Tag Archives: American Society for Reproductive Medicine

BPA may be Responsible for Women Infertility

Bisphenol A (BPA), which is a chemical used to harden plastic and line food containers, may be harming women’s eggs.
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Evidence links exposure to the chemical to a lower quality among eggs retrieved for in vitro fertilization. A study found that as blood levels of BPA in the women studied doubled, the percentage of eggs fertilized normally declined by 50 percent.

UPI reports:

“The researchers noted BPA — found in the urine of nearly everyone tested in a 2004 U.S. analysis — is an endocrine disruptor that either mimics or blocks body hormones.”

Resources:
AnnArbor.com December 16, 2010
UPI December 19, 2010
Fertility and Sterility December 4, 2010

Posted  By Dr. Marcola.Jan.3.2011

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IVF

Introduction:
IVF or in vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the woman’s womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

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IVF was developed in the 1970s. The first British test tube baby was Louise Brown, who was born in 1978.Some 30,000 test tube babies have been born in the UK since then.
There are several different techniques, but the main process involves the women taking fertility drugs to help her produce more eggs.The eggs are then harvested and fertilised in the laboratory.
The woman is given hormone drugs to prepare her womb to receive the fertilised eggs. The fertilised eggs are placed inside the womb and a normal pregnancy follows.

The term in vitro, from the Latin root meaning in glass, is used, because early biological experiments involving cultivation of tissues outside the living organism from which they came, were carried out in glass containers such as beakers, test tubes, or petri dishes. Today, the term in vitro is used to refer to any biological procedure that is performed outside the organism it would normally be occurring in, to distinguish it from an in vivo procedure, where the tissue remains insided the living organism within which it is normally found. A colloquial term for babies conceived as the result of IVF, test tube babies, refers to the tube-shaped containers of glass or plastic resin, called test tubes, that are commonly used in chemistry labs and biology labs. However in vitro fertilization is usually performed in the shallower containers called petri dishes. (Petri-dishes may also be made of plastic resins.) However, the IVF method of Autologous Endometrial Coculture is actually performed on organic material, but is yet called in vitro.

Around 6,000 babies a year are born in the UK to otherwise infertile couples as a result of in vitro fertilisation.

But the techniques used often arouse huge controversy and some say the process can falsely raise would-be parents’ hopes since it only has a success rate of around 15%.

There have also been cases of fertilised eggs being mixed up in the laboratory and the wrong embryo being transferred to the woman, leading to fears about how the process is carried out.

New techniques coming on stream:

One of the biggest and most controversial advances in IVF in recent years has been the introduction of a technique called ICSI – intra-cytoplasmic sperm injection.

This works by injecting a single sperm directly into an egg.

Some people fear the technique could increase the risk of genetic defects that make the donor infertile being passed on to babies.

ICSI was introduced during the 1990s, but new advances are helping men with a very low sperm count to benefit from it.

These include operations to search for sperm which can be retrieved and injected into an egg.

Another advance being developed at St George’s Hospital in London involves a 3D ultrasound device which helps to spot fertility problems before IVF begins.

For example, it can test whether there are any blockages in a woman’s fallopian tubes that could harm her chances of having a healthy pregnancy.

Other doctors at the hospital are pioneering a technique that could mean an end to hormone treatments and the painful retrieval of eggs from infertile women.

The technique involves collecting thousands of immature eggs from the ovary and developing them in the laboratory.

It works by removing a bit of the skin of the ovary which masks the place where immature eggs develop.

It takes five months to grow there properly and lots of nourishment.

The eggs can be frozen so that they can be used whenever the woman wants.

Again, the technique is controversial because it means a woman could store the eggs and use them at any age.

It is likely to be available in the next 10 years, say doctors at the hospital.

Dr Ian Findlay is also developing a test that can check for 10 genetic abnormalities in one go before a fertilised egg is placed in the womb. He said: “This could lead to a dramatic reduction in miscarriages as the vast majority of miscarriages are due to abnormalities.”

The politics of IVF

IVF is only successful in 15% of cases and a recent report from the College of Health shows that success rates vary widely across the country.

Only 18% of IVF treatment is funded by the NHS and waiting times can differ greatly.

It can cost up to £2,000 per cycle for a couple to go private.

Most couples have three cycles at an average cost of £3,420.

One way of getting free treatment is for women to donate their eggs to other infertile couples.

Opponents of IVF argue that it falsely raises would-be parents’ hopes that they will be able to have a baby when the chances are not that high.

They also argue that it can be a traumatic experience to go through repeated IVF attempts, only to find that the woman does not get pregnant.

Another possible drawback is the fact that IVF treatment increases the chance of having multiple births which the couple may not have planned for.

One to two per cent of pregnant women give birth to more than one child, but with fertility treatment the odds are raised to 25%.

Most of the babies born are twins, but bigger births are on the rise.

Many doctors are worried that they are being put under increasing pressure to use more of the fertility drugs to produce more eggs and so increase the chance of the woman getting pregnant.

Some believe fertility drugs could cause ovarian cancer.

Liz Tiberis, author of ‘No Time to Die’, believes her ovarian cancer was the result of nine attempts at IVF.

But fertility doctors say the link has not been proven.

The Cancer Research Campaign is investigating.

Who regulates the IVF process?

In the UK, the Human Fertilisation and Embryology Authority regulates and licenses fertility clinics under the 1990 Human Fertilisation and Embryology Act.

One area of controversy involves the processes clinics have for ensuring mix-ups do not occur over embryos.

This follows a US case where one woman wrongly received the fertilised egg of another.

Fertility experts say procedures in the UK are very tight and there is unlikely to be the same mix-up here.

But the Medical Protection Society recently reported the case of an expert who transferred three embryos from one woman into another by mistake.

However, he realised his error in time.

Calls have been made for procedures for matching eggs with mothers to be tightened, for example, by stipulating that doctors have to do a DNA test before implantation goes ahead rather than relying on written records.

You may click to learn more about IVF

BBC NEWS:31 March , 1999

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Vasectomy: Safe, Simple and Little Used

Newer surgical techniques reduce the risk involved with having a vasectomy.
Vasectomy is a simple, painless procedure that is very effective in preventing pregnancy. Men usually have no side effects from vasectomy, and no change in sexual performance or function.

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Newer surgical techniques reduce the risk involved with having a vasectomy.

In Short:-

Vasectomies are safer and more cost-effective than tubal ligations, the sterilization technique for women, but remain relatively underused.

A new no-scalpel vasectomy technique significantly reduces complications.

The rate of unwanted pregnancies after vasectomy remains low; most of those pregnancies can be traced to patient error.

A tiny puncture and a little snip, done under local anesthetic — that’s essentially all there is to a vasectomy.

“Vasectomies are the safest, simplest, most cost-effective method of contraception we have,” said Dr. Edmund Sabanegh Jr., director of the Clinic for Male Fertility at the Cleveland Clinic Foundation.

They are also strikingly little-used. About 500,000 American men have the operation each year. More than twice as many women undergo tubal ligation for permanent contraception, even though that operation costs three to four times as much, requires general anesthesia and an abdominal incision, and carries a small but real risk of serious complications.

“There’s something about having a surgeon fiddling around down there with a scalpel that makes even tough guys squeamish,” said Dr. Marc Goldstein, director of the Center for Male Reproductive Medicine and Microsurgery at the Weill Medical College of Cornell University in New York.

And then there are the misconceptions that discourage many men from having vasectomies, especially the widespread and groundless worry that the procedure will lower testosterone levels and affect sexual performance.

Whatever the reasons in the United States, the situation is not the same among men everywhere. By the time they reach their 50s, roughly half of men in New Zealand have undergone vasectomies, according to Dr. Sabanegh, compared with fewer than one in six in the United States. In Canada, vasectomies outnumber tubal ligations.

Experts hope that recent advances in vasectomy techniques will ease some of the fears.

The chief advance is the no-scalpel vasectomy, a technique pioneered in China in the 1970s that has been steadily gaining popularity in the United States. In a traditional vasectomy, doctors make two half-inch incisions on either side of the scrotum to sever the vas deferens, the two narrow tubes that carry sperm from the testicles during ejaculation. The no-scalpel approach does away with the need for incisions.

In the new technique, doctors use their fingers to locate the vas deferens by feel through the thin skin of the scrotum.

“Once we’ve located the vas, we make a tiny poke-hole over it,” said Dr. Phillip Werthman, director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles. The hole can be gently expanded in a way that pushes blood vessels aside rather than cutting through them, so there is almost no bleeding. Using a hooked instrument, surgeons pull the vas through the hole, then cut it.

“A lot of men can’t even tell where the procedure was done afterwards, the hole we make is that small,” said Dr. Goldstein, who was the first Western doctor to travel to China to learn the technique. Compared with traditional techniques, no-scalpel vasectomies result in less bleeding, less postoperative pain and quicker recovery. They also require less time to perform — a little more than 10 minutes in the hands of an experienced surgeon.

Although the traditional incision method is still more widely used, that is likely to change as more and more medical schools teach the no-scalpel approach.

In another bid to win over squeamish males, some doctors have replaced the needles used to inject anesthesia into the scrotum with high-pressure jets that deliver painkillers through the skin.

“A lot of men’s biggest fear is that needle,” Dr. Werthman said, even though the actual needle used is so narrow that most men barely feel it. “Pressure injection takes the psychological edge off that,” he said, though many patients find the loud popping sound it makes unpleasant.

In the end, the success or failure of a vasectomy depends not on how surgeons reach the vas but how they block it. Many doctors use several methods to ensure that sperm don’t find another path. Along with cutting out a small section of the tube, they may burn the inner lining of the two remaining ends, clamp them and separate them.

With current techniques, the chance of an unwanted pregnancy occurring in the first year after a vasectomy is 1 in 1,000, Dr. Sabanegh said. Some of those failures are the fault of the patient, not the procedure. Because it can take several months for sperm remaining after a vasectomy to be washed out, men are counseled to use other contraception methods until tests show that their semen is free of active sperm. Many men don’t bother. In a 2006 study of 436 vasectomies, researchers at the Cleveland Clinic Foundation found that only three out of four returned for follow-up semen analysis, and only 21 percent followed the full instructions to continue to be tested until two specimens came up negative.

Sources: The New York Times : June 29, ’08

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It’s Lime Time

 

Lemons and limes are an excellent source of vitamin C, one of the most important antioxidants in nature.


Lemons are a good source of Vitamin C

Vitamin C is one of the main antioxidants found in food and the primary water-soluble antioxidant in the body. Vitamin C travels through the body neutralising any free radicals with which it comes into contact in the aqueous environments in the body both inside and outside cells.

Free radicals can interact with the healthy cells of the body, damaging them and their membranes, and also cause a lot of inflammation, or painful swelling, in the body. Vitamin C has been shown to be helpful for reducing some of the symptoms of osteoarthritis.

Since free radicals can damage blood vessels and can change cholesterol to make it more likely to build up in artery walls, vitamin C can be helpful for preventing the development and progression of atherosclerosis and diabetic heart disease.

Source:The Times Of India

Piecing Together the Infertility Puzzle

Couples With Infertility Problems Often Focus on a Woman‘s Biological Clock and Forget About the Male Contribution.
It is well known that a woman’s ability to conceive takes a dramatic dive as she approaches 40, but, what about the male biological clock?…….click & see

Men are often the forgotten piece of the infertility puzzle, but recent research suggests that infertility or early pregnancy loss isn’t always because of an aging egg.

A recent report from the Journal of the American Medical Association looks at past research to examine why aging men experience declining fertility.

It appears that men older than 35 are twice as likely to be infertile as men younger than 25.

As men age, both the number and quality of their sperm decline   so older men become less likely to father a child and more likely to father a child with schizophrenia, Down syndrome, or other problems.

A recent study suggests that autism, an increasing problem with no known cause, may also be linked to paternal age because men 40 years or older are almost six times more likely to have a child with an autism disorder than men younger than 30.

Miscarriages also are more common as dad gets older.

It’s not unusual for a woman to get her hormones, ovulatory function and fallopian tubes tested months before her husband has even had a basic semen analysis.

Given that 20 percent of couples are infertile because of abnormal or absent sperm and that 27 percent of infertile couples have a combination of male and female factors, it makes sense to evaluate a man’s equipment, so to speak, sooner rather than later.

Sperm Quality, Not Quantity, Sometimes a Problem

While it’s true that it only takes one sperm to impregnate an egg, sperm are not particularly skilled at the whole penetration thing.

While women only need to release one egg to successfully conceive, pregnancy is unlikely to occur unless there are millions of sperm swarming around it.

That’s why the first step in an evaluation of male fertility is a semen analysis, to see how many of the little guys there are.Counts greater than 20 million are considered to be normal.

Before a proud man with a count in the zillions alerts the media, he needs to keep in mind that even if the number is high, sperm quality is also a factor.

Every sample of semen has lots of sperm that are abnormal. If more than 85 percent of the sperm don’t have heads, tails, or look funny in some way, it doesn’t bode well fertility-wise.

In addition, if a sperm looks normal but is directionally challenged, the likelihood of finding its way down the fallopian-tube highway is limited.

Anything less than 25 percent to 40 percent forward motility reduces pregnancy rates. These are all factors doctors consider when running a semen analysis.

The Source of the Problem Sometimes Solvable, Sometimes Unexplained

There are four main causes of male infertility.
In roughly 10 percent to 20 percent of infertile men, an obstruction prevents sperm from traveling from the testis (where it is produced) to the urethra.

Roughly 30 percent to 40 percent of infertile men suffer low-sperm production as a result of testicular problems, resulting from infection, drugs, radiation or environmental toxins.

While hormone levels should be tested, they are rarely the problem.

Sometimes a low-sperm count is attributed to a varicocele — dilated veins in the scrotum. Varicocele repair was at one time a routine procedure thought to enhance male fertility, but is now highly controversial.

Studies show that the improvement in semen quality after varicocele repair doesn’t always translate to increased pregnancy rates and can use up precious time, especially when a woman’s biological clock is ticking.
The remainder of infertility is unexplained.

Men, unlike women, produce new sperm throughout their reproductive lives.
So while a 40-year-old woman is dealing with a 40-year-old egg, sperm is never older than 3 months old regardless of the age of the man.

However, that sperm becomes lower in quality as a man ages.
Aging men have declining levels of sex hormones, and it appears that these declining levels of testosterone have a significant impact on sperm production.

This well-publicized fact is certainly part of the reason that a number of men taking supplemental testosterone have increased 210 percent since 1999.

Supplemental testosterone is no magic pill, however. While higher testosterone levels potentially, but not definitively, result in improved sperm number and quality, supplemental testosterone may also be responsible for a number of health problems such as an increased risk of prostate hyperplasia, and possibly cancer.

Treatment: No Sperm Isn’t Always No Way

What is a man to do if doctors find his sperm isn’t up to donor quality?
Testosterone supplementation is rarely the cure. Urologists who specialize in male fertility can sometimes come up with specific causes and treatment recommendations for a less than terrific semen analysis after an evaluation of the man in question.

If there are quality sperm   but not a lot of them   assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm Injection (in which a sperm is actually injected into the egg) can solve the problems of many infertile couples in which a male factor is the dominant problem, but the techniques are complicated and expensive.

If sperm is being produced but is not transported properly, it can be retrieved from the testis prior to ejaculation.

Certain conditions result in an inability to make sperm and are not treatable. If that is the case, pregnancy can be achieved only with donor sperm.

What a Man Can Do Now?
Men can eat right, not smoke, and exercise regularly — the standard and very effective health advice that applies to so many situations — to help keep sperm as healthy as their biology allows.

Contrary to popular opinion, it is not necessary to replace those tight jockey shorts with baggy boxers.
It really doesn’t make a difference and clearly does nothing to enhance a man’s desirability.

Source:ABC News