No Bad Carbs + Increased Protein = Increased Fertility & Increased Pregnancy rates

I know I talk about it all the time, but a good diet, and I mean a good diet (not half hearted, I am trying to do it diet), can actually increase your fertility and pregnancy rates

Every day I get people ask me “What can I do to increase my fertility and my chances of pregnancy?”

Well, I always say “How long is a piece of string?”, but while there are many things that people can do to increase their fertility, one being start of my fertility program, the other important one is starting with a good diet. That is one thing “You” are solely responsible for and something “You” can do for yourself. This is for the couple too. Not just the woman.

Healthy couples produce healthy babies. That means health men produce healthy sperm and healthy women produce healthy eggs and the combination creates healthy embryos that go on to become healthy babies. It really is a fact. Even for same sex couples, a partner should be supporting their other half in the journey and at the end of the day a healthy diet is going to help everyone live longer to enjoy their children later on, and hopefully grandchildren too.

Obviously there is a lot more to it, and why in my fertility program I cover “everything” for the couple,  but this is one way to ensure your body is ready to have a baby. This is also part of my PACE (Primal, Ancestral, Clean Eating) diet that I have formulated.

Recent studies have shown that when the bad carbohydrates are removed and the protein increased, that the clinic pregnancy rates shot up by 80%. Yes… a massive 80%

The other thing that is important is that eating this way also improved the embryo quality. Blastocyst development was higher in the high-protein group than in the low-protein group (64% vs 33.8%), as were clinical pregnancy rates (66.6% vs 31.9%) and live birth rates (58.3% vs 11.3%).

Reducing carbohydrates and boosting protein intake can significantly improve a woman’s and couples chance of conception and birth according to the research presented at the American Society of Reproductive Medicine (ASRM) several years ago.

The effect is “at the egg level,” said lead investigator. He presented the findings here at American Congress of Obstetricians and Gynecologists 61st Annual Clinical Meeting.

Carbohydrate-loaded diets create a hostile egg and embryo environment even before conception or implantation, he explained.

“Eggs and embryos are not going to do well in a high-glucose environment.” By lowering carbs and increasing protein, “you’re bathing your egg in good, healthy, nutritious supplements,” he said.

These studies demonstrate how little many in the reproductive medicine and fertility profession know about the effect of micronutrients in our diets on various aspects of reproduction.

These studies demonstrate a field wide open for future research and shows how bad carbohydrates (refined grains, refined sugars etc) have an inflammatory effect that affects fertility and pregnancy outcomes and also detrimental to IVF outcomes.

This is why I always promote a grain free, primal based diet (PACE Diet) to all of my patients, especially my fertility and gynaecology patients. It is an essential part of my overall success rate and why I have been able to help over 12,500 babies into the world and help many with gynaecological issues as well.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-The International Baby Maker

-No Stone Left Unturned

Vitamin D Increases Fertility & Assisted Reproduction Success Rates.

New research has concluded that there is a relationship between a woman’s vitamin D status and the success rates of assisted reproduction therapy(ART), which includes IUI, IVF and ISCI. While this is research is nothing new, and something I have been promoting for years, finally it is now official. Women trying to conceive should be taking vitamin D supplements, eating vitamin D rich foods, and getting a healthy dose of the sun daily.

Infertility, or what we call subfertility, is becoming an increasing problem and affects millions of people worldwide. More and more people have to turn to assisted reproduction therapy (ART) which now means more and more people are having to use IUI, IVF and ICSI.

The problem is that even with assisted reproduction therapy (ART), at best the success rates are only around 25- 30% on average, and that depends on the clinics individual success rates. Some clinics are also inflating and bodgying success rates to bring in unsuspecting customers.

While there has been much advancements in assisted reproduction (ART) such as IVF and improvements in success rates, the success rates have also started to stagnate. This is why couples need to look at all options to help increase those success rates and this is why I have set up a fertility program that can boost those success rates by as much as 96.1% *. This is why what I do has helped over 12,500 babies into the world and why couples need to look at a multimodality approach to increasing their chances of conception.  I often explain to couples that it is like preparing for a marathon; because that is what doing ART can be like. You need to prepare the body (both the man and woman), get the right diet, get the right nutrients, prepare mentally, prepare physically and basically get the bodies into the best shape possible to give the best success. Nobody should ever run a marathon without adequate preparation and the same goes for assisted reproduction.

Vitamin D and reproduction

Researchers across the board know that there is room for improvement in ART success rates. A range of potential factors are being explored, and some scientists have turned their attention to the potential role of vitamin D. While vitamin D is something that needs to be explored, and something that I give to my patients, it needs to be combined with other things mentioned above. It isn’t just as simple as taking Vitamin D and all your fertility problems are gone. But, it is one of the things that can help increase your overall success rates and should be used.

Most of our vitamin D supply is generated in our skin after exposure to sunlight. We do get some from our diets as well. This means that individuals who live in colder or darker environments are more susceptible to lower vitamin D levels, or those who regularly wear clothes covering the majority of their skin, and those who rarely go outside. The problem these days, many of us have jobs that require us to be inside most of the time and therefore were aren’t getting enough sunlight. The current figures actually show that up to 97% of Australians, and most probably other countries like the US are the same, are actually vitamin D deficient. The other issue is that even though some of us do get out in the sun, it actually needs to be at a certain time of the day, for optimal absorption. The optimal times are 10am and 2pm in the afternoon. The thing is, most of us aren’t getting out in the sun at these times.

A link between vitamin D and fertility has been theorized for many years and based on a number of observations and studies.  This is one of the reasons I have been promoting the use of Vitamin D for more than 20 years now, for those who are on my fertility program. For instance, vitamin D receptors and enzymes have been found in the endometrium. This is why Vitamin D is also good for women with gynaecological issues such as endometriosis, or adenomyosis. It is good for any gynaecological issue really. Vitamin D deficiency has been shown to increase the risk of pre-eclampsia, pregnancy-induced hypertension, gestational diabetes, and lower birth weight. Vitamin D is also essential for a health immune system and reducing inflammation in the body too.  It also helps with bone health.

We have also seen that in animal studies, vitamin D deficiency causes poorer fertility and reduced function of the reproductive organs. Many of our breakthroughs in medical science, actually come from animal studies first, especially when it comes to ART and IVF. Many cows and other animals are now impregnated using ART and advancements in this area have helped with human studies.

Vitamin D deficiency and lower success rates

Getting back to the feature studies, Vitamin D was shown to help women undergoing IVF, or intracytoplasmic sperm injection (ICSI), frozen embryo transfer, or both.

All the participants’ vitamin D levels were checked by blood test. What people need to know is that many of the reference ranges still used  are actually under review and that if levels of vitamin D in the blood are under 100 Nmols\L, then you need to be supplementing. Anything under 75 Nmols/L is actually deficiency in vitamin D.

This analysis of the current research showed that when women, who underwent ART and had adequate vitamin D levels, were “one third’ more like to have a successful live birth compared to those who were deficient. When compared with women who had insufficient vitamin D concentrations, those with sufficient amounts were “46 percent more likely” to have a clinical pregnancy, and “34 percent more likely” to have a positive pregnancy test result.

Vitamin D is something that I promote and all of my fertility patients are on, as well as other beneficial supplements, diet, emotional support, medicines etc. Before you run off trying to buy vitamin D just remember it is just one thing that can help, and it isn’t a miracle cure, but, it can help. Lastly, before using any supplementations, please consult with a qualified healthcare professional and please don’t self-prescribe, or buy products of the internet. Make sure you buy practitioner dispensed supplements only, which are known to be of the highest quality and not filled with all sorts of things such as heavy metal, low levels of arsenic, toxic fillers etc, which is what some supplements off the internet can have.

 

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-The International Baby Maker

-No Stone Left Unturned

The Truth About Natural Killer Cells & Miscarriage

On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells are only attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly. This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) can be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells. You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

At my clinic, I have a proper Natural Killer Cell protocol and treatment plan that is individually tailored and looks at the “cause” of high number of Natural Killer Cells and makes sure that proper investigations, testing and treatment are administered to treat the person properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Medicine Specialist)

-The International Baby Maker

-No Stone Left Unturned

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.

 

 

What You “Can” Eat During Pregnancy

A while back, I put up a post to see what people thought that you (can) and (can’t) eat during… pregnancy, or if you were trying to fall pregnant. It was really interesting to see what foods people thought you could not eat during pregnancy. It is really interesting that most people want to tell you want you can’t eat, but hardly anyone tells you what you can eat during pregnancy and while trying to fall.

What prompted this post was that a while back I overheard one of my staff and lovely mother to be, talking to another mother to be about what she has been cutting from her diet while she was pregnant and how her food choices were so limited.

I heard all kind of wonderful things from not eating any seafood; not eating any cold meat, not eating soft cheeses, not eating eggs, not eating nuts and nearly the whole food pyramid was being added.

What many people don’t know is that I actually have a background in food science and that I used to teach about bacteria and food hygiene and the nasty consequences of what bacteria can do to the body.

Most pregnant women have the number one fear of foods containing Listeria. It is a rare form of bacteria but it can be fatal (very rare) to a lady if she is pregnant and cause issues such as miscarriage. So not discounting it at all and some countries around the world do not have the food hygiene standards we have here in Australia. We only see about 5 cases per million people in Australia. Basically there is about 0.3-0.4% chance of getting it and we all make such a big deal about it. Again, this is not to discount it either. Listeria can be found in unpasteurised products such as diary and cheese and can be found in some forms of deli meats mainly. To be honest, it is usually the home made/backyard deli meats and cheeses you really have to watch, with regards to hygiene and bacteria.

But if a health issues such as Listeria poisoning is so rare, why do we make such a fuss about it and not warn women of other potentially worse factors that cause more cases per year, and can be potentially fatal too. The problem is if women only hear about the foods they can’t eat, many of them are going to be nutrient deficient all for the fear of a tiny chance of listeria causing an issue with a pregnancy.

The truth is, other bacteria such as Salmonella, Shigella and Camphyobacter have a higher rate of infection per year than listeria ever will and nobody ever talks about them. There are over 25,000 cases of these combined and most of the spread is through person to person contact, not just foods themselves. Basically many food poisoning cases are actually from bacteria being on your own hands, which then at some stage end up in, or near your mouth. This is why smokers are at higher risk of food poisoning. To be honest, shopping trolley handles are probably one of the most unhygienic places you can put your hands on and probably cause more bacterial health issues than anything. Money can be the same.

Then we have a far wider implication of gestational diabetes, which account for about 15,000 plus, pregnant women per year, with an annual increase of 5% per year. When someone eats sugary foods, highly processed foods, grains etc during pregnancy, that are a major cause of diabetes, nobody says a thing. Yet mention the word Brie cheese, cold meats etc and everyone goes nuts. Oh yes, we now mention ‘nuts’ and people go nuts too. Again this is not to discount that some people have true allergies to nuts.

So what do pregnant women really need to know and what can you eat?

Basically the same food hygiene that is needed when you aren’t pregnant is to be observed when you are. There only needs to be a little bit more caution, not an ‘OMG’ stay clear of everything, that unreliable Dr Google, or ‘Someone’, has told you. I would love to know who ‘Someone’ is because he, or she, causes a lot of problems. Remember temperatures between 5 and 60 degrees C are you danger zone area. This is why foods need to be stored below 5 degrees and heated over 60 degrees C.

So what can you eat?

  • So basically you can eat any deli meats as long as they are cryo-vacced and in date. Cryovacced means the air has been taken out and not even bacteria can live in an non-oxygenated environment.
  • You can eat all seafoods as long as they are cooked and fresh.
  • You can eat all cheeses but need to be more careful around the soft cheeses. New research actually shows that small amounts can be beneficial for you. If you cook soft cheeses there is definitely no issue. Just don’t eat cheeses from unpasteurised sources.
  • You can have any form of pasteurised milk or UHT milk.
  • You can have soft serve ice-cream as long as the place you are getting it from looks hygienically clean. Maybe not a good idea to get them from the old ice-cream trucks that aren’t checked regularly by food standards.
  • You can eat nuts and now there is evidence to show that mums not eating nuts during pregnancy may now be the cause of nut allergies.
  • You can definitely eat eggs and you just have to make sure they aren’t raw. Boiled eggs, poached eggs and fried eggs are all fine. Egg custard is fine because it is cooked
  • You can eat all meats if they are cooked and you don’t have to char it until it resembles an old leather shoe. Medium is fine. You just need to cook all chicken right through because all chicken contains salmonella and cooking it kills it.
  • You can have coffee and tea and you just need to limit all caffeine to no more than two cups per day (remember tea has as much caffeine as coffee)

Basically the healthy food pyramid I teach at my clinic needs to be applied.

1. Take a good practitioner only Multivitamin, Omega 3 Oils, prebiotics and probiotics daily

2. Eat 2 handful of nuts daily or two tablespoons of healthy oils

3. Limit you grains to one serve (only) per day or cut them completely (best)

4. Eat 2 pieces of low GI fruits per day

5. Protein with every meal or snack

6. 3-5 serves of veggies or salads per day (just not from a salad bar)

7. 8 glasses of water

8. 2 serves of electrolytes per day when pregnant

9. 30 -45 minutes exercise 2-3 times per week

# No diet drinks or artificial sweeteners, or alcohol at all

Remember food is to be enjoyed and so is pregnancy. Don’t get too caught up in all the worry of what you can’t eat and look more at what you can eat and stick to those foods.

Take care

Regards

Dr Andrew Orr

(Reproductive Medicine and Women’s Health Medicine Specialist)

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Alcohol Decreases Fertility & Makes Gynaecological Conditions Worse

In today’s modern society, alcohol has become the cornerstone for social engagements, business dinners and after work relaxation. It is important to realise however, that alcohol can directly impact the fertility of both males and females. In males it can decrease sperm quality, reduce testicular size, decrease libido and cause impotence, all of which can impair fertility. In females it has a more systemic response, affecting the reproductive hormones, leading to abnormalities in the menstrual cycle and an increased risk of miscarriage.

Many men and women these days are actually consuming copious amounts of alcohol and may think that their drinking habits are normal, when compared to others around them. When people do things on a regular basis, it becomes their normal. But truth be told, many people’s drinking habits, both men and women, are actually in the realms of alcoholism. The impacts of that are far reaching and fertility and gynaecological conditions are definitely impacted by alcohol consumption.

Effect of Alcohol on Conception for Men

Fecundability refers to the probability of conception during a particular menstrual cycle. It is dependent on the reproductive potential of both partners. Alcohol decreases fecundability by its effect on sperm quality and quantity. Men who continue to consume alcohol on a regular basis, can decrease their sperm motility, morphology and their DNA in the sperm. All of which are important factors in achieving fertility. While outwardly a man’s sperm may look OK, many forget that inwardly, the sperm DNA could be highly fragmented and unless this is tested every ejaculation, you will have no idea how bad the sperm actually is. A one off DNA fragmentation analysis does not mean the sperm each time is OK. It only measures the sperm from the ejaculate that was tested and sperm quality can change by as much as 20% each ejaculation.

Testicular size is also affected by alcohol intake; and can also affect sperm production. Alcohol is a depressant of the central nervous system (CNS), and can disrupt the autonomic system of the CNS. These effects are temporary and short lived. Abnormal sperm production is also temporary and also can resume after abstaining from alcohol.

One study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.

Effect of Alcohol on Conception for Women

In women, alcohol affects fecundability, by disrupting the delicate balance of the menstrual cycle. Clinical research data published in the “British Medical Journal” suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fecundability when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

Alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even Anovulatory cycles, (menstrual cycles where ovulation fails to occur). Menstrual pain can directly be linked to the amount of alcohol consumed in the lead up to the menses and consumptions of alcohol, even small amounts, exacerbates most gynaecological conditions. These changes can drastically decrease a woman’s chance of becoming pregnant and thus affect fertility.

Alcohol effects fertility in both partners, and can do so in so many ways. For couples who desire to have a baby, it is best to stay away from drinking completely. Presently there is no safe limit of alcohol intake; even socially acceptable amounts of alcohol can affect fertility potential and outcomes. Moderate drinking (1-2 drinks in one sitting) is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, or trying to conceive naturally, you might consider cutting out alcohol for the time being. A woman that is trying to concieve, or trying to improve a gynaecological issues, or menstrual issues, should not be consuming more than 4 standard drinks per week. A male who is trying to conceive, or have sperm quality issues, should have no more than 2 standard drinks in one sitting and be having at least 2 alcohol free days per week. These are all part of the healthy drinking set out in health department and government safe drinking guidelines.

Trying to conceive is a special time in a couple’s life, it should be filled with love, devotion and safe health practices, which means a healthy diet and lifestyle and having a healthy mind too. It also means having healthy drinking habits as well.

Decreasing alcohol, having bete foods and looking at a healthy detoxification program is also a great idea for those trying to increase their fertility and get their reproductive systems working better. Healthy eggs and health sperm make healthy babies. Healthy reproductive systems also mean better menstrual cycles and better testicular health too.

Safe drinking everyone

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Specialist)

– The International Baby Maker

-Women’s and Men’s Health Advocate

– No Stone Left Unturned

Sex Around The Time of Embryo Transfer Increases The Likelihood of Successful Early Embryo Implantation and Development.

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One of the things that I  promote is that regular sex is so important for our fertility patients, on so many levels. Sometimes the obvious eludes some people though

One of the things I see quite regularly is that couples doing Assisted Reproduction (ART) are abstaining from sex fearing it will affect their chances of conceiving. Actually the opposite is true. By not having sex during ART cycles (IUI, IVF etc) you are affecting your chances of conception.

I have often spoken about the importance of sex and orgasm assisting implantation in other posts and there is so much medical research to back this up

Let me ask the question “If you were trying naturally, would you stop having sex for fear that conception has taken place?”

Then why would you stop having sex around an ART cycle?

Let’s face the facts, implantation takes place in the uterus, and not the vagina, and no man is that well endowed to even penetrate the cervix, so…. Let’s get a grip here

The question to ask is “What does an embryo feed off and need to successfully implant?”

The answer is blood!

Think of a tick borrowing into skin to feed off its host.

How do you get blood flow into the uterine lining?

The answer is that sex and climax stimulate blood flow to the lining to assist implantation and also prepare the lining for implantation!

Nature has given us all the tools for healthy conception to take place, and yet many of us just aren’t using them.

This article shows that sperm are also beneficial in assisting implantation and exposure to semen around the time of embryo transfer increases the likelihood of successful early embryo implantation and development.

http://humrep.oxfordjournals.org/content/15/12/2653.full

Don’t forget that regular sex during this time not only helps assist implantation, but it also helps with the bonding process and physical connection process during this stressful time. Many couples split up because of losing this connection during the ART process and sex is a way of keeping that physical and emotional connection. Sex also tells your body you are also preparing to conceive on another level too.

For those doing IVF etc, next time you are doing an ART cycle maybe it is time to start doing things the way nature intended to give you that boost you so desperately are needing. Time to go and get busy people.

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-The International Baby Maker

– No Stone Left Unturned

Seminal fluid improves fertility women and improves IVF pregnancy rates

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Seminal fluid is often viewed as simply a vehicle to carry sperm to fertilize the female egg, but a more complex function in influencing female reproductive physiology is now evident
Remarkably, seminal fluid contains special signaling agents that interact with the female reproductive tract to prime the immune response, with consequences for fertility and pregnancy outcome. This research isn’t new and we have spoken about this in previous posts. But we now know a bit more about how sperm may assist in implantation for, especially for IVF.

See my other post http://drandreworr.com.au/sex-around-the-time-of-embryo-transfer-increases-the-likelihood-of-successful-early-embryo-implantation-and-development/

Recent studies demonstrate a key role for seminal fluid in enabling  embryo implantation and optimal placental development. In particular, seminal fluid promotes health immune responses which facilitate embryo implantation by suppressing inflammation, assisting uterine circulation and blood supply and also protecting the embryo.

There is emerging evidence  where seminal fluid provokes an adaptive immune response in the cervical tissues after contact at intercourse, and spermatozoa accessing the higher tract potentially affect the endometrium directly. Research has now shown that sperm and seminal fluid actually help with endometrial receptivity, which is needed to create the right environment for a healthy embryo to implant.

These biological responses may have clinical significance, explaining why

[1] intercourse in IVF ET cycles improves the likelihood of pregnancy

[2] inflammatory disorders of gestation are more common in women who conceive after limited exposure to seminal fluid of the prospective father

[3] preeclampsia incidence is elevated after use of donor oocytes or donor sperm where prior contact with conceptusalloantigens has not occurred.

Research like this is important to define the mechanisms through which seminal fluid interacts with female reproductive tissues, to provide knowledge that may assist in preconception planning and infertility treatment. It also bring attention to the fact that couples still need to be engaging in regular intercourse during IVF cycles to help not only with implantation, but to increase pregnancy rates through optimization on the endometrial lining through contact with seminal fluid. Regular intercourse also promotes connection and bonding for the couple as well and this is something that is very much overlooked.

My clinic offers a comprehensive Fertility Program where couples are educated on important factors such as this… and more

If you would like to find out how you could improve your chances of having a baby, please give my clinic a call and ask about my highly successful fertility program that has helped over 12,500 babies (and counting) into the world and can increase a couples chances of conception by 96.1% *

For more information on my highly success fertility program, see also http://drandreworr.com.au/fertility/fertility-program/

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-The International Baby Maker

-No Stone Left Unturned

Facts about sperm health and their lifespan

Typically, millions of sperm cells are produced in the testicles every day. During this time, many things can affect their formation and interfere with their quality and maturity.

From a tiny sperm cell it can take between 90-120 days before a sperm is fully mature. The sperm eventually develops a head and tail, so that its cells start to resemble the shape of a tadpole. The head contains all of the DNA, or genetic material, and the sperm uses the tail to help it move. A sperm doesn’t reach full motility until it actually reaches the egg, where when touching the egg it creates a reactions that causes “super motility” to give it the final power to push inside the egg. This is called the acrosome reaction.

There has been lots of debate about the actual time it takes for a sperm to mature and become fully motile, but general consensus is that it will take somewhere between 90-120 days. This is why it is important that men look after their health long prior to conception, because the sperm they ejaculate today was created around 90-120 days ago and what they did to their bodies at that time, will influence how healthy those sperm are. So if a man had a poor diet, was drinking, smoking, had heaps of stress and goodness knows what, this can all have an impact of the maturing sperm and this can result in poor sperm quality and damage to the DNA of the sperm, which will then be carried onto his offspring, should the sperm be successful in fertilising an egg. This is why the couple need to be healthy prior to conception, not just the female.

Biology 101 tells us it take a sperm and an egg to make a baby, not just an egg. Sperm quality issues make up a big part of fertility issues and they can also be a big part of miscarriage issues too. I have spoken about this many times in previous posts. Up to 85% of miscarriage issues can be related to chromosomal and DNA factors related to poor quality sperm and this is often very much overlooked.

What factors impact on sperm health?

There are always many factors that can affect the sperm formation process and interfere with sperm quality and the DNA of the sperm.

Health and lifestyle factors

  • Recreations drugs, medications or alcohol use
  • job, or occupation
  • tobacco use, or smoking in general (including recreational drugs)
  • stress
  • overheating the testicles (spas, saunas, bike riding)
  • excess weight gain and excess body fat
  • Trauma
  • Bike riding (due to heat and trauma through the seat of the bike)
  • Poor diet and nutrition
  • Excess sugars and additives
  • Preservatives and artificial colours and artificial sweeteners

Environmental causes

  • exposure to industrial chemicals
  • heavy metals
  • radiation or X-rays

Medical reasons

  • infection of the testicles
  • cancer of the testicles
  • swelling of the veins (varicoceles etc) that drain blood from the testicle
  • hormone imbalances
  • physical problems in the tubes that carry sperm through the reproductive system
  • chromosomal or genetic disorders (such as Kleinfelters syndrome)
  • certain medications
  • surgery involving the pelvis, abdomen, or reproductive organs

How long do sperm live inside the female body?

There is always a huge misperception about how long sperm can survive outside the man’s body and when they enter into the female reproductive tract. Many women are told all manner of untruths of sperm lasting for weeks at a time. The truth is that sperm cannot survive for long once they are exposed to the air outside of the body.

Precisely how long they can survive depends on the environment that they are released into and how quickly the fluid surrounding the sperm cells dries up.

Sperm lifespan inside the female body

After ejaculation, sperm may be able live inside the female body for several days, but that is dependent on many varying factors once they enter a woman’s body.  The fluid in a woman’s reproductive tract, especially the fallopian tubes, has all of the nutrients that sperm need for their survival during that time. But while the woman’s body can help sperm on their way to meet the egg, it can also hinder it their survival as well. But even so, sperm really only have about 24 hours to fertilise an egg once it is released. After 24 hours, if the egg isn’t fertilised it will die, so really, it doesn’t matter how long the sperm can survive for if the egg has already died.

Poor sperm have to contend with many things when they enter a woman’s body. A woman’s vagina is coated in acids, to protect her from infections and bacteria, but it is also lethal to sperm. This is why within minutes and hours, most of the 300-500 million sperm that set off in search of the egg will be dead. Only a few million will survive to swim through cervix.

A woman’s body can help to get the sperm going up into to the cervix though. Through climax (orgasm) contractions are created that can help pull sperm up and into the uterus. Through these contractions the cervix is dipped time and time again into a pool of waiting sperm and this then helps carry the sperm up into the second stage of their journey through the uterus and then up into the tubes.

Once inside the female reproductive tract, the sperm cells must swim through the cervix and into the uterus to reach the fallopian tubes and then on to find the female egg. It is a very long journey for sperm to make and very few survive. Many get lost inside the uterus and some are attacked by the woman’s immune system along the way. By the time the survivors make it to the fallopian tubes to have a rest, there will only be less than 20 or more left to make the final journey.

After the sperm have a rest in the tubes and actually feed off some of the nutrients in the tubes many more will die, or be lost inside the tubes and by the time the final sperm reach the egg, there will be less than 10 single sperm left. Only one may then go on to fertilise the egg and an embryo is then started to be created.

This is why all men need to have their sperm quality checked by a proper andrology lab and some men will need further testing of the DNA (DNA fragmentation analysis) and further genetic testing if the semen results are poor. This should all be done prior to trying to conceive, as 50% of fertility issues are related to men. If a man has any of these risk factors, he should try to change them at least 3-4 months before trying to conceive, since that is how long it takes for sperm to fully mature. Some men may need longer than this, depending on what is causing their sperm to be of poor quality.

I will discuss some more myths and facts around sperm and what the most important parameters are to look at with sperm, in some later posts.

Regards

Dr Andrew Orr

(Reproductive Medicine and Women’s Health Medicine Specialist)

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

 

 

 

How to cope with endometriosis and manage it moving forward

Endometriosis can be a challenging condition to deal with, both physically and emotionally. But with proper interventions and proper management and treatments after diagnosis, you can be shown how to deal with the associated symptoms of endometriosis and improve your quality of life. Please have a read of some of the best ways to cope with endometriosis.

Endometriosis can be painful disorder that is characterized by tissue that behaves like the lining of the uterus but that grows outside the uterus. Endometriosis is really normal tissue growing in abnormal places. This tissue can be found in various places, such as the ovaries, fallopian tubes, and pelvic lining, and even in or around the bladder and bowel.

Endometriosis affects around 1 in 10 women and girls and those are only the ones diagnosed. This mean these figures are grossly under-diagnosed and downplayed with many women not being diagnosed properly and those that do not even know they have the disease. Endometriosis can cause symptoms during the reproductive years, between the ages of 12 and 60, but it can show up in young girls under 10 years old too.  Many people with the condition remain undiagnosed and many more and missed and dismissed with many taking up to ten years or more to be diagnosed.

The main symptom of the condition is usually pelvic pain typically associated with the menstrual period. While women can experience some discomfort during their menstrual period, some of those with endometriosis describe pain that is worse than usual. For some it is actually unbearable. There are also other symptoms such as painful periods, pelvic pain, ovulation pain, pain with sex, chronic fatigue, irritable bowel like symptoms, bladder issues and pain and bleeding on bowel movement. This is why all women need to know that period pain is not normal, because many times, period pain can actually be a sign that a woman has an underlining gynaecological conditions such as endometriosis

There is no cure for endometriosis (not yet anyway), but there are treatment options and lifestyle changes that can ease your symptoms so that the condition does not interfere with your day-to-day life. The main thing with endometriosis is to manage the disease and try and create a quality of life moving forward. While there is no cure for endometriosis, it is possible for women to become asymptomatic (meaning having no symptoms) and this requires the right treatments and management of the disease and to see the right people from the beginning. Again, it all gets back to who you are seeing and their experience with knowing about endometriosis. This is one the biggest issues women face when trying to get treatment. Many just do not know much about the disease at all and why women are left to deal with the horrible symptoms. But with the right treatment and management, women can have a better life and be able to cope with this horrible disease.

Before we look at proper management for women with endometriosis, it is important that all understand the facts because there is so much misinformation out there and this is part of the bigger issue for women with this disease.

The Facts About Endometriosis

  1. Period Pain IS NOT Normal
  2. A significant portion of women with Endometriosis are asymptomatic
  3. Symptoms DO NOT correlate to the extent of the disease
  4. The only way to diagnose Endometriosis definitely is via surgical intervention
  5. There is NO cure for Endometriosis
  6. Having a baby will not cure endometriosis
  7. Endometriosis does not always cause infertility
  8. Endometriosis is Estrogen Driven and is not caused by Estrogen dominance
  9. The Pill, or Contraceptives DO NOT fix endometriosis
  10. You can have Endometriosis at a Young, or Older Age
  11. Hysterectomy does not cure endometriosis
  12. Endometriosis requires a multi-modality approach to be managed properly. You need a team for proper management
  13. Endometriosis IS NOT an autoimmune disease
  14. There Are Hereditary and Genetic links
  15. Endometriosis can cause many other issues in the body
  16. The first line approach for hormone therapy should be the use of progesterone only options
  17. Endometriosis needs to be excised (cut out) by an advanced laparoscopic surgeon, who has had extra years of specialised surgical training, and who specialised in the excision of the disease and specialised in the disease itself. Surgery should be performed by anyone other than an advanced laparoscopic surgeon and not by just a regular gynaecologist
  18. Not all women with endometriosis have suffered sexual abuse

 

What Women Can Do To Help Manage Endometriosis

1.Seeing the Right Specialist & Surgeon

First and foremost make sure you have seen someone who specialises in endometriosis and the management and treatments moving forward. You also need to make sure that your first surgery is your best surgery and that you have seen an advanced laparoscopic surgeon to ensure you have had the proper surgical intervention. This is many women’s biggest issue as they have not seen the proper surgeon initially and they aren’t seeing someone who specialises in the management of the disease moving forward.

2.Watch your diet

Eating the right foods may provide some protection from the symptoms of endometriosis. The role of diet in endometriosis has been investigated in recent years due to the influence of diet on some of the processes linked to the disease, such as inflammation, prostaglandin metabolism, and estrogen activity. Many of the so called endometriosis diets out there are now outdated and have outdated nutritional and dietary advice that don’t really help much at all. Women need to adopt an anti-inflammatory (grain free, primal, ketogenic style diet) to help with settling any inflammation in the body and also helping the immune system. This also needs to include prebiotic and probiotic bacteria to help with digestive function, immunity and gut health.

Certain environmental estrogens such as preservatives, plastics, pesticides and insecticides that can be ingested through certain nutrients have been suggested as risk factors for exacerbating endometriosis too.

Excess body fat, now known as obestrogens (because it is estrogenic) needs to be controlled and managed through diet and exercise too. We know that estrogen drive endometriosis and that any estrogens (dietary, body fats, environmental etc) needs to be regulated and controlled.

3.Boost intake of omega-3 fatty acids

Researchers have also found that the type of fat included in your diet makes a difference in your risk of endometriosis. Studies have shown that people whose diets were heavily laden with trans fats increased their risk of the expression of endometriosis by 48 % when compared with individuals who ate the least of these. By comparison, women whose diets were rich in omega-3 oils lowered their risk of endometriosis by 22 % compared with those who consumed the least amount.

Eating foods high in omega-3 fatty acids, such as salmon, flaxseeds, almonds, and walnuts, may be helpful for endometriosis. Women should also be supplementing with Omega 3 oils too. Just remember, it is all about reducing inflammation.

4.Exercise

Often, people who experience pain fear exercising, in case it causes more problems for them. But over time, regular physical activity may decrease the pain and discomfort that you feel. High-intensity exercise and resistance training can help to reduce the symptoms of endometriosis.

Exercise may help those with endometriosis in many ways, including:

  • encouraging the circulation of blood to your organs
  • maintaining nutrients and oxygen flow to all your body systems
  • decreasing estrogen production
  • reducing stress
  • releasing endorphins in the brain, which are pain-relieving, “feel good” chemicals

Women who regularly exercise may be likely to have the symptoms associated with endometriosis. Research has shown that those who engage in frequent high-intensity physical activity have fewer symptoms of  endometriosis than women who do not participate in regular exercise. High-intensity physical activity, such as running, swimming, weight training etc, may be beneficial for reducing your symptoms.

Low-intensity exercise, including Yoga and Pilates may provide some relief in endometriosis, too. Yoga and Pilates can stretch and strengthen your muscles, help with core strength, help with circulation, which all may be beneficial for pelvic pain management and stress reduction.

5.Managing Stress Levels

Stress is a big factor in any disease and can make any disease worse. Not only can stress be exacerbated by endometriosis, but so can endometriosis symptoms be exacerbated by stress, in a never-ending cycle. Endometriosis could contribute to making your stress levels worse, due to the impact that the associated symptoms have on all aspects of your life, including family and personal relationships and work.

Stress management, Counselling, Mindfulness and Relaxation techniques can help to reduce stress that exacerbates endometriosis-related symptoms and pain.

Women with endometriosis need to manage stress by using mindfulness and relaxation techniques. These can help you to increase your awareness of your body, refocus on something calming, and reduce the activity of stress hormones and inflammation in the body. It is all about learning coping mechanisms and what works best for you, not what works best for others.

6.Try complementary medicine and therapies

Many women with Endometriosis find symptom relief from using a range of different complementary and alternative medicines. The Royal College of Obstetricians and Gynaecologists also recommends that women try natural medicines to help with the management of endometriosis and the associated symptoms. There is now some good research to support many natural medicines treatments such as acupuncture, Chinese herbal medicine, vitamins, omega 3 oils, probiotics, chiropractic/osteopathy, yoga, pilates and more.

Out of all the natural medicine therapies, Acupuncture and Chinese medicines has been the most researched and have shown to be the most beneficial to those suffering this disease and its associated symptoms.

Certain strains of prebiotics and probiotics have also been shown to help with the immune system, microbiome, bowel, and digestive associated symptoms of endometriosis. Probiotics have also been shown to not only help with digestive and immune function, but also with the psychological function as well. It does need to be specific strains of probiotics though.

Just like with medical treatments, when it comes to complementary medicines, it is important to find someone who is a qualified practitioner and who specialises in endometriosis. Just like in the medical model, this can also be hard to find.

7.Medications

Your endometriosis specialist can provide you with a list of treatment options for endometriosis and outline the risks and benefits of each. They will take into account your age, your symptoms, whether you want to become pregnant, and any treatments that you have had previously. It is important to manage pain and inflammation so that you can have a life and to be able to function daily.

You may need to use different forms of pain medications on script, as well as those that can be purchased over the counter. Please ensure you speak to your healthcare provider about setting up a pain management plan when using medications

You will also need to look at hormone therapy to help slow down the growth and expression of the disease and microscopic implants and also help with the associated symptoms of the disease. Hormones will usually be in the form of progesterone only medications and gonadotropin-releasing hormone antagonists and agonists. You may be prescribed other hormones depending on your individual case and symptoms.

Although all of these hormone therapies are effective at treating endometriosis, but,  they all have different side effects. You need to talk to your doctor and pharmacists about the side effects and risk factors of any medications and hormones that you are taking.

In Summary

It is important to know that women with endometriosis will need a multi-modality, or team approach to deal with this disease. The team you need and modalities that you will need will be dependent on your individual symptoms. Try and find healthcare professionals that can offer you a multi-modality approach for ongoing care and support and who also have a team of other people who specialise in the disease too. Again, the approach that you and your specialist choose to take will vary depending on your signs and symptoms, and whether or not you would like to become pregnant in the future.

Before starting any treatment, it is important to know all of your options and the potential outcomes of all of them and to know that the people that you are seeing are specialists in endometriosis and know how to manage the disease properly. That can often be the hardest thing to find and why you need to do your homework and see people who are specialists in this area of medicine.

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

Period Pain “IS NOT” Normal and Doctors in Australia and The Rest of The World Need to Start Listening

Millions of women around the world are told that period pain is normal and then go on to endure years of suffering and even infertility because it. Some women have endured so much pain and been “missed” and “dismissed” by so many healthcare professionals so many times that they have taken their own life because of it. It just should not happen and it needs to stop.

One of the major causes of period pain is Endometriosis, or its sister disease Adenomyosis. This crippling disease can cause period pain, pelvic pain, joint pain, pain with bowel movement, irriatbel bowel syndrome, pain with ovulation, swollen painful belly (known as endo belly), chronic fatigue, anaemia, heavy painful menstrual flow and can lead to infertility. Some women will quite literally not even be able to work due to debilitating symptoms of this disease.

It is estimated to affect 176 million worldwide and affect one in ten women, but that is only the ones diagnosed, so those figures are grossly understated. The facts around the disease are also grossly understated and poorly understood by many and why so many women are “missed” and “dismissed” by all the so called healthcare professionals they have seen. The other issue for a significant portion of women with the disease, is that they are asymptomatic (meaning no symptoms) and do not even know that have it. Many of them may never be diagnosed unless they are having problems falling pregnant, and even then many of them are not investigated properly to see if endometriosis is the cause of their long-term struggle to have a baby. It really is disgusting on so many levels. There is no other way to put it.

Of those one in ten women actually diagnosed many of them have taken up to ten years, or more, to be diagnosed and have their disease “missed” and been “dismissed” by multiple healthcare professional during their debilitating journey to find an answer for their sufferings. It is a nightmare of epic proportion for women world wide and the nightmare needs to end and healthcare professionals and everyone else needs to become educated and start listening to women and getting the message out there that “Period Pain IS NOT normal”.

So many women worldwide are suffering from period pain, pelvic pain, pain during sex, or infertility and endometriosis is the first thing that needs to be ruled out. Young women in particular have trouble convincing people they are having more than just bad period pain. So many young women (and older ones) are told just to “Suck it Up”, or “Deal with it”. Many mothers will even tell their daughters “This is just normal”, or “This is just what happens”, or “I have to put up with this, so you need to as well”, when in fact nothing could be further from the truth. Teenagers are not too young to have the disease and have it diagnosed and investigated either. Early intervention, diagnosis and management is crucial when it comes to endometriosis. The longer the disease is left, the harder it is to treat and manage, and left untreated can cause a woman years of debilitation and misery in every aspect of her life, years of surgery, years of pain killers and opiates, even after the best medical treatment. Healthcare providers and women around the world need to know that the longer it takes to diagnose, the longer the disease is there and the more damage it can do inside the body. Some women will have their lives crippled by not having early intervention. Some women have got to the point that they can no longer put up with the disease and being dismissed and have either attempted taking thier own life, or have succeeded in doing so. It is just so wrong that women get to this point.

The other issue that women face, once they are diagnosed, is that many of them end up seeing the wrong specialist to do their surgery. While most gynaecologists can do investigative surgery, many of them are ill-equipped to surgically remove the disease and actually do not specialise in the disease, or the excision of the disease properly. So many women have not seen the right specialist, who has not investigated and managed the disease properly and then left women to deal with the consequences of this inadequacy in their scope of practice. Women and healthcare providers need to be educated that women who potentially have endometriosis, or have a high likelihood of the disease, need to see an Advanced Trained Laparoscopic Surgeon, who has had extra specialised training in the excision of the disease and who has had extra specialised training in the management and treatment of the disease as well. Just because someone is a gynaecologist, or specialist, does not mean they are a specialist in the disease. This is also a huge misunderstanding when women require diagnosis and management of the disease and why so many are still left with crippling pain and symptoms, even after medical intervention. Quite simply, they have just seen the wrong person for the job and this also needs to be addressed in education and training around this disease.

This week the National Institute for Health and Care Excellence (NICE) in England has released the first ever guidance on managing this horrible disease that affects millions of women worldwide. They are hoping it will not only help GP’s and healthcare providers in the UK, but also GP’s and healthcare providers here and around the rest of the world too. NICE is calling for GP’s in Australia and the rest of the world to stop overlooking symptoms of this disease, such as bad period pain, so that women are not “missed” and “dismissed” for up to a decade or more. NICE are asking for endometriosis to be taken more seriously than it presently is and while that is starting happen here in Australia and the rest of the world, the changes have still been too slow. It really is just not good enough given that so many women are suffering from this debilitating disease worldwide.

One of my mottos is that “Period Pain IS NOT Normal” and I will continue to say this forever and a day and it is great to see national health care bodies like NICE actually backing that up and trying to get healthcare providers to do the same. While others are slow on the uptake, I will never stop in my quest to get women the help they need for this disease and will do my best to stop women being “missed” and “dismissed” and get them the help, care and attention they need and hopefully be a part of one day bringing an end to this debilitating disease.

Next week I will be in Sydney at a National Endometriosis Symposium shouting my message to healthcare practitioners as well. Let’s hope they finally start listening to the facts about endometriosis too. Let’s end the silence and get this information out there to everyone. If you do want to find out more about the facts about period pain and this disease, you can visit my webpage, or you can also visit Endometriosis Australia at www.endometriosisaustralia.org. I specialise in the treatment and management of this disease and want every woman on the planet to know that Period IS NOT Normal and that there is help out there.

 

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-“No Stone Left Unturned”

-“Period Pain IS NOT Normal”