Glossary

• Abdominal massage

  Abdominal massage helps to detoxify and strengthen the lower abdomen, and is particularly useful for relaxing tension in the abdomen and promoting blood flow. At Zita West clinics abdominal massage is used as part of the Preconception Programme, using key abdominal acupressure points, and work on the lymph nodes in the abdomen
  

  Acupuncture

  A key component of traditional Chinese medicine, acupuncture works on the principle that our individual health is maintained by an internal energy flow along specific channels, or meridians, within the body. This energy flow is known as qi (pronounced chee) and when this energy is blocked or interrupted, then an imbalance in the function of body organs can occur. The meridians also correspond to the organs of the body and their functions, so blocked energy to the liver can make the whole system sluggish. Stimulating the specific acupuncture points, using a very fine needle, can help release energy and rebalance the body. Acupuncture is one of the complementary therapies used by Zita West clinics. The Zita West Clinic's approach to Acupuncture combines aspects of Five Element and Traditional Chinese Medicine. We use a unique form of acupuncture largely based on the principles of TCM yet influenced by the concepts of the Five Elements. Zita herself is trained in both TCM and five element acupuncture hence her and her team's unique approach. TCM treats the underlying condition of the patient and makes a diagnosis based largely on the patent's symptoms. Most of the studies showing evidence of the positive effects of Acupuncture on fertility and pregnancy have been based on TCM eg improving bloody flow to the uterus and reducing stress levels which is why TCM is often seen as the 'complementary treatment' of choice in fertility. Five Element Acupuncture looks more at the emotional needs of the individual working on harmonising the body, mind, heart and spirit, making a diagnosis inters of what the patient's individual 'element' is, whether it is Water, Earth, Wood, Fire or Metal. Above all, it's the relationship that develops between the practitioner and the patient that is the most integral part of the treatment.

  Alcohol

  Studies have shown a definite link between miscarriage and alcohol consumption, and regular excessive drinking will affect sperm production in men. The guidelines for ‘safe’ alcohol consumption is 14 units a week for women, and 21 units a week for men. A unit of alcohol is the equivalent of one small glass of wine, a single measure of spirits, and half a pint of beer or cider. The recommendation at Zita West clinics is total abstinence for both partners in the week leading up to ovulation and possible conception. Otherwise, a couple of units a week is fine – but for many couples this may mean a complete reassessment of drinking habits.
  
  
  
  During pregnancy we recommend that our clients avoid alcohol completely.
  
  

  Antenatal Consultation

  At Zita West clinics, an early antenatal consultation – as soon as a woman knows she is pregnant – is offered as part of the routine antenatal care offered in the Pregnancy Programme. This can be immensely reassuring to couples who have previously miscarried, have had trouble conceiving, or who have used assisted reproductive technology to conceive. It creates an opportunity to provide emotional support as well as practical information. Withn the NHS, an antenatal consultation isn’t usually offered until around 12 weeks pregnancy.
  
  
  
  After that we offer midwifery consultations at each trimester to reassure and support you throughout your pregnancy.
  
  
  
  

  Antenatal depression

  Depression in pregnancy can occur for all sorts of reasons, some simple and straightforward, some complex and deep seated. Having a baby means making all sorts of adjustments, practical, physical and emotional. Your body no longer feels your own and it changes, which can be hard to handle. There is a loss of freedom, which some people resent. Sometimes personal circumstances are far from ideal. The prospect of bringing a new life into the world can bring up difficult feelings to do with past experiences, and these need to be worked through. Hormones can play havoc with both your emotional and your physical state, causing mood swings, exhaustion, and nausea. And as the birth approaches, all sorts of fears can surface. As many as 15 percent of women show signs of mental illness in their first trimester. And women who have never suffered from depression before can become vulnerable now.

  Here at the Clinic, we recognise that the mind often needs support as much as the body. Sometimes this can be as simple as makng changes to diet and exercise, and ensuring that what is needed nutritionally is there. Supplementation with vitamins, minerals or essential fatty acids like DHA can also help, as can complementary therapies like acupuncture and hypnotherapy in certain cases. The support of one of our counsellors or therapists can be particularly valuable, or we can refer you to a psychotherapist if we think this is necessary.

  Antioxidants

  Antioxidants – vitamins A, C and E, and the mineral Selenium in particular – enable the body to neutralise free radicals, a chemical by-product of cell metabolism, that can damage the DNA of cells if produced in excess. The UK Government’s recommendation of ‘5 a day’ fruit and vegetables will ensure an adequate intake of antioxidants, that help prevent the sort of cell damage that can give rise to cancers and heart disease. When it comes to fertility, the use of antioxidants can help neutralise damage to the ovum and to sperm.
  
  
  
  

  Anxiety

  Everyone feels anxious occasionally, but for some this can become a continuous mindset, often irrational but difficult to reduce alone. The problem with chronic anxiety is that it produces raised amounts of stress hormones that can disturb the general hormonal balance in the body. Stress hormones like cortisol are useful in the short term, but chronic production can lead to adrenal stress and the body becomes exhausted. No doubt anxiety about fertility can be self-perpetuating, but there are numerous steps that can be taken to help reduce levels of anxiety – exercise, meditation, hypnotherapy – and supporting the body with a good diet and adequate rest to overcome the impact of anxiety.
  
  

  Arginine

  The amino acid arginine is a biochemical precursor in the synthesis of putrescine, spermidine, and spermine, which are thought to be essential to sperm motility. In 1973, Schachter et al published a study in which arginine was given to 178 men with low sperm count. Seventy-four percent of the subjects had significant improvement in sperm count and motility after taking 4 g/day for three months.
  
  
  

  More recently, researchers in Italy evaluated the clinical efficacy of arginine in 40 infertile men. All the men had a normal number of sperm ( > 20 million/ml) but had decreased motility which was not due to immunological disorders or infections. Subjects were given 80 ml of a 10-percent arginine HCl solution for six months. Arginine supplementation significantly improved sperm motility without any side effects.

  Assisted Conception

  Assisted conception describes those techniques that enable a couple to conceive with help. This may be as simple as artificial insemination, either by partner or donor; the use of fertility drugs like Clomid; IVF (in-vitro fertilisation) conception where fertilisation of the ovum occurs outside the body; or ICSI (intra-cytoplasmic sperm injection) where one sperm is injected into an ovum.

  Assisted reproductive technologies

  This is an umbrella term for those forms of assisted conception that require highly skilled technology like IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection), SUZI (sub-zonal insemination) and other forms of MAF (micro-assisted fertilisation).
  
  
  
  

• Birth

  At its simplest, birth is the end of labour, when a baby is born. For most couples this is the culmination of their desire to become parents, and greeted with relief, joy and often euphoria.
  
  
  
  
  We can prepare you for labour and birth with our unique one day birth and parenting preparation classes or with our hypnosis for birth classes.
  
  
  

  BMI

  BMI – body mass index – is a way of calculating the optimum body weight by height. This is calculated by dividing an individual’s weight (in kilograms) by the square of their height (in metres). For example, a woman of 1.65 metres (5’ 4”) weighs 57.15 kilograms (9 stone). Her BMA will be 57.15 divided by 2.7225 (1.65 x 1.65) = 20.99
  
  Acceptable BMIs range from 20 to 25; anything below that is considered underweight and anything over a BMI of 30 is considered clinically obese.
  
  

  Books

  Fertility & Conception, by Zita West, Dorling Kindersley priced £14.99
  
  Zita West’s Guide to Getting Pregnant, by Zita West, Thorsons priced £14.99
  
  Natural Pregnancy by Zita West, Dorling Kindersley priced £12.99
  
  Babycare Before Birth, by Zita West, Dorling Kindersley priced £12.99
  
  
  
  

  Breastfeeding

  While some women may feel ambivalent or resistant to breastfeeding it is always worth considering as it provides a newborn baby with exactly the right mix of carbohydrates and fats (the fats in breastmilk are unique because they help with the continued development of both the brain and the eye), and antibodies that help both the immune and digestive system. Breastfeeding is ‘powered’ by the hormone oxytocin, which helps the womb contract, while also stimulating warm, tender feelings that help bonding with the baby. Milk production is stimulated by the baby’s sucking and this also stimulates the ‘let-down’ reflex that releases the milk. We provide one to one ante-natal Breastfeeding classes in our Pregnancy Programme.
  
  

  Breathing Dynamics

  Although we breathe automatically, and do so from the moment of birth until the day we die, we tend to breathe poorly, not fully utilising our lung capacity. This restricted breathing can leave the body cells poorly supplied with oxygen and under energised. Because of this, it is useful to re-learn our breathing techniques, focus on abdominal breathing rather than thoracic breathing, breathing deep into our stomachs rather than from the top of our chests. This takes practice at first, but will become more automatic in time. Breathing in this way not only provides the body with increased oxygen intake, it also calms the mind, which is way it is part of some many relaxation and meditation techniques. During this consultation you will also be taught relaxation techniques that you can use at home to help you stay calm and feel positive.
  
  
  
  Many women undergoing IVF find this session particularly beneficial during the two weeks after embryo transfer.
  
  

  Breathing exercises

  The simplest breathing exercises can be self-taught, and will contribute to a calmness and feeling of wellbeing as well as improving your oxygen intake.
  
  · Lie on your back with your knees bent, feet together
  
  · Consciously relax your shoulders and tuck your chin in so your neck is long
  
  · Rest on hand on the chest and one on the stomach
  
  · Close your eyes and breathe gently in through your nose and out through your mouth
  
  · Breathe into the stomach, feeling it expand on the in-breath
  
  · Practise for 10 minutes, two to three times a day until it feels ‘normal’ whether you are lying, sitting or standing
  
  · As breathing becomes more efficient, you will notice that you are taking between 12 and 16 breaths a minute
  
  
  
  
  
  

• Carnitine

  The main function of carnitine in the epididymis is to provide an energetic substrate for spermatozoa. Carnitine contributes directly to sperm motility and may be involved in the successful maturation of sperm. This is especially important since epididymal sperm use fatty acid oxidation as their main source of energy metabolism, and thus tend to concentrate carnitine while in the epididymis, as carnitine is necessary for transport of fatty acids into the mitochondria. Low levels of carnitine reduce fatty acid concentrations within the mitochondria, leading to decreased energy production and potential alterations in sperm motility.
  
  

  In a study involving 124 infertile patients, a direct correlation between semen carnitine content and sperm motility was found. The results also show a positive correlation between free L-carnitine and both sperm count and the number of motile sperm per milliliter (P<0.01).

  In one multi-center trial, 100 patients received 3 g/day of oral L-carnitine for four months. Sperm parameters were assessed before, during, and after the study. Motility was determined by computer-assisted sperm analysis. The results clearly demonstrate carnitine has a positive effect on sperm motility. The percentage of motile spermatozoa increased from 26.9 ± 1.1 to 37.7 ± 1.1 percent. The percent of sperm with rapid linear progression increased from a baseline of 10.8 percent to 18.0 percent. Not only did carnitine significantly affect sperm motility, but the total number of spermatozoa per ejaculate also increased.

  Another clinical study reported similar results with 3g carnitine given daily for three months. Thirty-seven of the 47 participants had increases in sperm motility, rapid linear progression, and total number of sperm.
  
  

  In a related study, 20 men with idiopathic asthenospermia (defective sperm motility) were given acetylcarnitine, 4 g/day for 60 days. While acetylcarnitine did not affect sperm density or total motility, it did significantly increase progressive linear sperm motility. It is interesting to note that gains in sperm motility were sustained in 12 of the subjects during the four-month follow-up period. Five pregnancies occurred during treatment, with two more occurring during the four months following the trial.

  Case histories

  Chlamydia

  This is the most common of the sexually transmitted diseases that shows up at STD clinics. Caused by a bacteria, Chlamydia symptoms can be vague and non-specific, with an estimated 50–80 % of sufferers having no symptoms, making diagnosis difficult. In women complications can cause PID (pelvic inflammatory disease) or even blocked fallopian tubes making conception difficult, while in men it can cause chronic inflammation of the prostate or testes, reducing sperm production. In both cases, diagnosis can be made by taking a vaginal or penile swab, and antibiotic treatment given.

  Complementary treatments

  The use of complementary treatments like nutritional therapy, acupuncture, hypnotherapy, MLD (manual lymphatic massage), abdominal massage, reflexology and breathing dynamics are routinely offered at Zita West clinics by experienced and qualified practitioners to complement the rest of the treatment on offer.
  
  

  Conception

  Conception describes the process by which a woman achieves pregnancy, the ovum is fertilised by the sperm, and the fertilised egg travels to the womb where implantation occurs. Once this has happened successfully, conception has occurred and pregnancy begins.

  Constipation

  Chronic constipation can be a result of poor diet, inadequate fluid intake, hurried eating, poor posture and lack of exercise. A bowel movement should occur once a day for good health, and a poorly functioning digestive system will have a negative effect on other body systems – for example, the immune system – if this isn’t corrected.
  
  
  
  
  
  Constipation is common in pregnancy and can be treated with Nutritional Therapy.
  
  

  Contraceptive pill

  Many women use hormonal methods such as the contraceptive pill as their contraception of choice prior to trying to get pregnant. After many years of taking hormones - whether the pill or other hormonal methods such as injections, implants or intra-uterine systems - women have frequently lost touch with their natural fertility cycle.
  
  Although for the majority of women fertility returns very quickly after stopping hormonal methods, for other women there may be months of irregular cycles, sometimes with delayed or absent ovulation. This can cause a lot of uncertainty and anxiety.
  
  A fertility awareness consultation after stopping the pill can help to identify the potentially fertile time and to consider what is normal and what is abnormal and may require more immediate investigation.
  
  
  

• Depression

  Being depressed, at being told you will have difficulties conceiving, for example, is a reactive depression – the reasons for it are quite obvious and straightforward and the low mood it induces is perfectly understandable. It can be less easy to identify the reasons for other forms of depression and some can be caused by biochemical imbalances. However, whatever the cause, antidepressants are often prescribed and these can cause fertility problems, for example reduced libido in some using SSRIs (selective serotonin re-uptake inhibitors) like Prozac or Seroxat.
  
  
  
  At Zita West clinics we recognise the impact depression can have on one or other, or both partners who are trying to conceive or are undergoing assisted conception, and look at ways individuals can help themselves. Making sure you get adequate rest and relaxation is obviously important. And there are many other ways you can help yourself too. For example, through adopting a nutritious and well balanced diet – many foods can contribute to elevating mood, while many processed foods exacerbate the problem. Vitamin, mineral and EFA (essential fatty acids) supplements can also help – research has shown that a gram of pharmaceutical grade EPA (an EFA) a day is as effective as Prozac for treating depression. Exercise can help too by raising the levels of feel-good endorphins in the brain. Hypnotherapy and other therapies can also be be be used effectively to restore positive thoughts.
  

  Detox

  Detoxification is a useful precursor to achieving pregnancy. Not only does the reduction of toxins in the body help it to function more effectively, but it also helps to focus on what lifestyle changes are probably necessary to boost health and enhance a couple’s chances of conception and successful pregnancy.
  
  
  
  The principles of detox are to replace an intake of poor and processed foods with fresh, organic foods; restricting known dietary toxins like caffeine, processed sugars, and salt; reducing the intake of highly acidic foods like meat and replacing these with alkaline foods like green vegetables; dramatically increasing the intake of fibre and antioxidant rich fruit and vegetables, stimulating the lymphatic system (to reinvigorate waste disposal) through MLD (manual lymphatic drainage), drinking two litres of filtered water a day, supporting the body with gentle exercise and increasing rest and relaxation. The benefits of a regular detox twice a year in the Spring and Autumn can restore health and energy, and help reduce common complaints like headaches, weight gain and poor skin.
  
  

  DHA

  DHA (docosahexaenoic acid) is one of the Omega-3 essential fatty acids that cannot be manufactured by the body, and has to be gained from the diet. It is found naturally in oily fish like mackerel, herring, salmon, trout, sardines, and pilchards. Vegetable sources of its precursor ALA (alpha-linoleic acid) can be converted by the body to both DHA and EPA (eicosapentaenoic acid) but is a less efficient way of gaining the benefits. DHA is essential for sperm production, and for pregnant and breastfeeding mothers – not just for their own health, but because the benefits of DHA on brain structure development are passed on to the baby from the mother while in the womb, and also through breastmilk after birth.
  
  

  DNA Fragmentation

  DNA (deoxyribonucleic acid) is the genetic material within each cell chromosome, and it carries the code for all the characteristics of that individual. If there are any flaws in the DNA material, this can cause cell reproduction to cease.
  
  
  
  Recent research has shown that even though a man can produce adequate quantities of sperm of apparently good quality, if the DNA within the sperm is fragmented – flawed or damaged in some way – this can make conception difficult and in some cases impossible. Standard sperm testing doesn’t check for this, although DNA fragmentation within sperm can be implicated in unexplained infertility or recurrent miscarriages in a woman, where the flawed genetic material means the embryo can’t develop and dies within the first eight to 12 weeks.
  
  
  
  At Zita West clinics, testing for DNA fragmentation occurs if we think necessary but results are carefully explained in a consultation with our male health specialist. We may also recommend Nutritional Therapy to help improve the quality of the sperm.
  
  

• EFAs

  EFAs (Essential fatty acids) are just that – essential, and can’t be produced by the body, they have to come from the diet. The two main groups of EFAs are Omega-3 and Omega-6. In the West, we generally have an excess of Omega-6 EFAs in our diet, which come from polyunsaturated fats like vegetable oils like sunflower or maize oil, heavily used in processed foods like crisps, pastries, biscuits, etc. which contain a lot of hidden omega-6. The problem with our excessive intake of omega-6 is that it competes in our bodies for absorption against the lower intake of omega-3s EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) reducing the availability of omega-3 EFAs still further. Without an adequate intake, which would mean eating oily fish at least twice a week, many people are deficient in omega-3 unless they take a supplement. A sign of chronic omega-3 deficiency can be one of a range of minor inflammatory complaints like itchy skin, runny nose, headaches and more serious conditions like eczema, hay fever, rheumatoid arthritis, and colitis.
  
  
  Zita West supplements include DHA because of the crucial importance of omega-3 EFAs in the diet of couples trying to conceive.
  
  
  
  

  Emotions

  Our emotions – whether we feel happy, sad, depressed, worried, elated or bad tempered – can be as much a result of our physical state as our mental state. And vice versa. An obvious example is PMS (pre-menstrual syndrome) where an hormonal imbalance can drastically affect a woman’s mood. The mind/body link is being increasingly recognised in modern medicine, and more and more people are taking a holistic approach to their health that takes account of this. At Zita West clinics, this is an important part of the approach to each individual’s care. It starts with the initial, extensive questionnaire and is part of every consultation.
  
  

  Endometriosis

  Endometriosis is a complex problem that occurs when the cells of the lining of the womb, the endometrium, migrate from the womb to other areas of the internal reproductive organs in a woman. Patches of endometrial cells can occur around the ovaries, the Fallopian tubes, and elsewhere in the woman’s abdomen. The problem is that these cells, like the lining of the womb, respond to the hormonal fluctuations of the woman’s cycle. During the second phase of the cycle, after ovulation, when progesterone secretion makes the lining of the womb thicken and produce a rich blood supply, the same effect occurs with the endometrial cells elsewhere which swell and engorge with blood. Then when a period occurs, these cells behave in the same way and bleed. Depending on the severity of the disease, endometriosis can cause pain, blockages, and infection throughout the reproductive organs, and make conception very difficult if not impossible. Interestingly, pregnancy itself sometimes resolves the problem. Treatment, however, is usually hormonal, while some surgery is sometimes necessary if adhesions have formed around the internal organs. The severity of the symptoms don’t necessarily affect the severity of the problem, which can be mild, moderate or severe, but needs skilful assessment and treatment. Our treatments and therapies can help with the symptoms of Endometriosis.

  EPA

  EPA (eicosapentaenoic acid) is one of two Omega-3 essential fatty acids available from fish sources. DHA (docosahexaenoic acid) is the other. Both are essential for the brain, but while DHA is essential for the structure of the brain, EPA is essential for the brain’s function. It helps with nerve synapses – where information is passed from one brain cell to another – making them more efficient. EPA is extremely useful for improving mood, and research has shown that a gram a day of pharmaceutical grade EPA is as effective as Prozac for treating depression.
  
  

  Exercise

  While everyone knows that regular exercise is essential for our bodies to function well, it is increasingly being recognised that it is helpful for stabilising and improving mood. However, most people do nothing like enough exercise and this becomes apparent when trying to achieve something like conception, which requires the body to be functioning well.
  
  
  
  As a consequence, information about regular exercise is covered in the initial questionnaire at Zita West clinics, and discussed at consultation where a fitness assessment is made, and advice on increasing exercise given. Not only does exercise increase fitness, it also helps energy levels, improves mood and aids relaxation and sleep. Occasionally, clients are advised to reduce their exercise levels if they are excessive and obsessional, because in some cases it can inhibit menstruation, and ovulation, in women.
  
  

• Fertility Awareness

  Fertility awareness provides information on male and female reproductive anatomy and physiology, as it relates to fertility. For a woman this involves identifying the indicators (signs) of fertility and for a man this includes understanding his reproductive potential. This educational approach helps people to learn to observe their own bodies, understand the normal changes and know what is healthy and typical for them. By understanding what is normal, it is easier to identify changes from the normal which require medical advice and to make informed decisions that can have a positive effect on reproductive health.

  Accurate information is every couple's right. It is crucial for all couples at all stages of pregnancy planning, and to help understand how factors such as contraceptive pills or life events such as childbirth, breast-feeding, or miscarriage can impact on the return of natural fertility.

  fertility cycle

  A woman’s fertility cycle starts on day one of her period, when she experiences a menstrual period lasting between two to five days. The next phase of the fertility cycle is the pre-ovulatory phase, when the secretion of FSH (follicle stimulating hormone) by the pituitary gland in the brain stimulates one follicle in the ovary to ripen in preparation for the release of a mature egg, or ovum, capable of being fertilised, which is known as ovulation.
  
  
  
  During this time, the secretion of oestrogen from the ovary increases until it peaks, which is the trigger to ovulation. Oestrogen also makes cervical mucus thinner and more watery, to help sperm travel through the female reproductive tract into the womb and Fallopian tubes, in order to fertilise the released egg. Once ovulation occurs, the secretion of oestrogen drops and the follicle from which the ovum was released starts secreting large quantities of the hormone progesterone, which makes the lining of the womb thicken, the blood supply to this area increase, ready for the implantation of a fertilised egg. It also makes the cervical mucus thicken.
  
  
  
  Secretion to progesterone continues but, if no implantation occurs, it ceases and the lining of the womb disintegrates and the bleeding of menstruation occurs again. These events form the fertility cycle a woman experiences, although if implantation occurs, the secretion of progesterone continues until around the 12th week of pregnancy, when the placenta takes over.
  
  
  
  

  Fertility health screen

  A fertility health screen at Zita West clinics is designed to give the whole picture of someone’s health, to assess how this might affect their fertility. It looks at the following:
  
  - age
  
  - weight
  
  - contraceptive history (women only)
  
  - menstrual history
  
  - sexual history
  
  - sexual health screen
  
  - physical health
  
  - family history
  
  - previous surgery and illnesses
  
  - nutrition and diet
  
  - exercise
  
  - lifestyle
  
  - pregnancy history (women only)
  
  
  
  
  
  

  Fibroids

  The lining of the womb has a middle, muscular layer, called the myometrium. Fibroids are an overgrowth of this layer, a benign tumour, but can grow quite large and if this occurs, can prevent the implantation of a fertilised egg. The effect of fibroids on fertility largely depends on how large they grow, and whereabouts in the womb they are growing – some women conceive and give birth quite successfully with small fibroids, for others they will need to be removed before pregnancy is possible. Fibroids can cause heavy periods – menorrhagia – and the excessive blood loss can sometimes lead to iron-deficiency anaemia. Fibroids can also run in families, and there may be more of a risk if a mother or sister also had them.

  Fluctuating hormone levels

  All hormones fluctuate, but it is when this fluctuating is outside the normal range – either higher or lower – that problems can occur. Because hormones are chemical messengers, they have an affect not only on body systems but also on each other. For example, an excessive secretion of FSH (follicle stimulating hormone) may be a result of reduced oestrogen levels, because it is the rising oestrogen levels that tell the pituitary to ‘switch off’ the FSH. In response to low oestrogen levels, associated with declining fertility, higher levels of FSH are necessary to produce ovulation.Assessing hormone levels, via a blood test, gives an idea of what is going on inside the body because of this interplay, particularly with the female reproductive hormones.

  Folic Acid

  This is a supplement recommended by the UK Department of Health for all women contemplating pregnancy, and for the first three months of pregnancy as it has been proved to help prevent spinal defects (like spina bifida) in the developing fetus. The daily recommendation is 400 mcg, but women with epilepsy and some other medical conditions might benefit from a higher dose, and this needs to be checked with a doctor.

  Follicle Stimulating Hormone

  This does exactly what it says: it stimulates a follicle in the ovary to produce an egg at ovulation.Secreted by the pituitary gland in the brain, it is one of the four main sexual hormones that govern a woman’s fertility cycle during her reproductive years. It is stimulated by the absence of oestrogen at the beginning of a woman’s fertility cycle, but as the oestrogen rises so FSH falls, until oestrogen peaks at ovulation and the egg is released. The interplay between the hormones is what both stimulates and inhibits each other.

  Free radicals

  Free radicals are a normal bi-product of cell chemistry and occur when a molecule in a body cell isn’t paired, or balanced, by another – these molecules then have to scavenge to find another molecule to pair with. It’s this scavenging process that can cause damage to other body cells. Free radicals can cause oxidation – the process that makes iron rust, or a cut apple turn brown – which is essentially cell damage, which is why antioxidants are an important source of cell protection. Antioxidants like vitamins A, C and E, and the mineral Selenium, are found in fresh fruit and vegetables – hence the UK Government’s recommendation to eat ‘5 a day’ to help avoid the sort of cell damage that can cause cancers, diabetes, and heart disease.
  
  Free radicals arise during normal body cell activity, but can also be produced by smoking, eating processed foods (especially those high in artificial additives), alcohol, recreational drugs, fried and barbecued foods, and exposure to environmental pollution, like traffic fumes. Kept in check by a good intake of antioxidants, they do little harm, but production increases with age, exposure to pollutants, and a poor diet.This can become an issue while trying to conceive, so taking steps to minimise their effect can be important.

  FSH levels

  FSH (follicle stimulating hormone), secreted by the pituitary gland in the brain, rises and falls throughout a woman’s fertility cycle. The drop in progesterone at the end of a cycle stimulates the secretion of FSH, which rises to stimulate a follicle in the ovary to ripen an egg ready for ovulation. At the same time, oestrogen levels are rising to stimulate ovulation, and the rise in oestrogen causes FSH levels to drop again, until the next phase of the cycle.
  At menopause, because oestrogen levels fall, FSH levels tend to rise and rise in an attempt to kick start the oestrogen rise necessary for ovulation, but excessively high levels suggest that the hormonal interplay that influenced ovulation is out of balance. Checking FSH levels in women who have irregular cycles, and may not be ovulating efficiently, is one of the many diagnostic blood hormone tests carried out at Zita West clinics. We use Acupuncture and Nutritional Therapy to treat raised FSH levels with very good results.

  Further information

  For further information contact;

  Zita West Clinics

  37 Manchester Street

  London

  W1U 7LJ

  Tel: 0207 224 0017

  Fax: 0207 224 0062

  email: info@zitawestclinics.com

• Gynaecologist

  This is a qualified doctor who has done further, post-graduate study, to specialise in the medical care of women’s reproductive health. They are not necessarily obstetricians, who specialise in the care of pregnant women, but often the two specialities are combined. A Fellow, Doctor or Member of the Royal College of Obstetrics and Gynaecology (FRCOG, DRCOG, MRCOG) will have passed exams in both obstetrics and gynaecology, but may choose to specialise in one field or another. Gynaecologists are often fertility specialists, although not exclusively so. We can help you with referrals for Gynaecology if necessary.
  
  

• Heartburn

  Heartburn describes the pain of indigestion or gastric reflux, where the valve on entry to the stomach allows a little of the stomach fluid to regurgitate into the oesophagus, which leads from the mouth to the stomach. Because the stomach fluids are acidic, this can irritate the mucosal lining of the oesophagus, causing pain. Often a problem of late pregnancy, because the growing baby and enlarging abdomen reduces the space for the stomach, and relaxes the muscle sphincter enough to allow regurgitation, the usual treatment is an antacid preparation taken after food.
  
  
  
  Heartburn is common in pregnancy but can be treated with Nutritional Therapy.
  
  

  High blood pressure

  Blood pressure is a measure of how hard the heart has to work against the resistance of the blood vessels to pump blood around the body. If blood pressure is described as high, it means that the heart is having to pump harder than normal against the resistance, which may be caused by narrowed arteries, obesity, or anything that causes increased tension in the blood vessels. Normal blood pressure is usually around 120/80 but can rise, especially during pregnancy. Pregnancy induced hypertension (PIH), which is high blood pressure that only occurs during pregnancy, affects between 5 and 10% of women, and needs to be monitored and an upper limit of a blood pressure reading of 140/90 is considered safe, after which closer monitoring is necessary. If blood pressure becomes abnormally high during pregnancy, it can indicate a potentially dangerous condition called pre-eclampsia. Blood pressure is routinely taken during pregnancy to check all is well, and is also taken for a routine baseline test at first attendance at Zita West clinics, for whatever consultation.

  Hormone tests

  Hormone tests, to see whether the secretion of fertility hormones is within the normal range for effective ovulation and conception, are carried out by taking samples of blood for laboratory testing. Sometimes it is also necessary to test for other hormone levels, like thyroid levels, that can have an effect on fertility hormone levels.
  
  Blood tests to check the blood profiles of a number of different hormones are routine for infertility investigations. We can arrange hormone blood profiles for you which may include the following tests:
  
  - anti-mullerian hormone (ovarian reserve test)
  - FSH (follicle stimulating hormone) levels
  - Oestradiol levels (oestrogen levels)
  - LH (luteinising hormone)
  - Prolactin levels
  - Progesterone levels
  

  Hydrotherm massage

  This is a profoundly relaxing and beneficial massage technique used for pregnancy. The massage is carried out while lying face up on comfortable Hydrotherm cushions filled with warm water, making it ideal during pregnancy. The cushions support the body in the natural position of the spine and the combination of the heat and massage help the mind and body to relax. Stress can be a powerful barrier to conception, and massage is known to help to reduce the muscular tension that can exacerbate stress and promote anxiety, calming the mind and the body.

  Hypnosis for birth

  Hypnosis for birth is rapidly becoming one of the most popular methods for reducing childbirth pain and making birth a natural, peaceful experience. The mind and body are inextricably linked and pain is usually caused by fear and tension that can restrict muscular movement and aggravate pain. The benefits of hypnosis during labour and birth include:

  • reduced fear and tension, and reduced pain
  • eliminates or reduces the need for chemical pain relief
  • labour may be shortened by several hours
  • labour fatigue is reduced, allowing more energy for the birth
  • fewer breech presentations
  • babies are shown to cry less, sleep and feed better and
  • are generally calmer
  • more rapid post-natal recovery.

  The experience of hypnosis is a state of being deeply relaxed yet having focused concentration, where you are able access to your subconscious mind where positive suggestions can be made, is made possible. This part of your mind influences how we think, how we feel, and the choices we make. It can actually control pain. While using these techniques you will be fully aware of your body’s contractions, and endorphins (the body’s natural anaesthesia) are released naturally which helps counteract the stress hormones that create pain.

  Zita West clinics teach hypnosis for birth techniques in two three hour classes (class duration is 3 hours long), where both partners are taught self-hypnosis skills and techniques. The classes cover all aspects of labour and birth as well as information on nutrition exercise, interventions, and birth plan preparation.

  Hypnotherapy

  We have qualified and experienced hypnotherapists working as part of our team at the Clinic. Hypnotherapists work with a fully conscious client, helping them to reach a profound state of relaxation where the subconscious part of the brain is accessed and positive suggestions can be made that release deep-seated fears and phobias. It is completely safe and very effective.
  
  Many women, particularly those who have had problems conceiving, have miscarried, or have had emotional problems in the past, can all find hypnotherapy valuable in addressing and releasing the fears that may be restricting them and their desire to get pregnant. It can also be effective for men suffering from sexual performance anxiety, or resistance to the pressure to deliver when their partner is ovulating, as can be the case when trying to conceive, especially for a prologed period of time.
  
  
  In addition to dealing with deep-seated fears, hypnotherapy is effective in general stress reduction too, and this in turn reduces stress hormones (stress is thought to have an adverse influence on all stages of reproduction). Hypnotherapy, is often recommended to couples, particularly those who are having difficulty conceiving, not least because of the very positive feed-back it receives from those of our clients who use it.

• IVF

  One of the assisted reproductive technologies, IVF (in-vitro fertilisation), sometimes known as ‘test-tube’ conception, is when the eggs are removed from the woman’s body, fertilised with the partner’s sperm, and the fertilised eggs re-introduced to the womb for implantation. IVF was originally devised to help women with blocked Fallopian tubes to get pregnant, but today it is also used for women who produce antibodies to their partner’s sperm, where there are hormonal problems, or even for cases of ‘unexplained’ infertility.

  Success rates vary, and it is a demanding process to hormonally stimulate the maturation of numerous eggs at one go, to be surgically ‘harvested’ before seeing how many eggs can be successfully fertilised. Then up to three embryos are transferred to the womb, in the hope of successful implantation, two to three days later.

  We can help you increase your chances of success with our IVF Support Programme and also with referrals to IVF clinics.

• Labour

  This is the process at the end of pregnancy that leads to the birth of the baby. The womb begins to contract, gently at first then with increasing effect, to make the cervix dilate and eventually expel the baby via the vagina. The start of labour is usually heralded by contractions, or the waters breaking (where the amniotic fluid is released from the womb), or the cervical plug – sometimes known as the ‘show’ – which is a plug of mucus, sometimes a little blood-stained, that comes away as the contractions begin to dilate the cervix.

  The process of labour takes a predictable course, although the timing of each stage varies from woman to woman. The first stage of labour is up until the woman’s cervix is fully dilated, at 10 cms, and there is an urge to push. The second stage is when the baby is pushed out of the womb, and born. The third stage of labour is the delivery of the placenta.

  Lifestyle advice

  For many couples who seek advice from Zita West clinics, an assessment of their lifestyles, and the influence this might have on their ability to conceive, forms part of the initial consultation. Many modern couples live busy, work-oriented, stressful lives, where there is a big dependence on prepared food, eating out, drinking alcohol to excess, smoking, not taking exercise, and not allowing enough time to rest, relax and recuperate from these lifestyles.

  Helping couples to assess their lifestyles, and what changes could and maybe need to be made is essential, especially for those finding conception difficult, facing health problems, or embarking on assisted conception.

• Male Fertility

  While fertility problems have traditionally been considered a female concern, we now know that around 35 to 40 percent of problems lie with the man. Sperm counts, in particular, have been declining at a very rapid rate over the last 10 years, so at Zita West Clinics, a semen analysis is one of the first tests offered to men. Knowing the quality and quantity of male sperm, particularly if couples have been trying to get pregnant for a while, is extremely useful information.

  The good news is that there is a lot that can be done to improve sperm. New sperm are constantly being produced over a 72 day cycle, and a few, often very simple, lifestyle changes in a number of ways can make a significant difference to both the quality and quantity of sperm.

  At Zita West Clinics, a full semen analysis is offered for men, especially if this hasn’t been checked before, prior to consultation with our male fertility expert. Also provided is a comprehensive questionnaire on all aspects of a man’s general health, diet and lifestyle to be completed prior to this appointment. The questionnaire is very specific, detailed and wide-ranging, and the kind of detailed history it provides is enormously valuable. Problems with sperm production can often be overcome by rectifying a series of seemingly minor imbalances in diet, lifestyle or general health, which only this kind of comprehensive review can reveal. Sometimes it may be necessary for a DNA Fragmentation test to be arranged for a more detailed analysis of the semen quality.

  Dealing with a negative result can be difficult, particularly as many men find it difficult to admit to how they feel. Finding somebody to talk to about it (other than a partner) isn’t always easy, even though the problem is far more common than most people imagine. Zita West Clinics have many years of experience in handling these kinds of issues, and the support programme offered also ensures availability of a professional counsellor to talk to.

  Male fertility health programme

  While fertility problems have traditionally been considered a female concern, we now know that around 35 to 40 percent of problems lie with the man. Sperm counts, in particular, have been declining at a very rapid rate over the last 10 years, so at Zita West Clinics, a semen analysis is one of the first tests offered to men. Knowing the quality and quantity of male sperm, particularly if couples have been trying to get pregnant for a while, is extremely useful information.

  The good news is that there is a lot that can be done to improve sperm. New sperm are constantly being produced over a 72 day cycle, and a few, often very simple, lifestyle changes in a number of ways can make a significant difference to both the quality and quantity of sperm.

  At Zita West Clinics, a full semen analysis is offered for men, especially if this hasn’t been checked before, prior to consultation with our male fertility expert. Also provided is a comprehensive questionnaire on all aspects of a man’s general health, diet and lifestyle to be completed prior to this appointment. The questionnaire is very specific, detailed and wide-ranging, and the kind of detailed history it provides is enormously valuable. Problems with sperm production can often be overcome by rectifying a series of seemingly minor imbalances in diet, lifestyle or general health, which only this kind of comprehensive review can reveal. Sometimes it may be necessary for a DNA Fragmentation test to be arranged for a more detailed analysis of the semen quality.

  Dealing with a negative result can be difficult, particularly as many men find it difficult to admit to how they feel. Finding somebody to talk to about it (other than a partner) isn’t always easy, even though the problem is far more common than most people imagine. Zita West Clinics have many years of experience in handling these kinds of issues, and the support programme offered also ensures availability of a professional counsellor to talk to.

  Male health specialist

  A male health specialist is usually a qualified doctor, who has done further research and training in male health. They are often urologists, embryologists, genito-urinary physicians or andrologists, with specialist knowledge of male reproductive and hormone function.

  Male infertility health tests

  A semen analysis is a very good starting point for finding out how fertile a man may be. A poor result may require referral for a DNA fragmentation test or to an urologist, and perhaps blood tests and ultrasound scanning will be advised. However a good result does not rule out other factors that may play an equally important role in infertility:

  1. Infections - infection is a major cause of infertility that may not always produce any symptoms, but may result in so-called 'unexplained infertility' or miscarriages in the woman, if not treated in the man. Checking for, and treating any infection, is done for both partners if necessary.

  2. Sperm Genetic Quality - for decades, semen analysis has been considered the definitive test to give a clear answer about male fertility. Current research, however, now shows that the genetic quality of the sperm is of primary importance, and that this is independent of the sperm count, motility and shape. A new test is now available which looks directly at the DNA (genetic) fragmentation in the sperm. Studies have shown that if there is a very high level of DNA fragmentation, the chances of a successful pregnancy are significantly reduced.

  3. Age - is a major cause of DNA fragmentation as well as poor sperm quality. Plus, in later life men can suffer from hormone changes which can result in impotence or a decrease in libido.

  4. Environmental pollutants - there are many studies in scientific literature that point to the effects of exposure to occupational hazards and pollutants in our environment, which appear to have a significant impact on sperm quantity and quality, and subsequently on a couple’s fertility.

  5. Stress – The Clinic can provide a counselling service for couples, or for just the male partner, if this is appropriate. Coping with fertility problems can be hugely stressful and can place substantial pressures on a relationship. Our resident psychotherapist or our counsellor is always available to help clients through what can be a particularly taxing period.

  Manual lymphatic massage

  This is an extremely gentle form of massage therapy, aimed at stimulating the movement of lymph in the body. Lymphatic drainage is an important way in which the body moves toxic waste around the body for removal, but because the lymphatic system has no pump to help circulation, it relies on the muscular movements of the body. However, it is a system that can become sluggish and manual lymphatic drainage helps to improve its function greatly, and significantly help to cleanse the body. At Zita West Clinics, MLD is routinely offered as part of the physical support the body needs to detox and prepare for pregnancy.

  Massage

  There are many different types of massage, but the main aim is to relieve tension and stiffness in the muscles, so removing any build-up of lactic acid that can impair muscular function, and to physically reduce the tension that can also contribute to emotional stress and difficulty in relaxation. As part of a programme to improve and stabilise general health, it has an important role to play and can be combined with other complementary therapies, like aromatherapy, or reflexology on the feet, to enhance its effect.

  See also Abdominal massage; Hydrotherm massage; Postnatal massage; Pregnancy massage.

  Meditation

  Meditation is a learnt skill, and one that comes easier to some than others. It takes an initial practice of between 10 and 15 minutes a day, and most people find some guided instruction very helpful at first. The idea is to reduce your brain’s activity consciously, allowing the brain’s alpha-waves to predominate. Not only does this process allow us to utilise the brain’s power more effectively, it also helps reduce the stressful effects of mental over-activity, on both the mind and the body. For those dealing with the challenges of trying to get pregnant, meditation can help reduce the impact of stress, allowing the body’s uninhibited ability to self-regulate, which in turn can help stabilise hormonal activity, for example.

  Midwife

  Midwives are practitioners and experts in normal birth: they are trained to support women through antenatal care, labour, birth and the immediate postnatal period. They may have originally trained as a nurse, and done a post-graduate midwifery qualification or they may have done a direct entry course to qualify. Most midwives deliver in hospital settings, but some choose to work in the community, or independently. Legally, they are able to deliver babies without a doctor being in attendance, as they are qualified to do so and are registered practitioners with the Nursing Midwifery Council in their own right.

  Mind body link

  There is more and more evidence that the link between the mind and the body is one to be acknowledged and worked with. This link can easily be seen with breathing techniques, for example. We breath automatically, but we can consciously and physically calm the breathing to instil a feeling of calm and control in our mind, to help counteract stress or work towards a meditative state, where brain waves are positively affected. We also know that prolonged psychological stress has an impact on the function of our bodies, which can be seen in muscle tension, breathing patterns, posture and physical complaints like migraines or irritable bowel syndrome. Knowing that this link exists, and can be seen in detrimental ways, also means that we can use it to work more positively, using our minds to improve our body’s function.

  Miscarriage

  Miscarriage is the loss of pregnancy any time from conception to twenty-four weeks, and is referred to, medically, as spontaneous abortion. There can be many reasons for miscarriage, and it can be a form of primary or secondary infertility. Identifying the reasons for miscarriage helps to find ways to prevent it, and at Zita West Clinics, the Miscarriage Programme is specifically designed to help couples for whom this is a problem, drawing on the most rigorous and up-to-date research, to help support couples towards successful pregnancies.

  Morning sickness

  Sometimes referred to as pregnancy sickness, this affects many women to a greater or lesser degree, ranging from feeling nauseous for all or part of the day, or to actually vomiting. For most women it disappears, almost overnight, after between 12 to 16 weeks pregnancy. Usually caused by the body’s early adaptation to the pregnancy hormones secreted in the first three months, it usually causes no harm, but can be debilitating and leave a woman feeling very tired and unwell. At Zita West Clinics, the Pregnancy Programme offers help and support for sickness during the first three months, including nutritional advice, acupuncture, and reassurance.

• NSU

  Non-specific urethritis (NSU) is a sexually transmitted disease, which causes inflammation of the urethra – the tube through which urine leaves the bladder and is excreted from the body. In women this tube is short, but in men it is longer because of the length of the penis. It is referred to as ‘non-specific’ because the cause of the infection isn’t always identifiable, and in some cases it also produces no symptoms. NSU is sometimes referred to as non-gonococcal urethritis (NGU), if gonorrhea and Chlamydia trachomitis (which is an established agent for non-gonococcal urethritis) have been eliminated as a cause of infection. The most likely cause of NSU is ureaplasma urealyticum generally symptom free, but which affects an estimated 80 per cent of all sexually active people.

  For some people, this infection may not prevent conception. But for others it can, so at Zita West Clinics, an infection screen is sometimes advised for couples where conception is a problem, to eliminate any infective causes, which can then be treated.

  Nutrition

  What we eat has a direct impact on how our bodies function. Food is, after all, the fuel on which our bodies run, so it pays to think about this when thinking about how to maintain or improve health. Too many people eat ready-meals, high in preservatives, fats, salt and sugars, and too few people eat a balanced diet of freshly prepared foods.
  
  Because fertility and pregnancy is a whole-body event, not just something limited to the reproductive organs, good nutrition is important. For many couples, correcting underlying nutritional deficiencies, improving digestion and balancing the diet - perhaps with the inclusion of nutritional supplements - can bring significant health benefits. The right nutrition can help to stabilise hormonal problems, regularise menstruation, and have an impact on problems like PCOS (polycystic ovary disease). And it’s not just important for women. Nutritional therapy can be an effective way of improving male fertility, too.

  Nutritional Consultation

  At Zita West Clinics, every client completes a detailed questionnaire before a first consultation. Included on the questionnaire are extensive questions about diet and nutrition, which allows the clinic nutritionist to evaluate clients’ needs. Inevitably, almost all clients benefit from a nutritional consultation with one of the clinic’s fully trained and experienced nutritional therapists. This ensures that advice is personal to each client, and all nutritional recommendations – which may include the need for nutritional supplementation – are individually tailored, in the full light of the multi-disciplinary and complementary approach that is the trademark of Zita West Clinics.

  Nutritional Therapy

  For some people, just correcting and improving their diet through their food intake may not be enough in the short term. Nutritional therapists differ from dieticians in that they work on the optimum amount of nutrients necessary to minimise health problems and promote good health, while a dietician tends to work with recommended daily allowances (RDAs). They also view a client holistically, and take into account factors like everyday environmental pollutants, as well as the quality and range of foods eaten.

  Nutritional therapy aims to detoxify the body, correct mineral and vitamin deficiencies, restore healthy digestion (so that the body can actually benefit from the nutrients taken in), and help clients develop a positive attitude to food and its benefits. The therapist then devises a diet for that individual that can help restore and promote good health.

• Obstetrician

  An obstetrician is a fully trained and qualified doctor who has undertaken further training to care for a woman during her pregnancy, labour and birth, and immediately after birth. Unlike a gynaecologist, they are not concerned with fertility but rather the outcome of conception. However, some obstetricians are also gynaecologists, and vice versa. Obstetricians are considered to be the experts in birth problems, whereas midwives are experts in normal births, although both may attend a birth in a hospital setting.

  Oestrogen

  Oestrogen is one of a woman’s reproductive hormones, produced by the ovaries, and responsible for ovulation. Production of oestrogen is stimulated by the secretion of FSH (follicle stimulating hormone) by the pituitary gland in the brain. Oestrogen production builds during the first half of the fertility cycle, and peaks at ovulation, after which its production declines until a woman has her period, when it begins its cycle again.

  The secretion of oestrogen, which begins as the ovaries start to function at puberty, is responsible for the secondary sex characteristics of a woman: the development of breasts, the increase in body fat around the hips, and the beginning of regular menstrual periods. After the menopause, when oestrogen production dramatically declines, not only do women cease to be capable of ovulation and pregnancy, they also lose some of the other benefits of oestrogen, for example, protection of the heart and the strength of the bones.

  Ovarian reserve tests

  This is a blood test that measures the levels of FSH (follicle stimulating hormone) and LH (luteinising hormone) in a woman’s blood, during a particular time of her fertility cycle, which will show how well the ovaries are functioning. Levels of these two hormones are measured, and compared with the normal levels known to indicate good fertility. If an FSH level is higher than it should be, for example, this gives an indication that the pituitary gland (which secretes this hormone) is secreting more and more FSH in an effort to stimulate the ovary to secrete oestrogen. If the ovaries are failing, oestrogen isn’t secreted, and without this to inhibit FSH secretion, levels of FSH rise beyond the normal range.

  These tests give an indication of how well the ovaries are functioning, and what their reserve of follicles, capable of producing an egg, might be. An indication of ovarian function, or reserve, can be a useful pointer to a woman’s fertility.

• Pelvic floor

  This is the term used to refer to the muscles that support a woman’s internal reproductive organs, (plus the bladder and urethra, rectum and anus) providing a strong, supportive ‘floor’ to keep everything in place. These muscles need to be kept strong, and can be weakened through childbirth. Combined with age, poor muscle tone in this area can eventually lead to problems with urinary continence, and even prolapse of the womb, where it descends down into the vaginal canal. Exercising these muscles, through doing pelvic floor or Kegel’s exercises, is recommended after childbirth to restore muscle tone, and throughout life to keep the area strongly supported.

  PID

  PID (pelvic inflammatory disease) is a generalised infection of the female pelvic organs, that passes from the vagina through the womb and all the way up the Fallopian tubes, sometimes affecting the ovaries. The inflammation is usually caused by a bacterial infection, and the commonest cause of PID in the UK is Chlamydia. If identified, PID can usually be effectively treated with antibiotics.

  PID causes pain and tenderness on one or both sides of the lower abdomen, and if left untreated can cause such inflammation of the Fallopian tubes that this can cause the tubes to block. This is a significant cause of infertility, and is difficult to resolve after the blockage has occurred. Micro-surgery is only rarely effective, leaving IVF an only option if there is a blockage on both sides. Even if only one Fallopian tube is blocked, the possibilities for conception are greatly reduced.

  Polycystic ovarian syndrome

  As many as 20% of women are thought to have polycystic ovaries, although most cases are mild, and only about 5% to 10% of women develop problems as a result. PCOS is caused by a hormonal imbalance, where the ovaries produce too many male hormones, which block the normal growth of the egg follicles. As a result, multiple small cysts develop, and the ovaries can then enlarge to up to four times their normal size.

  The good news is that as many as 70% of women with PCOS get pregnant without drugs, and another 20% will conceive with help. PCOS responds well to changes in diet and exercise; acupuncture can also help. More research has been carried out on the benefits of acupuncture for PCOS than for any other gynaecological problem. We have years of experience in working with women with PCOS, and have a wealth of knowledge to offer in helping them overcome the problem.

  Postnatal depression

  Postnatal depression (PND) is a depressive illness that can occur after having a baby, and can happen for a variety of biological, psychological and social reasons. It occurs in 10 to 15 per cent of women, so is relatively common, and can vary in severity from mild mood changes to the rarest form, a postnatal psychosis. Although many women experience a dip in mood a few days after birth, caused by the dramatic change in hormones following delivery, with PND depression comes on over the first month and lasts longer. Symptoms include exhaustion, lethargy and a constant desire for sleep, plus unexplained tearfulness; lack of concentration, forgetfulness, confusion and difficulty in sleeping.

  The Zita West Postnatal Support Programme covers the emotional and psychological impact of birth, as well as the physical care a mother needs, and has much to offer women who are struggling with low mood and depression after birth. Identifying postnatal depression is crucial, as trying to struggle on makes it difficult for new mothers to bond with their babies. Allowing time to recover physically after the birth is important, with lots of rest while meeting the demands of a new baby. And not only is a good general diet helpful to help stabilise mood, but DHA supplementation is recommended by Zita West Clinics towards the end of pregnancy and during the first few months after birth, because it is known to help women prone to depression. Acupuncture can help rebalance the hormonal changes that can dramatically affect women after birth, helping to restore balance and energy, while hypnotherapy can help encourage deep relaxation and stress reduction.

  Postnatal massage

  As your body begins to get back to its pre-pregnancy state, which can take a while, massage is good for helping to both soothe and stimulate. Plus the hands-on effect of this therapy helps nourish a new mother. We often recommend a full body massage as part of our Postnatal Support Programme, using our own formula of uplifting citrus massage oils.

  Preconception

  This describes the important, preparatory time before conception, when a woman can ensure she is in good physical health and her body is well nourished to sustain a healthy pregnancy. For women planning their conception or their pregnancies, a Zita West Preconception Healthcheck and/or an Early Pregnancy Healthcheck can provide valuable advice and support to help ensure the best possible start to a pregnancy. For couples facing problems conceiving, or for those undergoing assisted conception, our Fertility Healthcheck or an IVF Support Consultation Programme can also be very useful.

  Pregnancy massage

  Generally, massage in pregnancy is an excellent way of reducing the muscular tension caused by your body’s changing size and shape and the stress that can arise from that. In addition, gentle massage of the legs can help lymphatic drainage and help reduce swelling, while gentle massage of the abdomen with oil, as the skin begins to stretch, can help relieve itchiness, discomfort and – some say – reduce the chance of stretchmarks.

  Zita has developed a range of products specially for use in pregnancy, made from ingredients that will soothe and not irritate. Preconditioning Down Under Oil uses avocado oil, vitamin E and borage, making it ideal for the perineal area. Beautiful Belly Balm includes aloe vera, jojoba oil and rosehip oil, along with essential oils of lavender, chamomile, sandalwood and rose, to soothe and nourish the skin. Or why not try our wonderful Back Ease Massage Oil? Made with lime and grapefruit oils, to give the circulation a bit of a boost, it has been designed to be safe not only in pregnancy but during labour too.

  Pregnancy sickness

  Sometimes referred to as morning sickness, this affects many women to a greater or lesser degree, ranging from feeling nauseous for all or part of the day, or to actually vomiting. For most women it disappears, almost overnight, after between 12 to 16 weeks pregnancy. Usually caused by the body’s early adaptation to the pregnancy hormones secreted in the first three months, it usually causes no harm, but can be debilitating and leave a woman feeling very tired and unwell. At Zita West Clinics, the Pregnancy Programme offers help and support for sickness during the first three months, including nutritional advice, acupuncture, and reassurance.

  Progesterone

  Progesterone is one of the two main hormones secreted by the ovaries, the other being oestrogen. The secretion of progesterone begins after ovulation, when the follicle containing the egg ruptures and ovulation occurs. After the egg has left the follicle, the follicle is known as the corpus luteum, or ‘yellow body’ and secretes progesterone. This is to prepare the womb for implantation of a fertilised egg, should it occur, by increasing blood flow to the womb and thickening the lining, making it a nurturing environment for a fertilised egg.
  
  The ovary continues to secrete progesterone throughout the second half of a woman’s fertility cycle and, if conception occurs, will continue secretion to make sure the pregnancy continues. After around 12 weeks, the placenta is mature enough to take over the production and secretion of progesterone. If conception and implantation doesn’t occur, there is no need for the ovary to continue secreting progesterone, so after 14 days following ovulation it stops, and the woman has her period.

  Prostate problems

  The prostate is a walnut-sized gland located at the internal base of the penis, and produces the seminal fluid in which sperm is transported at ejaculation. As a man ages, the prostate gland tends to enlarge. This is termed benign prostate hyperplasia (BPH), and symptoms include a need to frequently urinate, including during the night. This enlarged state may or may not eventually produce malignant cells, but it is usually said that more men die with prostate cancer rather than of it.

  Prostatitis is an inflammation of the prostate, which can sometimes be caused by infection, injury, or even an immune response. It generally causes a degree of pain and discomfort, which can vary depending on its cause. Although prostate problems in themselves shouldn’t cause fertility problems, the reasons for the problem might be a contributory factor to infertility. In making an assessment of male reproductive health, especially if there are problems with a couple’s fertility, any prostate problem is taken into account, its cause identified and treatment recommended.

  Psychotherapist

  A psychotherapist is trained to work with individuals, couples or groups, who seek help for a wide range of psychological and emotional concerns. The relationship between therapist and client is an active one, with the client participating in their own efforts to address thought processes, feelings and behaviour to try and identify, address and relieve the distress of any concerns.

  Psychotherapists can be trained in a number of ways and the ‘talking treatment’ they offer will reflect this. Psychotherapists’ training vary, and the approach they offer can range from cognitive behavioural therapies, psychoanalytic therapies, psychodynamic therapies, humanistic and integrative psychotherapies, and more. However, the primary aim is to enable the client, by talking through various issues within a safe structure and within a professional, completely confidential context, to review thought patterns or strategies that may be unhelpful.

  At Zita West Clinics the ethos of all treatment is that it should integrate both the physical and the psychological, and be client led. So where it is felt that some psychological work might be useful to resolve past or present issues, this would be recommended and a referral made to a psychotherapist.

• Referrals

  Zita West Clinics offer a number of specialist practitioners, from doctors to embryologists, to midwives and nurses, to nutritionists, to acupuncturists and other relevant complementary health therapists. Where referrals are necessary outside the Clinic, perhaps to a gynaecologist or urologist, or to an assisted conception unit, this can be arranged for you by us as part of our continuity of care.

  Reflexology

  Reflexology is based on the principles that different areas on the sole of the foot correspond, via meridians or energy pathways, to different organs of the body. Through massage and manipulation of these areas, the organs themselves can be rebalanced or stimulated to improve function. It is one of a number of complementary therapies that can be utilised by individuals or couples that want to make general or specific changes to their health, prior to conception. Reflexology has been shown to be helpful in preparation for IVF, for example, particularly on the parts of the foot corresponding to the pelvis and lymphatic system.

  Reflexology can also help with;

  Dysmenorrhea – an excellent first aid remedy for relieving monthly contraction and cramping of the womb.

  Amenorrhoea (absence of menstrual periods) – by helping balance hormones, reflexology helps cycles return to their natural rhythm.

  In pregnancy, reflexology is recommended monthly from 12 weeks and weekly from 35 weeks onwards to help keep up with the woman’s hormonal changes and help prepare for birthing. Once past your due date reflexology can be an excellent aid in bringing on labour. One or two sessions usually suffice to kick start your body’s natural rhythms for birthing.

  Relaxation techniques

  There are numerous techniques that can be learnt to aid relaxation, and they are a useful skill for life that can be drawn on at any time to reduce stress and anxiety. Techniques include breathing exercises, meditation, visualisation and hypnotherapy. Initially, some guidance and support is useful to learn an appropriate technique, but mainly it comes down to practice, so that regular relaxation becomes part and parcel of daily life.
  
  Stress is widely recognised as having an adverse influence on reproduction. Which is why we offer our clients training in appropriate relaxation techniques as a part of most of our programmes.

  Reproductive hormones

  Reproductive hormones in the woman include FSH (follicle stimulating hormone) and LH (luteinising hormone) secreted by the pituitary gland, and oestrogen and progesterone, which are secreted by the ovaries during a woman’s reproductive years. Hormones are chemical messengers, influencing action in different areas of the body, and it is the subtle interplay between these hormones that creates a woman’s fertility cycle, influencing everything from the stimulation of egg production, cervical mucus, ovulation, the thickening of the lining of the womb, and the stability of the first three months of pregnancy.

  In men, the reproductive hormone is primarily testosterone, although this is kicked into action at puberty by the hypothalamus that starts secreting gonadotrophin releasing hormones to stimulate the gonads – the testes in the man, the ovaries in the female – while also stimulating the pituitary gland to produce FSH and LH. Because there is no hormonally controlled fertility cycle of events, as with women, there is less hormonal interplay in men, but the reproductive hormones in men, and their function, is still important.

• Secondary infertility

  While primary infertility describes the inability to conceive at all, secondary infertility means that a couple are currently experiencing infertility, but there has been a past history of conception, with or without a successful outcome to the pregnancy. We see lots of couples with secondary infertility problems at the Clinic who need help and support, often where there has been a diagnosis of ‘unexplained infertility’ when trying to get pregnant.

  Semen Analysis

  At the Zita West Clinic, a detailed semen analysis is offered for men - especially if this hasn’t been checked before - prior to consultation with male fertility expert Dr Sheryl Homa. Also provided is a comprehensive questionnaire on all aspects of a man’s general health, diet and lifestyle, which we ask to be completed prior to this appointment. The questionnaire is very specific and wide-ranging, and the kind of detailed history it provides is enormously valuable. Problems with sperm production can often be overcome by rectifying a series of seemingly minor imbalances in diet, lifestyle or general health, which only this kind of comprehensive review can reveal.

  For years, semen analysis results have been considered the definitive test that gave a clear answer about male fertility. Current research, however, shows that the genetic quality of the sperm is also of primary importance, and that this is independent of the sperm count, motility and shape. A new test is now available which looks directly at the DNA (genetic) fragmentation in the sperm and, where appropriate, we can arrange this for you in addition to the more basic tests. Studies have shown that if there is a very high level of DNA fragmentation, the chances of a successful pregnancy are significantly reduced.
  

  Dealing with a negative result can be difficult, particularly as many men find it difficult to admit to how they feel. Finding somebody to talk to about it (other than a partner) isn’t always easy, even though the problem is far more common than most people imagine. We have many years of experience in handling these kinds of issues, and the support programme offered includes access to a specialist counsellor where this may be helpful.

  Semen production

  Sperm is produced in the seminoferous tubules of each testis in the male. Sperm production doesn’t get ‘switched on’ until puberty, somewhere around the age of 12 to 14, when the reproductive hormones become active. Once this happens, there is a cycle of around three to four months for sperm to be produced and reach maturity. Prior to ejaculation, sperm is mixed with prostatic fluid, which provides a nutritious and liquid environment in which the sperm can live and travel, enabling them to last for up to five days. This combination of sperm and fluid is known as semen.

  Sperm production is very much influenced by lifestyle factors like nutrition and exposure to environmental pollutants, so it makes sense for a couple experiencing fertility problems to have the quality and quantity of the sperm comprehensively checked out. At Zita West Clinics, male fertility is as much a priority as female fertility, and the semen analysis offered also includes a look at the genetic health of the sperm, as many sperm may look ‘normal’ but the DNA (genetic material) may show a degree of fragmentation, which can contribute to unexplained infertility, or recurrent miscarriage.

  Sperm production needs a good supply of some quite specific nutrients, many of which are depleted in modern diets. These nutrients include zinc, selenium, co-enzyme Q-10, calcium, vitamins C, E and B12 and, for those whose diets have become depleted over the years, supplementation is recommended while general nutrition is improved. Zita West’s Vitamen supplement is specifically designed to provide men with the right nutrients and micro-nutrients, in the right balance, to help give the body what it needs to produce strong, healthy sperm.

  Sexual health screening

  There are numerous infections that can affect the reproductive organs, but without necessarily producing the symptoms that alert a sufferer to seek medical treatment. Which is why sexual health screening is crucial for every couple experiencing fertility problems. Chlamydia, NSU (non-specific urethritis) and other sexually transmitted problems (that can also include Candida Albicans that causes thrush) can each contribute to reproductive problems. A persistent, low-grade, symptom-less infection can lead to difficulties with sperm production and sperm motility, as well as blocked Fallopian tubes and a hostile environment in the womb that can prevent implantation. It is essential for every couple to know that there is no infection reducing their chances of conception.

  Sperm Count

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  STDs

  STIs (Sexually transmitted infections) are any infection that is transmitted from one person to another through sexual contact. Some infections, like hepatitis for example, can be sexually transmitted, but also transferred by other means. However, when it comes to fertility it is those STIs that may prevent successful conception that need to be fully considered, screened for if necessary, and treated.
  
  A low-grade, symptom-less, but persistent infection in one or other partner, can be a contributory factor in preventing conception, however minor the infection appears to be. Candida Albicans, which causes thrush in a woman, but rarely causes symptoms in a man, can disrupt and thicken the cervical mucus to the point where it prevents sperm reaching the egg. A more serious infection, which can cause PID (Pelvic Inflammatory Disease), which can lead to blocked fallopian tubes and infertility, is Chlamydia, thought to affect up to 80 per cent of all sexually active adults. NSU (Non-specific Urethritis) can cause problems in both men and women, while Gonorrhoea can also cause PID. The implications of sexually transmitted infections like Syphilis, HIV and AIDs are greater than just their affect on fertility.

  However, with a full sexual health check as part of the Preconception Programmes at Zita West Clinics, the aim is to diagnose, treat or rule out at the earliest opportunity any possible STI that might have an impact on fertility.

  Stress

  Stress is a phenomenon of modern life, but it’s not something that should be accepted as normal. Long-term stress produces an excess of stress hormones, like cortisol and adrenaline, and muscular tension that produces a physical state of acidity, both of which are extremely detrimental to the physical and psychological well-being of any individual.
  
  This can affect other functions in turn, disrupting, for example, the overall hormonal balance of the body, which can lead to fertility problems. Stress may start with an emotional response to life, but the impact on the physical body is often underestimated. Here at the Clinic we pay particular attention to the emotional life of our clients, because of the mind/body link, and because stress can disrupt some of the finely tuned functions of the body that can tip the balance, and make conception difficult.

  Stress management

  Identifying and removing the causes of stress in your life is obviously the best way of dealing with it; at least in theory. However, in reality, it often isn't possible to remove it entirely, which is why it can be valuable to learn how to manage it as well, so that it doesn’t become overwhelming, or start to have an affect on the functioning of the body.
  

  One way to manage stress is to learn how to consciously relax, using breathing techniques, or other easy to learn techniques such as positive visualisation, meditation or the right kind of exercise. Massage and hypnotherapy can help too.
  
  Stress is thought to be a negative influence on all stages of the reproductive process. At the Zita West Clinic we have years of experience in how to help reduce it and how to help you to manage it for yourself.

  Supplements

  Nutritional supplements are easy to buy over the counter and online, but supplements should be used to supplement a good diet and not to compensate for a poor one. The choice of supplement is also crucial because, basically, you get what you pay for. There is a huge range of supplements to choose from, with some more nutritionally beneficial than others. This doesn’t just come down to the quality and quantity of the ingredients, but also whether or not the micro-nutrients are balanced and in a form that makes the supplement available to the body.

  One of the many benefits of a nutritional consultation is to gain good information and appropriate advice about supplements, what is actually needed and what to use. In addition, Zita West Supplements have been specially designed to meet the specific needs of women and men who need supplementation to improve their fertility, support their pregnancies, and for use during the postnatal period.

• Testes

  A man’s two testes are located in the scrotum. They are ovular in shape, slightly mobile and easily felt inside the scrotum, as long as they have descended from inside the abdomen. Although it makes the testes more vulnerable to be outside the body, they need a cooler temperature in which to function. Although checked for at birth, one or other testicle in a boy might not descend, or might require surgery later. If a man reaches maturity with an undescended testicle, this will affect his fertility. Attached to each testis is around 40 feet of tiny, coiled tubing, called the epididymis, through which the immature sperm travel to reach maturity.

  Thrush

  Thrush is generally caused by Candida albicans, an overgrowth of yeast in the woman’s vagina that leads to a thickening and whitening of the cervical mucus. It can also be extremely itchy, and often occurs when the slightly acidic environment of the vagina has been temporarily disturbed, allowing for the possibility of an opportunistic infection like Candida albicans, perhaps following a course of antibiotics, or from taking the contraceptive pill.

  Candida albicans is a fungal infection, and can be repeatedly passed to and from each partner, so any treatment for the woman – in the form of an antifungal pessary inserted in the vagina, or the use of an antifungal cream – must also include the male partner being treated with an antifungal cream around the tip of the penis and under the foreskin, if he has one.

  Although not a serious infection, and easily treated, thrush can become a problem when it comes to conception because of its affect on the vaginal environment, making it difficult for sperm to reach an egg for possible fertilisation and implantation. Some women are much more prone to thrush than others, and become repeatedly infected. Not only is treatment important, but also a look at nutrition, reducing the sugar intake of the diet, for example, and other lifestyle changes – like changing to pure cotton underwear, or using a hypo-allergenic washing powder, for example – should also be considered.

  Thyroid problems

  Thyroid problems are much more common than originally thought. Around 2% of the population have an underactive thyroid, and 2% an overactive one – while women are affected about 10 times more frequently than men.
  
  The thyroid secretes a hormone, thyroxin, and both excess, or an inadequate supply of this can affect the function of the other hormones of the body. When this occurs, and symptoms can be difficult to identify, there can be an affect on the fertility hormones, preventing ovulation. The good news is that thyroid problems are easily identified, with a simple blood test that a GP can carry out, even if symptoms are unspecific.
  
  It is usually an underactive thyroid that causes problems, and in severe cases, menstruation is irregular or infrequent. Even a borderline deficiency can cause a problem, so it’s important to identify, which is why it's one of the tests we frequently do at the Clinic. The solution is a daily replacement of the missing hormone, but it’s also important to look at your nutrition. Complementary therapies, like acupuncture, can also assist, by helping to rebalance the body.

  Trimester

  A trimester is the name given to the three-month period - of which there are three - of a woman’s pregnancy. Generally referred to as the first, second and third trimesters of pregnancy, each three-month period covers a particular sequence of progress, leading to labour, delivery and birth.

  Zita has produced a range of different nutritional supplements (Vital Essence 1, 2 and 3) that have been specifically formulated to help support both mother and baby for each specific trimester, as well as post-natally (Revital Essence).

• Ultrasound scan

  High-pitched sound waves – inaudible to the human ear – are directed at a woman’s pregnant abdomen, reflected back off the baby, and recorded electronically to give an image on screen. Now a routine part of antenatal care, and offered first of all at around 12-16 weeks of pregnancy (unless there is a reason for early scanning, for example, past miscarriage), scans are used to check the date of the pregnancy, whether or not there are multiple pregnancies, and can be used to check for certain abnormalities as part of prenatal diagnostic techniques. A scan will also check the position of the placenta. They are painless, cause no harm to the baby, do not induce miscarriage and for most women are immensely reassuring. Nowadays, most pregnant women expect to have at least one scan, if not several, to monitor the growth and health of their baby during the pregnancy.

  Unexplained infertility

  One of the most frustrating diagnoses that a couple experiencing problems with conception can receive is one of ‘unexplained infertility’, where no specific reason for failure to conceive can be found after extensive tests. Unfortunately, this diagnosis affects one in three of infertile couples.

  It is now thought that unexplained infertility is most usually caused by a minor problem in each partner. On their own, the problems wouldn't matter, but if both partners have something slightly wrong, the combination tips the balance and affects the chance of them conceiving successfully. For example, if a woman is underweight to the point where ovulation is irregular, and the man’s sperm is not of great quality, the combination of these two, seemingly minor problems, may tip the balance against conception.

  Over the past ten years, the experts at our Clinic have dealt with many, many cases of unexplained infertility. And the good news is that by assessing and improving minor health details in both the man and the woman, this can often be overcome.
  
  If we're not able to help you to conceive naturally, and you decide to go for IVF, then our IVF Support Programme is there to give you all the physical and emotional back-up you need to improve the chances of a successful pregnancy.

  Urologist

  An urologist is a qualified doctor who has undertaken further research and training to specialise in urology – the study of diseases of the urinary system. Although not a direct equivalent to a gynaecologist who cares for women’s reproductive health, by nature of the male urinary system, which is so closely linked to his reproductive system, an urologist tends to be a specialist in male reproductive health as well.
  
  Where there is some problem with a man’s urinary system – for example, prostatitis, a variocele of the testes, or a twisted spermatic duct – that could interfere with his fertility, then referral to a urologist would be recommended for a complete diagnosis and treatment.

• Vaginal secretions

  Most women are aware of their vaginal secretions, the mucus produced by the glands of the cervix at the entrance to the womb, and how they vary during the course of their fertility cycle, but few are aware of how crucial these secretions are to fertility. A woman’s body cleverly changes the vaginal secretions, through the effect of the female reproductive hormones oestrogen and progesterone, in order to protect her body and to aid conception. Immediately after a period there is little vaginal secretion but, under the influence of oestrogen, the cervical mucus changes from being white and sticky, becomes less and less opaque, becoming more watery, clear and stretchy, until it resembles raw egg white. This type of mucus is produced at the time of optimum fertility in a woman and is designed to help the sperm swim through the reproductive tract, increasing its chances of meeting and fertilising an egg as soon after ovulation as possible.
  
  Women who are taught to observe their vaginal secretions, looking out for these signs of peak fertility, can enormously improve their chance of conception, using this particular symptom of approaching ovulation to time intercourse. This is a key feature of fertility awareness, taught to all couples that come to Zita West Clinics, to improve their chances of conception.
  
  If a woman's vaginal secretions do not conform to the "classical picture" this may be a reason for delayed conception. A consultation with our fertility awareness expert would help to explore the factors which can affect the secretions. This may be related to age, hormonal imbalance or to diet, general health, medication, or the use of tampons or thongs. Once identified many of these problems can be rectified quite easily.

  Visualisation

  Visualisation is an easy to learn technique, which is very simple but very effective, helping to give a sense of calm and tranquillity. Most importantly, it also helps to create a positive approach to whatever process is being embarked upon. The aim is to visualise in your head a series of images that creates a positive image of what you want to achieve, or what you are aiming for. For example, if you want to think positively about conceiving, the visualisation process will involve picturing the egg at ovulation, the egg meeting the sperm, and fertilisation occurring, then moving down the Fallopian tube to the nurturing environment of the womb and implanting securely, attaching firmly and growing strongly.

  It helps to have some formal guidance when learning visualisation techniques. It also helps to get comfortable, in an environment where you won’t be disturbed, and are feeling warm and secure, letting your breathing become calm and peaceful before starting. The whole process utilises the mind/body link, which our experience has shown to be important when it comes to trying to conceive.

• Zinc

  Of all the nutrients linked to fertility, the mineral zinc is probably one of the most important, especially for men. Where a man’s zinc intake is known to be low, his sperm count and sperm motility is likely to be correspondingly low. Although a micro-nutrient, it is essential for the genetic material that is the basis of new life, and if this is flawed, fertilisation can fail or miscarriage can occur. It is also a key nutrient for efficient use of the female reproductive hormones, oestrogen and progesterone.
  
  Vegetarians and vegans are particularly at risk of zinc deficiency, because animal products are valuable sources of it. Taking a large amount of zinc by way of supplementation won't necessarily solve the problem either, as you also need to make sure that the other micro-nurients necessary for zinc absorption are available. If you are suffering from depleted zinc, taking a specialised supplement is usually advisable. Zinc is one of the key ingredients in Zita's own range of preconception supplements: VitaMen for men and VitaFem for women.

  Zita West

  Zita West originally trained as a midwife, and now combines her practice of midwifery with a firm belief in holistic principles. She is a highly regarded authority on pregnancy and birth, and has been the pregnancy and fertility expert on GMTV, The Wright Stuff, Richard & Judy, The F Word, Loose Women and Tonight with Trevor McDonald.
  
  She writes a regular column for Junior Pregnancy and Baby and is quoted in the press on a regular basis. As a practising acupuncturist she combined this with her NHS midwifery practice, and pioneered the opening of the Acupuncture Clinic at the Warwick Hosptial. Zita has also studied nutrition with the Institute of Optimum Nutrition and is qualified to advise on preconception nutrition.
  
  The first Zita West Clinic was set up on Harley Street over ten years ago, to provide couples with advice, support and treatment for the full range of fertility and pregnancy issues from preconception to pregnancy and birth and postnatal care, and is now based at 37 Manchester Street, London W1. Zita has written several books – Natural Pregnancy, Fertility & Conception, Babycare Before Birth (all published by Dorling Kindersley) and Zita West’s Guide to Getting Pregnant (published by Harper Thorsons). She also produces her own range of preconception, antenatal, and postnatal nutritional supplements and products.

  Zita West Clinics

  The main Zita West Clinic is located in central London, between Baker Street and Marylebone High Street, at 37 Manchester Street, London W1U 7LJ (Tel:020.7224.0017).

  We also run an acupuncture clinic within the Fertility Unit of the Lister Hospital in London.

  Zita West Questionnaire

  The Zita West "Five Star" Questionnaire helps pinpoint areas that may affect your reproductive status, both positively and negatively. The detail this provides, in conjunction with the initial consultation, helps to indicate whether further support and/or lifestyle changes may be beneficial, and if so, which tests, treatments or therapies might be appropriate. It ensures that all relevant areas are assessed right from the start.

  Zita West supplements

  Nutritional supplements are easy to buy over the counter and online. As the name suggests, they should always be used to supplement a good diet and not to compensate for a poor one. The choice of supplement is also crucial because, basically, you get what you pay for. There is a huge range of supplements for fertility, preconception and pregnancy to choose from, with some more nutritionally beneficial than others. This doesn’t just come down to the quality and quantity of the ingredients, but also whether or not the micro-nutrients are balanced and in a form that makes the supplement available to the body.

  Zita West supplements have been specially designed to meet the specific needs of women and men who need supplementation to help improve their fertility and to prepare for conception, and for women, to help support their pregnancies and their recovery after the birth. Zita West products are premium multivitamin and mineral supplements.
  
  Vitafem and Vitamen have been developed to help support fertility and preparation for preconception. Vital Essence 1, 2 and 3 have been uniquely tailored to help meet both mother and baby's specific nutritional needs during each of the three trimesters of pregnancy, and ReVital Essence has been developed to help support post-natal recovery. Vital DHA is a companion Omega 6 and Omega 3 oil, mixed with Evening Primrose, and is designed to complement each of the other products in the range at each key stage of reproduction.
  
  For more details of the Zita West range, click on "supplements" from the menu bar at the top of this page.