Doctors Prescribe More Sex!

Damaged sperm DNA can contribute to reduced male fertility potential. Recently, Australian fertility researchers reported that they may have identified a way to reduce the amount of DNA damage in sperm from males who produce such sperm: more sex! According to this article, more frequent sex resulted in a 12% decrease in DNA damaged sperm cells. This small study of 118 men was presented at the European Society of Human Reproduction and Embryology (ESHRE) meeting in Amsterdam in June. Most IVF protocols recommend several days of abstinence before egg retrieval, with the aim of optimizing the overall number of sperm available for use. But this new study may provide evidence that frequent sex can increase the overall quality of sperm instead. Doctors theorize that frequent sex results in a more rapid turnover in the sperm 'inventory' stored in the epididymis. This reduces the amount of time freshly produced sperm are held in this storage structure, thus reducing the opportunity that DNA damage will occur in the stored sperm.

Other experts caution that percentage of damaged sperm is only one part of a more complex picture when dealing with male factor infertility. "Looking at sperm DNA is just one part of the puzzle," said Bill Ledger, a professor of obstetrics and gynecology at the University of Sheffield, who was not connected to the research. "Maybe this will improve pregnancy rates, but we still need to do more studies." While daily sex may result in "fresher" sperm, it can result in reduced number of sperm in an ejaculate and can increase stress in a relationship, which is known to have negative effects on fertility.

Extreme Cycling Bad For Sperm

Four major traits are evaluated when a semen analysis is performed: seminal volume, sperm concentration, sperm motility and sperm morphology. The interaction of those four traits is an indication of normal testicular function and, thus, the male's ability to provide sufficient numbers of normal, motile sperm to effect pregnancy. The product of seminal volume and sperm concentration yield the number of sperm available. Sperm motility is the percentage of those sperm that are actively swimming. Sperm morphology is the percentage of sperm that have normally shaped heads and tails. Although sperm numbers and sperm motility receive much attention when men (and their wives) swap semen quality results, sperm morphology, while an important quality trait, is often ignored. Abnormal sperm morphology may take the form of broken or misshapen tails, which would impair the sperm's swimming ability. An abnormally shaped sperm head may indicate that DNA structure or DNA packaging is not what it should be. This could possibly impact swimming ability, fertilizing ability or the ability of the male genome to make its appropriate contribution to supporting normal embryonic development.

A small Spanish study of 15 triathletes showed that men who cycle more than 186 miles per week had less than 4% morphologically normal sperm. When evaluated using strict criteria, a 'normal ' level of morphologically normal human sperm is between 10% and 15%. Thus the levels of abnormally shaped sperm found the cyclists could lead to fertility problems. It is thought that tight clothing and the friction against the saddle of the bicycle seat could contribute to the sperm abnormalities as other training routines such as running or swimming did not show the same abnormalities. The effects of the extreme cycling would likely disappear upon stopping or reducing the level of cycling. Nonetheless, it may be prudent for professional cyclists to freeze sperm prior to training or accept that their fertility may be affected during and for up to 3 months after extreme training. It is important to note that if this data is correct it only applies to extreme cycling....not your average cycler.

PCOS Discussion In Fairfax, VA

Ervin Jones, MD will host an informal discussion on the infertility aspects of PCOS at GIVF in Fairfax, VA. The event is scheduled from 6:30-7:30 PM on Monday July 27, 2009. PCOS is the most common female reproductive endocrine disorder, affecting between 5-10 percent of reproductive aged women. PCOS is a common cause of infertility, menstrual irregularity, hirsutism (excess hair growth) and acne. For more information or to register please visit this webpage.

Treatment Path Shortens Length To Pregnancy

A study recently published in the journal Fertility and Sterility showed that for couples beginning infertility treatment, moving to IVF treatment sooner has many benefits. They become pregnant faster, save thousands of dollars, and have a reduced risk of multiple births. The study followed over 500 couples who met the following criteria: no prior infertility treatment, female partner age 21-39, and adequate sperm production in the male partner. Half of the couples went the "traditional" treatment route of 3 clomid IUI's, then 3 stimulated IUI's, followed by 6 IVF cycles. The other half had the "accelerated" treatment course which skipped the stimulated IUI's and went straight to IVF after the clomid IUI's. The couples in the accelerated treatment achieved pregnancy in an average of 8 months compared to an average of 11 months for couples in the traditional treatment.

Elizabeth Ginsburg, President of the Society for Assisted Reproductive Technology, said "This is a very important study that will likely influence physicians to reduce the number of stimulated inseminations for patients with unexplained infertility. Adoption of such an accelerated course of treatment could result in many patients conceiving in less time with less expense."

Data Converges About Older Fathers

A recent post in the New York Times presents some evidence that men who become fathers at a later age have unhealthier children. It is well recognized that men retain their reproductive potential longer, and lose it in a more gradual manner, than do women. Whereas women's fertility declines sharply after age 35 or so, men retain their ability to father children, albeit to a diminished degree, for several decades longer. Recently, some evidence has been presented in the scientific literature that suggests that children conceived with sperm from an older male may have cognitive or psychological challenges compared to those fathered by younger males. A recent study performed by Australian scientists concluded that older dads have children with slightly lower IQs. Others have shown increased rates of schizophrenia, bipolar disorder, and autism in children fathered by older vs. younger men. This evidence suggests that men are susceptible to age-related effects on reproductive ability. This should not surprise anyone. However, the effects of reproductive ageing appear to be expressed differently in males than in females. Dr. Dolores Malaspina, a professor of psychiatry at New York University Medical Center, puts it this way: “It turns out the optimal age for being a mother is the same as the optimal age for being a father.”

New Georgia Law Allows For Embryo Adoption

A new law passed in Georgia went into effect July 1st which permits embryo adoption. This is considered a victory for the pro life movement, as it basically defines an embryo as a living person, eligible for adoption. Although the legislation doesn't specifically state that embryos are humans, the implications are clear. There are more than 40,000 frozen embryos in Georgia who are potentially available for adoption services now. In the past Georgians were allowed to "donate" their embryos. The author also notes that these adoptions might also qualify for a new $11,000 federal adoption credit. The law was introduced by Georgia state's Rep. James Mills, who claimed that parental rights custody battles involving frozen embryos required additional legal measures.

Stress Not Healthly For Fertility

New research shows more evidence that stress can be damaging to fertility. Scientists have long known that increased levels of stress hormones such as cortisol can inhibit the production of gonadotropin releasing hormone (GnRH). GnRH stimulates the synthesis and secretion of the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Hence this single hormone controls a set of very complex processes.

The study showed that during stress the levels of a hormone called gonadotropin-inhibitory hormone (GnIH) are increased and can directly inhibit GnRH. The study was performed on rats but the researchers believe it may also apply to all mammals. "We know stress affects the top-tier reproductive hormone, GnRH, but we show, in fact, that stress also affects another high-level hormone, GnIH, to cause reproductive dysfunction," said lead author Elizabeth Kirby.

Many Women Are Uninformed About Fertility

Most women who have experienced infertility have a very good understanding of reproduction. But it turns out that is not the case for most other women. An informal study in the UK sponsored by Clearblue (makers of ovulation predictor kits and home pregnancy tests) showed that 2 out of 3 women did not know that there is only a short period of peak fertility every cycle in which a women is most likely to conceive. Many of these women mistakenly thought they can conceive at any point during their cycle. This lack of understanding of basic fertility could cause women to have many months of wasted cycles by not trying on to concieve on peak fertility days. The current social trend points to women deciding to conceive later in life which makes timing even more important. Clearly we need to do more to educate the general public about fertility.