infertility – Hello Doctor

What you need to know about testosterone

January 5th, 2018 by The Hello Doctor Team

Ever wondered why some guys are able to build rock solid muscles in no time and others (to their dismay) just can’t? One reason could be due to the amount of testosterone they produce. Testosterone is a sex hormone found in males and females, but it’s more prominent in men. Production starts to increase during puberty and dips after the age of 30.

This macho hormone helps with sperm production, helps male characteristics fully develop and plays an important role in the overall health of men. Here’s what you need to know about it:

Testosterone’s main jobs:

Helps with the growth of testes at puberty.
Controls male physical features.
Aids in the development of facial and pubic hair.
Helps build muscles and strong bones.
Deepens the voice.
Helps produce sperm.
Increases sexual drive.

Running low

The levels of testosterone in a man’s body fluctuate daily, and is usually at its peak in the morning. High or low levels can lead to dysfunction in parts of the body, which are normally regulated by this hormone.

As a man ages, his amount of testosterone naturally decreases, but in some cases, low testosterone can be caused by other issues:

An injury, infection or loss of the testicles
Too much iron in the body
Stress
Obesity
Alcoholism
Dysfunction of the pituitary gland (a gland in the brain that produces important hormones)
Kidney failure
Inflammatory diseases like sarcoidosis (a condition that causes inflammation of the lungs).

Low levels of testosterone causes different symptoms like

decreased sex drive
low energy levels
weight gain
moodiness
less body hair
low self-esteem.

Besides the symptoms, a depletion in this hormone can lead to serious health conditions like erectile dysfunction. This condition, also known as impotence, is when a male has an inability to get or keep an erection firm enough to have sexual intercourse. Although low levels of testosterone aren’t the only culprit for this dysfunction, it does play a role.

Treating testosterone issues

Intramuscular injections (injection directly in your muscles), given anywhere from every two weeks to every 10 weeks.
Testosterone cream applied down the sides of the neck down to the collarbone.
Long-acting subcutaneous pellet (provides a slow continuous release of hormone after being inserted into your buttocks or near your hip).
Clomiphene tablets which increase testosterone and sperm production in the testicles.

Good to know

Testosterone treatments are prescribed only for conditions where the hormone is low and not for age-related drops. Testosterone replacement therapy is also available, but you should talk to your doctor before making the decision to use it as there might be possible complications.

References:

Your sperm ages with you. Here’s how to save them

August 28th, 2017 by The Hello Doctor Team

There’s no need to rush into fatherhood, but men, just like women, shouldn’t wait too long to have a baby. Even though most men can have children well into their 50s, fertility becomes challenging after the age of 40. This is because ageing affects every cell in your body, including your sperm cells.

Your swimmers age too

As you grow older, your sperm quality decreases. Their morphology (size, shape and appearance) and motility (the ability of sperm to move towards an egg) deteriorate with age, and the volume of semen also begins to decline.

Research published in Fertility & Sterility found that between the ages of 30 and 50, the average man’s sperm declines by up to 30% in volume, swims up to 37% slower, and is five times more likely to be deformed. This can make it more difficult for sperm to fertilise an egg. The older you are, the longer it will take for you and your partner to conceive – no matter the woman’s age.

Your hormones may also be working against you. Around the age of 40, your testosterone levels may go down. Low testosterone can affect your ability to make sperm, and result in low sperm count. It can also reduce your libido and lead to infertility. Illnesses that cause infertility are also more common among older men. These include erectile dysfunction (the inability to achieve and maintain an erection), varicocele (the abnormal dilation of the testicular veins in the scrotum), and orchitis (inflammation of the testicles).

The risks

There’s also a high risk of not being able to conceive at all and miscarriage. The risk of miscarriage is twice as high for women whose male partner is over the age of 45 than for those whose partners are under 25, says the Infertility Awareness Association of South Africa (IFAASA).

Fertility is ageist. Older men typically have older partners. Female fertility starts to decline after the age of 30, and drops more sharply after the age of 35. The older your partner, the more difficult it may be to conceive.

Age also affects your chances of having a healthy child. Children of older fathers have a greater risk for mental health problems and autism spectrum disorders. According to statistics from IFAASA, children with fathers aged 40 or older are more than five times as likely to have an autism spectrum disorder than children fathered by men under 30. Down’s syndrome, schizophrenia, and Type 1 diabetes are other conditions that seem to be more common among babies with older fathers.

Keep your swimmers healthy

Eat right. A diet high in fat and low in plants can shrink sperm count and quality. Fill up on antioxidant-rich foods like fruits, vegetables, and wholegrains to improve the health of your sperm.
Limit your drinks. Alcohol can harm your sperm and interfere with sperm production. Stick to two units of booze a day.
Quit smoking. Tobacco reduces sperm count and motility. Nicotine can also negatively affect sperm morphology.
Keep cool. Heat slows down sperm production and lowers sperm count. Avoid tight-fitting underwear and clothes, hot baths and using your laptop directly on your lap.
Stop stressing. Too much stress can degrade and permanently damage your sperm. Protect your boys by finding healthy ways to deal with stress. Take a timeout, get enough sleep, or vent to someone.

Save your swimmers

If you are planning for children later in life, it may be a good idea to get your sperm frozen. This ensures that, even if your body changes, you have a few billion copies of your younger self, ready and waiting to reproduce. You can do this at places such as http://medfem.co.za/sperm-freezing-and-storage/ .

If you and your partner have been trying to have a baby for over a year, but haven’t been successful, see your doctor – especially if your partner is over 35 or either of you have a history of infertility. There may be a medical reason for your difficulty to conceive.

References

Infertility: there is hope!

July 9th, 2017 by The Hello Doctor Team

It’s heartbreaking to realise you may not be able to get pregnant. Infertility is not the end of the road, though. Medically defined, infertility is the inability to conceive after a year of unprotected intercourse in women under 35, or the inability to carry a pregnancy to term.

In South Africa, it’s estimated that one in six couples struggle with infertility.

As doctors and experts understand, lifestyle factors can wreak havoc on fertility. Dr Paul le Roux from Cape Fertility concedes that infertility is on the increase in SA, at least 10% each year. “Women are now delaying childbearing until they’re older. This is a global trend and all around the world with women having children at an older maternal age, until after they’ve completed their studies, established a career, and found the right partner. Unfortunately, medical science cannot always assist due to the deteriorating quality of their eggs. Excessive alcohol and smoking is bad for fertility, as is being over- or underweight when trying to conceive.”

A particularly sad aspect of infertility is the age factor. Age does affect fertility, especially in women. Studies show that a woman’s fertility starts to decline at age 30, and then even further in her late 30s and early 40s. According to the Society for Assisted Reproductive Technology (SART), in America, a healthy 30-year-old woman’s odds of getting pregnant during a specific ovulation cycle is approximately 20%.

Why is age such a big issue? All women are born with a finite amount of eggs, as they get older, the eggs too get older. These eggs don’t have the same “potency” as they age to respond to fertilisation. “It’s true that women have a limited number of eggs,” confirms Dr le Roux. Here, knowledge is power, and a scan of the ovaries and a blood test (called an AMH) can tell you how many eggs remain.

Male infertility is also a smoking gun, and can be brought on by the same lifestyle factors that affect women. Stress, excess body weight, smoking, too much alcohol, drug use and erectile dysfunction are all possible risk factors.

The good news

Tackling the issue of ineffective eggs, egg freezing is a viable and successful procedure that’s worked for many couples. The process of preserving eggs or oocytes is called vitrifcation. This involves stimulation with injections and getting the ovaries to product a number of eggs which are then retrieved through the vagina. Once these eggs have been extracted, they can then be frozen for the future.

This isn’t to say that the eggs, in a few years’ time, will be completely viable. Experts still debate the success rate of thawing and fertilising at a later stage. It really depends on the experience and expertise of the individual fertility centre. Some institutions have a pregnancy rate of 20-25%.

Egg donation is another possibility. This is used for women with poor quality eggs or those who are premenopausal or menopausal. The treatment involves stimulation of the egg donor’s ovaries, retrieval of the eggs and fertilisation of the eggs with the recipient’s partner’s sperm. You’ll then carry the baby, but it won’t be your DNA.

Millions of couples have also successfully opted for IVF (in-vitro fertilisation). In this process, eggs are surgically removed from the ovary and mixed with sperm. This is done outside the body in a dish and after about 18 hours, the eggs are examined to see if the sperm has fertilised them.

Other options like sperm donation and surrogacy can be helpful in certain patients, and of course – adoption. So, there are always avenues to explore.

As always, before it gets to this stage though, it’s a good idea to watch for infertility culprits (taking care to manage stress, and make healthy lifestyle choices).

Go for regular check-ups if you want to get pregnant soon so if there are any potential threats, you can take steps to fix the problem as soon as possible.
Always be safe when having sex. Sexually transmitted diseases can harm your reproductive system.
Smoking and other recreational drugs can do a lot of damage to your infertility so stop well before you want to conceive.

References

Guys, what do you know about male fertility?

June 4th, 2015 by The Hello Doctor Team

Can you crack our Male Fertility quiz? Give it your best shot! Continue reading “Guys, what do you know about male fertility?”