Fibroids are benign growths in the womb and are extremely common: an estimated one in four women will have fibroids at some stage in their life. However, many women will not know they have fibroids as only one third of cases present symptoms; these can include heavy and prolonged periods, swelling, post coital bleeding and infertility. They vary both in size – from that of a small pea to a large grapefruit – and location, the most common of which is within the muscle tissue of the womb (intramural fibroids).
Surgery is not always necessary
Fibroids do not always cause symptoms or they may only be mild; if this is the case, you may not require any treatment. Furthermore, fibroids tend to shrink after the menopause and symptoms ease. There are also medication options to manage the symptoms.
Fibroids and fertility treatment
During your consultation at Miss Amanda Tozer’s London fertility clinic you will initially undergo an ultrasound scan; sometimes an MRI will be required to locate and establish the size of multiple fibroids. Miss Tozer, a female gynaecologist with many years’ experience of treating fibroids, will then discuss the results with you, explaining the implications, if any, regarding your fertility. If the fibroids lie in the muscle tissue (intramural) and are smaller than 5cm, it is unlikely that removal will be recommended.
However, larger intramural fibroids can be removed either in an open procedure or laparoscopically, depending on their location. If Miss Tozer identifies fibroids growing from the inner wall into the middle of the womb (sub mucosal fibroids) she will most likely recommend they be be resected before you embark on fertility treatment. Resection of sub mucosal fibroids entails a hysteroscopy, usually performed as a day case; in some cases, pre-op suppression of hormones will be required.
At the London Clinic, Miss Amanda Tozer’s patients can count on attentive and specialist care.
When a couple has successfully overcome the first stages of the IVF process, a failure at implantation can be devastating. For couples who have had repeated failures despite highly rated embryos, the chances of pregnancy may be improved by a process known as ‘endometrial scratching’. It has been shown in several randomised studies that this procedure of performing endometrial biopsies, usually during the luteal phase (after ovulation) of the menstrual cycle, can improve the rate of implantation, pregnancies and live births.
How does endometrial scratching work?
Endometrial scratching has been widely offered since 2003 but why it is effective is still not clearly known. The belief is that ‘injuries’ to the endometrium (the womb lining) stimulate the production of endometrial white blood cells, creating an inflammatory reaction that in turn enhances the uterus’s receptivity to implantation. Female gynaecologist Miss Amanda Tozer offers endometrial scratching at her London fertility clinic where it takes not more than 15 minutes. It can be uncomfortable and some women may find it painful; it is advisable to take analgesia such as ibuprofen an hour or two before the procedure – your doctor will advise you on this. It is also a good idea to bring a friend or your partner so they can escort you home afterwards.
How much does it cost?
If you are an existing patient of Miss Amanda Tozer, endometrial scratching will cost £100. The procedure is available to any patient, whether or not they are undertaking their IVF treatment with Miss Tozer; for these new patients, the price is £125. Miss Amanda Tozer is an experienced female gynaecologist who offers her London fertility patients expert and individualised support and guidance through this most difficult of challenges; she will talk you through the theories and practicalities of the procedure and its success rates, while ensuring you understand any associated risks or side effects.
Polycystic ovarian syndrome (PCOS) is a very common menstrual disorder affecting around 1 in 10 women. It is diagnosed when a woman has two of the three following symptoms: ovaries with many small cysts, a raised level of the male hormone testosterone and irregular periods.
Why is my fertility affected?
The exact cause of polycystic ovarian syndrome is not known; several factors are likely to be involved including insulin resistance and a high level of luteinising hormone. What is known is that one symptom is the abnormal development of the follicles in the ovaries: they often fail to develop fully, causing problems with ovulation and therefore irregular periods. Ovulation is essential to the conception process: a reduction in periods tends to result in reduced fertility.
What are my treatment options?
Polycystic ovarian syndrome is often associated with being overweight or obese. If this is the case, then the first step is to lose weight as this can significantly improve your chances of regular menstruation. After this point, you may be a suitable candidate for fertility treatment or, in some cases, surgical intervention.
During a consultation at the London Clinic, female gynaecologist Miss Amanda Tozer will take your full medical history before conducting a pelvic ultrasound and running blood tests. Diagnosing your individual case, Miss Tozer will then advise you on the most appropriate treatment. Many women with polycystic ovarian syndrome respond well to fertility drugs such as Clomiphene whereby a more predictable window for conception is created by inducing ovulation.
Miss Tozer is a Consultant Gynaecologist and Sub-Specialist in Reproductive Medicine. She has treated the whole spectrum of menstrual disorders, helping many women to achieve the family they desire. Testimonials from her previous patients in London credit her for her attentive, personal and encouraging care.
For women who wish to delay having a child until their late thirties, be it for financial or social reasons, egg freezing is becoming an increasingly viable option.
How successful is egg freezing?
To improve the chances of the process being a successful one, a woman will ideally be under 35 years old when she freezes her eggs. While there are limited good studies that look at live birth rates from frozen eggs, what we do know is that approximately 90 per cent survive the process, and of those 70 per cent will fertilise, producing embryos.
The age of the woman at this stage remains an important factor as it does with any pregnancy: live birth rates from frozen eggs decline with age. In terms of potential risks, there are no increased risks in chromosomal abnormalities or development problems.
How does the process work?
Women attending female gynaecologist Miss Amanda Tozer’s London clinic will first have a pelvic ultrasound. This enables Miss Tozer not only to assess the accessibility of the ovaries, but also to check the antral follicle count, an indicator of remaining egg supply (the ovarian reserve).
The treatment of egg collection itself involves daily injections that stimulate the ovaries to produce more eggs; the level of stimulation will be adjusted according to your age and your ovarian reserve. Over the next fortnight, you will have two or three scans, before the eggs are collected on approximately days 14 to 16. Miss Tozer will perform the collection herself; the procedure takes around 30 minutes during which you will be sedated. You may experience mild bloating but this should settle within five days of the eggs being collected.
At Amanda Tozer’s London fertility clinic you will benefit from personal, one-to-one care with all aspects of the egg freezing process being explained, assessed and performed by Miss Tozer herself.