What the CARE fertility director tells his patients about how to increase chances of pregnancy
During the last Fertility Fair in London I attended a fantastic lecture given by Prof. Charles Kingsland, clinical director of the CARE Fertility Group and the spokesman for the Royal College of Obstetricians and Gynaecologists.
Here comes the transcript of his talk, I hope you will enjoy as much as I did!
Prof. Charles Kingsland first reminded us of a few simple and yet often forgotten facts:
– It wasn’t that long ago that going to the doctor was not only of no benefit but actually quite dangerous! Napoleon Bonaparte, was given liquid led to treat his stomach ulcers; one year later he died of stomach cancer. Wolfgang Amadeus Mozart died of pneumonia, one week after he went to see his GP for common cold. If you carefully read the biography of Elvis Presley, which I did as I’m one of his biggest fans, you will realize that his doctors killed him. You also may remember the story about Michael Jackson: he needed a sedative, his doctor gave him a powerful one and Michael Jackson never woke up. So if we go back 100 years most of the medicine we prescribed had no scientific evidence of benefit. A lot of medicines were prescribed by non-medically qualified people.
How can i increase my chances of getting pregnant: Questions that patients won’t ask and doctor’s won’t tell
What I find surprising is when you go and see a doctor, patients will not ask one important question: doctor is there any evidence that what you are telling is gonna do me any good?
If I say to you, to start taking folic acid, what you should then say to me is “What evidence have you got that that’s gonna do me any good?”. In that moment I could take you to the online library and show you scientifically proven evidence that if you will have better chances of having a healthy baby if you take folic acid than if you don’t.
Also if I say to you to stop smoking, there’s a load of evidence that if you stopped smoking you will increase your chances of getting pregnant.
Dieting is a lot more difficult than we think. There’s no doubt that that if your body mass index is between 20 to 25, you have higher fertility than if your index is over or bellow that. Most of us have difficulty losing weight. The fist thing that comes to my mind about dieting is how it always surprises me when patients come to my fertility clinic and the first thing they’ll do is they sit down in the waiting room… and take out their bottle of Lucozade or other high-energy drink! And it’s 9 a clock in the morning?! Quite often my patients drink fresh orange juice. But do you know how many calories are in a glass of juice? Some people can easy swallow their daily portion of calories before they even had breakfast!
And it always makes me smile that patients will come to me and they have loads of various substances from various nutritional therapies. And then say things like, “it’s natural”…“it’s made by bees” etc. It has never been proven to be of any benefit to anybody ever, yet we buy it. Evening Primrose oil, there’s another one! It’s a treatment looking for a disease.
What to eat to improve chances to get pregnant
Do you really believe that eating pineapples or avocados will improve your chances of getting pregnant? Do you think that women who are hanging of the train with 9 children, living on a poverty line in Mumbai are thinking “gosh I didn’t eat my avocado today”?!
Than, do you think that stopping coffee entirely is gonna improve your chances of getting pregnant, so you deprive yourself of what makes you smile?
Alcohol is also a good one! People who completely give up alcohol – where’s the evidence that drinking one or two units of alcohol per week is gonna stop you getting pregnant? How do most people get pregnant when they don’t want to be pregnant?
What all these things have in common is that they are all part of balanced sensible diet. Eating avocado, eating fruits and vegetables, and all thing that don’t taste nice are probably good for you; everything that grows above the ground is good, everything that grows bellow the ground or moves is probably not that good. Everything in moderation. If you got a calorie control, good diet, that’s good enough.
You know the thing that are not good for you – chocolate. Anybody who’s eaten a bar of chocolate, you know as well as I, and you feel uneasy about it, don’t you?
Another thing that makes me laugh, putting a pillow under your bottom. What is that?
If I said to you close your eyes and think of the first time you had sexual intercourse with your partner (if you can still remember, or if you were sober enough to remember, laughs). Now think about last time you had sexual intercourse. Is there a difference?
When I was trying for a baby with my wife, we were having difficulties because sexual intercourse becomes routine and nonproductive, and all this stuff about relaxing and look after yourself and pamper yourself. Have any of you seen animals having sex? The missionary position is all wrong. And putting a pillow under your bottom, there is a reason why sperm dribbles down your leg, because in an ejaculate there are two things – the sperm, and little wrigley things that you can’t see.
How to deliver a sperm sample to the fertility clinic and other stories
Another patient come to me, a gentleman, few years ago delivering his sperm sample in silver foil object. He went to the desk and he opened it up and there was a steaming baked potato put in half and in the middle there was a decent amount of sperm at the bottom.
What’s that? – I asked.
– That’s my sperm sample!
But it said “Bring sample in jacket pocket!”
– Oh, I thought it said jacket potato.
Sexual intercourse is meant to be enjoyed. We do everything we can to try and make it relaxed and comfortable. That’s nice – safe, easy, and comfortable, but that doesn’t mean it’s better!
Let’s now talk a bit about evidence based medicine. I am not criticizing non-medically based treatments. What I am criticizing is if you don’t know whether it’s gonna do you any good.
Say for example I am to sell this. If I said to you would you like to buy my fertility monitor, what you do is you put it in your pocket and electric current will stimulate your ovaries to improve your ovulation, and increase your chances of getting pregnant. I got a supply of these they’re 100$ each. I can guarantee you that I will sell some today. And I will also guarantee you that somebody will get pregnant, and they will go on internet and say “that Professor Kingsley is marvelous, we bought the fertility monitor, which looks suspicious like a pointer and we got pregnant straight away.” You know as well as I know that’s daft. Some people would have gotten pregnant anyway. That’s sort of success that non-evidence based medicine relies on.
I love reflexology, I had acupuncture, and if they say it can’t do you any harm and it might be beneficial, do it, because it’s all about making you feel good and positive.
About embryoscope, time-lapse, embryo diagnostics, and other add-ons in IVF treatments
In medicine and in general medicine you won’t get a hemorrhoid conference, because it’s not interesting, and we don’t talk about it. Fertility is unique – it’s high profile, happy endings, wicked scientists, cute babies…Fertility is medical Harry Potter, it’s got all the ingredients!!
A lot of it is magic, and a lot is about we’re trying to achieve the most precious gift you can ever have in life. And because fertility is so high-profile, many people are trying to sell you stuff you shouldn’t be buying.
You can buy whatever you like for your fertility treatment. Embryo glue, that’s a good one. Clinics will tell you, you got to use that one when you have your IVF. It’s not scientifically proven, it’s not harmful, in theory it could improve your chances. If you want to spend extra money, provided that it’s not harmful, and you know exactly what you’re buying, go for it.
If any of you are going through IVF, you have heard of short protocols, long protocols, mild IVF, severe IVF. But have you ever heard or have been to a surgeon and heard of him saying I’m going to do a mild appendicectomy? But we say many things to get the treatment done.
Let’s now mention the thing called embryoscope. If we’re making embryos or growing embryos in a laboratory, we actually pop them in an incubator and video them, and not only we watch them grow, we watch them divide in real time. Then all the data that we have measured are put into an algorithm and computer predicts which embryo is likely to turn into baby. That sounds great doesn’t it?! And yet there is no evidence behind it that it really helps with getting pregnant or reduces miscarriage rates if you do get pregnant.
Preimplantation and genetic screening is where we biopsy an embryo. There’s no evidence of suggesting that would increase your chances of having a baby. What it would do, it would help us to find embryo which is most likely to turn into baby, but also conversely which embryo is not likely to turn into baby on account of being genetically abnormal.
You need fertility doctors who have time for you
If I look at my clinic in Liverpool, I used to walk in in 8 clock in the morning, and I’d look up my list and see I would have 45 couples to see before lunchtime. Now, being a senior, I’d walk in and they would say good morning professor Kingsland, lovely day today, you’ve got four couples waiting for you. Now I can sit with them and talk about everything, and that’s what I want you to have. You need doctors who have time for you, you might want to chat about their diet, they might want to review your supplement list.
Fertility is biological drive. Whether you are a mammal, dolphin, elephant, giraffe, or human, we all do the same things – breath, grow, reproduce, eat, and die.
If I said to you I want you to hold your breath for two minutes, take a deep breath and hold it in for two minutes. I can guarantee you that within 10 seconds all you will be thinking about is breathing. If I said to you don’t eat for fortnight, this time tomorrow all you will think about is food. If I said don’t move for a minute you’ll be desperate to blink your eyes. Similarly if I said to you that you can’t have a baby and you want to have baby, all you’ll be thinking about is babies. First thing in the morning, last thing in the night, every second of every minute, of every hour, of every day, of every week, of every year.
Any supermarket you put an infertile women in and blindfold her, she find the nappie isle. Because that’s what infertility is. Your mother or your best friend will say: I know how you feel. How would they know how you feel? Nobody knows what infertility is unless they personally encountered it. It’s a bit like depression: nobody knows how bad it is until they felt it themselves.You can’t go to doctor and say I’m a bit depressed. When you’re depressed that is it and that’s the only feeling that dominates your life – only if you have suffered depression you will know exactly what I’m talking about.
Summary – lifestyle interventions that help increase fertility naturally
Is that treatment make any difference to me, that’s what you need to tell your doctor.
I could bottle it down my advice into: don’t smoke, don’t be overweight, don’t ride on motorbike, it can have devastating effects on female. Take your folic acid. Eat well. Think before you drink.
I’m not suggesting you don’t drink LINK, but just think; when I’m drinking, is this going to be of benefit to me, is it gonna make me feel good, is it vodka in which case what the hell, there’s no calories (laughs).
Try being on the right weight, says Prof.Kingsley to all young women who wish to shorten their time to pregnancy. This means having a BMI (body-mass-index) of 20-25.
If you can’t lose weight (or simply grow 4 or 5 inches, same effect – laughs). Exercise. Exercise is good for your body and for your brain. And yes, you can over exercise, you can go mad.
Have two really good friends if you can. Two really good, you can confide in. If one of them is your mother, that’s not so good. You got to have two real friendsat least, because you need stereo. If I could have all my patients just to have a friend – it makes life so much easier.
I see some patients who come to my clinic and they say that if only they had a baby life would be better, the house would be bigger, I’d have better car, more friends. The two of them sit there and I look and I think sometimes: they don’t even seem to like each other, why do they want a baby?
It really helps if you love your partner because it’s a very difficult journey. And you need to walk that journey together. We male are suffering in our own way. It’s important that you work as a team, because you’re both going to the same process. If you love each other, it just makes life a little bit easier. Try having good sex, ‘couse good sex is good for you on many levels.
(I couldn’t agree more with this one. In my book “How to improve egg quality”, I’ve dedicated an entire chapter to this topic: If you haven’t read it yet, please download a simple PDF and read on your PC or Kindle HERE).
By the way, let me give you another example of how to not have sexual intercourse (laughs). Once I saw a couple, they were 22 year old Irish Gypsies (name of the minority taken out). They’ve been trying for a baby for 8 years. I took a history from the girl, she had regular periods, was fit and healthy, no serious operations, husband loved her dearly, fit and healthy. I said:
– Do you have sex and now many times per week do you have sex?
– 15 times a week.
– Really? – I was shocked a bit they couldn’t get pregnant for such a long time.
So we did all kinds of tests. Everything was great. The couple came back two weeks later, they had loads of eggs, she was ovulating, you could almost hear her husband’s sperm chatting, there were so many of them. So we sat there, I scratched my head and I thought I can’t find anything wrong. Any pain? No pain at all. Then there was a silence, ant than the NURSE who was sitting behind me uttered the words I will never forget. She leant over and she said to the female:
– Where do you have sex, front bottom or back bottom?
Back bottom. This is how the couple were having unprotectedanal intercourse 15 times a week for eight years. And when we told them where babies come from the couple were horrified. She thought babies come from back bottom and that’s where sperm needs to go, and nobody told them.
I learned that day that I don’t know what normal is.
We all aspire to normality but actually to be abnormal is not wrong. Don’t try to conspire to normality because normality is different for different people. Simply try to have good sex.
It is absolute privilege for me to work in the profession I do, I love it.
It a privilege to work with couples in their most vulnerable time in their lives, because I feel in that position you can do a lot of good. And I still think that a lot of what we do is magic.
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