Parabens linked to decrease in male fertility

male fertility and parabens

After the recent revelation that sperm quality is dropping at an alarming rate, recent research reveals part of the problem could be linked to parabens. These common chemicals are found in numerous cosmetics and cleaning solutions and have been found to have a potentially significant impact on male fertility.

How parabens affect semen quality

The Polish study analysed lab tests taken from 315 male fertility patients. The goal was to assess why they might be experiencing issues with reproduction. Samples of blood, semen, saliva and urine were tested from all the participants.

The findings were surprising, showing male patients who had an increased level of parabens found in their urine, had a much larger number of sperm with abnormal morphology. This means the sperm has an unusual shape or size and it is known to cause problems with fertility.

The increased level of parabens discovered in the urine, were also shown to cause DNA damage within the sperm. This affects the mobility of the sperm, making it more difficult for it to reach the egg.

This isn’t the only study to link parabens with infertility. Previous research has revealed that mice who were exposed to parabens, were unable to reproduce. Another study carried out by the University of California, also discovered parabens can damage the sex cells in both men and women, which are responsible for creating a baby.

Parabens also have a negative effect on female fertility, affecting the oestrogen hormone. The worrying thing is, they can be found in a huge range of common household and cosmetic products. Even the toothpaste and mouthwash you use could be laden with parabens.

Can parabens be completely avoided?

It would prove extremely difficult to avoid being exposed to parabens altogether. They’re found in a significant range of products. It is also worth noting that small to moderate levels may not affect male fertility; it is when you are exposed to excessive amounts that they can become a severe problem.

Patients can try to minimise their exposure by reading the labels of any cosmetics and household cleaning products they buy. There are some products which clearly state they do not contain parabens, however they can be quite difficult to find. They can also be listed under numerous names, most of which the average consumer has never heard of.
Those looking to minimise their exposure should look out for ingredients such as methylparaben, butylparaben and propylparaben. As you can see, ‘paraben’ is typically included at the end of the word, making it a little easier to spot. Out of the three ingredients listed, butylparaben has been especially linked to a higher percentage of sperm abnormalities.

Due to their known negative effects, some parabens are banned from being added to products within the European Union. However, this doesn’t mean remaining legal parabens are safe.

Overall, the recent study does deliver some worrying results. However, due to its small size and its inability to look into other factors which may influence sperm quality, it doesn’t produce a 100% accurate picture of the true risks parabens present.

Study finds female cancer survivors one-third less likely to conceive

fertility preservation

Cancer survivors are one-third less likely to conceive, according to a new landmark study. The findings were presented to the European Society of Human Reproduction by Professor Richard Anderson of the MRC Centre for Reproductive Health.
Data was analysed from 23,201 cancer survivors from the Scottish cancer registry, making it one of the largest studies of its kind. It showed just 6,627 women became pregnant, compared to an expected 11,000 pregnancies taken from a comparable, controlled matched group of non-cancer patients.

Now, experts are calling for enhanced strategies to be developed in order to preserve the fertility of young women.

Understanding the results of the study

The findings of the study showed cancer survivors do have a significantly lower chance of getting pregnant. For those who had never been pregnant before undergoing treatment, just 20.6% went on to achieve pregnancy, meaning women who do develop cancer are only half as likely as non-cancer survivors, to become pregnant.

However, the study also revealed something particularly interesting. It showed specific types of cancer were more likely to affect fertility, but the chances of pregnancy had improved over the years. Breast, cervical cancer and leukaemia, are all more likely to cause problems with fertility; though advancements in techniques and the drugs used during chemotherapy, have improved the chances for cancer survivors to conceive.

The study only shows pregnancy rates for women who chose to become pregnant. Many of the cancer survivors involved in the study may have decided not to try to get pregnant. This means although it can give some idea of how chemotherapy and cancer can affect the likelihood of pregnancy, it doesn’t provide a full picture.

The role of fertility preservation

While cancer has become an incredibly common disease, survival rates have improved drastically over the years. This means cancer survival rates in young men and women are constantly increasing. As the study shows cancer survivors have less chance of becoming pregnant, it highlights the need for fertility preservation.

Young girls need to be told about the risks cancer has in terms of fertility, allowing them to make necessary preparations if they do want to become pregnant someday. It’s not only cancer survivors who could benefit from fertility preservation either. Many young women today prefer to focus on their careers before they decide to have children. It has become common for women to hold off starting a family until they are in their 30s or 40s. This can be problematic as fertility does decrease naturally over time, making it much more difficult to conceive in later life.

Some couples are also choosing to undergo fertility preservation simply because they aren’t ready to have a baby yet, but they do want one in the future. There are numerous reasons why fertility preservation is often chosen, but more certainly needs to be done to raise awareness of the issues conditions such as cancer can have on fertility.

Overall, the study does help to raise awareness and show how fertility preservation could help cancer survivors achieve a successful pregnancy. However, more in-depth studies would be required to reveal the full extent of the problem.

The impact of endometriosis: new study looks at how it affects partners

impact of endometriosis

Endometriosis is a devastating and often extremely painful condition that many women suffer with. However, as a recent study highlights, the condition doesn’t just affect the woman’s quality of life; it can also significantly affect her partner too.

The emotional and devastating impact of endometriosis on male partners is often overlooked. The majority of studies conducted over the years have been carried out on women. This ‘Endometriosis on Partners’, study is one of the first to delve into the male perspective and experience and its results are pretty surprising.

The impact of endometriosis on partners

The recent study looked at the perspective of 51 male partners. They were given questionnaires asking them about the impact endometriosis had on their lives. The goal was to assess the psychological impact of the condition on male partners.

The results showed some comprehensive common themes including:

  • Intimacy issues
  • Low mood
  • Anxiety
  • Powerlessness
  • Issues planning to start a family

What was most surprising, was it appears men go through a very similar grief-like process as the women themselves.

Seventy per cent of the men questioned claimed endometriosis had either severely or moderately affected their lives. Their sex lives in particular were reportedly significantly affected according to 74%. Many have been unable to have sex with their partner due to the pain caused by the condition.

It isn’t just emotional trauma male partners go through. The financial burden can also be really tough, as many women are forced to either work part time, or quit work altogether because of the symptoms. This means it falls solely to the male partner to provide for the family financially. Having endometriosis does not necessarily mean a woman cannot work, but for many women this is the reality.

More engagement is required during diagnosis

One of the key findings the study revealed is that more needs to be done to support male partners during the diagnosis. A staggering 92% of respondents admitted they felt helpless, frustrated and worried when the diagnosis was delivered.

The time it took to receive a diagnosis was also listed as a frustration, and most felt disengaged with the practitioner. In fact, just 34% felt that they had been engaged during the diagnosis and provided help and support in making decisions.

Eighty per cent of the men also claimed they didn’t receive any information at all regarding how the condition affects couples. This highlights the need for better education, more partner engagement and much more support in the treatment and decision-making process.

Overall, endometriosis may not necessarily affect fertility and even, in severe cases, many women are still able to go on to conceive naturally. However, the emotional toll the condition takes on the couple can lead to other intimacy issues which would reduce their chances of starting a family. Therefore, more does need to be done to support couples and especially male partners, in order to address fertility issues.

NHS cost-cutting plans to affect IVF and fertility services

Fertility cuts

The NHS is currently in the process of introducing cost-cutting plans which will affect IVF and fertility services.

Due to financial pressure, NHS bosses are now considering only allowing women aged 30-35 to undergo fertility services. This means many women will be denied treatment. Since the start of 2017, fertility cuts have already been made in 13 areas across England and there has been a significant drop in Clinical Commissioning Groups (CCGs), offering full IVF treatment cycles.

Understandably the news has caused a lot of concern, but what does it mean for the IVF and fertility services industry?

CCGs are rendering IVF treatment a ‘postcode lottery’

CCGs are responsible for the running of GP practices and they basically decide which treatments are funded in which areas. This means, patients living practically next door to each other, but who attend different GP practices just 500m apart, could be given entirely different levels of service.

Since the beginning of the year, 13 areas throughout England have either cut fertility treatment or stopped it completely. An additional eight areas are also currently consulting on whether services should be limited according to the Fertility Network UK.

The new restrictions to fertility services are going against national guidelines created by NICE. They state, women under the age of 40 should have access to three cycles of IVF treatment. In some instances, women aged 40 to 42 should also be given access to one full cycle.

However, North Somerset, South Gloucestershire and Bristol CCGs are currently consulting to lower the age of IVF treatment to women aged 30 to 35. If it goes ahead, these areas would be the first to restrict treatment to such a narrow age gap. Croydon is the first area to completely stop all funding for IVF. Meanwhile, in Swindon and the majority of Cheshire, the number of IVF cycles per patient has been reduced from three to one.

Experts are now outraged stating if the guidelines set out by NICE aren’t being adhered to, there is no point in having them.

It is thought the restrictions to fertility services and IVF will save CCGs £836,000 each year.

Stricter IVF eligibility in south

The majority of IVF cutbacks have been made in southern England, with some practices offering very limited treatment. A lot of couples in the south can now only receive IVF on the NHS under what is being referred to as ‘exceptional circumstances’. This means patients who are recovering from and have experienced fertility issues due to cancer for example.
Other practices are refusing to give IVF treatment to women over the age of 42, smokers and those who are classed as obese.

So, what does this mean for women in the UK struggling with fertility issues? Well, statistics provided by NICE show women tend to have a 20 per cent to 35 per cent success rate for each cycle. With each IVF cycle, the success rate increases, with the highest rate of success (65 per cent) coming after six cycles. Therefore, if the majority of GPs limit patients to just one cycle, the success rate is going to drop significantly.

Overall, many health experts are arguing this postcode lottery is cruel and unfair. However, the cutbacks have only just started, making it likely more services across the UK will be strictly limited in coming months.

Male sperm counts plummeting, according to new research

sperm counts

New research has revealed the sperm count in Western men has declined significantly over the past 40 years. Some reports are even going as far as to say it could put the human race on the brink of extinction. While that may be a little over-dramatic, there’s no denying it’s a cause for concern as male fertility rates continue to drop.

So, what’s behind the sperm count decline and what can be done about it? Below, we’ll look at the results of the recent research and what it means for Western countries.

Understanding the research

The recent research was co-produced by the Hebrew University of Jerusalem and the Icahn School of Medicine. Together, they analysed data from 185 different studies involving nearly 43,000 men from New Zealand, North America, Europe and Australia.

Published in the Human Reproduction Update journal, the research found from 1973 through until 2011, the total sperm count had dropped by 59.3 per cent. Furthermore, the sperm concentration levels had also declined by 52.4 per cent.

In contrast, the sperm count levels in countries such as Asia, Africa and South America, didn’t show the same pattern of decline. However, this could be in part, down to fewer studies available in these countries.

Experts are claiming the results of this research should be a drastic wake-up call that more needs to be done to prevent further decline.

Why are sperm counts plummeting?

The research didn’t look for the reasons behind the decline, however it has previously been associated with both modern lifestyle and environmental changes. In particular, obesity levels have increased in western countries; a problem known to lead to fertility issues.

As published in the British Journal of Obesity, the majority of research into the link between obesity and fertility has largely been focused on women. However, studies carried out on obese men have discovered it often results in a low sperm count and even erectile dysfunction.

Over the past 30 years, the rate of male obesity has tripled. Studies have shown that obese and overweight men are 50% more likely to experience fertility issues than men of a normal weight.

It isn’t just increased obesity levels that are the problem, however. Chemical exposure is also said to be a major contributor to dropping sperm counts. Studies have shown that certain chemicals are damaging the endocrine system in humans and wildlife; leading to Testicular Dysgenesis Syndrome. This is a collective term for numerous conditions including birth defects and low sperm counts.

These chemicals are said to be found practically everywhere in Western societies, including household products, health and beauty products, food and even our children’s toys. Just some experts warn against include Phthalates, Fluoride and pesticides.

Overall, the significant drop in sperm count isn’t just a major concern in terms of fertility. Other studies have shown that men who do have a low sperm count, are at an increased risk of developing a serious illness, much sooner than men with a normal sperm count. One thing this recent research has shown us, is that more definitely needs to be done to combat and prevent sperm count levels dropping further.

IUI found to increase pregnancy chances

IUI benefits

New research has suggested IUI could be a more cost-effective and successful fertility treatment than IVF. Known in full as Intrauterine Insemination, the study found that using this technique increases pregnancy chances after three months of trying, from 9 per cent to 31 per cent.

However, NICE advises couples who have been trying to conceive for nine months, to go straight for IVF, rather than IUI, treatment. Experts have hit out at this advice, likening it to “cracking open a nut with a sledgehammer”.

So, is NICE right in suggesting IVF first, or should more couples be looking into IUI as their first option?

Understanding IUI benefits

IUI is typically seen as the less intrusive, more natural and affordable fertility treatment. It uses a technique where sperm is placed directly into the uterus within a specific fertility window.

The prepared sperm is chosen for its motility; with a higher concentration of high-quality sperm being used for insemination. As the sperm is inserted directly into the womb, it doesn’t have as far to swim which makes it a good option for men with ‘slow swimmers’. However, what many couples don’t realise is that many women undergoing IUI treatment, are placed on medication or additional hormones, just like with IVF. Therefore, more than one egg can be released during the cycle, increasing the likelihood of having twins or triplets.

Benefits of the IVF procedure

IVF has come a long way over the years and is now a very advanced treatment. Each clinic may do it slightly differently, but typically there are six different stages involved.

First, the natural menstrual cycle is suppressed using medication via either daily injections or a nasal spray. These continue for approximately a couple of weeks before a fertility hormone is given. This helps to boost the supply of eggs and is again provided via daily injections. This second stage continues for approximately 10 to 12 days.

You will be monitored via a vaginal ultrasound scan and around 34 to 38 hours before the eggs are to be collected, a hormone injection is given to make them more mature. Once the eggs are ready to be collected, you’ll be sedated before a needle is inserted through the vagina, into the ovaries. It takes roughly 15 to 20 minutes and may lead to a little cramping or bleeding after the procedure.

The eggs are then mixed with either donor, or your partners sperm within a laboratory. They will be checked to see if any of the eggs have been fertilised after 16 to 20 hours. If they have been, they will be left to grow for up to a maximum of six days before being implanted into the womb. During this waiting period, you’ll be provided with hormone medication to help the womb prepare for the embryos.

Once ready, the embryos are inserted into the womb via a catheter passed through the vagina. It’s actually very similar to a cervical screening test. It’s worth noting, the number of embryos implanted will be determined largely by your age. After they have been successfully implanted, you’ll be required to wait for two weeks before taking a pregnancy test.

IVF vs IUI: which gives better results?

The new study claims IUI is a more cost-effective treatment option, but the truth is this isn’t always the case. Many women need to undergo up to six rounds of IUI, whereas with IVF many women go through just one to three treatments before falling pregnant.

With IUI it’s still very much down to fate in terms of which eggs will be fertilised. However, with IVF only a single embryo is typically required to be inserted in order to be successful.

The cause of infertility can also determine which treatment would be better. IUI can be better used for couples experiencing unexplained fertility issues, while IVF is better suited to those experiencing severe male infertility or recurrent miscarriages.

Overall, IVF is a lot more advanced these days. Therefore, the treatment time has been greatly reduced, while success rates have also improved. Both IUI and IVF have their own advantages and patients should discuss their situation with a fertility specialist in order to determine which course of treatment would be better suited.

What are complementary fertility treatments?

News image

Fertility treatment can be a daunting and stressful process. Not only might be you be facing a number of clinical procedures which can cause anxiety in themselves there’s also the added worry about the success or failure of such an enormous investment of time, money and emotion. This can become a self-perpetuating situation as the stress of dealing with infertility makes the chances of the treatment succeeding less likely and adding further to the anxiety.

Fortunately, there are a number of complementary options that are designed to work with people undergoing fertility treatments to ensure that, not only is some of the stress relieved, but also that the body can be in the best shape for optimising the treatment and subsequent pregnancy, if it’s successful.

Fertility counselling

Counselling is available to anyone undergoing fertility treatment as a matter of course. At Chiltern Fertility, we can put you in contact with trained counsellors who are used to the tensions, worries and fears of infertile couples, undergoing treatment and will be on hand throughout the process to provide support and an empathetic ear.

Sometimes counselling is a required part of the treatment and the clinic will not proceed until satisfied that the individuals are fully aware of the implications of the treatment. This is mainly in the case where a donor has been used or a surrogate has been found as there are a number of potential social pitfalls including the rights of donors and subsequently the children’s rights to seek out the donor’s identity once they have reached 18 years old. It also a normal step in receiving a sperm donation to ensure that the donor provides his consent that the sperm can be used in the future, particularly in cases when the donor may be incapacitated or are no longer alive.

Diet and nutrition

It’s important to eat a good balanced diet if you are considering fertility treatment. The fitter and healthier your body is the more likely you are to become pregnant. A high Body Mass Index (BMI) could be a problem for anyone thinking of embarking on treatment as it has been proven to have a negative impact on likelihood of conception. Also, a high ration of body fat can prevent certain surgical and anaesthetic procedures.

Good nutrition will generally improve the chances of conception by stabilising hormone levels, lowering stress as well as tackle problems such as polycystic ovary syndrome.

Acupuncture

For many couples, IVF treatment can be one of the most stressful times they face in their lives and although it may not be for everyone there are holistic remedies available which can help to reduce anxiety. Acupuncture is one of the complementary therapies that can aid individuals to relax during the stresses of the fertility treatment. Some acupuncturists will claim that their therapy can help stimulate fertility without additional treatment because it helps to remove stress whilst stimulating blood flow and helping to regulate hormone levels.

At Chiltern Fertility, we can arrange appointments with the relevant practitioners and Mr Julian Norman-Taylor will discuss this in full during your consultation. Fill in the contact form and Mr Norman-Taylor’s private secretary will be in touch. If you wish to check availability, click here to look at our online booking calendar.

What are my fertility donation options?

Embryo transplantation tips

One of the possibilities that has opened up with the development of IVF and its associated treatments is the facility to donate sperm or eggs to couples or individuals who are not able to conceive.

Donor eggs

Women may require donor eggs for a number of reasons. It could be that the egg store has depleted with age or that the ovaries are missing or no longer functioning due to illness or a genetic problem. In these cases, it is possible to request an egg from a donor programme.

The majority of eggs are donated by young, healthy women under 36 who have completed their families and wish to donate their eggs for altruistic reasons whilst being sterilised. This means that in some cases the eggs will be young and more likely to turn into embryos than the recipient’s. In the past, most donor eggs came from a surplus collected in the IVF process but this is no longer the case as less eggs are collected due to improvements in the freezing process. Eggs are now often sourced through an agency where the eggs have been donated for altruistic reasons.

The process is similar to normal IVF although it involves two women. The menstrual cycles of the donor and recipient will be synchronised to give the best chance of allowing an embryo to grow on the uterine wall.

Sperm donation

Sperm donation will usually be from men in the age range of 18 to 41 and a detailed profile will be built up of the individual donor so that the best match can be made for the recipient. It is a highly personal decision and whilst photographs cannot be shown to preserve anonymity, the depth of the profile will include likes, dislikes, hobbies, for example, and this will be helpful in making the selection.

In some cases, the recipient will have a donor in mind, maybe a family member or friend and in these instances there will be a rigorous screening process to ensure that the sperm is suitable.

Are there any advantages of a donor programme?

  1. Egg sharing: this is a solution designed to help couples who cannot afford IVF treatment. They share their eggs with another paying couple and receive free treatment themselves. If enough follicles aren’t produced then we can discuss the options with both couples. The recipient could receive all the eggs and the donor would get another free IVF cycle or the donor couple could pay for the treatment and take all the eggs.
  2. Screening reduces possibility of genetic defects etc. Because all donated sperm and eggs go through a rigorous screening process for a whole range of defects it increases the possibility of developing a healthy embryo.

The social problems with being a donor or recipient

Most clinics will provide an anonymous service whereby only information pertaining to the health, race and age of the donor is provided. Under UK law the donor has no rights of access to the child nor any financial obligations. However, it is worth noting that donor status is actually non-anonymous which means although the recipient has no information about the donor the child is legally entitled to this information when he or she turns 18.

At Chiltern Fertility, we can discuss all the implications of egg or sperm donation and whether it is the treatment option you should explore. Fill in the contact form to arrange our fertility expert Mr Julian Norman-Taylor. If you wish to check availability, click here to look at our online booking calendar.

Surgical Sperm Retrieval FAQs

Surgical Sperm Retrieval questions

Before you and your partner undergo IVF treatment, Mr Julian Norman-Taylor will carry out a semen analysis as some men have issues producing semen in ejaculate and require Surgical Sperm Retrieval (SSR), a procedure to remove sperm directly from the testis of a male partner for use in IVF or IUI treatments.

Here are some of the common questions asked about surgical sperm retrieval:

When will surgical sperm retrieval be required?

The procedure is usually only needed for the following reasons:

  • The male partner is producing no sperm in his ejaculate, a condition known as azoospermia
  • The male partner is impotent and cannot produce ejaculate

What does SSR involve?

Normally a fine needle will be inserted into the epididymis, which is located next to the testis and some fluid is withdrawn for analysis. This procedure is known as Percutaneous Epididymal Sperm Aspiration or PESA or Micro Epididymal Sperm Aspiration (MESA).

If either of these procedures do not retrieve sperm then a second procedure can be attempted, Testicular Sperm Extraction (TeSE) whereby a biopsy (a small piece of tissue) is taken from the testis for close analysis under a microscope. Dependent on the case, this may require open or closed surgery to retrieve the biopsy and Mr Julian Norman-Taylor will discuss the operation with you in detail, focusing on the procedure that is likely to produce the best results for you.

What is the likelihood of success?

This depends on the reason for the lack of sperm. If the problem is caused by a blockage in the vas deferens, the tube which carries sperm from the testis then there is a relatively good chance of success, of up to 80 per cent. Blockages can occur as the result of a vasectomy, infection or it may simply be that the vas deferens has never developed fully.

The chance of success where there is no blockage and the testis are not producing enough sperm are much lower at 20 to 40 percent dependent on whether any sperm can be located in any part of the tissue. TeSE will be required to locate sperm in this case.

When is the operation carried out in the IVF cycle?

Usually the procedure is carried out at least a week before the rest of the IVF treatments to give time to establish the number and viability of the sperm for implantation. The sperm will normally be frozen until required and there is some risk that the sperm will not survive the thawing process. Assuming healthy sperms can be located, then they are normally implanted using the ICSI method where a single sperm is injected directly into the egg using micromanipulation tools to ensure the best possible chance of success. Frozen sperm will never be as reliable as a fresh sample as damage can occur during the thawing process.

Is the surgical sperm retrieval process painful?

The treatment is normally carried out under a local anaesthetic so is not painful. It is not uncommon, however for there to be some bruising and aching for a few days after the TeSE and MESA procedures. Normal over-the-counter painkillers are sufficient to provide some relief. It’s also advisable to wear tight underwear or specialist scrotal supports to minimise any swelling or light bleeding for a few days.

To learn more about the treatments we offer at Chiltern Fertility or to arrange a consultant with our lead fertility expert, Mr Julian Norman-Taylor, fill in the contact form and one of the team will be in touch.