Archive for May, 2011

Hormone Levels May Predict a Woman’s Future Fertility

A combination of a woman’s age and the blood levels of a specific hormone may be able to predict her future fertility.

“Women often postpone having children until their career has been well established.

However they may find that it is difficult to get pregnant at this time.

It could therefore be very useful for women to know beforehand up to which age they remain fertile,” write Dutch researchers in a study published online May 26 in the Journal of Clinical Endocrinology & Metabolism.

In general, a woman’s fertility ends about 10 years before she goes into menopause.

Now Dutch researchers say they can use a woman’s age and her blood levels of anti-muellerian hormone (AMH) to predict the end of her fertility.

AMH is a hormone produced by the follicles in the ovary.

A higher AMH level indicates a higher number of follicles and eggs in the ovaries.

As a woman gets older and the number of eggs in her ovaries decreases, the AMH levels also start to decrease.

So AMH levels can be used to help predict a woman’s ovarian reserve, that is, the number of eggs she still has available to become fertilized.

Researchers at the University Medical Center Utrecht, The Netherlands, followed 257 healthy woman, ages 21 to 46, for 11 years.

The Dutch researchers were able to link AMH levels to the point when 48 of the women entered menopause.

Based on this information, they built a model using age and AMH levels to predict when an individual woman would enter menopause.

They are working on standardizing an assay so this can be translated into clinical practice.

For example, if a woman receives a prediction that she will become infertile at an early age, she may choose to have her eggs harvested and frozen.

This would give her a good chance of having children later on if it turns out that she has a reduced egg count.

The AMH test is still considered experimental because the cutoff values have not been standardized in many countries, notes Zev Rosenwaks, MD, director of Reproductive Medicine and Infertility at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York.

The Weill Cornell fertility center has been using the AMH test for several years.

AMH levels can also be used to predict a woman’s response to ovarian stimulation in in vitro fertilization (IVF) cycles, he says.

Dr. Rosenwaks determines which woman will have a higher or lower response by measuring her AMH levels at any time during her menstrual cycle.

This allows him to choose a high or low follicle-stimulating hormone (FSH) dosage even before the woman begins her treatment.

“FSH levels along with AMH concentrations can help a couple decide on whether to proceed with IVF, particularly if their previous IVF cycles have failed,” says Dr. Rosenwaks.

However, no hormonal marker of ovarian reserve is an absolute determinant of success or failure with IVF, he points out.

Keep Exercising to Age Gracefully

To age gracefully, keep exercising to keep your muscles strong and fit.

A new study just published online in the FASEB Journal suggests that aerobic activity increases the training effect of exercise for older people, whether they have a protein drink or a carbohydrate drink after exercise.

“It is not a mystery that exercise and nutrition help slow the aging process,” said Benjamin F. Miller, Ph.D., a researcher involved in the work from the Department of Health and Exercise Science at Colorado State University in Fort Collins, CO.

“Studies such as ours help to explain how exercise and nutrition work so that we can better take advantage of those pathways to slow the aging process.”

The Colorado researchers recruited 16 participants, average age 50, and had them exercise on treadmills for 45 minutes 3 times a week for 6 weeks.

A younger untrained group provided a non-exercising comparison.

After each treadmill session, one group of exercisers was given a mixed carbohydrate-and-protein drink and another group of exercisers was given a carbohydrate drink.

The researchers took muscle biopsies at the end of the 6 weeks to determine how much of the muscle and its component pieces were new.

They found that muscle protein synthesis was significantly higher in the older exercise groups than the younger sedentary group.

Contrary to other studies, consuming protein after exercise did not increase skeletal muscle protein synthesis rates.

This shows that endurance exercise, which is commonly prescribed for older people for a healthful lifestyle, can induce positive changes in skeletal muscle structure.

The bottom line: Don’t concern yourself about what you drink after exercise.

Just make sure you get out and exercise regularly.

Future Dads: Keep Your Cell Phone Out of Your Front Pocket

If you plan to father a child, don’t keep it in your pocket – your cell phone, that is.

The reason: the number of hours you use your cell phone each day may affect your sperm profile and future fertility.

A new study by a team of international researchers led by those at Queen’s University in Kingston, Ontario, adds to the evidence that men who have been diagnosed with poor sperm quality and who are trying to have children should limit their cell phone use.

The researchers found puzzling results.

While cell phone use led to an increase in the level of testosterone circulating in the body, it also led to lower levels of luteinizing hormone, which is a key reproductive hormone secreted by the pituitary.

Previously, Cleveland Clinic researchers have noted an association between cell phone use and sperm quality.

The more hours men from an infertility clinic spent on their cell phones each day, the lower their sperm count and the greater their percentage of abnormal sperm.

Men who used their cell phone for more than four hours a day had the lowest average sperm counts and the greatest percentage of abnormal sperm.

The effect of cell phones on sperm parameters may be due to the electromagnetic radiation the devices emit or to the heat they generate.

The Canadian researchers believe electromagnetic radiation may block the conversion of circulating testosterone to the more active, potent form of testosterone associated with sperm production and fertility.

While there is a strong association of cell phone use with decreased semen quality, this does not prove a direct cause-and-effect relationship.

Further studies will be necessary to identify the mechanism involved in the reduction of sperm quality due to cell phones.

The Cleveland Clinic researchers are doing a follow-up study in a large group of men that also takes into account other lifestyle habits and occupational exposures that might affect sperm quality.

In the meantime, Marc Goldstein, MD, Director of the Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College says, “there may not be conclusive evidence but I recommend that a man not keep a live cell phone in his front pants pocket.”

Tai Chi Prevents Falls and Boosts Balance Confidence

Tai Chi has been shown to be very safe for elderly, frail, and de-conditioned people who often have poor balance.

In older people, good balance prevents falls and provides confidence to sustain physical and social activities.

Not surprisingly, Tai Chi is increasingly being adopted in community programs for balance rehabilitation and fall prevention.

Two new meta-analyses show that Tai Chi is, indeed, a good exercise for fall prevention and balance.

One overview analyzed 35 systematic reviews assessing the health effects of Tai Chi.

The Korean and British researchers found Tai Chi helps to reduce the risk of falls and to improve balance in older people.

The second systematic review examined 30 studies that looked at balance confidence among older adults.

The Israeli researchers found Tai Chi was the most beneficial in increasing balance confidence when compared to exercise and other multifactorial interventions.

How does Tai Chi help?

The effectiveness of Tai Chi is due to its multiple components, says Peter Wayne, PhD, Director of Tai Chi and Mind-Body Research Programs, Harvard Medical School’s Osher Research Center.

1. Tai Chi is a weight bearing exercise.

It involves a constant shifting of weight from one leg to the other and lots of one-legged standing with the knees bent, which facilitates improved dynamic standing balance and strength of the legs, ankles, and feet.

2. With Tai Chi, your sensory systems become sensitized, which leads to better balance and function.

Tai Chi’s continuous, slow, even tempo facilitates sensory awareness of the speed, force, trajectory, and execution of movements, as well as awareness of the external environment.

3. The sequencing, timing, and combinations of different muscle groups in Tai Chi helps coordinate neuromuscular patterns.

The quiet standing of Tai Chi enhances the ability to stand upright with optimal efficiency.

More importantly, it also improves your balance as you move and helps you deal with perturbations in balance, for example, when you walk on a rocky road.

4. Tai Chi improves balance and reduces falls by reducing the fear of falling.

Many studies show that Tai Chi reduces the fear of falling, which is one of the biggest predictors of falls.

This is probably because Tai Chi is such a holistic intervention that enhances awareness, cognitive training, and provides more confidence from better strength.

“Based on systematic reviews of exercise and falls prevention, Tai Chi may be one of the better exercises you can do,” says Wayne.

“The diverse, multiple active ingredients inherent in Tai Chi allow you to compensate for deficiencies in the physiological and cognitive components that underlie balance loss.”

Buying Fertility Treatments in Bulk

The mounting cost of getting pregnant has led some fertility clinics and doctors to join forces and offer bulk discounts on in vitro fertilization (IVF) treatments.

The Attain IVF network includes 40 fertility clinics and 190 fertility doctors across the country.

The network offers a program that provides you with multiple IVF cycles for a single, discounted fee that costs about 30-40% less than the same exact treatment plan if you were to pay for it on a cycle-by-cycle basis.

The idea is paying upfront for a few cycles offers peace of mind and takes the stress out of subsequent tries.

With a good fertility work-up, most couples take home a baby after 1 or 2 cycles, but some couples need 3 or more cycles of IVF.

Attain IVF may be particularly appealing to couples who recognize they may have trouble getting pregnant.

This includes couples where the woman is over age 35, when her egg quality is in decline.

This may also include women with polycystic ovarian syndrome, who usually require higher doses of drugs to stimulate egg production and often have their IVF cycles canceled because of overstimulation of the ovaries.

And, of course, this concept may work for couples who can not afford to continue to pay for more than 1 IVF cycle.

On the other hand, younger couples with a single, known fertility problem probably don’t need to enroll in Attain IVF.

A 28-year-old woman who has endometriosis with a partner who has no male factor infertility has a good chance of becoming pregnant with a single IVF cycle.

No one size fits all medical treatments, including IVF.

It comes down to a question of how risk aversive you are, and your particular fertility problem.

School Intervention May Improve Kids’ Heart Health

Offer middle school students healthier cafeteria food, get them more gym class time, and teach them about making good health choices and they can reduce their risk of future heart disease.

So say the results of a new study presented today at American Heart Association’s Quality of Care and Outcomes Research 2011 Scientific Sessions in Washington, D.C.

Over the past 4 years, researchers at the University of Michigan have collected information on nearly 600 middle schoolers who participated in Project Healthy Schools.

This school-based intervention program educated 6th graders about heart-healthy lifestyles in hopes of reducing their future risk of heart disease and diabetes.

The program’s five main goals for the kids were:

1. Eat more fruits and vegetables
2. Make better beverage choices
3. Include at least 150 minutes of physical activity each week
4. Eat less fatty foods
5. Spend less time in front of the TV and computer

Students received classroom education, healthier cafeteria selections, and more opportunities for physical activity to meet these goals.

The researchers collected yearly follow-up data, including body mass index, lipid levels, blood pressure, heart rate, and self-evaluation of healthy eating, exercise habits, and other lifestyle behaviors.

After 4 years, the results show significant improvements in total cholesterol, low-density lipoprotein (LDL) cholesterol (so-called “bad” cholesterol), and resting heart rates (an indicator of fitness level).

The wellness survey indicates that the students continued to make health-conscious decisions by eating more fruits and vegetables, participating in more organized physical activities, and spending less time in front of the TV and computer.

By improving overall cholesterol and LDL’s, choosing to eat healthier food, and participating in more physical activities, these children effectively decreased their risk of CV disease and diabetes, the researchers concluded.

“This 4-year school intervention in Ann Arbor, Mich., was designed to promote healthier lifestyle choices and it shows that programs like this could have long-term impact on obesity and other health risks,” said study co-author Elizabeth A. Jackson, M.D., M.P.H., assistant professor of internal medicine at the University of Michigan.

The program, which is a coalition of the University of Michigan and local community and business organizations, was considered so successful that it’s now being expanded to about 20 middle schools in Michigan.

Just goes to show that simple lifestyle changes and a little education goes a long way to help kids stay healthy.

Rapping about Qi and Tai Chi

The rappers Lil Wayne and Mac Miller get lots of play in my house by my two teenagers.

For my money, I prefer these two cool rap videos about qi and Tai Chi, one by Michael Clark, “Qigong and Tai Chi Rap” of Heaven and Earth Tai Chi, and the other by Dr. Love “This is Why I Do Qigong”.

As Dr. Love says, “I’m strong because I do qigong!”

Infertile Couples Can Cope with Family Gatherings

The media treat Mother’s Day as a news peg to publish articles about happy families celebrating having children.

Headlines recount tales of how couples celebrate Mother’s Day after in vitro fertilization (IVF) treatments for endometriosis and blocked fallopian tubes or to overcome production of too few eggs.

Other articles tell of dozens of IVF moms gathering at a fertility clinic to form their own support group.

But infertility may cause a tremendous amount of strain on relationships with family and friends, particularly on Mother’s Day.

Family gatherings may be particularly painful as you deal with loss and grief.

Some families and friends are supportive, while others just add to your stress.

This may make you angry or cause you to isolate yourselves from them.

You may feel jealous of friends and relatives who have babies.

Friends and relatives may aggravate the situation by repeatedly asking you when you plan to have a baby, or by unwittingly talking endlessly about their own children.

Some family members may want to help, but don’t know what to do or say, while others may prefer to avoid the topic completely.

Many people feel uncomfortable discussing infertility because it relates to having sex.

The older generation may be ignorant of modern technology and new methods of conception.

Siblings and friends may flaunt their own fertility, intentionally or unintentionally.

If you feel a lack of understanding, you may not want to go home for the holidays or may decide to avoid anything having to do with children.

But you don’t want to sacrifice your social networks just when you need them the most, say Weill Cornell fertility experts Drs. Zev Rosenwaks and Marc Goldstein, the co-authors of A Baby at Last!.

If you put a temporary limit on contact with insensitive family members and friends, seek out help from other more supportive friends and family members, therapists, or online or in-person infertility support groups, they write.

Also, a family gathering may be the right time to share your experiences with family members.

The doctors suggest you might speak to one or two family members ahead of time and let them spread the word, or simply answer probing questions honestly.

Be aware of who is capable of being understanding and supportive, and increase your time with those people.

Reduce your time with those who cannot provide the support you need.

Also, take heart that more and more fertility treatment are now available to couples.

Half of all women under age 35 going through one IVF cycle at Weill Cornell take home a baby.

World’s Largest Exercise Class

If you felt the ground shake slightly at 10 a.m. today, that was because millions of children all over the world were exercising simultaneously in what’s known as the world’s largest exercise class.

Today is Project ACES (All Children Exercise Simultaneously) Day, designed to engage millions of children, parents, and teachers each year to participate in physical activity at their schools and homes.

Through Project ACES, children learn the value and importance of good nutrition, adequate physical fitness, and healthy decision-making.

Len Saunders, a physical education teacher from New Jersey, started Project ACES in 1989. He and HJ Saunders, of The Youth Fitness Coalition, now organize the event each year.

The American College of Sports Medicine is also a partner, and other groups providing organizational support include the President’s Council on Physical Fitness & Sports and the American Heart Association.

Children from all 50 states and more than 50 countries were expected to join in today.

Schools and organizations can also join Project ACES clubs, which commit to exercising daily, weekly, or monthly, concluding with the main ACES event the first Wednesday in May.

There’s also a wealth of education material on the Project ACES website. I particularly found two worksheets informative and fun, one on “Nutrition Fuels Fitness” and the other on “What’s Your Family Fitness IQ?”.

Added Protein in Carb Drink Improves Endurance

Sip a sports drink with added protein while you exercise and you may be able to go a little farther before tiring out.

Studies have shown that carbohydrate-containing beverages increase endurance exercise performance, compared to water and placebo drinks.

Some previous studies have suggested that adding a moderate amount of protein to a low- or moderate-carbohydrate supplement can further enhance endurance.

For about 20 years, researchers at the University of Texas at Austin have been looking at the effects of carbohydrate-protein drink combinations.

In their latest study they found a “low-carb, mixed-carb” sports drink with added protein led to prolonged endurance performance in trained female athletes.

Carbohydrates help with the rapid restoration of depleted muscle fuel stores after exercise, and protein provides the amino acid building blocks needed for the repair and building of muscle tissue in response to exercise.

If you are able to take in a bit of protein during exercise, it may help to protect muscle tissue to some extent.

Some sports drink manufacturers have come out with products that contain both carbs and protein.

But there’s no reason that protein has to be in liquid form.

You could also nibble on a so-called energy bar that contains protein as you exercise and sip on a sports drink.

And the real caveat is unless you’re running or biking a long distance, you probably don’t need any supplements during activity.

Afterwards, your body might recover just as well with lots of water and a protein snack (think peanut butter sandwich), which is a lot less expensive than fancy sports drinks.