Endometriosis is the second most common gynaecological condition in the UK affecting around one in 10 women. It is a chronic condition and the symptoms vary, often worsening with the menstrual cycle. Usually affecting women of reproductive age, one of its principal complications is a difficulty in getting pregnant.

What is endometriosis?

The endometrium is the lining of the womb. Endometriosis is a common condition where tissue that behaves like this lining is found elsewhere in the body, most commonly on the ovaries, on the lining of the pelvis and over the top of the vagina. Despite being outside of the womb, the cells of these patches of endometrium react the same way to the monthly cycle as the womb lining: by thickening in preparation for implantation, and then shedding if no fertilisation has occurred. However, with nowhere for this shed tissue to go, the result is often swelling and pain, usually in the lower abdomen or pelvic area. There is no known cure but symptoms are often managed by hormone therapy or medication. Endometriosis can sometimes damage the fallopian tubes or ovaries, thereby impeding a woman’s chances of pregnancy.

Can fertility treatment help?

Endometriosis is a common finding in patients presenting at Miss Amanda Tozer’s London fertility clinic. For women who have visible patches of endometriosis on their reproductive organs, surgery may be able to help. There is good evidence that the removal of these tissues can improve the chances of getting pregnant. During your initial consultation with highly experienced female gynaecologist Miss Tozer, you will discuss your full medical history and will undergo diagnostic tests and a pelvic ultrasound scan. Based in London’s Harley Street, Miss Amanda Tozer is accredited by the RCOG in Obstetric and Gynaecology, Subspecialist in Reproductive Medicine and Minimal Access Surgery, and well respected by her previous fertility patients for her support and attentive care.

Ovulation is a vital factor when a couple are planning a pregnancy. As the woman ovulates, she releases an egg that can then be fertilised by the sperm; fertilisation cannot occur until the egg is released. Some women do not ovulate regularly, and others do not ovulate at all. Female gynaecologist Miss Amanda Tozer treats many women at The London Clinic, helping them to regulate the ovulation process with ovulation induction, thereby increasing their chances of fertilisation.

What factors influence ovulation?

Stress, weight fluctuations and Polycystic Ovarian Syndrome (PCOS) are common factors in irregular ovulation. Among other issues, can also be caused by disorders of the thyroid or pituitary glands. During an initial consultation, Miss Amanda Tozer will take a full medical history, conduct a physical examination and run tests to inform her diagnosis; these will include an ultrasound of the ovaries and womb and blood tests.

How does ovulation induction work?

The purpose of ovulation induction is to stimulate the ovaries in order to produce a mature follicle and, in turn, egg growth, which creates a predictable window for intercourse. This is achieved most commonly by using Clomiphene, a mild fertility drug which comes in tablet form. Women take Clomiphene from day 2 to day 6 of a bleed and usually have a scan on day 10 to ensure that ovulation is going to occur and that the ovaries are not over-stimulated. If a woman does not respond to Clomiphene, daily injections of Gonadotrophins may be appropriate; in this case, scanning will be necessary to avoid over-stimulation of the ovaries.

Each woman responds differently to ovulation induction and therefore needs careful monitoring and attention. Amanda Tozer is a highly qualified female gynaecologist with many years’ experience of helping women with fertility problems. At Miss Tozer’s London clinic, you will receive individual care to guide you through this process.

Preventive Care through Well-Woman Screening Provided by Gynaecology London Specialist Dr. Amanda Tozer

Most people see the doctor only when they feel something unusual happening in their bodies. And even then, many seek medical attention only when they are already encumbered by an ailment and are no longer able to function properly. This ought not to be, for many sicknesses can be avoided through early detection and prevention. Dr. Amanda Tozer, a gynaecology London specialist, believes in prevention which is why she offers well-woman screening. Well-woman screening is a regular full check-up that focuses on preventive care. Dr. Amanda Tozer, a gynaecologist London women can trust, conducts a series of tests to determine conditions that might lead to eventual sickness, starting with a full medical history. Patients then undergo examinations, which include: blood tests and full blood count; liver and renal function tests; blood pressure; urinalysis; and breast examination. The body mass index is also taken, as well as glucose and cholesterol levels. Through these, Dr. Amanda Tozer can help determine whether a patient is at risk of a disease and recommends ways of addressing it before problems begin to occur. A change in lifestyle or diet, for instance, can have a huge impact on a patient’s wellbeing. Patients can also consider undergoing other screening tests performed by the gynaecologist London women can rely on, such as human papilloma virus (HPV), cervical smear, mammography, and faecal occult blood test. These tests greatly help in detecting precancerous cells, among other conditions. In addition, bone densinometry helps in detecting mild or severe bone loss by studying bone density; while gynaecological pelvic ultrasound can help in assessing conditions such as ovarian cyst and uterine fibroids. Prevention is still the wisest approach to any medical condition, and Dr. Amanda Tozer is ready to help. For more information about the gynecology London care provided by Dr. Amanda Tozer, please call 0207-034-6240 or visit The London Clinic at 5 Devonshire Place in London. You can find the gynecology London specialist online at https://www.amandatozer.com/.

The Daily Mail posted an article on 50 women who collectively had had 150 failed IVF treatment attempts till they were able to conceive. It was all down to a fertility treatment called Immunomodulation Therapy, costing around £7,000 a cycle. That’s around £2,000 more than conventional fertility treatment.

Immunomodulation Therapy works by flooding your bloodstreams with fatty acids which reduce the ability of the body’s NK cells to produce toxic chemicals.

These toxins can attack and reject the developing embryo as a foreign object.

The fats are about 200 calories a dose.

Administered via a drip usually twice before conception, and then three more times after, the treatment is thought to help the embryo implant and grow normally.

Alongside this, women are also recommended to take steroids, which further suppress the immune system, and blood thinners to prevent blood clots, which also can impede embryos implanting.

In an era of practising ‘evidence based medicine’, the beneficial use of Intralipids in IVF treatment is controversial, mainly because there are no large randomised controlled trials to look at its efficacy. This does not mean, of course, that intralipids should not be used and do not have any benefit. It is becoming ever more apparent that, in some women, their immune system may be the cause of failure of implantation, but it is trying to identify who those women are that is often the problem.

Indeed, whilst the identification of Natural Killer Cells either in blood or in the womb is possible, we do not know if abnormal NK cell levels cause implantation failure or not. However, when treating couples who have had repeated IVF cycle failures, I do not think that women should be denied the option of taking additional, unproven treatments, as long as those treatments do no harm.

The use of intralipids and steroids potentially have significant, if not proven, benefits with minimal risk. Whether or not the immunomodulation therapy resulted in the birth of the babies delivered, the stories are inspiring to those who may feel like their situation is hopeless. There are never any guarantees in IVF treatment, as many couples learn very quickly, and I believe it is not giving false hope but some hope.

Amanda Tozer
Consultant in Reproductive Medicine