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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

Cartoon sperm

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

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

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

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.
AMH Levels

AMH Levels Alone Are Not Indicative of Ovarian Reserve

One of my biggest bug bares is having so called specialists tell women that AMH (Anti Mullerian Hormone) levels alone are indicative of their ovarian reserve and having them freak out that they now have little, or no eggs left. Nothing could be further from the truth.

AMH levels alone ‘are not’ indicative of ovarian reserve. There is no test on this planet that can tell you how many eggs you have left. There never has been and there will probably never will be.

AMH levels are not a definitive diagnosis for ovarian reserve and their predictive value alone is very questionable. It just gives a ‘rough’ guide that someone may be a poor responder to Assisted Reproductive Therapies (ART) and that is it. Even then, you will often see women with low AMH levels still producing 5-8 eggs a cycle many times while doing IVF etc.

What has inspired my to talk about this, is that last year I had a friend come to see me and she told me she couldn’t have children because she had no eggs left. I found this quite disturbing and continued to ask how she had come to this conclusion.

What was most disturbing is that her whole basis for not being able to have children, was based around the fact that some ….ummmm… and I can’t really voice it any other way… but some “A-Hole” specialist had told her she can’t have children because she had low AMH levels.

No other investigations, no trial of IVF to see if she can respond and get eggs, just one lousy blood test.

This is so disgusting and such BS, they I couldn’t contain myself and had to sit this poor woman down and tell her the facts. Worse still this was from a Fertility Specialist who basically calls himself God and believes he is the best specialist here in the city where I live.

This idiot has basically had someone believe they cannot have children based on one single blood test. This is the sort of thing I see everyday and it shouldn’t happen. The saddest part of this story is that this person is no longer with us and tragically lost her life in a car accident. She never got the opportunity to try and have children all based on some egotistical horrible man who has no idea around the facts about fertility.

I always talk about this subject to other healthcare practitioners and as part of my education in my seminars. AMH alone “Is Not”… repeat “Is Not” indicative of ovarian reserve and nobody can tell you how many eggs you have left anyway. It is utter BS.

To get an “Idea” and I mean a “rough idea” of how well you may respond to producing eggs, AMH levels give us a “rough idea” or a pointer to “maybe” how many eggs you may have left, or if you will respond to fertility drugs. It is not a definitive diagnosis on its own.

To get a more accurate picture of Ovarian Reserve, there also needs to be other tests factored in too. All of these things I discuss when I evaluate someone as part of my fertility program and their initial consultation. Then after these levels and a special test is performed for 5 days, then we evaluate all these factors to basically give a rough idea how well a person will respond to produce eggs. Again this is not an exact, or not precise.

Then if it does look like the person is a poor responder, we put them through a stimulated cycle (basically an IVF cycle) and follicle track (check to see if they produce eggs and how many). Then we can truly evaluate a person for ovarian reserve.

But even if you do have low AMH levels, it does not mean you have a limited number of eggs. It means you might be a poor responder and not produce as many eggs. That is all.

High AMH levels are indicative of PCO/PCOS however and could also be signs of a granulosa cell carcinoma (which is what the test was originally designed to detect)

I have women with AMH levels less than 1 ( <1) still producing 5-7 eggs per IVF cycle, then go onto have a child, or several children with low levels like this.

Yet based on this rude, arrogant, obnoxious specialists evaluation, he would have told women with low AMH levels they can’t have children and many of them may have given up, despite the fact that they may have actually been able to have children. This makes me so upset.

AMH levels only give us a rough idea of how you will respond to fertility treatments and how many eggs you may produce. It is an estimate, or should I say “Guess-timate”

I see so many women come to see me who are freaking out after getting low AMH levels and then being told they have little, or no chance of conceiving, when actual fact they might.

Many of these ladies are also Dr Googling too, which is also spreading BS about AMH levels, just through ignorance and perception and lack of understanding of what these levels actually mean.

As someone with a Reproductive Medicine and Women’s Health Medicine Specialisation, please let me tell you the fact and  that AMH levels only give us a small, inaccurate insight into what is going on in the body.

AMH levels are not a diagnostic tool on its own and it is never meant to be a diagnostic on its own. There are many other tests that need to be done first and along side this to come to a conclusion of low ovarian reserve, or being a poor responder. Sure, some women may have low AMH levels and after all the testing, we actually do find out they are a poor responder, but not all women will be poor responders.

I hope this story helps those who might have been given the same diagnosis my late friend was given. This is why everyone should get a second opinion, or a third, or even a 5th, when it comes to fertility treatment.

The fertility profession is not well regulated and there are a lot of underqualified people out there saying they are fertility specialists, when they are not. There are also a lot of “A-Holes” with no bedside manner out there and telling people lots of things that just aren’t true as well.

Sorry for having to use some swear words, but as someone with a Reproductive Medicine & Women’s Health Medicine Specialisation, and who knows the facts, I need for everyone to be aware of this information.

Take care everyone and I’m here to be a voice for anyone wanting have a baby and I’m here to keep the bastards honest as well.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

Endometriosis Does Not Always Cause Infertility

Endometriosis DOES NOT Always Cause Infertility

Many women are led to believe that if they are diagnosed with endometriosis, that they will be infertile. The one thing I do want all women to know is that Endometriosis DOES NOT always cause infertility.

Over the years I have helped over 12,500 plus babies into the world and many of the women who went on to have these babies had endometriosis.

I have had women who have been diagnosed with endometriosis being told that they cannot fall pregnant, based on the diagnosis and AMH (Anti-Mullerean Hormone) levels alone, and no other fertility investigations. This is disgusting and should never happen. It is so sad hearing things like this and women believing they are infertile and cannot have a baby, when it fact they actually may be able to.

Endometriosis can make it harder to fall pregnant

While having endometriosis can increase your chances of having fertility issues (about 50%), it does not mean you are infertile. To be honest the word infertility is often wrongly uses. Unless you have absolutely infertility and have been diagnosed with a condition that would render you infertile, then we should really be using the word subfertility. Subfertility is a better word to use for those that may be experiencing difficulty falling pregnant, but may need assistance of some come.

Biology 101 tells us that it takes two people to make a baby

Let’s not forget that just because you have endometriosis, it does not mean that the fertility issue falls solely with you. Men are just as big an issue when it comes to fertility issues and could be the bigger part in you not being able to fall. The problem is that many fertility clinics will solely focus on the women because she has a diagnosed condition and this is wrong. Many times I have seen a women with endometriosis blamed as the main cause of the fertility issue, when in fact it is actually the man’s sperm that is at fault. Please remember this. Biology 101 tells us that it takes a sperm and an egg to have a baby, not just an egg.

Endometriosis can make it harder to fall pregnant and can affect egg quality, fertilisation and implantation, due to the resulting inflammation from the disease. But this is where it gets a bit tricky.

Pregnancy rates are not necessarily related to the extent of the disease

It isn’t always about the amount of the disease either. We know that pain levels and the associated symptoms of endometriosis are not related to the extent of the disease. I will address this in one of the other facts posts sometime in the future. The hard thing is that sometimes stage 4 endometriosis sufferers, with lots of the active disease, will have not issues falling pregnant at all. Meanwhile a woman with stage 1, or minimal disease, may have lots of issues falling.

Then we have the women who are having issues falling pregnant and will not even know that they have endometriosis and then it is found as part of fertility investigations, via a laparoscopy. Just remember that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms).

Like I always say to my patients, Endometriosis can make it harder to fall, but having the disease does not mean that you are automatically infertile, or will have trouble conceiving. This is why it is important to see someone who specialises in Fertility, not just a regular OB/GYN or a GP, and also specialises in the area of endometriosis.

Fertility Program

If you are having issues falling pregnant, please give my clinic a call. I can help you and assist you in receiving proper fertility evaluation and investigations and treatment moving forward. This is for the couple, not just the woman. Like I mentioned before, my multi-modality fertility program has helped and assisted over 12,500 babies into the world and it may be able to help you too.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

01 Dr Andrew Orr 1

time for a change 2015164 1920

The Importance of Following Through With Advice, Treatments & Change

I see so many people who have been ‘missed’ and ‘dismissed’ and who have suffered in silence with their disease state.

But the biggest shame is when those that are offered real help, then do nothing with that advice and continue on the vicious, merry-go-round cycle of their disease.

My motto is “No Stone Left Unturned” and I apply that to every patient that I see. My initial consults are usually 1-2 hours in length and I also do lots of preliminary work prior to see a patient as well. I make sure all my patients are now only sent health appraisal questionnaires, but are also evaluated with mood and stress questionnaires for their mental health too. I really want to delve into every fine detail of a persons life to see what may be driving their disease state and symptoms. It is to also help with diagnosing those that have not been properly diagnosed either. I then write up a comprehensive report for all my patients, with everything they need to do, the changes they need to make, the medicines they need to take, the investigations and testing they need to have and all their step by step health management moving forward. No Stone Is Left Unturned as I mentioned before

As I mention in this video blog is that the greatest shame is those that come to get the advice and help and then do nothing with it. Just remember that if you do not change anything, or do the work needed, then nothing changes. The key to real change is actually within you.

If you so need help with a particular health issue, or you just aren’t getting the right answers and care, then please book in a time to see me and let me be your guide to better health and getting your life back to normal.

 

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Let’s Talk About Fertility

Dr Andrew Orr has an honest and open chat about his years of experience dealing with couples with fertility issues.

Much of it gets back to couples not having the proper testing and investigations, being on the same page, preconception planning, getting healthy, doing the work and the expectations versus reality.

Have a listen to Dr Andrew Orr’s open and honest discussion about a very serious topic.

If you do need help and are struggling with fertility and not having a baby, Dr Andrew Orr can assist you in your journey to becoming parents and having your little miracle.

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The Journey to Have a Baby Can be Like a Marathon For Many Couples.

The Journey to have a baby can be like a marathon for many couples. It can be physically, emotionally and financially draining on every level.
 
One of the things I teach my patients, struggling with fertility issues, is that the journey often is like trying to run marathon. I also explain that they also need to prepare for the journey, just like preparing for a marathon too. 
 
I teach them that ‘couples’ (meaning two people) not just the woman unless she is doing it alone, need to get into the best shape possible prior to running the marathon, not just think about it half way through, when they are tiring and the finish line is nowhere in sight.
 
Healthy couples create healthy sperm and healthy eggs, which then go onto to being health embryos and then later health babies.
 
When preparing for a marathon you need to get the body into the best shape possible. That means physically and mentally too. Never overlook the mental aspect and this is why counselling and mindfulness is so important for couples struggling to have a baby. Many times this is the most important, but often overlooked aspect to a couple having success. 
 
Then couples need to get their diet in check, their lifestyle in check, get the body investigated and assessed properly and get the body fully ready to be able to make that finish line.
 
Nobody should ever just decide to run a marathon without proper training, good nutrition, mental preparation and getting the body in shape.
Unfortunately many couples try to run the marathon without the proper preparation and preconception care and then try to patch things as they struggle along the journey. This is when I see many of them. They are struggling on every level and exhausted and ready to give up.
One of the things I mention often is that  I wished that I saw every couple before they even started their journey. This way they are less likely to end up at this point of exhaustion and despair and clutching at straws to make it all work. I see so many out at sea in a leaky boat trying to patch the holes as they go along, when really they should have got the boat sea ready before they head out. Trying to patch things half way through the journey never works. It  just causes desperation and wasted time and money as well. It can also lead to much worse and many couples actually end up breaking up due to the stress of it all.
 
This is why my fertility program is about preparing the couple on every level. Making sure everything is evaluated and properly investigated on a medical front first and then preparing their bodies on a holistic, and physical and emotional level too. It is also teaching the couples the power of intimacy and connection again too. Literally, I make sure “No Stone is Left Unturned” and then I know couples are ready for the journey ahead. For many it is often a short journey afterwards and this is what I hope for everyone trying to have a baby.
 
I always say that the couples that put in the work, get their bodies ready, prepare physically and emotionally, get the right nutrition, change their lifestyles, take all the supplements and nutrients, talk to a counsellor, do mindfulness, get some acupuncture, do some exercise, connect as a couple, have date nights, make love often, and do all the requested investigations and testing etc, they are the one that get that baby they so desperately deserve.
 
I have assisted in helping over 12,500 babies into the world and I know what couples need to do to get their little miracle. I want all couples to have their little miracles and experience the joy of being a parent.If you are having trouble have a baby, or not getting the help you so desperately deserve and need, then it is time to make the change and make that call.
Regards
Dr Andrew Orr
-The Brisbane Baby Maker
-No Stone Left Unturned
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Pre-Fertility Program Meet and Greet Appointment with Dr Andrew Orr

Dr Andrew Orr’s clinic has a Pre-Fertility Program Meet and Greet appointment available for those thinking of joining the Fertility Program and who just want to meet Dr Orr first and find out a bit more about the program. The meet and greet appointments gives couples, or individuals, a chance to meet and greet with Dr Orr and have a quick look over their basic health history, as well as have the program explained to them. Patients can go straight on the program and bypass the meet and greet if they wish to do so. For more details about the Fertility Program (click link)

Couples attending the meet and greet appointment are sent out the pre-fertility program questionnaire, and this must be sent back prior to the appointment. The appointments can be in person, or online for those living out of our local area, or who are international. You will be given more comprehensive questionnaires upon signing up to the program.

Please note that the introductory meet and greet appointment is ‘half an hour only’ and ‘is not’ the initial appointment for Dr Andrew Orr’s Fertility Program. This means that you will not receive any fertility supplements, special fertility formulas, medical advice or referrals during this appointment. Please also note that Medicare and private health rebates are not available for this appointment. (The cost of the appointment is $120). 

Dr Andrew Orr’s fertility program has assisted and helped over 12,500 babies into the world and this number is increasing every week. He has helped couples locally, interstate and internationally and has had many media stories about his success with couples.

Dr Andrew Orr  has been awarded a Masters of Reproductive Medicine and a Masters of Women’s Health Medicine through the faculty of medicine at UNSW. He is also a Doctor of Traditional Chinese Medicine, a Nutritionist, a Natural Medicine practitioner, a qualified Chef and more. With his wide range of qualifications and over 20 years experience in assisting fertility and gynaecological issues, he is able to bring you a truly integrative multi-modality approach to assisting couples with fertility and having a baby. His motto is “No Stone Left Unturned” and the media have named him “The Brisbane Baby Maker”

If you aren’t getting the answers you need and the help you need, then Dr Orr’s Fertility Program could just be the answer you are looking for. The Meet and Greet appointments allow you to see if this program will be what you would like to do.  If you would like more information about this, please do not hesitate to call Dr Orr’s clinic,  ask us to email you an information pack.

We look forward to helping you on your journey to have a baby, just as we have helped over 12,500 (plus) couples bring their babies into the world too.

Regards

Dr Andrew Orr’s Team

-No Stone Left Unturned

-Meet and Greet Appointments

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