What does a low AMH reading indicate? And how does it relate to your IVF Cycle?
AMH is the Antimullerian hormone. This test correlates to the size of
your residual follicular pool. Basically your egg reserve. When applying
the results in clinical practice in IVF
it will generally indicate that you will yield or produce a smaller
amount of eggs than with someone that has a higher reading. Lower AMH
levels have been associated with poor response to ovarian stimulation
(generally they will use a higher dosage of Gonal F, maybe up to 450mg),
low oocyte yield (not producing many eggs) and embryo quality. Doppler
ultrasound evaluation showed, women who respond poorly to ovarian
stimulation for IVF have compromised blood flow to their ovarian
follicles.
1. Acupuncture can help improve your egg quality
2. Acupuncture can increase blood flow to the reproductive organs,
which dramatically improves a woman’s response to hormonal therapy. 3. Acupuncture reduces stress 4. Acupuncture improves blood to the uterus and follicles.
Did you know when you orgasm it also improves blood flow to the endometrial lining and follicles. The more orgasms you are having the better. If you can't orgasm during penetration, I tell my clients to finish the job themselves.
On a serious note, when you begin your IVF cycle please make sure your doctor has tested
your AMH levels. If you are unsure what you needed to be tested for, we
can help you at Angea. We have a specific list of blood tests that we
have all our Fertility patients take before starting on their Fertility Journey.
The truth is out about Men's infertility. Now we are faced with the cold hard facts. The results of your Semen Analysis stare you straight in the face. What information does this piece of paper hold. Is it good or is it just plain bad?
A Semen Analysis considers many factors. However, it is the Morphology that is the most important aspect of the analysis. Good sperm is what will fertilize the egg.
The World Health Organization provides a definition of a 'normal' sperm count:
-Volume: >1.5ml
- Concentration: >15 million/ml
- Motility: >40% forward rapid progressive
- Morphology: >4% normal forms
To qualify for "good sperm" your values need to be greater than the above reference values.
Volume: You need to be able to provide a good volume of semen. The average volume of semen produced at ejaculation is between 2 and 6 ml. A low or absent volume can suggest the possibility of failed emission, incomplete collection, a short abstinence interval or structural obstructions.
Concentration:The concentration of spermatozoa should be at least 20 million per ml. Azoospermia describes the ABSENCE of sperm on a standard microscopic examination. We need to see visible swimmers! Oligospermia (Oligo = few) is defined traditionally by a sperm density less than 20 million/ML and is considered severe when the sperm concentration is below 5 million/ML. And what is considered a normal sperm specimen contains more than 15million/ML.
Motility: Quality sperm is better than the count. Sperm motility is the percantage of sperm moving. Sperm that can move forward fast are the sperm capable of swimming up to the egg and fertilizing it. Forward progression is graded on an arbitrary scale (Grade 0-4) and most often reported as the percentages exhibiting rapid (grade 3-4), slow (grade 2) and non-progressive motility (grade 0-1). You can see below:
Grade 4 sperm are those that swim forward fast in a straight line.
Grade 3 sperm swim forward, but either in a curved or crooked line, or slowly.
Grade 2 sperm move their tails, but do not move forward.
Grade 0-1 sperm do not move at all. Sperm of grade 2 and 1 are considered poor.
So far, your results are looking pretty good. Your volume, motility and concentration are all within reasonable parameters. Now for the big one- morphology. This is when you will hear the Doctor say your results are good or you need to do ICSI/IVF. "The Good, The Bad and The Ugly". When they talk about ICSI you know it’s serious. This indicates your sperm analysis has come back with low sperm morphology percentages. For males and their partners, this can come as a complete shock.
Sperm morphology: reflects the quality of spermatogenesis- the process of becoming spermatozoa (sperm). If your sperm analysis reads 92% morphology. This indicates only 8% of your sperm are morphologically sound- which is not great. Sperm classified as normal must be NORMAL in all respects. Generally speaking for men, conventional fertilization rates are highest when you have a percentage of sperm that is 14% or higher. Any percentages that fall close to 6-4 % doctors will normally indicate that you look at your options of doing ICSI.
What distinguishes morphologically sound sperm?
Ideally, good sperm should have a regular oval head, with a connecting mid-piece and a long straight tail. Morphological abnormalities are categorized by location involving the head, neck (midpiece) or tail. Abnormal sperm is distorted in its shape. If too many sperm are abnormally shaped (round heads; pin heads; very large heads; double heads; absent tails) this may mean the sperm are abnormal and will not be able to fertilize the egg.
When you are diagnosed with low sperm morphology it is extremely important you take a long hard look at lifestyle and also medical history. Sometimes, poor Semen Analysis can be due to trauma or structural abnormalities.
According to Chinese medicine your reproductive health is the result of your body being in proper balance. Stress, poor lifestyle, inadequate diet and other factors can disturb your natural balance. This results in poor health including impaired semen quality and quantity.
What Can you do to improve your sperm quality and morphology.
Take COQ10
Brazil Nuts are high in selenium
Take a Zinc Supplement or eat pumpkin seeds they are great source of Zinc
Take Vitamin E
Stop Alcohol
Supplement with Vital Greens, they are high in anti-oxidants.
Include lots of green vegetables in your diet.
Stop drinking coffee and substitute for tea
Take Create the Essence - chinese herbal supplement.
Generally if you modify your lifestyle you can change the quality of your sperm. Remember it does take 70 days for sperm to develop. The good news is, new sperm is constantly being produced. At Angea we offer specific treatments in treating poor semen Analysis results. You can contact the clinic to discuss.
Ok boys the data is finally out about the
quality of men’s sperm. The truth is male factor infertility is on the rise and
the quality of men’s sperm is on the decline. I wanted to raise awareness around this topic as it has
affected many of my male clients recently.
In 2010, the World Health Organization
published and revised their reference values for semen analysis, in fact they
lowered their reference values, determining that the quality of men’s sperm is
decreasing. What’s more concerning is the value for determining sperm
morphology has changed rather substantially. This is definitely not a good
thing when it comes to fertilizing an egg.
It takes around 70 days for sperm
(spermatozoa) to develop. The good news is that men are constantly producing
new sperm. The not so good new is that because of the long development and
maturation time of sperm cells, events in a man’s life such as binge drinking
can have a far-reaching effect on the quality of his sperm. To be realistic you need to give
yourself three months of clean living to produce what I call “healthy or
improved sperm”.
What happens in the magical testes
is really quite amazing. Men produce individual sperm from a cell called
spermatogonium. The spermatogonium then divides to produce spermatocytes, which
then develop into spermatids. The next process is really important when it
comes to having good swimmers! Take note. The spermatids then develop their
tail and then gradually acquire the ability to move by beating its tail. The
spermatid then eventually develops in mature spermatozoa otherwise known as
sperm. This maturation process takes a whooping 60 days and the sperm another
10-14 days to pass through the ducts of each testicle, and it’s sperm-maturing
tube, the epididymis before it can leave the body in the semen during
ejaculation. You can see just how long it takes for new sperm to produce. It is
a lengthy process almost 3 months in fact.
Did you know? Sweet potato or wild yam is famous for containing hormone-like compounds that are very similar to progesterone, and it may encourage the body's own production of the hormone. I always recommend to my patients to eat sweet potato to help support your luteal phase and progesterone production. Sweet Potato Curry is a must!
Working in the field of Fertility, I constantly see woman struggling with the issues of infertility. Gone are the days of falling pregnant like our parents did. When I ask my patients about their Mother’s history relating to fertility, most say, Mum had little or no difficulty falling pregnant. Every woman that walks through my door has some issue relating to fertility. It’s hard enough trying to conceive naturally and if your doing IVF even harder again.
"In the past 40 years, Australian women and girls have stepped up to join the men and boys at the bar," Dr Stone said. This indicates that women have a real issue when it comes to alcohol. We live in a culture where we think it’s ok to drink. Have a stressful day at work then have a drink to relieve the stress. Anna Kokavec did a recent study examining the effects of alcohol on hormones. She describes this situation perfectly. In her transcript she quoted “That's right, and most of us, if you do have that glass of white wine it's not unusual for somebody to say 'oh, I really needed that,' and 'oh, I feel so much better'. So there is this reinforcing effect. So if we are lowering the level of, say, stress hormone in the brain, well we will be feeling more relaxed. That has implications for things such as addiction, because of course if you are stressed you're being rewarded for actually consuming that alcohol, so you're more likely to reach for a glass of white wine the next time you're stressed”. When it comes to alcohol and fertility, the two do not mix. Alcohol has a huge impact not only on your health but also your child’s. We need to take our health seriously when it comes to falling pregnant. All literature and research conclude the same findings that the adverse affects of alcohol range from; infertility, increased risk for spontaneous abortion to impaired fetal growth and development. Bascically, drinking alcohol puts you and your baby at risk for a miscarriage, pre –term birth and other serious health issues.
There are many reasons why we choose to leave pregnancy till our 30s or 40s. For most of us we are in mid to late 30s when make this decision. The decade of the 30s brings security in our careers and relationships, so having children in your 30s makes financial and practical sense. However, pregnancy at any age comes with its distinct advantages and disadvantages. What we are faced with in our 30s is what I call the “odds of success”. We all know that from 30s onwards our eggs are on the decline and the probabilities of conception are reduced with age. Particularly, if we have made bad lifestyle choices during our 20’s and 30’s,
The reality is “the older you get, the more lifestyle choices you make influence your health”. When we make the decision to have a baby we make the choice to live a healthy lifestyle. We want to give our children the best possible start to life and this therefore begins with us. Numero uno. Wanting to have a healthy baby is a primal urge. So most women are therefore capable of being very well behaved while pregnant. It easy, by cleaning up your act it will actually help you get pregnant
What effects does alcohol have?
Alcohol induces a rise in estrogen levels as a consequence of the metabolic breakdown of alcohol in the liver
Evidence points to an induces rise in natural or synthetic estrogen levels in woman.
Increased rate of testosterone- in women
Decreased rate of testosterone in men
Decreased rate of estraodial to estrogen
Decreased levels of progesterone
Alcohol impairs regulation of blood sugar levels
What does this mean?
Ovulatory disorder
Luteal Phase defects
Alters blood sugar levels
Impairs reproductive functions
Interferes with calcium metabolism and bone structure
Inadequate functioning of the ovaries and testes
Hormonal deficiencies
Sexual dysfunction
Infertility
It can be seen that Alcohol has a wide range of effects on the hormone system and can present many real concerns. When it come to our fertility and having babies, make the conscious decision to stop drinking before and during your pregnancy. I have a no alcohol rule and I don’t negotiate this with my patients. I witness the struggles of woman everyday. If we remove the external factors that can contribute to infertility then we are already half way there to having a healthy baby and conception. My advice is think twice before you sip that glass of wine. Ask yourself do I really need this glass of wine? Instead, go for a walk, have your favourite cup of tea or have some dark chocolate (80%). Look for the healthy alternative. Remember get healthy to get pregnant and get pregnant by getting healthy.
This year has brought many smiles, many tears, heartache, happiness, sadness, love and the list could go one. It's one big box wrapped up in emotions. It's my gift box i give to myself for Christmas each year.
This year for me has been another year of intense growth, not only in work but also my personal life. On reflection, I have learn't more about myself this year than any other previous years. For the first time in my life I finally feel comfortable in my skin and who i am. I also ponder the question will this change? Considering this is the first time i have experienced this and secondly does everything remain the same? Of course not i say casually. That is the beauty about life and human beings, everything in motion is constantly in a changing state. So, as humans (lucky us) we are constantly evolving, changing thought patterns, changing our belief systems, constantly working on ourselves, our relationships, etc, and the list goes on. So much work, so much work! I confess, life is definitely hard at times. It's the hard times that really push our boundaries, it's these moments that we have to pull out the shovel and start digging deep. Also too, sometimes i think why can't this end? haven't i been through enough, why is this happening again. Ok, universe what is that you are trying to tell me. Haven't I learn't all the lessons???
What I have come to learn, is that sometimes there are no answers!
Give yourself a gift box for Christmas, we all deserve one! We have all worked so hard, and its nice to have these little reminders to be kind to ourselves! To love ourselves! And sitting with just BEING!
This year has been such a big year for so many people on so many levels. At the end of the day all our stuff is a big as each others. There are no comparisons just moments of sharing and experiencing. I have been so grateful for my clients who have blessed me with the chance of knowing them. From each other we all keep learning and growing. I feel so lucky to have been able to share the loss of my Mum with my patients. Everyone has been so amazing!
What does 2012 bring us? The invetible question. My opinion is change. I think 2012 will be a great year. This year we have been faced with many challenges on a large scale. It has been a big year! The energy is definitely shifting. Next year will be the last year we ever have a calender year 12/12/12.
I love writing and I haven't been in the head space to write about fertility. So next year lookout. I have lots of wonderful things to share and write about. I can't wait to put thoughts to paper and share with you what i know about fertility, life experiences etc.
