Ultrasounds and blood tests have limited value for diagnosing some causes of period pain and menstrual irregularities

Posted on December 5, 2017August 25, 2019 by Andrew Orr

I know I have said this often, but it seems that every day I get another email saying that “I have period pain and I have been to the GP and done scans and bloods tests and he/she says that there is nothing wrong”

The problem is that there is something wrong and the first thing wrong is that someone was told that there is nothing wrong, when they have only had very basic testing done

The second thing wrong is that most of these women are not being referred onto an appropriate specialist, which is what good sound ethical practice is. This is why some conditions like PCOS are taking up to 3 years to be properly diagnosed and conditions such as endometriosis are taking up to a decade to be properly diagnosed. It just should not happen

I can’t begin to tell you how many women I have seen over my years in practice, that have been told that there is nothing wrong with them, or that the practitioner hasn’t found anything, when really all they have done is a basic scan and a few random blood tests. Then when these women are properly investigated we end up finding all manner of issues. Yet, these women were told that there is nothing wrong

All I can keep telling people is that while ultrasounds can find some causes of gynaecological issues, there are many issues they cannot find. It also depends on the technician, or person scanning you too.

Gynaecological issues such as endometriosis, cannot be diagnosed by ultrasound and can only be diagnosed by surgical intervention, in the form of a laparoscopy. Then, as I have said many times too, it all depends on the surgeon you have seen. If your surgeon isn’t an advanced trained laparoscopic surgeon there is a very good chance you may not have been investigated properly. I have mentioned this in one of my previous posts.

Even some cysts,PCOS, polyps and other masses can be missed on scans and let’s not even talk about blood tests. Sure, some hormones levels can be a pointer to a certain issue, but they are not an accurate diagnostic.

To be completely honest, many women with serious gynaecological issues will have normal hormonal levels and have completely normal blood results. This can even happen in certain cancers and why some of the cancer markers are now not being used as definitive diagnosis.

I can tell everyone that I have seen many gynaecological issues being missed, and women being dismissed over the years, and it still happens on a daily basis. If you have menstrual issues, or are in pain daily, or just with your menstrual cycle, and you are being told everything is fine, then you need to get a second opinion and a referral to a specialist.

If you do need help with a women’s health issue, and would like to see how I can assist you, please call my friendly staff and book in a consultation with me.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

Asking the Right Questions about Period Pain & Gynaecological Issues.

Posted on November 23, 2017September 7, 2019 by Andrew Orr

All to often women have gynaecological disease states “missed” and “dismissed” because their healthcare practitioner was not asking the right questions about period pain and gynaecological issues.

I didn’t know how I was going to start this post, or begin to talk about what I am about to talk about, other than I got some inspiration after a text message, and a phone call later on, from my eldest daughter some time ago.

I will talk about that soon. But let’s talk about some of the phone calls and messages I get from people every day and how some of these messages gives me a heads up into what may be going on for these people and then getting them in for a proper consult and the right help.

Every day I get phone calls, emails, Facebook messages etc, from women (young and older) who are experiencing period pain, menstrual issues, and other related symptoms and nearly all of them have the same story.

“I have been to the GP and I have had blood tests and scans and they say that there is nothing wrong”. This is what I hear all so often.

It happens so often and it is like there is a script written for these poor women who just want to get out of pain and get some sort of normal life back. I get so annoyed when I hear this repetitious line. Not at the people telling me, but knowing that these poor women really haven’t been investigated properly at all and probably won’t be unless they come and see me.

I remember I got a text that I really wasn’t expecting, as it was from my eldest daughter.

It read “Hey Dad, is endometriosis hereditary?”

To which I replied “Yes it can be, why?”

I anxiously awaited the next reply and thankfully she was asking on behalf of a friend. But this poor friend had been experiencing really bad period pain and had basically had blood tests and scans and been told that everything was normal.

Apparently one of the scans showed some fluid in the Pouch of Douglas (POD), which can actually be a sign of endometriosis and inflammation. Worse still, this poor girl’s mother actually has endometriosis and nobody is putting two and two together and asking the question “I wonder if the daughter may have it too?”

Well, there is more than a good chance that she does have it and thank goodness my daughter actually knows the signs and knows that scans and bloods tests cannot diagnose many gynaecological issues, especially endometriosis.

Lucky my daughter also knows that you need to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis and has done years of extra surgical training to specialise in these disease states. The good thing is that she knows that you cannot just see a regular gynaecologist to get this done.

But, not everyone is as fortunate as my daughter to know this and help her friend to come and see me to help her see my surgeon and then I can help her with management of the disease, if found (which is highly likely) after the surgery.

The other good thing is that my daughter knows there is no cure for endometriosis and that surgery isn’t going to fix the problem either. She knows it will help, and is needed, but after the surgery, the management post surgery is the most important, for disease states like endometriosis.

Unfortunately not many people know this and don’t have the disease managed properly post surgery. Women with endometriosis and some other inflammatory gynaecological issues will need a team approach, or a multimodality approach post surgery, because even with the best medical intervention, it really isn’t enough and why so many women have the disease and symptoms return, or may still be in pain and have other recurring symptoms.

There is never a one treatment, one pill, fix all approach to disease states such and endometriosis. This is where so many go wrong.

One of the main issues for women can be that they really have not seen the right healthcare professions, especially the right surgeon and unfortunately this is many of the women that have had surgical intervention. This one is so important.

Whenever I get messages from women in pain, or I consult with women who have period pain and all the other associated symptoms, there are some standard questions I ask, to know if they have been given the right information, been diagnosed properly, or seen the right surgeon.

I always ask “what tests have you had done?” – I know that if they have only had blood tests and some scans, then these women have not been investigated, or diagnosed properly.
Then I usually ask “Have you just seen your GP, or have you seen a specialist?”– Most of the time many women have not been referred onto a specialist and have only just been seen to by a GP. This is one of the biggest issues women face when it comes to gynaecological conditions. GP’s are just general practitioners. They are not gynaecologists and definitely not advanced trained laparoscopic surgeons. The best thing any woman can do is ask for a referral to a specialist and a good GP should know to do this anyway. This is one of the biggest reasons that women from all over the world take up to a decade to be diagnosed with disease states such as endometriosis. On a daily basis women are missed and dismissed and told there is nothing wrong, go on the pill, or that they have some inflammatory bowel condition, when in fact they have endometriosis, or adenomyosis, or some inflammatory gynaecological issue. Btw, this isn’t to put GP’s down, unfortunately this is what happens to so many women and why it often takes up to a decade for women to be diagnosed with diseases such as endometriosis. This is an unfortunate fact and it needs to change.
Then I ask “Have you had a laparoscopy?”– One of the most common responses is “What is a laparoscopy?” and that way I know they haven’t had one done. A laparoscopy is the gold standard investigation of the pelvis and the only way to properly diagnose disease states and causes of period pain, such as endometriosis.
If the woman has had surgery I then ask “was the surgery done publically, or privately?” – This will tell me a few things. It will let me know if it was just done be a public surgeon, who probably isn’t an advanced trained laparoscopic surgeon. The issue is that there really aren’t that many advanced trained laparoscopic surgeons that do public work, and even if you strike the jackpot and do happen to get one, there is a good chance they are only in a teaching role to instruct a trainee surgeon to do the surgery anyway. But mostly women do not get an advanced trained laparoscopic surgeon in the public system. It is sad, but true unfortunately. Many times the first surgery in the public sector is purely investigative too and no excision (disease removal) is performed. This means that the woman has to come back for further surgery, or surgeries.
If they the woman has had surgery done previously by a private specialist then I usually ask “Who was the surgeon that did your investigation and surgical procedure?” – Sometimes I can ask if the surgeon was an advanced trained laparoscopic surgeon and the patient usually will respond to not knowing, or even know what I was talking about. That usually gives me a clue that it most probably wasn’t, but then I can go and check the specialists qualifications online and see if they are, or most probably aren’t, an advanced trained laparoscopic surgeon who has done years of extra specialised surgical training.

All those 5 questions can tell me much about what some of these poor women have had done, or haven’t had done, and then I can formulate an appropriate treatment plan and management for these women moving forward.

It is always hard explaining to the ones that have had surgery before that they haven’t seen the right surgeon and that they are going to need further surgery. The hardest thing for me is seeing women on support pages about to have their first surgery and I always worry that they aren’t seeing the right surgeon and if they don’t, there is a good chance that they are still going to be going through the same issues, over and over again, until they find the right person to help them.

If only I could see all these women before they did anything, so that they can be given the right information and the facts and be managed properly.

The good thing is that when I do get to see women who chose to see me, I can explain to them the facts and the right information and then why and how with a proper surgeon, that it can make a huge difference to how they are feeling and their recovery and management post surgery.

I can also explain how surgery really is necessary, but is only a small part of their overall treatment and management of their disease moving forward. I can also explain the facts around their disease moving forward too and make sure that women under my care are given the right information, the right investigations and right management going forward.

This is why my initial consultations take about an hour and a half and we go over everything from their health history, medical history, hereditary issues, diet, lifestyle, surgical intervention, medications, natural medicines, blood tests, scans, investigations, sleep, sexual health, libido and everything that a woman needs to know about her particular issues.

It is also about listening to a woman’s concerns and complaints and really hearing what she has to say and is experiencing.

Then I formulate a treatment plan and management and 20 page report of findings for them for what we are going to be doing to help them moving forward.

I also give them a step by step treatment plan of treatments and medicines etc they will need too. That is why my motto is “No Stone Left Unturned”, because there is no stone left unturned and I also make sure they see the right people (surgeons and anyone else that they may need to see).

If there are things that I can’t do (surgery etc), I make sure that my patients only see the best people, in my trusted network, and then I can help manage their disease state alongside other specialists and medical interventions.

I wish I could see every woman before they went for any investigation, or surgery, so I can point them in the right direction and help them manage their gynaecological condition properly.

This is why I am so passionate about doing my posts on social media, or giving time for charity events to talk about women’s health issues and gynaecological issues such as endometriosis, adenomyosis and PCOS.

It is why I do healthcare practitioner education and seminars to help educate them better too, so that they can help their patients better and not miss and dismiss them.

I just hope that I can help those who have not been heard and that have been missed and dismissed. I also hope we can get people to listen to the things I have presented above and also help women get a voice, be heard and get government listening and get more education to younger women too.

Lastly, I cannot say it often enough….. Period Pain “IS NOT” normal and if you, or your daughter, or your sister, or your mother, or cousin, your best friend, or anyone you know has period pain, especially bad period pain and other symptoms, please, please, do not tell them that this is normal.

Period Pain is not normal and women who are experiencing period pain need to see someone who specialises in women’s health and gynaecological conditions, so that they can be investigated properly and have their issues managed properly too.

If you do need assistance with a women’s health issue, you can make a booking to have a consultation with me. Please call my friendly staff to find out more.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Care Advocate

-The Endometriosis Experts

-The Women’s Health Experts

No Bad Carbs + Increased Protein = Increased Fertility & Increased Pregnancy rates

Posted on November 23, 2017September 7, 2019 by Andrew Orr

I know I talk about it all the time, but a good diet, and I mean a good diet (not half hearted, I am trying to do it diet), can actually assist with increased fertility and pregnancy rates

Every day I get people ask me “What can I do to increase my fertility and my chances of pregnancy?”

Well, I always say “How long is a piece of string?”

While there are many things that people can do to increase their chances of a pregnancy, one important thing is starting with a good diet. That is one thing “You” are solely responsible for and something can do for yourself. This is for the couple too. Not just the woman.

Healthy couples produce healthy babies. That means health men produce healthy sperm and healthy women produce healthy eggs and the combination creates healthy embryos that go on to become healthy babies. It really is a fact. Even for same sex couples, a partner should be supporting their other half in the journey and at the end of the day a healthy diet is going to help everyone live longer to enjoy their children later on, and hopefully grandchildren too.

Obviously there is a lot more to it, and why in my fertility program I cover “everything” for the couple, but this is one way to ensure your body is ready to have a baby. This is also part of my PACE (Primal, Ancestral, Clean Eating) diet that I have formulated.

Recent studies have shown that when the bad carbohydrates (see below) are removed and the protein increased, that the clinic pregnancy rates shot up by 80%. Yes… a massive 80%

Let me explain what bad carbs are. They are:
Refined grains, refined sugars, refined flour products, breads (gluten free included), pastries, heavily processed foods etc. Anything highly refined and man made and highly processed.

Good carbs are the following:
Fresh fruits, fresh vegetables, fresh salads, sweet potato etc, and basically any carbohydrate that is not highly processed and man made.

Decreasing bad carbs and increasing protein increases embryo quality

The other thing that is important is that eating this way also improved the embryo quality. Blastocyst development was higher in the high-protein group than in the low-protein group (64% vs 33.8%), as were clinical pregnancy rates (66.6% vs 31.9%) and live birth rates (58.3% vs 11.3%). (1)

Reducing carbohydrates and boosting protein intake can significantly improve a woman’s and couples chance of conception and birth according to the research presented at the American Society of Reproductive Medicine (ASRM) several years ago.

The effect is “at the egg level,” said lead investigator. He presented the findings here at American Congress of Obstetricians and Gynecologists 61st Annual Clinical Meeting.

Refined Carbohydrate-loaded diets create a hostile egg and embryo environment even before conception or implantation, he explained.

“Eggs and embryos are not going to do well in a high-glucose environment.” By lowering carbs and increasing protein, “you’re bathing your egg in good, healthy, nutritious supplements,” he said.

These studies demonstrate how little many in the reproductive medicine and fertility profession know about the effect of micronutrients in our diets on various aspects of reproduction.

These studies demonstrate a field wide open for future research and shows how bad carbohydrates (refined grains, refined sugars etc) have an inflammatory effect that affects fertility and pregnancy outcomes and also detrimental to IVF outcomes.

This is why I always promote a grain free, primal based diet (PACE Diet) to all of my patients, especially my fertility and gynaecology patients. It is an essential part of my fertility program. If you do want to find out more about my fertility program, please give my friendly staff a call.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

References

https://doi.org/10.1016/j.fertnstert.2012.07.849

Alcohol Decreases Fertility & Makes Gynaecological Conditions Worse

Posted on October 31, 2017August 25, 2019 by Andrew Orr

In today’s modern society, alcohol has become the cornerstone for social engagements, business dinners and after work relaxation. It is important to realise however, that alcohol can directly impact the fertility of both males and females.

In males it can decrease sperm quality, reduce testicular size, decrease libido and cause impotence, all of which can impair fertility.

In females it has a more systemic response, affecting the reproductive hormones, leading to abnormalities in the menstrual cycle and an increased risk of miscarriage.

Many men and women these days are actually consuming copious amounts of alcohol and may think that their drinking habits are normal, when compared to others around them.

When people do things on a regular basis, it becomes their normal. But truth be told, many people’s drinking habits, both men and women, are actually in the realms of alcoholism. The impacts of that are far reaching and fertility and gynaecological conditions are definitely impacted by alcohol consumption.

Effect of Alcohol on Conception for Men

Fecundability refers to the probability of conception during a particular menstrual cycle. It is dependent on the reproductive potential of both partners. Alcohol decreases fecundability by its effect on sperm quality and quantity. Men who continue to consume alcohol on a regular basis, can decrease their sperm motility, morphology and their DNA in the sperm. All of which are important factors in achieving fertility.

While outwardly a man’s sperm may look OK, many forget that inwardly, the sperm DNA could be highly fragmented and unless this is tested every ejaculation, you will have no idea how bad the sperm actually is. A one off DNA fragmentation analysis does not mean the sperm each time is OK. It only measures the sperm from the ejaculate that was tested and sperm quality can change by as much as 20% each ejaculation.

Testicular size is also affected by alcohol intake; and can also affect sperm production. Alcohol is a depressant of the central nervous system (CNS), and can disrupt the autonomic system of the CNS. These effects are temporary and short lived. Abnormal sperm production is also temporary and also can resume after abstaining from alcohol.

One study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.

Effect of Alcohol on Conception for Women

In women, alcohol affects fecundability, by disrupting the delicate balance of the menstrual cycle. Clinical research data published in the “British Medical Journal” suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fecundability when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

Alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even Anovulatory cycles, (menstrual cycles where ovulation fails to occur). Menstrual pain can directly be linked to the amount of alcohol consumed in the lead up to the menses and consumptions of alcohol, even small amounts, exacerbates most gynaecological conditions. These changes can drastically decrease a woman’s chance of becoming pregnant and thus affect fertility.

Alcohol effects fertility in both partners, and can do so in so many ways. For couples who desire to have a baby, it is best to stay away from drinking completely. Presently there is no safe limit of alcohol intake; even socially acceptable amounts of alcohol can affect fertility potential and outcomes.

Moderate drinking (1-2 drinks in one sitting) is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, or trying to conceive naturally, you might consider cutting out alcohol for the time being.

A woman that is trying to concieve, or trying to improve a gynaecological issues, or menstrual issues, should not be consuming more than 4 standard drinks per week.

A male who is trying to conceive, or have sperm quality issues, should have no more than 2 standard drinks in one sitting and be having at least 2 alcohol free days per week. These are all part of the healthy drinking set out in health department and government safe drinking guidelines.

Trying to conceive is a special time in a couple’s life, it should be filled with love, devotion and safe health practices, which means a healthy diet and lifestyle and having a healthy mind too. It also means having healthy drinking habits as well.

Decreasing alcohol, having bete foods and looking at a healthy detoxification program is also a great idea for those trying to increase their fertility and get their reproductive systems working better. Healthy eggs and health sperm make healthy babies. Healthy reproductive systems also mean better menstrual cycles and better testicular health too.

Safe drinking everyone. This is something I talk about as part of my fertility program and preconception care. If you would like to find out more about my fertility program, please contact my friendly staff to find out more.

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

– No Stone Left Unturned

-The International Fertility Experts

Seminal Fluid Improves Fertility in Women and Improves IVF Pregnancy Rates

Posted on October 26, 2017August 25, 2019 by Andrew Orr

Seminal fluid is often viewed as simply a vehicle to carry sperm to fertilize the female egg, but a more complex function in influencing female reproductive physiology is now evident.

Remarkably, seminal fluid contains special signaling agents that interact with the female reproductive tract to prime the immune response, with consequences for fertility and pregnancy outcome. This research isn’t new and we have spoken about this in previous posts.

But we now know a bit more about how sperm may assist in implantation for, especially for IVF.

See my other post https://drandreworr.com.au/sex-around-the-time-of-embryo-transfer-increases-the-likelihood-of-successful-early-embryo-implantation-and-development/

Recent studies demonstrate a key role for seminal fluid in enabling embryo implantation and optimal placental development. In particular, seminal fluid promotes health immune responses which facilitate embryo implantation by suppressing inflammation, assisting uterine circulation and blood supply and also protecting the embryo.

There is emerging evidence where seminal fluid provokes an adaptive immune response in the cervical tissues after contact at intercourse, and spermatozoa accessing the higher tract potentially affect the endometrium directly. Research has now shown that sperm and seminal fluid actually help with endometrial receptivity, which is needed to create the right environment for a healthy embryo to implant.

These biological responses may have clinical significance, explaining why

[1] intercourse in IVF ET cycles improves the likelihood of pregnancy

[2] inflammatory disorders of gestation are more common in women who conceive after limited exposure to seminal fluid of the prospective father

[3] preeclampsia incidence is elevated after use of donor oocytes or donor sperm where prior contact with conceptusalloantigens has not occurred.

Research like this is important to define the mechanisms through which seminal fluid interacts with female reproductive tissues, to provide knowledge that may assist in preconception planning and infertility treatment.

It also bring attention to the fact that couples still need to be engaging in regular intercourse during IVF cycles to help not only with implantation, but to increase pregnancy rates through optimisation on the endometrial lining through contact with seminal fluid.

Regular intercourse also promotes connection and bonding for the couple as well and this is something that is very much overlooked.

My clinic offers a comprehensive Fertility Program where couples are educated on important factors such as this… and more

If you would like to find out how you could improve your chances of having a baby, please give my clinic a call and ask about my fertility program that has assisted over 12,500 babies (and counting) into the world may be able to assist you as well.

For more information on my fertility program, see also https://drandreworr.com.au/fertility/fertility-program/

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

-The International Fertility Experts

Facts About Sperm Health and Their Lifespan

Posted on October 25, 2017August 25, 2019 by Andrew Orr

There is a lot of misinformation with regards to facts about sperm health and their lifespan.

Typically, millions of sperm cells are produced in the testicles every day. During this time, many things can affect their formation and interfere with their quality and maturity.

It takes around 90-120 days for a sperm to become motile

From a tiny sperm cell it can take between 90-120 days before a sperm is fully mature. The sperm eventually develops a head and tail, so that its cells start to resemble the shape of a tadpole.

The head contains all of the DNA, or genetic material, and the sperm uses the tail to help it move. A sperm doesn’t reach full motility until it actually reaches the egg, where when touching the egg it creates a reactions that causes “super motility” to give it the final power to push inside the egg. This is called the acrosome reaction.

There has been lots of debate about the actual time it takes for a sperm to mature and become fully motile, but general consensus is that it will take somewhere between 90-120 days.

This is why it is important that men look after their health long prior to conception, because the sperm they ejaculate today was created around 90-120 days ago and what they did to their bodies at that time, will influence how healthy those sperm are.

A man’s lifestyle affects his sperm quality

So if a man had a poor diet, was drinking, smoking, had heaps of stress and goodness knows what, this can all have an impact of the maturing sperm and this can result in poor sperm quality and damage to the DNA of the sperm, which will then be carried onto his offspring, should the sperm be successful in fertilising an egg. This is why the couple need to be healthy prior to conception, not just the female.

Biology 101 tells us it take a sperm and an egg to make a baby, not just an egg. Sperm quality issues make up a big part of fertility issues and they can also be a big part of miscarriage issues too. I have spoken about this many times in previous posts. Up to 85% of miscarriage issues can be related to chromosomal and DNA factors related to poor quality sperm and this is often very much overlooked.

What factors impact on sperm health?

There are always many factors that can affect the sperm formation process and interfere with sperm quality and the DNA of the sperm.

Health and lifestyle factors

Recreations drugs, medications or alcohol use
job, or occupation
tobacco use, or smoking in general (including recreational drugs)
stress
overheating the testicles (spas, saunas, bike riding)
excess weight gain and excess body fat
Trauma
Bike riding (due to heat and trauma through the seat of the bike)
Poor diet and nutrition
Excess sugars and additives
Preservatives and artificial colours and artificial sweeteners

Environmental causes

exposure to industrial chemicals
heavy metals
radiation or X-rays

Medical reasons

infection of the testicles
cancer of the testicles
swelling of the veins (varicoceles etc) that drain blood from the testicle
hormone imbalances
physical problems in the tubes that carry sperm through the reproductive system
chromosomal or genetic disorders (such as Kleinfelters syndrome)
certain medications
surgery involving the pelvis, abdomen, or reproductive organs

How long do sperm live inside the female body?

There is always a huge misperception about how long sperm can survive outside the man’s body and when they enter into the female reproductive tract. Many women are told all manner of untruths of sperm lasting for weeks at a time. The truth is that sperm cannot survive for long once they are released.

Precisely how long they can survive depends on the environment that they are released into and how quickly the fluid surrounding the sperm cells dries up.

Sperm lifespan inside the female body

After ejaculation, sperm may be able live inside the female body for several days, but that is dependent on many varying factors once they enter a woman’s body. To be honest, most of the 300-500 million sperm are dead with an hour. That is a fact.

The fluid in a woman’s reproductive tract, especially the fallopian tubes, has all of the nutrients that sperm need for their survival during that time. But while the woman’s body can help sperm on their way to meet the egg, it can also hinder it their survival as well.

An egg has 24 hours to be fertilised, otherwise it dies

But even so, sperm really only have about 24 hours to fertilise an egg once it is released. After 24 hours, if the egg isn’t fertilised it will die, so really, it doesn’t matter how long the sperm can survive for if the egg has already died.

Poor sperm have to contend with many things when they enter a woman’s body. A woman’s vagina is coated in acids, to protect her from infections and bacteria, but it is also lethal to sperm. This is why within minutes and hours, most of the 300-500 million sperm that set off in search of the egg will be dead. Only a few million will survive to swim through cervix.

Climax helps with getting sperm into the uterus

A woman’s body can help to get the sperm going up into to the cervix though. Through climax (orgasm) contractions are created that can help pull sperm up and into the uterus. Through these contractions the cervix is dipped time and time again into a pool of waiting sperm and this then helps carry the sperm up into the second stage of their journey through the uterus and then up into the tubes.

Only a small number is sperm survive the journey

Once inside the female reproductive tract, the sperm cells must swim through the cervix and into the uterus to reach the fallopian tubes and then on to find the female egg. It is a very long journey for sperm to make and very few survive. Many get lost inside the uterus and some are attacked by the woman’s immune system along the way. By the time the survivors make it to the fallopian tubes to have a rest, there will only be less than 20 or more left to make the final journey.

After the sperm have a rest in the tubes and actually feed off some of the nutrients in the tubes many more will die, or be lost inside the tubes and by the time the final sperm reach the egg, there will be less than 10 single sperm left. Only one may then go on to fertilise the egg and an embryo is then started to be created.

All men should have there sperm quality tested

This is why all men need to have their sperm quality checked by a proper andrology lab and some men will need further testing of the DNA (DNA fragmentation analysis) and further genetic testing if the semen results are poor.

This should all be done prior to trying to conceive, as 50% of fertility issues are related to men. If a man has any of these risk factors, he should try to change them at least 3-4 months before trying to conceive, since that is how long it takes for sperm to fully mature. Some men may need longer than this, depending on what is causing their sperm to be of poor quality.

I will discuss some more myths and facts around sperm and what the most important parameters are to look at with sperm, in some later posts.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The International Fertility Experts

Women with PCOS Have Four Times Higher Risk of Developing Type 2 Diabetes

Posted on August 31, 2017August 22, 2019 by Andrew Orr

One of the hardest things I find that is hard to get through to women with PCOS, is their risk factors for type 2 diabetes, gestational diabetes and their increased risk of cardiovascular disease. They just aren’t being educated about it either.

It has long been known that the major driving factor behind PCOS is insulin resistance and this also increases the risk factor of developing diabetes for those with this endocrine/reproductive disorder.

Polycystic ovary syndrome is an endocrine/reproductive disorder that affects millions of women of reproductive age worldwide, and a new study has shown that it also put these women at a significant risk of developing type 2 diabetes.

PCOS is also the leading cause of female infertility and many women with this condition are often misdiagnosed, or do not know that they have it. PCOS is also a risk factor for miscarriage too. Please see my other posts about signs and symptoms of PCOS. (Click Here)

All women with PCOS will have insulin resistance, either hereditary insulin resistance, or purely caused by diet and lifestyle choices. Insulin resistance is a condition wherein the muscles, fat, and liver do not respond properly to the hormone, so the body keeps producing more of it.

Excessive insulin production is a risk factor for type 2 diabetes and gestational diabetes. This is why it is so important for women with PCOS to follow a modified low GI/low inflammatory/ style diet and that the number one treatment for assisting PCOS (as recommended by the World Health Organisation) will always be diet and lifestyle changes.

Young women with PCOS at risk

This new study investigated 54,680 women in total and found that younger women with PCOS are now more at risk of developing diabetes than older women with the disease. The study found that the risk factor for developing diabetes is four times greater for younger women. This is probably due to poor diet and lifestyle choices that many young women are choosing these days.

The increased risk of developing type 2 diabetes is an important finding and this is something that women with this disease should know, especially those who are obese and have PCOS as well. But it is important for women that are of normal weight, or even underweight to know that they are also at an increased risk as well. Just because you are underweight, or of normal weight, doesn’t mean you cannot have PCOS, or be at risk of diabetes.

This new research was carried out by Denmark-based scientists and the findings were published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

If you do need help with managing PCOS and dietary and lifestyle changes, then please call my friendly staff and book in for a consultation with me.

Regards

Andrew Orr

-Women’s and Men’s Health Crusader

-“No Stone Left Unturned”

-The Women’s Health Experts

What is Implantation Bleeding?

Posted on August 3, 2017August 22, 2019 by Andrew Orr

Implantation bleeding: Causes and symptoms

Implantation bleeding occurs when a fertilized egg attaches to the lining of a woman’s uterus to start the growth process of pregnancy. Some women’s lining can be more affected and be more prone to bleeding during a pregnancy. It is a normal occurrence in pregnant women, yet many women are completely unaware of what it is. Obviously it can be a bit worrying for anyone when they are bleeding during a pregnancy and I will discuss this later.

Some women may confuse the bleeding with spotting from menstruation, as the two can appear similar. What women also need to know is that getting a menstrual cycle, or the appearance of what looks like a menstrual bleed, does not mean you aren’t pregnant. You can have a bleed and still be pregnant.

Usually when it is implantation bleeding. The bleeding is very light and will usually require no medical attention. In some cases, however, implantation bleeding may require a visit to your specialist, midwife, or healthcare provider

What is implantation bleeding?

Implantation bleeding can just before the expected menstrual cycle, or around the early stages of pregnancy. It can also happen again when the embryos is growing and impacting on the lining of the uterus. Again this is a normal part of pregnancy for many women. Some women may not get any bleeding, or signs of implantation either.

The process of implantation starts shortly are fertilization. Once a sperm has fertilized an egg, it is called an embryo. The embryo travels through the fallopian tube towards the uterus. During this time, the embryo multiplies, becoming a blastocyst, which usually takes about 5-6 days to reach this stage.

About 1-2 days after an embryo reaches blastocyst stage, it will then attach itself in the wall of the uterus and this is called implantation. During this implantation stage, the embryo can cause disruption the uterine wall and this then cause what we know as implantation bleeding.

As the embryo and growing foetus grows even bigger, it can then cause further bleeding later on in the first trimester as well. While this is considered normal, it can cause distress for women and any bleeding should be checked by your healthcare provider.

Signs and symptoms

Implantation bleeding is one of the earliest easily identifiable signs of pregnancy. It is also a normal part of pregnancy and all women should be aware of this. As explained before, women can still have a normal menstrual bleed and still be pregnant. It is usually a lighter bleed, but some women can actually have quite heavy bleeds and still maintain a pregnancy. About 1 in 4 women actually have a bleed during their pregnancy.

Despite all that, there are some distinct signs and symptoms to help women identify implantation bleeding:

Early bleeding: Implantation bleeding will often occur a few days before the expected menstruation cycle. This is not always the case, however, and many women confuse the two. As discussed, it is not uncommon for women to actually get their normal menstrual bleed and still be pregnant. Never think that just because you get a period, that you cannot be pregnant.
Unusual coloured bleeding, or discharge: Implantation bleeding produces an unusual discharge that varies in colour from pinkish to very dark brown or black.
Very light bleeding: Bleeding and discharge caused by implantation will usually not last no more than about 24 hours. It can last a bit longer for some women though. Many women experience just a few hours of spotting or one spot or streak of discharge. Obviously any bleeding should still be checked by your healthcare provider.
Cramping: Implantation can also cause mild and temporary cramps. Some women who are doing IVF may also be on progesterone gels that can also cause bleeding and cramping too. Cramping and bleeding does not always mean a miscarriage. If you do experience this and are worried, please always consult with your healthcare provider.

Other signs

As implantation is an early sign of pregnancy, a woman may also experience other pregnancy-related symptoms. Early signs of pregnancy can vary from woman to woman and may include:

Mood swings
Fatigue and tiredness
Dizziness
Headaches and Migraine’s
Tender, swollen breasts
Nausea and vomiting
Changes to the bowels (constipation, or loose bowels)
Heightened sense of smell
Food cravings and aversions
Increased body temperature

Treating implantation bleeding

Implantation bleeding is a normal sign of pregnancy and is not usually dangerous. Because of this, there is no need for treatment. As I have stated before, if you are unsure, you should always consult with your healthcare provider.

Bleeding caused by implantation usually clears up within a couple of days with no treatment necessary. Abnormally heavy bleeding may be a sign of menstruation or a pregnancy complication.

As I have previously shared, some women who are doing IVF, may be on progesterone gels and other medications, which may also cause some bleeding and cramping.

Some women with signs of abnormal bleeding may need the same medications to help with hormonal levels. Some bleeding could be a sign of something more serious so please consult your healthcare provider.

If you are experiencing heavy bleeding along with pain, please present to your nearest emergency centre as this may be signs of a miscarriage, or ectopic pregnancy.

Complications of implantation bleeding

Implantation bleeding is not usually a cause for concern most of the time. It is just a sign of embryo implanting into the lining of the uterus.

Women who are still uncertain about whether they have experienced implantation bleeding should consult their healthcare provider and take a blood test to see if they are pregnant, or not.

Please do not rely on home pregnancy tests as these can be inaccurate in the early stages of pregnancy. The most accurate way to determine pregnancy is to do a blood test. This is very important for women undergoing IVF treatment too.

Too often women will do a home pregnancy test and think they are not pregnant, when in fact they are. The issue is that the home pregnancy tests won’t pick up pregnancy hormone in the urine if it is too early. This can cause a woman much distress at the time and then when she finds out later on through the blood test, that she is actually pregnant. Please never rely on urine based home pregnancy tests.

Please note that if you experiencing heavy bleeding during any stage of pregnancy that this can be a sign of a complication and women should seek medical attention.

Regards

Andrew Orr

-Women’s and Men’s Health Crusader

“No Stone Left Unturned”

-The International Fertility Experts

The Facts About Period Pain & Endometriosis- “What Women Need To Know”

Posted on July 25, 2017August 22, 2019 by Andrew Orr

Every day I hear stories about women being told their symptoms are normal, or they have been missed and dismissed for many years. Some of the things I hear women get told gets me angry sometimes.

Many of you have also been told utter BS (bullshit… sorry for swearing) and it just gets me so upset to hear this BS continues in both the public arena, closed groups and by other healthcare professionals. When are women going to get the support they need and get the health system to start listening?

When I have to talk to men about this topic, usually partners of women who have endometriosis, or who suffer bad period pain and other symptoms, I explain it like this. I explaint that if guys had pain in their testicles daily and couldn’t walk, were curled up on the bedroom floor, had vomiting from the pain, had to ingest copious amounts of pain killers etc to just function, then governments would rewrite the health system, laws would be made, research would be done and those testicles would endure pain no longer. Well.. that is what I think anyway.

The biggest problem for women is that many of you believe that period pain is normal, because that is what you have been led to believe. Then some healthcare professionals reinforce it and you are basically made out to be neurotic when you try and tell anyone that you can’t handle it any longer.

Suck it up they say. Take some painkillers they say. Have a baby they say. Take the pill they say. There are so many BS things said to you all and all of them are wrong. There are so many other things wrong with everything from support groups sprouting misinformation, GP’s telling people misinformation, specialists telling people misinformation and people now relying on “Dr Google” as the gospel for their healthcare diagnosis. This is where the problem all starts and in many ways ends.

So how do we fix this?

Well, education is the first step. This is not just to the public, but to healthcare professionals as well. We also need to start educating women at a young age that “Period Pain IS NOT normal” and neither are other menstrual irregularities that could be the signs of other gynaecological conditions.

Early intervention and treatments and management it always going to be the key to any disease state. Thousands of years ago in China, the Yellow Emperor had a classic saying “To treat a disease once it has already started and been expressed in to the body is like trying to forge arms once a war has already started, or trying to dig a well once one if already thirsty”.

Trying to treat any disease once it has been expressed is hard work and for some diseases, nearly impossible. Prevention is the key and like any disease, we need to find ways of preventing endometriosis too. But if the disease is expressed, we need proper education to know the signs, know the symptoms and get early intervention and treatments and management as soon as possible.

Endometriosis can be managed, just like any other disease. I have asthma and I am symptom free because I manage it properly and have the training and education and proper treatments to manage it. I still have the disease, but I have learnt to manage it and be symptom free most of the time. Doesn’t mean I don’t get the odd flare though.

The same can be for endometriosis if you see the right people and get the right treatment and health management. Let’s be real about this, even with the best management, sometimes you will still just have a bad day, or a few bad days, despite what you do. This is the reality of living in chronic disease state.

Finding the right people to listen and to do the right investigations and management can be hard and we also need people to listen and do the treatment too. We do need people to take some ownership in their health too. I mean this is a caring way when I say this.

Having had a debilitating and life threatening disease I know how hard it can be just to function, both physically and emotionally. I also know hard it was for me to find the right people to help me too. So I get it. But we still need to talk about this and be honest about ownership too.

Please don’t buy into the diagnosis and the label if you know what I mean. Doing that can eat you up, make you angry/mad and then makes things worse. I know because I have been there. I now teach people to rise up, ditch the label and be the best they can be daily. But, it can be hard work, as many of you know. I get it.

So, lets start with looking at the facts around Endometriosis first and in the next lots of posts I’ll talk about the management and treatments to get women their lives back

The Facts about Endometriosis

1. Period Pain IS NOT Normal- You are not meant to get period pain. Some slight heaviness, or mild discomfort maybe, but pain you should not get at all. Pain is not normal and we need to stop saying it is.

2. A significant portion of women with Endometriosis are asymptomatic– A significant portion of women DO NOT get pain, or any symptoms at all. Just because you do not have pain, does not mean you do not have endometriosis.

3. Symptoms DO NOT correlate to the extent of the disease– As mentioned previously, some women with relatively small amounts of endometriosis will have significant pain, have lots of symptoms, while some women who are riddled with it may have no symptoms at all. This is why i do not like the staging system (1-4) because it really does not accurately describe a women’s symptoms, or have it correlate to the extent of the disease.

4. The only way to diagnose Endometriosis definitely is via surgical intervention– Scans, blood tests etc do not diagnose endometriosis. You cannot have a scan to diagnose endometriosis and you cannot have a blood test to diagnose endometriosis.

The definitive diagnose IS and ALWAYS WILL BE via a laparoscopy/laparotomy, along with a biopsy and tissue taken to examine. A laparoscopy is the goal standard investigation of examining the pelvis and for investigating gynaecological disorders such as endometriosis.

The laparoscopy also need to be done by what we call an Advanced Trained Laparoscopic Surgeon, who has extra years of surgical training, and who specialises in this disease and specialises in the excision of endometriosis. It can’t just be done by a regular gynaecologist and this is where many go wrong. They just haven’t seen the right surgeon first up who has the proper skills to deal with it effectively. Many women have been under-serviced surgically previously and this is a big issue. It just means that they may get some relief, but it will not be long lasting.

The first surgery should always be your best surgery and early intervention and management of this disease is crucial. The longer it is there, the worse it can become. But, please know that surgery does not cure endometriosis. It is just the first stage in the management of the disease and endometriosis needs ongoing care and a multimodality approach to treat if effectively. It needs a team to manage it properly.

5. There is NO cure for Endometriosis– At present there is no cure for endometriosis. Just as I mention my asthma before and it having no cure, the same applies to endometriosis. Once it is expressed into the body, it will always be there. Even if someone becomes asymptomatic, the disease it still there. But while there is no cure, the disease can be managed and women can become asymptomatic with the right help, right treatments and right management. I see this is practice daily.

6. Having a baby will not cure endometriosis– Many women are told to go away and fall pregnant and have a baby as this will fix their period pain and cure their endometriosis. This is a load of rubbish. Having a baby will not cure endometriosis. It may stop you having period pain for 9-10 months because you won’t be getting your menses, but you can still get other symptomatic pains and referral pains etc. Pregnancy does not fix endometriosis. The reason why women are told to go and have a family as soon as possible is because endometriosis can make it harder to fall pregnant, for some people.

7. Endometriosis may cause Infertility– While it may make it hard to fall pregnant for some women, other women with it may have no trouble falling at all. But women do need to be educated that it could affect your fertility and one of the major reasons women end up seeking help for fertility services.

8. Endometriosis is Estrogen Driven, Not caused by Estrogen dominance– Estrogens do drive endometriosis. This could be from oestrogen’s in our diet, in our environment, from hormones, drugs, plastics, abdominal fats, body fats and any small amounts of circulating oestrogen’s. Estrogens do not have to be in excess, or be dominant to drive endometriosis.

9. The Pill, or Contraceptives DO NOT fix endometriosis– While the pill and contraceptives can help with hormonal regulate and in some cases even stop the period, they do not fix endometriosis. In many cases the Combined pill can actually make it worse because of the oestrogen’s in it. Plus it then masks the symptoms of endometriosis and then when a woman comes off it, the endo is still there and for some women it could lead to them being infertile. The pill masks endometriosis and many other gynaecological issues. It does not fix them

10. You can have Endometriosis at a Young, or Older Age– Endometriosis does not discriminate age. Young girls can have it and older ladies can have it also. It can present at almost any age once the menses has started and can continue even when the menses has stopped. The symptoms may get less with menopause though.

11. Hysterectomy does not cure endometriosis– Hysterectomy does not fix endometriosis because many times endometriosis is not in, or on, the uterus and it can present anywhere in the body. It has been found in the joints, in the brain, around the heart, on the retina of the eyes, around the bowel and in nearly every part of the body. So removing the uterus does not cure endometriosis in many cases.

12. Endometriosis requires a multi modality approach– Like many diseases we all face, there is never one particular miracle cure, or miracle treatment for endometriosis. It requires a multi modality approach to manage it properly. This is how you diagnose, treat and manage endometriosis properly

13. Endometriosis IS NOT an autoimmune disease– Endometriosis is not an autoimmune disease. It is an autoimmune like disease because it is made worse by inflammation in the body, but it cannot be classed as an autoimmune disease.

14. There Are Hereditary and Genetic links– While we do not know the exact cause of endometeriosis, we do know that it does run in families and it there is genetic and hereditary links.

15. Endometriosis can cause many other issues in the body– Like any inflammatory disease, endometriosis can cause issues with moods, interfere with hormones, disturb sleep, cause fatigue, cause depression, exacerbate mood disorders, cause muscular pain, cause skeletal pain, have pain refer down your legs, make your joints ache, cause bowel movements to be difficult, cause loose bowels and IBS like symptoms, cause UTI like symptoms, cause bladder pain, nocturnal urination, pain with sex, pain and bleeding with exercise, ovulation pain and so many other symptoms not mentioned.

It can cause many issues both physically and emotionally and people need to be aware of this. Some women are at the point of suicide and recently we have seen women take their lives, because they just have not been listened to and it has all become too much.

There is probably a few more things I need to add in here. Please feel free to add comments to add in more. But, this is a start and hopefully people can learn from this and we can start educating people on the facts around this horrible disease. Please know there is always help.

Please know the disease can be managed with the right people on board helping you. Please know there are some really good support groups out there too.

Please know there are some amazing women ( and some men) out there trying to be your voice and get people to listen. Hopefully one day we will get a cure and women will get the treatment and management of this disease that they so desperately deserve. Sorry for the long post. But we need to get this out there.

Take care amazing people. Keep your chins up and know that there are people who will listen too.

If you would like to book in a consultation with me, please call my friendly staff, or using the automated emails system on the website.

Let me hold your hand and care for you and assist you in every step of the way to better health and a better way to live daily.

Regards
Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-Period Pain is not normal

Why Sperm Is The 51st Shade of Grey

Posted on June 25, 2017August 22, 2019 by Andrew Orr

Sperm is something that is very little talked about and why sperm is the 51st shade of grey. Men always think they are born with super sperm, when in fact it is the complete opposite now. Many fertility clinics are letting men use substandard sperm and are not holding men accountable for their sperm health. No wonder so many couples are failing to fail pregnant.

Over the years I have put up some serious posts about sperm and sperm quality and the importance of maintaining sperm health. While my post are intended for people trying to actually have a baby, but many of those not trying for babies loved the posts as well.

It is still good to promote healthy sperm production and reproductive function, even if you aren’t trying to have a baby. Healthy lifestyle promotes health bodies, which then helps promote healthy sexual and reproductive function.

In many of my posts about sperm, I also talk about the importance of regular ejaculation to help with better quality sperm and also healthy reproductive function. These posts always raise a few eye bows, and caused a few giggles, or “There you go dear, I told you we need to have sex more often”.

However, I did see that there were some major misperceptions around the topic of sperm. So, I thought I’d better educate you all on the finer details of sperm

Biology 101 tell us that it takes a sperm and an egg, not just an egg (as many people seem to forget), to make a baby. The trouble is, over 50% of fertility issues are related to poor quality sperm and up to 85% of miscarriage issue are related to men’s defective swimmers. So what do guys do when they hear this?

Well, they bury their heads in the sand and say “My boys are fine, I just know they are” and guzzle some more alcohol, that has their swimmers having two heads, two tails and swimming around like a drunk man in a pool. Guys are shockers when it comes to keeping their sperm healthy and why I will always be in business for fertility services.

But besides the downside of men and sperm, there are some good points to sperm, but most of the time Dr Google has you all believing things that just aren’t true at all.

So lets look at the facts about Sperm.

Sperm can help fight depression in women– Research has shown that have oral sex, or unprotected sex (not that I advocate this unless in a healthy relationship), have less depression, have healthier moods and have healthy immune systems and are happier in general. Sperm helps increase oxytocin, prostaglandins and seretonin in women according the The State University of New York study.
Sperm can make you more fertile – Semen isn’t just vehicle for carrying sperm – it also plays a crucial role in triggering ovulation, according to a new study.Scientists have discovered the protein in the sexual fluid acts as a hormonal signal on the female brain.This triggers the release of other hormones that signal the ovaries to release an egg.
Sperm can help Embryo Implantation– Studies have shown that sperm actually assist in embryo implantation via several chemicals and hormones. Yet many people are told refrain for having sex after IVF. I can tell you that you need to have more sex and not listen to the BS and listen to the research that proves otherwise.
Storing up sperm does not make it better– Research has shown that regular ejaculation improves sperm quality and the resulting transport of seminal fluids. (as was told to you in previous posts). Storing it up, does not make it better, it makes it worse. Regular ejaculation also helps the prostate.
Sperm do not last for days– On ejaculation into a woman, most of the 300-500 million sperm that set off are dead within an hour and only about 5-10 single sperm actually survive the journey to the tubes, where many more half of those die off once more. Sperm are killed by acids,killed by the woman’s immune system, die in the uterus, get lost in the uterus, die on the tubes and so on. Only the fittest survive the race to pregnancy. (The human body series BBC)
You can cook with it– Yep, there are cooking books that use semen to cook recipes with. (Natural Harvest – A Collection of Semen-Based Recipes). Where semen is described as “Semen is not only nutritious, but it also has a wonderful texture and amazing cooking properties. Like fine wine and cheeses, the taste of semen is complex and dynamic” Well there you go, crack open the bottle of grange now.
Sperm is good for your skin– Sperm contains minerals such and zinc, vitamin C, prostaglandins, collagen, vitamins, amino acids and many other health things to help with skin. Bioforskning, a Norwegian company, has synthesized the compounds into a facial cream. According to Bioforskning, the cream Spermine is 30 times more effective than vitamin E and can delay the aging process by 20 percent. However, nature’s most natural facial cream can cost you a whopping $250. I’d like to see them try to market that at Myer 🙂
The first sperm under a microscope– Antonie van Leeuwenhoek was the person to view sperm under a microscope. It’s a bright day in 1677, in the city of Delft, and Antonie van Leeuwenhoek is making love to his wife. But moments after he shudders with orgasm, he hurries out of bed to grab his microscope. After all, he’s not just spending time with his wife: he’s running an important scientific experiment at the request of the Royal Society in London. Sounds like nothing much has changed for some men. Now some are just rushing to watch the footy.

Well, there you go. 8 things Wikipedia can’t tell you about sperm. The good, the bad and the down right outrageous. You heard it hear first. The doc provides you news that other people are to scared to report. I hope all of you have a great up and coming week. Pardon the pun. Life is too short to be serious, about a serious topic.

References

1.http://www.dailymail.co.uk/health/article-2190863/Semen-good-womens-health-helps-fight-depression.html

2.http://www.dailymail.co.uk/health/article-2191495/Does-having-sex-make-women-fertile-Semen-trigger-ovulation-mammals.html

3.http://humrep.oxfordjournals.org/content/15/12/2653.short?rss=1&ssource=mfr

4 & 5. World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm – Cervical Mucus Interaction (4th Edition). Cambridge University Press, Cambridge, UK (1999)

6. Human Body Series (BBC) – Conception

7.http://cookingwithcum.com

8. http://www.medicaldaily.com/extraordinary-things-you-can-do-sperm-242190

9.http://rstl.royalsocietypublishing.org/content/9/101-111/121.full.pdf+html

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The International Fertility Experts