Posts Tagged ‘Male infertility’

Newly Designed Molecule Blocks Chlamydia Infections

A newly designed molecule may block the damaging effects of Chlamydia, the bacteria responsible for the largest number of sexually transmitted infections in the United States.

About 3 million cases of Chlamydia trachomatis are reported each year among Americans.

If left untreated, the infection can scar a man’s sperm-carrying tubes and permanently damage a woman’s egg-transporting fallopian tubes.

The end result can be male infertility or female infertility if the infection is not treated properly with antibiotics.

Now a team of Duke University researchers may have come up with a new way to fight off a chlamydial infection, they report in the July 21 print edition of Cell Host and Microbe.

They have designed a molecule that takes away the bacteria’s self-defense mechanisms.

Instead of directly killing the bacteria with antibiotics, they disarm a central weapon of Chlamydia, and let the body take care of the rest.

By blocking a specific enzyme with this molecule, the enzyme no longer could degrade the proteins in the cell that would normally mount an immune response to the infection.

When the enzyme is inhibited, the infected human cells effectively “commit suicide,” says lead researcher Raphael Valdivia, Ph.D., an associate professor in the Duke Department of Molecular Genetics and Microbiology.

“When the infected human cell dies, so does Chlamydia, and this ends the infection.”

Up to 25% of men infected with Chlamydia have no symptoms at all.

What’s more, almost two-thirds of men have not one but two genital infections, usually with gonorrhea, putting a double whammy of their reproductive tracts.

In women, the symptoms of pelvic inflammatory disease, often caused by a chlamydial infection, may also be silent.

Most often, when a fertility evaluation finds a woman’s fallopian tubes are closed, she was not aware that she had previously had a pelvic infection.

Sometimes a man does not feel any symptoms either, and he may unwittingly pass the infection back and forth with his female partner.

If the Duke approach pans out, it could be a welcome addition to help fight off chlamydial infections.

“Klingon Cloaking Device” May Be Key to Male Infertility

The lack of a protein that normally coats sperm may be the reason why some sperm don’t reach the egg to fertilize it.

This protein acts as a “Klingon cloaking device” to allow sperm to swim through cervical mucus and avoid the immune system on its long journey to the egg, says Gary Cherr, a professor at the UC Davis Bodega Marine Laboratory and Center for Health and Environment.

The protein DEFB126 is generated by a specific gene, and men with two copies of the defective gene do not produce the protein, the researchers reported in a study published online on July 20 in the journal Science Translational Medicine.

Some 70% of men have infertility that can’t be explained based on their sperm count and quality, say the researchers.

This discovery may help explain a significant portion of this infertility.

In tests of men worldwide, they found about half of all men carry 1 defective copy.

One quarter have 2 defective copies and therefore make sperm that are poor at swimming through cervical mucus.

In studying about 500 couples in China who were trying to become pregnant, they found that men with 2 copies of the abnormal gene were 30% less likely to father a child over about a 2-year period.

And it took nearly 2 months longer for the couples to have a baby if the man had 2 copies of the abnormal gene.

The researchers are now looking to develop a test for the mutation.

If a couple found that the man has a double mutation, they could go directly to single-sperm injection with intracytoplasmic sperm injection, or ICSI, to inseminate the woman’s egg.

Choosing a healthy sperm becomes crucial to ICSI success.

In a natural conception, only the fittest and healthiest sperm makes the arduous journey to the egg.

ICSI bypasses this natural selection barrier, so the chances of a genetically abnormal sperm fertilizing an egg are higher.

A new test for sperm DNA damage could help select the best sperm for a single-sperm injection.

Eat Fresh To Preserve Fertility

Cut out packaged foods from your diet and you may be able to reduce the levels of bisphenol A (BPA) in your body.

Originally created as a synthetic estrogen, BPA was adopted by the chemical industry when it was discovered that it could make plastic light, clear, and shatterproof.

Now it can be found in the lining of tin cans, plastic lunch boxes, plastic water bottles, baby bottles, mobile phones, DVDs, and thousands of other products.

BPA has been linked to male infertility and has also been associated with polycystic ovarian syndrome, chromosome abnormalities in the egg, and miscarriage among women.

It has also been associated with a host of medical problems, including heart disease, diabetes, and breast cancer.

If you substitute fresh foods with limited packaging for 3 days, you can significantly limit your exposure to BPAs, according to the results of a new study.

Researchers at the Silent Spring Institute and Breast Cancer Fund selected 20 participants in 5 families who said they frequently used canned and packaged foods.

The participants ate their usual diet, followed by 3 days of fresh foods that were not canned or packaged in plastic, and then returned to their usual diet.

The fresh-food diet led to an average drop of 66% in BPA levels and a 76% reduction among those with the highest BPA levels, the researchers report in the March 30 online version of Environmental Health Perspectives.

There are a number of small, preliminary studies on the effects of BPA on fertility, but it will take many years, decades even, to firm up this connection.

In the meantime, to protect your reproductive health, it’s probably prudent to limit your environmental exposure to BPA:

— Install a filter in your home to ensure your water supply is free of BPA.

— Don’t drink out of plastic containers or cans.

–Store food in glass, not plastic, containers and avoid microwaving food in plastic containers.

–Avoid eating packaged foods whenever possible.

The Breast Cancer Fund suggests that you avoid canned foods that are acidic, salty, or fatty because BPA is more likely to leach from can linings into these kinds of foods.

The Fund has created a wallet-size card that notes 10 Canned Foods to Avoid to Reduce BPA Exposure.

Cancer Survivors Can Father Children

Men who have a zero sperm count from cancer treatments may still have a chance to father a child.

“We can usually retrieve sperm from the testicles of 30-50% of men who had chemotherapy even 15 or more years ago. Using ICSI, about 20% take home a baby,” write Weill Cornell Drs. Zev Rosenwaks and Marc Goldstein in A Baby at Last!

Sperm can be extracted using a procedure called microdissection testicular sperm extraction (TESE), a procedure that was developed by Weill Cornell researchers.

The procedure enables doctors to identify small areas in the testicles where sperm are made and then carefully extract these healthy sperm cells, even in men whose testicles have been severely damaged by chemotherapy. These sperm are then directly injected into a woman’s egg using an advanced in vitro fertilization (IVF) procedure called ICSI, which stands for intracytoplasmic sperm injection.

In a new study published online in the Journal of Clinical Oncology on March 14, Weill Cornell researchers report on more than 1,000 TESE procedures on nearly 900 men, including 73 cancer patients.

The researchers retrieved sperm in 27 (37%) of the cancer survivors, which led to the birth of 20 children using IVF techniques.

If you have cancer, the type of cancer and type of chemotherapy you receive affects your chances of successful sperm retrieval. For men with testicular cancer who received platinum drugs, the sperm retrieval rate was 85%. Men with lymphoma treated with an alkylating agent such as cyclophosphamide had lower retrieval rates, ranging from 26-36%. Sarcoma patients had the lowest retrieval rate, only 14%.

“When we started this study, we thought sperm retrieval rates would be close to zero among the group of cancer survivors, but we were surprised to discover that in many cases small areas of testicular tissue survived and resumed sperm production over a period of several years,” said lead author Peter Schlegel, MD, chairman of the Department of Urology at Weill Cornell Medical College, in a press release about the study.

“This study gives men a new way to achieve fertility and the potential of parenthood. Survivors of childhood cancer should be made aware of options besides using banked sperm, adoption or donors if they want to be fathers,” noted Lisa Diller, MD, Associate Professor of Pediatrics, Harvard Medical School, in the release.

Because the numbers of sperm retrieved from the testicles of cancer survivors are low, TESE is best performed at the time of egg retrieval so that fresh sperm can be immediately injected into the egg using ICSI. Any extra sperm can be frozen and preserved for future use.

No Need to Stress Out Over Fertility

Does stress affect fertility?

A body of evidence continues to build about the effects of chronic stress on a woman’s ovulation and a man’s sperm production. Stress may lead to a cascade of hormonal events that led to inhibition of the body’s central reproductive hormone signal, and subsequently disturb ovulation or sperm production and sexual activity, write Weill Cornell fertility doctors Drs. Zev Rosenwaks and Marc Goldstein in A Baby at Last!

Humans are designed to endure acute stress. That’s a part of life. But the significant amount of stress couples endure, cycle after cycle, as they attempt to conceive may disrupt reproductive function. Normal fitness and diet routines may fall by the wayside, leading to a more frazzled, stressed lifestyle. Putting this into Eastern philosophic terms, if you are not in harmony with yourself and your culture, you are stressed.

However in studies attempting to make a direct connection between stress and lower in vitro fertilization success rates, the results are mixed.

A new meta-analysis of 14 studies and more than 3,500 infertile women undergoing assisted reproductive treatment found emotional distress did not affect their chances of becoming pregnant. In the Feb. 24, 2011 online edition of the British Medical Journal, Cardiff University psychologists conclude: “The findings of this meta-analysis should reassure women and doctors that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise the chance of becoming pregnant.”

We still need more information to determine the exact relationship between stress and its effects. It may be helpful for couples to know that anxiety and depression won’t necessarily ruin their chances of having a baby.

Double Your Sperm Count?

In his new best-selling book, The 4-Hour Body: An Uncommon Guide to Rapid Fat-loss, Incredible Sex, and Becoming Superhuman, Tim Ferriss sets out to rewrite the rules on how to reshape your body. He describes how he developed a minimalist approach to fitness and health, using himself as a human guinea pig to test every fad, diet, supplement, and workout he could find to identify the things that really work.

The back cover boasts about a dozen things you will learn (in less than 30 minutes), including how to double your sperm count. Ferriss has some interesting ideas here, which I ran by Marc Goldstein, MD, who is the Director of the Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical Center, and one of my co-authors of A Baby at Last!.

Ferriss had his sperm tested in his early 30s after a friend developed testicular cancer. Even though he was in top physical shape, his sperm count was borderline normal. After researching the medical literature, he hit upon the effects of cell phone radiation on sperm. So the first thing Ferris did was to remove the cell phone from his pants pocket and carry it either in an armband or in the front pocket of a backpack.

Good idea says, Dr. Goldstein: “I agree with that. Rat studies were randomized controlled studies and indicate live cell phones near testicles might have a negative effect. I give that advice to my patients. I include this in my updated list of lifestyle changes to preserve a man’s fertility.”

In addition, Ferriss started cold treatments, taking short ice baths and/or cold showers 10 minutes upon waking and before bed, even though he admits that the effects on sex hormones are largely untested. And he began eating Brazil nuts, which contain selenium, a mineral Dr. Goldstein says has been shown to increase sperm production and sperm quality.

After 11 weeks, Ferriss had his sperm tested again, and says he nearly tripled his motile sperm (the number of good swimmers) per ejaculate. His ejaculate volume increase by 44%, motile sperm per millimeter by 100%, and motile sperm per ejaculate by 185%.

“The increases in his numbers are well within the large range of variability seen in multiple semen analysis in the same man,” says Dr. Goldstein. “They could have nothing to do with the changes he made unless he didn’t mention that he also stopped drinking heavily and using drugs.” Ferriss doesn’t say anything about limiting alcohol or drug use.

Ferriss also recommends that men over age 30 highly consider storing their sperm because, in general, men are becoming more infertile, many medical conditions and procedures can render men infertile, and men may change their minds about wanting kids, so why not do it?

Dr. Goldstein’s advice is not so liberal: “Only store your sperm if you are going to be treated for cancer, or already have a critically low sperm count.”

Ferriss has other intriguing ideas in The 4-Hour Body I’ll comment about in the future.

Men Can Maintain a Healthy, Fertile Lifestyle Over Age 40

One of my co-authors of A Baby at Last!, Marc Goldstein, MD, appeared as a panelist on the Weekend Today Show last Saturday Jan. 22, answering viewers questions about men over age 40. Looking dapper as usual, Marc succinctly described how a 40-plus man could maintain a fertile lifestyle — watch your weight, don’t drink too much, and stay away from anabolic steroids.

On Marc’s Cornell Institute for Reproductive Medicine website he lays out guidelines on how men can live a healthy, fertile lifestyle. “Patients with infertility can have some control of their reproductive function by living healthy lifestyles. Often some ‘negative’ lifestyle may be contributing to their infertility. Therefore, if patients live healthy lifestyles, it is possible that there will be some improvement in their reproductive function. There may not be conclusive evidence for all these lifestyle recommendations, but rarely will following these guidelines hurt, and often they may help,” he says.

10 Tips to a Fertile Lifestyle

1. Males should avoid excessive heat (such as saunas or hot tubs and placing laptops on the lap).
2. Limit coffee to 1 or 2 cups per day.
3. Do not smoke.
4. Do not use marijuana, cocaine, or other recreational drugs. Marijuana stays in the testicles for 2 weeks, so even using it once every two weeks will have a negative effect.
5. Exercise regularly and moderately.
6. Drink no more than 2 ounces of alcohol twice per week.
7. Have good nutritional habits, especially a diet rich in fresh fruits, leafy vegetables (oranges, tomatoes, peppers, leafy greens – any bright-colored fruit or vegetable), as well as fish (think SMASH: salmon, mackerel, anchovies, sardines, and herring). Avoid excess of animal fat (red meat, fried food, cheese, and whole milk). Diets high in animal fat are associated with a high risk of prostate cancer and heart disease. Meats lower in animal fat include venison, buffalo, and grass-fed beef.
8. Be aware of sexual problems and do not hesitate to ask for medical help.
9. Educate yourself about health and reproduction.
10. Seek emotional and/or psychological support; consider meditation to reduce stress.

Take Your Vitamins

It is believed that taking certain vitamins may help improve a man’s fertility. The mechanism of action is believed to be as follows:

The breakdown of oxygen as it passes through the cells in our body results in substances known as free radicals. Infertile men have a higher concentration of free radicals in their semen as compared to fertile men. Free radicals attack and destroy the membrane that surrounds sperm. Anti-oxidants fight against these bad effects, and vitamins are natural anti-oxidants.

Marc suggests men take daily vitamin C (500 mg), vitamin E (200 IUs), selenium (200 mcg), a multivitamin that contains no more than 20 mg of zinc, folic acid (800 mcg), and co-enzyme Q10, or CoQ10, (200 mg). Co Q10 is an antioxidant that has been shown to increase sperm motility.

One product currently available that contains all of these suggested supplements except CoQ10 is Conception XR Natural Conception Formula for Men. It can be used with CO Q10 200 mg daily to fulfill the recommended vitamin requirements.

Welcome!

NY Resident magazine book review

Welcome to my new blog. My current news is the positive responses I’ve been getting regarding my latest book, A Baby At Last!

A very favorable review ran in this month’s issue of the Resident magazine.

A Couples’ Guide to Getting Pregnant

“Everyone seems to know someone who has a fertility problem…”  That’s the start of  A Baby At Last!: The Couples’ Complete Guide to Getting Pregnant—from Cutting-Edge Treatments to Common Sense Wisdom by Mark L. Fuerst, Zev Rosenwaks, M.D., and Marc Goldstein, M.D.

This book is for every couple seeking a solution to fertility problems. It conveys the knowledge that you are not alone and much can be done. You’ll learn when to seek help, how to find doctors and ask the right questions, what tests are worth having and why. The book covers up-to-date therapies and provides support for the emotional rollercoaster of fertility treatments.

Céline Dion’s many failed attempts at in-vitro fertilization were heartbreaking but in October 2010 the 42-year-old singer gave birth to twin boys. She said, “When I think about Dr. Rosenwaks and the extraordinary talent and intelligence that allows him to combine nature and genius to create new life, I am in awe and forever grateful for his talent.”

“Sugar” Ray Leonard, six-time world boxing champion, said, “One of my toughest fights was to father children with my loving wife, Bernadette. After two failed surgeries, I found Dr. Goldstein. My greatest victories are my Olympic gold medal, my world titles, and my family, the last one with thanks due to Dr. Goldstein.”

Mark L. Fuerst’s writing talents shine. Publishers Weekly said, “The text is reader-friendly and accentuated with informative ‘Take Home Messages’ that will help couples expand their knowledge and foster fertility success.”

About the Authors

Mark L. Fuerst is a health and medical writer and coauthor of ten books including The Couple’s Guide to Fertility. His many articles on fertility have appeared in major magazines.

Zev Rosenwaks, M.D. and Marc Goldstein, M.D. are fertility experts at the NewYork-Presbyterian/Weill Cornell Medical Center, a leading pioneer in treating infertility.

By Dorri Olds