The Basics of Conception

In this excerpt from her book, MFC Clinical Director, Prof Mary Wingfield, explains the basic biology behind conception and how this culminates in the miracle of new life:

“The way a human pregnancy and child can develop following a single act of sex between a man and a woman is indeed a miracle of nature and something that, even after all these years, still leaves me in awe. So many minute steps have to happen in a highly co-ordinated and precise pattern – all at a microscopic level. When we realise how intricate it all is, it is not surprising that things can go wrong.

In order to conceive a baby a sperm (male reproductive cell) must fertilise an egg (female reproductive cell). This fertilized egg then develops into an embryo, which implants in the woman’s womb (uterus) and subsequently develops into a foetus and eventually a baby. A woman produces one or two eggs in one or other of her ovaries every month and this is called ovulation. The egg is released from her ovary at the time of ovulation and, by some miracle, the woman’s Fallopian tube, which lies close to the ovary and connects with the uterus, is able to pick up this egg. If the woman has sex around the time of ovulation, some of the sperm that is deposited in her vagina swim through her cervix and uterus up to her Fallopian tube. The hope is that one egg and one sperm will meet in the Fallopian tube. The sperm will penetrate the egg and hopefully fertilise it.

The process of fertilisation takes about 24 hours and then the fertilized egg, which is one cell, divides into two cells, which subsequently divide into four cells and then eight cells and so on. Once the fertilised egg has started dividing into numerous cells we have what is called an embryo. After 2–3 days in the Fallopian tube, the embryo begins to move down towards the uterus or womb. If the lining of the womb is appropriate, which it should be at this time of the woman’s menstrual cycle, the embryo will start to implant in the woman’s uterus – this is approximately five days following ovulation and the embryo at this stage is called a blastocyst. As implantation progresses, the placenta part of the embryo starts producing a hormone called hCG (human chorionic gonadotropin), which supports the pregnancy. This hormone, which is excreted into the woman’s blood and urine, forms the basis of a pregnancy test and will give a positive pregnancy test 10 to 16 days after ovulation.

In order for all of the above to happen, it is really important that the couple have had sex in the days leading up to and around the time the woman is ovulating as that is the only time when there will be an egg available for the sperm to fertilise.

If a couple have an active sex life and are having sex every two or three days, they don’t need to concern themselves with the ‘fertile time’ – they will be having sex often enough.

Eggs are also called ova or oocytes. They are stored in the ovaries, in small sacs called follicles. These follicles can be seen on an ultrasound scan. Women are born with all their eggs in their ovaries. At birth, the ovaries contain one to two million eggs and these are arrested at an early stage of development. After puberty, several eggs begin to mature each month but only one or two are ovulated and the final stage of development of the egg does not happen until the egg is fertilised by a sperm.

The egg is one of the largest cells in the human body, and can even be just about visible to the naked eye. Like sperm, eggs contain half the normal number of chromosomes (23) in their nuclei and these combine with the 23 male chromosomes at fertilisation to produce one fertilised egg with a full complement of chromosomes (46). The egg also contains other structures, such as mitochondria, which are essential for normal development of the early embryo (mitochondria produce energy for the cell). Indeed, the first three days or so of an embryo’s life is controlled and determined by the egg, rather than by the sperm.”

‘The Fertility Handbook’ is available to purchase – click here – with profits going to Merrion Fertility Foundation.

Please click here if you are concerned about your fertility and would like to make an appointment to see one of the MFC team of doctors.

ART In Europe

ART In Europe

We know that the cancellation and postponement of treatment due to Covid 19 has brought untold stress and disappointment for our patients and for those all across Europe – see map released by ESHRE on 20/04/20.

But there are signs that activity is resuming as Denmark, Germany and the Netherlands slowly recommence services. We in MFC hope to also commence treatments in May, if the current trends in suppression of the virus continue and if national restrictions begin to ease. This will have to begin slowly and under strict guidelines and we will update our website as things progress.

In the meantime, don’t lose hope, try to optimise your health and wellbeing and don’t hesitate to contact our team of caring professionals if you have any queries or concerns.

http://www.eshre.eu/COVID19WG

 

 

Coping During the COVID-19 Pandemic: Message for Our Patients

The Covid-19 pandemic has changed life as we know it. For those patients struggling with infertility, particularly those awaiting treatment, anxiety and distress are both common and understandable responses to an unprecedented situation. At Merrion Fertility Clinic, we are here to support and guide you through this uncertain time.

Merrion Fertility have a number of support systems in place, including:

  • Support group meeting next Wednesday, 15th April by phone/video link
  • Patient consultations via phone or video link
  • Clinic is currently fully staffed and available to answer any questions (though most of us are working remotely)
  • Kay Duff, our fertility counsellor, can be contacted through the clinic or confidentially on +353 (1) 8319625 or  at catherineduff76@gmail.com.

For additional practical information on coping with stress and anxiety, please see the following excellent article recently published by the Mental Health Professional Group.

https://www.asrm.org/news-and-publications/news-and-research/announcements/coping-during-the-covid-19-pandemic–messages-for-patients/

Now more than ever it is important to take good care of yourself, and to remember that we are all in this together.

Stay safe and well.

 

Pre-Implantation Genetic Testing

Pre-Implantation Genetic Testing:

 

PGD (Pre-implantation genetic diagnosis) was developed several years ago and is an excellent technique for diagnosing embryos that have a specific genetic disease such as cystic fibrosis or muscular dystrophy.  This helps people who have a strong family history of such conditions to consider only using embryos that are not affected by these conditions.

PGS (Pre-implantation genetic screening) on the other hand is a similar technique applied to embryos  in the hope of identifying changes in the numbers of chromosomes in the embryo.    Embryos with a normal pattern of chromosomes (euploid) have the best chance of developing into a healthy baby, whereas aneuploid  embryos, that do not have the correct number of chromosomes, are less likely to implant and, if they do, the pregnancy is more likely to end in miscarriage or the birth of a baby with a genetic condition.

In recent times, more and more clinics are offering PGS for couples undergoing fertility treatment.     The exact place of PGS has yet to be determined as there are still many questions to be answered about the technique.    While it can reduce the number of miscarriages and failed pregnancies, it has not yet been shown to increase the number of live births from an IVF or ICSI treatment.    There are no studies on the long term effects of this technique as it has just not been around long enough.     In addition, the results are not always straight forward.   A significant problem is mosaicism, where some cells have a normal number of chromosomes and others don’t.  In these cases, it can be difficult for geneticists to determine the likely outcome of such pregnancies.  There have also been cases of false positive and false negative test results.

For all these reasons, Merrion Fertility Clinic’s policy at present is to recommend PGS for certain of our patients but not for all couples undergoing IVF.   However, we are cognisant that this is an evolving issue and that, as more studies are done, hopefully, the true role of PGS and its place in fertility treatment will be established.

Recently the HFEA, the official regulatory body for Assisted Reproduction in the UK,  determined that PGS should be classified as a ‘red status IVF treatment add on’ i.e. that ‘there is no evidence that the treatment is effective and safe’.  This decision is controversial.  It certainly has merit but others in the field disagree.    For that reason Merrion Fertility Clinic, as described above, takes an individualised approach to patients when discussing the benefits and risks of PGS.

 

For more reading:

https://www.hfea.gov.uk/about-us/news-and-press-releases/2019-news-and-press-releases/pgs-rating-now-red-following-review/

https://www.hfea.gov.uk/treatments/explore-all-treatments/treatment-add-ons/pre-implantation-genetic-screening-pgs/

Merrion Fertility Clinic’s Top Ten Highlights of the Past Decade

No. 1: Expanded Facility

2010: We moved into our current facility in no.60 Lower Mount Street which gave us the space we needed to grow and expand our services, while still being part of the National Maternity Hospital complex. We also had a state-of-the-art laboratory built.

No. 2: Donor Egg Service Launched

April 2015: We announced that we had established a satellite service to support appropriate patients requiring donor egg treatments. Our satellite service comprises pre-pregnancy medical advice and counselling, psychological support, arrangement of pre-requisite tests and prescriptions, provision of necessary ultrasound scans and tests during treatment, and relay of results to overseas clinic.   READ MORE

 

 

No. 3 Launch of MFC Support Group

August 2015: We began our support group which runs every month and is facilitated by our very experienced fertility counsellor, Kay Duff. This allows our patients to share their feelings and stories. The fertility journey can be emotionally demanding and many couples and individuals have benefited from the support of this group.   READ MORE

 

 

No. 4 Awarded Guaranteed Irish Membership

June 2017: We are a not-for-profit, Irish clinic. Not all fertility clinics are Irish-owned; some are owned by foreign corporations, which are answerable to shareholders. Our partnership with Guaranteed Irish reflects our MFC values of quality in patient services and care, and our commitment through education, research and training. As Ireland’s only fertility clinic with ‘Guaranteed Irish’ membership, we take great pride in reflecting the Guaranteed Irish beliefs of Provenance, Quality and Trust.   READ MORE

 

 

No. 5 Prof Mary Wingfield Launches ‘The Fertility Handbook’

June 2017: This comprehensive, research-based book provides excellent guidance on the fertility journey. Proceeds go to the Merrion Fertility Foundation, our sister charity which provides financial support to those who cannot afford fertility treatment.   READ MORE

 

Fertility

 

 

 

No. 6 Prestigious Grant for Fertility Innovation Received

July 2018: We received the highly competitive grant for fertility innovation for our research on the role of endometrium (lining of the womb) in embryo implantation at the 34th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE). Dr. Louise Glover, Research and Development Coordinator at MFC, was awarded the Merck GFI (Grant for Fertility Innovation) for this project. Dr. Glover is pictured below with Louise Brown, the first child born through IVF at the award ceremony.   READ MORE

 

 

 

 

No. 7 Certified as Complying with ISO 9001:2015 

November 2018: We are regularly audited by the Health Products Regulatory Authority (HPRA) to ensure compliance with the highest standards in relation to the Tissues and Cells legislation. We decided to transition to ISO 9001:2015 from the 2008 version of the quality management standard, which ensures that all processes are governed by Standard Operating Procedures and that any non-conformances result in corrective action so that our system is continuously improving.

 

No. 8 First Baby Born from Frozen Eggs

December 2018: We were delighted to announce the arrival of our first baby born through our egg freezing program. Egg freezing or ‘oocyte vitrification’ was first introduced in MFC in September 2016, so this successful pregnancy and birth within only 26 months of establishing the service was a testament to the expertise, hard work and outstanding dedication of the MFC team.

READ MORE

 

 

No. 9 First Baby Born through the Donor Sperm Program

December 2018: We were delighted to welcome our first baby conceived using the donor sperm service at our clinic. This successful pregnancy and birth occurred less than one year after introduction of the donor sperm program in MFC in 2017.   READ MORE

 

 

No. 10 MFC Patients

We are delighted to have been able to help thousands of patients achieve their dreams over the last decade.  We help patients through our various services, some of which are Ovulation Induction, IUI, IVF, ICSI, Egg Freezing, Donor Sperm Services and SSR.  One of our patients shared the following story on her IVF journey:    READ MORE

 

 

If you enjoyed this article, please share across your favourite social media channels.

Also, if you ever wish to consider fertility treatment, you can self-refer to our clinic by clicking here.

MFC Research at Fertility 2020

Fertility Research

 

Research and clinical staff from Merrion Fertility Clinic presented their findings recently at the Fertility 2020 Conference in Edinburgh. Clinical Fellow, Dr Lucia Hartigan, described her work on fertility preservation practices and referral pathways for children and adolescents with cancer in Ireland.

Doctors Fiona Reidy and Maebh Horan described the clinic’s ongoing collaborative project with Trinity College Dublin on the role of endometrial inflammation in early pregnancy.

Fertility 2020

Fertility 2020

The 2020 Joint Conference of the Association of Clinical Embryologists, British Fertility Society and the Society for Reproduction & Fertility is currently being held in Edinburgh.  The theme for the joint annual conference is ‘Reproduction in a changing world. 

MFC is well represented at the conference with staff from our clinical, nursing, embryology and research departments.  For more information on the conference please click on the link:

https://fertilityconference.org/

 

Fertility 2020

IVF Add-Ons: Do à La Carte Menus Serve Infertility Patients?

IVF Add-Ons

“Add-on” treatments and medications in IVF are highly controversial in the infertility field. At Merrion Fertility Clinic, we believe that strong evidence from clinical trials is needed before add-on treatments should be offered as part of the IVF cycle. These experimental techniques are expensive and poorly regulated, meaning that they can be introduced into routine practice before they have been shown to improve live birth rate.

In some cases, they may even have adverse effects on patients. A recent series of articles by specialists in the field, published in the journal Fertility and Sterility, looked at add-on treatments used by fertility clinics. All concluded that there is still not sufficient evidence to show that these techniques work or what their long term effects are for patients and their babies.

To read more, please follow the link below:

https://www.fertstert.org/article/S0015-0282(19)32454-9/fulltext

 

Donation – Thank You!

Donation

MFC and Prof Mary Wingfield would sincerely like to thank the kind donor who recently gave a very generous donation to help fund fertility treatment for people in need. This donation will make a big difference in people’s lives and will be administered via our sister charity, Merrion Fertility Foundation.

The Foundation was established to provide financial assistance to those who require assisted fertility treatment and who are unable to afford it.

If you would like to find out more about MFF or if you wish to donate please click on the following link:

https://merrionfertility.ie/a…/merrion-fertility-foundation/