Waterstone Clinic has announced the first reported pregnancy as a result of an advanced sperm retrieval technique, Microsurgical Testicular Sperm Extraction (Micro-TESE) in Ireland. This development offers new hope to men struggling with sperm-related fertility issues. It means there is a greater possibility for affected couples to have children, without having to use donor semen.

The Micro-TESE procedure was carried out on a patient from Cork in conjunction with the centre’s scientific team, before the man and his partner underwent IVF treatment. The patient previously had testicular surgery which affected his sperm production, and as a result required Micro-TESE.

The procedure was performed by Waterstone Clinic’s Consultant Urologist and Andrologist, Dr Ivor Cullen at his practice in University Hospital Waterford. Dr Cullen is one of only a few urologists in Ireland qualified to carry out this highly specialised surgery.

Commenting on the success with Micro-TESE, Dr Cullen said “This is a landmark pregnancy and very positive news regarding the treatment of male infertility and in particular azoospermia. Azoospermia is a condition where no sperm cells are found in a semen sample, perhaps as a result of a hormone imbalance or other medical problem. It offers renewed hope to these men, and to men who have been diagnosed with defective sperm production, or had previous unsuccessful conventional sperm retrieval procedures.”

Micro-TESE is a welcome development in the treatment of men who cannot produce sperm. The procedure involves carrying out targeted dissection of tiny tubes within the testicle, which are more likely to contain sperm. A high powered microscope is used during the procedure to distinguish between healthy and unhealthy tissue. The healthy tissue samples are then examined in the laboratory. If viable sperm is found, it is prepared and frozen for use in a subsequent IVF cycle.

Head of Laboratory Services at Waterstone Clinic, Dr Tim Dineen, also commented “The team at Waterstone Clinic is delighted for this couple and would like to extend our congratulations. This procedure involved precise surgery and robust laboratory techniques; we will continue to pioneer innovative and evidence-based procedures and techniques, such as Micro-TESE, that help and benefit our patients overcoming their fertility struggles.”

Waterstone Clinic has carried out in-house testicular biopsy – known as TESE – for men with azoospermia for over a decade, and achieved their first birth through this technique in 2004. TESE is beneficial for azoospermic men whose basic problem is duct blockage. Micro-TESE is a more advanced procedure for men whose basic problem is failure to produce sperm cells. Both treatments are available at Waterstone Clinic.

Under the covers with men’s sexual health issues

Do a quick Google search for womens health. You will receive approximately 152 million results. Do the same for mens health and you will get 22.3 million. Is this sexism in another guise, or is it purely indicative of male reluctance to discuss their health issues, even with Dr Google?

Consultant urologist and andrologist at University Hospital Waterford (UHW) Ivor Cullen says men should be aware that there is a wide range of solutions to many problems they may perceive as being embarrassing or distressing.

Cullen trained in several ground-breaking techniques during his time working in the leading urology centre at University College London Hospital. Many of these have not been available in Ireland until now.

Breakthroughs in fertility medicine have not just been confined to female fertility issues; the area of male infertility has seen a revolution in recent times, says Cullen.

Sexual dysfunction has also moved on from the “little blue pill”. When Viagra doesn’t work, there are many other options for men struggling with erectile dysfunction.

The important thing to remember is that no worrying or “embarrassing” health problem can be addressed if a man doesn’t approach his GP or health professional about it, Cullen says.

Erectile dysfunction

Erectile dysfunction affects about half of all men at some point in their lives. For some it may just be temporary, but for others it can be a persistent problem. For some this can be treated with physiotherapy and muscle re-education exercises. It can also be treated with medications – the phosphodiesterase type 5 inhibitors (such as Viagra). However, for those men who do not respond to these treatments, there is now the surgical option of an inflatable penile prosthesis.

As part of this procedure, hydraulic pumps are inserted so that men with erectile dysfunction can have functioning erections and have sex normally. Although this procedure has been offered in Ireland before, in Cullen’s opinion, the uptake has been quite poor, mainly owing to a lack of knowledge in the area among both patients and the health profession at large. “Penis implant surgery is just not requested or desired by patients as they are unaware of the option,” says Cullen, contrasting this with his experience in London where a significant proportion of men with ED are aware of and will choose the implant surgery as an option when the medications fail. “It has been offered to a limited number of patients in one or two centres. There is very little knowledge about penis implant surgery. No one talks about it here, but in other parts of the world that’s not the case, it’s quite commonplace.”

According to Cullen, common candidates for this procedure are younger men with type 1 diabetes who often ultimately get erectile dysfunction early in life, often starting after the age of 40 and medication eventually does not work. In addition, men who have had their prostates removed or had radiation or hormonal treatment, usually as a result of prostate cancer, would also benefit from this surgery, as the majority of these will lose the ability to have an erection and often will not respond to the usual medications.

The procedure can be carried out by Cullen and his team at UHW. A three-piece hydraulic inflatable implant is inserted, which isn’t visible externally. A small pump sits in the scrotum, much like a third testicle, explains Cullen. The two-piece prosthesis is implanted in the penis, while a reservoir is laced in the lower abdomen. When the pump is squeezed, the fluid goes from the reservoir into the prosthesis and makes it erect. This ensures a rigid erection every time, satisfactory for penetrative intercourse and dispensing with the need for expensive medications or injections. “Obviously that’s not for everyone but it is a fantastic addition to our options. Satisfaction rates with penile implant surgery are always remarkably high – 90-95 per cent. In a well-chosen patient who is properly counselled, it can be a wonderful option for erectile dysfunction,” Cullen says.

Curved penis

A curved penis, also known as Peyronie’s disease, affects 4-8 per cent of men, and can make normal intercourse impossible. “Peyronie’s disease does not refer to a mild curve,” explains Cullen. “Every man’s penis has a minor degree of curvature, but problems arise when there is over a 30-45 degrees of curvature, making penetrative sex impossible.

“The curve develops because of abnormal deposition of scar tissue – “plaque” in the erectile bodies within the penis – which shortens the affected side and results in curve development. “Men cannot have a satisfactory sex life due to the shape of their penis, which can resemble a boomerang.”

Several surgical options exist for patients, whereby the penis can be straightened. One possible option to correct the curvature is the Nesbit procedure, which involves plication (suturing) of a section of the penis opposite the problematic plaque or scar. This operation will usually ensure a straight penis albeit with a minor loss of length.

Other potential approaches range from injections of a digesting enzyme (collagenase) into the scar tissue to break it down, grafting procedures and potentially implant surgery, if the co-existing erectile dysfunction is significant. Again Cullen says that in most cases men are not forthcoming about what they might see as an embarrassing problem. “Men are often very bashful and shy and don’t talk about these problems with their partners or friends, much less see their doctors about them,” says Cullen.

“It can often be slowly destroying their relationship or marriage, and they need to understand that this is a recognised and correctable phenomenon, and easily fixable surgically.”

Male factor infertility

Male factor infertility contributes to approximately 50 per cent of cases of infertility and for men whose semen analysis is suboptimal, there are more treatment options than ever before. There is a plethora of reasons as to why someone might have what is deemed an “abnormal” semen analysis, says Cullen.

“They may have a low count, poor motility, or a low number of normal sperm forms. We evaluate them and investigate them and, in many cases, we have medical, surgical options or lifestyle interventions that can improve the quality of their sperm. It could be something as simple as stopping them from using daily saunas and Jacuzzis, to putting them on zinc and folic acid supplements.”

One of the more common reasons for a subnormal semen analysis is a varicose vein of the spermatic cord, known as a varicocoele. This condition can raise the temperature of the testicle and impair sperm production. “Lots of men have a minor degree varicocele, which is of no clinical significance, but when we find a significant varicocoele in a gentleman with an abnormal semen analysis, simply tying off the extra varicose veins will typically improve that man’s sperm analysis.” Unfortunately, there are also men with no sperm at all in their semen, a condition known as azoospermia. Cullen says these are the most challenging patients he will treat with respect to male infertility. “It is a devastating diagnosis for a man; they will usually have been trying for a family for 12-18 months before someone says, let’s get checked. To find out there is no sperm at all is just a disaster for them.”

Tests are carried out to determine if the condition is due to an obstruction in the transport of sperm cells from the testicle to the ejaculate, or if there is a fundamental problem with sperm production within the testis. The obstructive type could be due to scarring of the vas deferens or epididymis, sometimes as a result of chlamydia or gonorrhoea.

A hernia repair or undescended testicle repair may also be the culprit. This can often be treated with a procedure that is much like a vasectomy reversal. “With this scenario, it really isn’t the end of the world, because even if you can’t fix it, their testes are still full of sperm,” explains Cullen. If this is the case, an option is a intracytoplasmic sperm injection (ICSI), where the sperm is injected directly into the egg. This treatment is offered in a number of clinics in Ireland. “That works so well now that all we need is sperm.”

In cases of non-obstructive azoospermia, a man will have no sperm at all in his semen. Recent advances in treatment have meant that at last these men have therapeutic options.

In the past, these couples had no choice other than using donor sperm or going down the route of adoption. In particular, a technique known as microdissection testicular sperm extraction (micro-TESE), has revolutionised the approach to finding small numbers of hidden sperm for use in the ICSI procedure.

The technique is another Cullen learned during his time in London; he now offers the procedure in conjunction with the Waterstone Clinic. He warns, however, that there is only a 50/50 chance of “success”; small numbers of sperm will be located in approximately half of the men he treats, while no sperm will be found in the other 50 per cent. “What I am trying to do is find their sperm for use in ICSI or as part of an IVF regime. But before I carry out the procedure I like to make sure that couples have had a chance to discuss and develop a back-up plan and perhaps speak to the sperm donor service if they so wish. “When there is no success, it can be devastating for a couple, and anticipating and discussing the implications of not finding sperm in advance of the operation often helps tremendously.”

Andrology

Andrology (from Ancient Greek, Andros, meaning man) is the medical specialty that deals exclusively with male genital, reproductive and sexual health. It is the counterpart to gynaecology, which deals with medical issues specific to the female reproductive system. It is a recognised subspecialty of urological surgery. Although andrology is a well-established subspecialty in mainland Europe and also the UK, thus far Ireland has had low numbers of specialists trained in this field.

Cullen suspects this is because of the well-recognised need for prostate, bladder and kidney specialists in Ireland, with the majority of his contemporaries instead choosing these routes for subspecialisation. The area remains under-served in Ireland.

“Andrology is a fascinating subspecialty, which offers tremendous medical and surgical options to gentlemen with a variety of male specific ailments,” says Cullen, who has spent 13 years training in this area.

With men living longer and our increasingly elderly demographic, he says there is a need for particular focus to be paid to late onset hypogonadism – often termed the “male menopause” – in older men. Symptoms range from sexual, such as erectile dysfunction, physical, with a loss of vigour and frailty, as well as having significant psychological impact. This can be successfully treated with testosterone replacement therapy, although lifestyle modification, weight reduction and appropriate treatment of comorbid diseases is the first step, Cullen is keen to emphasise. “Symptoms of low testosterone are well recognised and correctable in the hands of a specialist, which can lead to tremendous improvement in cardiovascular, sexual, mental and metabolic health.”

http://www.irishtimes.com/life-and-style/health-family/under-the-covers-with-men-s-sexual-health-issues-1.2660563

Waterstone Clinic takes pride in providing the highest standard of fertility treatment with evidence-based medicine the cornerstone of our good clinical practice.

We at Waterstone Clinic welcome the recent British Fertility Society practice guidelines published in Human Fertility, which confirms our long-standing belief that insufficient evidence exists to recommend adjuvants such as intravenous immunoglobulin (IVIG), anti –TNF α agents (e.g. Humira), intralipid infusions, corticosteroids, aspirin, sildenafil, DHEA or low molecular weight heparin in routine IVF practice.

Indeed, apart from the lack of evidence to support the use of these adjuvant therapies, the practice guideline emphasises the potential risks associated with these therapies, such as the risk of anaphylaxis and infection with IVIG and the increased risk of lymphoma, skin cancers and granulomatous infections with prolonged use of anti –TNF α agents. It is of paramount importance that patients prescribed unproven therapeutic agents have the available evidence for clinical benefit and the potential adverse effects discussed with them.

Waterstone Clinic continues to produce excellent success rates that are not reliant on the provision of therapies of unproven benefit.

The UK’s fertility watchdog is becoming “increasingly concerned” that private clinics are offering ‘add-on’ treatments which have not been properly tested to see if they actually work, it can be revealed.

In a series of interviews with The Independent, leading experts variously claimed some clinics were giving out “expensive, potentially harmful stuff like Smarties”, announcing breakthroughs that were closer to marketing “hype” and that half of the people treated did not actually need any help to have a baby.

A Cambridge university immunologist also said the use of immune-suppressant drugs by clinics was based on a flawed theory that this could help prevent miscarriage and broke the medical maxim to “first do no harm”.

Despite regular announcements of new techniques, progress has been relatively modest. In the 10 years to 2013, the average birth rate following IVF rose from about 20 per cent per cycle of treatment to 26.5 per cent.

After the Human Fertilisation & Embryology Authority was contacted about the experts’ concerns, the HFEA’s chair Sally Cheshire said it was planning to take action to help patients decide which techniques were worthwhile.

“Although the vast majority of clinics provide excellent care for fertility patients, we are becoming increasingly concerned about IVF treatment ‘add-ons’ without a strong evidence base being offered at some clinics,” she said in a statement.

“We know from talking to patients that they can find navigating the IVF process difficult and the offer of ‘add-ons’ can increase their confusion, and the cost of their treatment.

“Patients are often not sure whether they need the additional treatments but worry that they could regret not making every attempt they can to get pregnant.”

She said the HFEA was now working with scientists and the industry to “provide accurate and easy-to-understand information about these new treatments”.

One of Britain’s leading fertility experts, Yacoub Khalaf, director of the assisted conception unit of at Guy’s and St Thomas’ Hospital in London, stressed that some of those working in private fertility clinics were “very decent and honest people”.

But he added: “At best, patients are subject to exploitation; at worst, patients are being subjected to harm.

“All of this needs to be subjected to rigorous checks — and a reality check among the providers and the users.”

Mr Khalaf said some fertility clinic staff were simply putting “two and two together” about treatments that appeared to show signs of success without waiting for genuine scientific proof.

He said there might be a small number of patients who would benefit from such treatments, but this was “not a recipe to just dish out expensive, potentially harmful stuff like Smarties”.

“Some patients, through their use of expensive, unproven medication, could be deprived of the financial resilience to try again,” he added.

IVF treatment was developed in the 1960s by Sir Robert Edwards in work that later won him the Nobel Prize and one of his first graduate students was Martin Johnson.

Now emeritus professor of reproductive sciences at Cambridge University and joint senior editor of the journal Reproductive BioMedicine and Society, he pointed to “a lack of scientific rigour” behind some fertility clinic techniques.

“What it means is the treatment could be making their situation worse and certainly not improving it — and is costing them money. It’s all about anecdotal evidence or no objective evidence,” Professor Johnson said.

He said he felt the people doing it generally acted in “good faith”. “People can believe something that isn’t necessarily true. I would not describe it as a scandal. It’s over-enthusiastic clinics hyping some of their treatments more than they should do so,” he said.

But when asked if he had an “understanding” attitude towards their actions, Professor Johnson disagreed, saying: “I’m trying to think of explanations for why people, who are otherwise ethical, might do this.”

Dr John Parsons, founder and former director of King’s College Hospital’s assisted conception unit and a trustee of the Progress Education Trust fertility and genetics charity, has more than 30 years’ experience in the field.

Now semi-retired, he said he felt “very strongly that the industry – whatever you want to call us – has used whatever is to hand, regardless of whether it works or not, ever since I’ve been involved”.

“Every time there was a new, in inverted commas, ‘breakthrough’, it was tried on everybody and anybody,” said Dr Parsons.

“It’s got a bad smell about it. It’s all about the money. I worked in King’s College Hospital and was paid an NHS salary, but you get tainted by it. That was a pretty unpleasant feeling.

“I genuinely believe at least 50 per cent of the people who got pregnant didn’t need our help.”

Perhaps the most alarming technique is the use of drugs to suppress specialised immune cells in the mother’s uterus.

Cambridge University immunologist Professor Ashley Moffett said the idea that the foetus might be attacked by its mother’s body because half the unborn baby’s DNA comes from the father was first suggested by Nobel Prize winning biologist Sir Peter Brian Medawar, known as the “father of transplantation”.

“That’s a very attractive idea, but it’s actually not correct. But it’s become firmly embedded and it’s extremely hard to dislodge it, even among scientists,” Professor Moffett said.

“There’s certainly no evidence that it [immune-suppression] does any good and there is the potential that it can do harm because these treatments are immunosuppressive.

“Risking immunosuppression in someone who is young and fit is to me … first do no harm.”

She said one woman given immunosuppressant drugs by a private clinic became pregnant, but also seriously ill with a fungal infection. After the infection got into her bloodstream, she “lost the baby as a result quite late in the pregnancy”.

“I think these women are quite obviously, one understands, desperate, desperate and they will try anything,” Professor Moffett said, adding that their financial exploitation was “very sad”.

Professor Adam Balen, chair of the British Fertility Society, which speaks on behalf of the industry, said the most important thing was for patients to be given a genuine choice.

“Clinics have to be transparent and be open and provide appropriate information about exactly what it is they are offering and provide their own statistics as to the potential prospects of success,” he said.

“All of these treatments have been tested around the world and have been studied in clinical trials – every single one. None have been shown to do harm.”

Professor Balen, a reproductive medicine consultant at Leeds Teaching Hospitals NHS Trust, said exploring new techniques was also useful in driving up the success rate, which he said could be as high as 50 per cent for the best clinics.

“It is acceptable to provide certain treatments that may not have been conclusively shown to be absolutely beneficial to everybody, provided patients are informed,” he added.

Asked about critics of this idea, he said: “There are some people who are very outspoken and may have an axe to grind.”

Source:http://www.independent.co.uk/life-style/health-and-families/health-news/fertility-watchdog-hfea-concerned-private-clinics-ivf-treatment-a7028751.html

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