It’s time we talked

Andrew Coutts

Admit it. Us men in general don’t talk about our sperm do we. But perhaps we should.

Around a third of fertility issues are male issues and in a world where fertility rates are dropping in the vast majority of countries the importance of keeping healthy down there is more important then ever.

But why should we?

Well, remember if it takes two to tango and you are not doing your bit, two ain’t going to be three anytime soon.

So, what determines sperm health and how can we improve ours?

Essentially sperm health revolves around three key indicators – quantity, movement and structure.

Basics. The semen discharged in a single ejaculation contains at least 15 million sperm per millilitre. Too little sperm in an ejaculation might make it more difficult to get pregnant because there are fewer of the little fellas trying to fertilize the egg. So, more is better then – job done. Well, no, not quite.

Motility. It is no good if you have plenty of potential candidates but none of them are that active! To reach and fertilize an egg, sperm must move and navigate through a woman’s cervix, uterus and fallopian tubes. So, not only do you have to produce semen but you have to produce semen that are capable of moving!

Morphology. To the men – do you know what your sperm looks like? “Little tadpoles” I hear you shout. Well, good call – healthy sperm have oval heads and long tails which enable them to move effectively. The more normal looking sperm you have, the more likely you are to be fertile.

So, we know where we need to be but how do we get there?

Firstly, it is not going to happen overnight. Sperm is produced constantly and can be up to three months old at any time therefore anything we did or didn’t do for the previous three months can affect our sperm today. So, let’s forward plan.

There are a number of simple lifestyle changes you can make without causing too many hardships which can substantially improve your sperm health.

A healthy weight supported by a balanced diet is a good starting point. Research suggests that high body mass index (BMI) is linked to low sperm counts and movement. Reducing your red meat and increasing your oily fish intake as well as taking on plenty of fruits and vegetables, which are rich in antioxidants will help.

If you smoke, don’t. If you can’t give up permanently do so whilst you are trying to get ‘sperm healthy’… men who smoke cigarettes are more likely to have low sperm counts.

Limit alcohol. Heavy drinking can lead to reduced testosterone production, impotence and decreased sperm production. If you have to drink alcohol, try to do so in moderation!

Don’t stress. Most of us will feel anxious, threatened or under pressure at some time and those times tend to come thick and fast when we are trying for a family.

Stress can be a serious and insidious problem; it can jump up and smack you in the face without warning or it can envelope you subtly overtime. Whatever form it takes it can decrease sexual function and interfere with the hormones needed to produce sperm.

Stress is a natural feeling of not being able to cope with specific demands and events – whilst we may not be able to eliminate it we can try to manage it by reviewing our diet and stopping or reducing our alcohol and nicotine intake.

And there is always exercise. Moderate physical activity can help decrease stress levels whilst increasing levels of antioxidant enzymes, which can help protect sperm.

Our sperm health is in our hands. We can influence it by removing, modifying or adopting personal lifestyle choices and actions as well as limiting our exposure to external or environmental factors such as excessive heat or toxic chemicals.

Keep your cool. It has long been argued that increased scrotal temperature can hamper sperm production. We can help ourselves by wearing loose-fitting underwear, avoiding saunas and hot tubs, and limiting scrotum exposure to warm objects, such as laptops.

Seek and heed advice regarding any medications you take. Tricyclic antidepressants, anti-androgens, anabolic steroids and other medications can contribute to fertility issues.

Keep toxins at arms length. Exposure to pesticides, lead and similar can affect sperm quantity and quality. If you have to work with these do so with caution, avoiding skin contact and always protect yourself with appropriate clothing.

So, we can have a decisive impact on our sperm health by making and taking, tweaking and eliminating lifestyle changes as well as avoiding or making safe environmental dangers.

We can all do it and maybe it’s a good idea to talk about it too.

The International Fertility Company is pleased to be working in partnership with a carefully selected group of companies who offer products to promote good sperm health. You can view these here.

Getting to Know

In the first of a series of blogs designed to share the thoughts and work of our partners we talk to Professor Aleksandar Ljubic, President of Forever Young Holdings which includes the SEGOVA ovarian rejuvenation programme. Professor Ljubic is a past President of the World Congress of Perinatal Medicine and is visiting professor at Weill Cornell Medical School, USA.

Will the Covid-19 pandemic change IVF as we know it?

After the stabilization of the pandemic, it is necessary to re-establish IVF cycles. Infertility is a disease that requires active treatment, therefore, according to the advice of world and European human reproductions it will continue albeit with additional prevention and precautionary measures attached to its undertaking.

We have adopted new recommendations issues by professional associations which define the manner of selection and preparation of patients, as well as working conditions during the process of in vitro fertilization. This means that the process is allowed once more, but with strict adherence to the instructions.

It is recommended that treatments for patients at high risk (for instance those with diabetes, hypertension, patients on immunosuppressive therapy, pulmonary and renal patients) be delayed at the present time.

What do you see as the latest innovations in your field?

There are numerous, exciting innovations taking place in the field of reproduction which relate to the application of biotechnology and information technology. The development of biotechnology, for example, is working to create artificial eggs or seeds, which can develop from any cell in the body. Attempts to construct an artificial uterus have advanced greatly.

Advances in certain branches of medicine, such as molecular genetics or understanding the importance of the microbiota (the comprehensiveness of microorganisms), are also of great importance for understanding human reproduction. A large number of analyzes of genes, epigenetics and various products of cell metabolism, using IT – artificial intelligence and big data, try to help create and select the highest quality cells and embryos.

An important part of these innovative technologies relates to the application of biological therapies – therapies for cells and their products. In my country, Serbia very advanced biological therapies are being successfully implemented, which are currently used in reproduction, the fight against sterility, neurological diseases and injuries, hormonal disorders, diseases of the cardiovascular system, as well as in aesthetic medicine. An important segment of the application of biologically innovative therapies is the fight against aging and increasing the quality of life.

What is the current situation regarding the use of stem cells?

Stem cells and their products (microvesicles, exosomes) are an important part of biological therapies, which is increasingly used in human medicine. These cells and their products can be autologous (of their own origin) or allogeneic (of another person’s origin), which are usually propagated and manipulated in laboratory conditions.

The storage of blood or umbilical cord elements enables the use of these cells (autologous) in certain diseases (primarily diseases of the blood and immune system) during later life.

Propagated stem cells are much more widely used, which are used in laboratory conditions for the treatment of certain diseases. There are numerous clinical studies that examine the application of stem cells in various branches of medicine. The application of mesenchymal stem cells and their products are currently being used in the fight against Sars-CoV 2, for instance in severe forms of COVID-19 infection. The use of stem cells, along with other forms of therapy, has been shown to lead to a significant reduction in mortality and faster recovery from disease. A large number of studies examine these cells in the fight against cancer, immune, endocrine, surgical diseases and others. So it has a very wide application.

This does not apply, however, to cells derived from umbilical cord blood. For this application, it is necessary to process and multiply them in strictly controlled laboratory conditions. In addition, there are other ways to get mesenchymal stem cells later in life. What, however, cannot be compensated for is the fact that the youngest stem cells are the most potent and of the highest quality. They can be safely obtained from the umbilical cord or fetal blood. So, if you have the conditions, it is wise to have the baby’s blood and umbilical cord frozen in safe conditions.

What problems do biobanks deal with in general?

Biobanks are generally viewed as institutions whose only task is to preserve biological tissue. However, in reality they are a type of biorepository (biological repository) in which biological samples and related information are stored for research and therapeutic purposes. So they store samples and information related to those samples. They are responsible for the ethical and legal part of the collection, storage and use of biological material.

As far as the storage of samples and information is concerned, the rules and conditions are strictly defined, which enable safe storage, and possible application of these tissues.

Continuous innovation in biomedical research has given new value to sample collection. This also refers to their use in the prevention, diagnosis and treatment of diseases, as well as the development of new biotechnological products and procedures.

Currently in Serbia there are no legal frameworks that apply to biobanking, but there is a strong will for significant progress on the ground. Our goal is to build a legal and infrastructural system that will include all potentials, public and private centers that will enable us to become a driver of innovation in the life sciences, especially in biotechnology, genetics and regenerative medicine.

Will the pandemic significantly change certain aspects of the health segments you are dealing with, be it reproductive health, fertility, childbirth, anti-aging medicine, etc.

It will certainly change the approach in everyday practice, which will be with more caution. Since we still have a lot to learn about the virus, medicine and everyday clinical practice will have to adapt to new knowledge.

Should You Sweat it Out?

By Andrew Coutts

For those of you who do; why do you do it? To lose weight, to improve your mental health or are you just plain competitive?

We all have our reasons. More of us are taking up physical exercise than ever before and we are also scaling up. Marathons, once the domain of the elite sports person are being run by literally thousands all over the world; 40% of whom are women.

We equate fitness and exercise with positivity and good health but is this always the case? If we are trying to conceive should we take out feet off the gas and just relax?

In the latest edition of Creando Familias Head of Nursing at Grupo UR, Bernardo Fernández Martos discusses the relationship between physical exercise and fertility.

Bernardo describes a range of individual and societal reasons for the increase in women taking up exercise – Social mores, legislation, medical controls, popular culture and advertising all play a part but he highlights suggestions and concerns that excessive activity may in fact have a negative effect on fertility. As Bernardo points out these negative effects can manifest themselves as menstrual disorders as well as ovulatory dysfunction and even have negative effects on oocyte quality.

Such effects may well be related to the intensity, volume, and type of physical activity carried out but awareness of the link between physical assertion and fertility health is key.

On the flip side there are numerous studies which demonstrate the importance of physical exercise aimed at lowering the body mass index in patients with obesity and Polycystic Ovary Syndrome (PCOS). Studies also point to the role exercise plays in increasing success rates following assisted reproduction treatments; enabling a higher rate of embryo implantation and subsequent pregnancy.

Click here to read more about the pros and cons of exercise in relation to fertility and to access the latest copy of Creando Familias.

A Strategy for Freedom

Andrew Coutts

Former fertility patient Natalie Silverman launched The Fertility Podcast in 2014 following successful treatment. Her passion for the audio platform was palpable and I remember her saying back then with complete confidence that fertility patients would find their voice through podcasts.

Six years on and I think we can safely say she was right. Podcasting has become an invaluable tool for self-expression. Fertility patients across the globe have launched their own podcasts, sharing negative, positive and often personal experiences of fertility to a growing audience eager to hear more. The fertility podcast has enabled infertility to step out of the shadows and we can’t get enough of them.

As a respected and experienced broadcaster and voiceover artist Natalie has been at the forefront of the podcast revolution with over 9000 hours of interviews with men and women, almost half a million downloads and listeners from over 100 countries being testimony to that.

The Fertility Podcast features patients, professionals and celebrities who share their honest take on subjects as diverse as miscarriage, fertility treatment within the LGBTQ community, restorative medicine and mental health. You can listen to the latest episode of The Fertility Podcast here.

Wanting to provide even more support to those experiencing fertility issues Natalie recently qualified as a Freedom Fertility Specialist and in her words is on a new mission, “to support the emotional wellbeing and mental health of anyone trying to conceive, by teaching them the tools of this formula, which is a combination of counselling, coaching and mindset tools”.

Over six sessions, with an IVF Enhancement session if needed, patients learn easy to use tools to help them cope with everyday stresses that can arise when trying to conceive. The aim of The Freedom Fertility Formula™ is that participants learn a self-care strategy enabling them to live their lives to the full whilst on their fertility journey rather than having their lives being placed on hold because of infertility.

You can listen to Natalie in conversation with Dany Griffiths, Founder of The Freedom Fertility Formula™ here or if you would like more specific information Natalie can be reached via natalie@thefertiiltypodcast.com