Infertility among men is a common issue but it’s one that is rarely talked about.

A doctor from Waterstone Clinic said the procedure for men to get checked out is “non-invasive and not expensive compared to what a female has to do”.

Head of Laboratory Services at Cork Fertility Centre Dr Tim Dineen told TheJournal.ie that men are far slower to seek help compared to women and that finding out they are infertile can have a massive impact on a man’s opinion of himself.

However, he also stressed that treatment is straightforward and usually very successful.

Dineen said, ”Men tend to take a back seat role when couples are looking at fertility issues but male infertility is common.

“Generally speaking it’s the women that want to seek help in trying to address the problem if the couple realise conceiving is taking longer than expected.”

However, Dineen pointed out that the procedure for men to get checked out is “non-invasive and not expensive compared to what a female has to do”.

“We just need a semen sample but sometimes men are not able to produce when they’re told to produce due to the environment.

“From an investigation point of view it’s pretty straight forward and it gives us an indication of what the problem may be.

“Some guys may already be aware there could be an issue there, for example if a guy is diagnosed with CF, but the majority of men will come to the clinic not expecting that there’s an issue.”

Reaction

Being diagnosed as infertile can have a very negative impact on men.

Discussing a study that looked at men’s reactions to infertility, Dineen said that if a man is not expecting it, there can be low self esteem, a loss of confidence and a sense of guilt.

He added that there’s a tight link between virility and fertility, “It can be taken as an attack on their masculinity”.

Dineen said that generally speaking the majority of women he sees would be most concerned with having children and experiencing parenthood while many men want to get their partner pregnant.

“It varies somewhat- we have some guys who come through who are really open about it. There probably still needs to be a bit of work done but it is common, it’s not unusual.

“We would always encourage guys who have been given a notice of infertility – to talk about it and not to just keep it in themselves, sharing it with somebody does help.”

Solution  

He also explained that while it can be difficult to find why the sperm count is low or why a man is infertile, it can often be straightforward to treat.

“For a number of cases we see it’s difficult to find a reason and then correct the problem.

“Assisted reproductive technology is successful in overcoming the problem … we might struggle to tell him why his sperm count is so low but we can treat it.

“We do say that – if nothing has been picked up on her side and it’s solely the male problem – the chances of success are high.”

He explained that diet, exercise, smoking, cutting down on alcohol and caffeine can all have an effect, adding that even going into saunas and steam rooms – if done a lot – can make a difference.

Dineen also encouraged men who intend to be fathers to have a sperm analysis early on as it will get a couple onto treatment earlier and that’s important as the quality of eggs in women deteriorate with age.

He concluded that, “It’s the end result which is the main thing and making that transition to parenthood – people shouldn’t hold off on getting there”.

Any new Leaving Cert biology textbooks should include sections outlining how women’s fertility falls sharply during their 30s, according to fertility experts.

Dr John Waterstone, president of the Irish Fertility Society and medical director of the Waterstone Clinic, said the message is not hitting home to men and women that if they want to avoid fertility difficulties, women should start trying to get pregnant in their late 20s and early 30s.

He said too many patients at fertility clinics are “losing sight of the biological realities” and are shocked to discover that due to their age, their egg quality is poor and their likelihood of conceiving is low.

He and his colleagues also want the Department of Health to consider a TV ad fertility campaign, not unlike TV ads on contraception, warning people in their late 20s and early 30s they should be “fertility conscious”.

About 20% of first births in 2013 were to women aged 35 years or older, compared to 13% in 2004. Surveys have shown that women defer having a baby because they have not met the right partner while others wish to focus on their careers.

But Dr Waterstone said a fertility campaign should not be confined to women: “If men are not making the big life decisions and are just fiddling around, they are doing the woman in their lives a disservice.”

The Irish Fertility Society’s 10th conference is taking place in Kildare this Friday and Saturday.

http://www.irishexaminer.com/ireland/leaving-cert-biology-should-include-sections-on-womens-fertility-398951.html

Zika virus has spread to more than 20 countries in the Americas.

The unprecedented and explosive outbreak of the mosquito-borne disease is causing fear in the affected regions.

While the effects are generally mild, the greatest concern is about a strongly suspected link with brain defects in babies.

There have been no travel bans, but what advice is there for people visiting the regions?

Which countries are affected?

The Pan American Health Organization is publishing updates on the affected countries.

But the virus is expected to spread throughout North, Central and South America, except Canada and Chile, and people should check for the latest advice before travelling.

Should I go?

Only pregnant women have been advised to reconsider their plans to visit countries affected by Zika.

It is thought that within the female body the virus can travel across the placenta and affect the health of an unborn baby.

There has been a surge in microcephaly – in which the baby’s brain does not develop properly – in Brazil.

The UK’s National Travel Health Network and Centre says pregnant women should reconsider their travel plans, and that any traveller should seek advice from a health professional before departing.

And it adds that pregnant women who have to travel should take “scrupulous” measures to avoid being bitten by mosquitoes.

The US Centers for Disease Control says women trying to get pregnant should “talk to your doctor about your plans to become pregnant and the risk of Zika virus infection [and] strictly follow steps to prevent mosquito bites during your trip.”

Is it safe to get pregnant after visiting?

The CDC says Zika lingers in the blood for approximately a week.

And: “The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood.

“There is currently no evidence that Zika virus infection poses a risk of birth defects in future pregnancies.”

How to avoid mosquito bites?

Zika is spread by the Aedes aegypti mosquito which is most active during the day.

People are advised to:

• Cover up with long-sleeved shirts and trousers
• Use insect repellents such as those containing DEET or picaridin
• Apply sunscreen before using applying insect repellent
• Keep doors and windows closed and to use air conditioning

What about men?

It is thought the virus can persist in semen for two weeks after a man recovers from an infection.

Public Health England is taking a safety-first approach after two suspected cases of sexual transmission.

The organisation says the risk of spreading the virus through sex is “very low”.

But it recommends using condoms if you have a pregnant partner or one who might become pregnant.

This should be done for 28 days after coming home if you have no symptoms, and for six months if Zika symptoms do develop.

The US Centers of Disease Control advises either giving up sex or using condoms for the duration of a pregnancy.

What are the symptoms?

Most infections do not result in symptoms, but they may include:

• fever
• joint pain
• itching
• rash
• conjunctivitis or red eyes
• headache
• muscle pain
• eye pain

If you have Zika?

If you have symptoms such as fever, a rash, joint pain or red eyes, which develop either on holiday or when you return, then you should speak to a doctor.

The US Centers for Disease Control says:

• Take medicine, such as acetaminophen or paracetamol, to relieve fever and pain
• Do not take aspirin, products containing aspirin, or other nonsteroidal anti-inflammatory drugs such as ibuprofen
• Get lots of rest and drink plenty of liquids
• Prevent additional mosquito bites to avoid spreading the disease

By James GallagherHealth editor, BBC News website

http://www.bbc.com/news/health-35441675

It is important for men and women to know that their fertility health is not beyond their control. Some people will struggle with fertility issues, which can be male or female related, a combination of both, or sometimes can be unexplained. For most men and women though, there are simple precautions they can take to safeguard their fertility health.

Kick the habit: Not only is it beneficial for your overall health to quit smoking, but research shows it takes longer for smokers to become pregnant. Smoking can cause damage to the ovaries and fallopian tubes and alter the hormone levels required for pregnancy. Smoking also increases the risk of miscarriage within the first 12 weeks of pregnancy. Men who smoke have a lower sperm count that those who do not smoke.

Eat ‘fertility’ foods: Maintain a balanced diet with plenty of fresh fruit and vegetables, avoid processed foods, junk food and fizzy drinks. Reduce your alcohol intake if you consume more than the recommended units. Also reduce your caffeine intake; we would recommend not more than one cup of coffee a day, and less if you are actively trying for a baby. Eat essential fats instead of trans-fats. Omega 3 essential fatty acids, found in fish oils and good-quality flaxseed oils, are an excellent source of essential fats. While recommended for healthy cell development, essential fats also play an important role during pregnancy. Cut down on animal protein and boost your intake of plant proteins, such as pulses and legumes which are rich in B vitamins necessary to support fertility. Nuts are a great source of zinc, which is an essential nutrient for fertility. Brazil nuts are good for selenium which is important for male reproductive health.

Aim for the right BMI: Being either underweight or overweight can have a negative impact on fertility for both men and women. If you are actively trying for a baby, or even just trying to boost your fertility health for the future, it is a good idea to calculate your body mass index (BMI). Aim for a healthy weight; a BMI of between 20 and 24.9 is ideal. For women, maintaining a healthy weight will help regulate your menstrual cycle and increase your chances of conceiving. You should also be aware of your mid-abdominal fat. Excess fat in this area can disrupt hormones and interfere with the functionality of the reproductive glands. The key message to achieve this is to engage in regular exercise and maintain a healthy diet

Exercise the right way: Avoid vigorous exercise – especially if you are actively trying for a baby. For men, over exercising can potentially overheat the testicles, which need to be kept at a cooler temperature to produce sperm in the right way. Over exercising and being underweight can play havoc with your reproductive health. For example, underweight women can often experience problems with irregular periods, which affects ovulation. The exercise you engage in should be enjoyable, and also should also be a stress reliever for you. Stress can also have a negative impact on fertility. So if you and your partner are trying for a baby, exercise such as yoga, swimming, dancing or walking is ideal. 

Become informed: Become aware of the link between age and fertility, this is especially important for women. Fertility is age related and everyone should be aware of how their fertility changes. Women’s fertility rate begins to decline from age 30. Research has shown that there is a more pronounced decline at 35 and then a sharp decline from age 40. Men’s sperm can also start declining in quantity and quality from 40 on. The reason it is good to be aware of this is so you can take charge of planning for your future. If you are certain you want to have a baby, but are not ready right now, you can avail of a simple and straightforward fertility assessment. This will inform you of whether you are in top fertility health, or whether you might need to take some early steps to address an issue.

Experts have said young adults are putting their future chances of becoming parents at risk by their lack of knowledge about fertility.

Many young people don’t learn about their reproductive health until they’re trying to conceive, they said.

The comments come ahead of a conference of leading fertility experts – they’re coming together to address how the nation can improve young people’s knowledge of fertility.

“Many young people encounter few opportunities to learn about their reproductive health until they try to conceive,” said Professor Adam Balen, chairman of the British Fertility Society, who organised the summit.

“One in six couples experience difficulties in becoming pregnant and the associated emotional and physical impacts cannot be underestimated.

“Our aim is to ensure that the knowledge components of sex and relationship education not only cover how to avoid pregnancies and sexually transmitted infections, but also include information about fertility to help people plan.

“It should be choice not chance – we want to enable young people to make informed choices about pregnancy, whether that choice is to start a family or not.”

Fertility rates for both sexes actually decline gradually from the late 20s, and can be affected by genetic and environmental factors such as smoking, obesity and nutrition.

But in a new poll, conducted to mark the Fertility summit, four in five of those polled thought a women’s fertility only started to decline after the age of 35.

And two-thirds of the 1,000 young adults surveyed thought men’s fertility only started to decline after the age of 40.

A third of the young women polled were unaware that being overweight or underweight affected fertility.

And 40% of these women mistakenly believe that having a miscarriage or being on the contraceptive pill for too long could adversely affect fertility.

Dr Chris Wilkinson, president of the Faculty of Sexual and Reproductive Healthcare and a consultant in sexual and reproductive healthcare, said: “We remain concerned that sex and relationship education in schools is not universal.

“Where it does occur, this education can be variable and time spent on it is often very limited.

“We strongly urge governments across the UK to improve the quality of sex and relationship education so young people leave school armed with the necessary facts about not only safe sex, contraception and consent but also fertility and reproductive health.”

http://www.irishexaminer.com/examviral/science-world/young-peoples-chances-of-parenthood-at-risk-due-to-lack-of-fertility-knowledge-393185.html

Here are 11 things people struggling with infertility want you to know:

1) Being infertile is tough.

Every day, we think about how we want to get pregnant but aren’t able.

2) Other people’s pregnancies hurt.

Just being honest here. It’s painful when someone announces they’re pregnant. We don’t want to take away your happiness, so don’t be afraid to share the good news. But yes, it’s difficult for us.

3) Saying “You’re lucky not to have kids” doesn’t make us feel better.

We know our lives will change drastically if we have kids. You may think that making your blessing sound like a curse would make us feel better. It doesn’t.

4) Don’t say, “Worse things could happen.”

To a couple who just wants to love and nurture a child, infertility is definitely the worst thing that could happen.

5) Being young doesn’t always mean we have plenty of time to get pregnant.

It’s simply not always true. Infertility.About.com gives this example: for a woman with premature ovarian failure, time is not on her side. The longer she waits, the more likely she will need an egg donor. Commenting on age is dismissive and unhelpful.

6) Don’t tell us success stories.

We’re well-educated on statistics and success rates. We see specialists, and monitor ovulation, sperm count and hormone levels. So those tales of someone else’s success make us feel inferior. Besides, success stories don’t make us hopeful, they make us feel worse.

7) Don’t say, “Just relax.”

How can we relax when we can’t control the one thing we want more than anything? Infertile people aren’t just stressed-out and in need of relaxing. There is so much more to conception than that.

8) We don’t believe that “Everything happens for a reason.

Please don’t say that. We’re constantly asking ourselves why it isn’t happening. We know you may think it is a kind comment, but it’s not.

9) Don’t ask about IVF.

In vitro fertilization is not the cure-all for infertility. IVF is rarely covered by insurance and very expensive. One treatment cycle can cost between $12,000 and $25,000.

To be successful, many treatment cycles may be needed. Furthermore for women under 35, there’s a less than 40-percent-per-cycle success rate, according to Infertility.About.com.

10) We know adoption is an option.

Mentioning adoption ignores our feelings about wanting our own flesh-and-blood child. Not to mention the financial costs of adoption. There’s a lot involved in adopting a child. And it doesn’t just happen.

11) It hurts when people say, “Maybe you’re just not meant to be parents.”

No one knows why infertility happens to some people and not to others. Don’t pretend to know why we haven’t conceived.

Sandra and Gavin McSweeney tell our reporter about the unexpected joy of conceiving not once but twice via IVF

Anyone who has been through it, will tell you that IVF can be tough. There are the frequent doctor’s appointments, the injections, the procedures, the scans, the nerves, the hopes and often the disappointments. There’s the financial cost, the stress and the strain it can put on a relationship.

But then anyone who has been through it and held their baby at the end of it will tell you it was worth it. Not all of them, though, will want to go through it all again.

And yet Sandra McSweeney’s story is proof that happy endings can happen twice. The 38-year-old from Ballygarvan, Co Cork can still remember that aching feeling of longing she felt when she and her husband Gavin (38) were trying to conceive.

“I felt like there were babies and buggies everywhere,” she recalls. “I remember looking longingly at bumps. It was very difficult but at the same time I wouldn’t have wished it on anyone, it’s devastating not to be able to have children when you desperately want to have one.”

When she was 27 years old Sandra was diagnosed with Endometriosis, a condition affecting the lining of the womb. She needed surgery to have a painful cyst removed, but the procedure revealed how damaged her womb was and one of her fallopian tubes had to be tied.

“I was advised that it might cause fertility problems, but I didn’t really think about it too much,” she says. “At the time I felt I had time on my side and I remember thinking, ‘well, hopefully it’ll happen’.”

Unfortunately hope wasn’t enough. Despite changes to her diet and trying acupuncture, Sandra’s condition left her unable to conceive naturally. “It was devastating but we had to say ‘ok, what other options have we?’,” she says. “Thankfully Gavin and I were on the same page. We really wanted a baby and we wanted to give it our all to be parents but we also knew that we didn’t want it to consume our lives and destroy our relationship.”

In July 2011 they started In Vitro Fertilisation (IVF) treatment with the Waterstone Clinic. The process is one of the most popular routes taken by couples battling conception difficulties. Daily injections of medication are used to stimulate the ovaries to produce a number of eggs which are then collected and mixed with the male’s sperm in the laboratory, allowing fertilisation to occur.

“The developing embryos are then monitored closely and the healthiest embryos are then transferred to allow for implantation,” explains Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic. “There are several stages and the average treatment cycle takes approximately eight weeks from the start of medication until a pregnancy test is taken.”

Sandra’s first cycle was cancelled early on because she had no follicles to produce eggs for collection. Their second cycle also ended prematurely when they were told there were no eggs.

“It was very upsetting,” says Sandra. “Maybe we were a bit naïve but we felt like making the decision to start treatment had been the big thing, we weren’t really prepared for set-backs.”

And yet some statistics would suggest that only about 20-30 percent of IVF treatments lead to conception, with other factors like age also playing a part. Interestingly there is no official data available in Ireland for how many babies are born through IVF. Unlike the UK and USA, the State has no formal reporting procedure, something the fertility clinics here are seeking to change so patients can have access to transparent information on success rates.

With WHO statistics finding that one in five Irish people has some difficulty with fertility, it seems safe to assume that a growing number of people are choosing to go down the route of medical assistance, even if they’re not talking about it.

Sandra and Gavin decided to be open with friends and family from the start. “We wanted to talk about it and we found that the more we spoke to people, the more we realised how many other couples we knew had gone through similar experiences,” says Sandra.

“There’s definitely a taboo there, even when we went to the clinic for appointments there would have been a lot of eyes on the ground, no one wants to make eye contact in case they see someone they know!

“But our attitude always was that if this was something that, if it helped us, then it was amazing, but definitely not something to be ashamed of and I don’t know if we would have got through it if it hadn’t been for the support of our friends and family.”

On their third attempt, in March 2013, the couple completed a full cycle of treatment and Sandra was given a date to take a pregnancy test. After counting down for two weeks, the result was devastating: negative.

“We had to leave it for a while after that, just to get our heads around it, but I still knew that I really, really wanted to give it one more shot,” remembers Sandra. “We went back and were advised that maybe IVF wasn’t going to work for us and we might have to look at other options like egg donation.”

But just over nine months later, and weighing a healthy 8lbs 2oz, baby Maisey was born.

She arrived just eight weeks after the death of Sandra’s mother, and whilst she provided a light at a dark time, it was heartbreaking they never got to meet. Emotionally and financially both Sandra and Gavin’s parents had been a vital source of support. A full cycle of IVF costs in the region of €5,000 with incomplete cycles a fraction of that cost depending on what stage of the process is reached. They were, says Sandra, “extremely lucky” our parents helped us out with money.

Which was one of the considerations they had to factor in when they decided to try for another child.

“I’m from a family of five and there are four in Gavin’s family and we all live in Cork and are very close,” explains Sandra. “I really wanted Maisey to have a sibling and I knew from the point of view of my age, the clock was ticking.

“But at the same time it felt a little bit greedy. We’d already been so unbelievably lucky to have our first baby. There are only so many favours you can ask for and it’s hard to say, ‘would you mind funding this again?’ when the goal had been to have a child, which we did.”

She doesn’t know if they would have tried as many cycles again, but happily it’s not a question that needs answered – after the first round of treatment she was pregnant with their son Joey.

According to Dr Dineen, the fact that Sandra had already had a baby was a good prognosis for delivering a second child, nor did embarking on the treatment plan again come with any additional risk.

Sandra wants to pay tribute to the staff at Waterstone Clinic and reassure other would-be mums. “I hope our story might give hope to somebody who is considering IVF and maybe a bit scared,” she says.

Some nights she finds herself staring down at Maisey, who will be three next month, and 10-month-old Joey as they sleep.

“I just find myself reflecting on how unbelievably grateful I am,” she says. “Every baby is precious but they are definitely extra special to us. I tell them they’re my magic beans, they’re our little miracles.”

Advice for couples considering IVF

Research and review your choice of clinic asking questions about services offered, success rates, inspection records and any hidden costs. “Ideally you want to avoid long journeys as a number of visits to the clinic will be required for scans and having a local clinic will eliminate the stress and cost of travelling,” says Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic.

Ensure you fully understand your treatment plan and are aware of any possible side-effects.

Decide in advance whether to tell family and friends.

“It’s important to look after your relationship during treatment,” says Dr Dineen. “Complimentary counselling is available at Waterstone Clinic and patients are encouraged to avail of this service.”

Look after your health. “Start taking folic acid, engage in regular exercise (but nothing too vigorous), eat as healthily as possible and most certainly, stop smoking,” advises Dr Dineen.

Chrissie Russell, Irish Independent

http://www.independent.ie/life/family/family-features/irish-couples-unexpected-joy-as-they-conceive-twice-with-ivf-i-tell-my-babies-that-theyre-my-little-miracles-34605328.html

Cystic Fibrosis Ireland Annual Conference 2016 will take place from Friday 8th – Sunday 10th April 2016, in the Clarion Hotel Sligo. Dr. Tim Dineen, Head of Laboratory Services at Waterstone Clinic is delighted to attend the event as a guest speaker and will discuss “Reproductive Health – Management & Treatment in Cystic Fibrosis” at 11.30 on Saturday April 9th.

Cystic Fibrosis is a genetically inherited disease that primarily affects the lungs and the digestive system. Ireland has the highest incidence of Cystic Fibrosis in the world – approximately 1 in 19 Irish people are said to ‘carry’ one copy of the altered gene that causes Cystic Fibrosis.

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