Male Infertility Has Experts At A Loss

Male InfertilityAn interesting article by Rosanna Ryan has been posted on the ABC website. It essentially was an interview of Professor John Aitken from the University of Newcastle. The main point of the interview was that there is an over clinical focus on female infertility and more efforts should be made to consider male infertility.

Prof Ryan said there is a shortfall in expertise and knowledge of male infertility. He claimed this has created a situation where females are forced to undergo IVF treatment because there is not enough understanding of what is wrong with the male. He expressed a concern over there being few specialists in the field of male infertility. More interesting he said andrology (which considers male reproductive health) is ten years behind its female equivalent.

Statistics indicate most men are able to produce the right amount of spermatozoa to fertilize an egg. The issue is the sperm’s lack of ability to enact the fertilization. Approximately one in 20 men are infertile and there are many more who suffer from subfertility. Prof Ryan said medical experts do not know why. The aetiology (cause) of male infertility is not understood.

In contrast, Chinese Medicine theory has a clear understanding of male infertility within it’s paradigm. This will be the topic of next week’s blog post.

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Pelvic Inflammatory Disease: It can reduce your pregnancy chances.

Pelvic inflammatory disease can reduce your chances of falling pregnant. It is caused by a bacterial infection which starts in the vagina and/or cervix and spreads throughout the pelvis causing inflammation. The infection which leads to PID can come from numerous sources. For example, the bacteria can be initially caused by sexually transmitted diseases as well as childbirth, or even when just having an IUI fitted.

Please be aware PID can reduce your chances of conception. This is especially the case for instances of PID which are the result of a sexually transmitted disease. A common side effect is damaged fallopian tubes and increased chances of an ectopic pregnancy. You also need to be aware the disease can also affect the health of a foetus. During gestation it can cause both physical and mental side effects to unborn children and it also increases the risk of miscarriage.

The symptoms which are indicative of PID are:

  • Pain in the lower abdomen and/or lower back;
  • Pain or discomfort during intercourse;
  • Irregular vaginal discharge with a strong odour;
  • Pain when urinating;
  • Heavy period or bleeding between periods;
  • Pain or discomfort in the legs;
  • As well as nonspecific symptoms such as fever, vomiting or nausea.

If you have any of these symptoms and you are trying to fall pregnant, you should seek the advice of your doctor. It is also important to be aware that PID can be asymptomatic and some women have been infected and have been unaware.

Infertility: Do you underestimate your chances?

A recent study caught my eye on the overestimation amongst men and women on their likelihood of being infertile.

The study was conducted at the John Hopkins Bloomberg School of Public Health in Baltimore and will be published in the March edition of Perspectives on Sexual and Reproductive Health. The researchers surveyed 3.2 million women and 2.6 million men and asked each subject to assess their own fertility. The study found 19% of American women aged between 18-29 years of age believed they were infertile, and 13% of men believed they were infertile. In both instances the perception of infertility was far greater than is actually true. In reality, it is well accepted that only 6% of American couples are infertile.

Why is there a tendency to underestimate our own personal fertility? This question was addressed by the researchers. One of the possible explanations was attributed to sex education and public health messages. For obvious reasons, such messages are often oversimplified and exaggerate the likelihood of a pregnancy. This has caused many to believe that if a pregnancy has not occurred after several or even as few as one act of unprotected sex, they must be infertile.

Many of the IVF clinics recommend fertility treatment as soon as after six months of trying to conceive. Realistically 85% of couples are unable to conceive after one year of trying. Yet very few of these couples are truly infertile. From a clinical perspective, all this misinformation serves to do is unnecessarily induce stress into the process of conception.

What do you think? Do those in the fertility industry purposely misinform prospective patients for the benefit of profit? Why is there an absence of public health programs designed to give a more realistic gauge on falling pregnant? 

TTC: Promise of unlimited eggs.

For many years now there has been a general consensus that women have a limited amount of eggs they can produce within their lifetime. A new study headed by Jonathon Tilly from the Massachusetts General Hospital has challenged this long held belief.

The research examined both humans and mice. They found that oogonial stem cells (OSCc), which are present throughout a female’s adult life until menopause, can generate oocytes. This was true for both humans and mice. Oocytes are immature ova which in turn become eggs. For ethical reasons the study had limitations on the involvement of the humans. The research on the mice however had less rigorous ethical considerations. As a consequence, the researchers were able to fertilise the mice oocytes and produce embryos. If the human oocytes are able to respond the same as the mice, then we too may be capable of producing an embryo using the same method.

Professor Peter Illingworth from IVF Australia said the practical application of this research will be a ‘long way a way”. He also pointed out individual differences need to be considered as women lose eggs at differing rates. Consequently, women should not rely on this development in their future plans to start a family. Professor Mark Bowman, who is President of the FSA said, this technique has the potential to help woman who suffer from infertility due to illnesses. For example, cancer patients who need their eggs removed preceding chemotherapy. He does not consider this knew knowledge to be of any benefit for older women who are hoping to conceive.

IVF: Fertility financing a concern in USA.

I was in a state of shock when I read an article by Jessica Silver-Greenberg in the Wall Street Journal. The article was about the rise of “fertility financing” for couples who are undergoing fertility treatments such as IVF. I had no idea there was such an industry in the United States. I am from Australia and have never heard of the term “fertility finance”. Yet, Ms Silver-Greenberg used it in such a manner as to suggest it is a commonly used and understood term for Americans.

It was reported that some couples have taken out unsecured loans carrying interest rates of up to 22%! This is much higher than the average American credit card interest rate of 17%.

During slow economic times with low demand for conventional lending, financiers have honed in on the fertility industry, eyeing the $20,000 plus treatments. Banking regulators do not keep a track of this “fertility financing” but it is estimated to be an industry totalling at around $4 billion.

Surprisingly, there is no medical regulatory body overseeing this trend. The American Society for Reproductive Medicine does not have a policy in relation to this matter. It seems “fertility financing” is being regulated by the greed of financiers and doctors using the scheme to grow their practice. Lenders have recruited doctors to either sell or place brochures and marketing material in their waiting rooms. Some doctors even facilitate the processes on line by soliciting applications on their clinic’s website.

You may say, what is my problem? Being involved in reproductive treatments I understand how vulnerable couples can be when they are desperate to have children. There is just too much scope for abuse in such a system. Having funds so readily available will no doubt allow more couples to be “sold” fertility treatments. Come on doctors isn’t this about what is right for the patients? I have witnessed some predatory marketing tactics in the fertility industry, but this is just too much!

Infertility: Are you feeling alone?

Recently at the Fertility & IVF Acupuncture Clinic I have witnessed a spike in the number of women who are experiencing significant levels of stress or anxiety due to their difficulty in trying to conceive. The worrying commonality between these women is they are trying to bear the battle with infertility on their own.

If this sounds familiar to you, please let somebody know how you are feeling. It is not necessary for you to take the burden on your own. First of all, let those who are close to you know how you feeling. I am sure your partner would be concerned and willing to support you. Share your thoughts with a close confidant. Do not get hung up on the stigma associated with infertility. You may well find those who you take into your confidence have experienced problems associated with infertility as well. Statistics suggest that 85% of couples will take longer than one year to conceive, and that one in six couples will experience infertility at some stage in their life. Remember, if you remain silent, you are only helping to perpetuate the stigma that now imprisons you.

If you feel the stress is getting too much, let your doctor or your treating physician know. They will be able to refer to you an expert who will help you see through the tough times. Try to keep things into perspective, be patient, the longer you stay in the game, the more chance you will have. Be encouraged that only 2-3% of women are truly infertile, the rest will conceive in time. Also remember acupuncture is effective at treating both stress and anxiety.

IVF: Saliva test to measure hormones renders blood tests obsolete.

Blood tests for patients undergoing IVF therapy may become a thing of the past. Researchers at the respected Boston IVF have developed a saliva test to replace the daily blood test which was needed to monitor hormone levels.

The procedure for the saliva test simply requires IVF patients to spit into a container which is then sealed and handed in for analysis. This will save IVF patients from receiving six to seven blood sticks within a few days. The new process will make IVF therapy more user friendly both in terms of comfort and convenience. It is a common problem amongst IVF patients to find time to be away from work to attend blood tests. No longer will it be also necessary for IVF patients to make up excuses to employers in order to explain absences from work. More importantly, the net effect of the test will contribute to reducing the amount of stress that IVF patients experience during their treatment. It has been reported that stress is a major reason why many IVF patients choose to discontinue treatment.

Boston IVF is trying to sell the test commercially and they are hoping to have it available across the United States in the near future. To date, no plans have been announced to distribute the test overseas.

Pregnancy: A promise to conceive the ideal child.

Since returning from my Christmas break I have been surprised at the number of couples who have sought out my services with the aim of having a child born in the “year of the dragon”. I have since learned this trend is not just happening at the Fertility & IVF Acupuncture Clinic, it seems to be happening world wide. A Los Angeles IVF clinic has reported a 250% increase in either Chinese or Chinese-American patients!!! Being unfamiliar with Chinese astrology I decided to find out what all the fuss is about.

The year of the dragon is considered to be the luckiest of the Chinese lunar years. This means that couples who may be experiencing infertility problems believe they will have a greater chance of conceiving during this lunar year.  Moreover, children born under the dragon sign are also considered to be highly prized. Legend has it that dragon children are smarter, stronger and luckier than those who are born under other star signs.

If you like the idea of having an increased chance of pregnancy or you would like a child who possess these qualities, you had better hurry up. My information has it that you will need to conceive by some time in early to mid-May to ensure a birth before the next lunar new year.

IVF: UK may change the law to reduce mitochondrial disease.

Public consultation is being sought in the United Kingdom in regards to a possible amendment to the law which will allow for a three parent IVF treatment.

The new IVF procedure is designed to circumvent a hereditary disease which is caused by defects in a cellular structure called mitochondria. This type of defect affects about 100 carrier babies per year in the UK and is responsible for diseases such as muscular dystrophy.

Mitochondrial disease is carried only by females. More specifically, during the reproduction process the defect has only been found in the shell of the female’s egg. The proposed procedure will remove the contents of an egg and place it inside a shell from a donor egg. As a result, an ensuing embryo will not carry the mitochondrial defect yet it will carry the DNA of three parents.

The current laws in the UK do not facilitate this new ART procedure because of the “three parent” implications. The Human Fertilisation and Embryology Authority understand the need for this procedure and have commenced surveying public opinion on a three parent treatment. If implemented, the new treatment may be able to eradicate what is a very distressing disease for sufferers and their families.

Male Infertility: Have you overlooked your husband?

Do you really know for certain that female infertility is the reason why you are battling to conceive? Has your husband been examined?

It is all too common to hear from women who, after reporting to their GP they have been trying to conceive for more than a year, are then swept up into the into the rollercoaster ride that is IVF before they have time to blink. All the focus on conceiving is then more likely fixed on the woman. As a consequence, only a range of gynaecological options are considered. In the mad rush to conceive, often the male is overlooked or if not, only offered very little investigation. It is common practice for IVF clinics to rely on ICSI to circumvent male fertility shortcomings.

Did you realise that 20% of infertility is due to male related problems? Did you also know that 50% of these male related problems are treatable? The most common andrological (male reproductive) problems include testicular lumps, low testosterone, erectile dysfunction and ejaculatory problems. More often than not, male infertility is less invasive, cheaper and more successful.

Often lifestyle changes are all that is needed to improve male infertility. These changes include refraining from smoking, alcohol and caffeine, as well as to start to eat healthily and increase exercise.

If your husband has been overlooked and you are having no success with your fertility treatments, ask your GP to refer your husband to an urologist.