Trying for a baby can come with a multitude of challenges and can be very overwhelming to find the advice and support you need when beginning a fertility journey. From real experiences to expert knowledge, we caught up with Ellie, editor at My Baba and co-host of The JelliePod and embryologist expert Victoria, founder of All About Embryology talking all things fertility.
Read on to learn more about Ellie and Victoria and their insightful knowledge/journey or watch our Instagram Live here.
"My husband and I started vlogging about our TTC/IVF journey back in August 2016 to break the silence and the taboos surrounding infertility. From there, we set up a private Facebook support group, and launched our podcast The JelliePod."
"Infertility can be incredibly difficult for those affected. Over the years, I have seen that many patients just don’t feel comfortable discussing their infertility, even with close family and friends. My aim is to provide patients with independent Embryology advice and support through their fertility journey."
What are the different types of fertility treatment?
Victoria - Depending on what the patient's circumstances are, there are some very basic starters. As long as the part of the sperm is good and the tubes, they might start with what's called IUI, which is intrauterine insemination. It means you don't have to have any egg collection or anything like that. All we do is we prepare the sperm in the lab and at the time of ovulation, with using a very small catheter, put the sperm into uterus and it's very timed for ovulation. That's the most basic level.
Then you go on to what most people know as IVF, which is where the patient will undergo ovarian stimulation to generate as many eggs as possible. And then we'll collect those eggs into the lab and then we prepare the sperm sample. Depending on how good the sperm is, we either mix them together in a dish, which is the conventional IVF, or we would take individual sperm and inject them into each egg. And that's what's called ICSI. Then once we hopefully get the fertilisation the next day, we will then grow those embryos up in the lab and then they get transferred or frozen, depending on how well they've grown. So that's the main one that people know about.
At what point do you need to start thinking about fertility treatment?
Victoria - The guidelines say you should have had two years of unprotected sex before going down that route. I think that's a bit of a blanket policy. So I always say to people to get a ‘fertility MOT’ and it's worthwhile doing. I would say to take action after about six months of trying, because if your partner's got extremely poor sperm, there's no point in waiting two years. You can do a very simple semen analysis to check.
Also if you've got irregular cycles try at home ovulation kits. Not the expensive ones from Boots, but from Amazon, so you can just be keeping an eye. I'm an embryologist and for my second pregnancy, when it hadn't happened quite as quickly as my first, I realised I was having a 28 day cycle and I wasn't ovulating till day 17. We all really need to learn about our bodies first.
What stages would you go through to identify those initial issues?
Victoria - It's really about looking at your lifestyle - are you following a good diet, is your body in a good place for trying for a pregnancy. Smoking, reducing alcohol intake, all things like that are things you want to try initially. Also making sure to keep your stress levels down. All of these things have such an impact with your hormone cycles.
Then it's important to learn about your body, about your ovulation and the tracking. So really understanding whether you know that you're ovulating each month. When you're tracking, it's important have regular sex in the run up to the ovulation rather than once the egg has ovulated. All of this is really important to get yourself in a good position to say, ‘We've done a 6-12 month period of time where we know that we're ovulating, we know that we're timing the sex right, we know that our bodies are in the right shape for this, and we know we're healthy’ (And all of the factors that will improve your chances) Then if you're still not working, that's when it might be worth going down the fertility clinic route.
Do you have any advice for anyone starting the IVF journey?
Ellie - It is really overwhelming, and I think if you're starting at the beginning, it's finding a clinic that you feel comfortable with. We visited a few and went to the fertility show in Mayfair and we soon got to know the doctors or the clinics that we felt we could trust and eventually found one that we felt really confident with. I think that made a huge difference because we went to a couple that didn't feel right.
Also, ask questions because you've got to be as knowledgeable about what's going on as possible. Instagram is a great place for support, there's lots of people hashtagging the IVF support groups. Knowledge is power and trying to be as positive as possible. It is an exciting process as well, but of course, there's lots of obstacles along the way and it does feel like a never-ending race before you even get pregnant, if you’re lucky too and then you've got the whole pregnancy to worry about. It's a long journey, you must buckle up and really hope for the best!
How long generally is a fertility treatment cycle and what's involved in each stage?
Victoria – Generally, you have stimulation for about two weeks, and this is where you're going into the clinic usually every two to three days to have your blood checked. We're looking for the hormone levels to see how that's rising and doing internal scans as well. At that point you would be taking your medication, including doing your injections, which you usually do for about two weeks, and then you'll hit egg collection day. This is where the doctors are happy that your follicles have grown big enough on your ovaries, that they're ready to collect them and then you'll have the procedure. Usually it's done under sedation, but sometimes it can be done under local anaesthetic. The doctor will then be using ultrasound guidance using a sine needle, which will go into each of the follicles and draw out the fluid to collect the fluid up and that's where it comes out to the embryologist.
We'll search through the fluid and find all your eggs for you and at the same time we'll be preparing the sperm sample; depending on what the sperm is like, we'll either do IVF or ICSI. The embryos will grow in the lab for three to five days and you'll be asked to come back through your embryo transfer. It will really feel no different to a smear test and they'll put the very spine catheter through the cervix and then we'll put the embryos back in the middle of the uterus. Then you'll have about ten to twelve days after that until you then come and do your pregnancy test. You're looking around about a month from start to finish when you get your pregnancy test. Depending on what the result is, they may wait a month and you might start the following month after that, but different protocols will vary, that's just the approximate time scale.
Are there any side effects to IVF treatment?
Ellie - I was lucky when I did the injections with my fresh cycles for my first two children, but for the frozen cycle, I took tablets and felt a lot more hormonal. You can get bruises from putting the jabs in your tummy as well as bloating, headaches and mood swings.
Victoria - Doctors will be very aware if they think any patients are at risk or have any severe side effects. And then they'll adjust your dose, but it's not common for patients.
Do you need to tell your employer when undergoing IVF treatment?
Victoria - Unfortunately, there is no statutory right time off with IVF. Employers will have to treat it as a normal medical appointment. However, if you're going in every two days, it can be very tricky and quite stressful, especially if you're not telling your employer that you're having treatment.
Ellie - It's tough because you don't feel like you want to go to your employer because you probably haven't even told your close family and friends. Also, if you want to do things quite privately, it is quite tricky, but that comes down to again, choosing a clinic which you can get to and from appointments easily.
Do you have any tips for distraction during the treatment?
Ellie - Trying to plan things is super important. Obviously, you can't go to the pub or do the normal things that you might have done, but you can plan other things to distract yourself. Maybe join a support group or community that can help you along the way or confide in a friend. I did some hypnotherapy and yoga which I found useful for stress and implantation. It’s important to figure out what's right for you as everyone's different. If you're not sharing the news, then communication with your partner is important because although they're in it with you, they're not really going through it like you are.
Victoria - It's so important to take care of yourself as it's an emotional and physical roller coaster. You want to stay positive, but you must be realistic because it might be a longer journey. It’s important to ensure you start your journey being equipped with that knowledge, so that you're in a strong place mentally for it. Then you can start really looking after yourself, your body and your mind as you're going through each step.
Are there any support groups or networks that you would recommend looking into?
Ellie - Our JelliePod is there for support and can also be a bit of a laugh too. We've got our own support group on Facebook as well called: 'IVF trying to conceive a place to talk'. There's roughly about 900 women in there and they're all really supportive, friendly and warm and that's somewhere you can post.
Victoria - A lot of the clinics now offer support groups within clinics as well. In my last clinic, one of the nurses set up a support group and they now have their own WhatsApp group where they tell and support each other through their journeys.
Do think it's a good idea to tell friends and family when undergoing fertility treatment?
Ellie - It all comes down to how you feel, and you should share when you feel that it's right to. Whether that's when you're 12 weeks pregnant or whether you've been through 4 rounds of IVF and it's not worked, you might want extra support. I think you've got to ask yourself the question; if the cycle doesn't work or if I do get pregnant and lose the pregnancy, who would I want support from? And that should help make a decision on whether you're ready to tell people or not.
Can nutrition/ diet help with fertility? Are there any foods to avoid?
Victoria - It's all the things you should do normally; everything in moderation. When people are going through treatment, we generally say follow the guidelines for pregnancy because you don't know when the implantation is going to happen, if it happens that cycle.
There's a lot of fertility nutritionists out there who give great advice, but it's about making sure you're getting all the right supplements, the right nutrients and your hormones are all balanced, so it is very important to make sure you're following a good diet. It's about making yourself in the best possible shape you can be in without putting too much pressure on yourself.
Ellie - Folic acid is a really good supplement to take as well.
If IVF doesn't work the first time, are there any changes you recommend making for the second try?
Victoria – It’s a good idea to break down exactly what happened in the cycle. Some clinics will just say you need to do the same thing again, and then you might still get the same outcome. What we want to do is break it down. How was the stimulation? Did the number of Follicles that we were seeing get the equivalent number of eggs? Were the eggs mature? Would we be getting that final maturation? Was the fertilisation of a normal level? Might we convert you to ICSI at this point? If the IVF hasn't had a very good fertilisation, how were your embryos developing? Most of the time the reason that a patient doesn't get pregnant is something to do with the embryo.
To learn more about Ellie and Victoria and their insightful knowledge/journey, watch our Instagram Live here.