The Top 23 Things That Will Cause A Flare In What You Thought Was Endometriosis Adenomyosis Symptoms But Maybe Isnt 13 23 webpage

The Top 24 Things That Will Cause A Flare In What You Thought Was Endometriosis & Adenomyosis Symptoms, But Maybe Isn’t (13-24)

In the second part of my posts about the top 24 things that will cause a flare in what you thought was endometriosis and adenomyosis symptoms, but may isn’t, I continue with the next 12 causes of what you think is endometriosis, or adenomyosis symptoms, may just be caused by something else?

In this post I continue to bring awareness to the fact that sometimes it is not always Endometriosis, or Adenomyosis causing your current symptoms. It may be one of the following facts only, or in combination. What we need to remember is that many women with endometriosis, and adenomyosis, often have other issues that are flaring their current symptoms, and often present the same as endometriosis and adenomyosis, in their symptomology.

We also know that many other causes of flares of symptoms are often overlooked, and even dismissed, just as endometriosis and adenomyosis is often missed and dismissed.

Many women may have other issues going on at the same time as having endometriosis, or adenomyosis, and it is possible to have both endometriosis and adenomyosis combined and well as having other health issues in combination as well. Just remember that not all your symptoms may be endometriosis, or adenomyosis, and why it is so important to see and expert in these conditions.

If you do need and expert and need help with endometriosis and adenomyosis, please give my friendly staff a call and find out how I may be able to assist you.

 

Let’s have a look at the next 12 causes of “What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t”

 

Causes of a Flare of What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t ( 13-24)

13.Tight pelvic floor muscles – Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles. Have a read on my previous post about this. (Click here to read)

14.Interstitial cystitis– Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe. Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes. This is why proper differential diagnosis is very important as this can be missed very often, or completely overlooked. Have a read of my previous post about IC (Click here to read)

15.Pelvic Congestion Syndrome– Pelvic congestion syndrome (PCS) is a chronic condition that occurs in women when varicose veins form below the abdomen within the pelvic region. Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion can also cause chronic pelvic pain in some women. Pelvic congestion syndrome does share many of the same symptoms of endometriosis and adenomyosis and it important to have proper differential diagnosis and rule other causes of pelvic pain out first. Sometimes the varicose veins that cause pelvic congestion syndrome can be present alongside endometriosis and adenomyosis, or other pelvic issues. Have a read of my previous post about PCS (Click here to read)

16.Constipation and full bowel- A common cause of pelvic pain and abdominal pain and bloating and caused by constipation and a full bowel that is slowly backing up and starting to compact. In serious cases, the bowel can compact and even perforate if not addressed soon enough. When the bowel is not fully voided, it can lead to backing up of the bowel. Many people are still moving their bowel each day, but just do not realise, it is not being voided properly. This can lead to pain, gastrointestinal issues and also feeling unwell, due to not voiding waste from the body. It is a very commonly overlooked issue. This is why women need look at restoring the microbiome properly and also drinking enough water, eating enough fibre and also creating good bowel habits and not holding on too long at work.

17.Lack of sleep – Lack of quality sleep is a major issue for many women and is a common cause of their fatigue, increased pain, and exacerbation of symptoms, interference of moods, and a whole range of health issues physically and mentally. Sleep deprivation leads to reduction in hormones such as melatonin, which is a precursor to serotonin and then affect the moods etc. Lack of sleep also interferes with the other hormones in our body too. Lack of sleep also stops the body from repairing and can lead to increased inflammation within the body. We know that shift works do have a lot more disturbances with their menstrual cycles and also have lower fertility rates.

18.Over-exercising– Over-exercise can lead to tight pelvic floor muscles and hypertonus, but it can also lead to decrease body fats as well. Body fat plays a regulatory process with hormones and fertility. A significant decrease in body fact (10-15%) can lead to decreased hormone production and actually stop the menses and interfere with fertility. Over exercise can also cause stress and inflammation in the body and can also lead to adrenal exhaustion and fatigue. It is all about balance.

19.Lack of exercise– Lack of exercise if a big factor in a lot of people’s health issues. Lack of blood flow and lack of circulation to muscles and tissues, especially the uterus and vagina, can have some serious consequences for women’s health and gynaecological conditions. Without proper microcirculation into the uterus, and vagina and reproductive organs, these areas can become highly stressed, lack vital nutrients and then leads to inflammation, pain and other irregularities. It is a catch 22 situation. Too much exercise is not good, but similarly, not enough exercise is just as bad for us. While sometimes we may not feel like exercising, the fact is, research has shown that regular exercise can, and does help with pain, and other symptoms of endometriosis and adenomyosis.

20.Environmental Estrogens– According to a landmark US study published by the US department of environmental health, there are 87,000 plus environmental estrogens we are exposed to in all countries around the world, some being worse than others. These can be anything from plastics, detergents, petroleum products, chemicals and even the contraceptive pill ending up in our water ways. These endocrine disruptors (AKA as environmental estrogens) can interfere with hormones within our body and also lead to inflammation and many health issues. They have also been linked to the increase in lower fertility rates and the increase in expression of genetic mutations within the body. Endometriosis and adenomyosis is driven by estrogen and this may be a big factor in the increase in women with endometriosis and adenomyosis.

21.Lack of blood/increase of blood circulation– The microcirculation of the uterus, vagina and reproductive organs is a very important one and one of the reasons getting proper blood flow and improving microcirculation into these areas is important. I talked about this in the lack of exercise part. It is also important to check women for hereditary blood clotting and also bleeding disorders. All women with gynaecological and fertility issues should be screened for blood clotting disorders via prothrombotic studies and also bleeding disorders such as Von Willebrands Disease, when suspected.

22.Musculoskeletal issues– Women with postural issues, or their spine out of alignment can also experience referral pain, and pelvic pain due. It is important to have musculoskeletal causes of pain assessed by a qualified healthcare professional (physio/chiropractor/osteopath). When muscles are too tight, it can cause sublaxations, which can then impinge on nerves and also cause referral pain and other health issues within the body. Damage to nerves and tissue, such as pudendal nerve neuralgia can also cause pain and referral pain in the lower abdomen, pelvis and vagina.

23.Excess weight and body fat– At present up to 70% (or more) of Australians, and Americans, 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. Excess body fat in men and women leads to higher levels of the hormone leptin. 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. 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, adenomyosis, miscarriage and other factors affecting fertility. Excess body fat can also be a major driving factor of endometriosis and adenomyosis, due to the estrogenic effects it has. This is why reduction in body fat and a healthy diet and healthy lifestyle is imperative in the management of women’s health and fertility.

24. Iron Deficiency– Iron deficiency can be a very serious issues, and many women do not realise the health risk associated with it, and how often it goes undiagnosed. It can lead to disruption of hormones, and can lead to fatigue and exacerbation of pain and emotionally generated symptoms. Let’s face it, without iron, you aren’t going to be transporting oxygen around your body and then your muscles, brain, hormones and circulation suffer as a result of this. Women with endometriosis and adenomyosis are nearly always iron deficient from the heavy blood losses they suffer, or the internal bleeds they get from flares of endometriosis lesions. Have a look at my previous past on the serious consequences of low iron and why managing iron levels is so important (Click here to read)

 

The Top 22 Things That Will Cause A Flare In Endometriosis Adenomyosis Symptoms 1 11 for webpage

The Top 24 Things That Will Cause A Flare In What You Thought Was Endometriosis & Adenomyosis Symptoms, But Maybe Isn’t (1-12)

Many people often talk about how they get flares of their endometriosis and adenomyosis symptoms often. While in some cases it may actually be the endometriosis, or adenomyosis causing their flare, in truth, many times it is other things actually causing their flare and it is so important to understand this. Maybe what you think is endometriosis, or adenomyosis symptoms, may just be caused by something else?

In this post I want to bring awareness to the fact that sometimes it is not always Endometriosis, or Adenomyosis causing your current symptoms. It may be one of the following facts only, or in combination. What we need to remember is that many women with endometriosis, and adenomyosis, often have other issues that are flaring their current symptoms, and often present the same as endometriosis and adenomyosis, in their symptomology.

We also know that many other causes of flares of symptoms are often overlooked, and even dismissed, just as endometriosis and adenomyosis is often missed and dismissed.

Many women may have other issues going on at the same time as having endometriosis, or adenomyosis, and it is possible to have both endometriosis and adenomyosis combined and well as having other health issues in combination as well. Just remember that not all your symptoms may be endometriosis, or adenomyosis, and why it is so important to see and expert in these conditions.

If you do need and expert and need help with endometriosis and adenomyosis, please give my friendly staff a call and find out how I may be able to assist you.

 

Let’s have a look at the first 12 cause of “What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t”

 

Causes of a Flare of What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t ( 1-12)

1.Stress – Stress is the one of the biggest causes of ill health, or in exacerbating current health issues and their symptoms. Stress also heightens pain pathways, it increases inflammation, interferes with moods, disrupts hormone pathways and also increases acidity in the body. This then leads to increase in symptoms such as pain, gastrointestinal issues, fatigue, and increase in emotionally generated symptoms. Have a read of my previous article of this (Click here to read)

2.Anxiety– Anxiety is also a big cause in aggravating and exacerbating symptoms of endometriosis/adenomyosis. When control issues are heightened, the body spirals out of control and anxiety kicks in and exacerbates symptoms. This also heightens pain pathways like stress does, and also disrupts hormone pathways as well. This then drives pain pathways, upsets the gastrointestinal system, disrupts sleep and also creates fatigue. I have done a previous post of anxiety and pain pathways previously (Click here to read)

3.Busyness– Busyness is one of the number one drivers of stress and anxiety issues. Lack of time out and on the go, pushes the body to exhaustion, and also activates adrenalin and cortisol levels, which in turn interfere with hormone pathways. Busyness is really stress under another name, and can produce all the same symptoms as stress does. Busyness can also be a big factor with fertility and pregnancy too. See previous post (Click here to read)

4.Alcohol– One of the number one things to flare endometriosis/adenomyosis symptoms and any gynaecological issue is alcohol, especially excess alcohol. Alcohol can also be a big factor in period pain and also irregular cycles. It can also exacerbate heavy bleeding, especially with adenomyosis. Alcohol is full of sugars and it really is a drug and a toxin, especially in higher doses. Alcohol is also inflammatory and will exacerbate inflammatory conditions in the body. Alcohol also adds to fluid retention and body fat, and can interfere with moods.

5.Smoking – Smoking not only adds to inflammation in the body, but it also increases the risk of certain cancers, including gynaecological The byproducts of cigarette smoke have been found in the cervical mucus of women and these toxins are literally leaching into your uterus, your vagina, and surrounding tissues and organs. Ewwwww. Smoking definitely increases inflammatory processes in the body and leads to increases symptoms.

6.Refined foods– Highly refined foods increase blood sugar levels, which then makes the body store fat, and stops the burning of fat.
Excess body fat also drives inflammation, and is also estrogenic. Estrogen drives endometriosis/adenomyosis.
Excess refined carbs also cause increase insulin, which in turn causes inflammation in the body too. This increase inflammation exacerbates pain pathways and other symptomatic responses in the body.
A lot of refined foods are from grains, which also contain gluten. Gluten causes gut irritation and inflammation – a lot of people won’t even realise that their problems are caused by gluten. Have a listen to my video blog about a proper diet (Click here to read)

7.Too much sugar– Excess sugars and things such as chocolate (big one) is a big driver of inflammation in the body. The excess sugars also make the body store fat, and they also increase pain and exacerbate pain pathways. The excess sugars also disrupt the gut microbiome and increase bad bacteria, which also drive inflammation and increase gastrointestinal issues such as bloating and abdominal pain. It can also affect bowel function. Have a read of my post about the toxic consequences of sugar ( Click here to read)

8.Legumes (chickpeas, lentils, soy etc)- Lentils, beans (i.e. kidney, pinto, broad etc),peanuts (they aren’t nuts, despite the name), soy beans, garbanzos and chickpeas are alllegumes. Like grains, legumes too contain harmful substances such as lectins and phytates, inhibiting nutrient absorption and causing inflammation. They also cause gas and bloating and many people do not realise the reactions they can cause in the body.
Raw legumes are toxic, so they need to be prepared (by soaking,rising, cooking, sprouting or fermenting) – however, preparation doesn’t entirely negate the harmful effects of the lectins. Despite soaking and activating, many people still react badly .
Soy is particularly bad, since the phytoestrogens content acts like the female sex hormone estrogen. This has been shown to have some damaging effects with healthy hormone functions. Endometriosis and adenomyosis is estrogen driven and women should stay away from soy and soy based products where possible.

9.Excess bad bacteria – Buildup of bad bacteria, called dysbiotic bacteria can cause inflammation and ill-health, physically and emotionally. A buildup of bad bacteria is a common cause of abdominal pain and bloating in women with endometriosis and adenomyosis. I have discussed dysbiotic bacteria is a previous post (Click here to read)

10.Acidic foods– Acidic foods may cause or aggravate certain digestive disorders, such as acid reflux gastroesophageal reflux disease, otherwise known as GERD. Acidic foods can also add to inflammatory processes in the body and why there is now mounting evidence to use a more alkaline diet for those with chronic inflammatory disease states. Common acidic foods are alcohol, certain citrus fruits, soft drinks, processed foods, refined foods, junk foods, and tomato based products.

11.Junk foods – Junk foods contain all sorts of nasty things, from trans fats(carcinogenic fats), additives, preservatives, saturated fats, acid, gluten, soy, refined grains, processed foods, environmental estrogens, high sugar and a whole lot of others things that can create inflammation in the body and add to exacerbating someone’s symptoms. This one goes without saying, yet some many people do not realise that just one serving of junk food could exacerbate symptoms for days, or longer.

12.Certain medications– Medications can be both friend and foe, depending on the length of time someone has taken them, and also the side effect profile of a certain medication. Certain medications can also cause withdrawal effects each day, and they can exacerbate symptoms of your health issue, including pain. This can also go for natural medicines taken wrongly, or taken for too long a period. This is why it is always important to be properly managed and monitored by a qualified healthcare professional. Have a read about this issue in a previous post (click here to read)

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
Menstrual issues traced back to age 13

Many Fertility & Women’s Health Issues Could Be Traced Back To Mismanagement At Around Age 13

Early this week,  I was talking with a colleague about how I would love to be able to see all women before they head into IVF, or see them when they were a teenager to educate them and help the with a better future for their fertility and gynaecological health.

My colleague then said to me “The issue is that most women are mismanaged at around age 13 and this is why they end up having fertility issues and ongoing gynaecological and menstrual related issues later on.”

The truth is, if we really to trace back the cause, or start of a woman’s fertility, gynaecological, or menstrual related issues, it would most likely be due to mismanagement at around age 13 when she first got her period. In this video I bring light to this very introspective, and very interesting topic that many probably have not thought about. It isn’t always mismanaged by the people you think it is either.

Let’s bring better education and awareness to women’s health issues because we know that early intervention and early management if the key to better future outcomes. It all starts with education first. Have a listen to my video on this very important topic (click on the youtube video link to watch

If you, or your daughter needs help with a menstrual issue, or period pain etc, please give my friendly staff a call and ask how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Endometriosis Experts

-The Experts Program

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.

 

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.

Consequences of PCOS

The Serious Health Complications Of Unmanaged PCOS

Just like endometriosis, there is a lot of the information about PCOS, but it is more about the symptoms, time to diagnosis and future fertility outcomes.

While it is necessary to educate people about these things, nobody is really talking about the serious health complications of unmanaged PCOS.

There have been some big changes to the diagnosis of PCOS, but still it can often take up to 3 years or more to get a proper diagnosis. While it may not take as long as endometriosis to be diagnosed, it still means that many women are being missed and dismissed in those year before they are finally diagnosed.

Like Endometriosis, some women with PCOS are never diagnosed and some women do not have any symptoms and can have very regular cycles etc. Women can have PCOS and endometriosis together, alongside other issues such as adenomyosis as well.

There are serious health consequences with unmanaged PCOS

The main thing I am trying to bring to everyone’s attention is that it doesn’t matter what disease you have, if it is left unmanaged, or not managed properly, it can have some pretty serious consequences of ones fertility, and mental and physical health.

PCOS is not exception. While the symptoms of PCOS are not as bad as those suffered with endometriosis, or adenomyosis, women can still suffer in many other ways. The long-term consequences of unmanaged PCOS can be very serious and can also lead to early death (cardiovascular disease, stroke etc.) and also lead to certain cancers.

Risk factors

PCOS is thought to have a genetic component. People who have a mother or sister with PCOS are more likely to develop PCOS than someone whose relatives do not have the condition. This family link is the main risk factor.

Then there is the insulin resistance factor with PCOS as well. Insulin resistance is a primary driver of PCOS and there is now evidence to show that most, if not all, women with PCOS have insulin resistance by default. Again this appears to be through genetic or family links of someone having PCOS, or having diabetes in the family tree etc.

Excess insulin is thought to affect a woman’s ability to ovulate because of its effect on androgen production. Research has shown that women with PCOS have low-grade inflammation that stimulates polycystic ovaries to produce androgens.

This is why diet and lifestyle interventions are so important in the overall management of PCOS. It is because these changes help with the insulin resistance.

There are other risk factors such as obesity, stress, nutritional deficiencies and sedentary lifestyle. Have a look at my page about more information on PCOS and risk factors etc (Click Here)

The Common Symptoms of PCOS

It is important to know what the common symptoms of PCOS are, so that women and healthcare professionals alike know what to look for.

The common symptoms of PCOS include:

  • irregular menses
  • excess androgen levels
  • acne, oily skin, and dandruff
  • excessive facial and body hair growth, known as Hirsutism
  • female pattern balding
  • skin tags
  • acanthosis nigricans, or dark patches of skin
  • sleep apnea
  • high stress levels
  • depression and anxiety
  • high blood pressure
  • infertility
  • Increased risk of miscarriage
  • decreased libido
  • high cholesterol and triglycerides
  • fatigue
  • insulin resistance
  • type 2 diabetes
  • pelvic pain
  • weight management difficulties including weight gain or difficulty losing weight

Early Intervention and management is crucial

The causes of PCOS are unclear, but early intervention, early diagnosis and early management, can help relieve symptoms and reduce the risk of complications. Anyone who may have symptoms of PCOS should see their healthcare provider, women’s healthcare specialist, or PCOS expert.

Coping with the symptoms of PCOS and managing the treatments can be demanding ands sometimes stressful. But, to then learn there can be serious complications and added risks to your health from PCOS not being managed properly can be distressing.

Be educated and get proper help

Just like any disease state just being aware, and being educated there are added risks is an important first step. Once you have the common symptoms of PCOS under control then you can turn your mind to thinking about ways to prevent further complications.  The good news is that many of the treatments and management strategies you will use for your PCOS will also help to prevent many of the serious complications. A qualified healthcare professional, or a healthcare practitioner who is an expert in PCOS should be managing anyone with PCOS. Nobody should be trying to manage PCOS on their own without some form of professional help.

The serious complications of PCOS

Women with PCOS are thought to be at higher risk of having future heart disease or stroke. They are also at higher risk of diabetes, endometrial cancer and other cancers too.

What are the serious complications of unmanaged PCOS?

Besides the risk factors already mentioned, the serious complications of unmanaged PCOS are as follows:

  • Weight gain or obesity
  • Prediabetes
  • Type 2 diabetes
  • Cardiovascular disease
  • Metabolic syndrome (generally having at least two of high blood pressure, high cholesterol, obesity, high fasting blood glucose)
  • Endometrial cancer
  • Other cancers (breast, ovarian)
  • Sleep apnoea
  • Inflammation of the liver
  • Infertility
  • Increased Pregnancy induced hypertension and pre-eclampsia
  • Increased gestational diabetes
  • Increased risk of stroke
  • Increased risk of sudden death
  • Atherosclerosis
  • Psychological disorders
  • Mood disorders (anxiety, depression)

What you can do

If you are worried about the serious complications of unmanaged PCOS it is helpful to:

  • Get your symptoms of PCOS under control as a first step
  • Discuss any concerns with your healthcare practitioner, or women’s health/PCOS expert.
  • Learn about and understand your risks
  • Learn that early intervention and early healthcare management is the key to assisting any disease state.
  • Have your blood pressure, blood glucose and cholesterol checked regularly
  • Seek guidance and support to help with weight management and dietary and lifestyle management.
  • Remember that all body types can have PCOS, not just those who are overweight.
  • Do not try to manage the symptoms of PCOS on your own.

Final word

If you do need assistance with PCOS and would like my help, please call my friendly staff and found out how I may be able to assist you. There are options for online consultations and consultations in person.

As mentioned before the key to any disease is early intervention and early healthcare management and you taking the first steps to get the help you need. PCOS also needs a multimodality approach. There are many facets to it. Don’t put off your health. Just pick up the phone and make that appointment today. There can be some very serious consequences if you do, especially for some conditions such and PCOS.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicines

-The PCOS Experts

References
  1. Ehrmann D et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006 Jan;91(1):48-53
  2. Meyer C et al. Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease. J Clin Endocrinol Metab. 2005 Oct;90(10):5711-6
  3. McCartney CR, Marshall JC. Polycystic Ovary Syndrome. N Engl J Med 2016;375:54-64
  4. Hull MG. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol. 1987;1:235–245. [PubMed] [Google Scholar]
  5. Balen AH, Conway GS, Kaltsas G, et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod. 1995;10:2107–2111. [PubMed] [Google Scholar]
  6. Tian L, Shen H, Lu Q, Norman RJ, Wang J. Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment. J Clin Endocrinol Metab. 2007;92(4):1430–1433. [PubMed] [Google Scholar]
  7. Jungheim ES, Lanzendorf SE, Odem RR, Moley KH, Chang AS, Ratts VS. Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome. Fertil Steril. 2009;92(1):256–261. [PMC free article] [PubMed] [Google Scholar]
  8. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25. [PubMed] [Google Scholar]
  9. Palomba S, de Wilde MA, Falbo A, Koster MPH, La Sala GB, Fauser CJM. Pregnancy complications in women with polycystic ovary syndrome: new clinical and pathophysiological insights. Hum Reprod Update. 2015 Jun 27;:dmv029. [PubMed] [Google Scholar]
  10. Anderson SA, Barry JA, Hardiman PJ. Risk of coronary heart disease and risk of stroke in women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Cardiol. 2014;176(2):486–487. [PubMed] [Google Scholar]
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  13. Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(5):748–758. [PMC free article] [PubMed] [Google Scholar]
  14. Broekmans FJ, Knauff EAH, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BCJM. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210–1217. [PubMed] [Google Scholar]
  15. Haoula Z, Salman M, Atiomo W. Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod. 2012;27(5):1327–1331. [PubMed] [Google Scholar]
  16. Chittenden BG, Fullerton G, Maheshwari A, Bhattacharya S. Polycystic ovary syndrome and the risk of gynaecological cancer: a systematic review. Reprod Biomed Online. 2009;19(3):398–405. [PubMed] [Google Scholar]
  17. Giovannucci E. Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr. 2007;86(3):s836–s842. [PubMed] [Google Scholar]
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