fertility 1

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

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

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

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

 

Fertility and a piece of string

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

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

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

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

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

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

Regards

Andrew Orr

-Master of Reproductive Medicine

-No Stone Left Unturned

-The International Fertility Experts

Fertility

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

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

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

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

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

Let’s talk about the facts

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

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

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

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

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

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

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

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

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

The fertility profession is largely unregulated

1.The medical side of things

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

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

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

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

2. The complementary medicine side

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

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

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

There needs to be better regulation

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

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

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

So how do you know whom to see?

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

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

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

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

See someone who specialises in fertility and reproductive medicine

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

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

Many couples are having the basics missed

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

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

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

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

Males are not exempt from fertility issues

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

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

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

Proper fertility evaluation and testing

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

Proper testing should involve at least the following:

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

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

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

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

Expectation versus reality

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

Age 

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

Preconception care

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

Not everyone will be able to have a baby

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

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

Final word

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

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

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

How I can help?

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

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

Regards

Andrew Orr

-Master of Reproductive Medicine

-Fertility Expert

-The International Fertility Experts

-No Stone Left Unturned

 

 

 

 

 

3 Phase Fertility Program Facebook 1

New 3-Phase Fertility Program & Why We Are Doing It

We are now offering a step by step new 3-Phase multimodality fertility program for those who need assistance with being able to have a baby. In the next follow-up post I will explain it a bit more in depth and what the phases involve.

We already offering a full multimodality fertility program which covers everything couples/individuals will need for their journey to have a baby. For more information on the full program please click on the link- Dr Andrew Orr’s Full Fertility Program 

My motto is “No Stone Left Unturned” and I don’t offer quick fixes

My motto is “No Stone Left Unturned” and I apply this to every person I see. I also have a master in reproductive medicine and have been assisting couples/individuals with fertility issues for over 20 years. I have helped over 12,500 babies with my program and part of this is because I don’t do things by halves and I look thoroughly into every person’s health and reproductive history.

I don’t do things by halves and with fertility and reproduction there is not quick fixes. If you aren’t able to conceive there is something drastically wrong and it needs to be investigated properly and appropriate management and treatment administered. This goes for both men and women. As I always say, fertility is not just an issue that women need to work on. Men are an equal part of the equation.

While my motto is “No Stone Left Unturned” and I will never do things by halves, or give people the quick fix, unfortunately there are many out there who will. Unfortunately people also want the quick fix and won’t invest in anything that they perceive will take them time. It is just the world we live in these days. Everyone wants a quick fix and immediate gratification. But, when it comes to fertility and reproduction, perception and reality become apparent very quickly and many couples/individuals end up on the fertility round about for years.

My full program and the new idea for the 3 phase program

My full program is very extensive and includes a lot of things than many just do not realise. The program cost is inclusive cost up front and even so, it probably should be twice the price. But, with all that goes into it and what is involved, many couples/individuals find that a bit overwhelming as they want they just want the short cut and answer to have a baby.

My daughter runs my reception and takes all my patient enquiries and a few weeks ago we spoke about creating a separate program, which may be less overwhelming for couples/individuals. This is where we came up with the 3-phase fertility program.

This way couples can do things step by step, rather than everything up front, and pay for each phase they do, rather than an all-inclusive price up front *

The New 3-Phase Fertility Program

Couples/individuals* can now come and see me for an extensive 2 hour consultation and fertility education without having to commit to the full fertility program. This is phase 1. They have to fill out questionnaires prior to coming and will be given a 10-20 page report of findings and ongoing management plan. From there they can then go away and absorb everything and decide if they want to commit to the rest of the fertility program, which is then phase 2 and phase 3.

The cost is a little cheaper than the full fertility program and you pay for each phase, rather than an all-inclusive fee up front. You don’t get everything that is included in the full program, but it is another option for couples who need advice, who are unsure what they want to do next etc.

It would be a little strange to just do Phase 1 only, as you would have all this advice and plan set out, and then not be able to do anything with it. But what it does is allows couples to digest things and talk over all their options etc, before they commit to phase 2 and phase 3.

My mission 

I want every couple, or individual wanting to have a baby to have the best advice and care before heading into the journey of becoming a parent. The new 3 phase fertility program gives another option for this. It also makes things a little less overwhelming while still giving couples the “No Stone Left Unturned” approach that I always provide everyone. I will never do quick fixes, never cut corners, or try to cheapen what I provide to anyone. But, I will always look at ways I can meet people half way and this is what we have done.

Couples/individuals * can still do the full Fertility Program if they want, but now they have another option they can look at also.

I will explain the new 3-phase Fertility program option in a follow-up post. To find out more the best thing to do is call my clinic and get the full information and pricing from my staff. If you do need help with having a baby, or struggling to fall pregnant, please give my friendly staff and they will go over every option of how my fertility programs may be able to assist you. Yes, we do see couples from remote places, interstate and those overseas as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts.

*Conditions apply. Please ask our staff about these conditions. 
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Soft Drinks/Sweetened Drinks Reduce a Couple’s Chances of Conceiving by 30 Percent

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

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

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

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

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

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

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

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

Nk cells nurturing baby

Natural Killer Cells Nourish & Promote the Growth of The Fetus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

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

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

  1. https://doi.org/10.1016/j.fertnstert.2012.07.849
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Vitamin D May Increase Fertility & Assisted Reproduction Success Rates.

Research has shown that there is a relationship between a woman’s vitamin D status and the success rates of assisted reproduction therapy(ART), which includes IUI, IVF and ISCI.

While this is research is nothing new, and something I have been promoting for years, finally it is now official. Women trying to conceive should be taking vitamin D supplements, eating vitamin D rich foods, and getting a healthy dose of the sun daily.

Infertility, or what we call sub-fertility, is becoming an increasing problem and affects millions of people worldwide. More and more people have to turn to assisted reproduction therapy (ART) which now means more and more people are having to use IUI, IVF and ICSI.

The problem is that even with assisted reproduction therapy (ART), at best the success rates are only around 25- 30% on average, and that depends on the clinics individual success rates. Some clinics are also inflating and bodgying success rates to bring in unsuspecting customers.

While there has been much advancements in assisted reproduction (ART) such as IVF and improvements in success rates, the success rates not increased a great deal.

This is why couples need to look at all options and look at preconception care to help increase those success rates. This is why I have set up a fertility program to help educate a couple and assist a couple in everything they need to do in order to increase their chances of a health pregnancy. Couples need to look at a multimodality approach to increasing their chances of conception and this is something is also part of the fertility program.

I often explain to couples that it is like preparing for a marathon; because that is what doing ART can be like. You need to prepare the body (both the man and woman), get the right diet, get the right nutrients, prepare mentally, prepare physically and basically get the bodies into the best shape possible to give the best success. Nobody should ever run a marathon without adequate preparation and the same goes for assisted reproduction.

Vitamin D and reproduction

Researchers across the board know that there is room for improvement in ART success rates. A range of potential factors are being explored, and some scientists have turned their attention to the potential role of vitamin D. While vitamin D is something that needs to be explored, and something that I give to my patients, it needs to be combined with other things mentioned above. It isn’t just as simple as taking Vitamin D and all your fertility problems are gone. But, it is one of the things that can help increase your overall success rates and should be used.

Most of our vitamin D supply is generated in our skin after exposure to sunlight. We do get some from our diets as well. This means that individuals who live in colder or darker environments are more susceptible to lower vitamin D levels, or those who regularly wear clothes covering the majority of their skin, and those who rarely go outside.

The problem these days, many of us have jobs that require us to be inside most of the time and therefore were aren’t getting enough sunlight. The current figures actually show that up to 97% of Australians, and most probably other countries like the US are the same, are actually vitamin D deficient.

The other issue is that even though some of us do get out in the sun, it actually needs to be at a certain time of the day, for optimal absorption. The optimal times are 10am and 2pm in the afternoon. The thing is, most of us aren’t getting out in the sun at these times.

A link between vitamin D and fertility has been theorized for many years and based on a number of observations and studies.  This is one of the reasons I have been promoting the use of Vitamin D for more than 20 years now, for those who are on my fertility program. For instance, vitamin D receptors and enzymes have been found in the endometrium.

This is why Vitamin D may be beneficial for women with gynaecological issues such as endometriosis, adenomyosis and other gynaecological conditions.

Vitamin D deficiency has been shown to increase the risk of pre-eclampsia, pregnancy-induced hypertension, gestational diabetes, and lower birth weight. Vitamin D is also essential for a health immune system and reducing inflammation in the body too.  It also helps with bone health.

We have also seen that in animal studies, vitamin D deficiency causes poorer fertility and reduced function of the reproductive organs. Many of our breakthroughs in medical science, actually come from animal studies first, especially when it comes to ART and IVF. Many cows and other animals are now impregnated using ART and advancements in this area have helped with human studies.

Vitamin D deficiency and lower success rates

Getting back to the feature studies, Vitamin D was shown to help women undergoing IVF, or intracytoplasmic sperm injection (ICSI), frozen embryo transfer, or both.

All the participants’ vitamin D levels were checked by blood test. What people need to know is that many of the reference ranges still used  are actually under review and that if levels of vitamin D in the blood are under 100 Nmols\L, then you need to be supplementing. Anything under 75 Nmols/L is actually deficiency in vitamin D.

This analysis of the current research showed that when women, who underwent ART and had adequate vitamin D levels, were “one third’ more like to have a successful live birth compared to those who were deficient. When compared with women who had insufficient vitamin D concentrations, those with sufficient amounts were “46 percent more likely” to have a clinical pregnancy, and “34 percent more likely” to have a positive pregnancy test result.

Vitamin D is something that I promote and all of my fertility patients are on, as well as other beneficial supplements, diet, emotional support, and medicines etc.

Before you run off trying to buy vitamin D just remember it is just one thing that can help, and it isn’t a miracle cure, but, it may help.

Lastly, before using any supplementations, please consult with a qualified healthcare professional and please don’t self-prescribe, or buy products of the internet. Make sure you buy practitioner dispensed supplements only, which are known to be of the highest quality and not filled with all sorts of things such as heavy metal, low levels of arsenic, toxic fillers etc, which is what some supplements off the internet can have.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

References

  • Abadia L, Gaskins AJ, Chiu YH, Williams PL, Keller M, Wright DL, Souter I, Hauser R, Chavarro JE . For the Environment and Reproductive Health Study Team. Serum 25-hydroxyvitamin D concentrations and treatment outcomes of women undergoing assisted reproductionAm J Clin Nutr. 2016104 :729–35.
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The Truth About Natural Killer Cells & Miscarriage

On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells may only be attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.
  24. There is now new evidence that shows that natural killer cells help with implantation and a healthy uterine environment, which now supersedes old outdated research.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly.

This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) may be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells.

You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

As part of my fertility program, I talk to couples about the facts about Natural Killer cells, and makes sure that proper investigations, testing and treatments are administered and managed properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.