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Anxiety and Chronic Pain and Chronic Conditions

Chronic pain and chronic illness can be debilitating. Both pain and chronic conditions can go hand in hand and both can interfere in the daily function in life.

While chronic disease state can cause pain, many do not realise that there are also other factors that exacerbate chronic disease and chronic pain.

Diet, alcohol, drugs, cigarettes, additives in food, chemicals, environment, and emotions can all exacerbate and flare chronic disease state and pain. But some of these things people do not correlate to being part of their daily struggles and increased levels of pain.

Anxiety and depression are two of the things that can exacerbate pain and also lead to chronic pain pathologies. For this post I am going to focus of anxiety because I see so many people who have it. Many people do not realise that they actually have anxiety.

Many people also ignore the signs of anxiety and fob it off as not being able to switch off, or they think too much, or they just do not know how to slow down and relax. Many just fob it off saying that they are busy and don’t have time to stop. They are basically busy being busy. But is it really all those things they think they are?

What is anxiety?

Anxiety is a normal emotion and almost everyone has experienced anxiety at some point.  It is the emotion that people have when something dangerous might happen. Anxiety is closely related to fear. Fear occurs when something dangerous is happening. Anxiety can also activate that fight or flight response and get one adrenalin activated and running through ones veins. Adrenalin is activated to help us get away from danger. The problem with anxiety, danger isn’t really happening. It is the perception of something that may happen. None the less, the body prepares for danger and the nervous system goes into hyperdrive and the fight or flight response is activated.

As mentioned before, anxiety can also be when something dangerous is seemed to be pending, or hasn’t happened yet, though we perceive it could.  This is why people with anxiety always tend to be nervous. They are nervous in their feelings, their body and their behaviours as well. These people are quite literally waiting for the possibility of something dangerous to happen, or needing to get up and get moving. They literally cannot sit still.

Anxiety can also be divided into different aspects: feelings, physical manifestations, thinking, and behaviours.

Feelings

A number of feelings are associated with anxiety. It can cause one to feel apprehensive, feel alarmed, feel tension, feel nervousness, feel doubtful and also make one feel out of control.

Physical manifestations

Anxiety can also lead to physical manifestation in the body as well. It can cause muscle tension, increased hear rate, palpitations, increased blood pressure, heaviness in the chest, gastrointestinal upset and urgency, cold hands and feet, increased sweating, dizziness and increased energy and even cause the body to shake.

Thinking

Anxiety can also influence the way we think. It can cause increased worry, increase focus on things that have not occurred, increased focus on possible danger and all of the consequences that could occur, increased thinking of the worst case scenarios of what could happen to one self and anxiety can also cause increased thinking and overthinking in general.

Behaviours

Anxiety can also influence the way be behave.  It can cause restlessness, avoidance of activities ( for fear of perceived danger), cause nervousness, inability to sit still, need to get up and move all the time, and cause difficulty in completing things.

Sometimes, anxiety becomes persistent and then can get in the way of day-to-day life. When anxiety is persistent and interfering in day-to-day life, it’s considered no longer normal. It is then considered a disorder.

Anxiety and pain

Everyone experiences pain at some point in their life, but for those with anxiety and depression, pain can become intense and very hard to treat.

Anxiety is now known to be one the most common conditions that accompanies chronic pain. Anxiety tends to go hand in hand with chronic pain, because pain is a danger signal.  When we get pain it is to signal danger that something is wrong in the body and requires attention.  Pain then sets of the warning system that then leads the nervous system to respond. This then often leads to that fight or flight response talked about previously.

The nervous system’s response to pain just in the same way it responds to danger. This can be in the following ways:

  • Feelings of alarm, apprehension and distress
  • Increased reactivity of the body, such as
  • Increased muscle tension,
  • Increased heart rate ad blood pressure,
  • Gastrointestinal reactivity and digestive pain and upset
  • Increased cognitive focus on the pain, and then a tendency to worry and catastrophize about it
  • Avoidance behaviours, such as guarding, resting, staying home and not engaging in activities that might bring about or increase pain

In acute pain, these responses might be quite helpful. These feelings of pain and fear allow someone to seek help in order to prevent further injury.

In chronic pain, these feelings become anxiety and avoidance behaviours. When someone has chronic pain for a long time, the anxiety and avoidance behaviours can become chronic. The chronic anxiety leads to a chronic sense of alarm or distress, which makes patients nervous and can’t sit still and finds it very hard to relax and recover.

Anxiety and chronic pain

Chronic pain also affects the brain and thought patterns and it can lead to a chronic focus on pain, which pre-occupies the attention of the pain sufferer. Everyday decisions seem to turn on how much pain the patient has at any given time. It also leads to then nervous system to become over reactive. This can then lead to chronic muscle tension, which can switch pain pathways on more and this then leads to more pain. Chronic avoidance behaviours can then lead to an increasing sense of social isolation, inactivity, muscles loss and then not being able to cope or function physically and mentally. Daily life literally can become an effort and the person actually become disabled.

When the body reaches this state the nervous system has become stuck in the vicious cycle of constant reactivity. Pain pathways become more reactive and harder to switch off and pain levels can become very hard to manage. This state of reactivity is associated with a condition called central sensitization. This is where acute pain has becomes chronic and then this goes hand in hand with anxiety and other mood disorders.

Anxiety can present differently in each person

Anxiety can present very differently in each person and chronic disease states can also trigger anxiety. Anxiety can also exacerbate a chronic health condition too. It can be a vicious cycle that keeps going around and around.

Everyone’s cause of anxiety is different and it’s often a combination of factors that leads someone to feel the way they do. Many do not even realise they are suffering anxiety as mentioned before.

It’s important to remember that you can’t always identify the cause of anxiety, or change difficult circumstances. You cannot always be in control of every situation either.

Recognise the signs and seek professional help

The most important thing is to recognise the signs and symptoms and seek advice and support.

There are people that specialise in managing chronic pain. Good pain management programs should use a multi-modality treatment and management approach consisting of the most effective treatments for anxiety, such as counselling and psychology, medications, diet and lifestyle changes, exercise and other therapies that can assist with pain and anxiety.

With the right help and seeing the right people, it is possible to get ones life back despite having chronic pain, and in the process overcome anxiety. The one thing I always explain to people it that you will not be able to do this on your own. You will need help from qualified professionals. No amount of Dr Google, or advice from friends and family is going to be able to help you get through this without the help of qualified professionals trained to help in this area of healthcare.

If you are experiencing long term pain and could also be suffering from chronic anxiety, please go and talk to your healthcare provider. Many people are unaware that they have anxiety and this is actually exacerbating their current pain. Your healthcare practitioner can also talk to you about effective pain management and also help you seeking help and getting coping skills for your anxiety as well.

Beyond Blue has a very simple Anxiety checker (click here) and I urge everyone to take the test, especially those with chronic long-term pain and health issues.

Please remember that there is help out there. Please do not suffer in silence thinking that there is no help, or no end in sight for your pain and your anxiety as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr

 

 

Expectation versus reality with surgery and ongoing healthcare management

I have talked about expectation versus reality before but I wanted to go over this subject again. I think that many treatment plans and even surgical interventions and treatment outcomes are not explained very well.
This then leads to people not really knowing what realists health outcomes are and also what realists healing times are either.
In my latest video blog I talk about the expectation versus reality when it comes to surgery and recovery times. I also talks about being realist about time frames with treatment and results on ongoing healthcare.
I also talk about the realist time frames to help with certain conditions and also being real about healing times for pain.
Watch my latest video post to see what I am talking about and trying to explain
Regards
Dr Andrew Orr (DOAM, MRepMed, MWHM)
-No Stone Left Unturned
-Reproductive Medicines and Women’s Health Experts
-Women’s and Men’s Health Advocate
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Being Overweight, or Underweight, Can Adversely Affect Fertility

As mentioned in previous posts about fertility and weight, it is important to have healthy weight and waist size when trying to conceive. It is important to address dietary and lifestyle issues in order to be in health weight and waist range before trying to conceive.

Healthy Waist Size

Healthy waist range for a woman is 80cm (from the belly button around)

Healthy waist range for a man is 94cm (from the belly button around)

If a woman’s waist size is about 88cm and a man’s waist size if above 102cm then they are in what we call “metabolic syndrome”

This increases their chances of diabetes, heart disease, depression, gynaecological conditions (PCOS, endometriosis etc), sperm issues, egg quality issues, reproductive issues, increased miscarriage, increased risk of certain cancers and of course…. infertility.

Body fat and how it affects fertility

Excess body fat (now known as obestrogens) can disrupt hormones and fertility and can have a negative effect on egg and sperm quality.

Similarly being underweight and low body fat can affect fertility outcomes too. Body fat has a regulatory role in reproduction and a moderate loss of fat, from 10% to 15% below normal weight for height, may delay the menstrual cycle, completely stop the menses altogether and inhibit ovulation. Both dieting and excessive exercise can reduce body fat below the minimum amount and lead to infertility. But this is reversible with weight gain, increased body fat and reduction of intensive exercise, or both.

A moderate reduction in body fat, not just weight, for those overweight, can increase fertility and chances of pregnancy exponentially. Similarly an increase in body fat for those that are underweight, and who don’t have enough body fat, can increase their fertility and chances of pregnancy as well.

This goes for men too. Increased body fat, or not enough body fat can affect hormone production and fertility and can affect sperm quality and sperm production.

This is why preconception care and healthy screening and weight and waist management is so important before trying to conceive. This should also be a part of any fertility program and is definitely part of my fertility program for all couples.

Are you in healthy waist range?

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

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Sperm Quality and How To Took After It

More often than not, women are often told that is their egg quality, or some gyneacological factor is the cause of not being able to conceive. But, in truth, more often than not, it is actually the sperm quality that is at fault, or in combination. Fertility issues are not just a woman’s cross to bare.

Men are 50% of the fertility equation and up to 85% of miscarriage issues can be related to chromosomal and DNA factors relating to poor quality sperm in men.

To be honest, men often think that they have this inherent right to conceive and often believe there is nothing wrong with their sperm, despite never being tested. Many often avoid being tested and will often make great claims as to why they should not be tested either.

As part of proper fertility assessment, both the man and the woman need to be evaluated, not just the female.
A man will need to have a comprehensive semen analysis done and may also need further testing such as DNA fragmentation analysis, or a sperm chromatin assay. There will also be further genetic testing needed as well.

A semen analysis is really on a basic test that lets us know what the sperm look like and if they have 2 heads, 2 tails and may be swimming in circles. The fact is, that many men’s sperm quality is substandard and their sperm is actually not in a good shape at all. Recent research and statistics have shown that the male sperm quality has fallen by as much as 70% in the last 60-70 years.

There are many things that can affects a male sperm quality such as:
1. Steroids and recreational drugs
2. Alcohol
3. Smoking (including recreational drugs)
4. Chemicals
5. Drugs (pharmaceutical and illegal)
6. Being overweight and too much body fat
7. Age

These are to name just a few. There are also genetic and hereditary issues that need to be checked as part of proper fertility evaluation as well.

More often than not these days, men are the bigger part of the issue when it comes to not being able to have a baby. Men are often also overlooked as part of the issue as well, which is actually not good ethical practice.

Many couples are also quick to tell me, or other healthcare practitioners, that the man’s sperm is fine, or they have been told it is fine, when actual fact it is not. OK, or fine for IVF purposes does not mean that the sperm is fine. It is very rare to see a man that is having troubles conceiving a baby with his partner that has sperm that is fine. That is the truth.

If you have been trying to conceive for a long time (and not being able to conceive) and the male has not been checked properly, or on some kind of lifestyle and preconception care plan, then in might be time you looked into that.

If you do need help with preconception care and getting your eggs and sperm more healthy, then enquire about my fertility program that has helped over 12,500 babies into the world and counting.

In the mean time have a look at this great fact sheet about your sperm and how to look after them at yourfertitity.org.au and put together by Andrology Australia.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

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Why Excess Body Fat and Obesity is The Enemy of Fertility

Excess body fat and obesity is the enemy of fertility and it is something that needs to be talked about. Despite what anyone tells you, being overweight, or being obese significant affect on fertility and it can also affect the future health of offspring. This is a fact and we need to talk about it more and bring more awareness to this subject. This is why I have been focusing on this very important subject a lot more lately.

At present up to 70% (or more) of Australians are either overweight, or obese, so we can no longer ignore what the consequences of these statistics mean. We know that excess weight and excess body fat is linked to serious health consequences, but we need to talk about how it affects fertility and decreases the chances of obtaining a live birth.

Overweight, or obese men and women have higher levels of body fat and higher levels of the hormones leptin. As I have mentioned in previous posts, this excess body fat is also now referred to as obestrogens, as they cause the same health consequences as environmental estrogens (known as endocrine disruptors). These excess body fats and higher levels of leptin do impair production of sex hormones and also reduces fertility. It can also lead to poorer sperm quality, poorer egg quality and can also increase the risk of miscarriage. The more excess body fat, the greater the risk of fertility difficulties a couple will have. This is a fact. Despite what your specialist, your doctor, Dr Google, or your own mind tells you, this is a fact and we need to start being real about it. It isn’t about fat shaming either. It is to help people who are struggling with fertility and to help them seek the help they need to have a baby.

Excess body fat, especially excess abdominal fat is also linked to insulin resistance, metabolic syndrome and other health issues. It also interferes with the regulation of sex hormones and sex hormone binding globulin (SHBG).  This can then increase the risk of irregular cycles, PCOS, endometriosis, sperm quality issues, miscarriage and other factors affecting fertility.

While the facts around excess body fat, excess weight and obesity are very real and can often seem overwhelming, there is some good news for couples that are overweight and obese.

Dietary and lifestyle changes and fat loss interventions which also includes exercise, can significantly improve fertility outcomes. It can also help with regular menstrual cycles, PCOS, endometriosis, sperm issues, egg quality, mental health and many other health issues. It definitely improves the chances of pregnancy and lessens the chances of miscarriage.

Research has shown that fat loss of up to 7%, for those that are overweight, achieved by diet, exercise and lifestyle changes, can improve overall health, fertility and improve chances of a successful live birth.

There is no fast track, or easy way to lose excess body fat and people need to face the facts, face reality and just get in a do it. The best ways to do this are as follows:

Seek the help of trained healthcare professionals that can help you with dietary and lifestyle changes and can help monitor you and support you rather than blaming and shaming. It also helps to hold you accountable and keep you motivated.

Do any dietary, exercise or lifestyle changes as a couple. It is much easier if you both do it and can support each other in any changes. You can also hold each other accountable and also see the changes in each other.

Set realistic goals and be realistic about how long things will take. It is no use setting unrealistic goals and having an unrealistic perception of how long things will take to change it your body. This will only set you up for failure and chances of rebounding. It is about one day at a time and one step at a time.

Seek the help of a trained healthcare professional to educate you on what good nutrition, good dietary and lifestyle habits are. The more educated you are about what a good diet is, the better your chances are of eating the right foods and achieving your fat loss goals

You need to exercise as well. Diet changes alone will only help to a point and you do need to do some form of resistance work to help burn fat. While walking is great, it doesn’t burn fat and increase lean muscle like resistance exercise (weights etc) can. You may even need to see a personal trainer to get yourself started and be held accountable.

Have access to fresh foods and means to increase your levels of physical activity. It is important to have access to good fresh foods and stay away from the processed and refined foods. You also need to have ways of exercising and keeping your body active and burning fat.

It is all about perception versus reality. You need to be real about your weight, your body fat and then set realistic goals to lose the excess body fats. Just remember it is about being proactive. Nobody is going to do this for you, but they can help encourage you to be healthy and make better dietary and lifestyle choices.

Lastly, men and women are twice as likely to achieve healthy weight and waist range and proper dietary and lifestyle choices if their partner does it too. The journey to having a baby requires a couple to do it and the same goes for weight loss and achieving healthy body fat and healthy waist range too.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr

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Excess Weight and Male Fertility

It has long been known that for men, being overweight, or obese, is associated with lower fertility and poor sperm quality. We know that excess body fat causes inflammation in the body, but it is also known to cause the following:

  • Hormones Problems
  • Sexual Dysfunction
  • Erectile Dysfunction
  • Type 2 Diabetes
  • Sperm Quality Issues
  • Heart Disease
  • Sleep Apnoea
  • Lower Testosterone
  • Other Health issues.

It is now known that carrying an extra 10 kilos can reduce male fertility by between 10-50%. This is exactly why all men need to take their health, their body fat and their weight more seriously when trying to conceive.

A review of studies about the effects of paternal obesity on reproductive outcomes found that overweight, or obese men were more likely to experience fertility issues and less likely to have a live birth if they and their partner used assisted reproduction technology (ART) – (IVF, ICSI, IUI etc).

The reason being is because the extra body fats are known to be estrogenic (known as obestrogens) which not only reduce sperm quality, but also changes the DNA, the physical shape and molecular structure of sperm cells.

This is why all men need to look at preconception care and lifestyle changes for trying to have a baby, but also their future health and their future offsprings long term health as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicines

-Women’s and Men’s Health Advocate

 

IVF cover image

Let’s Talk About Why IVF Cycles Fail

Let’s talk about why IVF cycles fail because it is a very common question that is asked when a cycle fails. Often there will be no conclusive answer and often when I am asked this, I have to say the old saying “How long is piece of string?”

The reason I say this is that there are so many factors involved with a cycle failing. It could be from following

  • poor egg quality
  • poor sperm quality
  • age of the couple
  • genetic factors (diagnosed, or undiagnosed)
  • hereditary issues
  • DNA and chromosomal issues
  • a non-receptive endometrium
  • dietary and lifestyle factors
  • weight factors (excess or too little weight)
  • emotional factors, or mood disorders
  • stress
  • incorrect hormone therapy
  • medications
  • human error
  • lab errors
  • many other factors in the IVF process.

I wish it was as easy as putting a sperm and an egg together and it just happening. I know many couples do look at it this way, but there is so much more to the whole process of conception. I know it is often hard to understand, but no google search is going to tell you all of this and you would need years of study to completely understand the whole process. Plus IVF is still only a young form of medicine and it still evolving.

This is why IVFsuccess rates are still relatively low. We just do not have the technology yet to tell us which embryo will go on to become a baby. If we had that, then there would be a much higher, if not near 100% success rate. The reality is that type of technology may never be available, or would be many many years off. We can only hope.

The other thing I explain to couple is that sometimes it is literally the IVF process hindering a couples chances of success, by not having the right protocol, or right team helping them.  I could go on and on because there are so many factors that could affect a cycle and someones chances of conceiving. This is why I use the term “How long is a piece of string?”

This is why I do what I do and explain all of this and more to all my patients as part of my fertility program. I am literally there to hold their hands every step of the way and explain everything in detail each step of the way as well. I will always make sure everything is done properly and even go into bat for them and step on toes if I have too. My patient’s come first always.

What is required for a successful pregnancy?

At least three things are required for a successful pregnancy during in an vitro fertilization (IVF) cycle:

  • a healthy embryo
  • a receptive endometrium
  • careful transfer at the proper time in the cycle

There are things other things such as the right diet and right nutrients and right emotional state for the couples and proper preconception care, but for now I am just talking about a successful embryo transfer on a medical level. Firstly I will discuss the IVF process.

IVF has improved significantly in its almost 40-year history. Different types of hormone and fertility drugs have been developed that are easier to administer and are associated with an improved safety profile. In addition, numerous stimulation protocols are available that allow us to individually tailor treatments. For example, ultrasound-guided embryo transfer using soft catheters and embryo glue (enzyme to assist implantation) has also helped with ensuring better placement of the embryo, without trauma to the endometrium, but very few clinics are actually doing this. Tests can also be used to evaluate the receptivity of the endometrium in order to determine the best time to schedule the transfer.

Despite all these improvements, however, implantation and pregnancy rates with IVF only slowly increase year after year.

Achieving Implantation-The hardest step

The rate-limiting step of IVF is implantation. It requires the proper interaction of a healthy embryo and a receptive endometrium. It often fails due to problems with the embryos. The genetic health of the embryo depends on both its inherited genetic material and on the errors and repairs during the cell divisions.

A chromosomally abnormal (anuploidy) embryo is unlikely to implant, and when it does it is likely to be lost early on. Many embryos that are transferred have chromosomal abnormalities, even if they look fine on the outside, or are classified as being the best grade prior to transfer. We need people to understand that just because and embryo has reached Blastocyst, or Morella stage and it looks like a good quality embryo from the outside, it does not mean that the inside and the chromosomes inside the embryo are OK. Not every fertilised egg will result in a genetically sound embryo that will go on to become a baby.

DNA & Chromosomal When Sperm and Egg Combine

We also need people to realise that an embryo is made up the genetic material of two people and that requires the sperm to be healthy both outwardly, but also chromosomally, and this can change with each batch of sperm ejaculated. Sperm quality and the viability of sperm changes and just because something was “OK” last cycle, or two years ago, or last month, or last week, does not mean that it is OK now.

Unfortunately people need to face the reality of what happens with the body and reproduction. The health of the sperm is also reflected in the health and lifestyle and age of the male too. Unhealthy males produce unhealthy sperm and higher levels or sperm with chromosomal abnormalities and damage to the DNA. Unless you are testing every batch of sperm for DNA and chromosomal abnormalities, you aren’t going to see this and even then, testing can only see so much.

A healthy embryo (Euploidy embryo) also requires a female to be healthy and her eggs to be health chromosomally and on a DNA level. It also requires a healthy male for his sperm quality to be healthy on a DNA levels as well. Egg and sperm quality is also related to age, diet, lifestyle, environment, and exposure to environmental disruptors, weight, body fat, stress and so many other factors.

We need people to be aware of this. Then when you put two unhealthy people’s genetic and reproductive material together, there is a high likelihood that it will produce higher numbers of abnormal embryos, and sometimes it can be all of them. It all depends on the health of the sperm and health of the eggs at time of fertilisation. Even then we can still have random errors in chromosomes and DNA and this then produces faulty embryos. Again this is a hard process to explain and again Dr Google isn’t going to tell you this.

Pre-implantation Genetic Diagnosis/Screening (PGD/PGS)

Various methods of genetic testing of embryos have been evaluated in past decades. During the early days of PGD/PGD many embryos were lost in this form of screening. Today it is more routine and more perfected.  One can test the chromosome content of the polar bodies, but a cleavage-stage embryo (day 3 of development) or a blastocyst-stage embryo can be evaluated as well. In addition, various techniques  are available for assessing the chromosomes.  There are also new testing and new technologies that have addressed the shortcomings of these earlier tests.

The authors of a recent systematic review concluded that comprehensive genetic screening of embryos using day 5 blastocyst biopsy is associated with increased implantation and pregnancy rates. In addition, this technology appears to be a good tool to limit the number of embryos transferred. But embryos can still be tested early on in their development, with good results, too.

Most experts recommend genetic testing of embryos in women with advanced reproductive age, recurrent implantation failure, recurrent pregnancy loss, or severe male factor infertility/DNA issues. This then gives a greater probability of transferring a chromosomally normal embryo and having a higher chance of implantation and pregnancy occurring. But even a chromosomally normal embryos doesn’t ensure a pregnancy. This is often the hardest thing for people to get their heads around. To be honest, much of this comes down to luck and is really in the hands of the gods. Again this is often not told to people and no google search is going to tell you this either.

Preconception care increases chances of conceiving

But what you can do to ensure healthy egg quality, healthy sperm quality, healthy embryo quality, healthy uterine lining, decreases stress levels, optimal health at time of transfer etc, is doing proper preconception care as part of proper fertility program.  There is now growing evidence that the health of both parents before and at the time of conception influences the chances of conceiving and the short and long term health of the future offspring. (9,10,11,12,13,14,15)

This is why I offer couples a program to go over everything they need to know and everything the need to do prior to trying to conceive or trying to embark on the next IVF cycle. It is about getting the couple as healthy as possible and their bodies as ready as possible to give them the best chances of success. I always explain to people that preparing for an IVF cycle is like preparing for a marathon. If you do the work and get the body ready, it gives you a better chance of making it to the finish line.

If you are having trouble falling pregnant, or are having failed IVF cycle, then give my clinic a call and find out more about how my fertility program may be able to assist you achieving success of having a baby. So far my program has helped over 12,500 plus babies into the world and counting. It doesn’t matter if you are starting the journey, or well on your way into the journey or trying to have a baby. You can also do a meet and greet appointment to find out more about the fertility program before you commit to the whole program.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

References

  1. Mains L, Van Voorhis BJ. Optimizing the technique of embryo transfer. Fertil Steril. 2010;94:785-790. Abstract
  2. Society for Assisted Reproductive Technology. Clinic Summary Report. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0Accessed April 27, 2015.
  3. Staessen C, Platteau P, Van Assche E, et al. Comparison of blastocyst transfer with or without preimplantation genetic diagnosis for aneuploidy screening in couples with advanced maternal age: a prospective randomized controlled trial. Hum Reprod. 2004;19:2849-2858. Abstract
  4. Mastenbroek S, Twisk M, van Echten-Arends J, et al. In vitro fertilization with preimplantation genetic screening. N Engl J Med. 2007;357:9-17. Abstract
  5. Yang Z, Liu J, Collins GS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012;5:24.
  6. Scott RT Jr, Upham KM, Forman EJ, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100:697-703. Abstract
  7. Forman EJ, Tao X, Ferry KM, et al. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012;27:1217-1222. Abstract
  8. Scott RT Jr, Upham KM, Forman EJ, et al. Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not: a randomized and paired clinical trial. Fertil Steril. 2013;100:624-630. Abstract
  9. Buck Louis, G. M., et al. (2016). Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception: The LIFE Study. Fertility and Sterility, 106(1), 180-188. doi: 10.1016/j.fertnstert.2016.03.009
  10. Chiu, Y.-H., Chavarro, J. E., & Souter, I. (2018). Diet and female fertility: doctor, what should I eat? Fertility and Sterility, 110(4), 560-569. https://doi.org/10.1016/j.fertnstert.2018.05.027
  11. Day, J., et al. (2016). Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype. American Journal of Stem Cells, 5(1), 11-18
  12. Homan, G. F., Davies, M. J., & Norman, R. J. (2007). The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review. Human Reproduction Update, 13(3), 209-223.
  13. Nassan, F. L., et al. (2018). Diet and men’s fertility: does diet affect sperm quality? Fertility and Sterility, 110(4), 570-577. https://doi.org/10.1016/j.fertnstert.2018.05.025
  14. Salas-Huetos, A., et al. (2017). Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Human Reproduction Update, 23(4), 371-389. doi: 10.1093/humupd/dmx006
  15. Sharma, R., et al. (2013). Lifestyle factors and reproductive health: taking control of your fertility. [Review]. Reprod Biol Endocrinol, 11(66), 1477-7827.

Understanding Why Hysterectomy Does Not Cure Endometriosis

Hey everyone. I’ve just recently put up a post about the facts about why hysterectomy does not cure endometriosis.

It seems this is a very contentious issue and many people are not understanding the facts, or how endometriosis presents in the body. I also think that some people just haven’t read the actual article, as I do explain all of the reasons why.

But, it does seem some people are still not getting the reasons why, or have been told the wrong things. As usual, I am here to give the facts and this is what I am here to do with this post.. Give the facts.

I am sorry for many of the journeys you have been on too and that some of you are not being listened too as well. That is why I am here. To raise awareness and give the facts and help women with endometriosis have a voice.

This is to also raise awareness about adenomyosis too. Many really do not realise that they have this disease state, or have it coinciding with endometriosis as well.

So, I have done up the video blog to explain things in more detail and hopefully it helps all of you understand things better. It is also so people can see a visual explanation and see why hysterectomy will not “Cure” endometriosis.

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What Registered Practitioners Can and Cannot say on Social Media and Advertising

Dr Andrew Orr is often asked many questions while online in various social media platforms and often cannot respond the way people would like him to.
What many people do not realise is that Registered Healthcare practitioners are governed by strict laws around what they can, or cannot say on social media, or various forms of advertising. This also includes what they can, or cannot say on their websites too.

Dr Orr has a quick discussion around this so people realise why registered healthcare practitioners have to respond in certain ways, or why they cannot give advice when asked. I hope this helps everyone understand why.

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Give us this day our daily…..Bloating

Many people do not realise that the cause of their daily bloating may in fact start with their daily consumption of bread.

I always used to comment that when I was in travelling through Asia and eating all the great fresh foods over there, that I was feeling really good. I never got that bloated feeling that most people often get each day.

On arriving back home, I would always suddenly start to get stomach cramps and bloating for no reason. I find this quite ironic as most people have a perception that you are going to get food poisoning etc if you go overseas. I have never ever been sick in all the years of travelling there. Actually it is always the opposite, I always feel better when I eat the foods there.

Having ruled out bugs and parasites etc, I was starting to go a bit crazy as to what was going on. Then one day I didn’t get the bloating anymore.

What did I do that day?

Was it a virus just getting out of my system, or was it a food that I missed that day?

Then it all dawned on me that I had not eaten bread that day. I’m not a big bread eater anyway, but the next day I tried out my theory and ate some bread. Bingo!

I had bloating and pains all day again. So much for supposedly being a healthy staple food. While travelling in Asia, I didn’t have bread or many refined foods at all and that is probably why I always feel better when I go there.

Many people suffer bloating caused by bread

Actually many people suffer from bloating each day, caused by bread, and some suffer it quite severely. Some to the point that they actually look pregnant with it. Many people’s bloating and weight issues are caused from over consumption of bread and other refined flour foods. Many people lose weight just by giving up bread alone. The sad fact is many people continue to eat bread even when they know it is causing them bloating and pain etc.

When you look at the average Australian diet, we live on the stuff. Toast in the morning, sandwiches at lunch and sometimes we have bread with our dinner too. In this day and age, there is no reason to eat as much bread as we do. There are so many more healthy food alternatives available to us today, but we all go for the gut filler and bloater every chance we get. It’s quick and it makes you feel full, temporarily anyway.

Bread is just a filler to help you fill full

Actually if you look at the history of bread, it was born through poverty. It was born out of necessity when there was no other foods around and it gave the perception of being full. The trouble is the first breads were semi good for you as they were very dense and full of whole grains. Not this refined rubbish, full of chemicals and additives, that make it last for weeks. These days, weevils won’t even live in it and some kids can even get hyper on it because it can be laced with that many preservatives.

Gluten, yeast and other additives

Besides all the additives in bread today, there are two main ingredients that make many people have digestive issues. One is gluten and the other is yeast. Yeast is a rising agent and it can surely make the stomach bubble and rise too. Then the refined grains containing gluten also causes inflammation in the system. The other disturbing thought about bread it that it is really just flour and water. Flour and water makes glue and that’s why it clogs so many people’s bowels up each day. The gluten can also cause loose bowels for some people too.

Many people also have a misconception about the different types of bread too. Many people choose brown bread over white thinking it is a healthier option. Wrong!

Brown bread is just white bread with a tiny bit of wheat germ added and a splash of colouring to make it brown. Even when you do find a semi decent option, with the many breads out there, it still really isn’t a really healthy option. Again it is just a filler and there are many more foods out there with much more nutrition, and again it won’t make you bloated. We also now know how bad refined grains are for you.

Gluten free does not mean healthier

Don’t think for a moment that Gluten free is a healthier option, because it isn’t. It is still refined grains, minus the gluten. It is still inflammatory due to lectins and leptins and other things in the grains. Many gluten free products also contain a lot more sugars and emulsifiers too. It is best to go grain free than go gluten free.

Eating other foods instead of bread

I must admit that there is nothing quite like the smell of freshly baked bread, but that doesn’t make it good for you. The other hard thing about it is it is really hard not to give it to our kids, especially if they are going to school.

But I also know that with cooler packs now, there are many other options that we can give our children to take to school. Moderation is the key here. Have a look at some of the health snack options you can use instead of bread and refined flour products.

All of us need to cut back on the stomach glue (bread) and start eating some healthier foods such as salads, lean proteins, nuts, seeds, veggies and fruit. It isn’t all that hard.

Instead of eating that meat and salad sandwich tomorrow, how about just having the meat & salad. It is a much healthier option and it won’t bloat you either. Some nice sliced ham off the bone, or tuna, or chicken, and a lovely Greek salad and hey presto, we have a great healthy lunch option.

Other foods that may cause bloating

There are other may other things in our diet that cause bloating such as alcohol, oats, sugars, chocolate, fermented bean paste (miso) etc that people also need to be aware of. Overindulgence in all of these things can all lead the stomach to overload and cause bloating and pain.

One more thing, “no”, you just can’t take medicines and supplements to make the bloating go away and still eat the foods that cause bloating.  It doesn’t work that way. You have to remove the cause, otherwise the problem will continue no matter what you do.

So next time you look like you have added two clothe sizes,  with a stomach full of wind, remember that it may just be from the bread that you have just eaten beforehand. If you are getting bloating each day, it is a good idea to talk to your healthcare provider about this and look into the cause of your issues. There are simple testings for food allergens and your healthcare provider is trained to know what to test for and look for in your diet as well. There may also be an underlying disease state being missed as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate