/preeslev/ (Fertility Consultancy on LinkedIn) https://www.instagram.com/listerfertilityclinic/?hl=en (The LIster's Insta) https://www.instagram.com/fertilitybridge/?hl=en (Fertility Bridge's Insta) 

With the development of new vitrification techniques, egg freezing has become a viable option for women to protect and extend their fertility. Being able to control when to have children can help achieve life-goals. But there are downsides. This lecture explains the science of fertility and egg freezing, the impact of child-bearing and rearing on women's educational and employment prospects, and outlines the law on freezing eggs. It will cover the complex issues around the law's regulation of this practice.A lecture by Imogen GooldThe transcript and downloadable versions of the lecture are available from the Gresham College website:https://www.gresham.ac.uk/lectures-and-events/fertility-lawGresham College has been giving free public lectures since 1597. This tradition continues today with all of our five or so public lectures a week being made available for free download from our website. There are currently over 2,000 lectures free to access or download from the website.Website: http://www.gresham.ac.ukTwitter: http://twitter.com/GreshamCollegeFacebook: https://www.facebook.com/greshamcollegeInstagram: http://www.instagram.com/greshamcollege

KEINE ANLAGEBERATUNG ----LINKS---- Alle offiziellen Links: https://www.mauerstrassenwetten.de Subreddit: https://www.reddit.com/r/mauerstrassenwetten/ Shop: https://mauerstrassenwetten.myspreadshop.de/ ----TIMESTAMPS---- (02:04) Wie bist du überhaupt auf Mauerstrassenwetten gekommen? (07:50) Was ist deine Erfahrung mit der Quallenmagie? (13:30) Warum hast du dich dann mit HFEA beschäftigt? (17:10) Was ist die HFEA-Strategie? (22:00) Woher hast du diese Daten? Was konntest du aus den Daten lernen? (29:55) Wieso bist du so ein Ehrenmann? (32:35) Ist eine europäische HFEA Strategie überhaupt möglich? (39:25) Warum hast du hier Anpassungen vorgenommen? (Gold und Cash, Nassdachs statt S&P500) (44:25) Wieso hast du eine Alternativ-Strategie vorgestellt? Wieso hast du es dir schwerer gemacht ("Hebel für den Langlauf")? (48:20) Wieso hast du immer soviel geschrieben, und nicht einfach eine WKN genannt? (52:03) Das liest sich keiner durch, kannst du uns eine Zusammenfassung geben?

Here's a bonus mid-week episode continuing the focus that other fellow poddies have been giving to your stories about cancelled treatment as well as the brilliant open letter https://www.instagram.com/definingmum/ (@definingmum) shared on her insta. We chatted with the lovely Jen https://www.instagram.com/ivfpineapple/ (@ivfpineapple) who had her donor treatment cancelled and we know that there is a lot of anxiety and unease about when treatment will resume, whether some treatments might be prioritised and this is certainly something Jen is worried about. Trying to conceive Jen and her hubby had been trying for over three years and were still told they'd have to wait a year before being referred for fertility treatment as Jen had been pregnant naturally but sadly miscarried. Jen then fell pregnant with IUI but had a missed miscarriage before moving on to IVF. By their second appointment, Jen was told she had a very low AMH and was told they needed to have IVF. Feeling let down Jen felt let down that nothing was checked earlier, her AMH wasn't checked earlier, when she miscarried instead they went through three IVF cycles - none of which worked but only ever got to one egg to transfer on day 3 but they never worked. She was 32 and being told she had good egg quality.  We had conversations with private clinics who wanted her to carry on with her own eggs despite Jen already thinking about using a donor. Using a donor Jen talks about how they were on a waiting list for an anonymous egg donor which she was really not sure about. Then Jen met someone on facebook who her and her hubby have now met and become good friends with. Jen talks about the importance of support through all of this, having time to process and think about it, the importance of advocating for the things you believe in and making the right choices at the start so you don't feel let down at the end. They had started their cycle with their donor who had gone for her scan and was due to start her stims in the morning.. this was happening as we were all going into lockdown. By the afternoon Jen was told that her clinic were following HFEA guidance to stop donor cycles. Jen talked about how gutted her donor was and how she wanted to give them a baby by Christmas, about how this has impacted on their whole family as well. Coping with the impact of COVID-19 Just having to take it a day at a time, she works for the NHS and is throwing herself into it, avoiding 'fertility thoughts' and also finding it tricky not being able to spend time with friends and family. She is trying not to focus on the impact coronavirus is having on their donor cycle. Be mindful of the online community if it might be a trigger. SOCIAL MEDIA:  https://www.thefertilitypodcast.com/ (The Fertility Podcast ) https://www.instagram.com/fertilitypoddy/ (Instagram ) https://www.instagram.com/your_fertility_journey/ (Kate) https://www.instagram.com/ivfpineapple/ (Jen ) Please note if you want to get in touch please email info@thefertilitypodcast.com (not fertilitypoddy as I said in this episode)  

Male Infertility Meet Professor Sheryl Homa – Clinical Scientist and director of Andrology Solutions, an HFEA licensed male fertility clinic offering expert care and advice on men's fertility. Sheryl spoke about how we currently deal with infertility is wrong and how Sheryl she believes the triaging for fertility is inappropriate.  Women are fully investigated however there is currently very little focus on the man. As a result, couples are put forward for IVF treatment when they may not necessarily need it. If a man is investigated appropriately and treated then men's fertility may be improved to optimize their natural fertility or improve their chances of successful IVF treatment. Sheryl recommends that GPs consider referring men to a urologist or andrologist early on for proper management. More awareness on this issue is required and greater empowerment and education of both GPs and patients. A physical examination or ultrasound scan Can pick up conditions such as a varicocele or an obstruction. Varicocele repair is not always successful and not indicated for very small varicoceles, however, pregnancy rates following a repair are equal to or better than IVF success rates. Whilst it repairs fertility, IVF gives the couple a baby but the couple is still infertile, there is no treatment for their infertility. Men may not always notice a varicocele, however, it is most likely to present on the left side, the teste may be larger, may feel discomfort and the pain may come and go. Men also complain of their teste feeling like a bag of worms. Lifestyle factors and male fertility More men are being diagnosed with poor sperm parameters from using protein supplements and shakes. A recent study showed that these supplements contained some steroid compounds. Sheryl recommends that men should not take any protein supplement or shake as not all ingredients are listed. Supplements such as antioxidants work to reduce oxidative stress. A varicocele can raise oxidative stress and damages DNA.  You can have a normal sperm analysis but still have oxidative stress. Sheryl recommends that men have oxidative stress testing before starting antioxidants and then repeat testing after 12 weeks. Mumps in adult men The mumps virus can cause inflammation of the testes and can cause men's tubes to become blocked. Men have 6kms of tubes in their testes! Sheryl believes that unexplained infertility is actually un-investigated when it comes to men. She recommends that men are proactive and ask their GP for a referral to an uro-andrologist and that fertility clinics are more inclusive in working with male fertility specialists. Treating male infertility will reduce the need for invasive IVF and the demand on NHS resources, leaving more money for couples who really need IVF treatment. Support for men – men need support and information in a different format to women and a podcast or male-only fertility support groups on Facebook, for example, allows for anonymity. SOCIAL MEDIA:   http://www.andrologysolutions.co.uk (Dr. Sheryl Homa)  https://www.instagram.com/andrologysolutions/ (Instagram ) https://instagram.com/fertilitypoddy (Fertility Poddy  ) https://instagram.com/your_fertility_journey (Kate Davies) 

Meet Francesca Steyn,  Head of Nursing at the CRGH - Centre for Reproductive and Genetic Health in London. Francesca is involved with the Sperm, Egg and Embryo Donation (SEED) Trust and she spoke to Kate and I about the ‘minefield' that is surrogacy and how patients considering this option can get the information, guidance and support they need. When we interviewed Francesca she has just been nominated for Surrogacy Professional of the Year 2019 – an accolade she won in 2018, and we are delighted to announce that Francesca has been awarded this again for 2019! Congratulations Francesca! Francesca leads the nursing team at the CRGH but also leads on Clinical Governance and Quality as well as managing the Surrogacy Programme. Francesca has worked in the field of surrogacy for a number of years and has seen huge growth in surrogacy in the UK. Clinics are a lot more aware of surrogacy services then previously. For people considering surrogacy, Francesca recommends finding a clinic that has experience in surrogacy. The HFEA website provides more information on this and the important things to look out for are -  if the clinic has a dedicated surrogacy team, how long have they offered surrogacy,  do they provide open days etc. Legal considerations can be complex but the CRGH have very detailed protocols to follow to make sure that all steps are followed. The SEED Trust provides unbiased and independent support and guidance for anyone considering surrogacy. The website has information and resources for intended parents and donors.  Making the decision to seek surrogacy at home or abroad. Francesca has seen a change in that patients are considering surrogacy in the UK rather than seeking help abroad, mainly because of greater availability in the UK and more support and resources. LGBTQ community has increased since law changes in 2010. There is a huge amount of support for surrogacy among the LBGTQ community from various organisations and networks. More work needs to be done to normalise and raise awareness of surrogacy among the Heterosexual community. Main challenges to overcome when making Modern Families – the need for more awareness and greater funding. Individuals currently need to fund their own treatment and this is a barrier to many people creating their family. Francesca is involved in Fertility Preservation training with the Royal College of Nursing and BICA. In the UK we have a shortage of donors and Francesca urges people who may be considering this to come forward to find out about what's involved in donating. SOCIAL MEDIA https://twitter.com/fransteyn?lang=en (Francesca Steyn) https://crgh.co.uk (CRGH)  https://seedtrust.org.uk (SEED Trust) https://instagram.com/fertilitypoddy (@fertilitypoddy)  https://instagram.com/your_fertility_journey (Kate Davies) 

In this episode we answer emails from Spencer, Hannalore, Keith and Claire.  We discuss a new article at Portfolio Charts, leveraged intermediate treasury bonds and their possibilities and implications, and invitations for ads.Links:Ingredients Article:  Three Secret Ingredients of the Most Efficient Portfolios – Portfolio ChartsBias-Variance Dilemma Episodes:  Podcast #49| Risk Parity Radio; Podcast #64| Risk Parity Radio; Podcast #66| Risk Parity RadioHannalore's Seeking Alpha Article:  TYA: A Better Version Of TLT And My Top Fixed-Income Pick (NASDAQ:TLT) | Seeking AlphaTYA Fund Page:  TYA Simplify Risk Parity Treasury ETF | SimplifyPortfolio Visualizer Analyzer Analysis of TYD:  Backtest Portfolio Asset Allocation (portfoliovisualizer.com)Keith's Bogleheads Forum Link:  Modified versions of HFEA with ITT and Futures / Lifecycle Investing with Modern Portfolio Theory - Bogleheads.orgKeith's Beta Article Link:  Betting against Beta (and Gamma) Using Government Bonds - Federal Reserve Bank of New York - FEDERAL RESERVE BANK of NEW YORK (newyorkfed.org)Support the show (https://www.riskparityradio.com/support)

In our series Under Pressure we've been looking at what happens to relationships when couples are put under extreme strain: how do they cope? Today we hear from Kate and Annie who live in Northumberland. This year marks the 30th anniversary of the Human Fertilisation and Embryology Authority. In March, Julia Chain was announced as the new chair of the HFEA. Now Julia is calling for the 1990 Human Fertilization and Embryology Act to be updated. She joins Emma to discuss the changes she wants to see. We talk to Deborah Bull and Jill Baldock about how dancing can lift your mood. A report out today from the Institute for Fiscal Studies says there's been 'almost' no progress towards closing the gender pay gap in the last 25 years. Professor Lucinda Platt, who's on the panel of the IFS Deaton Inequalities review, and who researches inequality at the London School of Economic, explains why not. If your facial fillers aren't to your liking, or worse injected in a dangerous spot, you can get them dissolved with a substance called hyaluronidase. But women are reporting nasty side effects including swelling, tissue loss, burning sensations and headaches. A cosmetic surgeon, Daniel Ezra, is studying this to try to establish exactly what's going on. We hear from him as well as our reporter Melanie Abbott.

It can be rare to hear the partner's perspective when it comes to TTC and being finally pregnant so I'm really pleased to bring you an episode sharing just that. Chris and his wife Becca are heavily pregnant right now following many years of failed treatment before travelling to Greece for a round of donor IVF. I'm also excited that I recently recorded a chat with Emma aka Donor child, who shares her unique perspective as a donor conceived child. Make sure you're subscribed to the podcast to know when that goes live! We also talk add ons. If you're thinking about using any please head to the HFEA to check out their traffic light system first. If you need more information about getting the Covid vaccination whilst pregnant please head to the RCOG where you will find their vaccination guidelines which are updated regularly. In addition to my chat with Chris I also share that I am still in my 2WW and, as part of that, am loving listening to my pregnancy Meditations. If you're interested in joining us at our Hang Out get together on Friday 20th August (just one of more meet ups being planned this year) make sure you join to be part of it! There are lots of other benefits to being a member too! Whilst you're at catstrawbridge.com you can also find out more about the other support I offer including the Finally Pregnant Yoga and Pilates Sessions. You can also sign up to received my Top 5 Strategies to Enjoy Your Pregnancy. If you enjoy the podcast please do take a moment to subscribe, rate and review it wherever you listen! Thank you to sponsors Melio Health. Melio offer blood tests before, during and after pregnancy: from non-invasive prenatal tests to general health checks, helping you and your family take control of their health. Find out more here. Much love, Cat x @tryingyears

Earlier in June, a hugely important review by the Competition and Markets Authority (CMA) was published. This review produced guidance to help fertility clinics comply with their consumer law obligations but also provides guidance for you when considering purchasing IVF treatment. The word ‘purchasing' there is massively significant because as well as being a patient, you are also a consumer and it's very likely that you haven't thought about fertility treatments in that way. It's important that fertility clinics are fair and that you know your rights when it comes to consumer law.   In this episode, we're delighted to talk to two guests who have been actively involved in assisting the CMA in producing this guidance – Clare Ettinhauser Director of Strategy and Corporate Affairs at the HFEA, and Patient Advocate and founder of @uberbarrensclub - Katy Linderman. Later we're also joined by the chair of the British Fertility Society, consultant gynecologist Raj Mathur, to share his views on the CMA review.   Whilst we had Clare with us, we also asked her how best for women and couples to go about choosing a fertility clinic. Clare recommends checking out the Choose A Clinic function on the HFEA website. Kate uses this with her patients and finds it super useful in narrowing down your choices and finding the best clinic for you. She also mentioned paying attention to the individual clinics Live Birth rates on the HFEA website, these are collated and ratified by the HFEA every 2 years but are unlikely to differ very much in that time. Clare also talked about the benefits of attending, either in person or virtually, clinic open days.   Now on to the CMA review: Katy worked as a patient advisor to the CMA and it's really obvious from reading the review that the patients' best interests are at the center of every aspect. Katy talked about the need for patients to have accurate and timely information to help them make the right treatment choices and that there is a lot of work clinics need to do to adhere to this new guidance.   Here is what you should now expect to fully understand when choosing a clinic and treatments: a) Details about what the consultation consists of;(b) The cost of the consultation and any diagnostic tests and scans; (c) The possibility that additional diagnostic tests, and costs, maybe necessary once the results of the first tests are known; (d) Whether the results of any tests and scans already undertaken will be accepted; and (e) Details of any cancellation charges if they fail to attend the consultation appointment. Claire talked about the HFEA's involvement with the CMA review. Sadly, currently, the HFEA does not have any legal powers to ensure that clinics follow and adhere to the CMA guidance. We asked her if the HFEA had received any feedback from clinics since the review was published. As yet they have not but this is probably because clinics have been aware for some time that this review was happening, and that the guidance would be published.   As well as publishing information for clinics, the CMA has provided guidance for patients too. This also includes an informative video voiced by Lorraine Kelly and we urge you to watch this to understand your rights. Katy talks about the need to clinics to take considered action and make the legally required changes to their website, brochures, and any patient information so that there is treatment price transparency (among many of the other requirements) and a good understanding of what is and isn't included, from the outset.   Katy also states that it is your legal right to have access to this information and if it's not there, be your own advocate and persist in asking for it. By having this information you'll feel more empowered on your fertility journey.   Next up we get Raj's clinical opinion on the CMA guidance. He starts by stating that the British Fertility Society welcomes...  See...

This week we have a bumper episode and have not one guest, but three! Our episode is all about the fact that infertility knows no colour, meaning that infertility doesn't care about the colour of your skin – it impacts us all regardless but there are very unique challenges, and some similarities faced by differing communities.   First up we chat to https://www.vanessahaye.com/about (Vanessa Hay)   Talking about the issue of infertility within Black communities. Vanessa described how multi-layered up fertility issues were with other social-cultural things like faith “When you are trying to build a family, you feel like everyone else is affected. Your whole family are invested and I felt it was too much pressure to go through, so it took me a while to talk about it. Then you have to deal with comments such as ‘Why you going through IVF it's not something that we do' Vanessa chose to only share her experience after she was pregnant, she was 27 when they were trying..   She spoke about how Infertility has no boundaries in terms of what you go through and how it feels and how she felt she couldn't get anything from her community as she wasn't sharing so she needs to go elsewhere. She went on chat rooms… and realising there was the Instagram community… However the nuances in her journey -such as how to approach nosey aunties and uncles / the faith-based / they weren't being covered in this predominantly white community.   Vanessa https://metro.co.uk/2018/11/22/stigma-and-shame-struggling-with-fertility-as-a-black-woman-8166179/ (spoke to Metro )about her experience of going through IVF as a black woman had so much traction. People thanking her for sharing it. People saying they were also going through it. Women were saying this is something I'm going through but don't feel comfortable talking to my friends as it's not something that happens with Black women - started the conversation to help us feel less alone.   Vanessa said how people talking back to her and she then seeing other black women bloggers starting the conversation helped her feel less alone. It was reciprocal and reassuring. She explained how ‘If there is already a perception in a community and you aren't seeing people that look like you talking about it further breeds the idea that this isn't the type of thing you might go through. ‘   There is still shame within Black communities assumption of virility Vanessa spoke about Noni Martens who has been talking about how black women are raised to be Mother - which s something we spoke more with Christine about later in the episode. There is an assumption that black women are apparently ‘hyper fertile' Vanessa also explained her concerns about celebrity - saying how ‘There is also the perception of IVF is also that people are choosing what babies they have due to the celebrity association. As people don't understand it. If someone is choosing it they are guaranteed to get pregnant, that she has decided to now get pregnant… like you are trying to take matters into your own hands   She is now focusing more on Reproductive and Gynacolgical - having lost babies she has realised she still has work to do in the education she is sharing.   Next, we welcome back a friend of the podcast Dr Christine Ekechi. Christine is a consultant gynaecologist at Imperial College NHS Trust and a spokesperson for Racial Equality at the RCOG. Christine is passionate about tackling the healthcare inequalities of women. We last saw, and interviewed, Christine in a very busy and noisy British Library in London, just before lockdown.   We wanted to chat with Christine about the recent paper, shared by the HFEA, on the ethnic diversity infertility treatment and how using the term BAME is no longer acceptable. Christine is against defining women by...  See https://acast.com/privacy (acast.com/privacy) for privacy and opt-out information.

This fertility series is a mixture of our own stories and others.We start off by speaking with Embryologist David Gibbon. His wealth of knowledge comes from working in the medical field from the mid 90's as an Embryologist and in 2000 he joined the HFEA as a scientific inspector.Now retired from the NHS David supports patients that are seeking to use fertility services abroad. In this episode he talks us through the basics of embryology and the advances there has been in his career. #FeelingfemaleAF #Real #Wellness #singles #embryologist #embryology #NHS #singlewomenproblems #infertility #fertilitytips #infertilityjourney #infertilitysucks #ivf #fertilityjourney #pregnancy #fertilitycommunity #community #infertilitysisters #womenshealth #ivfjourney #healthyliving #eggfreezing #lgbtq #lgbt⁠ #ttccommunity #infertilityawareness #eggdonor #eggdonation #pcos #invitro

It’s nearly thirty years since Sharon Stone was in the film Basic Instinct, with the famous uncrossing-of-legs scene. She really wanted the role but only got it after twelve other actresses turned it down. After Basic Instinct more films followed including Casino alongside Robert De Niro. In 2001, after adopting her first child, she suffered a stroke and almost died. She’s now written her autobiography called The Beauty of Living Twice. She gave Woman's Hour her only UK broadcast interview. On the morning that a new helpline has been launched for potential victims of school sexual abuse we speak to Gillian Keegan MP who's from the Department for Education. We're talking about shop changing rooms with retail expert Catherine Shuttleworth. When lock-down lifts will you be using them, or sticking with ordering online and trying things on at home? People from ethnic minorities who have fertility treatment are less likely to be successful. That's according to the Human Fertility and Embryology Authority. Their data says Black patients having the lowest chances of successful treatment whilst only 4% of egg donors were Asian. We find out more with Sally Cheshire, outgoing Chair of the HFEA and Dr Karen Joash, Consultant Obstetrician and Gynaecologist at Imperial College Healthcare Trust and spokesperson for Race Equality at the Royal College of Obstetricians and Gynaecologists.

 We can't believe it's episode 3 already! Where has the time gone? We're loving all your messages since we've been back – so keep them coming.   So, in this episode, we're still chatting preconceptual care. All you need to know to help you conceive naturally. We start off by talking in more detail about the methods that can help you….   Have you heard of Mosie Baby? Mosie Baby is basically artificial insemination at home and can be useful when traditional methods may not be working or are simply not an option – for example for same-sex couples, women trying to conceive alone and couples who are finding it difficult to perform on demand. Find out more about Mosie Baby below and listen to our previous conversation with founders https://www.thefertilitypodcast.com/mosie/ (Marc and Maureen here )   Next up conception caps. Kate shares her view of FERTILILY – a hormone-free conception end that is clinically proven to increase the chance of pregnancy by 48%. It's made of soft medical grade silicone and is easy to insert after intercourse and is designed to push the sperm towards the cervix, increasing the chances of more sperm cells making their way into the uterus. You can read more about FERTILILY below.   On to this week's guest - Laura Robson from The Body Literacy Collective and co-founder of the Read Your Body App. Kate and Laura met through training in Fertility Awareness with Fertilityuk and as a result of her training and previous personal experience of using fertility awareness to avoid pregnancy. The idea for creating the App was born out of a desire to offer her clients a reliable and effective app without hesitation and to have no concerns over data privacy or ineffective app features.   Over the last year and a half, Laura has been on a mammoth journey to get the app released through crowdfunding, app development, and testing to 100 beta users. The app has now been live for 8 months and is available in different languages with lots of new features. Laura recommends that women use the app alongside an educator to help them understand how to chart their fertility effectively, and if trying to conceive, help reduce the time it takes you. Read Your Body has many different features that set it apart from other apps, to name just two - It is totally customizable, and importantly users have total data privacy. Check out the app and how it could help you along your fertility journey below. Here are some details of http://faeducators.directory/ (other fertility educators) Laura wanted us to share with you.   In Ask The Expert this week we're talking about the contentious issue of IVF Add Ons and the HFEA traffic light system with Dr. James Nicopoullos. James tells us that there is no evidence to support the use of assisted hatching for IVF making it a red traffic light. The HFEA highlights endometrial scratch and embryo glue as amber meaning that there is limited evidence and is down to individual clinics as to whether they offer this.   And finally…..we have a little offer for you. Kate is offering one lucky listener the opportunity for a complimentary 20-minute cycle interpretation chat. To be in with a chance to win email Kate on kate@yourfertilityjourney.com with the email header ‘Fertility Pod'. The first person that emails will win…..GO!   Don't forget to join us for every Thursday at 2pm on Instagram and https://www.facebook.com/groups/talkfertility (The Fertility Podcast Facebook group) for #brewattwo   We spoke about a previous episode with Toni Weschler which you can https://www.thefertilitypodcast.com/chartingyourcycle/ ( ) https://www.thefertilitypodcast.com/chartingyourcycle/ ( ) https://www.thefertilitypodcast.com/chartingyourcycle/ (See )https://acast.com/privacy (acast.com/privacy) for privacy and opt-out information.

People wanting to start a family, who need to use a sperm donor say they feel forced into finding sperm online in unregulated spaces because NHS funding is rationed or they don’t qualify for it and it's too expensive to go to a private clinic. The UK’s fertility regulator has warned that doing so carries “significant risks”. We hear from the Chair of the HFEA and from two women who sought donors via the internet. Julie Ma's first novel Happy Families won the Richard and Judy/WH Smith 'Search For A Bestseller Competition' in October and has just been published. She talks to Anita about the book which is centred around a Chinese takeaway the Yau Sum in West Wales which closely resembles the one she grew up in and now runs with her brother. And Charlotte Sibtain who's collected more than 400 vintage wedding photos from charity shops, markets and the internet and tries to track their owners. Presenter Anita Rani Producer Beverley Purcell illustration Chris Vallance

It was an absolute pleasure to chat with Professor Sheryl Homa this week on the podcast. Sheryl Homa is an HCPC registered Clinical Scientist with a special interest in male fertility. She obtained her degrees in Biochemistry at Imperial College of Science and Technology and the Middlesex Hospital Medical School. She spent a large part of her career as an academic research scientist in the field of oocyte maturation, funded by the National Institutes of Health in the USA. For many years she served as Scientific Director of several fertility clinics in the UK working in both the public and private sectors. During this time, she became aware that male fertility is considerably marginalised and as a result, opened Andrology Solutions in 2007, the first and only HFEA licensed clinic of its kind, dedicated to male infertility. She has collaborated on many research projects and is the author of numerous scientific articles, abstracts and book chapters in the fertility field. Her studies include investigating calcium signaling in sperm and more recently, the role of oxidative stress and infection on sperm quality. Sheryl has been responsible for introducing and CE marking novel state of the art testing for male infertility, including a chemiluminescence assay for measuring seminal reactive oxygen species. Currently Sheryl is honorary Professor in Biosciences at University of Kent and consultant clinical lead for Andrology at The Doctors Laboratory. We chatted about how men are equally responsible for creating an embryo that would lead to a child, how half of the genetic material is from men and that the child is a reflection of the genetic material of both partners. That it isn't just about getting pregnant or staying pregnant but ultimately the health of a child.    We talked about how sperm and eggs need to be as fit and healthy as they can be and how if the sperm or egg is damaged in anyway this passes to every cell of the child and this is an area that I talk about a lot with my clients: that we need to widen our vision looking further than just getting pregnant.  This helps us make the changes necessary. Sheryl said something that really made sense to me and she said that she advises her male clients to act as though they are pregnant so in the few months leading up to conception to think about their sperm as that they are carrying pre babies. We know that 11 to 12 weeks is necessary for both the sperm and the egg to develop fully and so a preconception preparation plan is absolutely vital and she compared this to preparing for Wimbledon and saying that if you were going to compete at Wimbledon you wouldn't just rush on and play would you? No, you would prepare with training, health and with the right equipment.  I’m a huge fan of an analogy myself, I’ve often used the example of how you wouldn’t ‘just run’ a marathon. We looked at how it's important to consider quality and not quantity and how this is important to maximise your chances of both natural and assisted fertility and we need the best quality egg and sperm. We talked about the sperm analysis and how this is a crucial first step and provides great information but it only tells you if there are potentially enough and we know the parameters are low, too low, and if sufficient are moving. However, it doesn't tell us whether the sperm is capable of getting to the egg or if it is capable of entering the egg or if it has the right triggers to ensure embryo development. Resistance infertility circles was something that we discussed as well and this letters onto the resistance amongst the fertility clinics to undertake two very specific tests that give it so much information about the sperm in terms of fertility but also importantly in terms of miscarriage and how this really should be offered to all couples experiencing recurrent miscarriage and those tests are the DNA fragmentation test and the oxidative stress test on the sperm. Something that comes up for me with my clients and with something that we discussed is how some Doctors and clinics will say that even if the test showed DNA fragmentation or oxidative stress there isn't anything that can be done about it, but Sheryl explained how there might be quite a bit you can do about it. We discussed also how a condition called Variocele maybe a huge factor in terms of sperm quality, how a full clinical history should be taken for male partners, how women have an ultrasound but that men aren’t examined at all. How underlying infections which are not looked at are an underlying cause of conception and potentially miscarriage as well and how a microbiology test on the sperm is a crucial  test. Of course we discussed the recent documentary by Rhod Gilbert ‘stand up for infertility’ Which led us to chat about physical issues and emotional issues. Not only emotional issues in terms of how they may affect sperm physically but the lack of support for men who are going through a fertility journey. She mentioned a Facebook group the men's fertility support run by Gareth Down which I would urge you to point your male partners in the direction of   We chatted about some basic general advice at the start of a couples fertility journey and we discussed as you've heard me talk about before why trying to conceive at or just before ovulation may in fact be too late and how important a regular ejaculate is because stored sperm is in effect rubbish sperm, and that again it's not just about numbers it's about freshness and quality She will also explained how we were missing a vital piece in the journey and that your GP referring you to the fertility clinic straight away which is ultimately for assisted fertility is like going to your doctor with heart palpitations and the doctor saying let's get you a heart transplant. She explains that IVF is circumvention, how it is not managing fertility and that after initial GP tests, further investigation should take place and treatments suggested to correct possible fertility factors.  Further investigation can be undertaken by an Andrologist. Something of interest that was pointed out in Rhod Gilbert's documentary is that there are 8000 registered Gynaecologists in the UK and only 200 registered Andrologist. It is Gynaecologists with a specialism in Fertility that you are referred to at the Fertility clinic Considering an Andrologist looks at male fertility factors this clearly isn't representing half of the equation is it? She said something which I have been saying you will have heard me saying certainly my clients have heard me say but there is too much emphasis on pushing towards IVF when this may not be needed and if IVF is needed we should be paying more attention to improving the quality of the egg and the sperm . You can find Sheryl at Andrology Solutions  If you want any more information, see where you’re at or would like to find out how working with me on the Fertility Rewire Method may help you, then you can arrange Free call Free resources are available including what your bleed can tell you about your fertility and a free visualisation. If you want to keep up to date on information, news, client progress updates, offers and podcast episodes, the best way is to receive my emails .

In this episode I talk to Dr Matt Prior. Matt is an NHS consultant doctor working at Newcastle Fertility Centre and also Medical Director at Dr Fertility.     Dr Prior specialises in reproductive medicine and surgery. He helps people with fertility problems using a holistic approach.    In this episode we discuss:    - How to better understand your fertility - When to go to your GP and how they can help you - An explanation of AMH  - Considerations when choosing a fertility clinic - The difference between IUI and IVF - The rough cost of fertility treatment  - Where to go for independent advice   In the episode we mention the HFEA, which is a UK based organisation. If you are listening from outside the UK, you can check if there is an equivalent independent body in your country.    If you'd like a consultation with Dr Prior you can contact him at @drfertility   For more of Matt's insights you can follow him on Instagram at:  @drmattprior @bigfertilityproject    

Where do you start on the fertility Journey? And who do you go with? Well we started at The Fertility Show in London.  This episode looks at how that microcosm of weird and wacky practices, hospitals touting for your business and awkward couples summed up the next five years. A rundown of what to expect from a male perspective and how it all starts with a discussion around your desire to have children and setting a  timetable.  Facts and  Figures on the chance of success of IVF and getting pregnant Working out who is top of  league of Fertility hospitals via the HFEA. Some practical tips for the start of the  Fertility journey from a male perspective.

In this bonus episode,Kate and I speak with  Sally Cheshire, who is the chair of the https://www.hfea.gov.uk/ (Human Fertilisation and Embryology Authority (HFEA) ) These shownotes are a transcript of part of our conversation with Sally. Please listen to hear the full interview: What is 'elective treatment'  It is the word that the NHS use when it's not an outright emergency. So the NHS made that decision. And it's an unfortunate name because no one chooses to go in for surgery, particularly with regard to fertility treatment, but that's the word that's been used.  So the NHS said that they would suspend all non-emergency treatment during the pandemic, so the only people who were being treated in the first stages of the pandemic after the 23rd of March, that was, were people who were in an emergency situation. What we said in terms of fertility is that patients who were having cancer surgery, for example, and needed fertility preservation would still be allowed to go ahead and our clinics would stay open for those patients to store gametes and embryos. But also, we would allow as many patients as possible to try and finish their cycles if they had started. And we know that there was a different response from clinics, and you can imagine that they were trying to manage, as well as all other NHS hospitals, some clinics carried on with those cycles, and then collected eggs or frozen eggs or embryos. But some patients we know had their cycles cancelled earlier than the 15th of April. And all I have to say is it was up to the clinic to decide whether they could go ahead. Some of them of course, had already lost staff to the front line. They'd had some of their equipment used for testing for virus testing from the embryology lab, and some of them also had staff who were self isolating or who've been diagnosed.   Counselling: We do know there's been a massive increase in patients seeking counselling support. But if you actually talk to counsellors, some patients are asking different questions. Some of them are clearly distressed, not being able to have treatment. Some of them are very fearful of the virus and what impact it might have. So counsellors tell us they've seen an increase in patients who were just seeking help to deal with their general anxiety, not necessarily ready to talk about the implications of their particular treatment and what that might mean. So we do know that there is support out there and I'm sorry to patients who didn't quite get what they wanted, perhaps from their clinic. Professional Guidance: We've had to rely on professional guidance. So from the UK bodies from the British fertility society and of and the clinical scientists, but also from Europe and America, who advised similarly to stop treatment, until we knew a few more things, and their guidance has been very similar to the UK all along. And the Royal College of Obstetricians and gynaecologists also had to think about whether they considered there was any risk in early pregnancy. And they've also issued a couple of sets of guidance. So I think everybody has issued at least two sets of guidance over the last four weeks from the professional bodies. We've issued a number of letters to clinics explaining our requirements. And we've also tried to communicate with patients as best we can. The professional bodies have issued their latest guidance, which is cautious optimism. Tough Decision: I think this is the most difficult decision the FDA has ever had to make in 30 years really and the board and the staff have tried so hard to get it right. One of one of our criteria, quite rightly, was that there was no, or that there was as much evidence as possible to say there was no increased risk in pregnancy. And when I was thinking about it this morning, as a patient, you know, pregnancy is somewhere over the rainbow, isn't it? It's a long, long time away. And if you are trying to think about having treatment, it's...

We've had hundreds of messages from listeners who are worried about restrictions on IVF treatment during Covid-19. We grabbed a few minutes on the phone with Rachel Cutting, the HFEA's director of compliance and information, to find out when it will be back. See acast.com/privacy for privacy and opt-out information.

Covid-19 and fertility treatments We appreciate given the current crisis you may well be worrying about what covid-19 means for your fertility treatments, and therefore at the beginning of this episode we give you an update on the current advice. At the moment, there is limited guidance out there, however this will likely change in the coming days/weeks. Currently, the HFEA recommend that you contact your clinic for advice as each clinic will likely have contingency plans in place. We plan to chat with experts this coming week and will, of course, keep you informed of any developments that relate to fertility treatments. If you are required to self-isolate over the coming weeks, then you can be reassured that The Fertility Podcast will be keeping you entertained. So, make sure you subscribe so not to miss an episode! Parenthood in Mind Next up, Natalie and Kate talk to Julianne Boutaleb who is a peri-natal psychologist and Clinical Director and Founder of the Parenthood in Mind practice. Julianne works with women and couples who have experienced trauma in relation to birth and miscarriage but also with women who suffer with fertility trauma. Typical patients that Julianne works with are couples who have concerns with regards to known genetic issues, couples who are facing assisted conception, couples who have had failed cycles or reproductive injuries and those contemplating donor conception, surrogacy or adoption to create or complete their family. Many couples who have previously experienced miscarriage come to Julianne as they have a fear – either physically or emotionally of a miscarriage reoccurring. Tokophobia Tokophobia is the fear of being pregnant or giving birth. Tokophobia may occur in women who have never given birth to a child, but it may also affect women who have had prior traumatic pregnancy or birth experiences.   Protecting your relationship Couples who don't conceive are 3 times more likely to separate or divorce than couples who do conceive. Clinics are starting to support couples more with regards to the emotional impact Often reaching the menopause can be a trigger for women who haven't been successful in conceiving through assisted conception. Julianne helps couples rewrite their ‘happy ever after' story without children. Fertility Trauma* The term Fertility Trauma helps to highlight that struggling to conceive is a true trauma and this also includes ‘perceived' trauma. Fertility trauma is not just depression, anxiety or stress but is your brain going in to ‘fight and flight' mode. SOCIAL MEDIA  https://www.parenthoodinmind.co.uk (Julianne Boutaleb)  https://www.instagram.com/parenthoodinmind/ (Instagram) https://www.jessicahepburn.com (Jessica Hepburn)  Unfortunately, since recording this episode, Jessica's Pond to Peak Challenge and her ascent of Everest has been cancelled due to Covid-19 but she will hopefully be making this journey next year! https://www.thefertilitypodcast.com (Natalie Silverman)  Ihttps://instagram.com/fertilitypoddy (nstagram ) http://%C2%A0www.yourfertilityjourney.com ( Kate Davies)  https://instagram.com/your_fertility_journey (Instagram)  * Fertility Trauma explanation The term ‘reproductive trauma' was first coined by perinatal psychiatrists Dr Janet Jaffe...  See https://acast.com/privacy (acast.com/privacy) for privacy and opt-out information.

Meet Dr Dean Morbeck, Scientific Director at Fertility Associates in New Zealand and Sunfert International Fertility Centre in Malaysia, which combined have 10 fertility clinics in the two countries. Prior to moving to New Zealand, he was an Associate Professor at the Mayo Clinic for 10 years. He is an internationally recognized expert on quality in the IVF laboratory, having published more than 40 papers, numerous book chapters and is the coeditor of a book that is a practical guide for embryologists. He is taking his passion and expertise for the science of IVF beyond the laboratory to engage with patients with the goal to improve the patient experience.   In his spare time, Dean has written many research papers, book chapters and is the co-author of a practical guide for Embryologists. If that wasn't enough, in 2010 Dean is also starting a Podcast with the aim of improving the patient experience, called "The Fertility Patient Revolution". Look for it in 2020! Single embryo transfer vs Multiple We interview Dean while he is at the American Society for Reproductive Medicine conference (ARSM) in the US, and he talks about his views on single embryo transfer vs multiple. In the US this is the first year that has seen a decrease in twin rate in both natural pregnancy and IVF. As a clinician, this is the preferred outcome to reduce the risks associated with multiple births. Twin pregnancies result in 8 times the risk of complications to both mother and baby but also an increased financial and time burden once the babies are born. New Zealand has seen less than 10% twin rate overall.   The IVF League Tables Dean has recently been reviewing the HFEA data for individual clinics in the UK and was surprised to see a number of clinics with high twin rates of 20% or higher. He feels there is a trade-off between clinics desiring high pregnancy rates and therefore an increase in twin pregnancy rate. Dean's impression is that patients are attracted to clinics high pregnancy rates but may not necessarily take on board the resulting twin pregnancy rate and what this might mean for adverse pregnancy outcomes. Increasing the chances of success In New Zealand 97% patients receive a single embryo transfer, however in particular clinical situations, women may receive a double embryo transfer. However Dean states that it is a myth that transferring more than one embryo increases the chances of success, you actually have the same or higher by transferring single embryos consecutively. Dean feels that it is critical that patients receive the right information at the right time to help them make informed decisions based on the risks associated with twin pregnancies.   Changing the narrative Dean is noticing a sea change globally and in particular in the US, with regards to an increase in single embryo transfers. This increase is impart, as a result of greater success with frozen embryo cycles.   Dean is also seeing more focus globally on supporting the patient and in particular supporting the couple and their relationship. Managing the expectations of a couples treatment is also vital, particularly with regards to the success rates of an initial cycle. http://www.multiplebirths.org.uk/ (The multiple births foundation) - as referred to in this episode  SOCIAL MEDIA:  Dean Morbeck: https://www.instagram.com/fertilitypatientrevolution/ (Instagram) https://www.facebook.com/FertilityPatientRevolution/ (Facebook) http://linkedin.com/in/dean-morbeck-b0a69b12 (LinkedIN) https://www.thefertilitypodcast.com (The Fertility Podcast )  See https://acast.com/privacy (acast.com/privacy) for privacy and opt-out information.

This conference, organised by Cambridge Family Law together with the International Academy of Family Lawyers (IAFL) and the American Bar Association (ABA) Section of Family Law, explored a range of issues and challenges surrounding the law and practice of national and international surrogacy from a practical perspective. Practitioners, lawmakers, academics and other participants will discuss the legal consequences of the rise in surrogacy arrangements and, in particular, reproductive tourism. For more information about the conference see: https://www.family.law.cam.ac.uk/international-surrogacy-forum-2019 This recording is from Part VII - The Way Forward - General discussion, with Dame Lucy Morgan Theis DBE (High Court of England and Wales). The former chair of the Family Law Bar Association, Mrs Justice Lucy Theis, was appointed to be a High Court Judge in 2010. Mrs Justice Theis DBE, was called to the Bar by Gray's Inn in 1982 and took Silk in 2003. She was appointed a Recorder in 2000 and was approved to sit as a deputy High Court Judge. She was head of Field Court Chambers until 2010. She was appointed a Family Division Liaison Judge on the South Eastern Circuit in 2011 with responsibility for Kent, Surrey and Sussex and in 2017 for London and Thames Valley. In 2018 she was appointed Senior Family Liaison Judge. She sits on the Family Procedure Rules Committee and the Family Justice Council and is the lead judge in relation to applications under the HFEA 2008.

This conference, organised by Cambridge Family Law together with the International Academy of Family Lawyers (IAFL) and the American Bar Association (ABA) Section of Family Law, explored a range of issues and challenges surrounding the law and practice of national and international surrogacy from a practical perspective. Practitioners, lawmakers, academics and other participants will discuss the legal consequences of the rise in surrogacy arrangements and, in particular, reproductive tourism. For more information about the conference see: https://www.family.law.cam.ac.uk/international-surrogacy-forum-2019 This recording is from Part VII - The Way Forward - General discussion, with Dame Lucy Morgan Theis DBE (High Court of England and Wales). The former chair of the Family Law Bar Association, Mrs Justice Lucy Theis, was appointed to be a High Court Judge in 2010. Mrs Justice Theis DBE, was called to the Bar by Gray's Inn in 1982 and took Silk in 2003. She was appointed a Recorder in 2000 and was approved to sit as a deputy High Court Judge. She was head of Field Court Chambers until 2010. She was appointed a Family Division Liaison Judge on the South Eastern Circuit in 2011 with responsibility for Kent, Surrey and Sussex and in 2017 for London and Thames Valley. In 2018 she was appointed Senior Family Liaison Judge. She sits on the Family Procedure Rules Committee and the Family Justice Council and is the lead judge in relation to applications under the HFEA 2008.

This conference, organised by Cambridge Family Law together with the International Academy of Family Lawyers (IAFL) and the American Bar Association (ABA) Section of Family Law, explored a range of issues and challenges surrounding the law and practice of national and international surrogacy from a practical perspective. Practitioners, lawmakers, academics and other participants will discuss the legal consequences of the rise in surrogacy arrangements and, in particular, reproductive tourism. For more information about the conference see: https://www.family.law.cam.ac.uk/international-surrogacy-forum-2019 This recording is from Part VII - The Way Forward - General discussion, with Dame Lucy Morgan Theis DBE (High Court of England and Wales). The former chair of the Family Law Bar Association, Mrs Justice Lucy Theis, was appointed to be a High Court Judge in 2010. Mrs Justice Theis DBE, was called to the Bar by Gray's Inn in 1982 and took Silk in 2003. She was appointed a Recorder in 2000 and was approved to sit as a deputy High Court Judge. She was head of Field Court Chambers until 2010. She was appointed a Family Division Liaison Judge on the South Eastern Circuit in 2011 with responsibility for Kent, Surrey and Sussex and in 2017 for London and Thames Valley. In 2018 she was appointed Senior Family Liaison Judge. She sits on the Family Procedure Rules Committee and the Family Justice Council and is the lead judge in relation to applications under the HFEA 2008.

In the news yesterday we saw claims that IVF clinics are exploiting older women by trading on hope.  The news report was in response to figures published by the  Human Fertilisation and Embryology Authority (HFEA) that women age 40-42 have a 9% chance of IVF success and if over 44, a 2% chance.  Sally Cheshire, Chair of the HFEA has urged clinics to be honest and transparent.   But are women being mislead, The only way I can see they are is if the results represented within clinics aren't true.  The success rates after all speak for themselves, don't they? This is an incredibly sensitive and emotional time.  Even with such low odds, if you believe that this is the only way that you can potentially have a baby, what if you were the in the 9% or the 2%?  What if it could work? wouldn't you give it a go? The thought may be that it is your ONLY option, and increasingly, I am finding that this is what we are lead to believe? So as I watched the news coverage ,   yet again it amazed me that only IVF was discussed.  Ok, so the item was about the success if clinics, but surely the discussion could have spread a little broader to pregnancies in your 40's full stop? At no point in any of the coverage I saw or read, was an alternative suggested, such as  any information about natural fertility.  It was as though IVF was the only option open to you when you "couldn't get pregnant" CAN YOU GET PREGNANT WITHOUT IVF OVER 40? Do you know how many women over the age of 40 fall accidentally pregnant? Well its more than the fertility rates for women over 40 suggest. Why are they falling pregnant accidentally?   They are still producing eggs, and yes we know as we get older they are of lower quality.  But if someone is looking after themselves, can these eggs be a higher quality than someone who doesn't? Just a thought. They may be falling pregnant accidentally because  they are not "trying". I know there are a variety of situations but let's look at those who were wanting to have sex.  They felt aroused, they are following their bodies natural procreation instincts when they were fertile.  perhaps it was just the once in the month, but biologically lead to the right time? This can become a rarity when you are 'trying' , baby sex can lose its lustre. Often precautions aren't taken because everybody knows it's near impossible to get pregnant at their age, don't they? Or because they are caught in the heat of the moment, and in the heat of the moment, oxytocin is present, cortisol is not, conditions are perfect. SO, CAN IT BE THE "TRYING" THAT AFFECTS FERTILITY? Absolutely, we know that chemicals are diverted when we feel unsafe, when our thoughts leads to emotions,   chemicals are produced that act as signals for body responses.  This instrinsic design is to put safety first and if we are not safe, fertility can slow or shut down.   Evolutionary this safety referred to physical safety, tigers near your dwelling perhaps.  But todays tigers as I often discuss, are the anxieties and stresses and fears we face, that create the same chemical response. It is common for some couples to fall pregnant when they are waiting for IVF, the pressure is off for some. Also when they have had a family via assisted methods and have assumed they cant get pregnant,  suddenly there is an addition to the family. THE FERTILITY HEALTH MODEL Our health model in the UK is that if you are under 35, you need a try to conceive for a year, if over 35, 6 months.   If you fail to conceive in this time, you undergo a hormone profile blood test for the female and a basic sperm count and morphology for the male. From this point you are in the fertility health system and the female will undergo a tube dye test to check patency of tubes, and an ultrasound.  If a potential cause of not conceiving  is identified,  appropriate treatment, and/or  assisted fertility will be suggested.  If there is no cause identified from these limited tests,  assisted fertility will more often be suggested. It is extremely rare, that at any point a discussion of natural fertility, health, intercourse timing, causes of hormonal imbalance, or pelvic congestion will be discussed, because you are in the system.  Don't get me wrong, it can happen and some areas are doing better at this. Please do not misread this and think that I am against IVF, because I absolutely am not. There are thousands of parents who perhaps otherwise would not be, many of them my clients.  But, I am against it as an only option, and often seen as the last resort.  It saddens me that vital fertility design information is not given. HOW SUCCESSFUL IS IVF? Based on figures from the HFEA, during 2014-2016, IVF success rates were as follows:  29% for those under 35, 23% for those 35-37 15% for those 38-39, and as already discussed 9% for those 40-42   2% for those over 44 There are so many variables at play here, specific conditions, genetics, diet, lifestyle, egg and sperm DNA, and so much more.   NATURAL FERTILITY BEING SEEN AS  AN ALTERNATIVE THERAPY? I truly believe that due to the lack of understanding of how  our bodies work, their intrinsic design, and how todays lifestyle affects this, we are missing a trick. Within our health care model we look outwardly before we look inwardly. We treat symptoms, not the cause.  Also, we fail to look at the mind and body connection all too often.  With limitations to access to treatment and increasing costs, it cannot be shown as the only option. The fear that people will need IVF, the funds, the physical and emotional strain may in fact be a contributing factor to their lack of fertility.  Because as I said earlier when the body is in danger, the chemicals produced say, fertility is not vital. In fact  it's down right reckless and the body will shut it down. It is incredible how many people people are unaware of the fundamentals of fertility.  And I'm not just  talking about sex. I don't know about you but I swear that I was told that when I started my periods, that was it, I could get pregnant, and all I had to do was make sure I didn't, until I wanted to!   SO ARE COUPLES BEING EXPLOITED?  Absolutely.  Not necessarily by false hope, but by a lack of knowledge, understanding and the tools to address.  Quite simply,  they they are not informed about their fertility.  About the intricacies of the body, the endocrine system, how hormones are diverted, how DNA in egg and sperm can become fragmented ,the effects of inflammation, how their posture (not during sex) can affect things, how nutrition affects things, what Vitamin D does, how their mindset can affect things, and so much more. They are being exploited by the lack of information they are provided with, right from the get go, from that period talk and beyond. They are being exploited in thinking that IVF may be their only way, and that it will be OK.  They are even not given the full information during IVF, because that whole list of stuff we are not told about, might affect the success of IVF too.  Its not deliberate, its the health care model, we need to look inwardly This is our health model, we treat symptoms because we have the technology.  In doing this we lose the whole picture.  We are not addressing the cause, because the cause is not being looked for beyond the standard tests.  We are being taught that we can access cutting edge health care interventions, so we have stopped looking inwardly. It doesn't have to be either or, but it's time for an integrative approach.  Inform, explore and implement. It's time for a Rewire..

In this episode, Kay takes us through some of the ‘add-ons’ that are offered when you are undertaking IVF treatments. She explores in detail the research and data that is available and explains what each treatment involves. This podcast is an invaluable listen for anyone considering IVF, tune in now. KEY TAKEAWAYS What are Add-ons? HFEA has developed a traffic light system to help people decide about add-on treatments. Green signals the treatment has one or more good quality. Amber signals the treatment has a small or conflicting body of evidence. The Red symbol signals the treatment has no evidence to suggest it is effective or safe. Assisted hatching - Red Before an embryo can implant in the womb it has to break out or ‘hatch’ from its zona pellucida. Assisted hatching involves using acid, lasers or other tools to thin or make a hole in the zona pellucida - helping the embryo to hatch. NICE the national body advising doctors on treatments. says: “Assisted hatching is not recommended because it has not been shown to improve pregnancy rates.” What is Elective freeze all cycles – Amber It’s thought by having all their embryos frozen, women are at lower risk of suffering from ovarian hyperstimulation syndrome, an overreaction to fertility drugs. Some research suggests that pregnancy rates are increased by using frozen embryo transfers and that the risks to mother and baby are lower. Artificial egg activation calcium ionophore – Amber If the egg doesn’t activate, then it won’t develop, egg activation may be stimulated by chemicals added to the embryo in the lab.   In the few studies done to date, egg activation may have improved fertilisation rates in cycles where the egg and sperm have failed previously. Embryo glue - Amber Embryo glue may improve the chance of the embryo implanting in the womb. Research suggests it may increase pregnancy and birth rates by around 10% but further quality studies are needed. Endometrial scratching - Amber The theory is that the scratch procedure triggers the body to repair the site of the scratch, releasing chemicals and hormones that make the womb lining more receptive to an embryo implanting. There have only been a small number of moderate quality studies. Intrauterine culture - Red Intrauterine culture allows the early stages of embryo development to take place within the patient’s womb. There’s currently no evidence to show that intrauterine culture improves birth rates and is safe. Pre-implantation genetic screening - Amber for day 5 embryos, Red for day 3 embryos It involves checking embryos for abnormalities in the number of chromosomes. A cell is removed and tested if done later several cells are tested Some small studies have shown that PGS on day 5 might be helpful in selecting a viable embryo to transfer in younger patients Reproductive immunology tests and treatment - Red Reproductive Immunology looks at how a woman’s immune system reacts when she becomes pregnant. There is no convincing evidence and there are risks attached to these treatments, some of which are very serious. Time-lapse imaging - Amber In IVF, time-lapse imaging is used to help select the embryos most likely to successfully develop into a baby. There have been various studies to try and see if time-lapse imaging can improve birth rates. Initial research has shown some promise. Intracytoplasmic morphologic sperm injection (IMSI) - Red The technique involves using a microscope to view sperm under very high magnification This allows clinics to view detailed images of sperm. The research that has been carried out does not support the use of IMSI over standard treatments. Physiological intracytoplasmic sperm injection (PICSI) - Red PICSI identifies sperm that can bind to HA and these sperms are selected for use in treatment. There have been a number of studies comparing PICSI with standard treatments but there is very little evidence to suggest there is any benefit to using it. BEST MOMENTS ‘Capitalising on the hopes of vulnerable people’ ‘I was given an abundance of information but nothing made it clear what the percentages were’ ‘You’re in the hands of the clinic’ ‘For me how the clinic worked was more important than the data’ ‘People who unfortunately require fertility treatments become their own experts’ ‘They read extensively  about each treatment but this is coupled with being desperate for success so they are open to many treatments’ ‘In the UK the top clinics' success rates vary only by a few percentage points’ ‘Non-evidence based therapies, known as add-ons can cost thousands’ VALUABLE RESOURCES https://itunes.apple.com/us/podcast/ivf-before-and-after-podcast/id1413710507?mt=2 ABOUT THE HOST The IVF Before and After podcast was founded by Kay Dempsey. She created IVF Before and After, after many years spent researching and practising every possible way to conceive with IVF. Kay has created a global community with the use of podcasts she will share the stepping stones to empower your mindset, fuel your body organically and support you along your fertility journey. CONTACT METHOD https://www.instagram.com/ivfbeforeandafter/ https://twitter.com/IVFBEFOREAFTER https://www.facebook.com/IVF-Before-and-After

On 15 November 2018 the Cambridge Family Law Centre, and the Cambridge Socio-Legal Group hosted Dr Zeynep Gurtin of the Institute for Women's Health, University College London, who spoke on the subject "Egg Freezing in the UK: The data we have is the tip of the iceberg".In this seminar, Dr Gurtin discusses her research into egg freezing in the UK. In particular, she focuses on what aspects of this fast-growing phenomenon have, to date, been accurately captured in national and HFEA data reporting and what aspects have remained obscured. Dr Gurtin assesses the current landscape and make some predictions regarding the future of egg freezing, as well as suggesting much-needed policy developments in this area.

On 15 November 2018 the Cambridge Family Law Centre, and the Cambridge Socio-Legal Group hosted Dr Zeynep Gurtin of the Institute for Women's Health, University College London, who spoke on the subject "Egg Freezing in the UK: The data we have is the tip of the iceberg".In this seminar, Dr Gurtin discusses her research into egg freezing in the UK. In particular, she focuses on what aspects of this fast-growing phenomenon have, to date, been accurately captured in national and HFEA data reporting and what aspects have remained obscured. Dr Gurtin assesses the current landscape and make some predictions regarding the future of egg freezing, as well as suggesting much-needed policy developments in this area.

On 15 November 2018 the Cambridge Family Law Centre, and the Cambridge Socio-Legal Group hosted Dr Zeynep Gurtin of the Institute for Women's Health, University College London, who spoke on the subject "Egg Freezing in the UK: The data we have is the tip of the iceberg". In this seminar, Dr Gurtin discusses her research into egg freezing in the UK. In particular, she focuses on what aspects of this fast-growing phenomenon have, to date, been accurately captured in national and HFEA data reporting and what aspects have remained obscured. Dr Gurtin assesses the current landscape and make some predictions regarding the future of egg freezing, as well as suggesting much-needed policy developments in this area.

On 15 November 2018 the Cambridge Family Law Centre, and the Cambridge Socio-Legal Group hosted Dr Zeynep Gurtin of the Institute for Women's Health, University College London, who spoke on the subject "Egg Freezing in the UK: The data we have is the tip of the iceberg". In this seminar, Dr Gurtin discusses her research into egg freezing in the UK. In particular, she focuses on what aspects of this fast-growing phenomenon have, to date, been accurately captured in national and HFEA data reporting and what aspects have remained obscured. Dr Gurtin assesses the current landscape and make some predictions regarding the future of egg freezing, as well as suggesting much-needed policy developments in this area.

Welcome to another episode of the IVF Before & After Podcast. In this episode, Kay gives you a quick guide to asking the right questions and deciding which clinic will suit you and your partner best. Discover how to choose the right fertility clinic for you and the key questions to ask both yourself and your clinic before undergoing the routine checks and IVF treatment. Subscribe to this podcast and hear Kay’s IVF story from start to finish. KEY TAKEAWAYS A quick guide to help you: If you are over 35 or have been trying to get pregnant for over 6 months chat with your GP. Check what treatments are available on the NHS as you will need to meet certain criteria to qualify for treatment. Discuss the criteria with the GP for your local area. If you cannot receive treatment, it’s worth considering treatment from a private clinic or abroad. Private clinic’s do cost, however, the waiting list is much shorter. Once you find a clinic look up their HFEA status. Questions to ask: Which clinics are available close to your home as during your treatment you’ll be visiting the clinic a lot. What treatments do they offer and what is the success rate for your age range? How long are the waiting lists? What are the full costs involved? Including the medication, the scans etc. Does the clinic have personalised treatment plans, individually for you? VALUABLE RESOURCES http://ivfbeforeandafter.com/ ABOUT THE HOST IVF Before and After was founded by Kay Dempsey. She created IVF Before and After,  after many years spent researching and practising every possible way to conceive with IVF. Kay has created a global community with the use of podcasts she will share the stepping stones to empower your mindset, fuel your body organically and support you along your fertility journey. CONTACT METHOD www.instagram.com/ivfbeforeandafter/ https://twitter.com/IVFBEFOREAFTER www.facebook.com/IVF-Before-and-After

The story of human evolution is long and complicated, but the simple truth is - you're only here because your ancestors got lucky. Plus, we wind the clock back to the very start of human life, and discover how new research is pushing back the frontiers of human embryology. Plus a suitably festive gene of the month. This is the Naked Genetics podcast for December 2016 with me, Dr Kat Arney, brought to you in association with The Genetics Society, online at genetics.org.uk. Like this podcast? Please help us by supporting the Naked Scientists

  The number of couples seeking fertility treatment is rising every year.  But donor assisted conception poses huge ethical and human rights issues.  Up until 10 years ago, sperm donors and women who donated eggs had a right to remain anonymous.  Then the law was changed in 2005 giving donor conceived people the right to information about their donors.  Most people agree that this was a milestone to be celebrated, but does it go far enough? This podcast explores the issues.  it is drawn from an event organised by the Progress Educational Trust  and is introduced by the Chair of the event, Charles Lister, Chair of the National Gamete Donation Trust, and former Head of Policy at the Human Fertilisation and Embryology Authority. He quoted a speech by the Public Health Minister, Melanie Johnson made in 20014, 'Clinics decide to provide treatment using donors; patients make a decision to receive treatment using donors; donors decide to donate. Donor-conceived children, however, do not decide to be born – is it therefore right that access to information about the donation that led to their birth should be denied to them?' This quote encapsulates the essence of the debates that led to the Human Fertilisation and Embryology Authority (Disclosure of Donor Information) Regulations 2004, which allow donor-conceived people born from donations made after 1 April 2005 access to identifying information about their donor on reaching the age of 18. It also set the scene for a series of lively presentations from a panel of five experts, who took to the stage to offer their perspective on the impact of the legislation. First to speak was Juliet Tizzard, Director of Strategy at the Human Fertilisation and Embryology Authority (HFEA), who gave the regulator's perspective on the change in law. Tizzard identified the lack of reliable outcome metrics in relation to donor conception as a key challenge, and hindrance, to accurate impact evaluation of the 2004 regulations. She also opined that the assessment of post-regulation sperm and egg donation trend as proxy measure of impact showed a gradual but steady increase in number of new donors registering in the UK – a reality that is a far cry from the doomsday prophecies of the early critics of the law, who predicted the possibility of severe donor shortages arising as a result of the end to donor anonymity. Next on stage was Dr Jo Rose, a donor-conceived adult who won a landmark court case that contributed to the decision to end donor anonymity in the UK. In her presentation, Rose argued that donor-conceived children should, as a matter of course, have more support and the right to access full and complete information about their genetic parent, particularly because 'wrong and incomplete medical history kills people'. She also argued that a lack of retrospective access to identifying information means a number of donor-conceived people born before April 2005 live the rest of their lives 'tortured' by not knowing who their genetic family is. 'Why then should we have legislation that protects the rights of donors but ignores the rights of donor offspring?' she asked the audience, and quoted Kevin Staudt's song, Novum: Rose's presentation gave a personal note to the debate and made it easy to appreciate the rationale behind her call for retrospective disclosure of donor identity. According to her, more needs to be done to ensure 'equality and respect for genetic kinship and identity for all groups of the society'. Eric Blyth, Emeritus Professor of Social Work at the University of Huddersfield, also made a case for retrospective disclosure of donor identity. Using data from the HFEA, Professor Blyth argued that the lack of retrospective access to identifying donor information means that upwards of 20,000 donor-conceived people born between 1991–2004 in the UK are denied the right to learn the identify of their donor. Blyth also argued that,

These days many of us check out TripAdvisor if we are booking a hotel.  We want to see what people like us think of the service, the staff, the food, the pool....... It's a great idea for bed and breakfast, but is the TripAdvisor approach, where consumers are encouraged to give their unvarnished views, the right approach for Fertility Clinics, where life changing decisions are being made? The UK's Human Fertility and Embryology Authority (HFEA) has decided to give more prominence to patient views and an event, A Trip Advisor for Fertility Clinics - Would You Recommend It? was held at the Royal College of Obstetricians and Gynaecologists in London's Regent's Park last month (April 2015) organised by Progress Educational Trust and sponsored by the British Fertility Society, to look at how best to do so. The HFEA's plans are consistent with an emphasis on patient choice and patient empowerment in recent health policy. Since 2007, for example, the NHS Choices website has published patient feedback on NHS hospitals and services, in the form of both star ratings and free text. Last year the National Information Board, of which the HFEA is a member, issued proposals which take this approach further. But such an approach is contentious. TripAdvisor has attracted controversy, with critics questioning its ability to vouch for the honesty and reliability of customer reviews. And since more than half of all fertility treatment in the UK is carried out in the private sector, people writing and reading feedback may be customers as well as patients. So clinicians, patients, companies and representatives of patients' organisations gathered at the event to explore the issues. All agreed. that the patient view is very important, and must be reflected, along with metrics such as success rates and inspection reports. Patients want to see what other patients are saying. But there was also concern expressed that a small numbers of responses could give a misleading impression, that clinics with active public relations staff could ensure good feedback, and that untried and unproven treatments, such as homeopathy, might get the thumbs up from patients despite having no rigorous evidence base. Speakers were: Juliet Tizzard, Director of Strategy and Corporate Affairs at the Human Fertilisation and Embryology Authority Dr Yacoub Khalaf, Member of the the Human Fertilisation and Embryology Authority, and Director and Person Responsible of Guy's Hospital's Assisted Conception Unit Susan Seenan, Chief Executive of Infertility Network UK, and Co-Chair of Fertility Fairness Antonia Foster, Senior Associate at solicitors, Carter-Ruck The event was chaired by Professor Adam Balen, Chair of the British Fertility Society, and Consultant in Reproductive Medicine and Surgery at the Leeds Centre for Reproductive Medicine This is a recording of the event. Photo by Mehmet Pinarci

How best to govern the field of assisted reproductive technologies? As UK and US authorities utilise different approaches, will the disparate structures and missions of these two bodies result in significantly different answers? In the past few decades, technologically advanced, democratic societies have struggled with the question of how best to govern the field of assisted reproductive technologies (ART). The UK's Human Fertilisation and Embryology Authority (HFEA) and the American Society for Reproductive Medicine (ASRM) embody two approaches that highlight the degree of diversity in answering this question. While British politicians fashioned the HFEA as a statutory authority built upon ideals of deliberative democracy, the US has avoided federal regulations on ART, leaving the ASRM - a professional self-regulating society - with the sole responsibility for producing guidelines. Both bodies, however, utilize a deliberative committee to debate and determine rules for ART. Drawing on interviews with committee members of the HFEA and ASRM, this talk will focus on opening these largely opaque deliberative spaces. When examining ethical arguments for and against certain procedures, what reasons do members consider to be "good" reasons, and how do they legitimate such judgements? How do members conceive of the general public and how does this conception affect the role of public perspectives in deliberations and final decisions? Perhaps most importantly, do the disparate structures and missions of these two bodies result in significantly different answers to these questions?

Baroness Deech, Chair of the Bar Standards Board, delivers a public lecture at Madingley Hall on 3 October 2011. The lecture is chaired by Professor Gordon Smith, Head of the Department of Obstetrics and Gynaecology at the University of Cambridge, and introduced by Dr Rebecca Lingwood, Director of Continuing Education. Please note that the lecture proper begins at the 4:10 minute point in the video.

How have judges treated the new issues and what oversight have they over the HFEA? There are issues here of general legal interest concerning regulation and discretion. The case of Diane Blood, who used gametes taken from her deceased husband, will be re-examined, along with the effect of media...