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Book Review: The Fertility Book – Your definitive guide to achieving a healthy pregnancy

17 January 2022
Appeared in BioNews 1128

If you are interested in finding out about fertility and fertility treatment, you will most likely embark on an online crusade only to find yourself completely inundated with information, a lot of which, sadly, is not very accurate. Actually, this is the problem with the digital age we live in. Information is easy to find; good information, however, isn't.

The Fertility Book: Your definitive guide to achieving a healthy pregnancy distinguishes itself by being written by two very respectable and reputable names in the world of fertility: Professor Adam Balen, NHS consultant and former chair of the British Fertility Society and Grace Dugdale, reproductive biologist and nutrition scientist, making it a solid and dependable source of reliable and accurate information.

The book is split into three parts: 'Fertility fundamentals', 'When you need medical help' and 'Ethics, the law and options if treatment doesn't work'.

The Fertility fundamentals part grounds the books into the essence of what fertility is, how to plan for a baby, and the importance of diet and lifestyle. In fact, one of the book's main strengths is its heavy emphasis on diet and lifestyle, and how that can have a significant impact on someone's conception journey.

By now, anyone that reads my reviews should know that male factor infertility is an equal culprit to female factor infertility when it comes to causes of infertility. Only two chapters were dedicated to male factor infertility which to me indicates one of three things: it is a reflection of how little attention is given to male factor infertility by the fertility sector, how little is understood about male factor infertility or the authors know their target audience are most likely women undergoing fertility treatment or concerned about their fertility. To be completely honest, I feel it's a combination of all three, as the topic of male factor infertility is tackled rather efficiently in the book, giving me the impression that the same could be done for other parts of the book that seem to be longer than necessary.

The second part of the book concerns when to seek medical help, and it is when things can get a bit more complex and advanced, and I suspect some lay readers may struggle with interpreting some of the concepts. For the most part, the book tackles complex issues quite well, with a well-woven and methodological build-up to some of its big ideas.

Fertility treatment options for the LGBTQ+ community and logistical and legal matters to do with surrogacy are outlined clearly, and the book provides solid guidance that can be useful for patients considering these options.

The reader is not told much about embryology, and being an embryologist myself, I know it is the part of the journey that patients find the most fascinating and frustrating, yet know the least about. True, the book's focus is on achieving a healthy pregnancy, but understanding how diet, lifestyle and treatment could affect embryo development may elevate this book further, making it a bible of fertility and fertility treatment.

Professor Balen is quite outspoken about 'add-ons' (and even about them being called 'add-ons'). On a personal level, I feel quite strongly aligned with his views on the topic, and was expecting a much more tenacious angle on the topic. However, it seemed significantly diluted, perhaps to ward off controversy, or perhaps, similar to embryology, it is not the main focus or topic of achieving a pregnancy. But I disagree. Especially for patients undergoing fertility treatment, the use or dismissal of 'add-ons' in their treatment can be the difference between a successful and unsuccessful cycle with varying magnitude.

The trending topic of fertility preservation and in particular social egg freezing is discussed in the book, but the shortcomings and misrepresentations of its success are not boldly stated. I feel very strongly about the miscommunications in the media about egg freezing. I personally know friends that have undergone egg freezing and were mistakenly thinking they can now put their concerns about fertility to rest. However, everyone in the field knows this isn't the case, and I feel the book should have spent more time elucidating the risks involved with this type of thinking.

Part three of the book delves into the ethics and legal dilemmas often debated in and around fertility and fertility treatment, which I thoroughly enjoyed reading. While the first two parts of the book are more informative and offer some form of guidance, the third part intertwines philosophy and sociology. It makes the reader question a few things, from access to treatment to certain predicaments with IVF treatments. It also discusses an option I didn't expect it to tackle: adoption.

This book is an essential read. Not just for people dealing with infertility or merely wanting to know more about fertility, but professionals in the field as well. It's comprehensive and as the title reads, definitive. It provides accurate and up-to-date information on many of the topics related to fertility. It's evidence based and references are provided to the claims it makes and facts it shares. I hope future editions will revise some topics and maybe shed some more focus on embryology, and male factor infertility, and maybe be a bit more bold with its stance on 'add-ons' and fertility preservation. A chapter, perhaps, on how to choose a clinic and interpreting success rates for patients wanting to undergo fertility treatment may be useful to help patients make informed decisions when choosing a treatment provider.

The Fertility Book: Your definitive guide to achieving a healthy pregnancy
Vermillion Books |  16 September 2021
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