Women are usually aware that their fertility will take a downward turn after 35, but there may be many factors – social, educational or financial – dictating a delay in starting a family. With advances in cryopreservation and IVF techniques, egg freezing is becoming an increasingly viable option for women who want to preserve their reproductive potential.

Will egg freezing work?

Many women have benefited from freezing their eggs: over 2000 babies have been born this way. However, unless you work for Apple or Facebook (who announced in 2014 they were offering egg freezing as an employee benefit), the process requires a financial commitment, roughly costing £5000. It is therefore important that anyone considering this route understand what is involved, what are the chances of success and what they can do to improve their prospects. The earlier the eggs are collected the better: the ideal age for egg collection is when a woman is in her mid twenties to early thirties. Clinical pregnancy rates from frozen eggs are approximately 35% – but this decreases for women over 35 years old. During a consultation with female gynaecologist Miss Amanda Tozer, you will discuss all aspects of egg freezing, including success rates and what it will require of you physically and emotionally. London-based Miss Tozer will also be able to advise on lifestyle changes that can improve the quality of your eggs and, in turn, your chances of success.

What should I look for in a fertility clinic?

Egg freezing is regulated in the UK by the Human Fertilisation and Embryology Authority (HFEA) so ensure your clinic is registered. Your choice of specialist is also important as the process makes demands of your body and you will value being in the care of an attentive professional. At her London fertility clinic, Miss Amanda Tozer offers individualised care, personally guiding her patients through their egg freezing with honesty and reassurance.

Fibroids are benign tumours that grow out of uterine cells, ranging from pea-size to that of a melon, and they tend to swell when oestrogen levels are high. An estimated one in four women will have a form of fibroids during her life, although many do not suffer any symptoms so will not be aware of them. The impact fibroids have depends not just on the size of the growth but on the location and type, too. Intramural fibroids are the most common, forming in the muscle wall, causing heavy, painful periods. Submucosal fibroids grow under the lining (endometrium) of the womb and are the most likely to affect fertility.

How can fibroids be a barrier to pregnancy?

It is rare for fibroids to present a serious obstacle to conception. Complications most commonly arise when submucosal fibroids protrude into the womb, distorting the uterus and potentially interfering with embryo implantation. They may do this by reducing the blood flow which would make the uterine lining inhospitable to a fertilised egg. Very rarely, fibroids are associated with miscarriage. A woman who has fibroids can have a normal pregnancy and birth, but surgical resection of the fibroids may first be required.

What are my treatment options?

In very few cases fibroids alone are a factor in infertility, but if you know you have a fibroid and you are experiencing difficulty in conceiving it is advisable to seek the guidance of a specialist such as female gynaecologist Miss Amanda Tozer. At her London fertility clinic, Miss Tozer can use ultrasound to diagnose fibroids and evaluate the implications of their number, location and size. She will talk you through your options; these may include a hysteroscopy during which the fibroid is shaved off. As a consultant gynaecologist with a sub specialist in reproductive and minimal access surgery, Amanda Tozer is able to offer her patients the full range of treatments at her central London clinic.

For couples coming to terms with the idea that conceiving a baby may not happen naturally, the next stage may be fertility treatment. Friends and family will often ask, ‘have you thought about IVF?’ – but what does it actually involve and are there intermediate steps? The first and most important action is to see a specialist such as London female gynaecologist Miss Amanda Tozer sooner rather than later. Until the cause of your infertility is diagnosed, relevant treatment cannot be planned. There may be a more suitable type of fertility treatment, such as ovulation induction or intrauterine insemination (IUI).

What does IVF involve?

There are three stages to IVF (in vitro fertilisation) treatment. At stage one, the woman has a course of hormones injections to stimulate the ovaries. At stage two, eggs are collected surgically and the man produces a semen sample. The woman is then given progesterone to prepare her body for implantation. Stage three occurs in the laboratory: the woman’s eggs are fertilised by the man’s sperm in a petri dish. Embryo development is monitored closely and, after 3–6 days, good quality embryos are implanted in the uterus.

Don’t feel daunted

Just as many people are familiar with the term ‘IVF’, the process is well known for putting stress on a couple who are longing to have a baby. A woman going through IVF will endure many physical demands on her body, including those caused by the hormone medication; anxiety is common to both men and women at this time. At her London fertility clinic, Miss Amanda Tozer aims to remove as much stress as possible from the process by offering a compassionate, one-to-one service, personally performing each step of the IVF and by always being available on the phone to answer any questions, big or small.

Polycystic ovarian syndrome is an endocrine disorder estimated to affect 5–10% of women. Here are six things you may not already know about PCOS:

  1. One in five women have polycystic ovaries. While PCOS itself is not uncommon, an even greater number of women will have polycystic ovaries; this is where the ovaries contain numerous harmless cysts measuring up to 8mm. More than half of those affected will experience no symptoms at all.
  2. PCOS can knock self-esteem. With appearance-affecting symptoms such as facial hair, alopecia or thinning hair, oily skin and weight gain, it is a condition that can significantly dent self-confidence.
  3. PCOS can cause reproductive problems. High levels of androgens in the body can negatively affect the reproductive system, causing symptoms that include pelvic pain, ovulation problems, irregular or painful periods, and infertility.
  4. Pregnancy is still a possibility. A common problem for women with PCOS is irregular ovulation, and it is this that brings many women to London female gynaecologist Amanda Tozer’s fertility clinic. The good news is that most women respond positively to fertility treatment and are able to have a family. Famous women who have become mothers in spite of their PCOS include Emma Thompson, Jools Oliver and Victoria Beckham.
  5. A healthy lifestyle is important in managing PCOS. Women who have PCOS have an increased risk of developing long-term problems including cardiovascular diseases and type 2 diabetes – and these are more likely in those who are overweight. Exercise and good nutrition are vital in the successful management of the condition.
  6. Polycystic ovarian syndrome is treatable but not curable. Specialists like London-based Miss Amanda Tozer can help women manage their PCOS symptoms through medication and guidance on lifestyle changes. A gynaecologist with much experience of helping women with PCOS achieve a family, Miss Tozer can also guide you through your fertility treatment options.

The belief that Well Woman Screening is relevant only for older women is a misconception. While the risk of many specific conditions does increase with age, a woman’s gynaecological health during her reproductive years is also of vital importance. The reality is that you are never too young to start taking care of your health. The purpose of screening is to flag up potential concerns; it may inform you that lifestyle changes are required, or that other preventative measures would be advisable.

Which conditions should I be screened for?

Female gynaecologist Miss Amanda Tozer offers the full range of screening tests at her London clinic, as well as a choice of three Well Woman Screening packages. Miss Tozer will gladly advise you on which type of screening is most appropriate for you, taking into account your age and both your personal and family medical history.

Standard tests include full blood count, liver and renal function test, blood pressure, glucose and cholesterol levels and urinalysis. Tests for early indications of cancer include HPV, cervical smear, faecal occult blood test, and ovarian and endometrial cancer screening. With an estimated 1 in 50 women in England living with an overactive thyroid, thyroid function is another important test; so, too, is bone densitometry.

I don’t think I want to know…

Feeling nervous when attending your Well Woman Screening is a very natural emotion; indeed some women wonder if they would rather not know that they are more likely to develop a condition in later years. However, as Miss Amanda Tozer explains to her London patients, knowledge is power: being aware of risks gives you the opportunity to manage and, potentially, to decrease them. With individualised screening in a reassuring and specialist environment, you can feel confident about taking charge of your feminine health.

Everything you need to know about the hycosy test:

What is it?

‘Hycosy’ is a contraction of the full name ‘hysterosalpingo contrast sonography’. Also known as a tubal patency test, it is a non-invasive ultrasound test to check the fallopian tubes for blockages or damage. Its purpose is to ascertain whether an egg can pass safely and easily through the fallopian tubes during ovulation. Furthermore, the procedure can assess the uterus, identifying congenital uterine abnormalities by ultrasound.

When do I have one?

A hycosy should be carried out somewhere between day 6 and day 12 of your period, depending on the length of your cycle.

What does a hycosy test involve?

The first step is a transvaginal ultrasound to assess the pelvis. Then a small catheter is inserted through the vagina, the cervix and then into the uterus. Initially, saline is instilled through the catheter, enabling the uterus to be visualised, after which a gel is instilled; this gel (sometimes referred to as a ‘contrast medium’) is visible by ultrasound and your gynaecologist can see if it travels unimpeded through the fallopian tubes.

The whole procedure takes just 10 to 15 minutes. To safeguard against infection, you will be prescribed a three-day course of antibiotics. It is a highly skilled procedure and should only be performed by a trained specialist. London female gynaecologist Miss Amanda Tozer offers hycosy in addition to the full range of fertility screening tests and treatments at her Harley Street clinic.

Is it painful?

You may experience some mild discomfort while the saline is instilled and some period-like cramping. To ease this, Miss Tozer recommends her patients take paracetamol or ibuprofen at least 30 minutes before the procedure.

When will I get the results of my hycosy?

At her London fertility clinic, Miss Amanda Tozer will share the results with you immediately and discuss their implications.

Starting a family is not always a straightforward affair. In fact, one in seven couples in the UK experience problems with infertility. For couples struggling on only to face disappointment month after month, conceiving can be a devastating time, causing emotional distress and putting strain on relationships.

Seek specialist help if having difficulty conceiving

There are many underlying causes of infertility, but until these are diagnosed, no targeted treatment can be prescribed. The sooner you can see a fertility expert, the sooner you can hope to have some answers – although it is important to bear in mind that some cases of infertility remain, frustratingly, unexplained. Age does not improve our fertility so prompt action is advisable.

London female gynaecologist Miss Amanda Tozer sees many couples who are desperate to conceive, and with both her specialist knowledge and compassionate, personalised approach, she has helped them through the potentially bewildering process of fertility treatment. During a consultation at Amanda Tozer’s Harley Street clinic in London, you and your partner will undergo diagnostic tests, the results of which will be quickly available.

What are the common causes of infertility?

There are many possible factors adversely affecting fertility. For women, these include ovulation disorders (e.g. premature ovarian failure, PCOS, thyroid function), damaged fallopian tubes, pelvic inflammatory disease (PID), endometriosis, fibroids, and cervical mucus defect. For men, their fertility may be hampered by low sperm count or decreased sperm mobility, or testicular damage. The underlying cause of your infertility may be lifestyle factors: being very over- or underweight, often stressed, a smoker or having a history of sexually transmitted infections (STIs) can all play a part.

The important thing is to seek specialist help to find out if there is a reason for your not having conceived thus far. Knowing what it is, and if it is treatable, means you are better able to move on from worrying in the dark to embarking on positive action.

Common in women of reproductive age and often symptom-free, an ovarian cyst is a fluid-filled sac that has developed on the ovary. They are usually harmless and will often clear within a few months; some women will not even know they have had an ovarian cyst. If the cyst is very large or has split, it can cause problems including pelvic pain and bloating, and may affect your bowel and urinary function.

Women presenting at London female gynaecologist Miss Amanda Tozer’s clinic will undergo a pelvic ultrasound during which ovarian cysts may be diagnosed. Very occasionally a cyst will display suspicious features; in these cases, an MRI scan will be performed and a blood test taken for CA 125 level.

Can I just leave ovarian cysts?

Depending on the nature of the ovarian cyst, it may be appropriate not to intervene at all; simple and haemorrhagic cysts (particularly if they are no larger than 5cm) would fall into this category. In post-menopausal women, where the risk of ovarian cancer is slightly higher, a year of regular ultrasound scans and blood tests may be recommended in order to monitor the cyst. Endometriotic and dermoid cysts do, however, necessitate being removed surgically as they will not resolve themselves. This will usually be done by keyhole surgery.

Will ovarian cysts affect my fertility?

In some cases, ovarian cysts may make it harder for you to conceive but they do not usually prevent pregnancy. Indeed, sometimes it is that difficulty in getting pregnant that impels couples to consult fertility experts such as Amanda Tozer for further investigation – and here cysts are diagnosed. During treatment, your surgeon will aim to keep your ovaries intact, preserving your fertility.

Before proceeding with any treatment at her clinic in London’s Harley Street, Miss Tozer will discuss the impact your individual procedure could have on your fertility and ensure you understand what is involved.

Endometriosis is a gynaecological condition affecting around one in ten women. It occurs when endometrial cells form outside the womb, often on the ovaries. These cells respond to hormonal changes and can cause significant pain, usually around the time of menstruation. Endometriosis does not just affect a woman physically: it can have a negative impact on relationships and on social life, often making one feel removed and isolated.

See a specialist

If your endometriosis is adversely affecting your life, speak to your GP about seeking the advice of a specialist. Miss Amanda Tozer, a female gynaecologist based in London’s Harley Street, treats many women with the condition every year. Endometriosis can have an impact on fertility and this is often a trigger for women attending Miss Tozer’s clinic, but many of her patients simply want to find a way of managing the condition, minimising the role it plays in their lives. During your consultation, Miss Tozer will ask you about your symptoms and your periods before conducting a pelvic examination and an ultrasound. She may recommend a laparoscopy.

How is endometriosis treated?

When the extent of your endometriosis has been ascertained, your specialist will talk you through your options. For three in ten of those suffering with the condition, it will improve with no treatment at all; however, if you are seeking specialist help then you are probably beyond that, and beyond taking over-the-counter painkillers to manage the pain. Your other options include hormone treatments to limit the production of oestrogen, and surgery to remove the endometriosis tissue. The type of surgery will depend on the location of your endometriosis.

Compassionate and reassuring in her approach, London female gynaecologist Amanda Tozer will discuss her recommended treatment plan at length with you, helping you to fully understand your options and ultimately to alleviate your symptoms.

Research suggests that one in seven couples experience infertility. Through a systematic process of diagnosis many causes of these problems can be addressed and the dream of a baby be realised. At London female gynaecologist Amanda Tozer’s fertility clinic, many couples have been successfully treated for their particular condition.

A wide range of treatments

At her London fertility clinic, Amanda Tozer offers the full range of fertility treatments. These include ovulation induction, intralipid infusion therapy, hormone balancing drugs therapy, endometrial scratching, tubal patency tests, saline sonography and reproductive surgery (removing patches of endometrial tissue from the ovaries, for example).

She also offers the full range of assisted conception treatments: intrauterine insemination (IUI), a low tech form of assisted conception where a small volume of highly motile sperm is placed high into the uterus via a catheter; in vitro fertilisation (IVF) where eggs are collected and fertilised in the laboratory with embryos transferred to the womb 2–5 days later; if this does not yield success, intracytoplasmic sperm injection (ICSI) may be appropriate, involving the injection of just one sperm directly into the egg.

One-to-one individualised IVF treatment

At her Harley Street clinic in London, highly experienced female gynaecologist Amanda Tozer adopts a methodical process of diagnosis and treatment. At your consultation you will discuss your medical history and undergo a series of diagnostic tests, including a pelvic ultrasound and sperm analysis. It is only by discerning the cause of the infertility that the problem can be addressed. Miss Tozer can then talk you through your fertility options which she will do at length, describing potential side effects and just what you can expect of the process.

Under Amanda Tozer’s care you are guaranteed continuity of care with Miss Tozer personally performing each step and always being at the end of the phone to answer your questions, however small, along the way.