Stress and fertility

Busyness, Stress and Anxiety Affecting Fertility & Pregnancy Outcomes

It is now known that modern day busyness, stress, anxiety and depression can significantly impact a couples chances of conceiving. When helping couples with fertility and achieving a pregnancy, one of the biggest issues I see overlooked is a couple’s emotional health. During the assessment of anyone’s fertility, depression, anxiety and stress scores (DASS) should be taken into consideration. Other assessment methods to look at anxiety and heightened adrenalin should also be utilised. It is so important to touch base on the topic of emotional health and make couples (or those who are single) aware of emotional factors that may be affecting their chances of conceiving.

I always recommend seeing a counsellor/psychologist

I always recommend that everyone should check in regularly with a counsellor/psychologist, but less than 10% of people do. What many do not realise is that their underlying stress, anxiety and other emotional concerns are actually a big part of them not being able to conceive, and that looking after our emotional health is just as important as looking after our physical health. There is research to suggest that a parent’s emotional state can be passed onto a child via the sperm, eggs and the parental mode of inheritance. Everything we put in our body, physically and emotionally, can be passed on to the unborn child. This is crucial to understand before considering having children because at the end of the day, it could affect them greatly.

Identifying the impacts of busyness, stress and anxiety

Another common observation I see when people are trying to conceive is they are adamant that they are not stressed, yet their mood/stress scores say otherwise. Many people have normalised their busyness and running on high levels of adrenaline to the point where they do not equate their heightened emotional states as being stress or anxiety. From an outside perspective, I can physically see how anxious and stressed some people are, but it is often hard for people to self-reflect and understand their emotional state.

Control issues exacerbating anxiety and stress levels

Statistically speaking, women have a higher likelihood of being the driving force behind wanting a baby/family so it is easy to see why they may be more focussed or driven in this regard. This also means that they carry a lot of the stress that comes with that. Unfortunately it is becoming more common to see said people struggle with letting go of control and feeling out of control which leads to underlying stress and anxiety. Occasionally this too leads to stress and instability in their relationships, especially if their partner isn’t stepping up.

The one thing I try to explain to all couples is that when it comes to IVF or assisted reproduction, nobody is in control. Everything is timed and controlled by hormones and medications and nobody can control that. Trying to control everything leads to high stress levels, activated adrenalin, heightened anxiety, and a vicious cycle of feeling like more control is needed. The only thing people can control is what they put in their mouths (food, medications, and supplements), how much they exercise, and how well they care for their emotional health. That is it.

Making the changes you need to do now

So many people try to justify their actions and behaviours with statements such as, “I will slow down and make time for myself once I am pregnant, or once I have the baby.” Any parent will tell you that once a child is born, there is hardly any time for yourself and things get a lot busier. The reality is that you need to work on yourself now, while you have the chance. It is not only important for you, but also for your child.

One of the things I say to future parents is this: “If I gave you your baby right now, what would you have to do to ensure its survival and yours? What changes in your life would you have to make?”

I then let them sit and think carefully about it because in reality, it would mean many changes to one’s life. The honest truth is that despite change often being uncomfortable, changing your life is exactly what you have to do right now to create the baby as well. I also tell parents that if you don’t have time for yourself, to do self-care, or to work on yourself, then you really need to question if you have time to have a child too. I don’t mean this in a bad way. I say it with absolute care and understanding of how demanding life gets when one is a parent.

Counselling needs to be mandatory

This is why it is so important to do counselling whether you are going through IVF or trying to conceive naturally. It is my personal belief that for the benefit of the parent/s and the child, counselling should be mandatory as many issues of not falling pregnant actually stem from high stress levels, anxiety, adrenaline, and an inability to slow down. It all stems back to control, and then lack of control, which then creates anxiety and stress. There can also be relationship dynamic issues that need to be addressed prior to having a baby. All this and more is not a good recipe to make a baby, or achieve a successful pregnancy outcome.

Stress animals don’t conceive and it applies to humans as well

The one thing we know from basic biology is that stressed animals do not conceive or will not carry a pregnancy. Many of our breakthroughs in fertility medicine actually come from vet science, where animals have undergone IVF or forms of assisted reproduction. We often forget as humans, that we too really are just animals.

Numerous studies have indicated how anxiety, stress and heightened adrenaline (common states of existence for many people) have a detrimental effect on egg quality, sperm quality, embryo quality, implantation, and overall pregnancy rates.

How busyness, stress and anxiety affect fertility and pregnancy outcomes

Going through IVF, or just trying to fall pregnant, is often described as the most stressful event in the lives of some couples. This is even more heightened if there are difficulties in achieving a pregnancy. There is increasing evidence that psychological factors, such as busy lifestyle, stress, anxiety and depression, have a negative impact on IVF and pregnancy outcomes.

Research studies have shown that the high levels of stress, anxiety and depression are significantly related to the treatment outcome in IVF and also achieving a natural pregnancy (Expert Review of Obstetrics & Gynaecology.2008- See diagram for how stress affects pregnancy outcomes).

Stress pathway

The autonomic nervous system is affected by busyness, stress, anxiety and depression. This also leads to increased neuroepinephrine and increased epinephrine, which then leads to vasoconstriction and decreased blood flow into the uterus. It can also lead to increased stress within the uterus itself.

The immune system is also affected by increased Tumour Necrosis Factor (TNF), which is a cell signalling protein (cytokine) involved in systemic inflammation. The immune system is also affected by increase in Natural Killer Cells and increased activated T cells, which then lead to reduced implantation and a stressed uterine environment.

The indirect effects of stress are that people will drink more alcohol, smoke, exercise less, sleep less, eat more junk foods and generally have a poor diet and lifestyle, all of which have a direct effect on fertility also.

In summary

In summary, lifestyle interventions and taking care of one’s emotional wellbeing can help reduce stress, anxiety and adrenaline. This should be a priority for all couples trying to conceive, or for those having difficulties conceiving. Body-Mind Medicine and Traditional Chinese Medicine have long understood that stress, diet, lifestyle and emotional factors are a huge cause of infertility. Modern medicine and research is now validating this and advocating for proper preconception care. By addressing the known possible emotional and lifestyle factors that affect fertility by utilising preconception care and a multimodality approach (including counselling and psychology), people can greatly improve their fertility, successful pregnancy outcomes, as well as improve their overall health.

Final Word

If you are having trouble conceiving please call our friendly staff and find out how our fertility program may assist you in having a baby. Our fertility program uses a multimodality, ‘no stone left unturned’ approach which looks at both the male and female aspects of fertility, is used alongside medical interventions, and also gives you access to counsellors and psychologists who have a special interest in fertility.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

-The Experts Program

References

  1. Paulson JF, Bazemore SD. Prenatal and Postpartum Depression in fathers and its association with maternal depression: a meta-analysis. JAMA. 2010;303(19):1961-1969. doi:10.1001/jama.2010.605
  2. Effects of caffeine, alcohol and smoking on fertility, http://yourfertility.org.au/resource/effects-of-caffeine-alcohol-and-smoking-on-fertility/
  3. Evans J, Heron J, Francomb H, Oke S, Golding J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001;323(7307):257-60.
  4. Akioyamen LE, Minhas H, Holloway AC, Taylor VH, Akioyamen NO, Sherifali D. Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review. Journal of Psychosomatic Research. 2016;84:69-80.
  5. Cesta CE, Viktorin A, Olsson H, Johansson V, Sjolander A, Bergh C, et al. Depression, anxiety, and antidepressant treatment in women: association with in vitro fertilization outcome. Fertility and Sterility. 2016;105(6):1594-602 e3.
  6. Sejbaek CS, Hageman I, Pinborg A, Hougaard CO, Schmidt L. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42,880 women treated with ART. Human Reproduction. 2013;28(4):1100-9.
  7. Ververs T, Kaasenbrood H, Visser G, Schobben F, de Jong-van den Berg L, Egberts T. Prevalence and patterns of antidepressant drug use during pregnancy. Eurpean Journal of Clinical Pharmacology. 2006;62(10):863-70.
  8. Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. Journal of Clinical Psychiatry. 2013;74(4):e321-41.
  9. Deave T, Heron J, Evans J, Emond A. The impact of maternal depression in pregnancy on early child development. BJOG. 2008;115(8):1043-51.
  10. Ross LE, Grigoriadis S, Mamisashvili L, VonderPorten EH, Roerecke M, Rehm J, et al. Selected pregnancy and delivery outcomes after exposure to antidepressant medication. A systematic review and meta-analysis. Outcomes after antidepressant use in pregnancy. JAMA Psychiatry. 2013:1-8.
  11. Rich-Edwards JW, Spiegelman D, Garland M, Hertzmark E, Hunter DJ, Colditz GA, Willett WC, Wand H, Manson JE. 2002. “Physical activity, body mass index, and ovulatory disorder infertility.” Epidemiology 13:184-190.
  12. Palomba, S, Falbo A, Valli B, et al. 2014. “Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study.” Reproductive Biomedicine Online, 29(1): p. 72-9.
  13. Ferreira RC, Halpern G, Figueira Rde C, Braga DP, et al. 2010. “Physical activity, obesity and eating habits can influence assisted reproduction outcomes.” Womens Health [Lond Engl] 6:517-524.
  14. Kucuk M, Doymaz F, Urman B. 2010. “Effect of energy expenditure and physical activity on the outcomes of assisted reproduction treatment.” Reproductive Biomedicine Online 20:274-279.
  15. Morris SN, Missmer SA, Cramer DW, Powers RD, McShane PM, Hornstein MD. 2006. “Effects of lifetime exercise on the outcome of in vitro fertilization.” Obstetrics and Gynecology 108:938-945.
  16. Green BB, Daling JR, Weiss NS, Liff JM, Koepsell T. 1986. “Exercise as a risk factor for infertility with ovulatory dysfunction.” American Journal of Public Health 76:1432-1436.
  17. Gudmundsdottir SL, Flanders WD, Augestad LB. 2009. “Physical activity and fertility in women: the North-Trondelag Health Study ” Human Reproduction 24:3196-3204
couple in love

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

Research has now shown that sex around the time of embryo transfer increases the likelihood of successful early embryo implantation and development.

Intercourse during an IVF cycle has the potential to improve pregnancy rates and there is adequate research to now back this up. We know that in animal studies, exposure to semen is reported to promote embryo development and implantation.

Intercourse may assist implantation

This is actually good news for humans as well as it shows that intercourse may act to assist implantation. Animal studies reveal that exposure to seminal plasma, the fluid component of the ejaculate, is particularly important for achieving normal embryo development and implantation. Animals that become pregnant through artificial insemination or embryo transfer without being exposed to seminal plasma have substantially lower rates of implantation than those exposed to seminal plasma (Pang et al., 1979; Queen et al., 1981; O et al., 1988; Flowers and Esbenshade, 1993), while rodents inseminated with spermatozoa prior to blastocyst transfer also have a higher rate of implantation compared with those not exposed to spermatozoa (Carp et al., 1984).

Intercourse may influence pregnancy success rates

A multicentre prospective randomised controlled trial was conducted through IVF centred around the world, including Australia. The study was conducted to determine if intercourse around the time of embryo transfer, or just before and embryo transfer in an IVF cycle, actually has the potential to have any influence on pregnancy success rates.

Participants in Australian IVF clinics underwent frozen embryo transfer (FET) and participants in Spain IVF clinics did fresh embryo transfer. Participants were randomised to either have intercourse, or to abstain from intercourse around the time of embryo transfer.

The study showed that there was no significant difference in the pregnancy rates between those couples that abstained and those that had intercourse. However, the portion of transferred embryos that made it to 6-8 weeks gestation was significantly higher in the women exposed to semen compared to those who abstained.

This landmark multi-centre international study showed that women who had sex around the time of embryo transfer, and who were exposed to semen around the time of embryo transfer, had increased likelihood of successful early embryo implantation and development.

Couples need to be having more sex during IVF cycles

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

One of the things we 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 spoken about the importance of sex and orgasm assisting implantation in other posts and there is so much medical research to back this up. This is seen in the research I have talked about above.

Let’s be real and look at the facts

Let 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.

Sex is more than just and egg and a sperm

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. Go get busy people

Final Word

If you are struggling to fall pregnant, or need advice with preconception care, please give my friendly staff a call and find out how my fertility program, which has helped over 12,500 babies into the world, may be able to assist you too.

Regards

Andrew Orr

– No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

References:

  1. http://humre.oxfordjournals.org/content/15/12/2653.short
  2. Bellinge, B.S., Copeland, C.M., Thomas, T.D. et al. (1986) The influence of patient insemination on the implantation rate in an in vitro fertilization and embryo transfer program. Fertil. Steril. , 46, 252–256.
  3. Carp, H.J.A., Serr, D.M., Mashiach, S. et al. (1984) Influence of insemination on the implantation of transfered rat blastocysts. Gynecol. Obstet. Invest. , 18, 194–198.
  4. Coulam, C.B. and Stern, J.J. (1995) Effect of seminal plasma on implantation rates. Early Pregnancy , 1, 33–36.
  5. Fishel, S., Webster, J., Jackson, P. and Faratian, B. (1989) Evaluation of high vaginal insemination at oocyte recovery in patients undergoing in vitro fertilization. Fertil. Steril. , 51, 135–138.
  6. Franchin, R., Harmas, A., Benaoudia, F. et al. (1998a) Microbial flora of the cervix assessed at the time of embryo transfer adversely affects in vitro fertilization outcome. Fertil. Steril. , 70, 866–870.
  7. Franchin, R., Righini, C., Olivennes, F. et al. (1998b) Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization. Hum. Reprod. , 13, 1968–1974.
  8. Marconi, G., Auge, L., Oses, R. et al. (1989) Does sexual intercourse improve pregnancy rates in gamete intrafallopian transfer? Fertil. Steril. , 51, 357–359.
  9. Pang, S.F., Chow, P.H. and Wong, T.M. (1979) The role of the seminal vesicles, coagulating glands and prostate glands on the fertility and fecundity of mice. J. Reprod. Fertil. , 56, 129–132.
  10. Qasim, S.M., Trias, A., Karacan, M. et al. (1996) Does the absence or presence of seminal fluid matter in patients undergoing ovulation induction with intrauterine insemination? Hum. Reprod. , 11, 1008–1010.

 

Sperm meets an egg

Regular sex found to trigger ovulation in females & make them more fertile.

Regular sex isn’t just beneficial for ones health, physical and mental well being and happiness.  Researchers have now found that regular sex and a protein in seminal fluid actually helps to trigger ovulation in females and make them more fertile to sustain a pregnancy.

Semen isn’t just a vehicle for carrying sperm

Semen isn’t just a vehicle for carrying sperm and studies actual now show that it also plays a crucial role in triggering ovulation. Researchers have discovered the protein in the seminal fluid acts as a hormonal signal on the female brain. This triggers the release of other hormones that signal the ovaries to release an egg.

The international team of researchers at the University of Saskatchewan, found this protein in a variety of mammals and say it plays an important role in reproduction in all mammals.

Male mammals have accessory sex glands that contribute seminal fluid to semen, but the role of this fluid and the glands that produce it are not well understood. From the results of the research, it is now understood that these glands produce large amounts of a protein that has a direct effect on the female brain and reproductive organs.

Ovulation Inducing Factor (OIF)

The protein, which was dubbed the ‘ovulation-inducing factor’ (OIF), works through the hypothalamus of the female brain. This part of the brain links the nervous system to the endocrine system (a system of glands that secrete hormones into the blood stream) via the pituitary gland.

The idea that a substance in mammalian semen has a direct effect on the female brain is not a new one, but now there is research to back these theories up. The scientists also discovered it is the same molecule that regulates the growth, maintenance, and survival of nerve cells.

OIF affects ovulation and fertility

In this study, they also looked at how OIF not only affected ovulation in females, but how it also affected their fertility and chances of a pregnancy.

For the purposes of the study, the research team looked at two species of mammals, that being llamas and cattle. They did this because Llamas are ‘induced ovulators, meaning that they ovulate only when they have been inseminated. Cows and humans on the other hand are ‘spontaneous ovulators,’ meaning that a regular build up of hormones stimulates the release of an egg.

Using a variety of techniques, the researchers found OIF present in semen samples taken from both animals. However, when they injected the llamas with this protein it caused them to ovulate. The same effect wasn’t seen in cattle.

While OIF didn’t appear to induce ovulation in spontaneous ovulators, such as cows and human, it did affect fertility in different ways. The protein was found to effect the timing of when cattle developed follicles (fluid-filled sacs in the ovary which carry the eggs). The researcher also found that OIF promoted the development of a temporary endocrine structure needed to sustain pregnancy.

Research has broaden our understanding of ovulation and fertility

This research definitely helps to broaden our understanding of the mechanisms that regulate ovulation and also helps to raises some interesting insights into fertility. More research is needed to see what role OIF plays in human fertility, as the researchers suspect it will be exactly the same. The study appeared in the Proceedings of the National Academy of Sciences.

It is great to see this research getting out there and this is something that I have promoted and taught for ages. It is great to see actual research to back up what I have teaching for years. Let’s face it, many of our advancements in fertility have actually come from veterinary science through use of IVF in cattle.

Couples undergoing IVF need to be having more sex

This is also great research that showed why couples trying to have a baby, or undergoing fertility treatments (IVF etc) need to still be having sex. It isn’t rocket science, yet so many people forget basic biology and that we are actually still an animal.

The problem is that so many couples actually stop having sex when doing assisted reproduction such as IVF. While I can totally understand the whole emotional aspect of why, it is still hindering their chances of conception and having a successful pregnancy. It is a truth that must be talked about and also get couples to understand.

Regular sex also helps with connection for the couple

I am always telling them how important it is to still have an active sex life, for the benefit of a happy, healthy relationship. It is also about the connection and not just about having sex. We do see so many couples split up while undergoing IVF and assisted reproduction, and some of this is purely due to lack of bonding and connection with their partner.

But even so, regular sex and intercourse also gives the chance of a natural pregnancy too, no matter how slim the chance for some couples. We still see couples that have done multiple cycles of IVF still conceiving naturally, but you actually have to have sex for this to happen.

Now we have research, which shows that a protein in seminal fluid actually acts as a hormonal signal that actually triggers ovulation, improves egg quality and may in fact make a woman more fertile for a pregnancy to take place. Again, when you look at this logically, it really is not rocket science and really is easy to understand.

Regular sex while doing IVF improves pregnancy rates.

This is why it is so important for all our couples using ART (Assisted Reproduction Therapy) and IVF to still keep having sex. Regular sex and more importantly regular climax, increases your sex hormones, helps regulate hormones, increases blood flow to the uterine lining, helps with libido, helps with egg quality, helps for better ovulation and most of all improves your fertility and the chance of sustaining a pregnancy. There is also research to show that regular sex before and after IVF transfer, improves pregnancy rates and I will talk about this research in another article on it’s own.

Final Word

If you are struggling to have a baby, and need help with fertility issues, then talk to my friendly staff about how our fertility program might be able to assist you. It has helped over 12,500 babies into the world… and counting.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

 

 

Let’s talk about fertility and reproduction what couples can do do during this time

There are many people trying to have a baby, and without success. Many now are stressed about what they can do to improve their fertility, during the times of COVID 19.

Many are also stressing thinking that they cannot access fertility treatment, when in fact some fertility clinics are providing full services, including IVF.

In this latest video blog, I talk all things fertility and some of the cold hard facts, especially about seeing a fertility expert.

There are many things couples can do at this time and one of them is get your body and mind ready for trying to have a baby. In this video also talk about the importance of preconception care and the importance of using this COVID 19 time to work on couples health, to help with their fertility.

fertility 1

Fertility- Before you go any further, you are forgetting one thing…….. The Male

In this video blog I explains how I often get emails from patients and practitioners, needing assistance with fertility issues. The only thing is, it is often only from the female perspective and I have to then explain this to people, or these practitioners. So often, as I am hearing their case study, or patients telling their story, I have to politely stop them and explain “Fertility Before you go any further, I can see what the issue is, you are forgetting one thing…… The Male”

Being completely honest, 95% of the time it is the full female history I am hearing and absolutely no mention of the male. The male is always 50% of the fertility picture, unless there is absolute infertility with the female (medically diagnosed infertility)

Fertility issues require proper evaluation of both the male and female, otherwise crucial things get overlooked. It takes a sperm and an egg to make a baby, not just an egg. Besides that it is a legal and ethical requirement to investigate the female and male. You cannot just investigate and treat the female. Have a listen to the latest video (below) of this very important subject.

If you do need assistance with fertility and reproductive issues, please give my staff a call and find out how my fertility program may be able to assist you and your partner.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

 

Fertility and a piece of string

Explaining The Facts of Fertility- “How long is a piece of string?”

When people ask me about what is the cause of most couples issues trying to conceive, I always say ” How long is a piece of string?”

There can be so many factors involved and there is never just one clear answer. Many times people are focussing completely on the wrong thing too.

In this video blog below,  I have an honest discussion about fertility on every level. I discuss diet, lifestyle, preconception care, supplements, natural medicines, western medicines, investigations, genetic issues, stress, IVF procedures, Natural killer cells, unrealistic expectations, self sabotage, weight issues and much much more.

So again, when anyone asks what the cause of fertility issues are, I will always answer “How long is piece of string?”

Because in reality, there are so many factors that couple are unaware of, and need to be aware of too.

Regards

Andrew Orr

-Master of Reproductive Medicine

-No Stone Left Unturned

-The International Fertility Experts

Fertility

Let’s Talk About The Facts Of Fertility & The Fertility Profession

Wouldn’t you love to sit down for 2-3 hours with a fertility expert and cover everything you need to know for your fertility and journey to become a parent?

Wouldn’t you love to have a fertility expert that can not only talk to you about all the medical investigations, medical protocols, genetics and genetic testing, hormones and medications etc, but can also talk you about preconception care, nutrition, diet, lifestyle changes, nutritional supplements, complementary medicines, acupuncture, counselling and other modalities?

Wouldn’t you just love it if someone could listen to your individual needs, listen to your full history, be empathetic to your journey so far, be there to guide you every step of way, and then make sure you are looked after on every level possible?

Well, you can have this, but before I talk about how, let’s talk about the facts about fertility and the fertility profession first.

Let’s talk about the facts

I never hold back from telling people the cold hard facts on any health topic I talk about. It may, or may not upset some people, but the truth is that it needs to be said all the same. People deserve to know the reality about every health condition and their reproductive system. For this post I am going to talk about the cold hard facts of the fertility profession and facts around fertility.

The fact is that many people are lucky to get half hour with a fertility specialist/expert when they decide that need help in having a baby. Some may only get a 15-minute appointment with a fertility specialist/expert and are lucky to get a few questions answered. Then at each of your next 15 minutes appointments, people are trying to cram in as many questions as they can before they are escorted to the door, because the next patient has arrived.

Many medical fertility specialists/experts have no idea about diet, lifestyle advice, preconception care etc, and the one subject that they did learn years ago at college is now a lost and distant memory. Basically it becomes a case of not my area, not my concern.

People then go home and arm themselves with a degree in ‘doctor google’ and then desperately search for answers themselves. They then end up on all manner of sites and support groups with a plethora of misinformation and angst. Have read of my post about Fertility and Dr Google 

This then leads to people searching for a local naturopath, nutritionist, Chinese medicine practitioner etc, trying to cover off on all the complementary medicines, nutrition, dietary advice and nutritional and herbal supplements.

Then this can lead to the case of too many cooks spoiling the broth, too many with differing ideas, or no idea at all, and the turf war on fertility begins.

The medical specialist damns the complementary medicines. The complementary medicine practitioner damns the medical specialist and the couple, or individual, is then caught in the middle. Dazed and confused, the couple/individual has to make a choice of whom they are going to believe and whom they are going to continue to see. But does it have to be this way?

Health professionals should be working together, for the greater good of the patient, not working against each other. Nobody has all the answer and a symbiotic relationship can greatly increase a couples success of having a child.

No wonder many couples/individuals don’t know where to turn to, who to believe and then end up searching for answers themselves. Worst still, while all this confusion and mud slinging continues, the couple/individual still have not get the answers they need, let alone the baby they are desperately wanting.

The fertility profession is largely unregulated

1.The medical side of things

What many are unaware of, especially here in Australia, is that the fertility profession is largely unregulated. Anyone can say they do fertility work and yet not have the qualifications to back it up. Only one state here is regulated, where you have to have what we call a CREI (Certificate of Reproductive Endocrinology and Infertility).

But let’s face it, it is a certificate, not a postgraduate degree and they are very easy to get. But now, many have to have a Masters in Reproductive Medicine as well. But this is only in one state mind you. In all other states, there is nothing stopping anyone doing fertility.

So what this means is that anyone can go and work in a fertility clinic, without the proper extra training to do so. We see obstetricians often do the change to fertility, without having to do extra training, and are basically learning on the job as they go along. The patients then become the guinea pigs and test cases while they are learning on the job. It really should not happen. Sure, they have some reproductive training, back when they studied, but fertility is a very different area to obstetrics and pregnant women.

We also are now even see some GP’s do the sea change to some of these bulk bill IVF clinics and then are consulting with people are their fertility. Many of these couples are then led to believe they are seeing a fertility specialist, when in fact they are just seeing a GP, without any formal training in fertility and reproductive. For many of these, the last time they did any study on fertility, was back in university, and it was probably one subject, if that.

2. The complementary medicine side

But, at the same time, this is not just an issue that is related to the medical side of things. There is just as many complementary medicine practitioners saying that they do fertility, when in fact they have had no formal training, and many often have no idea. They are doing the same thing of learning at they go along, and the patients are the guinea pigs.

Many of these complementary medicine practitioners are lucky to have studied one subject in fertility and reproduction. Many of their lecturers have no formal qualification in fertility and reproduction either. They are then leaving college, or university, and then setting themselves up as experts in fertility.

Many are literally setting up overnight, with no clinical experience, or post graduate certification in fertility, and then trying to say that they do fertility. Daily, I see some of these practitioners not even knowing the basics, yet are out there trying to treat people for fertility issues. I often comment on how some of these practitioners are out there trying to have a crack at it with no idea what so ever. This should not be happening.

There needs to be better regulation

It is a big issue for couples trying to wade their way through the murky waters of the fertility profession. It really should not be allowed to happen. But again, it is all due to lack of regulation and laws preventing it from happening.

As I said, it is on both sides and not just related to one profession. There desperately needs to be more tougher and tighter regulation with the fertility profession, so that couple know that when they are seeing a fertility expert, they actually do have the post graduation training and degree, as well as the clinical experience too. The only good thing here in Australia, is that nobody can advertise that they are a specialist, unless they have a specialisation. If they are caught advertising they are something that they are not, there are harsh penalties around this.

But seriously, this would not happen in any other profession. You would not see a backyard mechanic, or a backyard hairdresser, or someone without the appropriate levels of training?
Yet, why are people not checking who they are seeing for fertility, and just presuming on face value. Your fertility and reproduction is far more important than your car, or your hair. I hope people get what I am trying to say here.

So how do you know whom to see?

This is the million-dollar question and why I always say to patients to be careful. It really is a case of buyer beware.

What you need to do is ask the big questions and do not see someone unless they can answer all the questions and tick all the boxes.

  • Here are some of the things you need to ask:
  • Does you fertility practitioner have a post graduate degree in Reproductive Medicine?
  • Can you please see a copy of their degree?
  • What is their official academic title?
  • What extra study have they done in fertility and reproductive medicine?
  • How long have they been practicing for?
  • Is the practitioner a recent graduate (medical, or complementary medicine)
  • How many fertility patients have they helped?
  • What experience has the practitioner had, and who has mentored them, or trained them?
  • What was their motivation for getting in this area of healthcare?
  • Do they work in with a fertility/IVF clinic?
  • Do they have a symbiotic relationship with a fertility/IVF clinic?
  • Does the practitioner know all the fertility investigations, fertility terms, drugs, hormones, procedures, and all things related to fertility?

These questions are just some of the important questions someone should be asking any practitioner, medical or complementary medicine, before they decide to seek their help to assist them having a baby.

See someone who specialises in fertility and reproductive medicine

I also generally tell people that when seeing someone for fertility, the practitioner should specialise in that area and not have their hands in too many pies so to speak. If seeing a medical specialist, you should try and see someone who just does fertility work on, and who isn’t trying to juggle a busy obstetrics practice at the same time. I see this happen often, where patients are left waiting while a specialist is off delivering babies and the couples are left waiting for hours. Someone like this cannot give you his or her full attention and why I believe you need to see someone whom just does fertility work only.

But again, you just need to do your homework with whomever you see. This goes for complementary medicine practitioners as well. Find out if their primary focus is fertility and not trying to be someone who does a bit of everything. Remember, don’t forget to check that they have post graduate training and experience in reproductive medicine and fertility.

Many couples are having the basics missed

Many couples I see, are often at the point of desperation, and some are also at the point of giving up. I feel sorry for those who get to this point, when in fact it is because some of the basics just have not been investigated.

Being desperate can also lead to bad decisions and also for couples to be exploited by big fertility clinics and the hard sell on offering a solution to their fertility. The fact is that nobody has all the answers, there is no magic pill, and IVF is not a cure for infertility, and we need to start being real about this.

There is often the case of expectation versus reality and many are exploited because they are desperate. We need to be very real that while IVF etc, can help couples have a baby, it really is not a cure for infertility, and it cannot help everyone.

But at the same time many couples issue really are that they have not have the basics done, or proper evaluations done, purely because the person they are seeing is a properly trained in fertility and reproductive medicine. That is a fact.

Males are not exempt from fertility issues

I’ve talked about this often and it is one of my biggest annoyances with the whole fertility profession and men who do not need to be part of the fertility journey. Have a look at my previous posts on this (click here) 

The fact is that many men are not evaluated properly and are not having the basics done with regards to fertility testing. Women are being focussed on and the male is often almost excluded from the process. Let’s face it, some men are literally in denial and excluding themselves as well. I honestly do not know why some women chose to be with men who refuse to be part of the process. Their actions speak volumes.

The long and short of it is that men are often the biggest part of the reason why a couple is not conceiving. Up to 50% -60% of fertility issues are related to men and up to 85% of miscarriage and fertilisation issues are related to chromosomal and DNA factors related to men. Yet many men are under-investigated, or not investigated at all. I see it so often where couples have literally been trying for years and years, and then we find out it is the man who is the issue. Yet all along both the fertility practitioner, and the woman’s partner alike have blamed the woman as being the primary issue. I see this so often and it actual disgusts me. Why should women be blamed for all fertility issues, when men are an equal, and often greater part?

Proper fertility evaluation and testing

I’ve spoken about this in previous posts and it is so important that couples are evaluated properly. Personally I believe that everything that should be done is done up front and at the beginning. So many couples end up finding issues years later, which should have been found in the beginning.

Proper testing should involve at least the following:

  • Full blood testing and screening
  • Hormone assay
  • Scans and imaging
  • Surgical intervention (Laparoscopy, hysteroscopy and dye studies)
  • STI screening
  • Semen analysis
  • Sperm chromatin Assay (SCAT)
  • Full genetic screening
  • Advanced genetic carrier screening
  • Others

I make sure that all my patients have been screened and investigated properly on all levels, for both the man and the woman, not just the man.

You can also see my previous post about the importance of proper genetic screening as well (click here) 

We do have same sex couples and single women seeking help now, and it is still equally important that all concerned are screened properly. Sometimes one of the partners in a same sex relationship may have an issue which prevents them from conceiving, so you have to screen the other partner just in case. It is all about screening and proper evaluations and investigations.

Expectation versus reality

While we have talked about the fertility profession, we also need couples to be real about their chances too. As mentioned before, couples do need to be aware that IVF is not a cure for infertility and that is cannot help everyone. It can help many couples that would never have been able to conceive naturally too.

Age 

We also need for couples to be real about age related fertility, as that is the biggest issue as far as fertility and conception is concerned. The older you are, the harder it is going to be to fall pregnant. No matter is you are doing IVF, or not, age is a big factor in couples being unsuccessful. The older you are, the poorer quality your eggs and sperm are, and the more random chromosomal/DNA errors you get in embryos.

Preconception care

There are other issues with diet and lifestyle that need to be addressed too. Couples that are overweight are going to struggle more with being able to conceive. This is why proper pre-conception care is so important and why I have talked about it often before. We need for couples to look at their diet, their lifestyle, their alcohol intake, their stress levels etc. All these things in combination can affect ones fertility and chances of having a baby. Have a look at my post about the importance of preconception care 

Not everyone will be able to have a baby

There are also those couples, that despite the best medical interventions and help, that they may not be able to fall pregnant. This is really sad, but it is a harsh reality that some will have to face. You can read my post about why IVF cycles fail

But now they are more ways to have a baby then ever, with donor eggs, donor sperm, donor embryos and even surrogates.

Final word

There is a lot to know about fertility and many couples are unaware of the lack of regulation around the fertility profession. Many are literally at breaking point and for many of these it is really through lack of proper investigations, or seeing someone who is not properly qualified to be doing fertility work.

We also need couples to take responsibility for their own health and lifestyle and also be real about age related infertility too. It is all really overwhelming for couples, but the fact is that we still need to talk about it.

Lastly, you need to do your homework, when going to see someone for help with fertility. As mentioned previously the fertility profession is largely unregulated and there are a lot of practitioners out there, medical and complementary medicine, who really are dabbling, or who are not adequately qualified to be assisting you.

How I can help?

If you do need assistance with fertility issues, and do want to see someone with a masters of reproductive medicine and years of clinical experience, please give my staff a call and find out how my fertility program may be able to assist you. You can also look at some of my posts about my fertility program on my website too.  You can do our full fertility program or you can now do our new 3 phase fertility program too. There are also meet and greet appointments before joining the fertility program. Again for more information, speak to my friendly staff, or drop us an email.

I hope this helps those trying to have a baby better understand the fertility profession on all levels and seek the best help possible.

Regards

Andrew Orr

-Master of Reproductive Medicine

-Fertility Expert

-The International Fertility Experts

-No Stone Left Unturned

 

 

 

 

 

3 Phase Fertility Program Facebook 1

New 3-Phase Fertility Program & Why We Are Doing It

We are now offering a step by step new 3-Phase multimodality fertility program for those who need assistance with being able to have a baby. In the next follow-up post I will explain it a bit more in depth and what the phases involve.

We already offering a full multimodality fertility program which covers everything couples/individuals will need for their journey to have a baby. For more information on the full program please click on the link- Dr Andrew Orr’s Full Fertility Program 

My motto is “No Stone Left Unturned” and I don’t offer quick fixes

My motto is “No Stone Left Unturned” and I apply this to every person I see. I also have a master in reproductive medicine and have been assisting couples/individuals with fertility issues for over 20 years. I have helped over 12,500 babies with my program and part of this is because I don’t do things by halves and I look thoroughly into every person’s health and reproductive history.

I don’t do things by halves and with fertility and reproduction there is not quick fixes. If you aren’t able to conceive there is something drastically wrong and it needs to be investigated properly and appropriate management and treatment administered. This goes for both men and women. As I always say, fertility is not just an issue that women need to work on. Men are an equal part of the equation.

While my motto is “No Stone Left Unturned” and I will never do things by halves, or give people the quick fix, unfortunately there are many out there who will. Unfortunately people also want the quick fix and won’t invest in anything that they perceive will take them time. It is just the world we live in these days. Everyone wants a quick fix and immediate gratification. But, when it comes to fertility and reproduction, perception and reality become apparent very quickly and many couples/individuals end up on the fertility round about for years.

My full program and the new idea for the 3 phase program

My full program is very extensive and includes a lot of things than many just do not realise. The program cost is inclusive cost up front and even so, it probably should be twice the price. But, with all that goes into it and what is involved, many couples/individuals find that a bit overwhelming as they want they just want the short cut and answer to have a baby.

My daughter runs my reception and takes all my patient enquiries and a few weeks ago we spoke about creating a separate program, which may be less overwhelming for couples/individuals. This is where we came up with the 3-phase fertility program.

This way couples can do things step by step, rather than everything up front, and pay for each phase they do, rather than an all-inclusive price up front *

The New 3-Phase Fertility Program

Couples/individuals* can now come and see me for an extensive 2 hour consultation and fertility education without having to commit to the full fertility program. This is phase 1. They have to fill out questionnaires prior to coming and will be given a 10-20 page report of findings and ongoing management plan. From there they can then go away and absorb everything and decide if they want to commit to the rest of the fertility program, which is then phase 2 and phase 3.

The cost is a little cheaper than the full fertility program and you pay for each phase, rather than an all-inclusive fee up front. You don’t get everything that is included in the full program, but it is another option for couples who need advice, who are unsure what they want to do next etc.

It would be a little strange to just do Phase 1 only, as you would have all this advice and plan set out, and then not be able to do anything with it. But what it does is allows couples to digest things and talk over all their options etc, before they commit to phase 2 and phase 3.

My mission 

I want every couple, or individual wanting to have a baby to have the best advice and care before heading into the journey of becoming a parent. The new 3 phase fertility program gives another option for this. It also makes things a little less overwhelming while still giving couples the “No Stone Left Unturned” approach that I always provide everyone. I will never do quick fixes, never cut corners, or try to cheapen what I provide to anyone. But, I will always look at ways I can meet people half way and this is what we have done.

Couples/individuals * can still do the full Fertility Program if they want, but now they have another option they can look at also.

I will explain the new 3-phase Fertility program option in a follow-up post. To find out more the best thing to do is call my clinic and get the full information and pricing from my staff. If you do need help with having a baby, or struggling to fall pregnant, please give my friendly staff and they will go over every option of how my fertility programs may be able to assist you. Yes, we do see couples from remote places, interstate and those overseas as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts.

*Conditions apply. Please ask our staff about these conditions. 
3 PhaseFertility Program

New 3-Phase Multimodality Fertility Program Explained

  • Are you struggling to fall pregnant?
  • Have you had multiple failed cycles of IVF, or Assisted Reproductive Therapies?
  • Do you want to know ways to increase your chances of pregnancy?
  • Do you feel like your fertility specialist, GP, or gynaecologist isn’t listening to you?
  • Could you have had things missed in your fertility investigations?
  • Do you just want proper answers to why you aren’t conceiving?
  • Have both you and your partner been evaluated properly?
  • Are you considering IVF, or Assisted Reproductive Therapies and want to know more?

Dr Andrew Orr’s clinic is now offering a “3-phase multimodality fertility program”, which is also part of “The International Fertility Experts” program, for those who don’t wish to join our full fertility program straight away.

Who runs the program?

This new 3-phase program is run by ‘International Fertility Expert’ – Andrew Orr, who has over 20 years of experience in assisting reproductive and women’s health conditions.

Andrew has two medical degrees being awarded a Masters of Reproductive Medicine and a Masters of Women’s Health Medicine through the faculty of medicine at the university of New South Wales (UNSW). Dr Andrew Orr is also a doctor of Traditional Chinese Medicine, nutritionist, integrative medicine practitioner and more. Combining both his western and complementary medicine background, he brings a true integrative/multimodality approach to fertility.

What is involved with the 3 Phase Fertility Program?

Many couples/individuals that come to our clinic are often unsure what to do next when it comes to trying to have a baby. The new 3-phase multimodality fertility program allows couples/individuals to have consultation and guidance about their fertility journey before committing to the next 2 phases of the fertility program.

It also allows people the chance to hear the advice and guidance given and for them to go away and think about what they would like to do next.

1. Phase 1 of the program- “Initial Consultation & Fertility Education (2 hours)”

Phase 1 of the 3-phase fertility program begins with a 2 hour initial “No Stone Left Unturned” consultation/fertility education session with Dr Andrew Orr.

Phase 1 involves:

  • Preliminary workup of case history and questionnaire review.
  • 2-3 hour consultation and fertility education
  • Comprehensive health questionnaires & online questionnaires (sent prior to initial consultation)
  • Review of pathology, medical investigations, etc.
  • A 10-20 page report and management plan (written prior to your arrival).

What happens after Phase 1?

After phase 1, people can then decide what they want to do with the information and recommendations that they have been given. Rather than waste the information and advice given, people are recommended to do the next two phases.

*Phase 2 and Phase 3 of the multimodality fertility program are only for those people who to continue with the program after Phase 1. 

We highly recommend that Phase 1 followed by Phase 2 and Phase, which includes preconception care, extensive fertility investigations, multimodality treatments, diet & lifestyle advice, nutrition, medicines and supplementation, acupuncture and herbal medicines, and everything I couple will need to know and do as part of their ongoing fertility management. It is a very extensive multimodality fertility program which includes both medical science and complementary medicines combined.

2. Phase 2 of the program- “Review consultation & medicines/supplements prescribed”

Phase 2 involves:

  • 1-hour review consultation with master of reproductive medicine- Dr Andrew Orr (review of management/treatment plan, further fertility education, questions answered).
  • First lot of medicines and nutritional and vitamin supplements (for both partners).
  • Referrals for fertility testing/investigations/procedures and referral to other specialists if needed.
  • Fertility information pack.

*Please note that testings and investigations will come at an extra cost and are not included in the 3 phase fertility program. 

3. Phase 3 of the program- “Ongoing Treatments & Fertility Management”

Phase 3 involves:

  • Ongoing Acupuncture
  • Ongoing consultations and review consultations (those not local will do online consultations)
  • Ongoing medicines and nutritional supplements
  • Further testing and procedures (if needed)

*Please note that ongoing services, treatments, medicines/supplements, testings and procedures etc, all come at an extra cost. Some services may also be claimable under private health insurance. Online consultations are only available to those people who are not local, or who are living interstate, or overseas. 

Final Word

Please note that the 3-Phase Fertility Program is a little bit cheaper and little different to our full fertility program. Please talk to our staff about these differences and which program would suit you best.

[Special Note- Please note that due to legal and ethical guidelines for fertility management, all males must be involved in any part of investigations and ongoing fertility treatment/management. We cannot see a female on their own, unless they are single and using donor sperm, or in a same sex relationship]

Dr Andrew Orr’s vision is to help every couple, or single patient, get the right care, right investigations, proper treatment and management to help with increasing their chances of conceiving.

Through Dr Andrew Orr’s multimodality management fertility program, that combines ancient and modern science, he aims to deliver his “No Stone Left Unturned” for anyone wanting to have a baby.

For more in depth information about our 3-phase Fertility Program and Full Fertility Program, or to book in, please call our friendly clinic staff on 61+07 3832 8369, or email us at info@drandreworr.com.au

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts.