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.

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.

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.

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.

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.