From Acupuncture to Yoga: Can Lifestyle Choices Improve the Odds of IVF Working for You?

Progress Educational Trust
College Hall, Royal College of Physicians and Surgeons of Glasgow, 232-242 St Vincent Street, Glasgow G2 5RJ
14 June 2018
This public event was organised by the Progress Educational Trust (PET) and supported by the Scottish Government, and was held at the Royal College of Physicians and Surgeons of Glasgow.
Since the world's first IVF baby was born in the UK 40 years ago, most fertility treatment has centred on a small number of key procedures - ovarian stimulation, egg retrieval and sperm collection, the actual in vitro fertilisation, embryo culture, and embryo transfer.
However, there is more to being a fertility patient than simply undergoing these procedures. Patients are often told - by their clinic, by its partner organisations, by the media, or by other figures - that what they eat, what they do, and even what they think has an important role to play in the likelihood of their IVF treatment succeeding.
To be eligible for publicly funded IVF, UK patients are often required to fall within a certain range of body mass index (BMI), to abstain from smoking, and sometimes to abstain from alcohol as well. Such criteria are in place throughout Scotland (where, unlike England, there is a consistent level of IVF provision) and are justified with reference to research concluding that these factors can indeed affect the success of IVF.
But fertility patients also encounter high-profile claims, about what they can do to improve their chances, that go well beyond these criteria. Sometimes, recommended courses of action come at (additional) financial cost. And sometimes, these recommendations go beyond medicine as conventionally defined, and enter instead the realms of 'wellbeing' or of complementary and alternative medicine (CAM).
Questions explored at this event included:
To what extent is fertility-related lifestyle advice simply part and parcel of promoting good health more generally? At what point should fertility patients become sceptical of such advice? Should they be willing to pay for additional guidance, therapies or supplements to optimise their chances of success?
When fertility clinics offer additional forms of support to patients, that go beyond the straightforwardly medical, is this an enlightened and helpful thing to do? Or could it potentially be exploitative?
Approaches to fertility that fall outside conventional medicine are increasingly described as 'integrated' or 'integrative', or as addressing the 'mind/body connection'. Do such approaches offer an alternative to the mainstream fertility industry, or have they become an integral (and profitable) part of it?
Are patients who use assisted conception being singled out, as targets for non-medical or quasi-medical advice and marketing? Or is it becoming the norm for all prospective parents to receive this?
Undergoing invasive medical treatment to fulfil a cherished hope, with no guarantee of success, can be a source of anxiety or stress. Is it accurate to tell patients - as some do - that their anxiety or stress may reduce the odds of their IVF succeeding, and that this problem therefore needs to be remedied in its own right (perhaps at additional cost)?
A common theme of much lifestyle/wellbeing/CAM advice is that modernity, artifice, convenience and mass production - whether in relation to food, work, travel, electronic devices or household products - are associated with stress and toxicity. By contrast, products and practices which can be presented as 'natural', or which are derived from older customs, are presented as wholesome and helpful.
Can this stance coexist meaningfully with IVF, which is by definition an artificial intervention to bring about a pregnancy when nature will not oblige?

Dr Abha Maheshwari
Clinical Lead in Reproductive Medicine and Director of the Andrology Laboratory at the Aberdeen Fertility Centre, and Honorary Clinical Senior Lecturer in Reproductive Medicine at the University of Aberdeen
Isabel Traynor
Lead Nurse for Gynaecology and Assisted Conception at NHS Greater Glasgow and Clyde, and Senior Charge Nurse at Glasgow Royal Infirmary's Assisted Conception Service
Dr Jane Jamieson
Nutritional Therapist at the Natural Fertility Centre and at Portobello Natural Health
Dr Margaret McCartney
General Practitioner, columnist at the British Medical Journal and broadcaster for the BBC Radio 4 programme Inside Health

Richard Anderson
Professor of Clinical Reproductive Science and Head of Obstetrics and Gynaecology at the University of Edinburgh's Centre for Reproductive Health

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