Copy of Fertility Facts Being Overweight or underweight can adversely affect fertility

Being Overweight, or Underweight Can Adversely Affect Fertility

It is important to have healthy weight and waist size when trying to conceive. It is know that being underweight, or underweight can adversely affect fertility.

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”

Metabolic Syndrome

Metabolic syndrome increases their chances of the following:

  • diabetes
  • heart disease
  • depression
  • gynaecological conditions (PCOS, endometriosis etc)
  • sperm issues,
  • egg quality issues
  • reproductive issues,
  • increased miscarriage
  • increased risk of certain cancers
  • infertility

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

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.

The importance of preconception care

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

Andrew Orr

– No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

Chill Pill

A Special Kind of Pill for Better Health and Increased Fertility

Previously I have mentioned that I was going to talk to you all about a special medicine and a special kind of pill, that can not only help you with gynaecological and other healthy issues, but it can also help with fertility and being able to fall pregnant.

I was going to post this up straight away, but then I had to think more about it, because I know when you mention this subject, people can take a message with the intention of helping the wrong way.

So what is this special pill that I am talking about and not yet available on the market?

Well, it’s called a “Chill Pill” and many of us need to be taking it often, or learning to administer it often.

Now, before anyone gets all up in arms about this and what I am about to say, I need you to listen and take the personal out of this and just hear the reasons why.

I have been on the other end of stress, where it almost killed me, literally and I know how it then affected my health and then exacerbated pre-existing health complaints I had. So I am coming from a place of understanding, but also a place of wanting to help people through my own experienced personally, but also what I see in clinical practice daily. I was one of those people who kept saying that weren’t stressed, or that I don’t feel stressed, yet all the while my body signs were saying something different.

Like any change we need to make, the first part is admitting there may be something wrong in order to enact that change.

The sad fact is that 9 out of 10 people report being stressed and 41% of people feel they experience unhealthy levels of stress. Stress and the body’s response to it, can affect people in different ways. Small amounts of stress that are easily resolved can help to keep us motivated and achieve our goals.

The difference with long term or chronic stress is that it can affect the whole body in a negative way. It is the long grade, low grade stress (or busyness) that often creeps up on us and causes issues. Many people do not even know they are stressed, or that stress is a big factor in their current health issues, because they are either so used to it, or their health issues takes over and they cannot even begin to see the correlation.

The harsh reality of many problems in life is that we are ultimately responsible for our own well-being. Not all people will want to accept this, as it is so much easier to blame someone or something else for our dilemmas.

Nearly every problem we experience in life may have an element of stress to it bought on by ourselves and our busy lives, with many of us not consciously knowing it is at play. That means everything from a common cold to a long-standing illness. Everyone reading this will be by now squirming in his or her seats as the harsh reality of such a statement hits home. But the real problem with this is that it is true. I know I had to face this reality with my own health issues. We can and do cause many of our own health problems, or exacerbate them, either consciously, or subconsciously.

The problem with any health matter is getting people to become responsible for their own self. So much illness is completely preventable if we would just take responsibility for our own actions. It is so much easier to blame someone, or something else with comments such as “ I have tried everything”, “That didn’t work for me”, or “I’ve been everywhere and nothing can help me”.

The problem with many of these blanket statements is that they are all just excuses not to take responsibility for our actions. Maybe it isn’t that the methods you are trying aren’t working. Maybe it is simply a matter of nothing will ever work unless we make that all important change for ourselves first.

Sure, some disease states are hereditary, or someone have a predisposition for them, but even so, once the illness, or disease is expressed in the body, it is our responsibility to do what we can to control it.

Yes, sometimes it doesn’t seem fair, I get that, but sometimes you just have to admit there is an issue that isn’t going away in a hurry, or keeps being flared up, because you need to make some changes in your life to better manage this issue.

I know this is something I had to learn myself. Boy did I fight the reality of this in the beginning too. But, I also acknowledge that some people have seen some pretty shitty healthcare practitioners who have missed and dismissed their issues too. It all compounds and just makes everything seem so much worse. But, at the end of the day you can also find good practitioners who can help you too.

Stress is also a major factor in many couples not being able to conceive. Stress affects cortisol levels and the adrenals and this then has an effect on testicular and ovarian function.

Stress can affect both sperm and egg quality and high stress levels also affects our hormones and our immune system. Stress also has an effect on the uterine environment, which can affect implantation, affect circulation in the uterine lining, and also increase the risk of miscarriage. High stress levels also exacerbate, or fuel many gynaecological and men’s reproductive health issues too.

Looking for the ‘Off ’ Butt on

Stress can affect each of us differently. Perhaps you are suffering from anxiety, feeling worried, depressed or irritable; even feeling exhausted and overwhelmed can indicate you are under stress. As well as affecting your ability to cope, stress may also be causing a disruption to your health. When under stress for a length of time, you may be more susceptible to tension headaches, high blood pressure, frequent colds and flus, digestive disorders or a worsening of an existing condition.

So you can see, there are many reasons why it is so important to manage your stress now, take that “Chill Pill” before it starts impacting your health and wellbeing.

How Resilience Begins

Some people seem to deal with stress better than others. That doesn’t mean that the rest of us need to continue suffering. The ability to increase your resilience to stress is something that can be learned and helped with talking to a counsellor, or psychologist etc.

There are supplements, nutrients, and vitamins to support your body’s individual stress response system too. Many people are lacking key nutrients because of our highly processed diets now and we also know that gut health, and a healthy microbiome is integral to psychological wellbeing and our moods.

Taking a strain specific probiotic and a prebiotic daily can improve gut health and improve your immune system and psychological wellbeing. Omega 3 oils, multivitamins, melatonin, St John’s wort, passion flower, chamomile and many other herbs and nutrients can assist with coping with stress and its impact on the body.

Don’t buy vitamins or supplements off the shelf at the chemist or supermarket as these are so inferior and contain lots of fillers and additives that aren’t good for you. Always see a qualified healthcare practitioner to get proper advice on what nutrients and supplements are needed for your health complaint.

By the way, Dr Google is banned in my clinic. Dr Google is not a reliable way to find out about healthcare products and illnesses. Only a trained healthcare professional should be giving you that advice. But, in saying that, researching where to find a good practitioner is great and also developing and understanding of ones health issues is great too, as long as it doesn’t become an obsession and that is all you focus on. It is about a balance. There is nothing wrong with trying to be informed. But, trying to self diagnose, or self prescribe is not a good thing at all.

Some people may be in such a bad state that medication may be needed to get them over their first hurdles and develop some resilience and coping skills. This should always be done in conjunction with talk therapy as well. To be honest, most of us could do with talking to a good counsellor or psychologist to get some coping strategies to deal with work, business, health, or life better.

Lifestyle Tips to Help Manage Stress

Managing your stress is essential for long-term health and vitality. With proper support, a variety of stress relief techniques can be introduced, in conjunction with a

healthy eating plan to help assist you in stressing less. These may include:

  1. Exercise: Daily movement is essential for brain health. Aerobic exercise including running, swimming or walking is proven to decrease stress hormones. Resistance exercise is also great for stress relief, burning fats, increasing lean muscle and keeping you healthy.
  2. Enjoy the benefits of spending some time in the sun. Being in nature for 30 minutes per day can help reduce stress hormones and assist recovery after a stressful situation.
  3. Meditation and/or yoga can help to increase relaxation whilst benefiting not just the mind, but also the body. Learning to unwind is important for reducing stress.
  4. Favourite pastime: create time for YOU! Do something that you love, like listening to music, enjoying a candle lit bath, watching a movie, or starting a creative project – these fun activities can help you become more tolerant of everyday stress.
  5. Get creative and express yourself in as many different ways as feels good; singing, dancing, and art projects are but a few ways to do this.
  6. Eat seasonally, fresh and organic as much as possible. Include protein at every meal with a variety of fruit and vegetables.
  7. Include good fats such as omega 3s from fish, nuts and seeds, and olive oil to help with brain health and mood regulation.
  8. Drink plenty of water, a minimum of eight glasses per day and avoid excessive alcohol, caffeine, sugar and salt.
  9. See a counsellor, or psychologist to get some coping strategies in place.
  10. Acupuncture has been shown to be as effective as medications for stress and equal to the effects of talk therapy in several major studies.

Stress Less for Good Health

Our modern lifestyle is inescapable. The stress of it however, is manageable. This is why I mentioned the magic “Chill Pill”. All people have to do is take the advice and administer it often.

You aren’t born stressed and being stress isn’t a part of you. It is a learnt behaviour that can be changed. You can become more resilient to the symptoms and long term effects of stress through the aid of individualised lifestyle and dietary changes, together with nutrients, supplement and in some cases medicines that your healthcare providers can help you with.

Talk therapy such as counselling and psychology is an integral part of leaning to cope with stress and dealing with it better too. Mindfulness and meditation can also assist with stress.

Supporting a healthy stress response will allow you to feel more energised, resilient and ready to tackle life, so you can maintain the state of health and wellness that you deserve.

I hope that helps everyone and please remember to take off those superwoman/superman capes regularly, allow space to just breath and shut off the mind and just have some you time. It is OK to just sit there and not feel guilty about it. People need to learn to switch off the “busyness” and close down the 100 boxes they have open. It is Ok just to sit in peace and quietness and not feel guilty about it. Actually, your body needs to do this to maintain your inner health, but also your psychological health.

Every persons health, or disease state is different and while stress may not be the cause of ones particular issue, it can certainly exacerbate it. This is why it is so important to look at every aspect of ones life, not just a small isolated portion of it.

When was the last time you allowed yourself the space to just be, just take some quite time and let the world pass by for a little while without worrying about it?

Take care and relax and don’t work too hard. We work to live, not live to work.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

weight loss 2036966 1920

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

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.