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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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IVF cover image

Let’s Talk About Why IVF Cycles Fail

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

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

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

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

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

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

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

What is required for a successful pregnancy?

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

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

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

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

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

Achieving Implantation-The hardest step

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

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

DNA & Chromosomal When Sperm and Egg Combine

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

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

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

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

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

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

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

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

Preconception care increases chances of conceiving

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

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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.
Dr Andrew Orr Header Slider 03

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.

The Journey of Trying To Have a Baby is Sometimes Like a Marathon 1

The Journey To Have a Baby Can Be Like a Marathon For Many Couples.

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

The Facts About PCOS

These are some of the main Facts about PCOS

Copy of PCOS Awareness Irregular Menses or Absent cycles           PCOS Awareness Obesity and weight gain can be symptoms of PCOS

Copy of PCOS Awareness Hirsutism and PCOS           PCOS Awareness Acne and PCOS

PCOS Awareness Contraceptive Pills do not cure PCOS           PCOS Awareness Depression and anxiety can be a symptom of PCOS 1

PCOS Awareness PCOS does not always cause infertility           PCOS Awareness

Copy of PCOS Awareness You dont have to be overweight to have PCOS           PCOS Awareness Menopause does not cure PCOS

Regards

Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

-The PCOS Experts

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The Myth of The Barren Woman Runs Deep

The word “Barren” comes originates from the French word ‘Brehaigne’, which means not producing, incapable of producing offspring, infertility, infertile; sterile.

Sounds terrible doesn’t it?

Fortunately very few women are ‘sterile’ and the word “infertility” is often misused in our modern society. Nobody is truly infertile, unless they actually have reproductive organs missing, or have genetic abnormalities that will actually prevent conception from happening etc. When a couple is having trouble conceiving, we should really use the word “sub-fertility” instead of “infertility”

The problem with talking fertility, sub-fertility, or infertility is that we often reference, target, or even blame the woman. Yes, women are often the blame of not being able to conceive a child and therefore the myth of the barren woman still runs deep and is very much in existence and kept alive by all concerned today in our modern world.

But is conception and the ability to conceive a child inherently the fault, or responsibility of the woman?

The answer to that is “No!”, but there is still this expectation, or focus, that not being able to conceive all falls back on a woman. Sometimes women actually wrongly blame themselves, or wrongly take on that responsibility too. Some women will even take on that burden, to protect a partner, who may actually be the main issue.

Then we now have an area of medicine that has its focus as being the woman, because women are the primary driving force for wanting to have a child.  Hence the vicious cycle continues in this terrible loop and then many, practitioners included, buy into the myth of the barren woman and so the cycle continues over and over again.

Well, I am here to tell you that women are not the only part of having a child and that men play just as big a part when it comes to fertility issues and not being able to conceive.

No matter what you get sold, or what BS (bullshit) you are sold, while pulling on your ‘I need a baby heartstrings’, to make you part with your hard earned money, the fact remains, and will always remain, that it takes a sperm and an egg to make a baby. That is basic biology 101 and no matter what someone tries to tell you, sperm quality is just as important as egg quality in this equation.

Every day I see practitioners, both medical and in complementary medicine, focussing in on women as the primary focus of fertility and actually feeding the myth of the barren women by their very actions.

Many times the men are overlooked, or ignored, or completely disregarded in the fertility equation. Not only is this unethical, to just treat and focus on the women when it comes to fertility treatment, but it is highly negligent as well. Men are not born with an inherent right to automatically be able to conceive and worse still, the male sperm levels have fallen by as much as 60% in the last 70 years, with sperm quality levels said to be dropping at an alarming rate.

So why is the focus, the burden, the guilt and the whole emotional baby roller coaster left solely to women?

Well, I have explained that practitioners are to blame, the fertility profession is to blame, society is to blame, guilt is to blame and last of all men are a big part of the issue too.

Men are often to reluctant passengers in the fertility journey and are often very happy to bury their heads in the sand and pass the responsibility of not being able to conceive onto a woman. Then many men are told their sperm is fine, when in fact it is far from being fine.

Over 50% of fertility issues are related to male factors and up to 85% of miscarriage issues may be related to male chromosomal, or DNA issues related to sperm. As I said before, research has now shown that the male sperm quality has fallen by up to 60% over the last 70 years and is actually on the decline. Men are often the bigger part of the fertility picture and it isn’t just the woman at all.

Semen analysis parameters are based on what is needed for Assisted Reproduction (IVF, IUI, ICSI) , not based on what is needed for natural conception and this is where some of the biggest issues lay.

Misinterpretation of semen analysis and misinterpretation of parameters have many men believing they have OK sperm, when in fact it is far from being OK. With modern procedures such as ICSI, we only need a few single sperm to be able to fertilise eggs and this can still be considered ok, because at least there was some sperm to fertilise the egg in the first place.

A few single sperm, or a few hundred sperm, or even a few thousand sperm is not OK when it comes to natural conception. We actually need a few hundred million sperm for it to be OK and even then they need to be motile and they need to be swimming properly (rapid progressive) and actually be of good shape (morphology)

While a semen analysis is often the first part of male fertility evaluation, it is also very limited. While we can look at morphology, motility, concentration, count etc, it does not tell us about the actual quality of the sperm inside. Many sperm may look ‘OK’ via a semen analysis, but inside their DNA integrity is poor and there are high amounts of DNA fragmentation and this can only be measured by a DNA fragmentation analysis. Even then, each time a man ejaculates, the quality of the sperm will be different and can differ by up to 20% in each ejaculate.

We also know that what a man eats, drinks and even his physical and emotional health will affect his sperm quality and that a man’s physical, dietary and emotional health can be passed onto his offspring through the sperm. This is why it is important for a man to get his physical and dietary and emotional health in check way before he tries to conceive a child with his partner.

We always say that the healthier a man is, the healthier his sperm is and the healthier the woman is, the healthier her eggs will be also. A healthy man and a health woman produce healthy babies.

I have been assisting couples with fertility and pregnancy for over 20 plus years now, and helped over 12,500 plus babies into the world,  and I can tell you that conception is not just about the woman. It gets back to basic biology 101 that it takes a sperm and an egg to have a baby.

Even when couples are having issues trying to conceive, or doing IVF, or however they are trying to conceive, there will be some issue on the man’s side and the woman’s side. Unless there is absolute infertility on one side, or the other, there will always be a bit of both the man and woman to work on to assist in being able to conceive.

While the myth of the barren woman runs deep in society, fertility clinics and through the guilt handed down from their fellow sisters and mothers, fertility issues and the right to be able to conceive ‘does not’ fall solely into the hands of a woman, far from it.

Men are an equal part in the fertility equation and men need be held just as accountable when it comes to trying to have a baby, or if there are difficulties in conceiving.

No matter what anyone tells you, a man needs to be part of treatment, management and support of the journey to have a baby.  This is a big part in my multi-modality fertility program.

Fertility isn’t just the responsibility of the woman, it is the responsibility of the man as well and I make sure both the man and the woman are properly investigated, clinically managed and helped with treatments as well.

If you do need help with having a baby, then please give my friendly staff a call and find out how my fertility program may be able to assist you

Regards

Andrew Orr

-Master of Reproductive Medicine (MRepMed)

-No Stone Left Unturned

-The International Fertility Experts

Cancer Pregnancy Endometriosis

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting.

There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle.

A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such Endometriosis, but these disease states can be treated and managed to give women a normal life.

Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, complementary therapies, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a medical specialist if you have abnormal bleeding.

If you would like to book in a consultation with me and find out how I can assist you with women’s health conditions, please give my friendly staff a call and they will be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Soft Drinks/Sweetened Drinks Reduce a Couple’s Chances of Conceiving by 30 Percent

Consuming just one sweetened soft drink a day reduces a couples’ chances of conceiving by more than 30 per cent, according to new research published in the journal of epidemiology in February 2018.

Men who drink at least one sugary softdrink/soda a day reduce their chances of fathering a child by 33 per cent, research has found.

Women who drink just one sugar-sweetened softdrink/soda beverage a day are 25 per cent less likely to become pregnant in any given month, the research adds.

Before you think about switching to diet soft drinks, or diet soda, you may want to think again. Studies have shown that diet drinks of any kind are actually worse than the ones containing real sugar. These diet drinks contain aspartame, which then gets converted to phenylalanine in the body. Phenylalanine is toxic and what we use to preserve dead bodies with. It can have a detrimental effect on fertility.

Previous research has also shown that eggs and embryos may fail to thrive in high blood glucose environments. Sugar and highly refined foods has also been linked to erectile dysfunction in men.

The researchers analysed 3,828 women and 1,045 of their male partners, who enrolled in the study between June 2013 and May 2017, and were followed until pregnancy or for up to 12 menstrual cycles. The couples were not using fertility treatments and had only been trying to conceive for six months or less.

The researchers from Boston University found positive associations between intake of sugar-sweetened beverages and lower fertility, which were consistent after controlling for many other factors, including obesity, caffeine intake, alcohol, smoking and overall diet quality.

Couples planning a pregnancy should be looking and lifestyle and diet before trying to conceive and consider limiting their consumption of these beverages, especially because they are also related to other adverse health effects.

In my comprehensive fertility program, diet and lifestyle choices are all covered along with everything a couple needs to conceive. No stone is left unturned with my multi-modality approach to assist couples with fertility and trying to have a baby.  If you would like to find out more about my fertility program, please call my friendly staff and they will be able to assist you further

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-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. T

here 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

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Stressed Uterine Cells & Inflammation Cause Miscarriage, Not Natural Killer Cells

It is stressed uterine cells and inflammation causing miscarriage and causing the embryo not to implant, not Uterine Natural Killer cells.

For the first time the functions of natural killer cells in the womb have been identified by Researchers at the University of Warwick and University Hospitals Coventry

Although it has long been known that the lining of the womb harbours dynamic uterine natural killer cells, no functions have so far been given to these cells outside of pregnancy.

The researchers have discovered that the uterine natural killer cells remodel and refresh the lining of the womb at the time of embryo implantation. This is the first time a role for uterine natural killer cells in the lining of the womb has been identified outside of pregnancy. The research was published on December 14, 2017.

In addition they discovered that this process isn’t always balanced in each cycle. The natural killer cells perform the role of targeting and clearing inflammatory stressed cells, thereby making space for the implanting embryo. However sometimes not enough of these cells are cleared away and sometimes too many are targeted and removed. Excessive inflammation or insufficient clearance by uterine natural killer cells makes miscarriage more likely.

For many years I have been trying to tell people that they need to stop trying to get rid of the natural killer cells, or reduce their numbers. I have long known that natural killer cells are meant to be in the body and their job is to protect us from infections, bacteria, cancers, tumours and inflammation.

If killer cells are in high numbers, it means that there is something wrong and that is what needs to be treated, not the killer cells. But unfortunately, many clinics play on couples emotions and the use of the word “Killer”. So then we get this war on killer cells and people wanting to kill the killer cells because they think it is killing their babies.

No matter how hard I have tried to explain it, people just don’t listen and now it is finally great to have the research to back up what I knew all along, plus additional knowledge of how Killer cells actually help with implantation and reducing miscarriage.

The researchers have explained what happens if the natural killer cells cannot do their job properly, or there is inflammation that they haven’t been able to target. They said that a good analogy is Swiss cheese: without holes, the embryo has nowhere to go which will cause implantation failure; but if the holes are too large, the tissue will physically collapse and lead to miscarriage.

This imbalance, which may be short-lived or last for multiple cycles, explains the high rate of early pregnancy failure. It really can be a numbers game on how long that cycle could last and why it is important to make sure there are enough natural killer cells there to do their job properly. Without the natural killer cells, there is more chance of inflammation and stressed uterine cells being left behind, which will then lead to higher pregnancy loss and reduced implantation.

The researchers conducted an analysis of 2,111 endometrial biopsies, which is more than had ever been conducted previously. The research team examined the acutely stressed cells in the lining of the womb which generate tissue inflammation. They found that the natural killer cells which are in the womb perform the important function of selectively targeting and eliminating acutely stressed cells.

When there are high acutely stressed cells in the lining of the uterus, the lining of the uterus fails to sense the chemical signals from the fertilised egg and it then silences many of the genes involved in allowing the embryo to implant and embed into the uterus.

One of the chemicals needed for this process to take place is Trysin, which is a common enzyme the embryos gives off. If trysin isn’t detected the embryo is not accepted and left to disintegrate and then the cycle is reset once again. The lack of Trysin signal appears to indicate to the endometrium that the quality of the embryo is not very high and initiates a reduction of receptivity to implantation. These findings could help to improve the success rates of IVF, because one of the biggest problems with IVF is getting the embryo to implant

The research team also found that high numbers of Natural Killer cells in the endometrium are not only a sign of high inflammation and acutely stressed uterine cells, but also indicate a insufficient production of steroids, which in turn leads to reduced formation of fats and vitamins that are essential for pregnancy nutrition.

Again, this is exactly what I have been trying to say for years and why when I treat women who are having implantation issues and recurrent miscarriage I look at treating the cause of the issue, rather than masking it.

To treat miscarriage and help with embryo implantation you need to do the following

  1. Reduce inflammation in the uterine environment and pelvic cavity
  2. Make sure the pelvis, tubes and uterus have been surgically evaluated properly prior to conception, or assisted reproduction (IVF, IUI, ICSI etc)
  3. Increase blood flow and nutrients into the uterine lining
  4. Ensure adequate essential fats and nutrients are given prior to conception
  5. Reduce stress levels
  6. Increase protein and reduce inflammatory refined carbohydrates
  7. Make sure the couple in are optimum health (healthy sperm + healthy eggs=health baby)
  8. Make sure the man is being treated at the same time the woman is (up to 85% of miscarriage issues are related to chromosomal and DNA factors related to poor quality sperm, which cannot be measured by a normal semen analysis)

We need to stop blaming high NK cells as being the cause of miscarriage and embryos not implanting. We need to look at the real cause, which is inflammation, stressed uterine cells ( due to stress in the person), lack of nutrients and blood flow in the uterus and lifestyle factors that is also leading to increase miscarriage rates and reduced embryo implantation.

Let’s not forget that faulty sperm and DNA damage and chromosomal issues with sperm are also a big part of miscarriage too. Miscarriage is not just a woman’s issue. To be honest, statistically it is more likely to be on the male side of the equation and often gets overlooked. But that is a whole other post in itself.

Couples who are part of my fertility program are educated on issues such as this and all the things they need to do to assist them in having a child.  The program has assisted over 12,500 babies into the world and my motto is “No Stone Left Unturned.”

Hopefully in the future this new information will be used to screen women at risk of reproductive failure and help with new treatment options for women suffering recurrent miscarriages or recurrent IVF failure.

If you are having trouble conceiving my fertility program may be able to assist you in getting the answers that you need. If you would like to find out more about my fertility program, please call my friendly staff to find out more.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts