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The Gut-Fertility Connection

How is gut health connected to fertility?

One of the unsung heroes in the miracle that is the human body, your gut does much more than merely digest, absorb and excrete food. It’s responsible for:

the proper function of your immune system, how you think and feels, how you synthesize and excrete hormones. Oh, and it influences your fertility too.

Quite simply, when your gut— which influences the health of everything in the body— isn’t functioning at its optimal level, it has a knock-on effect on other body systems, including fertility.

When it comes to fertility (in both women and men), your gut microbiome can make a significant difference. Indeed, new research has shown how poor gut health can cause an estrogen imbalance, which may lead to infertility issues ranging from endometriosis and polycystic ovary syndrome to testicular dysfunction.

Research on the gut-fertility connection

It might sound hard to believe, but gut health and fertility are inextricably linked. And that’s why couples looking to conceive should always focus their attention on optimising their gut health.

A growing body of evidence has confirmed the gut-fertility connection and its importance for our wellbeing. These include the following:-

  • Women with recurrent pregnancy loss were found to have abnormal gut permeability (aka leaky
    gut), which has been shown to contribute to inflammatory reactions in the body¹. The researchers hypothesised that the inflammatory reaction caused by leaky gut may be contributing to miscarriage pathogenesis.
  • The gut microbiome is responsible for converting bound estrogen to free, active estrogen via
    the enzyme B-glucuronidase. According to a recent review, without a healthy microbiome, estrogen metabolism and function becomes impaired and can lead to a number of health consequences including endometriosis, PCOS, endometrial hyperplasia and infertility². Authors of this review concluded that treating the gut microbiome to modulate estrogen levels should be considered as a new future treatment for estrogen-mediated diseases including infertility.
  • A meta-analysis (a statistical analysis that combines the results of multiple scientific studies) completed in 2016 found that women with unexplained infertility have x 3.5 higher odds of having Celiac Disease³. Furthermore, it has been estimated that as much as 6% of women struggling with unexplained infertility actually have undiagnosed Celiac Disease⁴.

Gut health, specifically the gut microbiome, plays a vital role in immune function. When our immune system isn’t working optimally due to poor gut health, our bodies may enter a state of chronic inflammation. This, in turn, can result in recurrent pregnancy loss. Chronic inflammation may also cause decreased progesterone levels leading to implantation failure⁵, the development of autoimmune processes impacting fertility⁶, and the development of anti-sperm antibodies preventing fertilisation. Thankfully, probiotic supplementation to support gut health has been shown to decrease chronic inflammation and improve immune function⁷.

The importance of estrogen for fertility

Estrogen has always been considered a female dominant hormone for reproductive health, but this hormone actually pays a key role in fertility in both men and women.

For women, estrogen is needed for proper ovulation and thickening of the uterine wall for pregnancy. It’s important that estrogen levels are neither too high nor too low, though.

Excess estrogen, for instance, may cause irregular periods and can prevent ovulating, thereby resulting in infertility. Estrogen dominance has also been linked to infertility issues in women such as endometriosis and polycystic ovary syndrome.

Estrogen deficiency, meanwhile, can also cause amenorrhea (an abnormal absence of menstruation), which leads to anovulation. Disorders of ovulation account for approximately 30% of female infertility and present mainly with irregular periods or amenorrhea.

The importance of estrogen for men’s sexual health is equally significant, impacting on multiple organs and tissue by affecting their reproductive system in a number of ways.

A deficit or surplus of estrogen can, for example, hinder the male libido (sex drive), with obvious implications for fertility. Meanwhile, spermatogenesis, an inappropriate increase in estradiol (an estrogen steroid hormone) has been shown to lead to a decrease in sperm production, while too little estrogen has been shown to have a causative effect with erectile dysfunction

Hormones in your body are always in a careful balancing act. If one of your organs is not functioning properly, everything is thrown off-balance.

Your gut, the ‘forgotten organ’ or ‘second brain’ is a key regulator in circulating and eliminating estrogen, which is why it’s so important to focus on gut health when it comes to fertility.

I am recommending Nua Fertility supplements to more of my clients, simply because I believe this is an excellent way of supporting gut AND fertility health for pre-conception.  Ask me today how to get yours!

  • https://www.ncbi.nlm.nih.gov/pubmed/?term=recurrent+pregnancy+loss+leaky+gut
  • https://www.ncbi.nlm.nih.gov/pubmed/28778332
  • https://www.ncbi.nlm.nih.gov/pubmed/25564410
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216449/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137456/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845518/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701523/
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I got to meet my final fertility baby of this year

 

I got to meet my final fertility baby of this year

Well, what can I say?  What a day! Here’s me meeting a very precious new baby.

How did this baby get here?

This time last year, this baby seemed an impossible dream for her parents. They’d been referred for IVF after an agonising 18 months trying for a baby without success. They contacted me for support, advice and information.  After an in depth consultation, we spent time recording and reviewing cycle data, which revealed some irregularaties in the luteal phase, as well as being of variable length.  We looked at the different aspects for both parents that could be impacting conception, egg and sperm health and more.

Treatments included a tailored lifestyle, supplement and a specialist reflexology plan working on the hormonal cycles to promote a balanced and healthy cycle with definite ovulation and improved post-ovulation phase.

How long did it take to get pregnant?

Within 4 months just before starting to go down the IVF route at their fertlity clinic, they discovered they were naturally pregnant!

Specialist holistic fertility support can help to reveal what’s going on to stop you getting pregnant, bring balance back to cycles and provide the deep dive into some of the causes that the 1 in 6 couples experiencing fertility issues need.

When should I get help for fertility issues?

Sadly in the UK, there are criteria (I call them hoops!) you must meet in order to even get referred for fertility investigations within the NHS.  Usually you are expected to have been trying to conceive for at least 2 years if you are under 35, and 1 year if you are over 35.  Waiting lists for fertility clinics within the NHS can be quite lengthy – a first consultation may take anywhere up to 5 months from your GP referal.

You may not feel that you want to wait that long, or you may already be in the process of being referred.  I can work with you to investigate, recommend and treat for a variety of fertility issues immediately.  I am also able to refer you for further testing and investigations if I feel they will aid pinpointing any issues (eg semen analysis, blood testing etc).

My experience in this field shows me that working with my clients for at least 3 months BEFORE they start trying gives the best outcomes. If you are about to start an IVF cycle within the next few weeks, I would not offer fertility support – however, relaxing, stress-relieving treatments are ALWAYS an option!  Should your outcomes not be what you expect – come and see me, and let’s take some time to look at what may be going on.

How can I help you?

I am Rowena, trained to support your fertility using a unique combination of therapies, including Gentle Release therapy, Reflexology, Nutrition, Counselling, Aromatherapy and more. I work online and in person with my clients, so distance should not be a barrier.  I help people with all kinds of issues which can interfere with conception, including miscarriage, PCOS, unexplained infertility, secondary infertility male factors and even those who are preparing for IVF treaments.  You can book a call with me today to see what I can do to support your journey to your family, or use the contact box on the home page to send me a message.

I look forward so much to hearing from you!

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PCOS and your fertility

What is PCOS and how does it affect fertility?

What is PCOS and how does it affect fertility?

PCOS stands for Poly Cystic Ovarian Syndrome. It is a condition affecting somewhere between 3 and 10% of the female population1, although many people may have the condition but are un-diagnosed. You may be told that you have poly cystic ovaries, but this does not mean you have PCOS – ovaries change from month to month, and poly cystic ovaries can even be found in women taking the pill and in women with normal ovulatory cycles.

PCOS is a common diagnosis for the clients that I see in my Weymouth studio or online, whether they are trying to conceive, preparing for assisted fertility treatment (IVF) or trying to manage their cycles for health and wellbeing.

How is PCOS diagnosed?

PCOS is a syndrome which affects people with female reproductive systems. The diagnosis of PCOS (from the Androgen Excess and PCOS Society2) is made when your symptoms meet any two of the following criteria:

* periods less regular – more or less often than monthly
* higher levels of androgen hormones found from blood tests or symptoms such as excess body hair
* appearance of more than 20 follicles per ovary observed on ultrasound

This criteria is preferable to Rotterdam’s criteria for diagnosing PCOS, since it focuses on both of the main causes of the condition – a problem with ovulation and an overproduction of male hormones (androgens) like testosterone.

– PCOS is the single most common cause of infertility in young women3
– PCOS is the underlying cause in 75% of women who have infertility due to anovulation4
– Women with PCOS have a clinically significant increased risk of pregnancy complications compared with women without PCOS5

PCOS is not one disease

PCOS is not one disease – it’s a group of symptoms that relate to anovulation and high levels of androgens, and which result from a diverse group of underlying factors, which include insulin, inflammation, adrenal androgens and post pill androgens. It also generally falls into one of these types: post-pill, insulin-resistant, inflammatory and adrenal. Each type will affect you in different ways, and the type you have can mean the management of your symptoms might vary.

Symptoms of PCOS which are common include:

* Irregular or no periods
* Weight management
* Acne
* Hair loss
* Excessive facial and body hair (hirsutism)
* Difficulties in trying to conceive
* Higher risk of miscarriage
* Mood swings

PCOS is conventionally managed with the use of the oral contraceptive pill, however this tends to mask the symptoms and does not get to the root causes of the condition.  Once you stop taking the pill, your PCOS symptoms will return.

PCOS and conception

Around 30% of people with PCOS will have no problems getting pregnant, but this does mean that around 70% of people with PCOS may have issues.  As PCOS is a collection of symptoms that affect your health, being as healthy as you can when preparing for pregnancy may help to reduce your risk of possible problems such as recurrent miscarriage, and during pregnancy that of gestational diabetes.

PCOS and long term health

As PCOS is also associated with long term health implications for diseases including metabolic disorders (Type 2 diabetes etc.), high blood pressure, heart disease, psychological issues and reproductive organ cancers6 making changes to support a regular ovulatary cycle with your hormones in balance will help your health and wellbeing for life.

Managing PCOS

Fertility issues with PCOS are the most common condition that I work with. Because male hormones (androgens) produced in PCOS interfere with the delicate balance required for ovulation and then the support for potential embryos, I usually work with my clients for at least three months to make effective changes to their menstrual cycles. This helps to prepare the body for regular periods, ovulation and progesterone production which are necessary for an egg to be produced and an embryo to develop and then attach to the uterus lining.

If your body is working to produce eggs and the hormones required for successful implantation, your chances of pregnancy are higher with each cycle. Managing the hormones can also have an effect on whether a pregnancy can be sustained. This is because raised LH levels which are common in unmanaged PCOS can lead to an increased risk of miscarriage. What evidence is there to recommend reflexology for conception with PCOS? In a data collection study, the Association of Reproductive Reflexologists found the success rate for pregnancy with PCOS was 72% and the live birth rate was 57%.

Managing PCOS can be difficult unless you know what to focus on. When working with PCOS clients, I offer a range of support which is tailored to your needs. This includes dietary and lifestyle advice, healthy living, mindset and reproductive reflexology which helps to regularise hormones with specific routines for each part of your menstrual cycle, and helps to provide the optimal conditions for conception, pregnancy and wellbeing.

Combined in one package, you can benefit from my experience of supporting people with this condition to improve cycle regularity and balance hormones so they work effectively for you. In addition, you can feel better because your body is working in the way it’s designed to.

Your Next Steps

If you’re preparing for pregnancy and you have PCOS or, if you have a PCOS diagnosis and are struggling with the symptoms but aren’t getting ready for a baby, then book your free call with me today, let’s see what changes could be possible for you.

 

References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266413/
2. https://ae-society.org/patients/
3. Rosenfield, R.L. (2015) The Diagnosis of Polycystic Ovary Syndrome in Adolescents. Pediatrics 136(6), 1154-1165. [Free Full-text]
4. Balen, A.H. and Anderson, R.A. (2007) Impact of obesity on female reproductive health: British Fertility Society, Policy and Practice Guidelines. Human Fertility 10(4), 195-206. [Abstract]
5. Palomba, S., de Wilde, M.A. and Falbo, A. et al. (2015) Pregnancy complications in women with polycystic ovary syndrome. Human Reproduction Update 21(5), 575-592. [Free Full-text]
6. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/background-information/complications/

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How to Stay Cool in Extreme Heatwaves

Don’t Panic – There’s a Red Warning for Extreme Heat in the UK this week

It’s all we’re hearing on the news right now, and if you’ve missed it I will be amazed!  However, there’s no need to panic, I have collected my top five tips on staying cool and hydrated, so you can keep well.

Cool Down First

Start your day with a short cool shower, a tepid bath or even a cool strip wash.  This really helps, especially if you’ve had a hot and restless night.  Make sure that you are keeping the water at a temperature low enough to cool you down, and remember to get your head wet if you can.  This helps your whole body to cool down.  You can also run a bowl of tepid water and just soak your wrists for 5 minutes, or even one for your feet and ankles if you have any mobility issues.

Fruits and Vegetables

Eat plenty of fruits and veggies that contain water, like watermelon, cucumber, kiwis, strawberries, lettuce, tomatoes – you get the idea.  This is a super easy way to add easy fluids, especially for younger children, or to pack out your lunchbox.

Up Your Hourly Fluid Intake

This might be obvious, but you will need to drink plenty of fluids – at least one drink per hour throughout the day.  Aviod alcohol and caffeine as they can make you more thirsty. Remember to bring a water bottle if you are out and about, and top it up whenever you can.

Add Fluids from Food

MORE fluids in your food.  Choose to add things like soup, hummus, yoghurt and dips, smoothies made with water to easily add even more hydration into your diet.  Whizz up frozen fruit mixes half and half with water and freeze into small ice lolly moulds for a tasty, thirst-quenching cooler.

Stay Shady!

Keep the sun out.  Close curtains and blinds on the sunny side of any rooms, and remember to move around and open them when the sun has moved away.  Open windows to allow any cross-breezes, but keep in the shade as much as possible.  Avoid the sun between 10am and 5pm.  If you have a garden with shade, remember it may sometimes be cooler OUTSIDE (especially under large, shady trees).  Finally, sleeping may be more comfortable in ground floor rooms – be prepared to be flexible over sleeping times and places whilst it’s very warm overnight.
I hope these tips will help you to stay cool, hydrated and safe – please share them if they have.
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Three Most Popular Myths About Reflexology – Busted!

There are many more myths surrounding reflexology treatments, but these three are the ones that I get asked about the most.

Whether I’m treating people for fertility, pregnancy, or menopause issues, or aiming to improve their overall wellbeing, reflexology is a powerful tool that can make a big difference to how they feel on a daily basis.

Many people turn to reflexology when they are trying to conceive, or looking for help with other conditions like fibromyalgia, migraine, sleep issues or joint pain. Often people will receive reflexology to help them relax and unwind.

Reflexology has been around as a holistic therapy in various forms for over 5,000 years, but many people still   know very little about the practice, or make assumptions about reflexology that are just wrong. In this blog, read about the top three myths that people usually have about reflexology.

Myth 1 – It Hurts

Perhaps the biggest myth about reflexology is the idea that it’s painful, I promise you that this is simply not true! Reflexology relies on communication between the practitioner and the client, paying strong attention to what your body needs. As a result, the process is gentle, peaceful, and satisfying. There may be some moments of discomfort when certain areas are worked on, but these are usally fleeting, and indicate that a particular zone, system or organ may be out of balance. If you are experiencing pain, tell your therapist – they should stop or assess their technique to ensure your comfort.

Myth 2 – Reflexology Cures Diseases

Due to the fact that people turn to reflexology as an alternative to seeing a GP, it is often wrongly assumed that reflexologists can diagnose or cure illnesses and conditions. Your reflexologist may have clues to how your body is feeling, but will not make any diagnosis based on what they see or feel on your feet.

The truth is that reflexology does not deal with conditions, but stimulates the nervous system throughout the body and brings it back to a state of homeostasis.  This helps to promote your body’s healing as well as sense of general wellbeing.  Reflexology is not a substitute for conventional medicine, however it can be used effectively alongside conventional medical treatments, including recovery from surgery, cancer therapies, IVF cycles etc.

Myth 3 – It’s Just a Massage

For people seeing treatments taking place, reflexology may look like a foot massage!  It is so much more than simply stimulating the skin and muscles to promote relaxation. Reflexology treatments are based around gently manipulating specific reflex points on the feet that link to organs, muscles, and systems around the body.

Working on these zones around the foot activates the nervous system and can help areas of imbalance and tension, leading to boosted circulation, reduction of pain, and more energy throughout the body. Put simply, reflexology therapy is much more than a massage.

If you are looking for wellbeing or fertility support in Weymouth, I am here to provide personalised reflexology treatments that leave you feeling more grounded and less stressed, allowing you to heal and rest.

Please get in touch to ask any questions or arrange an appointment, or use the ‘book’ button to schedule a call.

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How Avoiding Toxins Can Improve Your Fertility

As someone who works with TTC, fertility, and wellbeing clients in Weymouth and online, I often find people worry about how exposure to toxins can reduce their chances of conceiving and how they may affect a healthy pregnancy. Both males and females can be affected. We do indeed encounter all kinds of toxins in today’s rapidly built-up, constantly-overheating world, and some of them are hard to avoid.

There are ways to reduce your exposure to toxins to a certain extent. Eliminating toxins to enhance fertility can be looked at from a two-tier perspective: the surface-level/easier to avoid toxins and then deeper level (more effort required) toxins. This post walks you through both kinds and what you can do about them.

Surface-Level Toxins

There are a number of every-day toxins that you may encounter on a daily basis, and generally they don’t do too much damage. However, in the case of fertility and when you’re trying to conceive, continual exposure to them can have a negative effect. One obvious source of toxins is smoking and smokers; quitting smoking, and staying away from exposure to smokers as much as possible is a must. Other things you can do include using more natural cleaning and personal care products – these will usually have higher environmental credentials, look for labels like Bio-D, SESI and eco-leaf.   Avoid highly scented air fresheners, candles and washing products. Avoid dry cleaning your clothes, if possible, as this also reduces your exposure to toxins.

Complex Toxins

The above toxins are what you would call superficial toxins – chemicals that can be avoided with lifestyle changes. However, other toxins are more deeply rooted and harder to avoid, and can negatively affect the body’s hormone balance, and therefore affect fertility by interfering with egg and sperm formation, as well as the internal evironment. These are the toxin esposures that you would discuss with me in greater detail.

An example would be Bisphenols – they are widely used in plastic products, can linings, and sales receipts printed on paper with a glossy sheen. Another plastic-based toxin group are Phthalates, which are often added to toys, footwear, food packaging, and care products as a way of making them more flexible. You should also be careful about pesticides, herbicides, and insecticides, which can sometimes be found on packaged food or in garden sheds.

There are other potentially damaging toxins out there, such as parabens, POPs, and heavy metals. Knowing what to do about them is not easy, but I am here to help you. My fertility, TTC, and wellbeing advice in Weymouth and online gives you the chance to outline your lifestyle and potential exposures, which in turn allows me to recommend a personalised treatment plan that may include diet, lifestyle changes, and reflexology.

Together, we will come up with a solution that ensures you stay away from as many toxins as possible and have the best possible chance of conceiving. Feel free to get in touch to arrange your initial consultation, or to book a free call.

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Online or In Person – Which Option is Better For You?

Along with providing specialist reflexology that supports TTC, fertility, and wellbeing for those in the Weymouth and wider Dorset area, I offer consultations, assessment, and self-care routines based around your needs and particular situation. This can be done in person or online over Zoom. If you are seeking fertility advice for the first time, you might be wondering whether it’s better for you to see me face-to-face or online.  To help you out, this blog post walks you through the merits of each choice.

Online

I understand that some people may feel anxious about going to a new physical location for advice on fertility and TTC. It is normal to feel a bit daunted by the whole prospect. In which case, you may prefer to start by speaking to me online. Having these sessions from the comfort of your own home can make the process a great deal easier, along with providing that valuable extra layer of privacy.

Perhaps a greater benefit of working with me online is that it provides flexibility and convenience. You are saved from unnecessary travel expenses and spending time travelling to and from my practice. And if you wish to attend these consultations with your partner, or another loved one, it is much easier for both parties to be present when sessions are on online. Work/life commitments often get in the way of each individual being able to attend a specific place at a designated time. If you have a busy schedule, working with me online is the way to go. You can receive personalised fertility and TTC advice from anywhere in the world, provided you have an internet connection.

In Person

Working with me online may be more convenient, but for many, in-person sessions are the only way to get the absolute most out of each session. Some people feel more comfortable being able to build up a relationship with me in ‘real life’. When it comes to issues like fertility, TTC, and general wellbeing, it can feel more natural to visit a dedicated clinic to discuss these matters, as opposed to sitting in front of your laptop.

And while many people feel most comfortable working with me from their own bedroom or office space, others might not have a peaceful home life at all. My Weymouth practice may be the safe and reliable space you need for accessing professional fertility treatment. Visiting the same place on a regular basis can become an important ritual on your TTC, fertility, and wellness journey. In addition, you might not have a dependable internet connection or the right equipment, space, or facilities for a truly private Zoom call.

If you are looking for consultations, assessments, and personalised self-care routines for fertility, trying to conceive or IVF support in Weymouth, Dorset, or online – give me a call or drop me an email. I am always happy to answer any questions you may have.

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What Are the Differences Between IVF, IUI, and ICSI?

As a specialist in providing reflexology designed to assist with TTC, fertility, and wellbeing for people in the Weymouth, Poundbury, and the wider Dorset area, I spend a lot of time discussing different fertility treatments with clients. These include IVF (In-Vitro Fertilisation), IUI (Intra-Uterine Insemination), and ICSI (Intracytoplasmic Sperm Injection).

Of course, many people know about IVF, but if you are seeking reflexology as part of your fertility treatment, or just want general advice regarding fertility support, you might be unsure about which specific fertility treatment is most suitable for you. It can feel a bit intimidating to decide. To help you choose the right course of action, this blog post walks you through the differences between IVF, IUI, and ICSI.

IVF

The most commonly employed fertility treatment, IVF involves using fertility drugs to produce mature eggs that are then fertilised in a laboratory with sperm from your partner/a donor. The sperm and eggs are placed in a special dish, with the highest-quality resultant embryo being placed into the uterus to grow for pregnancy. Additional embryos (if created) can be stored for future treatment cycles.

IVF is used to assist with all types of conception processes, but is particularly useful for women with certain fertility problems, such as damaged Fallopian tubes or low egg reserves. It can also be used when working with donors, surrogates or after unsuccessful rounds of IUI.

IUI

Couples who are trying to conceive may start with IUI before turning to IVF treatment. The process involves inserting a sperm sample into the uterus at peak ovulation. Direct fertilisation at ovulation, with the reduced ‘travel time’ for sperm can increase the chances of successful pregnancy. Some IUI cycles are ‘boosted’ with ovulation drugs to improve hormone levels around the natural ovulation time. You may have to have scans to see how a follicle is developing, and to time when the IUI procedure will take place.

IUI is essentially designed to give the sperm a better chance of reaching the egg compared to sexual intercourse. The treatment is usually recommended to couples who have had difficulty conceiving but aren’t experiencing any structural fertility problems, or for those who require donor sperm, including same sex female couples.

ICSI

ICSI serves as part of the IVF procedure and entails extracting the healthiest sperm from a sample and injecting it directly into an egg for fertilisation. In this sense, it is a more precise form of treatment and is used primarily for helping men with fertility issues such as low sperm count or substandard sperm mobility to achieve fertilisation and creation of quality embryos.

If you’ve been considering holistic support alongside IVF, IUI, or ICSI as part of your fertility treatment, I would love to chat with you. I offer professional guidance for those needing help with TTC and fertility issues in Weymouth and the surrounding areas in Dorset, as well as online using virtual consulting. Feel free to reach out at any time, using the contact form or booking your free call.

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How to understand sperm test results and what is ‘normal’?

What do your ‘Normal’ Semen Analysis Test Results Mean?

You’ve just had your initial semen test results back, and the doctor/receptionist will says ‘yes it was all normal’, without actually giving you the report. Please, always ask for a copy of your semen analysis, it is SO helpful to have the actual document to hand and provides really valuable information. Many semen analysis sheets that I review may be ‘normal’ but are not optimal for fertility.

What is a sperm sample?

A semen or sperm sample is the fluid produced when you ejaculate/orgasm, and should contain sperm, which are the male cells that fertilise a human egg.  Samples are collected into a pot, and sent to a lab for assessment. Samples are assessed using basic criteria, and you can usually have the analysis done via a request from your GP.

These criteria, based on reference ranges for male fertility via semen testing, are usually measured against World Health Organisation agreed levels. These have just been republished as until this year the most recent figures used were from 1999!

The criteria give expected ranges for a viable semen sample, so if your results fall outside those ranges – either below or above, then there may be an issue with your semen/sperm.

A basic sperm test usually give a report on all (or some) of the following measures:

Volume (the amount produced for the sample)
Appearance
Liquefaction
Viscosity
pH
Debris
Agglutination
Motility, broken down into rapid, slow, non-progressive and immotile
Vitality
Anti-sperm Antibodies
Concentration/count per ml and total for the sample
Round/other cells
Morphology, broken down into normal, abnormal, head/mid-piece/tail defects, cytoplasmic droplets

What is a normal sperm sample?

The WHO criteria look specifically at volume, total number of sperm in the sample, concentration of sperm per ml, motility, morphology and pH level, so these are what I am going to discuss in this article.

* There should be a certain volume of semen in a sample, the new range suggests a minimum of 1.5 ml, and up to 5ml is considered within range.
* The total of sperm in the sample should be greater than 39 million, and concentration per ml greater than 15 million.
* Motility will usually be total (all the sperm together) greater than 40%, and progressive greater than 32%.
* pH levels in the sample should be 7.2, anything below this or greater than 8 should be investigated further.
* Finally, morphology or normal forms should be greater than 4%

If a semen sample comes back outside of these ranges you may see notes on the report such as low motility, poor morphology, even azoospermia. These are technical terms which refer respectively to sperm which do not move well, sperm which are not properly formed, and lack of sperm observed. Observations about the pH might indicate infection or urine contamination of the sample, and issues with volume could be indicative of an issue with sperm production including physical obstructions, heat damage from varicoceles etc.

The above are all common, although as I’ve said before, not necessarily addressed, because male factor issues – despite being 50% of the base material for embryos – are not considered until last resort in many cases.

What might be wrong with a sperm sample?

Below I have listed some common causes of poor quality sperm samples.  Hopefully, this article will help you understand the issues surround male fertlity better. My job as a reproductive reflexology specialist is to guide you to understanding what’s happening with your sperm, by interpreting your specific results, and then a) use targeted reproductive reflexology (and a holistic approach) to see if we can make changes which may sustain improvements to sperm quality, and/or b) refer you for further testing as necessary, with continuing reflexology and holistic support.

    • Causes of low semen volume

You might see a low volume (called hypospermia) if some of the sample missed the collection pot, however, other causes can be linked to ejaculation problems such as retrograde ejaculation where semen travels backwards into the bladder, prostate gland cancer treatments, medications, diabetes and hormonal issues. Blockages in the seminal vesicles which deliver the sperm to the penis can be caused by varicocele, infections can also be a cause.

    • Causes of low sperm in semen samples

Low quantities of sperm in a sample can cause problems with conceiving a child. The reasons for fewer sperm in a sample can include problems with sexual function (low libido, erectile dysfunction), pain or swelling in the testicles, hormone abnormalities, previous injury to the testicles or penis, infections, varicoceles, anti-sperm antibodies (an immune system problem), blockages in the tubules anywhere in the male reproductive system and undescended testicles. Celiac disease, prior surgery and chromosome defects can also be the cause of low sperm counts. Many of these issues can be resolved, discovering them initially may be the hardest part of the problem.

    • Low motility in semen samples

Causes of poor motility are connected to infections, defects in the sperm DNA, alcohol and drug use, and inflammation. Low motility means that the sperm are not moving well – either going in circles, not moving fast enough or failing to move forward. As with poor morphology, low motility has effects on the ability of sperm to move to the fallopian tubes where the egg is waiting, and thus has a negative affect on male fertility. The corkscrew motion of a well formed sperm is much more effective in the long journey to fertilise an egg, so you can see again that good quality sperm making forward progress are likely to be better at moving through the uterus to their destination. Reducing inflammation, treating infection, and changing lifestyle habits can all have a positive effect on motility.

    • Semen pH levels

Semen is usually slightly alkaline with a normal pH range between 7.2-8.0. The acidity or alkalinity of a semen sample can indicate issues or infections – which are often invisible, additional screening often reveals these and then treatment with antibiotics and supplements can help to improve the levels. High or low semen pH can cause sperm death. It can also impact the ability of the sperm to swim and be able to penetrate the egg.

    • Causes of poor morphology

Morphology issues can be caused by heat damage, which include external heat such as use of saunas, heated car seats etc., or damaged caused by varicocele (lumpy collections of veins on the testicles), infections and lifestyle choices including drug and alcohol use. Some prescribed medications can also have a negative effect on the morphology of sperm, so it’s worth checking that any drugs prescribed are fertility friendly. Well formed sperms should have an evenly formed head, mid-piece and tail. Each part has a job to do: the head contains the genetic material, the mid-piece is the engine and the tail provides the movement towards the egg. If morphology is classed as poor, then the sperm may have missing or partial tails, wonky heads, and mid-piece defects, which can cause issues with actually getting into the fallopian tubes, egg penetration, and then faulty fertilisation, which can lead to poor implantation rates and contribute to chemical pregnancies and early miscarriage.

Red Flags for Sperm Quality and Quantity

Red flags which can contribute to issues of sperm quality and quantity include:
– Smoking
– Drugs (including prescriptions and steroids)
– Alcohol
– Infections (can be invisible)
– Nutritional deficiencies
– Shift work/poor sleep

Next Steps

Being aware of the issues surrounding your sperm sample can help you to understand where you can make positive changes to improve it.  There are of course lots of  things that can affect sperm quality, including physical issues but the above are very COMMON and many can be resolved with the right advice and support.

You may need additional testing or screening, or you may just need to make changes to your lifestyle. I expect to work with you for a minimum of 3 months, as this is when I see the best results for improvements with previous clients.  Are you ready for the next step?  If you have received a less than positive semen analysis, or have been told that you have a normal result but are still having problems conceiving, then book a call with me today.

Further reading

Men’s Health Week 2020

Varicoceles

Categories
Uncategorized

Fertility Language – What Do All These Abbreviations Mean?

Fertility Language can be very confusing and exclusive if you’re new to the game.

I’ve listed some of the more common abbreviations here that you may come across during your journey to conceive, and hopefully this article will help you to understand them a bit better.  Save it for later, and do share with anyone else who may be struggling!

TTC – Trying To Conceive

This is one you’re likely to know already, as probably it’s where you are right now. People who are trying to get pregnant or preparing to do so!

CD – Cycle Day

Very simple – if your period/bleed starts on Monday 1st Jan, that is your Cycle Day 1. The last day of your cycle is the day before a bleed. Recording cycle length is helpful, as not everyone has regular cycles, and even knowing the length of a cycle can help identify an issue. In co-ordination with charting temperatures, cycle days can be used to record bleeding days, days of fertile fluid observed, days when you have had sex, when/if you ovulate, and the length of the luteal phase after ovulation. It all comes back to data!

AF – Aunt Flo (Period/Bleed)

This somewhat jokey term is often uses as a quick way of referring to the onset of the monthly menstrual cycle. It’s when you start to bleed – shedding last months uterine lining. Bleeds should not be painful, should have a defined start and end, and you should not see spotting after the bleed has ended. Any of these may indicate an issue with hormonal balance, or structural issues with the uterus like endometriosis, adenomiosis, fibroids, polyps and more.

CM (CF) – Cervical Mucus/Cervical Fluid

Cervical Mucus or Fluid (CM/CF) can be a valuable tool in observing your menstrual cycle and its stages. When you wipe, it’s easy to check and see the colour, texture and amount. From the bleed to the end of your cycle, the cervical fluid changes from non-fertile, to fertile (around ovulation) and then changes again post-ovulation to protect a potential pregnancy before reverting to a bleed if not pregnant. Seeing fertile CF is one of the key signs of ovulation, and a great way to start noting how your body works. Download my handy guide to the types of CF here.

FSH – Follicle Stimulating Hormone

Ovarian follicle development is governed by a pituitary hormone called FSH: follicle-stimulating hormone, which stimulates the follicles to grow. You have less FSH when younger, and more as you mature – leading to shorter or irregular periods. FSH levels also contribute to how heavy or light your bleed is – the hormone stimulates estradiol which influences the thickening of the uterine lining.

LH – Luteinising Hormone

As you come up to the time of ovulation (which is the midpoint of your menstrual cycle), your hormones are preparing to release an egg from a mature follicle. Luteinising Hormone (LH) levels reach a peak at ovulation, triggering the follicle to ripen and release into the fallopian tubes, ready to be fertilised. Defects in the hormone balance can affect whether you ovulate or not.

DPO – Days Past Ovulation

This abbreviation is used to indicate how far past ovulation in your cycle you are. It’s used often for charting and fertility apps. Usually, if an egg has been released (ovulation) and potentially fertilised and implanted in the uterus, it will be producing enough hcG hormone to indicate a pregnancy if you tested at 14 days past ovulation. It’s useful to know to identify how long the luteal phase lasts – the time between ovulation and the next bleed. Often also called the Two Week Wait (TWW), see below.

TWW – Two Week Wait

For many people, this is the worst part of the whole cycle.  The two week wait refers to the 14 days post ovulation, when you *could* be pregnant. It also refers to the wait after an IVF embryo transfer.  There’s not a lot to do at this stage – if you’ve got everything right during the cycle, there’s about a 25% chance of a pregnancy. A lot of nail biting and symptom spotting takes places during this period of time. I recommend taking up an absorbing hobby!

BBT – Basal Body Temperature

We use a BBT to chart temperatures throughout a menstrual cycle, as they can help to identify the different phases of the cycle. Using a digital thermometer (accurate to 2 decimal places) and either a paper chart or an online app (I recommend Fertility Friend), you take your temperature under the tongue every day, record it on the chart, and then you can see an overall pattern of each cycle. It’s very helpful to record this information, as it can help to identify ovulation, pregnancy, or if there are potential fertility problems such as not ovulating, spotting, long or short cycles and more. I recommend charting to ALL of my clients, for at least 3 months because the chart data is so useful.

MFI – Male Factor Infertility

Male factor infertility is often not well understood, and can be ignored until female partners have had all sorts of intervention. Issues like poor quality sperm, deformations in the structure, lack of ability to move properly and quantity of viable sperm all have an impact on the potential for a pregnancy and viable embryo. If you have a male partner, ALWAYS get at least a basic semen analysis carried out if you are having difficulties conceiving.  I’ve written more about semen analysis in this article.

This is not an exhaustive list, and you are likely to see many, many more fertility related abbreviations, particularly if you are having IVF support. Please do feel free to ask me anything if you want them explained.  You can book a discovery call with me if you want to chat about your journey to conceive.  Remember to sign up to my newsletter if you want to read my articles first.

Further Reading:

Ovulation
What affects Fertility
When are the best days to get pregnant?