Posts Tagged ‘American Fertility Association’

Public Enemy #1 for Male Fertility: Anabolic Steroids

Anabolic steroids, such as testosterone and its derivatives, are often taken by athletes to get “pumped.”

But these drugs have a unique side effect — they can shrink a man’s testicles and drastically reduce his fertility.

One of the more serious side effects of these poisonous chemicals is on male reproductive organs, says Marc Goldstein, MD, director of the Center for Male Reproductive Medicine and Microsurgery and surgeon-in-chief of male reproductive medicine and surgery at Weill Cornell Medical Center.

“Because of the high level of circulating testosterone caused by the steroids, the testicles no longer need to manufacture this hormone, so they being to shrink.

This reduces sperm production and may lead to both impotence and sterility,” says Dr. Goldstein.

In a new article posted on the American Fertility Association website, Stanton C. Honig, MD, Associate Clinical Professor of Surgery/Urology and Obstetrics and Gynecology at the University of Connecticut School of Medicine, examines how anabolic steroids affect male fertility.

“The use of anabolic steroids historically has been used by athletes in major sports, such as weight lifting, baseball and football,” writes Dr. Honig, who is also a Staff Urologist at Yale New Haven Hospital and the Hospital of St. Raphael in New Haven, CT.

“Because these so-called ‘role models’ use these drugs, anabolic steroid use or abuse has filtered down and is being used by recreational weight lifters, college, and high school athletes.”

The good news is that in many cases this problem is reversible, Dr. Honig says.

Once performance enhancing drugs (PEDs) such as steroids are stopped, sperm production may start again and sperm will return in the ejaculate, usually in about 3 months.

However, for those who have used steroids for years, this may take up to 2 years.

Once steroids are stopped, medical therapy may help enhance the ability of a man’s body to restart sperm production.

What’s more, PEDs can also cause sexual dysfunction, Dr. Honig notes.

When testosterone levels crash, this may lead to tiredness, loss of energy, and loss of sex drive.

“The most important point here is if you want to have children at some point in your life, DON’T USE ANABOLIC STEROIDS!!!” Dr. Honig admonishes.

And Dr. Goldstein agrees: “If you want to preserve your fertility, do not use anabolic steroids.”

In fact, testosterone has been successfully used as a contraceptive for men, he notes.

“Don’t Hit My Balls” – How Young Male Athletes Can Preserve Their Fertility

“Don’t hit my balls. I want to have kids!”

I heard one of my son’s high school varsity soccer teammates shout this as he took his place in “the wall” to stop an opponent’s free kick at the goal.

At least he knew that testicular trauma could lead to fertility problems.

Most young men don’t know about the effects of damage of the male genitals and possible problems with having a child later in life.

The first installment from the American Fertility Association’s Male Reproductive Health Alliance (MRHA) features Dr. Ajay Nangia, Associate Professor of Urology at the University of Kansas Medical Center, addressing the topic of male fertility and sports activities.

Dr. Nangia notes that blunt trauma, such as being hit by a bat, ball or hockey puck in the genitals without breaking though the skin, accounts for most of the testicular injuries that send young men to the emergency room.

Yet, only about half of the men playing sports wear genital protection, such as a cup, during sports.

Dr. Nangia emphasizes the need for self-examinations for testicular cancer.

He is a big believer in preparticipation physical exams for all young athletes to check for testicular damage and hernias.

And he notes that while Lance Armstrong survived testicular cancer he really waited too long for the diagnosis and that’s why his cancer spread.

“Overall, sporting activities highlight the need to discuss men’s health issues at preparticipation physicals at all levels but also in schools from an early age,” writes Dr. Nangia.

“Sports also highlight the need to re-iterate education and protection of the male genitals during sports.

At present, there is a lack of adequate information provided to young men and also inadequate technology to make such protection comfortable to wear.

More work is needed to educate sports equipment companies and sporting leagues of the importance of this issue.

Great advances have been made with bike seats through better knowledge and health promotion, now it is time to improve other genital protection.

We urge boys and men who participate in sports on a regular basis to help and educate themselves to ensure a successful reproductive life and good long-term men’s health.”

Back to the game: With their hands covering their crotches, the young soccer players sighed in relief as the opponent’s kick went well over their heads, and they turned to play on.

How Vitamin D Levels Relate to Fertility and Prostate Cancer

If you want to conceive a child, just take a holiday in the sun since sunlight boosts fertility in both men and women by increasing their levels of vitamin D.

That’s how the media interpreted the results of a recent systematic review of the connection between vitamin D and fertility.

The new findings, say the pundits, mean that some infertile couples may be undergoing unnecessary and costly fertility treatments when spending time in the sun could be their answer.

There are some hints that vitamin D, the so-called “sunshine vitamin,” can help balance sex hormones in women and improve sperm counts in men.

Other studies show some evidence supporting a role of vitamin D in prostate cancer.

However, the evidence for the role of vitamin D in both fertility and prostate cancer is mixed, at best.

For more on my interpretation of the data, check out the piece I wrote for the American Fertility Association.

Upgrading Fertility Status with Varicocele Repair

The most common identifiable cause of infertility in men is a varicocele.

Approximately one third of infertile men who have never fathered a child have a varicocele, and up to 80% of men who were once fertile, but are now infertile, also have a varicocele.

Varicoceles are abnormally enlarged veins draining the testicles.

They cause pooling of blood in the scrotum and a rise in testicular temperature.

Even one degree rise in temperature in the scrotum can have an adverse effect on sperm production and testosterone function.

The good news is that varicoceles are treatable, writes Marc Goldstein, MD, who is the Matthew P. Hardy Distinguished Professor of Reproductive Medicine and Urology at the Weill Cornell Medical College of Cornell University, and Surgeon-in-Chief, Male Reproductive Medicine and Surgery at the New York Presbyterian Hospital, Weill Cornell Medical Center in New York, in a blog for the American Fertility Association.

“Dozens of reports have been published demonstrating the benefit of varicocele surgery to improve sperm counts,” writes Dr. Goldstein, who is also co-author of the book A Baby at Last!.

“Yet, varicocele repair remains controversial, particularly for small varicoceles that can’t be seen or felt on a physical exam.

Studies have shown greater improvements in semen quality for repair of large varicoceles compared with smaller ones.”

Dr. Goldstein details how he developed a microsurgical technique of varicocele repair using an operating microscope.

This technique can help couples achieve a 43% pregnancy rate after 1 year.

Microsurgical varicocele repair also:

— decreases sperm fragmentation, or the breaking up of DNA strands into pieces

— may cost less than in vitro fertilization with a single sperm injection (intracytoplasmic sperm injection, or ICSI)

— can induce sperm formation and help achieve pregnancy for couples in which the man has a zero sperm count (azoospermia) or a severely low sperm count and low sperm motility

— improve testosterone levels in two-thirds of men

“In conclusion, varicocele repair is a cost-effective treatment of infertility,” writes Dr. Goldstein.

“Men can upgrade to normal semen, which can allow for a natural pregnancy, or upgrade to semen of adequate quality for intrauterine insemination.

Men with azoospermia may produce ejaculated sperm adequate for ICSI.

Even if a man remains azoospermic, varicocele repair may enhance spermatogenesis allowing enough sperm production for ICSI.

Finally, microsurgical varicocelectomy will improve testosterone levels in a majority of men, which is a men’s health issue aside from fertility.”

Award for A Baby at Last!

The Board of Directors of The American Fertility Association (The AFA) unanimously decided to honor the book “A Baby at Last!” with an Illumination Award.   The AFA founding board chair, Carolyn Berger, presented the award on November 10, 2010.