Fertility Tips For Guys: Sleeping 9 Hours or More Weakens Sperm

Fertility Tips For Guys: Sleeping 9 Hours or More Weakens Sperm

Article on by Nandini on how sleep impacts male fertility provided by Health AIM.

Imagine this. You and your partner have been trying to make a baby for some time now. You are getting stressed as your baby plans are not working out. What’s more is that your lady gets all the tips to get the storks visiting. But when you look up for fertility tips for guys, it’s always limited to stop smoking, drinking, diet and fitness help. There is one more thing you can do to improve your sperm quality. That is, sleeping the right amount of time. Under sleeping or oversleeping will not help you get your partner pregnant.

Fertility & Sterility journal recently published a preliminary study conducted by The Boston University Pregnancy Online Study (PRESTO). The study evaluates the extent to which duration and quality of sleep impact male fertility. The study analyzed lifestyle habits of around 700 couples for a year. Researchers found that men who slept for 7-8 hours every night had the healthiest sperm.

An article in Men’s Health states that the study also found that men who slept for less than 6 hours a night were 31 percent less likely to impregnate their partners. Those who slept for nine hours or more were 49 percent less likely to impregnate their partners. Men who experienced broken sleep or had trouble sleeping all through the night were 28 percent less likely to get their partner pregnant than those who had no problems. Those men, who slept between seven and nine hours every night had the lowest risk of negative results.

Experts believe that the reasons might be hormonal. This is because testosterone is crucial for reproduction. Dr. Lauren Wise, the study’s lead author, explains that most men experience majority testosterone release during the night. Hence, those men who slept appropriate amount of time could impregnate their partners. However, there is less clarity on how long hours of sleep adversely affected male fertility.

About the study

An article in Mail Online explains that the study collected data from couples based in US and Canada. All of the couples were undergoing IVF treatment. Women, who participated in the study were between 21 and 45 years, while male participants were 21 years and older. Dr. Peter Schlegel, Vice President of the American Society for Reproductive Medicine, said that the study was welcome news. While the impact of stress on male fertility is well known, there is still very little data on how sleep impacts male fertility, states a WebMD report.

“This study strongly suggests that for men, aiming for the 7 to [less than] 9 hours of sleep helps to optimize their fertility and their chances of contributing to pregnancy,” he added.

More Articles on Male Fertility: 

Zika Virus May Impair Male Fertility; Could Be Sexually Transmitted

At-Home Fertility Test Lets You Zoom In On Your Sperm

How To Become A Dad: Sleep Naked To Boost Sperm Production & Quality

The approach and treatment of Secondary Infertility

The approach and treatment of Secondary Infertility

By Elena Trukhacheva MD, MSCI

President and Medical Director – Reproductive Medicine Institute (www.teamrmi.com)

In the immortal words of Baseball’s Yogi Berra “It’s Déjà vu all over again!” For many, Yogi’s words perfectly describe the struggle with secondary infertility, or difficulty getting pregnant a second time . . .or a third.

It is estimated that about 3 million people in 2005 suffer from secondary infertility (less than half the number that suffer from primary infertility). According to Resolve, a national infertility organization, that figure represents an increase from an estimated 1.8 million in 1995.

Secondary infertility is defined as the condition where a woman is unable to get pregnant or carry a pregnancy to term after already having had one or more children. Some experts put the added caveat of “after 12 months of trying to conceive naturally on their own,” to better qualify the term. Some experts define secondary infertility as occurring any time after a previous conception, whether that conception ended in a birth or a miscarriage.   Secondary infertility can occur whether the first conception was difficult or easy.  It can be due to female issues, male issues or a combination of both.

Whatever the exact nature of the definition, few disagree that secondary infertility, whether an adjunct to primary infertility or a new challenge all its own, can be a confounding and painful experience that seems to prevent many from creating the complete family of their dreams.

Many patients (and physicians) opt for the exact same plan that worked for you the first time. You may choose to try on your own, hoping for the possible reprieve from Infertility, Part 2.   Remember however, that if you had a diagnosed condition that caused primary infertility, chances are the same parameters still apply.  To give yourself the best opportunity within a reasonable amount of time, set limits. If you haven’t conceived naturally within 6 months to a year (less time if you’re over 40), consider going back to the drawing board and/or the original “architect,” whether that be your primary physician, OB/GYN or Reproductive Endocrinologist and Infertility (REI) specialist.

One thing that can be taken from this line of thinking, however, is a careful review of your first successful go around. Ask yourself the following:

*  Was it as easy as it seemed the first time or is that merely in comparison to the current struggle of secondary infertility?

*  Did you miscarry two or more times on the way to a healthy baby? Were these miscarriages investigated and found to be due to chromosomal abnormalities, which increase with age?

*  Was it ever suggested, prior to conception, that there might be issues that could cause a problem in conceiving or carrying a child (for example, abnormal hormonal levels; structural issues in the uterus, ovaries or fallopian tubes; a family history of infertility, and so on)?

Changes in age

Unless (or even if) your last child was born six weeks ago, time does march on! And from an infertility point of view, that’s never a good thing. One of the primary reasons for secondary infertility is the age of the mother.  Age related male infertility can also be a consideration, although Father Time does seem to be a bit more forgiving when it comes to the dads.  . Regardless of whose age we’re discussing, by definition, both you and your partner (should both parties remain the same!) will be older when you try to conceive your next child.  Fertility declines throughout the years, so the baby that popped up so easily in your 20’s, might not be as forthcoming in your 30’s or 40’s. The longer the interval between children, the more likely that time is not on your side. The fact that you have conceived, carried and delivered a baby are certainly positive predictors of your ability to do so, but realize that many cite the age of the mother as the primary reason for reproductive success. Is this true? Only time will tell.

Changes in health

As with primary infertility, your overall health does make a difference. While you may still be living the clean life, it doesn’t mean that your body hasn’t undergone changes all its own. Have you had an increase or decrease in your weight? BMI (body mass index) can certainly play a part in your fertility or lack thereof. Have you suddenly become a marathon or long-distance runner? This too can affect your metabolism and your body’s responses, including the reproductive ones. While these can be positive health changes, they can also upset the delicate balance that your body may be clinging to. Take a look at any lifestyle changes, good or bad, and discuss them with your physician to see if therein lies the culprit.

Occult, or not yet uncovered, chronic or acute illness can also play a role in reversing your fertility. Diabetes, autoimmune disease such as lupus, thyroid problems and a host of other issues, large and small, can also affect your ability to conceive and could be brewing without your knowledge. If you haven’t had a complete physical workup as well as a gynecological one, now would be the time.

Are you fresh from your first or last pregnancy? Still breastfeeding? Again, even subtle changes such as a shift in your sleep patterns can wreak havoc on your system, which can leave your fertility in less than fighting shape. Another thing to consider and discuss with your physician is any lasting effects from your previous pregnancy(ies). Could you have developed adhesions as a result of a caesarian section? Did you have problems with excessive bleeding that might indicate unresolved issues? Make sure that you check out normal from your last foray into baby making before jumping into the next.

The other large category of problems in secondary infertility is the status of the pelvic organs: Are you having abnormal bleeding (especially between periods) that might be indicative of a fibroid or a polyp in your uterus? Have you had any kind of abdominal surgery since your last delivery (appendectomy, gall bladder surgery, ovarian cyst removal)? All surgery is associated with a risk of scarring (adhesions), which may either block the fallopian tubes or pull them away from the ovaries so that they cannot pick up the ovulated eggs. The good news is that all of these conditions can be identified with the use of appropriate diagnostic tests that your doctor can order.

Changes in partners

You may be focusing on the wrong part of the equation, if you’re only thinking about what‘s different with you this time around. Remember, primary infertility is split fairly evenly between women’s issues, men’s issues and those issues that are shared by both. If you have changed partners since your last child, perhaps the problem lies with your other half.

Even if you’re with the same partner, once again, age can play a factor with men as well. More recent studies have shown that men over 40 have a decrease in the motility and morphology of sperm, reducing their fertile potential. In addition, DNA changes that come with age can also negatively impact a man’s sperm, making it abnormal and less likely to fertilize an egg.

And, just as with you, your partner’s health status can change in time as well, having a less than desirable effect on his contribution to the baby mix. If you’ve checked out in all areas, maybe it’s time to check…again.

 

Whether primary, secondary or both, Infertility can be managed and treated.  Options exist for helping you create the family of your dreams.

 

As one of the field’s devoted  female reproductive endocrinologists, Elena Trukhacheva, MD, MSCI, demonstrates a unique rapport and understanding of her patients.  As a woman and a mother, she takes pride in providing comprehensive care and strives to bring hope and support to her patients. Dr. Trukhacheva is Board Certified in the specialty of obstetrics and gynecology and in the subspecialty of reproductive endocrinology and infertility.

Dr. Elena Trukhacheva has devoted her professional life to academic medicine, research, and clinical practice in the field of Reproductive Endocrinology and Infertility. She received her medical degree from the Russian State Medical University in Moscow, Russia. She graduated magna cum laude in 2000 and received multiple awards for research and academic excellence during her studies. Dr. Trukhacheva completed her residency in Obstetrics and Gynecology at Baylor College of Medicine, consistently rated among the top medical schools in the country.

Following residency, Dr. Trukhacheva entered a three-year fellowship in Reproductive Endocrinology and Infertility at Northwestern University in Chicago. During fellowship she also received a Master of Science degree in Clinical Investigation. She has formal training in biostatistics, epidemiology, and the design of clinical research studies.

Dr. Trukhacheva is a speaker for the American College of Obstetrics and Gynecology. She also serves as a reviewer for the Fertility and Sterility journal and leads the Preimplantation  Genetic Diagnosis International Society (PGDIS) committee for Clinical Applications. She is a clinical assistant professor in Obstetrics and Gynecology at Midwestern University, and is actively involved in teaching medical students and OBGYN residents at the Midwestern University and at the Illinois Masonic Medical Center.

Her clinical interests include In Vitro fertilization, previous IVF failures, special approaches for poor responders, preimpantation genetic screening and diagnosis, as well as advanced laparoscopic and hysteroscopic gynecologic surgery.

Dr. Trukhacheva is fluent in English, Russian, and Ukrainian. A native of Russia, she now calls Chicago home.

Zika Virus May Impair Male Fertility; Could Be Sexually Transmitted

Zika Virus May Impair Male Fertility; Could Be Sexually Transmitted

Article by Ravi Mandalia on how the Zika virus could be impacting male fertility provided by Version Weekly. 

Scientists have found evidence that hint at the possibility of the link between persistence of zika virus in male reproductive organs and its role in male infertility.

Researchers have also found that if the zika virus persists in male reproductive organ, it could even be sexually transmitted. Researchers have based their findings on a study that concluded that the infection reduces the size of testes in mice up to 21 days after infection. The study is published in the journal Science Advances.

There has been evidence that point to the persistence of the zika virus in semen of humans for months after infection; however, there have been no studies to understand how the virus affected the testes and how it could have an impact on fertility of males and whether it could be sexually transmitted.

Erol Fikrig, Professor of Medicine at Yale University in the US, and team carried out the study on mouse model by infecting mice with a non-lethal strain of the Zika virus. The mice used in this study were genetically modified so the researchers could observe viral replication over an extended period.

Evidence indicated that the virus continued to replicate in testicular cells even after it was cleared from the blood. They also discovered that 21 days after infection, the testes of infected mice were significantly smaller than those of control mice.

“This study shows how the Zika virus replicates in and damages testes,” said first author Ryuta Uraki.

The persistence of the virus in a storage compartment known as the epididymis, which conveys sperm from the testicle to the urethra, is consistent with the reported cases of male-to-female sexual transmission, he said.
The finding of reduced testicular size – known as testicular atrophy – indicates a potential long-term effect on male fertility.

“These results suggest that infection can cause the reproductive deficiency in men,” Uraki noted.
The study results, which extend recent findings by other researchers, underscore the critical need for the development of a vaccine, as well as antiviral therapies, to combat Zika infection, the researchers said.

More Articles on Male Fertility: 

At-Home Fertility Test Lets You Zoom In On Your Sperm

How To Become A Dad: Sleep Naked To Boost Sperm Production & Quality

Obesity: Hidden Cause of Male Infertility

 

IVF: What are the Risks?

IVF: What are the Risks?

Article by Liji Thomas, MD about IVF risks provided by News Medical. 

In vitro fertilization (IVF) is a technique of assisted reproduction whereby a zygote is produced from the fertilization of sperm and oocytes outside the woman’s body, and allowed to proceed in its development under carefully controlled conditions, until it becomes an embryo.

Thereafter it is transferred into the uterus, either by inserting it into the Fallopian tubes, but more recently by intra-vaginal placement into the uterus. If the embryo implants, a pregnancy has begun. If the pregnancy results in the birth of a live infant who is capable of surviving outside the mother’s body, a successful IVF cycle has taken place.

Modern technology and advances in knowledge of the reproductive parameters is leading to increased success in both the pregnancy rates and live birth rates following IVF. However, the procedure is accompanied by risks.

General risks

IVF is a reproductive option which requires intensive hormonal treatments that can cause many medical complications i.e. IVF risks.

The emotional strain is no less because the results of the intervention are far from certain. This is exacerbated by the multi-stage nature of the process, which means the couple has to wait to see if the current phase has worked before they can proceed to the next, with some stages requires repetition until successful.

The time spent off work undergoing and recovering from the treatments is far from negligible, and there is considerable expense associated with this technology. Many insurance companies do not offer plans which cover infertility treatment, with the fees for a single IVF treatment cycle crossing $10,000 to $20,000. This includes the costs of the fertility hormones, laparoscopy and ultrasounds, anesthesia, the repeated blood tests for hormone levels, oocyte and sperm processing, storage, embryo storage and embryo transfer.

Since couples who opt for this treatment plan are already handling the difficulty of infertility, these added IVF risks can well precipitate stress and depression. The disappointment of a failed cycle on top of immense investments in the shape of time, money, and energy may deepen the impact of other stressors.

Ovarian stimulation

One of the IVF risks to consider is the adverse effects of many fertility hormones include abdominal or generalized bloating, abdominal pain, fluctuations in emotional states, and headaches. Many of them are administered by repeated injections, which can cause bruising besides being painful.

An uncommon but serious complication of ovarian stimulation treatment, which is the first stage of IVF, is ovarian hyperstimulation syndrome (OHSS). This is due to the accumulation of edema fluid within the chest and the abdomen. As a result, the abdomen may swell and hurt, the patient may bloat up, and they may report rapid increases in weight within a couple of days.

Their urine output may decrease because of extravascular sequestration of body water, despite an adequate fluid intake. Dyspnea, nausea and vomiting are other features. While mild OHSS can be managed by promptly stopping the cycle and complete rest, in severe cases intensive management, including paracentesis to relieve ascites, may be indicated.

While some fears exist that the use of fertility hormones is linked to cancer, no evidence has ever been produced.

Oocyte retrieval

Ovarian stimulation is performed to enable multiple oocytes to be produced, which have to be retrieved by ultrasound-guided transvaginal follicular aspiration of both ovaries. This is accompanied by its own IVF risks, though uncommon, such as:

  • Reactions to the anesthetic agent used
  • Bleeding from the needle track
  • Infection
  • Damage to surrounding structures, including the bladder and bowel

Embryo transfer

In general, more than one embryo is transferred into the uterus of the woman undergoing IVF – this is to maximize the chances of a successful pregnancy. While this is useful in preventing many repeated cycles, placing more than two embryos into the uterus increases the chances of multiple pregnancy, which is found to occur in almost half of pregnancies induced by IVF.

Multiple pregnancy increases the risk to both the mother and baby. The mother has a higher risk of pregnancy-induced hypertension, hydramnios, preterm labor, and complicated delivery. Additionally, the fetus may suffer from a higher risk of congenital malformations, premature birth, low birth weight, and the need for intensive neonatal care.

Pregnancy

If a pregnancy test is positive two weeks after embryo transfer is done, the woman is deemed pregnant. She is usually put on daily progesterone supplements from the day of transfer until the implantation is confirmed to be successful and until the first trimester of pregnancy is over. Progesterone is a hormone that makes the endometrium thicker and more vascular, preparing it for implantation of the embryo.

One of the IVF risks to consider is the complications of pregnancy have been reported following IVF, such as:

Pregnancy complicationReported frequency (%)
Ectopic pregnancy2
Miscarriage21
Multiple pregnancy28
Pregnancy-induced hypertension10
Preterm labor22
Intrauterine death10

Perinatal outcomes

Perinatal outcomes are significantly worse for children conceived by ICSI or IVF compared to natural conception.

Intracytoplasmic sperm injection (ICSI) has become part of the IVF protocol, allowing even azoospermic, asthenospermic, and teratozoospermic men to father children. However, it is not yet known how this artificial method of fertilization affects the natural process of sperm selection. It is possible that ICSI overcomes natural barriers to conception caused by genetically transmissible causes of male infertility.

Such barriers may include chromosomal anomalies, mutations in the cystic fibrosis transmembrane conductance regulator gene, or AZF deletions, all of which would normally not be transmitted to offspring because they were not conducive to conception. One study found that the incidence of new chromosomal aberrations in ICSI-derived pregnancies when the sperm count was extremely low (below 20 million per ml) was 10 times higher than that in ICSI-pregnancies using sperm from men with sperm counts higher than this level. Again, researchers have found that the rate of major congenital defects is doubled in ICSI or IVF pregnancies.

Another area of concern is the damage to cell organelles potentially caused by ICSI, which may cause congenital defects. Imprinting disorders are also found to increase in incidence in IVF pregnancies. It is postulated that the teratogenic influence may be the embryo culture medium rather than the use of ICSI, in these cases. Again, it is possible that the same mechanism underlay both infertility and the imprinting defect.

Children conceived by IVF techniques also have a tendency to be low birth weight and have higher fasting blood sugar and blood pressure levels than normally conceived children. Even singletons born after IVF tend to be at risk for preterm birth. They also have worse outcomes before, during, and after birth, and are more likely to require hospitalization.

Cerebral palsy, psychological diseases, and developmental delays, are more common in these infants than in naturally conceived children.

Reviewed by Afsaneh Khetrapal BSc (Hons)

Next Generation IVF

Next Generation IVF

Article by Simon Fishel on the various upcoming options for IVF such as testing your Ovarian Reserve and Genetic Screening has been provided by The Hippocratic Post. 

In some quarters, fertility continues to be seen as a contentious medical issue, which in turn leads some patients to approach treatment with trepidation. Whilst it remains true that fertility treatment can be a complex process, as a scientist in the field, I feel that as a medical speciality huge strides have been made in recent years and there is much to celebrate about IVF treatment in the UK both now – and for the next generation.

In fact, IVF science has advanced so rapidly in recent years that people have every reason to feel optimistic about the outcome, because in my mind, there’s never been a better time to undertake assisted conception.

However, with so many options now available, working with a fertility expert to “navigate” the treatment pathway is vital, as is the adoption of a wholly personalised approach.  Essentially, advanced techniques can only be applied successfully if they are tailored individually and patients are given time to understand the benefits – and if appropriate, the risks – of new procedures and are able to make their own, informed decision on which treatment to proceed with.

So, where do we stand with next generation IVF and which of these treatments provides the best chances of success?   

The Personalised Approach

The personalised approach can be used to assess the activity of genes in the womb lining to pinpoint a woman’s optimum time for treatment which significantly boosts success rates. There are more than 60,000 IVF cycles in Britain each year, but just 24% of these treatments lead to live births1. However, by using the personalised approach doctors can plant the embryo in the womb at the woman’s most fertile time.

Time-lapse embryo images allows us to safely monitor embryos and observe their developmental patterns closely. Time-lapse images are precise and significant and are able to predict which embryos have the highest potential for a successful pregnancy. In addition we can now spot developmental anomalies that we did not even know existed, and we now understand limit or prevent the chance of the embryo making a baby; we have now published an atlas of such anomalies. Alongside colleagues at Care Fertility, we pioneered this procedure and have since had over 2,000 babies born using time-lapse technology.

Testing your Ovarian Reserve

Testing ovarian reserve is an increasingly important and beneficial way to explore a patient’s fertility before proceeding with IVF treatments. The test will help to clarify what type of IVF is needed, the dosage and how current fertility levels. However, the test will only determine how fertile a patient is at that point in time and is currently unable to predict the future.

For women who are already going through fertility treatment and have a good ovarian reserve, it is advised that they should consider freezing their eggs. This helps to prevent secondary infertility, if the patient wants more than one child, and can be a pragmatic approach to utilising left over embryos from treatment. The industry is also publishing data suggesting that not only are frozen embryos as good as fresh, but they may actually do better when transferred to the woman some time after stimulation; better for the pregnancy and the baby!, Encouraging women to have their ovarian reserve tested at a younger age is also really important  if there has been a history of fertility problems within the family. It may be that patients are fertile at the time of the test, but it can be prudent to freeze your eggs to use in the future.

Preimplantation Genetic Screening

The most common reason why IVF fails is chromosomal abnormality (known as ‘aneuploidy’). Approximately 70% of embryos produced, either through natural conception or IVF, are lost before birth. A major cause of embryo loss, including miscarriage, is aneuploidy, where there is either a loss or gain of a single chromosome, or complex abnormalities.

Chromosome Screening is suitable for all patients. It is particularly suitable for the following groups: women who are aged over 37; men who have been shown to have sperm at risk of carrying abnormal chromosomes; couples who have had several miscarriages or several attempts at IVF but failed without explanation. But, knowing that even the younger female is at risk of up to half her eggs carrying a chromosome anomaly, it could be argued that using Chromosome Screening to effectively eliminate all such eggs or embryos will increase the chance of success for those couples. Many clinics even include it for egg donation to improve the chances of egg donation even further.

More Articles on Fertility Research: 

Trans Patients, Looking For Fertility Options, Turn To Cancer Research

The Official Definition of Infertility Is Changing. Here’s Why That Matters

Women With Early Periods At Increased Risk Of Early Or Premature Menopause

A Sister’s Promise: Growing A Family Through Surrogacy

A Sister’s Promise: Growing A Family Through Surrogacy

Article by Doug Ford on how a Factor V diagnosis causes family to seek out surrogacy provided by The Gazette – Virginian. 

Clover residents Melissa Fears and husband Scotty want children like most any other couple, but due to a pre-existing condition, Melissa has been unable to bear a child.

Through a sister’s and brother-in-law’s love and compassion, the Fears could be on their way to having a family.

The Fears have decided to pursue IVF through surrogancy, and Melissa’s sister, Jennifer Hatcher, and husband Adam of Nathalie have agreed to Jennifer’s trying to carry a baby for her sister.

“I have two children, and I had no problems carrying mine,” said Hatcher.

“Melissa and I are not only sisters, but we are best friends.”

“I’ve been pregnant eight times and lost five 14 weeks and under, and carried three girls, the latest being 23 weeks,” said Melissa, who suffers from a disease known as Factor V, a blood clot disease.

“It makes you at high risk for having children, said Fears, who takes a daily injection for the condition. “We talked about it a year or so ago. Christmas Day my water broke, and I lost a little girl.”

“She (Hatcher) brought it up again, and I said I love the idea. She said I’d be more than happy to do it for you. My husband and I talked about it, and we agreed to do it with my sister.”

“She buried three precious baby girls. Their names are Macy, Madison and Miracle Fears,” said Hatcher, who has been organizing a number of fundraisers to help pay for the procedure, including a stew and supper followed by a dance.

“I have started an Our Journey To Become Parents page on Facebook, if you would like to follow us,” said Hatcher. “Also, we have set up a (you caring) page to try and help raise money for this journey.”

In vitro fertilization is not cheap.

“We have to go to a facility in Charlottesville Feb. 2 for consultation,” Fears explained. “It costs between $400 and $600 just for the consultation.”

Fears said she did some online research and estimated the process of in vitro fertilization for one child could cost upwards of $50,000.

Shelly Beadles, a cousin to Hatcher, also is helping with fundraising.

Another fundraiser is one called “stink up your neighbor’s yard” with a toilet painted deep red and purple for Factor V awareness.

“How it works is it ends up in somebody’s yard, and they pay a $15 donation to have it taken out of the yard or $20 to have it placed in a friend’s, neighbor’s or anybody’s yard of their choice,” said Hatcher.

“Also, they have the option to pay toilet insurance and that is $40 to cover where the toilet never ends up in their yard.”

A sign next to the toilet explains the reason for the toilet being there.

“Jennifer moves the toilet every day, and she decides where to send it next,” said Fears. “So many people are interested in doing it, she started a second one.”

Melissa works full time as a LPN at The Woodview nursing home and part time at Triple A Grocery as a cashier.

Scotty works full time at Bobcat’s Bait and Tackle and also works on his boss’s farm when not at the bait shop, according to Hatcher.

“They both are two hard-working people and would give their shirt off their back for anybody,” said Hatcher.

“Melissa and Scotty are two of the strongest people I know. Please find it in your heart to help them to be the awesome parents they were meant to be and to bring awareness to infant loss, miscarriage and infertility.”

More Articles on Fertility News: 

Can This Fertility Diet Help You Get Pregnant?

7 Signs of Infertility You Didn’t Know About (But Should)

8 Reasons To See A Fertility Specialist

Trans Patients, Looking For Fertility Options, Turn To Cancer Research

Trans Patients, Looking For Fertility Options, Turn To Cancer Research

Article by Corinne Segal about how transgender patients are handling fertility options provided by PBS. 

On a recent drive to elementary school, M. told her mom: “I can’t have a baby.”

Her mother, Marlo Mack, pulled over — she had been expecting this conversation for awhile. Six years ago, M. told Mack that she is transgender and then socially transitioned to living as a girl shortly afterward — a journey Marlo Mack documented in the podcast “How to Be a Girl.” (“Marlo Mack” and “M.” are pseudonyms, the same ones used in the podcast to protect M.’s privacy.)

While the transition left M. happier and healthier, Mack had long worried about M.’s ability to reproduce as an adult and wanted to tell her daughter that scientists are working on fertility research for transgender kids. But Mack also wanted to keep it light. After all, M. is only nine years old.

“From early on I’ve been cringing when she’ll say, ‘When I’m a mom,’ or, ‘I‘m going to have this many babies,’ or ‘When I’m pregnant,’ those kinds of things,” Mack said. “As a parent, you don’t want your child who’s only five to have a whole aspect of human experience already shut to them.”

There are an estimated 1.4 million transgender Americans, and physicians told the PBS NewsHour Weekend that demand is increasing for health care unique to them. Many doctors are confronting the issue of fertility among trans communities, especially as children start to feel more comfortable voicing their identity at earlier ages.

Gender dysphoria — the feeling that an individual’s gender is different from the one assigned at birth — can cause distress in children who fear the physical changes that come with puberty. M. was alarmed as a toddler when she learned about the possibility of someday growing a beard like her father, according to Mack.

“There was this look of shock on her face,” Mack said. “It goes to show how deeply felt and experienced gender is for these kids.”

Before that happens, some transgender youth, under the care of a doctor and with the permission of a guardian, decide to take puberty blockers to halt the production of estrogen and testosterone. These drugs pause puberty while they decide how to move forward. And during adolescence, some transition with hormone therapy, taking estrogen and testosterone to develop the secondary sex characteristics of their gender.

At this point, doctors may recommend that their transgender patients preserve eggs or sperm for later use, according to Dr. Courtney Finlayson, a pediatric endocrinologist at the Ann & Robert H. Lurie Children’s Hospital of Chicago. But it’s a tricky time. If the patients haven’t gone through puberty, then their bodies have not made mature eggs or sperm yet, leaving their fertility prospects uncertain.

“You don’t have that mature biological material for reproduction,” Finlayson said. She added that fertility actions were poorly understood and rarely addressed in the past for trans people.

 

Drawing inspiration from cancer treatment

Twelve years ago, a group of doctors who treat cancer patients started a conversation about reproduction. Its effects are rippling through the transgender community today.

The Oncofertility Consortium brought together oncologists and fertility specialists from around the country who wanted to improve fertility options for cancer survivors — including young kids whose fertility was affected by chemotherapy.

Both groups — young cancer patients and transgender kids hoping to transition early — have a demand for fertility preservation at an age where it has not usually been possible. But researchers say they are drawing closer to a solution with new techniques to freeze or cryopreserve, immature reproductive cells.

So far, scientists can take a piece of ovarian tissue, freeze it and then re-implant it into a patient to produce mature eggs. That process has resulted in at least 100 births so far, mostly by adult patients who were treated for cancer, said Dr. Teresa Woodruff, a reproductive endocrinologist researching the issue at Northwestern’s Feinberg School of Medicine in Chicago.

This process does not work for all patients, and researchers say that it is unlikely to work for transgender people who transition with hormone therapy. So they started to look for ways to grow that tissue in a petri dish so that it can develop into a mature egg. “We’ve had to borrow knowledge from other disciplines and figuring out how that applies to trans people … What can be frustrating sometimes is having to adapt and extrapolate all of this information from work that is not done for trans people.” — Zil Goldstein, Mount Sinai

In November, Woodruff co-authored a study in the journal Nature that did just that.

“We can continue to develop that technology, and eventually, hopefully, this will transfer to all the individuals who are looking for fertility intervention,” Woodruff said.

The research is not as far along for people with testes, said Dr. Kyle Orwig, whose lab studies fertility at the Magee-Women’s Research Institute and Magee-Womens Hospital of the University of Pittsburgh. In several animal models, researchers can preserve testicular tissue outside the body and then re-implant that tissue to produce sperm. A study published by Scientific Reports this month showed that researchers could develop sperm from mouse tissue in a petri dish over the course of 6 months, producing healthy offspring. But this technique has never been replicated in humans.

In recent years, doctors treating transgender people have paid close attention to this cancer research, Finlayson said. “We have taken a lot of our inspiration and our information from the world of oncofertility,” she said.

Several years ago, Woodruff and others decided to start a committee that would focus on transgender patients within the Oncofertility Consortium, as she and others were approached by doctors and trans patients who had heard about the research.

“Some trans people were finding their way to our program. And it seemed to me that this was an obvious next step for the development of fertility management,” Woodruff said. “I think for the transgender community, the more they know this is out there, the more they will take advantage of these opportunities.”

These treatments are not fully developed or available yet, and will likely not be for decades, Finlayson said. But “there is a lot of progress in that area,” she said. “We hope that 20 or 30 years from now, that this technology will exist.”

For trans patients, a taxing trade-off

Even for trans people who have gone through puberty and can preserve mature eggs or sperm, the process isn’t always straightforward. Doctors will often advise their patients to stop taking hormones during fertility treatments, which can last weeks or months.

But doctors say that even a temporary disruption in their hormone therapy can cause symptoms of anxiety or depression in their patients.

Some who decide to move forward anyway are discouraged by staff and doctors who treat them “like an alien,” said Zil Goldstein, program director at the Center for Transgender Medicine and Surgery at Mount Sinai Hospital in New York.

“A lot of adults that I see choose not to preserve fertility because it is such an anxiety-inducing experience to go in and receive what is essentially ‘women’s health care’ when you are a man,” Goldstein said. “Even staff who are aware of issues around cultural sensitivity say things like, ‘We’ve never done this with a trans person before,’ or, “This is such an interesting case, let me bring in the resident.’”

For others, the procedures required to extract sperm or eggs can cause additional distress and dysphoria. People who produce sperm may not feel comfortable masturbating to give a sperm sample, and people with ovaries may not want to undergo the procedure of obtaining eggs, which can feel invasive, Finlayson said.

“If you have to have a transvaginal ultrasound or procedure to harvest eggs, that might be something that trans males say, ‘I can’t do that,’” she said.

But Finlayson said that with more trans people seeking these procedures, doctors are learning more about how to treat them. “Fertility preservation is a major decision for everyone,” Finlayson said. “I think that we have a lot to learn about how it’s different for trans individuals.”

In general, the trans community has always relied on a medical system that was not built for them, Goldstein said.

“Traditionally in transgender health, we’ve had to borrow knowledge from other disciplines and sort of figuring out how that applies to trans people,” Goldstein said. “What can be frustrating sometimes is having to adapt and extrapolate all of this information from work that is not done for trans people.”

Cost is an additional concern. Fertility preservation is rarely covered by insurance, for trans people or anyone else. And with a high rate of economic instability among trans people, many just cannot afford it.

Orwig said the process of freezing testicular tissue could cost between $2,000 and $4,000, whereas preserving ovarian tissue costs approximately $5,000. But that estimate is “probably on the lower end,” since it applies to an experimental treatment, and would be higher in a regular clinic, he said.

“We’ve asked insurance companies if this wasn’t researched, would you cover it? And across the board, the answer was no,” Dr. Jill Ginsberg, a pediatric oncologist at the Children’s Hospital of Philadelphia, said.

Insurance coverage for trans-related care is spotty across the nation, with a broad range of laws on whether insurance must cover it. Eighteen states and Washington, D.C. prohibit insurers from discriminating against trans people, and Medicaid covers transition-related care in 12 states and the District. But concerns over trans health were magnified recently, as a federal judge in Texas blocked Section 1557 of the Affordable Care Act — which would have prohibited discrimination by gender identity — just before the regulation was set to take effect.

Mack worries about obtaining insurance coverage for her daughter — and fears the ultimate cost of fertility treatments could be out of reach. “I’m worried about even just getting her coverage for primary treatment,” Mack said. “I don’t know what I’m going to do.”

When it comes to fertility, Mack was quick to highlight that adoption is a valid path to parenthood — but she also struggles with the thought of her daughter missing out on the opportunity to be a biological parent.

“I think, well, what do I do if someday she says, ‘Mom, this was available, and you didn’t do it?’ I don’t want that conversation,” Mack said. “If this becomes available, a lot of trans people who can stretch to make it work are going to have a hard decision to make, and for most people, it will be absolutely out of reach.”

Sitting with her daughter in the car, Mack told her she saw hope in the research progress.

“I can’t promise her that this is an option, but I can say that it’s a maybe,” Mack said.

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Can This Fertility Diet Help You Get Pregnant?

Can This Fertility Diet Help You Get Pregnant?

Article by Zara Husaini Hanawalt about a fertility diet that may help women conceive sooner provided by Fit Pregnancy. 

Most women save the focus on healthy eating until after they’re officially expecting. But if you’re trying to get pregnant, what you eat could help give your fertility a boost. And we’re not just talking about eating as many nutritious foods as possible or banning pregnancy no-nos from your diet when you’re TTC. We’re talking about a full fertility diet that’s loaded with healthy foods experts believe women should incorporate when they’re TTC to improve their odds.

“When trying to get pregnant it is important to evaluate your lifestyle and nourish your body,” Dawn Lerman, a nutrition consultant and author, told Fit Pregnancy. “Like you prepare your house before you bring your baby home, prepare your body for conception. The healthier we are physically before pregnancy, the better the environment to maintain a healthy pregnancy and conceive.”

That’s even led one UK fertility clinic’s nutritionist, Celia Cooper, to design a three-course menu with the purpose of helping women conceive. (Maybe perfect for a romantic dinner tonight, if you’re TTC?) Cooper’s meal plan is built around the vitamins and minerals that support fertility, according to Daily Mail, where it was originally published.

Cooper suggests the following:

• a starter of butternut squash hummus, served with a half of an avocado and milled oat crackers (which contains zinc and folic acid, while the avocado adds omega 3 and vitamins B and E)

• a salmon entree served with quinoa and pumpkin seed salad (salmon has essential fats that are great for the reproductive system; zinc has been shown to be beneficial for sperm development in men and in cell division)

• yogurt, granola, and berry parfait for dessert (the yogurt is high in calcium, and the berries are antioxidant-rich)

“For anyone who is thinking about conceiving it is worth taking a close look at your diet,” Cooper told Daily Mail. “Nutrition is vital and that’s why I’m often called in to help couples put together meal plans with the hope of filling their bodies with the right vitamins and minerals.”

Lerman also believes folic acid, zinc, calcium and healthy fats are all things women should seek out when trying to conceive, so if you want to stick to a very specific plan, you might want to give Cooper’s a try.

“With every bite, you are either depleting your body or filling it with substance,” Lerman said. “I recommend adhering to a whole food diet—rich in vegetables, lean sources of protein, fiber-rich whole grains and healthy fats such as avocado, nuts, wild salmon, eggs, and coconut oil. Don’t forget to include calcium-rich foods such as yogurt and dark leafy greens. And make sure not to go too long between meals. Try a mid-morning smoothie or a warming cup of bone broth, or lentil soup with diced sweet potatoes in the afternoon.”

We all know how important it is to maintain a healthy diet during pregnancy, but according to Lerman, what you eat before you’ve conceived is also incredibly important. “As a nutritionist I advise my clients who are trying to get pregnant to maintain a healthy weight. Many cases of infertility are due to weight extremes, which can alter hormone levels and throw off ovulation schedules.” Eating healthier and maintaining a healthy weight could be your key to conceiving.

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The Official Definition of Infertility Is Changing. Here’s Why That Matters

The Official Definition of Infertility Is Changing. Here’s Why That Matters

Article by Julia Naftulin about the World Health Organization and the new definition of infertility provided by Health.com. 

The World Health Organization wants to redefine “infertility,” so it’s not just a medical condition, the Telegraph reports.

The World Health Organization currently describes infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” But under the new revision, a person who wants to become a parent doesn’t have to be in a sexual relationship—or one that could lead to a pregnancy—to qualify as “infertile.”

David Adamson, MD, one of the authors of the new guidelines, told the Telegraph the change is designed to reflect “the rights of all individuals to have a family, and that includes single men, single women, gay men, gay women.”

The new wording is so meaningful because it could lead to policy changes around the world—specifically, greater access to fertility treatments such as in-vitro fertilization.

There’s no doubt the World Health Organization will receive backlash for the controversial move. But this new definition of infertility has the potential to become a great equalizer of reproductive rights: “It fundamentally alters who should be [classified as infertile] and who should have access to healthcare,” said Dr. Adamson. “It sets an international legal standard.”

According to the Telegraph, the revision (which as not yet been publicly announced by theWorld Health Organization) will be sent to health ministers next year.

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7 Signs of Infertility You Didn’t Know About (But Should)

7 Signs of Infertility You Didn’t Know About (But Should)

Article by Jessica Migala about the various infertility signs that you may not know about provided by Stylecaster.

Your feelings about having kids might be not right now or far in the future or not ever. Or maybe you absolutely know you want to get pregnant—and soon. Either way, it’s important to know the signs of infertility, because can often indicate a larger problem that can affect your overall health, whether kids are your goal or not. “If you think there’s something wrong, listen to your body. Talk to your doctor whether you want to get pregnant or not,” advises Meike Uhler, MD, a fertility specialist with the Fertility Centers of Illinois.

We’ve compiled a list that’s by no means exhaustive—for more information, you should always talk to your doctor in person—but it does hit on some of the biggest signs that should perk up your ears and let you know it’s time to make an appointment.

 Your Periods are Unusually Painful

Just so you know, you shouldn’t have to clear your calendar when your period’s coming because you know you’ll be in bed in agony. In fact, it may be a sign of endometriosis, says Dr. Uhler. And we’re not talking a little cramping here and there, but “enough pain that it affects your lifestyle. You can’t go to work or do the things you normally do,” she says. The condition, which happens when the lining of your uterus (endometrial tissue) grows outside of it, affects up to half of infertile women, according to the American Society for Reproductive Medicine. Hormonal birth control pills are one treatment. Talk to your doctor if period pain is messing with your ability to live comfortably—it doesn’t have to be your normal.

Your Hands and Feet are Always Cold

If your extremities are constantly icy, the answer isn’t to wear gloves and fuzzy socks. Get your thyroid hormone levels checked ASAP. Cold feet and hands are one sign of hypothyroidism (or an underactive thyroid gland), says Dr. Uhler. That can lead to irregular ovulation and affect your menstrual cycle. A blood test will tell your doctor if your levels are normal. Other signs: constipation, forgetfulness, dry skin, and being unusually tired.

Your Period is MIA—or Constant

While you might feel lucky to skip a period (or five), that can be a sign of what docs call “ovulatory dysfunction.” Your ovary has to release an egg in order to be fertilized, and if you’re not ovulating at all, you won’t get your period, explains Dr. Uhler. If you have cycles that are longer than every 35 days, you should get checked out, as well as if your period is MIA altogether. Also, keep a heads up if you get your period too frequently—that’s every 21 days or less—because it may be another sign of an ovulation problem.

Your Nipples are Leaking

If you’re not pregnant or breastfeeding, nada should be coming out of your nipples. If they are leaking fluid, it may be a sign of a condition called hyperprolactinemia, which means that you’re body is producing too much of the breastfeeding hormone prolactin. Causes can range from thyroid problems to medications to a (normally) benign tumor on your pituitary gland. When prolactin levels are high, it affects your hormonal balance and may tell your ovaries to go on hiatus. Don’t be shy about mentioning any weird symptom to your gynecologist—trust us, they’ve heard it all. A simple blood test can ID this problem, and medications can treat most cases.

You’re Very Overweight

If your BMI is 30 to 40, you qualify as obese, which can compromise fertility, according to the American Society for Reproductive Medicine. They note that obesity is the cause of six percent of infertility. Reproductive hormones can be stored in body fat and mess with the area of your brain that tells your ovaries it’s go-time, so if you’re trying for a baby or know you will be in the next several years, talk to your doc if you’re concerned that your weight could lower your odds of conceiving.

You’re Sprouting Facial Hair

Hair growing profusely in places you wouldn’t expect (like your face), or losing it in surprising places (like your head) are hallmark symptoms of PCOS, or polycystic ovary syndrome (it’s also marked by acne and screwy periods). The condition means your reproductive hormones are out of whack, which can impair your ovaries’ ability to make or release an egg. “PCOS is one of the most common, but treatable causes of infertility in women,” according to Womenshealth.gov. Meds like birth control can help manage the condition, as can reaching a healthy weight.

You Have a History of Gonorrhea

The common sexually transmitted disease can come with a few symptoms: burning while you pee, an abnormal amount of vaginal discharge, and bleeding mid-cycle. But, unfortunately, according to the CDC, most women don’t have symptoms. The STD can lead to pelvic pain, infertility, and cause scar tissue that blocks fallopian tubes, which prevents the egg and sperm from meeting in the first place. If your OB doesn’t mention screening for gonorrhea during your annual appointment, and you’re worried you might be at risk, be sure to ask to be tested.

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