When you make an appointment, you will be sent a detailed questionnaire which you will fill in and bring with you to my practice near Selfridges in Central London as a hard copy, or email back to me if we are Skyping or phoning. Our first appointment will last an hour and 15 minutes for one person, or two hours for a couple. I will endeavour to give you all the information you need to help you in that first appointment, based on scientific evidence, common sense and experience. I shall try and fit in with your existing diet as much as possible and I really will not give you a horrible punishing regime, I promise - most people quite enjoy their consultations! I may just tweak your lunch, make suggestions for dinner or ask you to eat a completely different breakfast. I make notes for you at our appointment and then I send you mases of information by email, including everything we have discussed, recipes and research.
I do prescribe supplements but try to keep them to a minimum. However, there are some supplements that have been very well researched for their effect on fertility. I pass on ALL my practitioner / trade discounts to my clients; I do not make commission from prescribing supplements to you.
But essentially it is a project; it has a beginning, an end and a goal. Usually three months preparation for both sperm and egg quality and to prepare for an IVF cycle. I will ask you to eat foods that are nutrient -rich and that have been shown to have a beneficial effect on hormone metabolism, sperm quality, ovarian function and egg development, and in pregnancy. I also cover lifestyle in our consultation – environmental chemicals and their effect on fertility, exercise, sleep, stress management, and our natural circadian rhythms, our body clock, all have a profound impact on fertility.
We may follow up after a few months if trying naturally, or before an IVF cycle, or if you need to lose or gain a bit of weight we may meet a bit more regularly for both support and keeping you on track. In pregnancy, I shall support you all the way through from that initial anxious first trimester, through to labour, post-natal and birth, until weaning.
I am a great believer in referrals and I know my place! I am a nutritionist not an IVF specialist, a gynaecologist or a urologist, an acupuncturist or a counsellor. But I have had 17 years of experience in this field and I certainly know where to send you if you need more help. I have made contact with some of the best fertility experts in their field. I can interpret test results and sperm analyses and I understand IVF drugs, immune medications, and the effect of any medications with nutrient interactions. My work with GPs have taught me a great deal about the human body and health and this, coupled with my MSc studies has given me a good, sound grounding in science.
FREQUENTLY ASKED QUESTIONS
How many appointments will I need?
That depends on what your individual circumstances are but generally I try to give you a good plan at the initial consultation that will carry you through until your IVF or while you are still trying naturally. Then we may review a couple of weeks before your cycle starts, or after three months of trying naturally. If you are on a weight loss or gain programme then I do advise that we meet at least monthly, to keep you motivated and on track.
My partner has been told he has good sperm. Does he still need to come too?
I would normally advise that men do come just to go through the dos and don’ts really. Research into sperm has grown over the last few years, as male fertility declines and often with NHS sperm tests the morphology (shape and quality) of the sperm is not tested. The better quality the sperm is the more it can help compensate for poorer egg quality. Men really only need come for one appointment.
But we are having ICSI, so does it still matter?
Yes absolutely. ICSI cannot determine if the DNA of that chosen sperm is good or not. Nutrition and lifestyle are critical for maintaining DNA integrity which is after all, what goes to make half your embryo/baby/child and the better the DNA the better the outcome.
If we are eating a good diet, why do we still need to take supplements?
Some particular nutrients have been shown to be especially good for fertility and they are difficult to obtain solely from the diet. Moreover, there are several that can be depleted by the IVF medications themselves. For example, vitamin D is important for both male and female fertility and in the winter, we are depleted so supplementation is recommended. Also drugs like Heparin / Clexane and steroids deplete vitamin D and calcium. Research has shown that several key anti-oxidants are essential for male fertility like vitamin E & C, and folic acid as well as zinc and less common ones like pycnogenol (pine bark extract), and supplements like CoQ10 and the amino acid L-Carnitine help motility. These are impossible to obtain from the diet. Novel supplements like turmeric and resveratrol which I use for egg quality and anti-aging would be impossible to obtain enough of naturally, as would the recommended amount of good quality omega 3.
Do you earn commission from supplements you prescribe?
No. The suppliers with whom I have accounts allow me to pass on my full trade discount to my clients. Other websites you just buy the products as I would, without discount. So, when I suggest supplements I do so entirely because I think they are right for you.
Do I need to change my diet or supplement regime when I start IVF?
Yes, I suggest that we always have a review whenever your circumstances change in whatever way. This may be an hour, 30 minutes or even a 15 minute catch up. If I see you just before an IVF cycle I will indicate clearly on your Supplement Plan when you stop or start any supplements within a cycle.
Do you recommend tests?
Yes, sometimes. I only recommend blood tests and may suggest these if I think you may be deficient in something from your history or diet, for example if you are vegan. Iron, iodine, zinc, omega three fats, vitamin D, vitamin B12 and folic acid are common deficiencies. I will also suggest thyroid and reproductive hormone testing if I think that is appropriate, and urinary infection screening and gluten or lactose intolerance testing. I also do stool testing if appropriate (I use an excellent lab in Germany). However, I always suggest that you try your own GP first if you can before you pay for tests.
I can also refer my male clients for fully comprehensive semen analyses, and specialised semen tests such as DNA fragmentation and Reactive Oxygen Species (ROS) tests, and infection screening. I can then refer on to excellent male fertility doctors if needed. I am also currently looking into using genetic screening for looking more in-depth into health and lifestyle issues related to fertility, but this is quite a new area and I want to be absolutely sure of its scientific validity and usefulness so I am not quite there yet!
Do you refer to other practitioners?
Yes, I am a great believer in referrals. I have worked in this area for 17 years and I have made relationships with many specialists, so if necessary can refer you to male fertility experts like urologists and andrologists as well as gynaecologists and obstetricians. I am also familiar with several IVF consultants and clinics so can help you decide which one may be right for you, without prejudice. I also work with several highly experienced complementary practitioners that I refer to, and vice versa. The people that I refer to are the best in their field. I would never trust my clients’ wellbeing with anything less.
Do I need to come and see you if I am pregnant?
Yes definitely. Those early weeks are important windows of growth and development for the embryo and your nutrient intake in early pregnancy is important. Moreover, I can help you prepare for any pregnancy sickness, and make sure that you are supplementing with vitamins and minerals that may be depleted by the IVF and other drugs like steroids or Clexane that you may have been prescribed.