It is not just the financial aspect that causes some couples to stall before embarking on IVF treatments but the fear of the process, too. While their eyes may be firmly focused on the hope of a baby at the end of it, many women are nervous about the side effects of fertility drugs and feeling out of control of their emotions.

There are many stressors at play

Undergoing any kind of fertility treatment is undoubtedly stressful. It will come on the back of many months, and possibly years, of dashed hopes; this itself can cause havoc with a woman’s emotional state, but commonly puts stress on a couple’s relationship, too. The aim of fertility drugs is to stimulate ovulation production, and the resulting fluctuating levels of hormones are likely to have a negative effect on mood. Some women fear this will exacerbate the existing levels of psychological distress.

Find the right specialist for you

During this unsettling time, comfort can be drawn from being under the care of a specialist with whom you enjoy a good rapport. London female gynaecologist Miss Amanda Tozer has helped many couples through their fertility treatment. At large fertility centres, the process can, at times, feel impersonal and you are likely to see several different doctors.

At Miss Tozer’s London fertility clinic you will receive personalised, one-to-one care which patients tend to find comforting. Miss Tozer talks couples through every step of the process, performing all procedures herself, and giving each patient her personal phone number, encouraging them to call with any query, however minor. She will discuss the side effects of any fertility treatments, describe how you they might affect your mood and can offer counselling, too. Amanda Tozer has many years’ experience of helping couples through this potentially bewildering and stressful time, and does so with compassion and reassurance, minimising stressors wherever possible along the way.

The menopause can be a trying time. There are a few lucky women who don’t experience any symptoms but for others they can be severe and debilitating. Common menopausal symptoms include headaches, hot flushes, depression, night sweats, changes to hair and skin, osteoporosis, loss of libido and vaginal dryness. While there isn’t a cure for the menopause itself, there is certainly help out there to help you manage its side effects.

Book a consultation with a menopause specialist

A menopause specialist such as London female gynaecologist Amanda Tozer can give you the support you need to help you through this testing time. Hormone replacement therapy (HRT) is usually the only possible way of alleviating all symptoms, and this may involve trialling a variety of combinations.

At your consultation, Miss Tozer will conduct a physical examination a run any necessary tests to assess your health and suitability for the treatment. She will also talk you through the associated side effects and much publicised health risks. These include a slight increase in risk of breast or ovarian cancer, stroke, deep vein thrombosis and blood clots; however, HRT can reduce the risk of bowel cancer and the risk of osteoporosis-related fractures. While there are risks, most experts now agree these are outweighed by the benefits if HRT is used only on a short-term basis of a maximum of five years.

I’d rather not have HRT…

For those who wish to avoid HRT there is a range of alternatives. These include medication such as anti-depressants, clonidine and gabapentin, and complementary therapies such as red clover and evening primrose oil. At her London menopause clinic, Miss Amanda Tozer can advise on how these can treat individual symptoms and discuss their effectiveness and safety issues, too. Furthermore, Miss Tozer can offer guidance on the lifestyle changes that have been found to have a positive impact on menopausal symptoms.

Couples who are desperately trying to have a baby will usually say ‘we’ll try anything’ – so when they see a story in the press about couples who have conceived after an intravenous infusion of ‘egg yolk extract and soya bean oil’, their interest is piqued. When they present at female gynaecologist Amanda Tozer’s London Fertility Clinic, they want to know if it is a treatment that could help them – and how does it work?

Who can benefit from intralipids?

In some cases of recurrent miscarriages or multiple failed IVF or IUI cycles, the cause is natural killer (NK) cell activation. With this condition, the uterine and peripheral natural killer cells react abnormally to the implantation of an embryo: the woman’s immune system goes into overdrive when it interprets the embryo as an invading cell and sends signals to the body to attack it – and, ultimately, to miscarry. Intralipid is a fat emulsion that is used to provide essential fatty acids and calories for intravenous nutrition, commonly used in patients who are unable to eat normally.

Crucially, intralipids have been shown to have a stabilising effect on cell membranes, thereby suppressing natural killer cell toxicity. Research has suggested that women experiencing recurrent miscarriage and repeated IVF/IUI disappointment may benefit from immunotherapy using intralipids.

How do I access this treatment?

Two doses of intralipids are given via an intravenous infusion as an auxiliary treatment in an IVF cycle; the first between five and ten days prior to embryo transfer and the second, five to seven days after a positive pregnancy test. Miss Amanda Tozer offers this treatment at her London Fertility Clinic where she assists many couples with a wide range of infertility problems. This treatment is not exclusive to Miss Tozer’s IVF patients but also available to those receiving IVF elsewhere.

Fertility problems can lay enormous stress on a couple’s relationship: many months, or even years, of dashed hopes can lead to strained relations and often recriminations, too. When couples attend Amanda Tozer’s London Fertility Clinic, she is very aware of their journey so far.

We’re both nervous…

A frequently voiced concern is that while a couple wants to know why they aren’t getting pregnant so they can do something about it, they are afraid of finding out. How will it affect their relationship? What if it is untreatable?

London female gynaecologist and fertility expert Amanda Tozer has helped many couples at this most stressful of times, treating each couple as an individual case, and talking them through every step of the way. Testimonials from her previous patients cite her personal attention, compassion, and even humour as reassuring factors during their treatment.

What happens at the consultation?

During your consultation at Amanda Tozer’s London Fertility Clinic, you will share your full medical history and then undergo diagnostic tests to identify the cause of the infertility. These include a pelvic ultrasound to identify any abnormalities, hormone level tests to identify an imbalance, tubal patency and sperm analysis. There are many other tests that can be run, depending on your individual case.

When armed with the facts, Miss Tozer will talk you through your options, explaining in detail what each approach entails and its pros and cons. Amanda Tozer offers her London patients a specialised one-to-one service; contrary to what you might experience in a large clinic, Miss Tozer will personally carry out each step of your fertility treatment: the scans, the egg collection, the embryo transfer, and so on.

Furthermore, understanding just what a bewildering process fertility treatment can be, Amanda Tozer encourages her patients to contact her directly on a personal phone number with any questions they have, no matter how small.

Although a laser treatment aimed at reversing vaginal atrophy might sound extreme and possible painful, this quick and relatively painless procedure could prove life changing for many thousands of women in the UK.

The ageing process can be cruel. For women it’s often not just the case of lines or wrinkles on the face and body as skin starts to sag, but a further, rarely discussed ageing problem is vaginal atrophy and laxity.

Often associated with the menopause, this condition is caused by the decline in the hormone oestrogen. The consequences of loss of oestrogen in relation to the vagina are as follows:

  • weakness of the vagina lining, called the mucosa
  • dryness and itching
  • pain during sexual intercourse

As a leading female gynaecologist, Miss Amanda Tozer has a number of treatment options that can help to relieve this problem, but the recent FDA clearance for the MonaLisa Touch laser was of great interest.

This fractional CO2 laser rejuvenates the vagina by stimulating the production of collagen, hyaluronic acid, glycosaminoglycans and proteoglycans, all of which we lose during the menopause. The aim is restore younger, healthy, pre-menopausal tissue.

Added benefit: reversing mild urinary incontinence

A further benefit of the MonaLisa Touch is that it can be used to treat mild incontinence that is a common side effect of vaginal laxity. Recent studies have shown that the new, stimulated vaginal tissue can help re-establish the functionality of the urogenital structures. Reversing this problem can have a profound impact on quality of life for the sufferer.

What to expect from my MonaLisa Touch procedure?

The procedure is relatively painless; it is recommended to have three, three-minute laser sessions, four to six weeks apart. No anaesthetic is required and there might just be a slight discomfort immediately after your session. Miss Tozer will advise you on what to expect and how to look after yourself in the recovery period.

To find out more about MonaLisa Touch and its many benefits, call Miss Tozer’s practice manager Lynne Bowen on 020 7034 6240 or email a.tozer@thelondonclinic.co.uk.

While stories of octuplets make for great news stories, fertility doctors advise returning a low number of fertilised eggs to the womb because of the associated complications. The UK regulating body, the HFEA, stipulates that women who are 40 and over can have up to three embryos transferred, but that women under 40 receive a maximum of two – and indeed say clinics should be encouraging their patients to choose a single embryo transfer.

What are the risks of twin and triplet pregnancies?

There are a range of risks to the mother associated with carrying and delivering multiple babies, including hypertension, gestational diabetes, pre-eclampsia and complications requiring a C-section delivery. A singleton baby is usually carried to full term but multiple babies tend to be born premature and underweight. A very low birth weight can lead to, among other complications, respiratory problems, lower IQ and delays in language development.

Surely transferring multiple embryos improves my chances?

It has been shown that replacing two embryos rather than one in women over the age of 40 does lead to an increase in the chance of pregnancy being realised; furthermore, that pregnancy is most likely to be a singleton pregnancy. However, in women under 40, the chance of pregnancy is not increased by replacing two embryos, but the risks of a multiple pregnancy are increased – and, for women under 37, this is even more so the case. During your consultation at her London fertility clinic, female gynaecologist Miss Amanda Tozer will discuss with you the implications pertinent to your individual case, explaining that a woman’s age is not the only determining embryo transfer factor, but the quality of embryos and number of previous failed cycles counts, too. Offering reassurance and one-to-one care, London-based Miss Tozer has guided many couples through this anxious time, ensuring they have all the facts they need to make informed assisted conception decisions.

For many women, the irregularity and heaviness of their periods or the occurrence of intramenstrual bleeding can cause frustration, pain and even distress. Irregular bleeding is usually secondary to either a pelvic condition such as polyps or endometrial fibroids, or to a hormonal problem. By seeking the advice of a specialist such as London female gynaecologist Miss Amanda Tozer, the causes of your irregular bleeding pattern can be diagnosed and, in many cases, a simple treatment prescribed.

What tests will I have?

At her clinic in London’s Harley Street, Miss Amanda Tozer will check for cervical abnormalities and conduct a pelvic ultrasound, identifying any pelvic pathology. She will also run tests for hormone imbalances. In some cases it will be appropriate to conduct a saline sonography whereby any hidden abnormalities in the uterine cavity become evident. If you are over 40, Miss Tozer may recommend a hysteroscopy which enables further investigation to ensure that nothing has been missed.

What are my treatment options?

If the investigations reveal the presence of endometrial polyps, a minor operative procedure – a hysteroscopy and polypectomy – can be performed to remove them. The treatment of fibroids (benign tumours) depends on their type, location and size. In some cases, no treatment is advised but where they are considered to be posing a threat to fertility or putting pressure on an organ such as the bladder or the rectum, surgery may be advisable. Miss Amanda Tozer lists menstrual disorders as one of her main interests and she has treated many women with irregular bleeding at both her private clinic and at London’s St Bart’s Hospital where she is a consultant gynaecologist. During a consultation with Miss Tozer, you will receive clearly explained specialist advice and be given compassionate, reassuring and personalised care.

Encountering fertility problems when you are trying to conceive a baby can make life very stressful – and the last thing you need is further anxiety over which fertility treatment provider you should choose. Here are five considerations to help you in your decision.

1. What are their qualifications?

Knowing that you are in the care of someone with specialist fertility training and a history of success in helping couples to conceive will give you confidence. Miss Amanda Tozer, a consultant gynaecologist at St Bart’s since 2004, is accredited by the RCOG in Obstetrics and Gynaecology, Subspecialist in Reproductive Medicine and Minimal Access Surgery.

2. Are they regulated?

Check your clinic is licensed by the HFEA (Human Fertilisation and Embryology Authority), the government body in charge of administering and regulating UK fertility clinics.

3. Are there hidden costs?

Financial concerns inevitably make a situation even more stressful so knowing just what the costs are is imperative. At London female gynaecologist Amanda Tozer’s clinic, you will be provided with a fully costed fertility treatment plan, including any necessary medical reports and tests, consultations and counselling.

4. What kind of care will I receive?

Large clinics can often feel impersonal, especially when you see a different doctor at each appointment. At Miss Amanda Tozer’s London fertility clinic you are guaranteed one-to-one care. Miss Tozer creates individualized treatment plans, seeing couples prior to treatment to discuss options, and she personally performs the various procedures along the way: the scans, the egg collection and embryo transfer, and the early pregnancy scan. She provides her patients with her personal telephone number and encourages them to contact her with any queries, no matter how small.

5. Was I made to feel comfortable?

Finally, a good test of a fertility clinic is how you felt during your consultation. Were you made to feel safe, reassured and less mystified about the journey ahead?

For around one in seven couples, starting a family is not an easy process but one that can take months, or even years. For every 100 couples trying to conceive naturally, 84 will do so in the first year, 92 within two years and 93 within three – so there are many other couples out there who are going through a similar ordeal.

When should we seek specialist help for fertility issues?

If you are concerned about your fertility, the first port of call is your GP who will then refer you on to a specialist. The general advice is that women under 35 should allow a year before seeking help, while women 35 and over do so after a shorter period of six months. An NHS consultation with a fertility expert such as Amanda Tozer may be an option – London female gynaecologist Miss Tozer is a Consultant at St Bart’s – but some couples do not wish to wait any longer than necessary and prefer to make a private appointment at Amanda Tozer’s Harley Street fertility clinic.

What help is available?

During your initial consultation, Amanda Tozer will take your medical history. She will run diagnostic tests to determine the underlying factors, including various screening tests and a pelvic ultrasound, and then talk you through the treatment options available to you. There are three main types of fertility treatment. The first, fertility medication, may be appropriate if you have ovulation problems; fertility drugs, such as Clomiphene, stimulate egg production, thereby improving your chances of conception.

Conditions such as endometriosis, polycystic ovaries and fibroids can be a cause of infertility; in these cases, a surgical approach can be effective. The third main type of treatment is assisted conception – IVF and IUI. These and other fertility treatment options, including egg and sperm donations, are all offered by Miss Amanda Tozer at her London clinic.

If you have undergone premature ovarian failure, egg donation may be an option. In many cases, women present at Miss Amanda Tozer’s London fertility clinic with the principal objective of receiving donated eggs as they know their ovaries have ceased to produce eggs, be it a result of premature menopause or cancer treatment, or that their ovaries have been surgically removed. In some cases, however, unsuccessful IVF treatment has revealed that the patient’s ovaries are producing too few eggs of sufficient quality to result in a healthy embryo and Miss Tozer may suggest egg donation be considered.

Where do the donated eggs come from?

The demand for donated eggs outstrips supply so there are very few ‘anonymous’ donors within the UK. You either need to find your own egg donor – a sister or friend – or look abroad. If you do not have your own donor, Miss Amanda Tozer will liaise with a very reputable clinic in Athens that has good success rates. Each woman having egg donation receives eggs from a single donor whose eggs are not shared between other patients. All donors, be they a relative from the UK or from a clinic abroad, are subject to the same screening requirements and must provide the same information to the Human Fertilisation & Embryology Authority (HFEA).

What happens next in egg donation treatment?

You will be required to have various tests and investigations before proceeding, including screening tests, pelvic scan and saline scan. Semen analysis will decide whether ICSI or IVF will be the more appropriate. At large clinics, where it is not uncommon to see several different doctors, the process can feel impersonal and confusing which often adds to the stress of the situation; at female gynaecologist Miss Amanda Tozer’s London clinic, you will receive personal, one-to-one care, to guide you through your treatment.