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NHS - Body dysmorphic disorder (BDD)
https://www.nhs.uk/mental-health/conditions/body-dysmorphia/

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https://www.theguardian.com/society/2020/jun/30/uks-ivf-success-rate-has-tripled-in-last-20-years

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IVF success rates have tripled over the last 20 years in the UK, with almost a third of all embryo transfers in women under 35 resulting in a baby, according to the fertility regulator.

But patients in parts of England are finding it increasingly difficult to access NHS funding for infertility treatment due to what one expert described as a "hugely disappointing" fall in NHS-funded cycles. Though UK guidelines say women under 40 should be given three full IVF cycles, that only happens by default in Scotland, where 60% of treatments were NHS funded in 2018, statistics from the Human Fertilisation and Embryology Authority (HFEA) show.

In England, where funding is decided by local clinical commissioning groups (CCGs), there is a postcode lottery, with just some offering three cycles and others none. Many CCGs have reduced funding for fertility treatment, with the biggest decreases seen in the east of England as well as Yorkshire and the Humber, cutting the England-wide share of NHS funded cycles to 35% from 41% in 2013.

The chances of IVF succeeding has improved across all age groups since 1998, though younger women continue to have a far higher birth rate. In 2018, the average birth rate per embryo transferred for all IVF patients was 23% - but was 31% for under-35s, compared with less than 5% for patients 43 and above when using their own eggs.

Women over 40 who use donor eggs rather than their own have a much higher chance of a baby - 25% per embryo transfer, compared with 10% when using their own eggs.

Since 2013, the number of egg and embryo storage cycles increased fivefold to just under 9,000 cycles in 2018, as freezing techniques improved and have become more commonplace.

Frozen embryo transfers are now more successful than fresh transfers, with 24.8% resulting in a baby (the birth rate from fresh transfers is 22.7%). Doctors increasingly freeze all embryos from each IVF cycle, not just the "spares", giving a woman's body more time to get back to normal after the physically arduous process of ovarian stimulation.

Black and minority ethnic women in the UK are more likely to turn to IVF the figures show. Just 59% of all IVF cycles in 2018 were undertaken by white people, who make up an estimated 86% of the UK population as a whole.

Prof Adam Balen, the Royal College of Obstetricians and Gynaecologists spokesperson on reproductive medicine, welcomed the increased birth rates but criticised the reduction in funding, saying IVF should not be an "easy target" for cost cutting.

"What is hugely disappointing is the continued fall in NHS-funded cycles. In 2018 in Scotland, 60% of treatment was NHS-funded, compared to 45% in Northern Ireland, 41% in Wales and 35% in England," he said.

"Whilst the Nice [National Institute for Health and Care Excellence] guidance states that all eligible couples should be entitled to three full cycles (including the use of frozen embryos) and we know, using latest statistics, that this will give them an 80-85% chance of having a baby - and indeed many will not require the full three cycles, with on average 30% conceiving with one cycle (and in the best cases maybe 40-45%) - IVF is seen to be an easy target.

"But infertility is a serious medical condition, resulting in huge stress and distress and caused itself by a large number of different medical problems. Indeed, it is the second commonest reason for women of reproductive years to visit their GP. IVF is cost effective and has shown to be an economic benefit to society."

Though IVF has traditionally been associated with twins, the multiple birth rate from the procedure has decreased to 8%, its lowest level since 1991, when the rate was 29.1%. This follows research proving that implanting more than one embryo does not result in a better chance of having a baby.

Implanting more than one embryo has no significant impact on the chance of a live birth but results in a 32% multiple birth rate for patients under 35.

Sally Cheshire, chair of the HFEA, said this reduction made pregnancy and childbirth much safer for women and babies.

"I am delighted that we have continued to make progress on reducing the multiple birth rate, making fertility treatment now safer than ever before. We know that multiple births are the biggest single health risk from IVF for mothers and babies and put an additional burden on the NHS.

"That's why it is a great achievement that for the first time our 10% multiple birth rate target was achieved across all age groups and nationally only 8% of IVF births resulted in a multiple birth. This shows that there is now a common understanding that implanting more than one embryo does not increase your chances of having a baby."

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UK's IVF success rate has tripled in last 20 years

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IVF success rates have tripled over the last 20 years in the UK, with almost a third of all embryo transfers in women under 35 resulting in a baby, according to the fertility regulator. But patients in parts of England are finding it increasingly difficult to access NHS funding for infertility treatment due to what one expert described as a "hugely disappointing" fall in NHS-funded cycles.

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The test tube diaries: and the gift of IVF
Verrone-Coffaro, G. (2007)
https://nelson.northampton.ac.uk/primo-explore/fulldisplay?docid=TN_cdi_proquest_journals_304861596&context=PC&vid=44NORTH_V1&lang=en_US&search_scope=Local%20Remote&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,IVF%20patients%20test%20tube%20sociology&offset=0

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https://www.nhs.uk/conditions/infertility/

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Infertility is when a couple cannot get pregnant (conceive) despite having regular unprotected sex.
Around 1 in 7 couples may have difficulty conceiving.

More than 8 out of 10 couples, where the woman is under 40, will conceive naturally within a year if they have regular unprotected sex (every 2 or 3 days).

For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 1 in 4, or less.

Getting help

Some people get pregnant quickly, but for others it can take longer. It's a good idea to see a GP if you have not conceived after a year of trying.

Women aged 36 and over, and anyone who's already aware they may have fertility problems, should see their GP sooner.

They can check for common causes of fertility problems and suggest treatments that could help.

Infertility is usually only diagnosed when a couple have not managed to conceive after a year of trying.

There are 2 types of infertility:

primary infertility - where someone who's never conceived a child in the past has difficulty conceiving

secondary infertility - where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again

Read more about how infertility is diagnosed.

Treating infertility

Fertility treatments include:

medical treatment for lack of regular ovulation

surgical procedures such as treatment for endometriosis, repair of the fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity

assisted conception such as intrauterine insemination (IUI) or IVF

The treatment offered will depend on what's causing the fertility problems and what's available from your local integrated care board (ICB).

Private treatment is also available, but it can be expensive and there's no guarantee it will be successful.

It's important to choose a private clinic carefully. You can ask a GP for advice, and should make sure you choose a clinic that's licensed by the Human Fertilisation and Embryology Authority (HFEA).

Some treatments for infertility, such as IVF, can cause complications.

For example:

multiple pregnancy - if more than 1 embryo is placed in the womb as part of IVF treatment there's an increased chance of having twins; this may not seem like a bad thing, but it significantly increases the risk of complications for you and your babies

ectopic pregnancy - the risk of having an ectopic pregnancy is slightly increased if you have IVF

Read more about how infertility is treated.

What causes infertility?

There are many possible causes of infertility, and fertility problems can affect either partner. But in a quarter of cases it is not possible to identify the cause.

Common causes of infertility include:

lack of regular ovulation (the monthly release of an egg)

poor quality semen

blocked or damaged fallopian tubes

endometriosis - a condition where tissue, similar to the lining of the womb (the endometrium), grows in other places outside the womb

Risk factors

There are also several factors that can affect fertility.

These include:

age - fertility declines with age

weight - being overweight or obese (having a BMI of 30 or over) reduces fertility; in women, being overweight or severely underweight can affect ovulation

sexually transmitted infections (STIs) - several STIs, including chlamydia, can affect fertility

smoking - can affect fertility: smoking (including passive smoking) affects your chance of conceiving and can reduce semen quality; read more about quitting smoking

alcohol - the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum. Drinking too much alcohol can also affect the quality of sperm (the chief medical officers for the UK recommend adults should drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more)

environmental factors - exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men

stress - can affect your relationship with your partner and cause a loss of sex drive; in severe cases, stress may also affect ovulation and sperm production

Page last reviewed: 09 August 2023
Next review due: 09 August 2026

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Find out about infertility, including the causes, treatment options, and when to get help and advice.

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The embryo as moral work object: PGD/IVF staff views and experiences
Ehrich, K., Williams, C. and Farsides, B. (2008/2007)
https://nelson.northampton.ac.uk/primo-explore/fulldisplay?docid=TN_cdi_pubmed_primary_18444955&context=PC&vid=44NORTH_V1&lang=en_US&search_scope=Local%20Remote&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,IVF%20sociology&offset=0

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The association between physical activity, fitness and body mass index on mental well-being and quality of life in adolescents - ProQuest - the impact of exercise on men's rates of depression - has lots of statistical research that may be useful to include

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Anselm Strauss (from today's session)
'Relationships between different sectors of the psychiatric profession in hospitals'
Link it to normal hospitals and midwives - pressure on new mums to breastfeed
Surveillance (Foucualt)

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‘I just don’t think it’s that natural’: adolescent mothers’ constructions of breastfeeding as deviant - Jamie - 2020 - Sociology of Health &amp; Illness - Wiley Online Library
How using other methods than natural breastfeeding is seen as deviant - stigma and surveillance (Foucault)

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Liberal Feminism - Discrimination against women who breastfeed in society/workplace and the inequalities in place preventing their participation

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https://ebookcentral.proquest.com/lib/northampton/detail.action?docID=254258&pq-origsite=primo
(Exercise, health, and mental health : emerging relationships)

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Men and infertility: Insights from the sociology of gender - Halcomb - 2018 - Sociology Compass - Wiley Online Library
research on the impact of infertility on men in terms of gender sociology, could be useful to discuss the mental impacts of infertility?

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Subjective Well-being: measuring happiness, suffering and other dimensions of experience by National Research Council (2014)
https://nelson.northampton.ac.uk/primo-explore/fulldisplay?docid=44NORTH_SFX_DS2670000000550231&context=L&vid=44NORTH_V1&lang=en_US&adaptor=Local%20Search%20Engine&tab=default_tab&query=any,contains,Subjective%20well-being:%20Measuring%20happiness,%20suffering,%20and%20other%20dimensions%20of%20experience.&sortby=rank

Research on subjective well-being (SWB), which refers to how people experience and evaluate their lives and specific domains and activities in their lives, has been ongoing for decades, providing new information about the human condition. (p.1)

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Tahirah Chinyere 20411283  body dysmorphia

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Tahirah Chinyere 20411283  body dysmorphia

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theories
-surveillance on the body and how the body is deemed to look like
-feminism women's mental health and appearance
-stigma
-male gaze
-identity and self-esteem
-power and position are determined by how "pretty" you are

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Emily Greenaway (20405764) - Relationship between Exercise and positive Mental Health  

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Emily Greenaway (20405764) - Relationship between Exercise and positive Mental Health  

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Theories
Foucault - Self Surveillance

Strauss - Venturing away from the medical sphere to improve health and using the public sphere e.g. Gyms to improve mental health

Parsons - Sick Role

Marxism - Commodification of exercise products
Labelling Theory - Stigma

https://www.mind.org.uk/information-support/tips-for-everyday-living/physical-activity-and-your-mental-health/about-physical-activity/

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Physical activity can help your mental health. Learn about 5 ways to get moving and what you can do if you don’t feel up to exercising.

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Theories:
Feminism - choice over your own body, women's right to have a child is being supported by medical profession. patriarchal control over her pregnancy and fertility
Foucault - surveillance of entire pregnancy and fertility journey = have to fit a certain criteria of health to be selected for IVF
Marxism - become a commercial product - babies become commodities - buying of your own body through medical profession. Privatisation of IVF - some available for free through criteria but is an expensive treatment
mental effects - not always successful

Possible References:
Dow, K., 2019. ‘Now She’s Just an Ordinary Baby’: The Birth of IVF in the British Press. Sociology (Oxford), 53(2), pp.314–329.
‘Now She’s Just an Ordinary Baby’: The Birth of IVF in the British Press (oclc.org)

-  'IVF has gone on to be one of the most influential technologies of the last four decades. More than a quarter of a million IVF babies have now been born in this country alone (HFEA, 2016). IVF has served as a platform for new technologies like pre-implantation genetic diagnosis and regenerative medicine and has kick-started a global fertility industry that is predicted to be worth $21.6 billion by 2020'

IVF
IVF - NHS (www.nhs.uk)

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In vitro fertilisation (IVF) is one of several techniques available to help people with fertility problems have a baby.
During IVF, an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory.

The fertilised egg, called an embryo, is then returned to the woman's womb to grow and develop.

It can be carried out using your eggs and your partner's sperm, or eggs and sperm from donors.

Who can have IVF?

The National Institute for Health and Care Excellence (NICE) fertility guidelines make recommendations about who should have access to IVF treatment on the NHS in England and Wales.

These guidelines recommended that IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for 2 years, or who have had 12 cycles of artificial insemination.

However, the final decision about who can have NHS-funded IVF in England is made by local clinical commissioning groups (CCGs), and their criteria may be stricter than those recommended by NICE.

If you're not eligible for NHS treatment, or you decide to pay for IVF, you can have treatment at a private clinic. Costs vary, but 1 cycle of treatment may cost up to £5,000 or more.

Read more about the availability of IVF.

Speaking to your GP about IVF

If you're having trouble getting pregnant, you should start by speaking to your GP. They can advise on how to improve your chances of having a baby.

If these measures don't work, your GP can refer you to a fertility specialist for a treatment such as IVF.

Read more about getting started with IVF.

What happens during IVF

IVF involves 6 main stages:

1. suppressing your natural cycle - the menstrual cycle is suppressed with medication

2. boosting your egg supply - medication is used to encourage the ovaries to produce more eggs than usual

3. monitoring your progress and maturing your eggs - an ultrasound scan is carried out to check the development of the eggs, and medication is used to help them mature

4. collecting the eggs - a needle is inserted into the ovaries, via the vagina, to remove the eggs

5. fertilising the eggs - the eggs are mixed with the sperm for a few days to allow them to be fertilised

6. transferring the embryo(s) - 1 or 2 fertilised eggs (embryos) are placed into the womb

Once the embryo(s) has been transferred into your womb, you'll need to wait 2 weeks before taking a pregnancy test to see if the treatment has worked.

Read more about what happens during IVF.

Chances of success

The success rate of IVF depends on the age of the woman undergoing treatment, as well as the cause of the infertility (if it's known).

Younger women are more likely to have a successful pregnancy. IVF isn't usually recommended for women over the age of 42 because the chances of a successful pregnancy are thought to be too low.

Between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was:

29% for women under 35

23% for women aged 35 to 37

15% for women aged 38 to 39

9% for women aged 40 to 42

3% for women aged 43 to 44

2% for women aged over 44

These figures are for women using their own eggs and their partner's sperm, using the per embryo transferred measure.

The Human Fertilisation and Embryo Authority (HFEA) has more information on in vitro fertilisation (IVF), including the latest success rates.

Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF.

What are the risks?

IVF doesn't always result in pregnancy, and it can be both physically and emotionally demanding. You should be offered counselling to help you through the process.

There are also a number of health risks involved, including:

side effects from the medications used during treatment, such as hot flushes and headaches

multiple births (such as twins or triplets) - this can be dangerous for both the mother and the children

an ectopic pregnancy - where the embryo implants in the fallopian tubes, rather than in the womb

ovarian hyperstimulation syndrome (OHSS) - where too many eggs develop in the ovaries

Read more about support available during and after IVF and the risks of IVF.

Community content from HealthUnlocked

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In vitro fertilisation (IVF) is one of several techniques available to help people with fertility problems have a baby. During IVF, an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory. The fertilised egg, called an embryo, is then returned to the woman's womb to grow and develop.

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Topic - Infertility

Theories -
- Stigma (Goffman)
- Social construction of infertility/ medicalisation of infertility
- Surveillance of the medical profession / of the self (Foucualt)

Sources:
Review Article – The experience of infertility: a review of recent literature

Greil A L, Slauson-Blevins K and McQuillan J

pp.140-162
https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1467-9566.2009.01213.x

Stigma
Goffman, E. (2009)
https://nelson.northampton.ac.uk/primo-explore/fulldisplay?docid=44NORTH_SFX_DS4100000007431822&context=L&vid=44NORTH_V1&lang=en_US&search_scope=Local%20Remote&adaptor=Local%20Search%20Engine&tab=default_tab&query=any,contains,goffman%20stigma&offset=0

Beyond (financial) accessibility: inequalities within the medicalisation of infertility
Bell, A. V. (2010)
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-9566.2009.01235.x

NHS Website - Infertility
https://www.nhs.uk/conditions/infertility/

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Theory:
Foucault - Surveillance and social control is there a pressure put on women to breastfeed.
Book - https://ebookcentral.proquest.com/lib/Northampton/detail.action?docID=866128&pq-origsite=primo

NHS breastfeeding - https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/