‘Fertility treatment’ refers to the assisted conception methods used to help people who are having difficulty conceiving. There is no single treatment suitable for everyone and we are researching all causes of sub-fertility (male and female) in our unit.
Helping people with genetic disorders
PGD (pre-implantation genetic diagnosis) is a treatment for people who know they have, or carry, a serious genetic condition that they do not want to pass onto their children. Their embryos are tested to ensure they are unaffected by the condition before they are implanted in the womb.
Our programme is the largest and most successful in the UK – approximately 60% of PGD carried out in the UK happens in our clinic.
Our PGD team are world leaders in research. They invented a revolutionary technique called ‘preimplantation genetic haplotyping’, which is more reliable, allows us to test for more genetic conditions, and identifies more embryos that are suitable for implantation. This technique is being taken up by other clinics in the UK and around the world.
Healthy BMI increases IVF success
The assisted conception unit has investigated the impact that being moderately overweight (BMI 25-30) has on the success of IVF treatment. It is known that being obese (BMI 30+) impacts the success of fertility treatment, but the effect of a moderate increase in weight had not been confirmed or quantified.
They were surprised to find that that being overweight – not necessarily obese – has a significant impact on the chances of a successful pregnancy. This is likely due to the effect of excess weight on the body’s hormones, egg quality and maturation, the way the embryo develops, and the receptivity of the womb.
Compared to a normal pregnancy, being overweight reduces the chance of a live birth by an average of 9% per IVF cycle, and increases the chance of miscarriage by an average of 24% per IVF cycle. Being obese has an even greater impact, reducing the chance of a live birth by an average of 20% and increasing the chance of miscarriage by an average of 40%.
Calculate your BMI (Body Mass Index)
Making emergency caesareans safe
We developed the first simulator used to train doctors in dealing with late-stage (emergency) caesareans, called Desperate Debra.
Developed with NHS Fife and Adam Rouilly Ltd, Desperate Debra consists of a pregnant abdomen, uterus and fetus, and is highly realistic in terms of how the baby’s head and neck moves.
Emergency caesareans affect around 20,000 births per year in the UK. They can be challenging for doctors, as the baby’s head may get stuck in the pelvis because the woman is fully dilated. As well as being life-threatening for both mother and child, there may be complications during the operation and in the long term.
Using Desperate Debra to help train doctors in this scenario will reduce the likelihood of serious complications for the infant and mother.
Predicting and preventing premature births
The risk of pregnant women giving birth early can be accurately measured with a simple cervical swab, according to research from our preterm surveillance clinic. This test will reduce distress for women who would otherwise have received unnecessary treatment.
The swab measures the level of a protein known as fetal fibronectin (fFN). If the protein leaks out of the womb into the cervix, the likelihood of premature labour is increased. fFN levels reliably indicate whether a woman is likely to give birth prematurely.
fFN is already used as an indicator of likely preterm birth, but not in a quantitative way, meaning that many women are treated unnecessarily. This updated test is more precise and gives a more definitive diagnosis, meaning we can reduce the need for low-risk women to stay in for observation or get treatment when they don’t have to.
Our hospitals were the first to use the newer version of the test, with its more accurate, quantitative capabilities.
Improving pregnancy rates from IVF
Using vibrating platforms like those found in gyms may help to prevent falls in older people, according to our clinicians and academics at King’s College London. When combined with exercise 3 times a week, older people’s mobility improved much more than through exercise alone.
Strength and balance training can help to prevent falls in older people, but those who are frail may not be able to exercise for long enough to fully benefit. Vibration treatment may help to solve this problem.
The Timed Up and Go (TUG) test is one way of measuring mobility and involves standing up, walking, turning and sitting down. After two months of standing on a vibrating platform for five bouts of one minute three times each week, older people increased their walking speed and completed their TUG test twice as much as with exercise alone. Exercise also helped to improve balance and ease worries about falling.
This is just a small amount of the research we do in this area. If you’re a patient interested in finding out more, then speak to your consultant at your next appointment. If you are not a patient at Guy’s and St Thomas’ then speak to your own consultant in the first instance.