Conception Success Rates

At the Jocelyn Centre for Natural Fertility Management we have been working with women and their partners to help them achieve a healthy conception, pregnancy, birth and baby since 1977. Our conception program has drawn strongly on the work done by Foresight – the British Association for the Promotion of Preconceptual Care which was established in the UK in 1978. So here we present some of the combined evidence of studies done on our and similar natural, holistic programs, to reassure you that the rewards for following this approach to conception are significant, substantial and very empowering.

The chances of a successful outcome with our conception program are highest if:

  • both prospective parents take part in the program prior to conception
  • lifestyle and dietary protocols are followed as closely as possible
  • general and reproductive health issues for both partners are resolved to a sufficient degree during this time. The closer the program is followed, the higher the success rate.

 

 Measuring the program’s success rates is complex

 

Success rate percentages for the NFM Conception Program at the Jocelyn Centre are complex to measure. Our patients come to us with such differing general and reproductive health issues that it’s often inappropriate to compare them with one another. Some have little difficulty with conceiving and want to simply optimise the health of their baby. However, the majority have some reproductive health or infertility issue. Many have tried assisted reproductive technologies (such as IVF) and some have ‘reached the end of the road’ before trying our services. Others are older prospective parents with decreased fertility and lack of time. We have cases deemed untreatable (many of which we have successfully treated). Also, the other factor that makes measuring success rates difficult is that treatment may be personalised for each patient. There is no one herbal formula, or specific disease treatment protocol, which we apply to everyone, which could then be measured for its effect. However, the general lifestyle, dietary and conception timing principles are applied universally, to all the women and their partners who come to the Jocelyn Centre, and provide the essential basis of all our treatments.

 

 Jocelyn Centre clinical outcomes are successful, despite difficult cases

 

As we have been in practice for over forty years, we have much anecdotal evidence (clinical observation) which strongly suggests that our overall success rate is high, despite a large proportion of challenging cases (such as older prospective parents in their late 30s and early to mid 40s – or more). We find that natural and holistic treatments can often succeed when orthodox treatments, such as drugs and surgery, fail. Since our clinic began, we have had successful outcomes with thousands of ‘infertile’ couples.

The work of NFM is a unique and new approach to addressing fertility problems. We are a pioneer of the concept and practice of ‘preconception health care’ which is now a term and method in common use throughout both natural and orthodox approaches to fertility, pregnancy and infant health. Because we primarily use natural therapies, there is little external funding available to conduct scientific studies to verify the clinically observed success rates we see each day. Also, the holistic approach does not easily lend itself to the scientific method because of its multi-faceted nature, the difficulty in monitoring self-help aspects of treatment, and the fact that treatments are highly personalised.

That said, there are several studies which go some way to support our clinical observations of success. One of these was an independent study conducted at The Jocelyn Centre by The University of New England, and three of these come from Foresight. A further study into the effects of diet on fertility was conducted at Harvard University, based on the Nurses’ Health Study.

  1. 1stForesight Survey 1995 (covering those enrolled during 1990-1992)

A Foresight survey, conducted in conjunction with Dr Neil Ward, (director of research, Department of Chemistry, University of Surrey) and published in the Journal of Nutritional and Environmental Medicine, clearly shows the effectiveness of preconception health care.

The survey involved:

  • 367 couples and lasted two years
  • age of females: 22-45 years
  • age of males: 25-59 years
  • 41% of the couples had no previous adverse reproductive history, but among these were the older couples.
Presenting with a Previous History Percentage in Sample
Reproductive health problems (217)       59%
Infertility – for 1-10 years (204) 56%
Miscarriage – from 1-5 occurrences (139) 38%
Therapeutic abortion (40) 11%
Still birth (11) 3%
Small for dates / low birth weight (55) 15%
Malformations (7) 2%
SIDS (3) 1%
86 women (24%) reported more than one of these problems. 154 men (42%) had previously had a semen analysis for infertility and most showed a reduction in sperm quality. Of the 204 couples with fertility problems, 136 had primary infertility (no previous children), and 68 had secondary infertility. 158 of the infertile couples were fully compliant in following the program and 46 were prepared for IVF.

Results

Outcome %  in Sample
Conceptions (327) 89%
Live births (327) 89%
Live births to previously infertile (175) 86%
Live births to infertile & fully complied with the program (145) 91%
Live births to those prepared for IVF (30) 65%
Average gestational age 38.5 weeks
Earliest / latest gestational age 36/41 weeks
Average weight of males (137) 7lb 4oz (3303g)
Average weight of females (190) 7lb 2oz (3232g)
Lightest baby 5lb 3oz (2368g)
  • all babies born healthy and well developed at birth
  • no miscarriages, perinatal deaths, malformations, multiple pregnancies
  • no baby admitted to intensive care.

Normal expectation – 92 miscarriages, 6 malformations, 25% conception rate on IVF.

  1. 2ndForesight Survey 2002 (covering those enrolled during 1997-1999)

Due to administrative problems at Foresight, a lower proportion of these couples were fully compliant with the preconception program and several left before completion. Despite this, the results still compare very favourably with normal expectations.

The survey involved:

  • 1,076 couples
  • 1,061 had previous fertility or miscarriage problems
  • 393 had previous (single or multiple) miscarriages.

Results

The statistics from this second survey show excellent outcomes, with a conception rate of 78.4% within two years of following the program (729 couples had given birth to a 779 healthy babies by the end of the survey, and 67 were still pregnant). Of the infertile couples, the success rate was 72.4% compared with and expected ‘norm’ of 22.6%.

Miscarriages

Of the 393 couples who had previously miscarried, there were 28 miscarriages – a rate of 7.1% as opposed to an expected ‘norm’ of 33%. With the other conceptions, there were no miscarriages – a rate of 0%. This gives an overall rate of 3.2% as opposed to an expected ‘norm’ of 25%. So, despite the lack of full compliance, the reduction in miscarriage is still extremely impressive.

Health problems 

Of the very few couples who had a negative outcome (four cases of defect in 846 pregnancies which is a rate of 0.47% as opposed to an expected ‘norm’ of 6%, and three stillbirths which is a rate of 0.13% as opposed to an expected ‘norm’ of 1.37%) there was either non-compliance with the program or unexpected, unavoidable and invasive trauma.

Birth weights

These were again above the national average, with half the expected rate of low birth weight babies, with most of these the result of multiple births (many more couples on this second survey embarked on ART cycles following their preconception preparation).

 IVF / ART

This study also suggests a more than doubled conception success rate for IVF of 47.1% following preconception health care as opposed to the national rate applicable at the time of 22.6%. Other ART conceptions showed similar success:

  • couples using IUI – 44.6% success
  • couples using IVF – 47.1% success
  • couples using ICSI – 43.1% success
  • couples using donors – 33.3% success.

Total success rate for all couples on the survey using any form of ART was 43.5%.

Increasing number of couples and single women are using IVF and other ART procedures, and they are generally advised, with a sense of urgency, to start on an ART cycle as soon as possible. However, it is clear from these figures that in fact they are much more likely to have success – both in terms of a conception and a full-term, healthy baby – if they allow themselves enough time (generally approximately four months) to fully prepare before embarking on IVF.

To summarise, we see that from the basic Foresight program, even when working under difficulties and without full compliance on this second survey, it is possible to:

  • more than double the success rate of IVF (22.6% to 47.1%)
  • raise the success rate of infertile couples overall from 22.6% to 72.4%
  • drop the miscarriage rate from 33% to 7.1% for those with a history of miscarriage
  • drop the miscarriage rate to zero for those who have not previously miscarried
  • drop the total number of miscarriages from 25% to 3.5%
  • very significantly reduce any chance of health problems.
  1. Third Foresight survey 2010 (covering those enrolled during 2002-2009)

The survey involved:

  • 1,158 couples who followed the complete program
  • 518 couples who did not complete the full program
  • a previous history of 2,383 failed and 162 successful IUI cycles (6.3% success rate)
  • a previous history of 3,004 failed and 407 successful IVF cycles (11.4%success rate)
  • a previous history of 1,081 failed and 211 successful ICSI cycles (16.5%).

 Results

Group one– 1,568 couples who completed the full Foresight program.

  • 1,122 babies were born, a success rate of 81.9%.
  • 220 ongoing pregnancies at the time the survey was completed.
  • There were 4 miscarriages – a rate of 0.26% compared to an expected ‘norm’ of 25%.

Group two– 518 couples who did part of the program, but did not complete it.

  • 358 babies were born, a success rate of 63.7%.
  • There were 39 miscarriages – a rate of 7.5% compared to an expected ‘norm’ of 25%.

This shows how important it is to complete the full minimum of four months preconception health care (or more if there is time required to overcome reproductive health or lifestyle problems)

  1. Male Fertility as surveyed by Foresight

A further analysis of the Foresight surveys shows that with 272 men who had been told that they would never father a child – of those who followed the program fully, 81% succeeded.

The Foresight Program combines:

  • hair mineral analysis for toxic (heavy) metals
  • detoxification of toxic minerals
  • supplementation of nutrient minerals
  • wholefood nutritional advice
  • cessation of smoking, alcohol, caffeine and drugs
  • natural family planning / avoidance of hormonal contraception
  • testing and treating genito-urinary infection, allergy and parasites
  • advice regarding avoidance of electromagnetic pollution
  • advice regarding toxic ingredients in cosmetics, personal care products , household cleaning products and pesticides
  • advice regarding organic food and purified water.

The NFM Conception Program covers the same approach used by Foresight and extends this at the Jocelyn Centre by using natural therapies to enhance, treat and resolve reproductive health issues.

  1. University of New England Study 2002

An independent study conducted at the Jocelyn Centre for Natural Fertility Management.

Susan Arentz , BHSc (Hons); ND, and Dr Gemma O’Brien, BSc (Hons); PhD (Syd), conducted an independent study of 67 patients on the NFM Conception Program conducted at The Jocelyn Centre.

The study involved:

  • a 4-6 month program of individually tailored combinations of medical and naturopathic treatments, conception timing and lifestyle, dietary and nutritional advice
  • a high proportion of the couples in this study (those in the test group) had serious fertility problems and were diagnosed as infertile
  • in both the test and control group 25% of women were over 40 years of age.

Results

  • 56% of previously infertile couples conceived within the first two months following their participation in the program, and
  • 50% of these women were in the 40+ age group.

How do these success rates apply to individual cases?

 

If you are considering the NFM Conception Program and require individual treatment, you can call the Jocelyn Centre for a free introductory consultation, when a naturopath will discuss the following with you:

  • whether the program can address your specific concerns
  • an approximate idea of how long it may take to resolve any fertility problems – if there is no successful outcome after 6 months of attempting conception (following the minimum 4 months of preconception health care) and if no further problems have become apparent, your naturopath will then discuss the orthodox and complementary options open to you
  • an approximate idea of your individual chances of success.
  1. Harvard University Study 2007

A study undertaken by Harvard University (Chavarro et al), and based on the Nurses’ Health Study, evaluated the relation of a ‘fertility’ dietary pattern and other lifestyle practices to the risk of ovulatory disorder infertility, and was published in the November issue of the Journal of Obstetrics and Gynecology. It showed a 69% lower risk with the lifestyle changes of switching to a fertility diet (based on similar principles to the NFM diet) and an 84% lower risk with the adoption of five or more low-risk lifestyle habits (all of which we recommend 0n the NFM Conception Program at the Jocelyn Centre).

 The study involved:

  • 17,544 women without a history of infertility who were followed for eight years as they tried to become pregnant or became pregnant
  • subgroups that were defined by women’s age, parity (number of previous pregnancies), and body weight
  • further adjustment for history of smoking and oral contraceptive use, alcohol and coffee intake
  • a dietary score based on factors previously related to lower ovulatory disorder infertility (monounsaturated rather than trans fats, higher levels of plant proteins, low GI carbohydrates, high fat dairy, multivitamins and iron from plant sources and supplements
  • advice on multiple lifestyle factors, including diet, alcohol and coffee intake, weight control, physical activity.

Results

  • All subgroups showed a 69% lower risk of ovulatory disorder infertility and a 27% lower risk of infertility due to other causes.
  • The risk of ovulatory disorder infertility decreased with each increasing number of low-risk lifestyle habits followed.
  • There was a 30% lower risk if one low-risk habit was followed, with up to an 84% lower risk with five or more low-risk habits (all including diet, weight management and physical activity).
  • Dietary composition had greater impact on fertility than either BMI or vigorous physical activity alone.
  • However, overweight women (BMI 25-29.9) and underweight women (BMI <20) had a higher risk of ovulatory infertility.
  • Obese women (BMI >30) had a more than two-fold greater risk of ovulatory infertility.
  • Underweight women had the highest risk of infertility.
  • Women who engaged in vigorous physical activity for 30 minutes or more each day had a slightly lower risk of ovulatory disorder infertility.
  • There were 25,217 pregnancies and pregnancy attempts.
  • Of these there were 3,209 reported cases of fertility failure (all causes).
  • Of these 2,032 women were further diagnosed as infertile and 416 reported as experiencing ovulatory disorder infertility.

The authors further concluded that:

  • “Following a ‘fertility’ diet pattern may favourably influence fertility” and
  • “The majority of infertility cases due to ovulation disorders may be preventable through modifications of diet and lifestyle”.