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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.

 

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

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8 Tips To Increase The Chances Of a Successful Pregnancy

More and more couples are now struggling to fall pregnant. The causes of this can be varied and this is why proper investigations and seeing a fertility expert is important. But, there are things couples can do to increase there chances of having a baby. Here are my 8 tips to increase the chances of a successful pregnancy.

Reduce stress

One of the  biggest cause of fertility issues and cycles not working is stress. This includes being busy all the time too. Stress  and being on the go all the time, increases cortisol and adrenalin and these can affect your hormones.  Stress can also interfere with blood circulation into the uterine environment, which can then affect implantation. We know that in animals, stressed animals do not conceive during time of stress. The same goes for humans.

It takes two people to have a baby

Biology 101 tells us that it takes a man and a woman to have a baby, meaning it takes a sperm and an egg. Unless you are a single woman, or a same sex female couple, using donor sperm, the man needs to be make sure his sperm is healthy and checked out properly too. Over 50% of fertility issues are related to male factors and up to 85% of miscarriage issues can be related to chromosomal and DNA factors relating to to sperm.

Sperm quality also changes by as much as 20% in each month so it is just as important for a male to continue on supplements etc to keep his sperm healthy. Men often bury their heads in the sand when it comes to fertility issues and we need them to be more proactive and not just leave it to the woman to do all the work and take all the burden on. There will always be a bit on each side when it comes to fertility, so men need to get their act together and support their partner and support the process more.

Seeking the right advice and proper investigations

All too often couples wait too long to seek advice and treatment for fertility issues. Early intervention, investigations and management is the key to any issue we face on a health perspective. The wait and see approach isn’t always the best advice that is given to couples. You also need to see the right healthcare professionals too. Fertility evaluation needs to be done for both the woman and the man, not just the woman. This is why it is important to see a fertility expert if you are having trouble falling pregnant.

Getting a second opinion

If someone asked you how many quotes would you get to renovate your house etc, how many quotes would you get?

Most people will say about 3-5 quotes, yet when it comes to their health, or fertility issues, they are only seeking 1, possibly 2 quotes, which means they place more importance on their houses etc. If something or someone isn’t helping you, then it is so important to get a second opinion. Just because someone is nice, or has all your health history, does not mean they are worth staying with, especially if they aren’t helping you fall pregnant. A second opinion, or even a third, fourth, or fifth, could just be what is needed to get you the right advice and see someone who is more suitable to helping you. Things do get missed and something I see daily, so please never underestimate the power of another opinion.

Eat more protein and Essential Fats

Protein and essential fats are the essential building blocks for life. They are also the building blocks for making your hormones and making healthy eggs and sperm. Increased protein also helps prevent ovarian hyper-stimulation and also dampens down inflammatory response caused by over eating highly refined sugars and refined carbohydrates.

Increase your Electrolytes

Water alone will not stop you from dehydrating. Electrolytes are a very important part of the body chemistry and hormone therapy, certain drugs and medications drastically reduce them. It is important to keep the cells body hydrated at all times and especially during an IVF cycle and during pregnancy. Electrolytes consumption during IVF cycles also helps prevent ovarian hyper-stimulation.

Regular climax

Regular climax, self induced, or with a partner, (also before and especially after embryo transfer) assists with implantation and health blood supply to the uterus. An embryo feeds off blood supply from the uterus and regular climax helps optimise this blood flow and with increasing hormones such as oxytocin. Without a healthy blood supply to the uterus and circulating hormones the embryo will die.

Regular sex also helps with men as well, by improving sperm quality. Storing it up does not help sperm quality and actually makes it worse. Lastly regular sex and climax also helps with a healthy relationship and bonding as a couple.

Not having enough sex and not at the right time

One of the biggest myths is that all women ovulate around day 14, or in the supposed fertile window between day 10 and day 17. A landmark study published in the British Medical journal showed that more than 70% of women were ovulating before day 10 and after day 17 of their cycle and there was actually only a 10% probability of being fertile in the supposed fertile window (day 10 to day 17). Couples need to be having regular sex, at least every second day, from the time the menses finish right up until the woman is due for her menses again.

An egg dies 24 hours after it is release so if there is no sperm there, then the egg cannot be fertilised and the egg dies. That is the facts. And no… sperm do not last up to seven days etc. Most of the three to five hundred million sperm that set off are dead after an hour. Less than 20 sperm actually make the journey to the fallopian tubes and even less make the journey to meet the egg.

Getting the right help

If you are having trouble conceiving, then give my friendly staff a call and find out more about how my fertility program may be able to assist you. For more information, please call +61 0738328369 or email info@drandreworr.com.au

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

Chill Pill

A Special Kind of Pill for Better Health and Increased Fertility

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Looking for the ‘Off ’ Butt on

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

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

How Resilience Begins

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

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

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

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

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

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

Lifestyle Tips to Help Manage Stress

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

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

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

Stress Less for Good Health

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

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

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

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

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

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

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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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

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Let’s Talk About Why IVF Cycles Fail

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

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

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

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

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

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

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

What is required for a successful pregnancy?

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

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

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

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

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

Achieving Implantation-The hardest step

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

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

DNA & Chromosomal When Sperm and Egg Combine

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

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

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

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

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

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

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

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

Preconception care increases chances of conceiving

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

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

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

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

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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.
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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 Andrew’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, Andrew can assist you in your journey to becoming parents.

To find out how Dr Andrew Orr’s fertility program, please call his friendly staff to find out more.

adults barefoot bed 1246960

17 Reasons You Should Having Regular Sex and Orgasms

Part of my job as a healthcare practitioner with a special interest in and reproductive conditions, and women’s and men’s health conditions, is to talk about sex, talk about climax and the benefits of this for a couple, or an individual.

Regular sex, or regular climax, can help have many benefits for an individual, with it helping everything from menstrual pain, right through to increasing pregnancy rates, regulation of the menstrual cycle and even helping moods, sleep and helping your live longer

Here are 17 reasons why you should be having regular climax, or regular sex and many of the health benefits that go with it.

1.It’s Exercise
It’s not necessarily a full workout, but it can be as good for you as moderate exercise. It raises your heart rate about the same as a brisk walk or a slow bike ride.

2.Good for a Woman’s Heart
Women who have sex a couple of times a week are less likely to get heart disease than those who have it once a month. Whether that’s because healthier women enjoy it more often, or because it helps protect a woman’s heart is unclear.

3.May Help Your Headache
Say goodbye to the old standby “Not tonight, Dear. I have a headache.” It turns out sex can help with pain, and that includes some kinds of headaches, such as migraines. Not feeling frisky? Try: “Not tonight, Honey. I have a highly contagious stomach bug.” Works every time.

4.Lowers Stress
People who have more sex are less anxious when they’re faced with stressful tasks like public speaking or arithmetic. But according to the study, it only works when you have a partner — masturbation doesn’t count.

5.You May Live Longer
One study suggested that married women who climaxed more often had a slight tendency to live longer. Researchers aren’t sure if the sex actually lengthens your life or it’s just a side effect of a healthy lifestyle. But why take any chances?

6.Sharpens Your Mind
Sex has been linked to the making of new brain cells, and that’s a good thing. People over 50 who had more sex were better able to recall numbers and do basic math, and the difference was pretty big. It seemed to help men more than women, but both did better than those who had less sex.

7.Makes You Happy
You don’t have to overdo it — once a week is plenty. More than that, and the effect fades. But scientists only studied couples in committed relationships, so if you’re trying to meet your quota by picking up strangers at your local bar, all bets are off.

8.Bonds You to Your Partner
The hormone oxytocin is released during sex, and it sparks feelings of intimacy, affection, and closeness with your partner. That helps build a strong, stable relationship, which is good for everyone.

9.Keeps You Lean
The more sex you have, the slimmer you’re likely to be. Is that because more sex keeps you trim? Or because lean people have more sex? Scientists don’t really know, but all you need is a partner and a bathroom scale to try to find out.

10.Good for Mental Health
Adults in committed relationships who have more sex are less likely to be depressed or take medication for mental health issues. Orgasm also helps with the release of beneficial hormones such as oxytocin and these help us feel euphoric and also help with other endorphins in the body. These then make us feel better emotionally.

11.May Help Your Immune System
Move over, vitamin C. College students who had sex twice a week had more cold-fighting antibodies in their saliva than those who had sex less often. Couples who have regular sex have healthier immune systems and tend to be healthier overall.

12.Helps You Sleep
Orgasm triggers a surge of endorphins and oxytocin in both men and women, and that dulls pain and relaxes you. Both of those can help you sleep more easily, though according to scientists — and many women — the effect is more pronounced in men.

13.Lowers Risk of Cancer
Men who have more sex may be less likely to get prostate cancer, and women less likely to get breast cancer. Pregnancy and contact with sperm are both linked to the lower risk in women.

14.You Could Make a Baby
If you’re trying to have a baby, the more sex you have, the more likely you are to hit the right time of the month. But more sex may also prime women for pregnancy and improve sperm quality in men, which can speed things along. An egg has but 24 hours to be fertilized otherwise it dies. We also know that ovulation does not occur just mid-cycle either. Couples doing IVF also need to have regular sex as climax helps with implantation (by hormones and increased blood supply into the lining) and sperm also assist in helping with implantation as well. Many couples stop having sex during IVF and this is where they are going wrong.

15.It helps regulate your menstrual cycle
Regular climax nourishes the uterine and vagina with blood flow, but it also stimulates hormones, which help to also nourish the uterus, vagina and reproductive organs. Oxytocin helps with moods but it also helps with keeping your cycle regular. Research has also shown that sperm actually help to trigger ovulation.

16.Climax helps with Gynaecological issues and menstrual pain
Regular climax (not just sex with penetration) helps with increasing blood flow into the pelvic cavity, the uterine lining, vagina and surrounding areas which helps to keep your reproductive organs and muscles healthy. Hormones and increased blood flow also help with pain and circulation too. Climax helps with the microcirculation of the reproductive organs and also helps with keeping ovarian function regular and healthy too. As said before regular climax can help trigger ovulation, keep the cycle regular, but sperm can also help with this also. We do know that some women with endometriosis and adenomyosis do have pain with penetrative sex, but climax does not necessarily need for penetration to happen.

NB-  If you do have pain with intercourse, please make sure you get investigated properly as there are treatments and management to help this.

17.Helps Your Future Health and is Anti-Aging.
People who have more sex may have better quality of life — and not just now, but in the future, too. If you have an active sex life in middle age, you’re more likely to keep it up as you get older, which is linked to better health and happiness. Regular sex and climax is also anti-aging.

Final Word

Please remember that sex and regular climax has more benefits to it that the actual enjoyment part of it. It helps with intimacy, helps bring couples closer together and it helps with many other health benefits in the body. In practice I am seeing a huge disconnect with both men and women and their reproductive organs and this is why we are seeing so many issues with gynaecological conditions, couples not being able to conceive, relationships issues and issues with peoples health and lifestyles.

In a healthy relationship, couples should be having sex at least 1-3 times per week and if you are trying to have a baby, you should be having sex everyday and be going for it multiple times per day to increase your chances of conception. Maybe it’s time to turn off the TV, close the computer, turn off the mobile phone and spend more time in the bedroom with your own lives, then watching someone else’s. You will be healthier and happier for it in the long run.

If you do want to find out more about my fertility program, or how I may be able to assist you with a women’s health condition, please call my friendly staff and they will explain everything to you.

Take care

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Fertility Diet for website

Mediterranean Style Diet May Help to Improve Pregnancy Rates for Couples Undergoing IVF and Assisted Reproduction.

New research published in Human Reproduction, has found that those who follow a “Mediterranean” style diet at least six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

As part of my Fertility Program, one of the first things I talk to couples about is the importance of a healthy diet that has adequate protein, lots of vegetables, seeds and nuts, healthy oils, adequate water intake, electrolytes and cutting out all the refined carbohydrates that cause inflammation.

The hard thing is that I hardly see a couple following those health food principles, with many not even really knowing what a health diet is. The diet that I promote is based on my specially formulated PACE diet.

Previous studies have shown that when refined carbohydrates are cut out and replaced with proteins, essential fats and good carbohydrates, such as fruit and vegetables, that the clinical pregnancy rates shot up by 80%. (Fertility & Sterility 2012 Volume 98 issues 3 Page S47)

In this new study, researchers focussed in dietary patterns rather than individual nutrients, food, or food groups. They found that those who ate lean protein, more fresh vegetables, fruit, fish and olive oil, had a 70% greater likelihood of achieving a successful pregnancy and birth compared to women who didn’t follow this style of diet.

The research outcomes found that out of the 244 women in the study, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby.

The most important message to come from the study is that women attempting to have a baby should be encouraged to eat a healthy diet, such as a Mediterranean style diet, because it may help increase the chances of successful pregnancy and successful live birth.

The researchers did note that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. Previous studies from the same research group showed that male partners that adhered to the same sort had better semen quality.

A healthy diet is important for all couples prior to trying to conceive and should be a part of any preconception planning by all healthcare practitioners assisting couples with fertility.

While this study focussed on improving assisted reproduction pregnancy rates, this style of diet should be adopted by any couple wanting to have a baby and should be implemented at least 6 months prior to conceiving. This is why it is essential for all couples to receive counselling and guidance on the importance of a healthy diet and having a healthy lifestyle as well.

This is a foundation of my fertility program that has helped over 12,500 babies into the world and continues to assist many more couples reach their goal of becoming parents. If you would like to find out more about my fertility program and how it may assist you, please give my friendly clinic staff a call to find out more.

Regards

Andrew Orr

-No Stone Left Unturned

-The International Fertility Experts

Nk cells nurturing baby

Natural Killer Cells Nourish & Promote the Growth of The Fetus

A study published  in the journal Immunity shows that part of the uterine Natural Killer cell population helps to optimize maternal nourishment of the fetus at early stages of development, not hinder it.

These Natural Killer Cells have actually been shown to secrete growth promoting factors that can also reverse impaired fetal growth and help prevent miscarriage, not cause it.

For many year now I have had people contact me and trying to kill the killer cells, or treat high natural killer cells, or wipe out these cells that they are being told is causing them to miscarry, or not be able to hold an embryo.

For those same amount of years I always said that Natural Killer Cells are meant to be there and the reason they are there is because of inflammation and are doing their job. Now finally, what I have been saying has been proven to be true and now we have an explanation of what these immune cells actually do and the mechanism behind it. They don’t harm the embryo at all. They are there to protect it, nourish it and help it grow.

Natural killer cells are among the most abundant immune cells in the uterus during the first trimester of pregnancy, but their numbers decline substantially after the placenta forms. Up until recently many in the fertility profession have led people to believe that Natural Killer Cells are the cause of all their issues and these new findings may have them eating their words.

Not only have women been offered hormones, steroids and the likes that have never been proven to do they say they do, but they not only have major side effects, but could actually be trying to regulate the very thing that is meant to help a pregnancy.

The results of these new findings not only reveal new properties of natural killer cells during early pregnancy, but also point to approaches for therapeutic administration of natural killer cells in order to reverse restricted nourishment within the uterine environment

Acting as our bodies’ frontline defense system, natural killer cells guard against tumors and launch attacks against infections. This is something that I have been trying to explain for years. If natural killer cells are in high amounts, they are there for a reason and that reason needs to be treated, not the high killer cells.

There has been much research on how Uterine natural killer cells promote immune balance and the growth of blood vessels in the placenta, having a positive impact on birth weight as well as fetal growth. But until now, it was not clear which subset of natural killer cells in the uterus are responsible for promoting fetal growth, or whether these cells help to optimize fetal nourishment at early developmental stages.

In the new study it was discovered that a specific subset of natural killer cells in the human uterine lining secretes growth-promoting factors, which are involved in wide-ranging developmental processes. This subset of cells made up a smaller proportion of natural killer cells in the uterine lining of patients who experienced recurrent spontaneous miscarriage and reduced implantation (42%) compared to healthy females (81%). These findings suggest that insufficient secretion of growth-promoting factors by a specific subset of natural killer cells may be responsible for restricted fetal development in humans.

The studies also showed that a deficiency in this subset of natural killer cells resulted in severe fetal growth restriction and defective development of the fetal skeletal system. The studies also showed that the transfer of uterine natural killer cells reversed fetal growth impairments.

For the purpose of promoting fetal growth in humans, it may be possible to transfer natural killer cells via intravenous infusion or the administration of a vaginal suppository to mothers, avoiding the need for invasive procedures. Moreover, uterus-like natural killer cells are a much safer alternative to many of the methods used in immunotherapy and safer that steroids, or other immunosuppressant’s.

Obviously more study is needed, but these findings are about to turn part of the fertility profession upside down and make it re-evaluate itself.

I’ve always said it isn’t the natural killer cells killing off embryos and always said it was from inflammation and inflammatory gynaecological conditions that weren’t being treated.

We now know that stress uterine cells are also a big part of the issue too. I always say treat the cause to treat the symptoms and now we know that Natural Killer cells aren’t part of the cause, they are actually there to help.

If you are having troubles not conceiving, my fertility program may be able to assist you. If you would like to find out more, please call my friendly staff and they will be able to explain more to you.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts