Category Archives: Sperm Quality

couple in love

Sex Around The Time of Embryo Transfer Increases The Likelihood of Successful Early Embryo Implantation and Development.

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Research has now shown that sex around the time of embryo transfer increases the likelihood of successful early embryo implantation and development.

Intercourse during an IVF cycle has the potential to improve pregnancy rates and there is adequate research to now back this up. We know that in animal studies, exposure to semen is reported to promote embryo development and implantation.

Intercourse may assist implantation

This is actually good news for humans as well as it shows that intercourse may act to assist implantation. Animal studies reveal that exposure to seminal plasma, the fluid component of the ejaculate, is particularly important for achieving normal embryo development and implantation. Animals that become pregnant through artificial insemination or embryo transfer without being exposed to seminal plasma have substantially lower rates of implantation than those exposed to seminal plasma (Pang et al., 1979; Queen et al., 1981; O et al., 1988; Flowers and Esbenshade, 1993), while rodents inseminated with spermatozoa prior to blastocyst transfer also have a higher rate of implantation compared with those not exposed to spermatozoa (Carp et al., 1984).

Intercourse may influence pregnancy success rates

A multicentre prospective randomised controlled trial was conducted through IVF centred around the world, including Australia. The study was conducted to determine if intercourse around the time of embryo transfer, or just before and embryo transfer in an IVF cycle, actually has the potential to have any influence on pregnancy success rates.

Participants in Australian IVF clinics underwent frozen embryo transfer (FET) and participants in Spain IVF clinics did fresh embryo transfer. Participants were randomised to either have intercourse, or to abstain from intercourse around the time of embryo transfer.

The study showed that there was no significant difference in the pregnancy rates between those couples that abstained and those that had intercourse. However, the portion of transferred embryos that made it to 6-8 weeks gestation was significantly higher in the women exposed to semen compared to those who abstained.

This landmark multi-centre international study showed that women who had sex around the time of embryo transfer, and who were exposed to semen around the time of embryo transfer, had increased likelihood of successful early embryo implantation and development.

Couples need to be having more sex during IVF cycles

One of the things that I always promote as part of my fertility program, is that regular sex is so important for our fertility patients, on many levels. Sometimes the obvious eludes some people though.

One of the things we see quite regularly is that couples doing Assisted Reproduction (ART) are abstaining from sex fearing it will affect their chances of conceiving. Actually the opposite is true. By not having sex during ART cycles (IUI, IVF etc) you are affecting your chances of conception.

I have spoken about the importance of sex and orgasm assisting implantation in other posts and there is so much medical research to back this up. This is seen in the research I have talked about above.

Let’s be real and look at the facts

Let ask the question “If you were trying naturally, would you stop having sex for fear that conception has taken place?”

Then why would you stop having sex around an ART cycle?

Let’s face the facts, implantation takes place in the uterus, and not the vagina, and no man is that well endowed to even penetrate the cervix, so…. Let’s get a grip here

The question to ask is “What does an embryo feed off and need to successfully implant?”

The answer is blood!

Think of a tick borrowing into skin to feed off its host.

How do you get blood flow into the uterine lining?

The answer is that sex and climax stimulate blood flow to the lining to assist implantation and also prepare the lining for implantation. Nature has given us all the tools for healthy conception to take place, and yet many of us just aren’t using them.

Sex is more than just and egg and a sperm

Don’t forget that regular sex during this time not only helps assist implantation, but it also helps with the bonding process and physical connection process during this stressful time. Many couples split up because of losing this connection during the ART process and sex is a way of keeping that physical and emotional connection. Sex also tells your body you are also preparing to conceive on another level too.

For those doing IVF etc, next time you are doing an ART cycle maybe it is time to start doing things the way nature intended to give you that boost you so desperately are needing. Go get busy people

Final Word

If you are struggling to fall pregnant, or need advice with preconception care, please give my friendly staff a call and find out how my fertility program, which has helped over 12,500 babies into the world, may be able to assist you too.

Regards

Andrew Orr

– No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

References:

  1. http://humre.oxfordjournals.org/content/15/12/2653.short…
  2. Bellinge, B.S., Copeland, C.M., Thomas, T.D. et al. (1986) The influence of patient insemination on the implantation rate in an in vitro fertilization and embryo transfer program. Fertil. Steril. , 46, 252–256.
  3. Carp, H.J.A., Serr, D.M., Mashiach, S. et al. (1984) Influence of insemination on the implantation of transfered rat blastocysts. Gynecol. Obstet. Invest. , 18, 194–198.
  4. Coulam, C.B. and Stern, J.J. (1995) Effect of seminal plasma on implantation rates. Early Pregnancy , 1, 33–36.
  5. Fishel, S., Webster, J., Jackson, P. and Faratian, B. (1989) Evaluation of high vaginal insemination at oocyte recovery in patients undergoing in vitro fertilization. Fertil. Steril. , 51, 135–138.
  6. Franchin, R., Harmas, A., Benaoudia, F. et al. (1998a) Microbial flora of the cervix assessed at the time of embryo transfer adversely affects in vitro fertilization outcome. Fertil. Steril. , 70, 866–870.
  7. Franchin, R., Righini, C., Olivennes, F. et al. (1998b) Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization. Hum. Reprod. , 13, 1968–1974.
  8. Marconi, G., Auge, L., Oses, R. et al. (1989) Does sexual intercourse improve pregnancy rates in gamete intrafallopian transfer? Fertil. Steril. , 51, 357–359.
  9. Pang, S.F., Chow, P.H. and Wong, T.M. (1979) The role of the seminal vesicles, coagulating glands and prostate glands on the fertility and fecundity of mice. J. Reprod. Fertil. , 56, 129–132.
  10. Qasim, S.M., Trias, A., Karacan, M. et al. (1996) Does the absence or presence of seminal fluid matter in patients undergoing ovulation induction with intrauterine insemination? Hum. Reprod. , 11, 1008–1010.

 

Sperm meets an egg

Regular sex found to trigger ovulation in females & make them more fertile.

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Regular sex isn’t just beneficial for ones health, physical and mental well being and happiness.  Researchers have now found that regular sex and a protein in seminal fluid actually helps to trigger ovulation in females and make them more fertile to sustain a pregnancy.

Semen isn’t just a vehicle for carrying sperm

Semen isn’t just a vehicle for carrying sperm and studies actual now show that it also plays a crucial role in triggering ovulation. Researchers have discovered the protein in the seminal 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.

The international team of researchers at the University of Saskatchewan, found this protein in a variety of mammals and say it plays an important role in reproduction in all mammals.

Male mammals have accessory sex glands that contribute seminal fluid to semen, but the role of this fluid and the glands that produce it are not well understood. From the results of the research, it is now understood that these glands produce large amounts of a protein that has a direct effect on the female brain and reproductive organs.

Ovulation Inducing Factor (OIF)

The protein, which was dubbed the ‘ovulation-inducing factor’ (OIF), works through the hypothalamus of the female brain. This part of the brain links the nervous system to the endocrine system (a system of glands that secrete hormones into the blood stream) via the pituitary gland.

The idea that a substance in mammalian semen has a direct effect on the female brain is not a new one, but now there is research to back these theories up. The scientists also discovered it is the same molecule that regulates the growth, maintenance, and survival of nerve cells.

OIF affects ovulation and fertility

In this study, they also looked at how OIF not only affected ovulation in females, but how it also affected their fertility and chances of a pregnancy.

For the purposes of the study, the research team looked at two species of mammals, that being llamas and cattle. They did this because Llamas are ‘induced ovulators, meaning that they ovulate only when they have been inseminated. Cows and humans on the other hand are ‘spontaneous ovulators,’ meaning that a regular build up of hormones stimulates the release of an egg.

Using a variety of techniques, the researchers found OIF present in semen samples taken from both animals. However, when they injected the llamas with this protein it caused them to ovulate. The same effect wasn’t seen in cattle.

While OIF didn’t appear to induce ovulation in spontaneous ovulators, such as cows and human, it did affect fertility in different ways. The protein was found to effect the timing of when cattle developed follicles (fluid-filled sacs in the ovary which carry the eggs). The researcher also found that OIF promoted the development of a temporary endocrine structure needed to sustain pregnancy.

Research has broaden our understanding of ovulation and fertility

This research definitely helps to broaden our understanding of the mechanisms that regulate ovulation and also helps to raises some interesting insights into fertility. More research is needed to see what role OIF plays in human fertility, as the researchers suspect it will be exactly the same. The study appeared in the Proceedings of the National Academy of Sciences.

It is great to see this research getting out there and this is something that I have promoted and taught for ages. It is great to see actual research to back up what I have teaching for years. Let’s face it, many of our advancements in fertility have actually come from veterinary science through use of IVF in cattle.

Couples undergoing IVF need to be having more sex

This is also great research that showed why couples trying to have a baby, or undergoing fertility treatments (IVF etc) need to still be having sex. It isn’t rocket science, yet so many people forget basic biology and that we are actually still an animal.

The problem is that so many couples actually stop having sex when doing assisted reproduction such as IVF. While I can totally understand the whole emotional aspect of why, it is still hindering their chances of conception and having a successful pregnancy. It is a truth that must be talked about and also get couples to understand.

Regular sex also helps with connection for the couple

I am always telling them how important it is to still have an active sex life, for the benefit of a happy, healthy relationship. It is also about the connection and not just about having sex. We do see so many couples split up while undergoing IVF and assisted reproduction, and some of this is purely due to lack of bonding and connection with their partner.

But even so, regular sex and intercourse also gives the chance of a natural pregnancy too, no matter how slim the chance for some couples. We still see couples that have done multiple cycles of IVF still conceiving naturally, but you actually have to have sex for this to happen.

Now we have research, which shows that a protein in seminal fluid actually acts as a hormonal signal that actually triggers ovulation, improves egg quality and may in fact make a woman more fertile for a pregnancy to take place. Again, when you look at this logically, it really is not rocket science and really is easy to understand.

Regular sex while doing IVF improves pregnancy rates.

This is why it is so important for all our couples using ART (Assisted Reproduction Therapy) and IVF to still keep having sex. Regular sex and more importantly regular climax, increases your sex hormones, helps regulate hormones, increases blood flow to the uterine lining, helps with libido, helps with egg quality, helps for better ovulation and most of all improves your fertility and the chance of sustaining a pregnancy. There is also research to show that regular sex before and after IVF transfer, improves pregnancy rates and I will talk about this research in another article on it’s own.

Final Word

If you are struggling to have a baby, and need help with fertility issues, then talk to my friendly staff about how our fertility program might be able to assist you. It has helped over 12,500 babies into the world… and counting.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

 

 

Let’s talk about fertility and reproduction what couples can do do during this time

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There are many people trying to have a baby, and without success. Many now are stressed about what they can do to improve their fertility, during the times of COVID 19.

Many are also stressing thinking that they cannot access fertility treatment, when in fact some fertility clinics are providing full services, including IVF.

In this latest video blog, I talk all things fertility and some of the cold hard facts, especially about seeing a fertility expert.

There are many things couples can do at this time and one of them is get your body and mind ready for trying to have a baby. In this video also talk about the importance of preconception care and the importance of using this COVID 19 time to work on couples health, to help with their fertility.

fertility 1

Fertility- Before you go any further, you are forgetting one thing…….. The Male

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In this video blog I explains how I often get emails from patients and practitioners, needing assistance with fertility issues. The only thing is, it is often only from the female perspective and I have to then explain this to people, or these practitioners. So often, as I am hearing their case study, or patients telling their story, I have to politely stop them and explain “Fertility Before you go any further, I can see what the issue is, you are forgetting one thing…… The Male”

Being completely honest, 95% of the time it is the full female history I am hearing and absolutely no mention of the male. The male is always 50% of the fertility picture, unless there is absolute infertility with the female (medically diagnosed infertility)

Fertility issues require proper evaluation of both the male and female, otherwise crucial things get overlooked. It takes a sperm and an egg to make a baby, not just an egg. Besides that it is a legal and ethical requirement to investigate the female and male. You cannot just investigate and treat the female. Have a listen to the latest video (below) of this very important subject.

If you do need assistance with fertility and reproductive issues, please give my staff a call and find out how my fertility program may be able to assist you and your partner.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

 

Fertility and a piece of string

Explaining The Facts of Fertility- “How long is a piece of string?”

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When people ask me about what is the cause of most couples issues trying to conceive, I always say ” How long is a piece of string?”

There can be so many factors involved and there is never just one clear answer. Many times people are focussing completely on the wrong thing too.

In this video blog below,  I have an honest discussion about fertility on every level. I discuss diet, lifestyle, preconception care, supplements, natural medicines, western medicines, investigations, genetic issues, stress, IVF procedures, Natural killer cells, unrealistic expectations, self sabotage, weight issues and much much more.

So again, when anyone asks what the cause of fertility issues are, I will always answer “How long is piece of string?”

Because in reality, there are so many factors that couple are unaware of, and need to be aware of too.

Regards

Andrew Orr

-Master of Reproductive Medicine

-No Stone Left Unturned

-The International Fertility Experts

Fertility

Let’s Talk About The Facts Of Fertility & The Fertility Profession

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Wouldn’t you love to sit down for 2-3 hours with a fertility expert and cover everything you need to know for your fertility and journey to become a parent?

Wouldn’t you love to have a fertility expert that can not only talk to you about all the medical investigations, medical protocols, genetics and genetic testing, hormones and medications etc, but can also talk you about preconception care, nutrition, diet, lifestyle changes, nutritional supplements, complementary medicines, acupuncture, counselling and other modalities?

Wouldn’t you just love it if someone could listen to your individual needs, listen to your full history, be empathetic to your journey so far, be there to guide you every step of way, and then make sure you are looked after on every level possible?

Well, you can have this, but before I talk about how, let’s talk about the facts about fertility and the fertility profession first.

Let’s talk about the facts

I never hold back from telling people the cold hard facts on any health topic I talk about. It may, or may not upset some people, but the truth is that it needs to be said all the same. People deserve to know the reality about every health condition and their reproductive system. For this post I am going to talk about the cold hard facts of the fertility profession and facts around fertility.

The fact is that many people are lucky to get half hour with a fertility specialist/expert when they decide that need help in having a baby. Some may only get a 15-minute appointment with a fertility specialist/expert and are lucky to get a few questions answered. Then at each of your next 15 minutes appointments, people are trying to cram in as many questions as they can before they are escorted to the door, because the next patient has arrived.

Many medical fertility specialists/experts have no idea about diet, lifestyle advice, preconception care etc, and the one subject that they did learn years ago at college is now a lost and distant memory. Basically it becomes a case of not my area, not my concern.

People then go home and arm themselves with a degree in ‘doctor google’ and then desperately search for answers themselves. They then end up on all manner of sites and support groups with a plethora of misinformation and angst. Have read of my post about Fertility and Dr Google 

This then leads to people searching for a local naturopath, nutritionist, Chinese medicine practitioner etc, trying to cover off on all the complementary medicines, nutrition, dietary advice and nutritional and herbal supplements.

Then this can lead to the case of too many cooks spoiling the broth, too many with differing ideas, or no idea at all, and the turf war on fertility begins.

The medical specialist damns the complementary medicines. The complementary medicine practitioner damns the medical specialist and the couple, or individual, is then caught in the middle. Dazed and confused, the couple/individual has to make a choice of whom they are going to believe and whom they are going to continue to see. But does it have to be this way?

Health professionals should be working together, for the greater good of the patient, not working against each other. Nobody has all the answer and a symbiotic relationship can greatly increase a couples success of having a child.

No wonder many couples/individuals don’t know where to turn to, who to believe and then end up searching for answers themselves. Worst still, while all this confusion and mud slinging continues, the couple/individual still have not get the answers they need, let alone the baby they are desperately wanting.

The fertility profession is largely unregulated

1.The medical side of things

What many are unaware of, especially here in Australia, is that the fertility profession is largely unregulated. Anyone can say they do fertility work and yet not have the qualifications to back it up. Only one state here is regulated, where you have to have what we call a CREI (Certificate of Reproductive Endocrinology and Infertility).

But let’s face it, it is a certificate, not a postgraduate degree and they are very easy to get. But now, many have to have a Masters in Reproductive Medicine as well. But this is only in one state mind you. In all other states, there is nothing stopping anyone doing fertility.

So what this means is that anyone can go and work in a fertility clinic, without the proper extra training to do so. We see obstetricians often do the change to fertility, without having to do extra training, and are basically learning on the job as they go along. The patients then become the guinea pigs and test cases while they are learning on the job. It really should not happen. Sure, they have some reproductive training, back when they studied, but fertility is a very different area to obstetrics and pregnant women.

We also are now even see some GP’s do the sea change to some of these bulk bill IVF clinics and then are consulting with people are their fertility. Many of these couples are then led to believe they are seeing a fertility specialist, when in fact they are just seeing a GP, without any formal training in fertility and reproductive. For many of these, the last time they did any study on fertility, was back in university, and it was probably one subject, if that.

2. The complementary medicine side

But, at the same time, this is not just an issue that is related to the medical side of things. There is just as many complementary medicine practitioners saying that they do fertility, when in fact they have had no formal training, and many often have no idea. They are doing the same thing of learning at they go along, and the patients are the guinea pigs.

Many of these complementary medicine practitioners are lucky to have studied one subject in fertility and reproduction. Many of their lecturers have no formal qualification in fertility and reproduction either. They are then leaving college, or university, and then setting themselves up as experts in fertility.

Many are literally setting up overnight, with no clinical experience, or post graduate certification in fertility, and then trying to say that they do fertility. Daily, I see some of these practitioners not even knowing the basics, yet are out there trying to treat people for fertility issues. I often comment on how some of these practitioners are out there trying to have a crack at it with no idea what so ever. This should not be happening.

There needs to be better regulation

It is a big issue for couples trying to wade their way through the murky waters of the fertility profession. It really should not be allowed to happen. But again, it is all due to lack of regulation and laws preventing it from happening.

As I said, it is on both sides and not just related to one profession. There desperately needs to be more tougher and tighter regulation with the fertility profession, so that couple know that when they are seeing a fertility expert, they actually do have the post graduation training and degree, as well as the clinical experience too. The only good thing here in Australia, is that nobody can advertise that they are a specialist, unless they have a specialisation. If they are caught advertising they are something that they are not, there are harsh penalties around this.

But seriously, this would not happen in any other profession. You would not see a backyard mechanic, or a backyard hairdresser, or someone without the appropriate levels of training?
Yet, why are people not checking who they are seeing for fertility, and just presuming on face value. Your fertility and reproduction is far more important than your car, or your hair. I hope people get what I am trying to say here.

So how do you know whom to see?

This is the million-dollar question and why I always say to patients to be careful. It really is a case of buyer beware.

What you need to do is ask the big questions and do not see someone unless they can answer all the questions and tick all the boxes.

  • Here are some of the things you need to ask:
  • Does you fertility practitioner have a post graduate degree in Reproductive Medicine?
  • Can you please see a copy of their degree?
  • What is their official academic title?
  • What extra study have they done in fertility and reproductive medicine?
  • How long have they been practicing for?
  • Is the practitioner a recent graduate (medical, or complementary medicine)
  • How many fertility patients have they helped?
  • What experience has the practitioner had, and who has mentored them, or trained them?
  • What was their motivation for getting in this area of healthcare?
  • Do they work in with a fertility/IVF clinic?
  • Do they have a symbiotic relationship with a fertility/IVF clinic?
  • Does the practitioner know all the fertility investigations, fertility terms, drugs, hormones, procedures, and all things related to fertility?

These questions are just some of the important questions someone should be asking any practitioner, medical or complementary medicine, before they decide to seek their help to assist them having a baby.

See someone who specialises in fertility and reproductive medicine

I also generally tell people that when seeing someone for fertility, the practitioner should specialise in that area and not have their hands in too many pies so to speak. If seeing a medical specialist, you should try and see someone who just does fertility work on, and who isn’t trying to juggle a busy obstetrics practice at the same time. I see this happen often, where patients are left waiting while a specialist is off delivering babies and the couples are left waiting for hours. Someone like this cannot give you his or her full attention and why I believe you need to see someone whom just does fertility work only.

But again, you just need to do your homework with whomever you see. This goes for complementary medicine practitioners as well. Find out if their primary focus is fertility and not trying to be someone who does a bit of everything. Remember, don’t forget to check that they have post graduate training and experience in reproductive medicine and fertility.

Many couples are having the basics missed

Many couples I see, are often at the point of desperation, and some are also at the point of giving up. I feel sorry for those who get to this point, when in fact it is because some of the basics just have not been investigated.

Being desperate can also lead to bad decisions and also for couples to be exploited by big fertility clinics and the hard sell on offering a solution to their fertility. The fact is that nobody has all the answers, there is no magic pill, and IVF is not a cure for infertility, and we need to start being real about this.

There is often the case of expectation versus reality and many are exploited because they are desperate. We need to be very real that while IVF etc, can help couples have a baby, it really is not a cure for infertility, and it cannot help everyone.

But at the same time many couples issue really are that they have not have the basics done, or proper evaluations done, purely because the person they are seeing is a properly trained in fertility and reproductive medicine. That is a fact.

Males are not exempt from fertility issues

I’ve talked about this often and it is one of my biggest annoyances with the whole fertility profession and men who do not need to be part of the fertility journey. Have a look at my previous posts on this (click here) 

The fact is that many men are not evaluated properly and are not having the basics done with regards to fertility testing. Women are being focussed on and the male is often almost excluded from the process. Let’s face it, some men are literally in denial and excluding themselves as well. I honestly do not know why some women chose to be with men who refuse to be part of the process. Their actions speak volumes.

The long and short of it is that men are often the biggest part of the reason why a couple is not conceiving. Up to 50% -60% of fertility issues are related to men and up to 85% of miscarriage and fertilisation issues are related to chromosomal and DNA factors related to men. Yet many men are under-investigated, or not investigated at all. I see it so often where couples have literally been trying for years and years, and then we find out it is the man who is the issue. Yet all along both the fertility practitioner, and the woman’s partner alike have blamed the woman as being the primary issue. I see this so often and it actual disgusts me. Why should women be blamed for all fertility issues, when men are an equal, and often greater part?

Proper fertility evaluation and testing

I’ve spoken about this in previous posts and it is so important that couples are evaluated properly. Personally I believe that everything that should be done is done up front and at the beginning. So many couples end up finding issues years later, which should have been found in the beginning.

Proper testing should involve at least the following:

  • Full blood testing and screening
  • Hormone assay
  • Scans and imaging
  • Surgical intervention (Laparoscopy, hysteroscopy and dye studies)
  • STI screening
  • Semen analysis
  • Sperm chromatin Assay (SCAT)
  • Full genetic screening
  • Advanced genetic carrier screening
  • Others

I make sure that all my patients have been screened and investigated properly on all levels, for both the man and the woman, not just the man.

You can also see my previous post about the importance of proper genetic screening as well (click here) 

We do have same sex couples and single women seeking help now, and it is still equally important that all concerned are screened properly. Sometimes one of the partners in a same sex relationship may have an issue which prevents them from conceiving, so you have to screen the other partner just in case. It is all about screening and proper evaluations and investigations.

Expectation versus reality

While we have talked about the fertility profession, we also need couples to be real about their chances too. As mentioned before, couples do need to be aware that IVF is not a cure for infertility and that is cannot help everyone. It can help many couples that would never have been able to conceive naturally too.

Age 

We also need for couples to be real about age related fertility, as that is the biggest issue as far as fertility and conception is concerned. The older you are, the harder it is going to be to fall pregnant. No matter is you are doing IVF, or not, age is a big factor in couples being unsuccessful. The older you are, the poorer quality your eggs and sperm are, and the more random chromosomal/DNA errors you get in embryos.

Preconception care

There are other issues with diet and lifestyle that need to be addressed too. Couples that are overweight are going to struggle more with being able to conceive. This is why proper pre-conception care is so important and why I have talked about it often before. We need for couples to look at their diet, their lifestyle, their alcohol intake, their stress levels etc. All these things in combination can affect ones fertility and chances of having a baby. Have a look at my post about the importance of preconception care 

Not everyone will be able to have a baby

There are also those couples, that despite the best medical interventions and help, that they may not be able to fall pregnant. This is really sad, but it is a harsh reality that some will have to face. You can read my post about why IVF cycles fail

But now they are more ways to have a baby then ever, with donor eggs, donor sperm, donor embryos and even surrogates.

Final word

There is a lot to know about fertility and many couples are unaware of the lack of regulation around the fertility profession. Many are literally at breaking point and for many of these it is really through lack of proper investigations, or seeing someone who is not properly qualified to be doing fertility work.

We also need couples to take responsibility for their own health and lifestyle and also be real about age related infertility too. It is all really overwhelming for couples, but the fact is that we still need to talk about it.

Lastly, you need to do your homework, when going to see someone for help with fertility. As mentioned previously the fertility profession is largely unregulated and there are a lot of practitioners out there, medical and complementary medicine, who really are dabbling, or who are not adequately qualified to be assisting you.

How I can help?

If you do need assistance with fertility issues, and do want to see someone with a masters of reproductive medicine and years of clinical experience, please give my staff a call and find out how my fertility program may be able to assist you. You can also look at some of my posts about my fertility program on my website too.  You can do our full fertility program or you can now do our new 3 phase fertility program too. There are also meet and greet appointments before joining the fertility program. Again for more information, speak to my friendly staff, or drop us an email.

I hope this helps those trying to have a baby better understand the fertility profession on all levels and seek the best help possible.

Regards

Andrew Orr

-Master of Reproductive Medicine

-Fertility Expert

-The International Fertility Experts

-No Stone Left Unturned

 

 

 

 

 

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8 Tips To Increase The Chances Of a Successful Pregnancy

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

Reduce stress

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

It takes two people to have a baby

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

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

Seeking the right advice and proper investigations

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

Getting a second opinion

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

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

Eat more protein and Essential Fats

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

Increase your Electrolytes

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

Regular climax

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

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

Not having enough sex and not at the right time

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

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

Getting the right help

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

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

genetics and fertility

Understanding How Genetics Play a Major Part in Fertility & Reproduction

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Understanding how genetics plays a major part in fertility and reproduction is very important. Many couples are completely unaware that their fertility issues and inability to conceive may in fact be from genetic, or hereditary issues that have not been screened for.

When it comes to fertility and being able to conceive more and more couples are now struggling. Some of this is due to increased stress levels, poor diet and lifestyle, increase alcohol consumption, lack of preconception care and many other factors. However, one key area that is not often talked about, or even known to many is genetic factors, chromosomal factors and DNA issues passed on through our sperm and eggs.

Fertility and reproduction is one of the hardest areas of medicine to understand. I am sure many people think that they understand it, but even with years of study and clinical experience, some questions just cannot be answered at this present time. No amount of “Dr Google” searching is going to bring answers for many couples and this is something that needs to be discussed more. Unless you have done years of study and clinical research into fertility and reproduction, you cannot understand the finer details and intricacies of conception. Even then, some answers are just not available to anyone at this present time.

The Reality of Fertility and Reproduction

The reality of fertility and reproduction is that just because an egg and sperm are put together, it does not mean that an embryo will be formed. Even if an embryo is formed, it does not mean that it will become a baby. Even if an embryo meets scientific grading categories (grade 1-4 etc), it still does not mean that the inner make up of that embryo is chromosomally viable. Even if the embryo is tested to be chromosomally viable (via PGD/PGS testing), it still does not mean that the embryo will go on to become a baby. This is the hardest thing for people to get their heads around and why we need to discuss this more. Quite simply, something that is supposed to seem easy really isn’t that easy at all. Reproduction and having babies is not as easy as many have led us to believe.

Chromosomal Errors

One of the biggest factors in embryos not developing, or IVF cycles failing, or even natural conception not working is chromosomal errors at the embryo stage. Even if both parents have normal karyoptype (46XX and 46XY) it does not mean that they cannot produce random chromosomal and genetic errors in their sperm and eggs. The thing is, the older we get, the more these errors occur and the harder it is to fall pregnant. An abnormal embryo with and abnormal number is cells is called aneuploidy. When an embryo has the correct number of cells it is called euploidy. Unfortunately, many couples are producing high numbers of aneuploidy embryos and this is why they are struggling to conceive. As mentioned before, just because the outer features of the embryo look fine, it does not mean the inner workings (chromosomes and DNA) are fine.

The Important of Genetic Screening

Speaking about chromosomal and genetics, when couples are struggling with fertility and being able to conceive, one of the biggest factors I see is that couples are not being screened properly. This is screening on all aspects, not just the standard blood tests and fertility investigations. Many couples that come to see me for help for fertility often believe that they have had everything done, yet most times I am finding that they have only had the basics done. Many couples have not even had basic genetic screening for karyoptype and genetic issues such as cystic fibrosis.

Understanding the Coding on DNA

Understanding the coding on the DNA is now having a profound practical impact on the practice of medicine today. This is particularly important in the area of infertility. There is increasing knowledge that there is frequently a major genetic component both from nuclear and mitochondrial DNA in couples with infertility or subfertility.

Significant examples include:

  • The demonstration of microdeletions on the Y chromosome in men with low sperm count (oligozoospermia)
  • The identifications of mutations in the Cystic Fibriosis gene in those with congenital bilateral absence of the vas deferens
  • The high rate of aneuploidy in normally dividing embryos after fertilisation in older infertile couples
  • The presence of an expanded triplet repeat in the androgen receptor in some men with low sperm counts.

Without seeing someone who has all this  knowledge of the molecular and genetic basis  of fertility many couples will continually have troubles trying to fall pregnant and may possible end up with repeated failed cycles in IVF too. There is so much to genetics and it is often overlooked in all areas of fertility these days. No amount of “Dr Google” is going to give you this information, nor will it give you understanding, unless you have a degree in reproductive medicine, or genetics. I do understand that people get desperate for answers, but unfortunately, sometimes these answers cannot be found by an internet search.

Other Genetic Factors Affecting Fertility

There are also other genetic conditions and chromosomal errors such as balanced translocations, reciprocal translocations, Robertsonian translocations, Turner’s syndrome, Kleinfelter’s syndrome, fragile X syndrome and many more. Again, many who are struggling with fertility issues and struggling to have a baby may not have even had some of these genetic screening done.

When I see couples, I also recommend advanced genetic carrier screening which tests for several hundred more genetically inherited mutations. Many fertility clinics do not recommend couples to do advanced carrier screening. Given that 1 in 22 couples are at risk of a hereditary gene mutation, it is really important to screen couples properly and not just do the basics.

Mutations in Genes

A mutation is a change in the information encoded in the DNA sequence. Such a change may result in the production of an abnormal protein, produce a truncated protein, reduce the levels of that protein, or cause it not to be made at all.

A single gene genetic disorder is one where an alteration in the DNA sequence of only one of the genomes 40,000 genes has resulted in significant pathology and disorders that affect the human body.

Such disorders include cystic fibrosis, Duchenne muscular dystrophy, Huntington disease and familial breast cancer. Although individually these disorders are rare, as a group, they are numerous and therefore important.

Cystic fibrosis, one of the most common autosomal recessive conditions affecting people of Northern European decent has a population incidence of 1 in 2,500.

To date up to 6,000 single gene disorders have been characterized and it is estimated that 14 per 1,000 people suffer from one of these conditions. A person who inherits a mutation in a single gene will carry that mutation in every cell of their body.

Mutations occur when a cell is dividing. The task of correctly copying 6 billion “bits” of information, the number of base pairs in the human genome, is huge and mistakes do occur. It has been established experimentally that these mistakes occur and are uncorrected in one in one billion base-pairs copied (or about 6 errors per cell division).

When a mutation occurs in the coding DNA sequence of a gene it may be a polymorphism with no effect or it may significantly impair the gene function. All mutations are thereafter inherited. Inherited or germ line mutations must be present in the egg or sperm. They are twice as common in sperm as eggs.

 Male Sperm Quality is a Big Part of Fertility Issues

Before everyone jumps to the conclusion that all failed cycles are related to women’s egg quality, I need to make it absolutely clear that men are half of the fertility equation. They are not exempt when conception does not take place, or an IVF cycle fails. As mentioned above many genetic mutations are twice more likely to be present in sperm than eggs. Up to 85% of miscarriage and chromosomally defective embryos are related to chromosomal errors that men have passed through their sperm.

Women’s eggs do have more errors as they get older, and eggs are not as viable as they get older, but men’s sperm are exactly the same. If men are not having their sperm quality managed while trying to fall pregnant, there is half your problem then and there. This is why all men are treated and managed on all levels of their health when doing my fertility program.

Sperm quality is variable and each time a man ejaculates the quality of that sperm can vary by as much as 20% at a given time. This is why men need to be continually looking after their health and sperm health while trying to conceive. Men are actually the bigger part of conception not taking place and we need to talk about this more. Men are not exempt when it comes to making babies.

Creating Life

Life does not begin with conception, but is simply a continuum from living cell to living cell with genetic information being transmitted through the genome from one generation to the next. A failure to achieve this is recognised as infertility.

At conception we are a single fertilized cell resulting from the fertilization of the egg by the sperm. The sperm contributes one copy of nuclear DNA, the egg the other copy and the mitochondrial DNA. That cell proceeds to divide, and over the course of 9 months (32 cell divisions) billions of cells are created, with specialized functions, forming complex tissues and organs that constitute the working human body. That first cell therefore must contain all the information necessary for embryological development, growth from fetus and then growth through to adult life. Without all the right coding and necessary information, life does not get created. This is also the answer to why so many couples are having problems trying to conceive.

The Importance of Seeing a Reproductive Medicine Expert

There are many factors to fertility and reproduction and why it is important that couples see someone who is a fertility expert. The fertility profession is largely unregulated and many who are now practicing in that profession are not experts at all. Many actually do not have further training and qualifications in reproductive medicine and are some of the reason why people are struggling to fall pregnant.

Final Word

Lastly, while we cannot change our chromosomes, or change genetic mutations, we can do things to change and improve our cellular DNA. This is why proper preconception care and preconception programs are so important. Everything we do, we ingest, we think etc, can be passed on to our future offspring via sperm and eggs. Health parents produce healthy sperm and eggs, thus producing healthy babies.

If you need help with being able to conceive, give my friendly staff a call and find out how my fertility program may be able to assist you. I use a ‘No Stone Left Unturned’ approach to assisting couples with fertility issues and will look at every aspect of a couples lives, including genetic and hereditary issues, to help them have the best chance of having a baby.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

Copy of Fertility Facts Being Overweight or underweight can adversely affect fertility

Being Overweight, or Underweight Can Adversely Affect Fertility

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It is important to have healthy weight and waist size when trying to conceive. It is know that being underweight, or underweight can adversely affect fertility.

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”

Metabolic Syndrome

Metabolic syndrome increases their chances of the following:

  • diabetes
  • heart disease
  • depression
  • gynaecological conditions (PCOS, endometriosis etc)
  • sperm issues,
  • egg quality issues
  • reproductive issues,
  • increased miscarriage
  • increased risk of certain cancers
  • infertility

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

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.

The importance of preconception care

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

Andrew Orr

– No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

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Lycopene Helps Improve Sperm Quality

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A new research study conducted by the university of Sheffield has shown that supplementation of Lycopene, a compound found in cooked tomatoes, has helped improve the sperm quality in a group of men.

Many studies have examined the role of dietary factors, antioxidants and amino acids and data from randomized controlled trials suggest that antioxidant therapy can improve sperm quality.

Health benefits of lycopene supplementation have been proposed for a variety of health conditions. This recent study examines whether 14mg of daily lycopene supplementation, for 12 weeks, can help improve sperm motility and sperm morphology in men.

Poor sperm quality

Poor sperm quality is a major contributor to infertility in heterosexual couples, but men are often overlooked and often are unwilling participants in the journey to have a baby. There is no doubt that sperm quality is declining and many couples inability to have a baby is actually coming from the male side of things, not the female side.

It is generally recognized that 50% of fertility issues are related to male sub-fertility and poor quality sperm. Typically, fertility problems in the male manifest themselves as ejaculates containing too few sperm (oligozoospermia), or sperm that swim poorly (asthenozoospermia), or sperm with poor size and shape (teratozoospermia) or a combination of all three.

Factors Affects Sperm Quality

Known factors that affect sperm are – Poor diet, obesity, alcohol, smoking, recreational drugs, steroids, medications, chemicals and environmental factors. There are also genetic and hereditary issues that affect sperm as well.

Women are often driving force behind fertility health

Women are often the ones being very proactive in whatever it takes to have a baby and will take supplements, improve their diet, and look at any way they can to help with conceiving. Unfortunately, getting men to do the same can be like pulling teeth and we need to start educating men of the importance of preconception care prior to having a baby.

Men offered very little advice about sperm health

Unfortunately many fertility clinics and healthcare practitioners in general, are giving very little advice and information around what men can do to improve their sperm. Many healthcare professionals are also only focussing on delivering general advice to highlight the known lifestyle risks for poor sperm quality. More advice around preconception care is needed.

Preconception care for men is a must

There is now lots of research about the importance of preconception care for men and lots of research on the importance of a healthy diet, lifestyle changes and the role of antioxidants and amino acids for sperm health and sperm quality.

This recent study could add to the ways that men can improve their sperm quality and help with the outlook for men with known sperm issues. This recent study could also add to existing research and could also lead to better ways to reduce the damaging impact of modern living on reproductive health. We really do need for all couples to know, that of all infertility cases, at least 50 per cent of the issue is due to male factors and poor quality sperm.

Lycopene increases sperm quality

This is the first ever double-blind randomised controlled trial to assess the impact of giving men a bio-enhanced form of lycopene (called LactoLycopene) to see if it helped with sperm quality. The team from the university of Sheffield discovered that the lycopene supplementation made no significant difference to sperm count and concentrations. However the rapid progressive motile sperm and the sperm with normal morphology increase by around 40% in response to the lactolycopene intervention. Rapid progressive sperm and morphology are the two most important parameters for sperm quality and for increasing chances of fertilisation and pregnancy.

During the 12-week trial half the recipients took LactoLycopene supplements and the other half took identical placebo (dummy pills) every day for 12 weeks. Neither the researchers nor the volunteers knew who was receiving the LactoLycopene treatment and who was receiving the placebo. Sperm and blood samples were collected at the beginning and end of the trial. The researchers were surprised by the improvement in the sperm quality shown by the results. The improvement in morphology and rapid progressive sperm was dramatic after lycopene supplementation.

What are Lycopenes?

Lycopene can be found in some fruits and vegetables, but the main source in the diet is from tomatoes. However, the bioavailability of lycopene from fresh tomatoes is low, but this is enhanced by a special natural processing technique of heating and infusing tomatoes with oil. As such, this study used lactolycopene, the main ingredient of which lycopene is embedded in a special protein mix for enhanced intestinal absorption.

This was the first properly designed and controlled study of the effect of LactoLycopene on semen quality, and it has spurred researchers to want to do more research into lycopene and well as other antioxidants and amino acids that may help with sperm quality. The research also shows the role these antioxidants play in helping inhibit the damaging effects of oxidation and oxidative stress.

Oxidation and Oxidative Stress Damage Sperm

Oxidation and oxidative stress is a known cause of damage to sperm and the sperm DNA. Lycopene is a powerful antioxidant that is potentially inhibiting oxidation and the damage of oxidative stress causes to sperm quality. Researchers believe this antioxidant is the key to improvements in sperm quality seen in this trial and could be an answer to the cause of many male fertility problems. More research is needed and the research team is hoping to embark on a new study as soon as possible.

Final Word

As part of my fertility program all males are educated on the importance of preconception care and about optimum sperm health. All men on my fertility program are given antioxidants and supplements that have been shown to assist with sperm quality and maintain optimum sperm health. Men are 50% of the equation of making a baby and why all men need to be included in any preconception care and any program to assist couples in having a baby.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

 

Journal Reference:

  1. Elizabeth A. Williams, Madeleine Parker, Aisling Robinson, Sophie Pitt, Allan A. Pacey. A randomized placebo-controlled trial to investigate the effect of lactolycopene on semen quality in healthy males. European Journal of Nutrition, 2019; DOI: 1007/s00394-019-02091-5