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By West Norwood Therapies Team, Jan 17 2018 11:00AM

Following on from her previous blog on imporving male fertility and 'normal sperm', Acupuncturist Phlippa Summers looks at practical steps men can take to boost their fertility.


Here we’ll take a look at some of the many things that you can do to help give your fertility a boost with the focus being on sperm and semen quality. This follows on from my previous blog, Improving Male Fertility Part I, which looked at why sperm and semen results that come back within normal ranges are not necessarily an indicator of good fertility.


With the excesses of the festive season behind you, the benefits of a healthy purge may be very welcome for your general health, as well as your fertility. Many of the changes apply to both men and women looking to boost their fertility so working together, supporting and encouraging one another and focussing on what you can do, rather than what you can’t, can make the changes easier. The intention is for this information to be a source of empowerment, certainly not guilt. Focus on making changes that feel manageable and get support when you need it.


So what can you do?

Start with a healthy lifestyle – eat a healthy diet, if possible take dietary supplements for fertility, exercise regularly and reduce exposure to toxins. Men produce sperm all the time and it takes approximately 90 days for the sperm to mature so these measures need to be maintained over the course of 3 months. Increasing the nutritional quality of what you eat and taking supplements will provide the necessary nutrients for optimal sperm and semen production. Reducing exposure to toxins and increasing the amount of antioxidants in your diet will protect the sperm and semen from damage. Even if you end up having IVF and ICSI, you will help to improve the likelihood of success and also support the health of your future babies.


Acupuncture

Have a course of acupuncture. Acupuncture helps fertility and can also be a great support, helping you to relax. It is very gentle, using needles the width of a hair to stimulate the points. Points used are located mainly on the arms, legs, abdomen and back – never in the genitals! Studies have shown that acupuncture can effectively:

• Increase sperm production

• Increase the percentage of healthy sperm

• Improve sperm movement (motility)

• Improve the levels of hormones responsible for fertility

• Increase the rate of pregnancy both in natural and assisted conception

Additionally, you will get support and encouragement to keep doing the things that help you on the path to fatherhood.


Now let’s look in more detail at some of the lifestyle changes that help.


Diet

A healthy diet based on wholesome, organic, unrefined food without harmful additives and chemicals will support fertility, help maintain a healthy weight and in conjunction with exercise improve your overall health. Here are some tips to help men improve their diet for fertility.


Eat more:

• Wholefoods, unrefined and as natural as possible, so whole fruit rather than juice. Whole foods provide the extras like fibre, enzymes and maximum nutrients.

• Slow carbs like wholegrains, beans, peas, lentils and vegetables. They help to avoid blood sugar spikes which in turn can help to regulate metabolism and hormones.

• Plant based foods with plenty of fruit and vegetables, nuts and seeds which are full of antioxidants to protect against free radical damage from Reactive Oxygen Species, a common cause of impaired male fertility.

• Healthy Fats from avocados, olive oil, nuts, seeds, and short lived oily fish (herring, mackerel and wild salmon) which help to reduce inflammation.

• Milk, yoghurt and eggs are good.

• For meat eaters high quality free range poultry and, in moderation, grass fed meat. Eating reduced amounts of meat, and ensuring the meat you do eat is of the highest quality, will help to reduce exposure to toxins and also xenoestrogens, the oestrogen mimicking hormones that are present in the environment.


Try to limit:

• Alcohol as it reduces semen volume and sperm morphology and motility. Keep under the recommended 14 units per week for men and spread them through the week.

• Additives, sweeteners, colours, flavourings and preservatives.

• Saturated fats, sugars and refined carbohydrates.

• Processed meat such as bacon and salami.

• Moderate caffeine intake is fine but you may wish to reduce your intake to support your partner who may be avoiding all caffeine.


Supplements

Supplements have an important role to play in enhancing fertility, especially as so many foods are now depleted of nutrients, however they are not a replacement for a heathy diet. I suggest a high quality formula aimed specifically at male fertility. Vitamen in the Zita West range was formulated by Melanie Brown, a leading authority on nutrition and male fertility. Another good brand is Fertilsan M in the amitamin range which also contains pine bark extract, said to enhance the effects of some of the other ingredients. For more tailored advice on both diet and supplements I would recommend seeing Melanie Brown, who works with both men and women.


Reducing Exposure to toxins

Toxins are widespread in food, the environment including our air and water supply and our exposure is also often higher in certain occupations. Some of the main culprits cited include:

• pesticides, plastics, detergents, solvents, paint fumes and metals including lead and mercury.

• Xenoestrogens which disrupt hormone balance


More research is needed to determine exactly how they are impacting men’s fertility. While we cannot avoid them completely we can take steps to reduce our exposure to some of them, seeking out less noxious alternatives and taking protective measures, for example:

• Delay house decoration and renovation.

• Use natural cleaning products.

• Use protective masks when cycling in polluted areas and choose routes with cleaner air.

• Avoid drinking and eating from plastic containers, especially when they are heated.

• Drink tap water filtered through a simple carbon filter, either fitted to your water supply or using a jug. It removes a significant amount of the oestrogen related compounds.


Exercise and optimal weight

Exercise has multiple benefits. It helps to maintain a healthy weight and the optimal BMI for fertility is between 19-25. It also helps calm the mind and manage stress which has an impact on so many aspects of our health, including fertility. Finding an exercise program that is sustainable is key, so aim for something enjoyable, that you can fit in around your other commitments. Make it something social if that helps. Take the stairs not the lift, incorporate a brisk walk into your commute – it all adds up. Being underweight is also detrimental to male fertility so it is important to get the right balance of diet and exercise for you. It is not advisable to lose weight while undergoing fertility treatment.


Keep your scrotum cool!

• Wear clothes that fit loosely around the groin

• Avoid hot tubs, saunas, hot baths, electric blankets and heated car seats

• Try to avoid sitting for prolonged periods

• Keep the laptop off your lap


Drugs - prescription and recreational

• Avoid recreational drugs especially cigarettes, marijuana and cocaine

• Avoid anabolic steroids, often used to increase muscle mass in body builders

• Have any prescription drugs reviewed by your pharmacist or GP. Those taken for high blood pressure and depression commonly impact on fertility.


Keeping it Fresh

Regular ejaculation is important for keeping your sperm fresh and healthy. Aim for intercourse every day or every other day during the fertile window and the rest of the month ejaculating every 2-5 days has been shown to improve sperm health. Place emphasis on keeping sex fun, loving, exciting and interesting for you both – sex that is recreational will also be procreational! Nurturing your relationship is important so keep talking and doing all the things you enjoy together that help to keep you close.


Stress, depression and relaxation

Stress and depression have an impact on male fertility, and understandably can commonly increase after the diagnosis of a fertility issue or following an unsuccessful round of IVF. They can affect sperm numbers and function and also hormone balance which controls development of sperm. Getting support, exercising and having acupuncture can all help. Interestingly, actively ‘coping’ with stress by being more assertive or confrontational makes matters worse. It increases adrenaline which in turn reduces blood flow to the testes and penis. Put time aside for the things that you enjoy. Take time to relax by yourself, with friends and with your partner. Get help if you feel things are not improving.


When to make changes and when to get tested

As it takes about 90 days for sperm to be produced most of the above changes should be made at least 90 days before you wish to start trying for a baby. Some men may benefit from making changes earlier, for example, if you need to lose a significant amount of weight.


The range of parameters tested varies from place to place with some being far more extensive than others. Fertility investigations and testing are usually not started until you have been trying for at least a year, six months if the woman is over 35. If you fall into this category or are concerned for any other reason then make an appointment with your GP. If you wish to be tested earlier or would like the benefit of more thorough tests and treatment, then I would recommend contacting Dr Sheryl Homa at Andrology Solutions, the only clinic in the UK licensed by the HFEA to focus purely on male fertility. They offer a fully comprehensive semen analysis, as well as other investigations where appropriate, and Dr Homa can advise on tests and discuss the results and next steps with you including referral to a consultant urologist if necessary.


Some of you may go all out and change everything you can, others of you may make a few changes to start with and take it from there. Keep it manageable and remember that help is at hand if you need it. You may be interested in this clip of three men discussing their experiences of struggling to have children which was broadcast on BBC Radio 4 on 11th December 2017 How do men deal with infertility?






By West Norwood Therapies Team, Dec 6 2017 09:00AM

Acupuncturist Philippa Summers considers male fertility and how often it is overlooked in conception attempts with focus tending to be on the female and despite the lack of support and treatment currently available there is actually much a man can do.


You’ve probably seen the headlines - sperm counts are dropping and male fertility issues are on the rise. A recent article on the male fertility in the Guardian explored the issues and highlighted the lack of proper diagnosis, support and treatment for men facing difficulties. So we know that there is a problem generally but what is less obvious is that the primary test for male fertility, semen analysis, is also misleading, with ‘normal’ results being as much as 5 times lower than the average for a fertile man. In this blog I’d like to explore this in more detail and in the next blog article in January take a look at some of the steps men can take to improve the quality of sperm, semen and their fertility.


A normal sperm result means normal fertility, doesn’t it?


Not at all. The latest semen analysis reference ranges, that are used to determine what is ‘normal’ and therefore who should be investigated and referred for treatment, were set by the World Health Organisation (WHO) in 2010. The researchers who collated and published the data themselves state "reference limits should not be over-interpreted to distinguish fertile from infertile men accurately. " A report, by an internationally acclaimed expert in male fertility, which looks in detail at how the WHO guidelines were drawn up, concludes “Because of the lowered threshold, countless couples are being misdiagnosed and therefore missing the opportunity to benefit from diagnosis and treatment. ”


Bear with me while I go into the process and numbers with you as I think it is important and I don’t just want you to take my word for it. The semen parameters included in the WHO reference ranges are semen volume, sperm concentration, total sperm number per ejaculate, vitality (percentage of live sperm), motility (%), progression (% moving correctly) and morphology (% with normal shape). The study looked at men who had fathered children within a year of trying, so all were fertile, and drew a line above the bottom 5% of results. It was then inferred that men with results above the bottom 5% have normal fertility. This is very misleading as there is a wide overlap in the measurements between fertile and infertile men, so a proportion of men will fall below the reference ranges and be fertile, and a considerable number of others will fall above the reference ranges in the ‘normal’ zone and have impaired fertility. Understandably, when men get back their ‘normal’ result they believe their sperm is fine and the focus of attention moves to the woman.


‘Normal’ can still be well below the average levels of fertile men - anything above a sperm count of 15Million sperm per ml is considered normal, yet among the men that took part in the WHO guideline study the average was 79 Million per ml, which is over 5 times higher. Similarly the shape of the sperm (morphology), which has a big impact on their function, is considered normal if 4% are of normal shape, but the average in the WHO guideline study was almost 4 times higher at around 15%. Semen Analysis tests include a range of parameters in addition to those mentioned above, such as semen characteristics (viscosity, pH, colour) and the presence of anti-sperm antibodies. A man’s fertility is going to be affected by all of these factors in combination and more besides.


Where this 5 per cent line falls is also dependent on overall fertility levels and we know that male fertility is dropping steadily. So, 40 years ago this 5 percentile cut off would have been much higher than it is now. It appears to be a rather arbitrary benchmark that will fall with declining levels, rather than a level that represents good fertility. How these measurements all contribute to overall fertility is complex and of course, reducing things to statistics and numbers misses the core human element of it all.


Are men missing an opportunity?


The vast majority of the clients most practitioners see for fertility issues are women and, as well as addressing any other issues, part of the aim of acupuncture treatment is to support the quality of the eggs as they undergo the maturation process, which takes approximately 6 months. Women change their diets, stop drinking, exercise sensibly, take supplements and come for regular acupuncture to increase their chances of both natural conception and success through IVF. The majority of men do not get support to the same extent and are missing out on an opportunity to help their conception rate as a couple, by supporting the quality of their sperm.


As the Guardian article points out this is likely to be because help and advice for men is less readily available via conventional NHS routes than for women and the way around the problem often defaults to IVF and a procedure where a single sperm is selected and injected directly into the egg. This completely misses the point, especially with regard to sperm quality. You want it to be as healthy as possible. While you might be able to see what it looks like and how it moves you can’t tell how healthy it is. It is so important to take steps to support sperm quality as this will affect the embryo from fertilisation onwards, probably even the health of your child throughout their life.


I suspect many men do not seek actively seek out help because of the false confidence that a ‘normal’ result instils in their fertility, possibly compounded by confusing fertility with virility, and what might feel like an insult to their sense of masculinity. With so much at stake I urge men to put any reticence aside and do all they can to give their fertility a boost.


Sperm counts dropped by 60% between 1970 and 2011 and sperm quality has also been dropping. Environmental pollutants, some of which are unavoidable, are believed to play a major role in the decline, and more research is certainly needed, but other factors over which individuals have more control also contribute. Each step taken may just give the advantage that enables a couple to conceive more quickly without the need for IVF. IVF may be a route couples end up taking but one that few would choose over natural conception – it involves the woman taking multiple medications some of which are daily injections, a series of appointments to monitor and carry out the procedures, invasive surgery to extract the eggs, an emotional rollercoaster ride as you await the results of each stage and that is without looking at the cost as access to NHS treatment becomes increasingly restricted. While the emotional impact and strain of undergoing IVF affect both the man and the woman, the physical burden of IVF falls on the woman. The best support a man can give might be by doing all he can to improve the quality of his sperm and semen to increase the chances of natural conception. He will be supporting his own health and that of his future baby, too.


So what can you do?


Start with a healthy lifestyle – eating a healthy diet, taking dietary supplements, reducing exposure to toxins, exercising, stopping smoking, moderating alcohol and caffeine intake - and having acupuncture can help to boost sperm quality and function. Other factors like exposure to heat and some medication can also be detrimental. Together these factors can have a significant impact. Men produce sperm all the time and it takes approximately 90 days for the sperm to mature so these supportive measures need to be maintained over the course of 3 months. If you do end up having IVF and ICSI, you will have helped to increase your chance of success. You will be very relieved to know that the acupuncture points used are generally in the abdomen, arms and feet, never in the genitals!


The range of parameters tested varies from place to place with some being far more extensive than others. Fertility investigations and testing are usually not started until you have been trying for at least a year, six months if the woman is over 35. If you fall into this category or are concerned for any other reason then make an appointment with your GP. If you wish to be tested earlier or would like the benefit of more thorough tests and treatment, then I would recommend contacting Dr Sheryl Homa at Andrology Solutions, the only clinic in the UK licensed by the HFEA to focus purely on male fertility. They offer a fully comprehensive semen analysis, as well as other investigations where appropriate, and Dr Homa can advise on tests and discuss the results and next steps with you including referral to a consultant urologist if necessary.


With the festive season almost upon us it is not the most welcome time to start focusing on dietary changes and temperance so I’ll leave the details of all the things you can do to help until January. But you could ask Santa for some baggy boxers and avoid sitting with the laptop on your lap, cosy as that may be when it gets chilly. Rest assured there are many things you can do that have a beneficial effect and they will likely give your own health a boost, too. Look out for the next blog in January. Happy festivities!


Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, et al. (2010) World Health Organization reference values for human semen characteristics. Hum Reprod Update 16: 231-245.

Chiles KA, Schlegel PN (2015), What do semen Parameters Mean? How to define a Normal Semen Analysis, Andrology 4:136






By West Norwood Therapies Team, Mar 13 2017 10:00AM

Our acupuncturist, Philippa Summers, shares some exciting new reserarch showing the positive impact of acupuncture on IVF outcomes


A recent study at the Homerton University Hospital demonstrated that acupuncture alongside IVF doubled the number of clinical pregnancies, with a corresponding increase in live births. The study followed 127 women aged between 23 and 43, on their first or second cycle of IVF. They were split into two groups – one having four sessions of acupuncture while undergoing IVF, and the other having none. Among the treatment group, 46.2 per cent conceived – more than twice as many as in the non-acupuncture group, where 21.7 per cent of the women became pregnant.


The treatment involved 2 sessions of acupuncture during the stimulation phase of IVF plus a treatment either side of Embryo Transfer. Acupuncture can help during IVF in many ways - improving egg quality, increasing the number of follicles, supporting optimal uterine lining, helping relaxation to reduce stress, reducing uterine contractions when embryo is transferred and lessening the side effects of IVF drugs.


As well as the obvious benefits to IVF outcomes, women consistently say how much easier they found IVF when they were supported by acupuncture treatments. It is an emotional journey as you await the results at each stage of the process. Acupuncture treatments provide an opportunity to talk about the results and help you to maintain a positive focus and relax.


Many of the benefits apply equally to supporting couples trying to conceive naturally.


The study was presented at the ESHRE (European Society of Human Reproduction and Embryology) in July 2016 by Karin Gillerman MBAcC and an article was appeared in the Telegraph.


http://www.telegraph.co.uk/news/2016/07/04/acupuncture-doubles-chance-of-having-a-baby-with-ivf-study-sugge/





By West Norwood Therapies Team, Apr 14 2016 09:13AM

Our acupuncturist with a special interest in women's health, fertility and pregnancy looks at the benefits of using acupressure in labour


Acupressure for natural pain relief in labour
Acupressure for natural pain relief in labour

Calling all soon-to-be Mums, Dads and other birthing partners!


Learn how to use acupressure as an easy and effective way to relieve pain and encourage a straight forward and efficient labour. Women reported that when the pressure was taken off the pain increased in intensity within 3 or 4 contractions and reduced immediately when pressure was reapplied. It is quick and easy to learn and can make a real difference. Empower yourselves!


With feedback from the woman about what feels right and helps, it gives Dads and birthing partners an active focussed role, helping them to stay connected and supportive throughout labour and beyond.


• Reduce the intensity of pain.

• Encourage a more efficient shorter labour.

• Reduce the likelihood of epidurals and strong painkillers.

• Promote calm and helps the woman stay in control.

• Help to restart labour and stimulate contractions.

• Encourage babies in breech position to turn into head down position.

• Post-natal treatments to restore energy and encourage milk flow.

• Can be used anywhere: at home, in hospital and in water.


You can learn these simple and effective techniques via a half hour DVD or a one hour online course put together by Debra Betts and Tom Kennedy. Learn exactly how to find and how to use the eight points. It is advisable to begin practising with very light pressure from about 36 weeks so that when the contractions eventually begin you are familiar with finding the points and working together. You will also learn how to use smokeless moxa sticks to warm points for restorative post-natal treatments and to encourage babies in the breech position to turn, the latter ideally at 34 to 36 weeks. The results can be extraordinary.

The material is simply presented and users have said that they were empowered and felt more confident about their birth. It gave both partners a useful focus, helping them to stay calm and in control.


How Can I Help?


If you would like to feel more confident about finding and using the points and the moxa then I offer a hands-on follow up session for you and your birthing partner(s) to guide you through. I can also supply you with high quality moxa sticks.

Acupuncture can also be useful leading up to the birth, helping you to feel calm and preparing the cervix and pelvis for labour. Treatment can be adapted to deal with specific symptoms. Midwives report that women receiving preparatory acupuncture consistently had an increased chance of a more efficient labour with less chance of needing medical intervention. Weekly sessions from 36 weeks are recommended.


Resources and more information

Online acupressure for labour course (60 minutes): udemy.com/acupressure-for-labour/ £16.


Acupressure for labour DVD (34 mins) https://www.jcm.co.uk/acupuncture-for-natural-pain-relief-in-labour.html) including booklet (£11.99 plus P&P). The link name is misleading, it is definitely about acupressure and not acupuncture. There is also an app version if that is preferred, which can be found by searching via iTunes or Google Play (£7.99).


Debra Bett’s website http://acupuncture.rhizome.net.nz/ contains a wealth of information on acupressure and acupuncture in pregnancy and childbirth including research summaries, feedback from users and midwives, plus downloads and youtube links on how to find the points.

Best Wishes

I wish you all a positive birth, as close to your desired plan as possible. Stay flexible and keep an open mind.


Philippa is at West Norwood Therapies on Tuesday and Friday mornings www.westnorwoodtherapies.com/philippa-summers


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