Tag Archives: Endometriosis

Nk cells nurturing baby

Natural Killer Cells Nourish & Promote the Growth of The Fetus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

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

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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

Knowing All Too Well What It Is Like To Live With Pain

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I often get asked how I know so much about pain and living with disease state and pain on a day to day basis. While I am a man and cannot truly understand what it is like to have a gynaecological condition and the associated symptoms, I can understand how pain can affect ones daily life and how hard it is to manage a chronic disease state.

You see, I too have a chronic disease state that was missed and dismissed for many years. It causes me pain when the disease grows back and the inflammation gets bad. It has required me to have multiple surgeries, because it was missed for so long. Even though surgery helps, it isn’t a cure and the disease can grow back and then start causing pain and associated symptoms again. Sounds a lot like endometriosis doesn’t it?

While I don’t have endometriosis, I do have a disease that is very much like endometriosis and just this week I have had my 7th surgery for this disease.

My disease state grows in my sinus cavities and it can cause such excruciating pain in my head and make me feel really unwell. It’s really hard to use your brain to shut off pain, when the actual pain is in your head and it feels like my head is going to explode. If the disease gets out of control too much, it could cause extreme pressure and actually cave the bones around the sinuses inwards, so it can be dangerous.  I wish someone had listened to me and helped me earlier on so that I wouldn’t have to have been going through the surgery again.

But, I have learned to find the right team to help me. I have learned to manage pain levels using a multimodality treatment approach. I have learned that diet and lifestyle choices can help me manage my disease state. This is why when I talk to all of you, I understand what you all go through and why I am so passionate about telling you all the facts and helping you get the right help and intervention. They always say that to truly understand pain, you have to experience it yourself. Unfortunately I know all to well how pain can affect the whole body, not just where the pain is orginating from.

While I know first hand how bad pain can affect ones life, I have also learnt that the disease does not define me. I am not the disease and I have made a conscious decision to be proactive with my health and not live and breath the disease.

While it is good to be educated and proactive about your health, it isn’t good to live in your disease and let it overcome you and rule your life either. It is about getting up each day, making healthy choices, pushing yourself to move forward and remember that it is all about small steps forward, not matter what is going on.

I found the more I focussed on my disease, the worse things became and I got caught up in the pain cycle and the disease took over and it just made things too hard on both a physical and emotional level. Sure, there are days when you will have a bad day and that is ok. I know I had days where I had to take painkillers and just get on with it and nobody would ever have known how much pain I was in. Sure, there are going to be days when it doesn’t seem fair and that nobody can truly understand what it is like for you. The main thing is to not live in the ‘poor me’ syndrome and not let the disease define you. It is about overcoming the disease and being you again. It is about finding your team to help you. It is about finding that support you need and not buying into the diagnosis and living in the disease.

The more positive you are, the happier you are, the quicker you will heal and the treatments will work better too. Whatever you need to do, you just need to go and do it. If that means seeing a counsellor, seeing a pain specialist, seeing a gynaecologist, seeing a nutritionist, getting some acupuncture, seeing a physiotherapist, seeing a chiropractor/osteopath, taking pain killers, taking herbal medicines, or whomever and what you need that can help you, then you need to do it.

I also know all too well how hard it can be to get started, but when you get started and you keep going and you find the right team of people to help you, that is when you get the results. Never underestimate the power of positivity and never think that all is lost and get lost in your disease state and symptoms. Even if you make two steps forward and then one step back, you are still moving forward. Try and do something you love each day and try and find joy and positivity in your day. It is so important.

Lastly, never ever just take one opinion and always get multiple opinions about what you are experiencing. This is why I offer a multimodality approach for people and offer a multitude of services like a one stop shop. It is why my motto is “No Stone Left Unturned” because I dont want to see anyone be missed and dismissed. The reason I do a multimodality approach and use and integrative medicine approach, is so I can help people as much as possible on my own and then only have to refer for things like surgery and some other specialty areas that I do not do.

Please remember that pain, no matter where it presents in the body, is a sign of inflammation and a sign that something isn’t right. It is a sign that something needs to be investigated and managed and is you are being missed and dismissed constantly, then you need to find another healthcare practitioner, or a team of healthcare people that can help you moving forward and get some sort of normalcy back in your life. If you can’t find the right person, or team, then book in and see me instead. I’ll make sure “No Stone is Left Unturned” and I also understand what it is like to live with pain. You wont be missed and dismissed at my clinic. Don’t forget that I can do online consultations for people that live interstate, aren’t local, or live overseas. I can be your eyes and ears and be your guide and coordinator too. I understand pain.

Take care

Regards

Dr Andrew Orr

Women’s and Mens Health Advocate

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

 

Early Intervention & Early Management Is Vital For Gynaecological Conditions & Menstrual Issues

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By now many of you would know my stance on Period Pain not being normal and that the sooner you get the cause treated and managed the better one is going to be in their day to day life.

Unfortunately not everyone knows that Period Pain is not normal and neither are some of the other symptoms women get each month with the onset of their menstrual cycle. Having heavy bleeding, bleeding in between cycles, menstrual cramps, severe pain, irritable bowel like symptoms, dark clotting, ovulation pain, bowel and bladder pain and urgency etc, are all not normal symptoms that a woman should endure with her cycle. Getting these symptoms at any time of your cycle is not normal either.

Early intervention and early management is the key to any disease state in the body and this definitely applies to menstrual issues and gynaecological disorders. Once a disease is expressed into the body, it can be very hard to treat, especially if it is left a long time and then inflammation spreads to other parts of the body, or in close proximity to where the initial disease was first expressed.

One of the reasons that prompted me to do this post was after a young woman, now in her 30’s, had contacted me and thanked me for helping her back when she was in high school. Since then I have known all of her family well and helped with maintaining their health. At the time she was about 14 years old and showed all the signs and symptoms of endometriosis. She was in so much pain each month, when her cycle came, and she was often curled up on the floor with nausea and vomiting from the pain. Everyone, including GP’s etc, had told her this is normal and that she needed to get used to it. They also told her that she is too young to have endometriosis, or any major gynaecological condition.

That is so bad. Please, please know that period pain IS NOT normal and that teenagers are not too young to have endometriosis. To be honest, they are now finding endometriosis in young girls under 10 years old. Many gynaecological issues can start very early on in a woman’s life, especially if there are hereditary factors involved.  Gynaecological and menstrual issues can be passed from generation to generation, so if mum, or your grandmother, or someone in your family tree had menstrual issues, or a gynaecological condition, there is a good chance that you may inherit this as well.

The long and short of it all was that her mother was also getting frustrated at everyone not helping and somehow ended up finding out about me and ended up in my clinic. From there I got her into one of the advanced trained laparoscopic surgeons I work closely with as soon as possible and this is where stage 4 endometriosis was found and excised properly.  Without coming to see me, this poor girl would never have found the cause of her menstrual pain and associated symptoms. I then did all her management of her disease moving forward. The main thing that this young girl and her mother were worried about was how this was affecting her education and daily life, but how this could also affect her future fertility.

The one thing I know is that the sooner there is intervention and treatment, the better the prognosis for a woman’s future fertility is. The one thing I do know is that endometriosis doesn’t always cause infertility, but it can make it harder to fall pregnant, if it isn’t managed early enough. The longer you leave a disease in the body untreated, the worse it gets, and then the symptoms get worse and the worse the future outcomes may be.

Lucky for this young lady is that she did have early intervention and management and she has proudly messaged me to tell me that she has had her 3rd child and that she puts it all down to me helping her when she was younger. I have many women message me and tell me much the same thing. It is so important not to leave these things just because you are being told it is normal. What the hell is normal about being in so much pain that you feel like you could die?

All too often I see women having gynaecological conditions, like endometriosis, missed and dismissed and that the longer that the disease has been dismissed, the harder it is going to be to treat. That is a sad fact for many women and some will have to endure repeated surgeries due to being missed and dismissed and have a life of issues, if their issue isn’t managed properly either. Many have not seen the right healthcare professionals, or the right surgeon either.

I have discussed in many of my previous posts.  Please have a read of my previous posts about this subject and the seeing the right team of people. This is why it is so important to have early intervention and also see a proper advanced trained laparoscopic surgeon who specialises in the excision of disease states like endometriosis. Then there needs to be proper management and treatments and lifestyle changes administered to help with suppression of the disease state, helping with inflammation and improving quality of day to day life.

There needs to be a multimodality/team like approach to the management of women with gynaecological issues, as there is no one single fixes all approach, with any medicine. While surgery may be a necessary part of the overall management of disease states such as endometriosis, it isn’t the saviour that many perceive it to be. Surgery does not sure endometriosis and there is no cure for the disease at present time. Once you have it, it is there for good.

Surgery is a necessary but small part of the overall picture that needs to combine many other treatments and modalities to give the best outcome for a woman overall. Once the surgery is done you need to look at managing and suppressing the disease and this is done by lifestyle changes, dietary changes, acupuncture, physio, herbal medicines, hormone therapies, pilates, yoga, pelvic floor and core exercises and many other modalities depending on one’s individual symptoms.

When I treat women with gynaecological conditions, or menstrual issues, I make sure they all get an individualised, person centred, caring approach tailored to how they are presenting rather than a one treatment for all approach that many seem to get. You won’t get the results you need that way because we are all individuals with different needs and different symptoms overall.

Lastly, please remember that period pain and menstrual irregularities are not normal and that the earlier you get onto it and get it treated and managed, the better your future outcomes will be.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

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Stop Telling Women That Period Pain is Normal

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After seeing my 10th case of misdiagnosed Endometriosis this week, and goodness knows what else, I can say that I am well and truly over it and about to scream.

I am about to scream if I hear that one more woman, young or old, is told by their healthcare professional, GP, specialist, best friend, mother, facebook buddy etc, that period pain is normal.

Period pain IS NOT normal. It is far from normal and we all need to stop telling our daughters, sisters and women of this world that it is.

I think that anyone that says that need to come and work with me for a day and see the ramifications of women believing that period pain is normal, just because their doctor, healthcare professional, friend, or mother told them that it is.

I think I should post up some rather gruesome pics of women’s reproductive organs stuck together, their insides bleeding, and their pelvis completely obliterated. Yes, obliterated. That was the words that one of the surgeons used today to explain the insides of a woman that had been told that there is nothing wrong, just suck it up, scans haven’t found anything and just go on the pill and btw, period pain is normal.

No it bloody well isn’t (sorry for swearing but time for diplomacy is over). Women need a voice and need to be heard. Some of these poor women may not be able to have children, or have a healthy sex life, or be able to feel the pleasure of wonderful sex without pain, or ever hold their own baby, because they have been told to suck it up and be told that period pain is normal.

Period pain IS NOT normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal. If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Please get them to get a referral and see a good specialist who will listen to them and not dismiss them and may miss a gynaecological issue that could affect them for the rest of their lives. No… scans and blood test etc, do not always find the cause of period pain. Have a read on my other posts about this.

If you cant find someone that will listen and help, then book in a consult with me and I will assist you in getting you properly investigated and properly managed moving forward

My motto is “No Stone Left Unturned”and my other motto is “Period pain IS NOT normal”. If you are in pain with your menses, or even any any other time during your cycle, or having pain with sex, or pain with ovulation, pain with bowel movements, pain for no known reason at all, then you need to get something done about it.

I think if I hear one more poor woman get told that Period Pain is normal, I am going to start sending those people gruesome pics of all the insides of women who have been told that period pain is normal, only to find out that it isn’t and all the reasons why.

Sorry for the rant, but our daughters, our sisters, our wives, our female partners and women all over this world deserve better.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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Getting a handle on pain with proper pain management

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One of the things that I see not managed very well is pain. I think much of this comes around a perception that we should be able to manage pain with over the counter medications and some of it is also not really knowing what to do, if what we are doing for ourselves, or are currently doing, isn’t working. Some of it is also that healthcare practitioners aren’t managing it well either.

Now, before I start talking about pain, and so that people understand where I am coming from, I need for people to know one thing.  Everyone’s pain levels are different and everyone’s cause of pain is different too.

I also know what it is like to live with pain daily and manage a chronic condition that causes pain and affects one’s life. So I understand pain and understand it well and I sympathise with anyone who is in pain. So I just ask for people to take the personal out of this, just listen and hear what I am going to say.

Again I have lived with chronic and acute pain daily and I know what it is like and I have loved ones who have to manage it daily as well. So what I am about to talk about is coming from a place of caring, wanting to help and also knowing how to manage pain on a clinical level as a healthcare professional.

Every day I see people posting in closed groups asking for help with pain and things they can do to manage pain. It breaks my heart hearing what some people put up with, or if I see they aren’t being told the right thing, or being clinically managed properly.

Often I see people putting up with pain because they fear going to the hospital, seeing their specialist, seeing someone else,  or that they should be able to handle it themselves.

No matter what, constant and acute pain is not good for the body and it also means that there is something wrong and it needs to be attended to. The longer pain is there, the more damage it does to your body on a cellular level. Long term pain causes cellular death and disrupts nerve pathways, pain pathways and emotional pathways to the brain too.  This is why proper pain management is so important.

The thing is, pain needs to be managed, just like any other health issue, and if it isn’t managed, or managed well, then it can really affect ones physical and emotional wellbeing. I know people will say that long term medication isn’t good, and it isn’t, but long term unmanaged pain can be far more detrimental than any long term medication. It truly is a catch 22 situation.

When pain gets to a point where over the counter medications aren’t working, or even some prescription medications aren’t working, then something needs to be done about it.

This either means surgical intervention, or it means that you need stronger medications and you need this in the form of proper medical management of that pain.

It may also means other therapies and treatments outside of what you are currently using and being managed with. It also requires working on the emotional pathways that may also be exacerbating pain. This is why talk therapy and working on emotions is such and important aspect of pain management. You need that multimodality approach for proper effective pain management.

Many times when I hear that people are in pain, one of the things that stops them doing anything is that they perceive that nobody is going to help them because what they themselves have tried, hasn’t worked.

I wish I could get it through to people in pain, that the best thing they can do is go and get the pain managed properly. This often means a trip to the nearest hospitals emergency department and I think this is where people then talk themselves out of it. It is always better to go and be managed properly, than sit at home still in pain. Once pain is managed properly, then you need to see someone who can help your pain, and your condition properly moving forward.

When people come to see me and then I have to refer them for surgery, one of the things I always talk about and have an action plan for is pain management. I always tell my patients to properly manage pain after surgery and even do precautionary pain management post-surgery.

I always give my patients a handout and action plan for pain management, whether they need it or not.  After surgery there is often a bit of illusion state around pain, because there have been anaesthetics used and other heavy duty sedatives. So often people wake up in recovery and think the pain isn’t as bad as it is, because it is being masked from the anaesthetics.

Then they go home and don’t bother to keep up their pain meds and then the pain kicks in and then it is really hard to get back on top of it again once it starts. Once the pain cascade starts, then it is really hard to then try and get back on top of that pain yourself.

This is why it is always good to take precautionary pain medications for a few days (or longer) post-surgery and then taper them down and start using some other alternatives to manage the pain. I’ll discuss some great alternatives for pain management later on, but for now, let’s just talk about the medical and pharmaceutical options.

The basic same principles also apply to people who have flare ups with pain, or have chronic, or acute pain. It needs to be managed and it needs to be managed as soon as possible. The longer you are suffering in pain, the harder it is to treat and get under control.

Sure, try all the conservative treatments for pain such as over the counter medications, herbal medicines, acupuncture, yoga, meditation etc, but if those aren’t working well enough, or aren’t working at all, it is time for medical intervention. The same goes in reverse too. You also need to look at the emotional aspects and cause of pain too. Again, you cannot treat one without the other.

Sometimes the body has been in pain that long, that you also need to turn that response off, because it has actually become a habit, rather than the body actually still being in pain. This one is a bit tricky to explain to people, but in essence what we need to do is actually tell the body it isn’t in pain any longer, so that it switches off that response in the brain.

Getting back to acute pain, and when pain is getting out of control, this is where I need people to listen. Many times I see people posting in groups, telling their support group and that they are in pain and saying things like that they feel it would be pointless to go to the hospital, as they usually do nothing to fix their issue.

The thing is sure, emergency departments aren’t there to fix chronic conditions, but, they are there to help you get out of pain, or patch you up, and then refer you on for appropriate management if need be.

Now, before I talk about this next bit, if you are in acute pain and do not know what it is from, you need to go and get that pain looked and get it under control. You can either consult with your healthcare provider (GP etc), or go to your nearest Emergency centre.

Speaking about emergency centres and hospitals, I need to let people know that there is no shame in going to these places to get your pain under control properly.

I also need people to know that emergency centres (A&E) are not there to fix your long term issue. They are there to assess imminent danger, control pain etc and then patch you up and refer you on to other specialists in the field of what your particular issues is. That is it.

All too often people do have a perception that if they turn up to emergency department, their long term health issue is going to be fixed. That is not their job. Again they are there to assess danger, control pain, stop your dying (if that is needed), then refer you on for appropriate management.

Sometimes that means staying in hospital until you are stabilised. All too often I hear people saying that they went to emergency and they did nothing. Well, I doubt they did nothing. They would have assessed you, medicated you (if necessary) and if your condition isn’t life threatening, you would most probably be sent home. That is what they do.

This gets me back to those in pain and are trying to talk themselves out of going to hospital, because apparently, through past experience, or someone has wrongly told them, that they won’t be able to help you. This is wrong.

If you are in acute pain, you are best going to your closest emergency centre, where trained people, not our untrained internet buddies, can assess you properly and then help you with pain and stabilise you.

If all emergency do is control your acute pain and make sure you aren’t dying and are stable, then they have done their job. Controlling someone’s pain can actually stabilise the body in more ways than one. Once that pain is stabilised, then what you need to do is ask them for medications to be continued to actually help with the pain cycle.

You can also continue on with previously prescribed medications to control that pain, now that stronger medications have been administered and your pain levels have lowered. This then buys you time to see your regular healthcare provider as soon as possible and talk about a better pain management plan.

If that said provider isn’t managing you properly, then you need to get a second, or third, or tenth opinion. Look, every profession has people who are not good at their job and some healthcare professional are crap at things like pain management. So, find someone who can help you with ongoing pain management. If you can’t find someone, then message me for details of someone who can. Better still, book in a consult to see me, where I can assist you and your condition and help you get the best help, advice, care and proper health management possible.

There are now also some pain modulators (neuro-modulators) and implants that are being used to control pain too. People are also getting great results with botox and other injectables. There are many options for pain management now and as said before, it does require seeing the right people and also using a multimodality treatment approach.

This also requires working on the emotional aspect too. Yes, I am mentioning it again so people finally get that we also need to deal with the emotions, if we are to manage pain properly.

Last but not least, sometimes you need to look outside the medical model, for help with pain. Actually I believe it is essential. Sure, get your acute pain managed with medical intervention, but you may also need to look at complementary medicines for ongoing pain management, especially chronic long term pain.

No medicine has all the answers, so this is why I am very passionate about people using a multimodality approach to their health issues and especially for pain management. I always say to people that if what you were doing currently is helping, then you wouldn’t be in pain and if you are still in pain, it means you need to change something, or look at other ways to manage it. Unfortunately while modern medicine saves lives and can help us in so many ways, it doesn’t have all the answers either.

If you aren’t getting the help you need, then book in a consult with me and I will do my best to get you the help and care you deserve and should be getting. I also have a great network of trusted professionals I work with if it is outside something that I do, or if you need that team approach for your condition. I have my trusted team and that is what you may need too.

One more thing, for anyone, pain is the sign that something is wrong in the body and means it needs to be addressed. Oh and always remember, period pain is not normal either.

Take care

Regards

Dr Andrew Orr

-Women’s & Men’s Health Advocate

-No Stone Left Unturned

-The Women’s Health Experts

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Can we always blame hormones being out of balance, for women’s health issues?

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Often I see people posting that the source of all women’s issues is their hormones being out of balance. While sometimes this may be true, saying that the source of all women’s health issues is hormones being out of whack is not completely true. Sure, hormones may have a bit to do with it, but is it all erratic hormones?

Hey, it is good to blame something, but is it really fair to keep saying that women are all just an imbalance of hormones, when they are just having a bad day, or just don’t know why they are feeling the way they do?

The fact is that when I consult with women and they tell me that they, or their partner, or family etc, think they are a hormonal mess, I always have to tell them that this may not necessarily be so. More often than not, when I do my work ups on women, their hormones are actually normal and not out of balance at all.

So why would a woman be feeling like she is out of balance if her hormones are all in normal range?

Well, the answer to that is…. “How long is a piece of string?”

Yes, this is one of my favourite saying because, with any health issue, or imbalance in the body, you need to look at the individual and what the individual has been doing.

When I consult with women about these issues I will always go through a thorough history and testing with them and find out the following

  1. Are they stressed?
  2. Are they sleeping?
  3. Have they had a major upset in their immediate environment?
  4. Are they eating well?
  5. Are they drinking too much alcohol?
  6. Are you taking medications, or recreational drugs?
  7. Are they having too much sugar?
  8. Are they exercising?
  9. Are they taking time out for self?
  10. Is their partner the source of their moods and ill health?
  11. Do they have a gynaecological condition that has, or hasn’t been diagnosed?
  12. Have you had a health condition, or virus, or some other long standing health issue?

There are so many things that can affect a woman’s moods and wellbeing. Stress is probably the biggest factor, followed by lack of sleep and poor diet. High sugar intake also causes inflammation and can affect hormones, but it can just affect your moods. Poor diet and high sugars can also affect gynaecological conditions and affect an upcoming menstrual cycle too.

Having a big drinking session on the weekend, or just a few drinks during the week can seriously affect your health, moods and motivations. Try not drinking for a month and see just how much better you will feel and how much better you wake up in the morning. A big binge drinking session on the weekend can affect you for a week afterwards

Lack of exercise can be another big factor in feeling tired. It is a catch 22 situation. When you are tired you don’t feel like exercising, but sometimes you are tired because you aren’t exercising. Exercise keeps the body feeling fit and moods better and your menstrual cycle better too. Not getting enough sleep can seriously affect your body on all levels.

Lack of sleep will not only make you feel tired, grumpy and teary, but it affects everything. Lack of sleep and too many bright lights in your room can affect your melatonin levels too. Melatonin is also responsible for conversion to serotonin, which is what helps moods as well

Too much stress and running on adrenalin does not help the body either. The body goes into this hyper-activated state and that can cause low grade anxiety and also affect the moods and the body’s energy levels. We also need to check if a woman is suffering depression and this is the cause of her health issues, or why she may seem out of sorts.

Then, you could have a gynaecological issue that is causing inflammation in the body and then being exacerbated by things you are doing in your life too. Some gynaecological issues are asymptomatic, but can cause issues with your health, your moods, your energy and yes, your hormones. But, many women with gynaecological issues actually have normal hormone levels, so it isn’t always hormones causing gynaecological conditions either.

At certain times of the year, we are more prone to colds and flu’s and viruses and these can affect our health, our energy, our moods and our systems as a whole. Some post viral symptoms are worse than the actual virus and can last long after the virus symptoms have subsided.

Chronic pain can also throw the body into a state of shock and affect both the moods and the bodies ability to function. Inflammation can play real havoc with a woman’s body and her health.

There are so many things that can affect a woman’s body and it as we can see, it can’t always be blamed on hormones. There are so many other factors to consider, which can affect a woman’s energy, her moods, her concentration and her daily life.

So next time you are feeling a bit off, or a bit moody, or teary, or tired, don’t be so quick to dismiss it as just being hormonal. It may have nothing to do with hormones at all. If someone else tries to dismiss you as being hormonal, maybe it is time to be hormonal like and tell them where to go. Politely, but firmly of course.

If you are feeling like there is something wrong with your body, or you feel out of balance, it is a good idea to see your healthcare provider and get some basic testing done and delve a little deeper into why your body isn’t feeling the best it could be.

I always make sure I get a thorough history off women and listen to all of their concerns so that they aren’t just dismissed as just having their hormones out of whack. They may be, but it is best to check first and that isn’t hard to do.

I think too many women are just dismissed as being hormonal, or that it is hormones out of balance. Nine times out of ten, it is often something else. Let’s not forget that as we get older, we do start to slow down more too. But, let’s not talk about that one as that could be a whole post on its own.

If you would like to book in for a consultation with me, then please call my friendly staff and they will be able to look after you and explain everything to you as well.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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Asking the Right Questions about Period Pain & Gynaecological Issues.

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

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

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

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

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

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

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

It read “Hey Dad, is endometriosis hereditary?”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Care Advocate

-The Endometriosis Experts

-The Women’s Health Experts

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

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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