The Evewell

Identifying PCOS can be tricky, as it manifests differently in individuals. Irregular or absent periods, weight gain, and excessive hair growth are common signs. A blood test to check testosterone levels and an ovarian scan can provide a definitive diagnosis. Other signs of PCOS may include difficulty getting pregnant, thinning hair, weight gain, oily skin, and acne.

PCOS has 3 main characteristics:
• Irregular or infrequent periods
• High levels of male hormones, which may cause physical signs such as excess hair (usually on the face, chest or back)
• Polycystic ovaries: ovaries containing many fluid-filled sacs (follicles) that surround the eggs

Your doctor will request a blood test to check your testosterone levels and a scan to check for polycystic ovaries. You may also have other signs and symptoms of PCOS:
• difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
• thinning hair and hair loss on the head
• weight gain
• oily skin or acne

September marks PCOS Awareness Month, shedding light on a condition that affects how a woman's ovaries function. With one in ten women affected, Polycystic o***y syndrome (PCOS) is a leading cause of female infertility.

In simple terms, PCOS is characterised by an imbalance of reproductive hormones, leading to the formation of tiny cysts in the ovaries. These fluid-filled sacs, measuring up to 8mm, prevent ovulation and hinder the release of eggs.

The hormonal nature of PCOS can have a significant impact on fertility, causing frustration and stress for those trying to conceive.

In this article, one of our newest consultants, Dr. Ewa Goncikowska, an experienced fertility specialist, who has a specialist interest in low AMH and conditions such as PCOS and gynaecological endocrinology, to explore the effects of PCOS on fertility and what can be done to overcome these challenges.

We know it’s tough when you scroll through social media, and all you see are photos of children starting their first
day of school...

So, we want you to know we’re thinking of the longed-for children who should be standing proudly on a doorstep, having their photo taken.

Maybe this is another year of asking yourself "what year would they be starting now?"

Or maybe you have a smiling little one, but you always hoped there would be more.

Whatever stage you're at, we're thinking of you this week ❤️

The questions you ask in the first few meetings with a fertility clinic can help you decide whether you feel comfortable to proceed – or not.

Over the last week and a half, has taken over our Instagram to explain the essential questions to ask in an IVF consultation.

"The take-home message here is never do anything that makes you feel unheard, without seeking a second opinion. Just because one clinic can’t or won’t offer you treatment with your own eggs and s***m does not universally mean that you have to move to a donor option. If that’s not what you want to do, seek advice.

If you’re already on your IVF journey, or you’ve completed your family, please share with people about to start IVF, or returning for more treatment; we’re stronger together and all of our experiences will help each other become better informed and less anxious.”

Essential questions to ask your IVF doctor. "What can I do to increase my/our chances?

"The process of IVF treatment should be a collaborative effort between the patient, the consultant, the embryology team and other lifestyle and holistic considerations," says

"Basically: there are things you can do to help improve the outcome, and better still: feel more in control.

Recommended questions to ask your consultant, before starting IVF, are:

- Can you recommend any holistic therapists that may help my outcome? (eg: acupuncturists, nutritionists)
- Are there any lifestyle changes you’d recommend, or supplements that I/we should be taking?
- Is there a potential situation where there needs to be a pause and delay before I/we start?

It shouldn’t all be go go go, sometimes you need to pause, take a moment and think about what you can do to help give yourself the best possible chance of success."

🔟 Essential questions to ask your IVF doctor. "What support do you offer?"

"Not all clinics are created equally." explains "Think about what is important to you when going through treatment.

- How do you consider my/our needs?
- Will the nurses be available for injection teaching or are we expected to watch a YouTube video?
- I’m scared of needles, how will this be respected and supported?
- I/my partner has a religious need that needs to be considered.
- I have a medical condition, will I need extra anaesthetic support?
- Is there an emergency number if required?
- What counselling support do you have and how do you tell me/us how to access it?
- How will you ensure I am listened to?"

9️⃣ Essential questions to ask your IVF doctor. "What if I want more than one child?"

Something is super passionate about is helping people build their family today, and for the future.

"Depending on your age, if you want more than one child, you may want to consider banking embryos before your first embryo transfer, so you don’t come back in a few years and have to start the whole process again.

This is what I refer to as ‘family planning’.

Ask:

1) I know I want more than one child. Would you recommend multiple egg collections and embryo banking, so I have options for future children?

2) Do I need to think about PGT-A to make sure we know the embryos frozen, will give us the best possible chance in the future of completing our family.

You may be just thinking “I’m desperate to just get pregnant and have a baby”, but I can’t tell you the amount of times I’ve had women and couples come back to me, this time in their early 40s, desperate for a second baby and by that time, it’s so much harder for them to secure a sibling for their child."

8️⃣ Essential questions to ask your IVF doctor. "What do we need to do before we start?"

"Before you start treatment, you want to do whatever you can to give yourself the best possible chance of success. And I mean both immediately, and in the long term," explains .

"Some questions to ask in this situation are:

- What investigations do both myself and my partner (if appropriate) need, before starting treatment?
- If there is a male partner, will he be properly evaluated?
- A semen analysis isn’t always enough. Has there been recurrent miscarriage? Has this been checked appropriately?
- How will you take into account our aspirations for having a family?
- How do you connect this to the treatment advice?
- What standard tests do I need to have before?
- Can I have them elsewhere and do any of them expire?"

7️⃣ Essential questions to ask your IVF doctor. "How long will it take?"

"Every patient deserves to understand the exact process, the timelines of IVF, how it fits into their lives, and how they can juggle work and life around their treatment," explains.

"Some of the questions you need to ask, include:

- What does the timeline look like? Is there a waiting list?
- What stimulation protocol will I be put on: long or short? And why?
- How will this impact my work schedule?
- How can your clinic reduce disruptions for me?
- Are early appointments an option?

There will be other questions perhaps more pertinent to your personal situation, but if you ask the above questions, you'll feel better informed, and more in control of how to manage IVF and your day to day life."

6️⃣ Essential questions to ask your IVF doctor. "How much will it cost?"

"When it comes to the cost of IVF, there shouldn't be any nasty surprises", explains .

"This has to be outlined from the beginning. Everything you are going to need to pay for should be shown to you, before you start treatment. IVF is stressful enough!

This includes if you need to have a “freeze all” embryo collection cycle, and a follow-up frozen transfer, typically not included in an IVF cycle."

Today is Rainbow Baby Day – a moment to think about all the rainbow babies in the world, as well as take the time to remember the siblings who came before them and sadly aren't with us any more.⁠
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Here at The Evewell, Rainbow Baby Day is also a day to thank the incredible teams who have worked tirelessly to research and provide care and support to parents, helping bring rainbow babies into the world. ⁠
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Within this community, we thank and for their research and constant support to women and couples going through baby loss. ⁠
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We know that for a lot of people in this amazing TTC community, today can be tough. So please know, that wherever you are on your journey, you’re not alone and your experience matters. We see you and we’re here for you.⁠

5️⃣ Essential questions to ask your IVF doctor. "How is the embryology team set up?"

explains the importance of the embryology team in your IVF cycle.

"The embryology team play a huge part in the success of your treatment — you should be able to know more about them.

If you don't have an embryology consultation as part of your IVF treatment, like we do at The Evewell, you should ask your consultant the following questions.

- What technology do you have in the lab?
- What do you do with atypically fertilised embryos?
- Do you have timelapse incubators, and can you see the embryos developing?
- How do you choose which embryos to transfer?
- How do they know if they are normal or not?
- How experienced are the lab team?
- Are the lab team available to speak with?"

4️⃣ Essential questions to ask your IVF doctor. "Do you run a 7-day service?"

explains why your treatment shouldn't be compromised by clinical opening times.

"Your treatment should not be affected by the work patterns of the clinic staff. The human body does not have an in-built calendar and embryos do not know it’s the weekend or a bank holiday.

If you are told you can’t have a blastocyst stage transfer at the clinic because it falls on a Sunday then the clinic shouldn’t be offering blastocyst culture, at all.

Equally, if you go to a clinic for a particular treatment e.g. PGT-A, this plan can’t be changed because the biopsy falls on the weekend — that’s not your fault."

3️⃣ Essential questions to ask your IVF doctor. "What is your multiple birth rate?"

"There are many potential medical complications that come with multiple pregnancies, for both mother and babies," explains.

"Multiple pregnancies are dangerous for both the mother and babies, as well as put a strain on the NHS when babies are born prematurely. The risks are 10x compared to a singleton pregnancy.

Before your consultation, look at the clinic’s multiple birth rate. A multiple birth rate above 4% is worrying. Rates above 8% raise big red flags!

Good questions to ask are:

- Why is your multiple birth rate so high?
- How many embryos would you put back inside me?
- And then challenge them on why, if they suggest two or more."

2️⃣ Essential questions to ask your IVF doctor. "What are your success rates?"

"Clinics choose which success rates to publish," explains. "Some publish their success rates on pregnancy rates and some on live births per embryo transferred.

But before we go on, we need to clarify something.

Pregnancy rates = a positive pregnancy test (not necessarily a live birth)
Live births per embryo transferred = numbers of babies born for every embryo transferred (not per embryo transfer event – as there may be multiple embryos transferred at a time) – see my point below *

These two success rates can’t be compared, therefore you can’t compare clinics if they report differently.

Pregnancy rates and babies born are both important measures of success, however, the chances of creating embryos to be transferred is more important, as without this you don’t fall into the published statistics.

A good question to ask is:

How many patients do not have embryos to transfer when having treatment?

* Be mindful of clinics that cherrypick the results they choose to show you. Remember you went there for a baby, not a pregnancy. They are not the same thing!"

1️⃣ Essential questions to ask your IVF doctor. "Will you treat me?

This is the most important starting question:

“Considering my circumstances: my AMH, my age, and my context, will you offer me the treatment I need/want to have?”

IVF is all about context, or it should be. And when choosing a clinic, you need to understand if the clinic can support your medical context.

For example... do they offer the right level of anaesthetic support (some clinics won’t treat you if your BMI is above a certain level).

Do they offer certain embryo genetic testing, if you know you need this.

And some clinics won't treat you if your AMH is below a certain number, or if your egg collection numbers look low. It affects their success rates too much... yikes.

🤨 Ever wondered what are the essential questions to ask during your IVF consultation... Read on...

The questions you ask in the first few meetings with a fertility clinic can help you decide whether you feel comfortable to proceed – or not. Emma Whitney, The Evewell Head of Embryology and Genetics (aka ) is taking over our Insta for the next week or so, helping to explain the essential questions YOU need to ask during your IVF consultation, so you get all the information you need before committing to treatment.

“I’ve done a lot of podcasts, webinars and Instagram Lives recently, and the one common theme is that patients don’t know what to ask in their first consultation with a doctor.

The questions you ask in the first few meetings with a fertility clinic can help you decide whether you feel comfortable to proceed with the information you have been given. You’re going to spend a long time in this clinic, so it’s important you feel supported and informed.

So here is my list of honest, unfiltered questions that, not only do you need to know the answer to, but a list of questions that you should be free to ask and should receive reasonable and honest answers to allow you to feel informed.... Stay tuned over the next week and I'll break them down, day by day."

https://www.evewell.com/support/essential-questions-ask-ivf-consultation/

The journey to becoming a solo mum by choice may be full of ups and downs, but it can be a fulfilling one when approached with a positive outlook. ⁠
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It's important to remember that you're not alone and that there's support available to you. Make time to connect with other solo mums by choice, get involved in online communities, and cherish the support of your family and friends. ⁠
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Finally, remind yourself of the reasons why you're on this journey and focus on the joy and fulfilment that will come from it.

How do you go about choosing donor s***m if you want to be a solo mum by choice?⁠
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Choosing the right donor s***m is crucial when deciding to become a solo mum by choice. It's important to do your research, understand the different s***m banks, and select the right donor for you. ⁠
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When choosing a donor, consider your values, beliefs, and traits. Some women may want to choose a donor whose personality and interests align with theirs, while others may focus more on physical traits such as hair and eye colour. ⁠
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Other considerations can be access to information about the donor as well as medical history. In the UK, all donors have to comply with UK legislation meaning they provide their ID. This means that donor-conceived people can learn the identity of their donor when they reach 18.⁠
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It's important to remember that there's no right or wrong way to choose a donor; the most important thing is that you are comfortable with your choice and that you can explain that to your children.⁠
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See linkinbio to read our article on selecting donor s***m.

Financial considerations when becoming a solo mum by choice⁠
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Becoming a solo mum by choice comes with financial responsibilities. It's important to map out a budget, identify your potential expenses, and explore your options for financial assistance and benefits. ⁠
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Make sure you explore all your options by talking to your doctors, lawyers, and financial advisors as well as other people who have been through the process. Consider the different options for fertility treatments and explore the potential costs. ⁠
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You may also want to research grants and charity organisations that offer financial support to women choosing solo motherhood.

Building a support network before and during your journey to become a solo mum by choice is paramount. This will help you cope with the emotional, physical, and financial challenges that come with this decision.

Your support network might consist of close family and friends, but you may also consider joining a community of solo mums by choice or connecting with other on Instagram.

By connecting with women who share the same journey as you, you'll find genuine understanding and support.

In Mel’s downloadable ‘Building Your Solo Parent Support Network’ booklet, which you get as part of the Thriving Solo Membership (£2.99 per month), she provides various tips on how to build your support network as well as a monthly community call to hear from and meet other solo mums by choice.

Here are some other tips from Mel:

• You might not know up to 80% of your support network before you start the journey as you meet people on the way
• Learn and practise how to ask for help
• Connect with other solo parents who get your situation
• Be honest with people about what support you need

Deciding to become a solo mum by choice is a huge commitment and a responsibility that can bring a lot of fears and doubts. ⁠
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It's important to have a good grasp of your thoughts and feelings before jumping into such a significant decision and address concerns regarding your support network, financial situation, and overall readiness for parenthood.⁠
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Mel offers; “I also recommend using a coach or counsellor. We run a Choosing Solo Group Coaching Course, where we go through all the fears and considerations you might have about becoming a solo parent.⁠
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It might also be worthwhile spending time with other solo parents to get a real insight into what it is like. You can find both online and in-person networks on The Stork and I Facebook Group and also through the Donor Conception Network. ⁠
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A few more books I recommend are: ⁠
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• Women Without Kids by Ruby Warrington ⁠
• Choosing Solo by Genvieve Roberts'

Mel’s first bit of advice is to research donor conception and listen to the voices of donor-conceived people. You can listen to donor-conceived guests on The Stork and I podcast and find additional resources on her Solo Parent Membership Site (see linkinbio).
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Mel also says: “I recommend you also hear about other solo parents’ experiences on podcasts, Facebook groups, and Instagram. ⁠
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A few recommended books to read are: ⁠
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• Research about the impact of donor conception - We Are Family by Susan Golombok ⁠
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• Research on the expectations of 21st Century egg and s***m donors and the impact of donating Donors: Curious Connections in Donor Conception by Petra Nordqvist and Leah Gilman⁠
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• Lived experience of a donor-conceived person raised by a solo parent - Chosen Family by Kiara Shuh⁠
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Another great resource for Solo Mums to Be is Paths to Parenthood, an online resource for donor conception run by Becky, aka on Instagram. You’ll find access to resources to help you and your family understand the many facets of donor conception."

Becoming a solo mum by choice is a decision that comes with a lot of thought, planning, and emotions. While it can be an overwhelming and daunting journey, it can also be a wonderfully fulfilling and empowering experience. ⁠
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We asked the UK’s first and only Solo Parenthood Coach, Mel, who runs solo motherhood parenting support group The Stork and I, for her practical tips and advice on where to get started if you want to become a solo mum by choice.⁠
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Mel supports single women looking to build their families worldwide and is keen to ensure they don’t miss out on parenthood.⁠
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Having been on her solo motherhood journey, and now mum to Daisy via IVF and donor s***m, Mel coaches thousands of women on the path to solo parenthood, by providing both one-to-one and group coaching to single women, enabling them to feel empowered and in control of their route to parenthood.

“The Evewell, couldn’t have done it without you guys! Whoever picked this embryo out, THANK YOU!!”

“I had a really helpful and containing consultation with my consultant - she was very knowledgeable, personable, kind and I felt like she genuinely cared.”

“When you are told you have a 1% chance of having children and then start IVF, it is very intimidating and scary and the process itself is gruelling but I couldn’t speak more highly of The Evewell, from the reception staff to the embryologists, everyone was supportive, sympathetic, and kind and made it such a positive experience even when there was bad news, and most importantly they gave us the biggest gift.

Hopefully, this helps anyone else going through or about to embark on this journey.”

“5 stars aren’t enough. If I had a chance, I’d put 100.

My husband and I can’t describe how grateful we are for the team at The Evewell for making our dream come true.

Special and big thanks to our consultant, embryology team and nurses for all your care and support during our difficult time. We do appreciate your hard work.

Thank you for being part of our lives. ❤️😍”

“The moment our life changed forever, the day we dreamt of for so many years, the day that our broken hearts were no longer broken, the pain went away and we have never felt love like it!

This day was the best day of our lives and we are so grateful to our clinic The Evewell who made our miracle happen.”

“We are forever grateful to The Evewell for helping us realise our dream with the birth of our baby boy.

Everyone at The Evewell was superb, supportive and very positive - from our main consultant to the wonderful nursing and midwife team always ready to help us, the brilliant embryologists, the reception team and all the other kind and caring staff.

They made our whole journey feel pleasurable rather than daunting, with constant updates, advice and options. Thank you so much for everything”