The business of fertility
One of the most confusing and vulnerable times of our life fuels a huge industry with a very human cost
Boy, do I have some unpopular opinions about the fertility industry. Or at least I thought I did, until I started working with people who struggle with theirs. Roughly half of my nutrition clients at any one time are preparing for or undergoing fertility treatment, are pregnant or are in the immediate post-pregnancy recovery time warp. And it is these lovely people that I work with who are always, always grateful for my unpopular opinions and for being honest with them.
Don’t get me wrong, I am still an eternal optimist who believes (truly) in the power of bringing new life into this world at least partly through sheer determination. Alongside evidence-based dietary advice and targeted lifestyle interventions sit my recommendations to try and practice visualising your family and heal your traumas before carrying on. There is a lot of evidence for the benefits of healing your mental scars and trauma, not so much empirical evidence on meditation and visualising for fertility success, but it definitely doesn’t hurt, as reducing stress is an important part of any fertility journey.
My very first foray into non-academic writing was actually driven by the lack of evidence-based advice to be found on the World Wide Web for pregnancy and fertility more generally. Pregnant for the first time in the middle of my PhD, I found myself rolling my eyes. A lot. The NHS website contradicted itself on dietary advice (smoked salmon is safe; smoked salmon should NOT be eaten) and most information available was essentially based on a mixture of guesswork (wild Atlantic salmon that is organic might be ok), inherited wisdom (fish is good), unfounded opinion (the reason you’re not pregnant is because you don’t eat fish) and a touch of open-endedness (check the mercury levels before making a decision) that left the original query completely unanswered.
I also naturally bought all the books I thought might be helpful. They ranged from dull to oversimplified, interesting but impractical to biologically not sound advice. I quickly realised there was a big gap between the scientific literature and evidence base, and the information available to those looking for some guidance. Friends were taking dietary advice from masseuses, cutting out entire nutritious food groups, and others were spending a fortune on expensive supplement regimes. At the very worst end of the scale, women who had no reason to suspect infertility were told that they should consider IVF because of their age alone or based on one blood test (usually AMH, which is pretty useless on its own for clinical use).
Some of my clients were told they should freeze their eggs but were not told what the actual odds of those eggs resulting in a successful pregnancy are. If eggs are frozen before the age of 35, women have a 30–40% chance to conceive if there are 10 eggs available. Others were not warned of the huge physical and emotional impact these procedures have. That first blog I wrote for my own benefit and those of my closest friends tried to unpick all of the what ifs and truth behind the most common questions: can I drink coffee? alcohol? do I need to take supplements? should I exercise or avoid exercise? why did I have a miscarriage? how can I avoid having another? should I have a vaginal birth? is breastfeeding easy? does formula provide the best start?
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