If you’ve found your route to parenthood hasn’t been straight forward, this podcast is for you. From how to optimise your fertility to get pregnant naturally, navigating IVF, understanding donor conception or surrogacy to how to prepare for a life without children. Whatever your situation, you are not alone.
Join me, Natalie Silverman, as I open up about my own fertility treatment, Kate Davies an independent fertility nurse consultant, experts from around the world as well as shared experiences from men, women and people just like you. We’re here to accompany you on your fertility journey x
LGBT Mummies with Laura Rose Thorogood
This week we welcome Laura Rose Thorogood to the show. Laura is the founder of the LBGT Mummies Tribe, an LBGT+ activist, a lesbian mother of two by IUI, and is currently pregnant again after 5 rounds of fertility treatment.
Laura’s organization supports, celebrates, and reunites the LGBT community on their path to parenthood providing information and guidance on whichever route you choose to create your family.
Laura has had a crazy few weeks of awareness days and months and is balancing this with being 35 weeks pregnant. Laura and her wife started creating their family 10 years ago. They have two children and another on the way, all from the same sperm donor from a US clinic. They’ve both carried children and have navigated failed rounds, PCOS, low ovarian reserve, and, most recently the pandemic, to get to where they are now.
Laura talks about the common pitfalls that the LGBT+ community might face, particularly that they often come to trying to conceive later in life and often don’t consider this and the benefits, for example of preserving their fertility if they’re not ready to start a family until later. Also, the importance of researching the legalities so that all parties in the triangle are covered. Some couples find private fertility treatments inaccessible and may choose to seek a known donor. Laura explains the importance of seeking legal guidance and whilst there are financial implications involved, it is likely to be less costly than should there be any legal challenges in the future.
Laura explains the difference in access to information from sperm back nationally and internationally. In the US and Europe, you have access to more information about the donor whereas in the UK the information is limited to height, hair color, nationality, etc. Sometimes the difficulties in accessing sperm donors in the UK will force couples to use unregulated donors and in some circumstances, this can be dangerous. However, there are organizations such as CoParents and Pride Angle that are regulated and offer a professional service.
The LGBT Mummies Tribe is a central point for information and guidance on starting a family but is also a supportive community to bring other LBGT+ families together. They have a private support group but also get together in person (when the Pandemic allows) for meet-ups.
Laura talks about her interaction with medical services and the microaggression she’s experienced. How, as a lesbian woman, you have to ‘come out’ time and time again. Comments like ‘Who had the baby?’ ‘How did that work then?’ ‘So, you’re the other Mother’.
Natalie asks Laura about the guidance she offers on talking to children to help them understand the make-up of their family. It’s about sitting down as a couple and deciding on how best you address this. It’s very individual and personal, but best done at various age-appropriate sections of their lives.
Laura tells us how the healthcare arena is very heteronormative and the main area where she sees disparity and lack of inclusivity. She hopes that they can one day get to a place where campaigning is not required but is currently working with the NHS and Government to support them in understanding the community better, dispel the stigma and discrimination against them, and ‘usualise’ – making LGBT families visible and the everyday. Laura talks about how she can understand how confusing it is for the heteronormative community and that the LGBT community needs help in the education so that they are better supported. Laura says the NHS and the fertility clinics she’s working with have been proactive in changing for the better.
Laura’s final advice is to take your time, explore all paths to parenthood, join support groups, research, listen to other people's lived-in experiences, and investigated how LGBT inclusive y
I Had a Miscarriage with Dr. Jessica Zucker
In this week’s episode we are discussing miscarriage and loss,so before we go any further we are putting a trigger warning firmly in place here.
If you’re not feeling strong today, then maybe wait and listen another day, or make sure you have lots of support around you as our guest does go into detail of her own loss. Please know, you can always reach out to us on our socials if you need a bit of extra support and please do also have a look at our previous miscarriage series on The Fertility Podcast website where we detail more information about the support available.
We start off by chatting about the developments around the world when it comes to miscarriage policy. New Zealand is the second country in the world to provide women and their partners with 3 days of paid leave following a miscarriage or stillbirth, which is amazing! Interestingly, India was the first country to support couples in this way. Let’s hope this is the start of more countries following suit!
You may well have seen that Tommy’s have published the results of their survey with fascinating and shocking stats including the link between depression and miscarriage.
Our episode starts with a snippet from a previous conversation we had previously with Dr. Ingrid Granne – researcher and associate professor in reproductive medicine at Oxford University Hospitals NHS Foundation Trust.
We asked Ingrid why miscarriage happens. She tells us that the most common cause of miscarriage is due to chromosomal problems in the early days and weeks following conception. Chromosome issues are heavily correlated with maternal age. If you’re in your 20’s you have a 1:10 chance of miscarriage but by 45yrs it's 1:2 risk of a miscarriage. Other causes are medical conditions such as uncontrolled diabetes and thyroid issues. Being overweight increases your risk but we don’t really understand why. There also seem to be some genetic factors that may predispose some women to miscarriage. There are also implantation factors, possibly related to hormones and immune factors.
Natalie asks Ingrid about malefactors. She says that paternal age can impact miscarriage risk but not to the same extent as maternal age. She goes on to explain that the DNA of the sperm can also impact. There is more and more information and research coming out with regards to male factors and DNA fragmentation.
Next up we chat to Jessica Zucker – a psychologist who specializes in reproductive and maternal mental health. She is the founder of ‘I had a miscarriage campaign’ and has just released a book too. Welcome to Jessica!
Jessica focuses on the mental health impact of suffering from a miscarriage. Jessica shares her experience of miscarrying at 16 weeks. A traumatic experience that occurred whilst alone at home and transformed both her professional and personal life. She talks about her ‘failure to allow herself to fall apart. She miscarried on a Thursday and assumed that she would be right back at work on Monday. Jessica says that the failure to allow yourself to fall apart is, in part, survival instinct. Just to keep going. She says she at that time, she couldn’t allow herself to slow down as this would mean being closer to her pain.
Professionally, having her miscarriage, showed Jessica just how much she didn’t understand about the emotions her patients would be going through and that this was incredibly enlightening.
Next, we talk about sex and miscarriage. Sex can be the last thing you want to think about following a miscarriage. How do you regain that intimacy with your partner? Jessica has interviewed people about returning to sex to see if grief and pleasure can co-exist. She has also investigated masturbation and self-pleasure; can this too co-exist with grief? Jessica says this an under-the-talked aspect of life after loss and it’s important to investi
Looking After Your Mental Health
This episode focuses on the impact fertility has on your emotional health and we’re delighted to have Abbie and Karen from Fertility Circle join us on the podcast.
Abbie tells us how she searched for fertility support when she was trying to conceive 7 years ago and how she felt completely lost. Tragically Abbie made some poor decisions on where she looked for support that has impacted her health for the long term. The same was for Karen, in that she didn’t know where to access support and for these reasons, this is why Abbie and Karen felt motivated to start Fertility Circle.
It’s also important to Abbie and Karen to provide women with the right expert advice and information across the whole spectrum which includes both the physical and emotional aspects. As Abbie and Karen are both now trying for their second babies, they both feel so much more empowered and informed to make the right decisions.
Karen talks about the forced break women have had during the pandemic and how it’s been an opportunity to reset and
At the time of recording, the Fertility Circle app has had over 5,000 downloads! Abbie explains that they want women to feel that Fertility Circle is their best friend when trying to conceive but with all the fertility smarts. The app provides a community to connect with peers, a platform to connect with experts, content to inform, inspire and empower and finally offering the very best in emotional wellbeing and support.
The app also includes a section on learning, the ability to watch events and tutorials, live events, ask the expert, offers, and planning to support fertility wellness and IVF.
As many of our guests start a fertility business when trying to conceive, it can be a challenge. Karen talks about the potential triggers she comes across on social media for example but with that comes the immense support from the community. Abbie says that stepping back and taking a break when you need to, is vital in enabling her to carry on supporting their community.
We talk about the amazing friendships that are made within the fertility community, especially when all around you, your friends and family are getting pregnant easily! Abbie and Karen met this way, and even Natalie and Kate met through both working in this space! Natalie is now taking on more clients teaching the Freedom Fertility Formula and if you want to learn more about how Natalie can support you with your mental health click here
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After the GP, Before the Fertility Clinic
So what is Secondary care and what should you expect to happen?
Well, we want to make sure you understand this, as we don't want you to get to the end of the year and find there is actually a problem because you have been dismissed along the way.
There are better tests that can’t be done in Secondary Care that can’t be done in Primary Care, which means at the GP and we've discussed them with our resident expert Dr James Nicopollus.
Seeing a gynecologist:
One with a special interest in fertility is key. Women often go to a fertility specialist later, because there is often a delay in referral from GP to Secondary care and then there can be a delay from Secondary Care to IVF. This has been heightened by the Pandemic.
Ideally referrals should happen through the NHS - should come from the GP to a fertility center.
What happens at the referral?
Clinics are trying to do a one-stop-shop. People will have done a semen analysis but will be asked for a report to make sure it is accurate.
GP’s will have tested FSH to check egg reserve and whilst this is OK, it varies between months as well as other variables.
The AMH test is more reliable, as it shows the more follicles you have which is better fertility indicator.
Tubal Patency checks tubes
Important to rule out pelvic issues such as thyroid, polyps, or endometrioma which might impact the outcome.
If sperm and egg reserve is OK, are you ovulating regularly, with a progesterone check if you haven’t had one?
Laparoscopy looks inside the tummy with a camera, however, this is done by general anesthetic and this is more likely if there are symptoms of endometriosis
Most people have a HyCoSy or HSG - inserting dye to screen the fallopian tubes
STI’s such as chlamydia can be silent so these tests are important to exclude them
A complicated appendix procedure could have caused adhesions or any other significant pelvic surgery can cause issues.If there is any suggestion of painful intercourse or painful periods this should be done.
Next, if these tests are clear, in the absence of sub-fertility then an assessment of Sperm DNA fragmentation is needed which looks at the sperm genetic material which can impact natural fertility, IUI, IVF, and ICSI.
Urologists are still not working as much with clinics as they should be
If all these tests are inconclusive and all investigations have been done and you don’t have a diagnosis and you keep trying and it isn’t happening, then the next stage is to go to the fertility clinic for fertility treatment. You should then have your options explained: Continuing naturally, IUI, IVF with the success rates explained
A lot of people are often well informed, other times incorrectly by Dr. Google, which is why we want to always guide you. The reason people's experiences vary so much in terms of the tests they get access too, is because different clinics and trusts offer different services, and the Doctors in clinics might not map things out correctly. There might also be limitations in funding.
These are all ways in which you might feel you aren’t being guided properly and this is why it is important to become a fertility advocate.
You should always go into a consultation with a list of questions and never feel you shouldn’t ask them.
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Male Infertility with Kevin Button
In this episode, we’re focusing on Male Infertility which is still not understood well enough and it’s something Natalie has been passionate about giving a voice too. As it was her and her husband’s experience and the pair felt very unsupported when going through treatment. Since its launched The Fertility Podcast has shared numerous episodes about Male Fertility explaining the issues that affect sperm health and also explaining how Men can seek more support and investigation.
Men are often overlooked in conversations with medical professionals and we have had numerous conversations about men feeling ignored at the fertility clinic, the very fact that when it comes to IVF treatment in a heterosexual relationship is it is the woman who has to go through the procedure means men are often left to feel redundant. In the many conversations we’ve had with Men, they have talked about the shame and guilt they have felt if the issue has been a male factor and how many men struggle in silence.
Kate and Natalie discuss the factors that can affect male fertility, such as diet and lifestyle issues. Smoking and drugs are a real no-no for sperm health. It’s really important that alcohol is taken into needs to be taken into consideration and ideally should be limited but not stopped. Factors such as heat and stress can impact. So consider saunas, heated seats, mobile phones in pockets, laptops on laps as important things to think about. Plus wearing tight pants and trousers can also be restrictive for the wrong reasons. When it comes to health and wellbeing, environmental toxins can impact sperm health and there is a real argument against Protein shakes and steroids impact which can you find out more here in this great conversation with Professor Allan Pacey thanks to our friends at Dr. Fertility
Our guest is Kevin Button who talked about his decision to set up The Man Cave to talk about mental health and male Infertility about 3 years ago after losing his cousin to suicide unrelated to fertility. Personally, Kev has had two failed attempts with NHS funding - IVF and ICSI and he couldn’t find anything online and has learned more from being on Instagram than just googling.
Kev’s diagnosis is Non-Obstructive Azoospermia which is defined as no sperm in the ejaculate due to failure of spermatogenesis and is the most severe form of male infertility. He had to undergo a micro-tease ( sperm extraction( which didn’t work and Kev was told his options were sperm donor or adoption.
You can imagine how heartbreaking this was for him and he was told the news without any support which was part of his motivation for setting up what he has done. Kev explained how when he was younger and out dating, he’d end relationships as soon as the conversation moved on to having a family until he met his partner Nicky, who at first he tried to end things, but luckily the pair are still together.
Kev is part of Fertility Network’s Male Fertility as an Ambassador and we spoke about the new HIM campaign and the brilliant Rhod Gilbert documentary’ Stand up to Infertility’
All too often Men won’t talk about this but they are finding their voice within support groups. We also discussed the brilliant Easy Bit documentary which you can find links to more information below;
Kev and Nicky won a competition to have treatment in California with California IVF and are waiting for current
Kev Button Insta
Kate on instagram
Fertility Network Men Only support Group
Podcasts to listen to:
Professor Sheryl Homer runs a clinic called Andrology Solutions specializing in supporting Male
Hear more from Sheryl
Hear a live conversation with a brilliant panel talking about what Men can do to improve sperm health and we also discussed the mental health implications of male infertility
Polycystic Ovary Syndrome with Professor Adam Balen
We have spoken about Polycystic Ovarian Syndrome (PCOS) on the podcast numerous times in the past so make sure you scroll down to find link to previous episodes.
Kate is an expert on the topic, working with women on a daily basis to support them with their diagnosis and in this episode, we've shared a previous conversation we had with Professor Adam Balen discussing the latest PCOS guidelines. Professor Adam Balen is a full-time National Health Service consultant and Lead Clinician at Leeds Fertility, one of the largest assisted conception units in the UK. His special interests include all aspects of PCOS, Assisted Conception, Paediatric & Adolescent Gynaecology and Disorders of Sexual Development.
In this conversation, you hear snippets of a previous episode whereAdam explains what the symptoms of PCOS are, including being over or under weight and how to maintain the condition with lifestyle changes. He also talks indepth about the use of Letrozole over Clomofin, or Clomid are most people know it. At the time of our chat, people were still needing to change their mindset regarding prescribing Letrozole, and Adam had written papers for the RCOG to support this further. Kate said she is still seeing a mix of what people are being prescribed and explained how in the UK, heath trust policies can dictate what drugs are prescribed. However, Kate advises if you are on Clomid and not responding after two rounds to go back and ask if you can go back and try Letrozole.
We discuss the link between Letrozole and Ovarian hyperstimulation syndrome (OHSS) as well as there being a lower risk of multiple pregnancy and also we discuss the frequency of scans people should expect when they are on these ovulation stimulation drugs
We also highlighted the problem with home ovulation kits.
When it comes to the common issues people are still coming up against Adam explains how women are still being told they won’t get pregnant with ovulation issues
or that they are overweight because you have PCOS and you can’t do anything about it. Which isn't the case. Also the fact that a lot of women with PCOS end up having IVF when they don’t need it which is why we want to ensure you know where to get more support. We also discuss howOvarian diathermy or Ovarian drilling which in vary rare cases is an operation used to stimulate ovulation.
When it comes to top tips you can take away to manage your PCOS, Kate's top 3 tips are:
Changing your diet to low refined carbs/sugar.
Tracking your cycle tracking
Become your own PCOS advocate
Kate has written numerous blog post about PCOS. This one discusses how whilst it can't be cured it can be controlled. You can also read about fighting back against PCOS here and Kate also has a brilliant journal you can use
Have a listen to previous PCOS podcasts we have shared - this one with PCOS Diva Amy Medling and this one with Kym Campbell both amazing women who have overcome their PCOS and had successful pregnancies and now work to support women further with lifestyle changes.
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The best UK fertility discussion app!
The most useful and comforting podcast I’ve found as a listener based in the UK and currently undergoing infertility struggles. Like others who have reviewed this podcast, I often listen whilst out for a walk and I always return home feeling a bit more calm and a bit more empowered every time I listen. Thank you so much Natalie and Kate for hosting such great discussions. It really is invaluable and makes me feel much less alone during the rollercoaster that is TTC
Love this podcast. Such varied fertility topics with great guest speakers too. Always feel like I take something away after listening.
I’ve been meaning to write this review for a while... 3 years later in fact:
Whenever I felt like infertility was becoming too much I’d go for a walk with my headphones on and listen to these podcasts. Natalie’s podcast helped normalise the situation I was going through and empowered me as I learnt about the wider world of fertility and how others cope. When I think back to that time I now see how these walks helped to lift me up through some really tough days. Thanks Natalie for all the work you have done and continue to do x