Adam Balen - The Fertility Book: Your definitive guide to achieving a healthy pregnancy

Knowledge is power and, in the disempowering situation of struggling to conceive, this book is an absolute game-changer. Whether youre brand new to the world of fertility or youve struggled for a while, this book is a beacon of clear, detailed information. It is an amazing resource and I would highly recommend it to anyone who is even considering having a go at conceiving!

DR XAND VAN TULLEKEN, TV presenter, Honorary Associate Professor, University College London

This unique, patient-centred book provides high-quality clinical and scientific information, but with an emphasis on a holistic approach that seeks to empower readers. Comprehensive and authoritative, it is written in an easy, accessible style that makes it a pleasure to read and understand. Everyone concerned about their fertility should read it and so should the clinicians looking after them!

DR RAJ MATHUR, Chair, British Fertility Society

An utterly brilliant book. Fully comprehensive and reader-friendly. I wish it had been around when I was on my own fertility journey.

JESSICA HEPBURN, founder of Fertility Fest

Inability to conceive is tremendously stressful for many couples. Whilst there is no shortage of information, it is difficult to separate what is credible and evidence-based from wishful theories and anecdotes. This is where The Fertility Book makes a unique contribution, by synthesising and presenting credible evidence to inform ones fertility journey. If you are struggling to have a baby, make time for this book. It will help you.

PROF ARRI COOMARASAMY, Director, Tommys National Centre for Miscarriage Research, University of Birmingham

This book has all that most need to optimise their fertility. It clearly explains the science in ways that should help couples feel empowered when it comes to making what could be some of the most important decisions of their lives.

DR EDWARD MORRIS, President, Royal College of Obstetricians and Gynaecologists

I absolutely love this book. I have learnt so much. It is an ideal read for non-medical professionals who wish to gain an understanding of the medical side of fertility treatments.

ANGELA PERICLEOUS-SMITH, Chair, British Infertility Counselling Association

A comprehensive and easily understandable text for couples who wish to take a proactive approach, optimising their chances of starting a healthy family. Highly recommended for women and men.

PROF BASKY THILAGANATHAN, Clinical Director, Tommys National Centre for Maternity Improvement

The Fertility Book is a comprehensive and reliable source of information for those with fertility problems and an essential read in a time when medical fictions spread faster than medical facts.

SARAH NORCROSS, Director, Progress Educational Trust

Balen and Dugdale have managed to distil a huge amount of complex information about fertility into an easily accessible read which includes a lot to help men, who are often overlooked. I highly recommended this book

PROF ALLAN PACEY, MBE, Professor of Andrology, Head of Oncology and Metabolism, Sheffield University

Having such high-quality and up-to-date information on reproductive health all available in one place is really important for womens health and well-being.

SHAISTA GOHIR, OBE, Chair, Royal College of Obstetricians and Gynaecologists Womens Network

The Fertility Book is a thorough and comprehensive guide to the issues that can cause fertility problems. It helps readers navigate a pathway through the tests and treatments they may face.

KATE BRIAN, Fertility Network UK

Taking care of your own health is really powerful, but that needs evidence-based, reputable sources of information, and the help of medicine and science when necessary. The Fertility Book is all of that. Its a comprehensive, easy-to-understand guide to preparing for the road to conception, whether natural or assisted.

CATHERINE NESTOR, former Vice-Chair, Royal College of Obstetricians and Gynaecologists Womens Network

This book is an invaluable resource for those on their fertility journey. An essential read!

CAROLINE ANDREWS AND RACHEL HAWKES, Secretary and Chair, Verity, the PCOS patient representative organisation

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Ebury is part of the Penguin Random House group of companies whose addresses can be found at global.penguinrandomhouse.com.

First published by Vermilion in 2021

Copyright Professor Adam Balen and Grace Dugdale 2021
Illustrations David Woodroffe 2021

The moral rights of the authors have been asserted

Cover design by Two Associates

ISBN: 978-1-473-55561-7

This ebook is copyright material and must not be copied, reproduced, transferred, distributed, leased, licensed or publicly performed or used in any way except as specifically permitted in writing by the publishers, as allowed under the terms and conditions under which it was purchased or as strictly permitted by applicable copyright law. Any unauthorized distribution or use of this text may be a direct infringement of the authors and publishers rights and those responsible may be liable in law accordingly.

The information in this book has been compiled as general guidance on the specific subjects addressed. It is not a substitute and not to be relied on for medical, healthcare or pharmaceutical professional advice. Please consult your GP before changing, stopping or starting any medical treatment. So far as the authors are aware the information given is correct and up to date as at July 2021. Practice, laws and regulations all change and the reader should obtain up-to-date professional advice on any such issues. The author and publishers disclaim, as far as the law allows, any liability arising directly or indirectly from the use or misuse of the information contained in this book. All names of patients given in the book have been changed to protect the people involved.

For Theo

Understanding your body is truly a skill for life.

My interest in reproductive science started, as these things often do, because of something personal. My older sister suffered a missed miscarriage in her twenties and was distraught. Her 12-week scan failed to show a heartbeat and the baby (or fetus to use the correct medical term) had stopped growing at 9 weeks. When conventional medicine couldnt offer any explanations and with others saying it was for the best in the typical clumsy style of those who dont know what to say to someone who has experienced this devastating loss, I decided to do some research. With a background in molecular biology and genetics, I was well placed to seek answers in the scientific literature. What I discovered was to define the rest of my career.

Evidence largely from animal studies at the time showed that underlying nutrient deficiencies and under-nutrition can contribute to the risk of miscarriage. Tests on my sister showed that she had various deficiencies including zinc and iron, so I identified suitable supplements and, after a relatively short period taking them, she conceived again and went on to have a healthy pregnancy and a beautiful healthy baby boy. While I would never suggest it is always this easy and we cant be sure nutrient deficiencies caused my sisters miscarriage, she did feel immediately better that we had found a possible reason and identified something she could do to help herself. For me, it started a lifelong fascination with the creation of new life and our ability to intervene in this seemingly miraculous event.