Listen to this fantastic podcast of two of my very lovely patients talking all things reciprocal IVF, egg donation and endometrial scratches. Spoiler alert - I get a mention! *blush*
I’d love to say I’ve read the book. But only because that’s what everyone loves to say! Instead I’ve read a different book and one in which the author shares my growing concerns. Until now I thought I was the only one who was worried by the rapid decline in sperm health, plummeting by 50% over the last 40 years. But finally researchers are starting to piece the evidence together. Professor Shanna Swan, one of the world’s leading environmental and reproductive epidemiologists provides disturbing statistics which makes me question whether The Handmaid’s Tale is not a work of fiction but more a glimpse into the very alarming future.
For the last few years, while everyone else has been talking about climate change, I’ve been worrying about a different threat. But this one seems to get way less traffic when it comes to the global stage. There’s no Sperm Summit for instance. Yet research shows that sperm health is rapidly declining with no signs of levelling off and it is predicted that by 2050 everyone will need to use assisted reproduction (IVF) to have a baby.
So how have we dealt with this? Thank goodness for the World Health Organisation who very cleverly stepped in to resolve the problem. In the 1940s the WHO considered an adequate sperm count to be 60 million/mL. In 1980 they lowered this to 20 million/mL and by 2010 it was further reduced to 15 million/mL. Phew!
By the 1980s they’d figured out what to do. “Male factor infertility is the only medical situation that’s treated by administering a painful procedure to a woman because of a problem that afflicts her male partner.” (Swan) This is in the form of assisted reproduction (AR), which to any who are unfamiliar, involves the woman injecting herself with hormones to stimulate egg production where ovaries swell to the size of grapefruits so that she might ripen anywhere from 5 to 20 eggs (in a natural cycle only 1 to 2 eggs would ripen and release every month). These eggs are extracted under general anaesthetic, mixed with sperm that has been extracted the ‘easy way’, before being implanted back into the woman’s uterus without the use of any anaesthetic at all. They’re told it’s like an “uncomfortable smear”, but for some it’s excruciating.
You might be under the illusion that this is the only way to make a baby when the sperm isn’t up to scratch and therefore an unfortunate necessity. It’s not. TESA (Testicular Sperm Aspiration) is exactly what it says on the tin. A needle is inserted into the testicles and sperm are aspirated out. Yet despite this radically improving the outcome of AR I have only known two men in my entire career who were willing to have the procedure. “The pregnancy rate using testicular [TESA] and ejaculated [the old fashioned way] spermatozoa was 44% and 6%, respectively.” (Zini & Agarwal) The lack of uptake for men having TESA is in part due to them being unaware it exists. It is not something offered in most fertility clinics despite them having the ability to perform the procedure. To add to this, men are rarely given any dietary, lifestyle or supplementation advice, even if they have a poor sperm assay. Instead women are told to cut out alcohol, reduce their BMI and take pre-conception vitamins when actually obesity and alcohol affect sperm quality far more than in female reproductive health. “Alcohol damages chromatin integrity and increases DNA fragmentation in sperm”. (Zini & Agarwal) Correct supplementation in men is shown to markedly improve overall sperm quality by 48.9% in three months and 80.9% in six months. (Gvozdjáková A et al, 2015) Yet I’m eternally gobsmacked that this type of useful information isn’t disseminated down to the patient. Are we so afraid that men can’t handle the truth? That they might be solely responsible for being unable to start a family and that THEY might want to do something about it. In my experience most men would do a whole lot about it given the information by a medical fertility consultant. I have certainly come across men who have said that if their fertility consultant isn’t bothered by their sperm assay then why should I be? You can imagine my frustration! The fact is the goal posts have been moved. What equates to a “good” sperm result today would be considered exceptionally poor as little as 10 years ago.
So why do women suffer unnecessarily, take the hormones, go on diets, etc and are totally willing to do whatever it takes? Because the pull for a baby is often far stronger than defending any female rights. Some women will do almost anything to have a baby, and herein lies the problem. It’s not a fault, merely a hormonal and innate urge to procreate and nurture a child. But in this way we can be manipulated into almost anything for the promise of a child. The same can be true of men too. (Of course it’s not just women who suffer.) My point here is that the subject of fertility is emotive and can make people do crazy things.
If you’ve not come round to my way of thinking, that The Handmaid’s Tale might be a prediction of the future, let’s consider what happens with the ageing process and fertility. Up until fairly recently we thought only women had a biological clock but it is clear now that men’s fertility also decreases steadily from age 35 onwards in the form of Sperm DNA Fragmentation. (You can read more about this is my blog article “Could it be Sperm DNA Fragmentation?”) “Studies suggest that for men ages forty and older, their partner has a 60 percent increased risk of experiencing miscarriage, compared to partners under thirty.” (Swan) Young eggs can accommodate older sperm and “make good” sperm that would not be viable if it was paired with an older egg. I predict that as sperm rates decline, younger, fertile women will become a commodity. We’ve already seen this with the rate of surrogacy rising in popularity. Couples seeing their only hope of starting a family by renting a uterus. I understand it. I can see how being unable to have a child can make you do some unorthodox things; I am a fertility acupuncturist after all!
And then, in the television series, there’s the issue of toxins and chemicals having created this unhealthy and infertile environment with barren Handmaid’s being sent to the “colonies” to finish their miserable lives. For anyone who hasn’t seen it this place depicts areas of contaminated, radioactive wasteland. Not too dissimilar to some parts of the UK! Bristol scores particularly high on the air pollution rankings with The Guardian reporting “Air pollution kills five people in Bristol each week, study shows”. (guardian.com)
Today, the rise in male factor infertility is thought largely to be due to environmental pollutants. Baby boys exposed to high levels of phthalates (found in plastics) in the womb were shown to have diminished fertility in adulthood. The trend continues if the exposure carries on through adulthood. Despite the overwhelming evidence that phthalates (among other chemicals) are responsible for such a downward turn in male fertility they are still widely used. Worse still, chemicals that have been shown to be “harmful” are replaced by chemicals that haven’t been tested and the replacements tend to be no better than their predecessors. “In essence, this takes advantage of the public’s misperception that the replacement is inherently safe.” (Swan)
In my blog article, Chemical Warfare, I speak about the issues of chemicals affecting our health. “There are around 70,000 to 85,000 chemicals in use today, with around 2,000 new chemicals coming onto the market each year. It is estimated that around 1% of these chemicals have been tested as Environment Protection Agencies struggle to keep up with the growing volume of new chemical compositions.” The fact of the matter is, we know they are not safe, yet we continue to use them as there just isn’t an alternative. What would we do without plastics?!
So, we know male fertility is rapidly declining. We know this is largely due to environmental exposure to chemicals and toxins that baby boys are exposed to in and outside of the womb. We know that with fewer young people we will not be able to support the older generation. “What will happen in the future - will sperm count reach zero? Is there a chance that this decline would lead to extinction of the human species? Given the extinction of multiple species, associated with man-made environmental disruption, this is certainly possible.” (Levine)
So realistically, I’m not sure if we’ll ever see the types of tyrannical characters and restrictions we see in The Handmaid’s Tale. But certainly we will see infertility becoming a global problem that will require radical intervention. Indeed male infertility IS a global problem but sssssh… don’t for goodness sake’s tell anyone!
For more information on the subject and to read a fantastic book packed full of research and statistics on the problems we face both in male and female infertility please read: Countdown: How our modern world is threatening sperm counts, altering male and female reproductive development, and imperilling the future of the the human race by Shanna H. Swan, PhD. I highly recommend it. And if you have sons it is your duty to read this book!
Swan, Countdown: How our modern world is threatening sperm counts, altering male and female reproductive development and imperilling the future of the human race, 2020
Zini and Agarwal, A Clinician's Guide to Sperm DNA and Chromatin Damage, 2018
Laville, Air pollution kills five people in Bristol each week, study shows, 18 November 2019, https://www.theguardian.com/environment/2019/nov/18/air-pollution-kills-bristol-health [Accessed on 8th April 2021]
When was the last time you had a common cold? A year? Maybe two years ago? With us all trying to live in such sanitary environments we are risking not only our health but the developmental health of our children.
This really is a double-edged sword. To avoid spreading Coronavirus to the vulnerable we’re all trying to stick to the advice to sanitise at all times but in doing so we’re not able to play host to the more harmless strains of bacterial and viral diseases.
Back in January 2020, just as Covid was in its infancy, I attended a wonderful lecture by Dr. Jayne Donegan, a GP and Homeopath with a wealth of knowledge on the subject of acute illness, especially illness in children. She explained that as children and adults, the body builds up toxins. The only way it can effectively eradicate those toxins is through an expulsion of mucous, faeces, vomit or sweat. When the body’s toxin bucket is full it looks for a virus to host so that it can have an acute response, i.e. nose running, fever, sneezing, etc and in doing so will effectively remove the toxins through secreting the mucous. So when a person is constantly catching colds, it has more to do with their overall toxin load than a weakened immune system, though of course that comes into play also.
She further embellished to explain that catching colds for children is fundamentally important for their development, in that after a child has caught a cold they will jump up a developmental stage. This was something I’d never really considered. After your child has been poorly you naturally feel that things have gotten easier because you’re not dealing with the sleepless nights and vomit! But if you take a moment to reflect, you’ll probably remember that your child started walking after that terrible stomach flu, or started talking after they caught a cold. It was certainly true for my family.
So my concern for my child is not “I hope he doesn’t get sick” but instead willing him to catch something! Yet try as I might, he doesn’t get ill. None of us do! And I know for sure he has toxins in there after he polished off a tube of Smarties over Christmas and I’m not even going to begin to think about what I ate over Christmas!
Catching a cold and going through the motions of eradicating it from your system is basically a dry run for the next big deal. It’s our immune systems’ practicing so that it knows what to do if a serious virus comes along. This is why the child’s response is often so acute when they have a cold and why ours is less so. We’ve already done it before and know we’re equipped for Armageddon. They need all the practice they can get!
This blog article isn’t really supposed to provide a solution to the dilemma because, let’s face it… there isn’t one! But perhaps if we all hope and pray then the Universe might deliver to your family a good old common cold and you can consider yourselves the lucky ones! Happy New Year!
In many Western cultures, including our own, women rarely speak of menstruation. Even just a few years ago periods were expected to be kept hidden from men and even from fellow menstruaters. However in many hunter-gatherer societies it is seen as something to be celebrated.
According to the Cherokee, a menstruating woman is described as powerful, she can ward off enemies and has the ability to heal the sick. Perhaps this is why in Western cultures women have been conditioned to keep their periods a secret, lest we become too powerful! Whatever the reason, one thing is set in stone; we are the only mammal to share the moon’s 29.5 day cycle.
If you were to research whether the menstrual cycle ties in with the moon’s synodic cycle it would tell you that there is no correlation between the two. But I wonder what the studies would have said before modern industrialisation, when people were in the fields instead of the factories?
What studies have been able to show is that women with longer cycles can shorten them by sleeping with the light on in the second phase of the cycle. There is also another interesting study that showed that women who conceived during a full moon were more likely to give birth to boys as a pose to women ovulating three days prior to the full moon.
So what this tells us is that our hormones are sensitive to light exposure. We of course know this, as our production of Melatonin has a direct impact on Oestrogen levels.
So ask yourself the question… When was the last time you looked at the moon? Would you even know which direction to look from your bedroom window? In this new world of tech, it’s no wonder we lost our way and our cycles are all over the place! Getting back to nature and taking some time to notice the moon in all its glorious phases must be a great place to start in getting us all back on track.
Why not try plotting your last few cycles in line with the moon phases to see whether you’re on track. The day of your bleed (day 1) should be in line with the new moon, and the full moon should be in line with ovulation (day 14).
Although there is no correlation in terms of the female cycle being linked to the moon’s, recent studies have shown that women whose cycles mirror the moon’s are more fertile. So there’s a reason we should be celebrating all things lunar!
Lichterman, Gabrielle, www.hormonology.co.uk. Accessed 14th April 2020 [https://www.myhormonology.com/hormone-horoscope-does-the-moon-affect-your-menstrual-cycle/]
Northrup, Christiane M.D, www.drnorthrup.com. Accessed 14th April 2020 [https://www.drnorthrup.com/wisdom-of-menstrual-cycle/]
When we emerge from Winter where we should have all been resting and preserving our energy stores (ahem!), we find that Spring brings a new energy. It’s a chance for renewal, rebirth and to make a fresh start.
In Chinese Medicine, Spring is a time to make changes. To embark on plans that might have been cooked up during the Winter months. Think ‘out with the old and in with the new’. It’s also a very important time to let go of old frustrations and resentment and practice forgiveness.
The Liver and Gallbladder are the organs that pertain to Spring. They can be personified as the army generals, keeping all the organs in check and making sure they're all working toward the task in hand. The Liver is also responsible for keeping the energy flowing smoothly throughout the other organs. If we harbour frustration and resentment, energy is unable to flow at this important time resulting in stagnation. Anything that is stagnant will generate heat because there is no free flow of energy. This is when inflammation occurs which we know is damaging to our system in many ways.
So make this Spring the one that counts and give your body what it needs to grow, both physically, mentally and spiritually.
Here are some tips to fully embrace the season:
Spring clean - recycle whatever you don’t need and declutter. Make space for new objects to come into your life. There’s a reason it’s called a Spring Clean!
Try something new - now is a time for change and growth. Give yourself something new to learn.
Practice Forgiveness - get rid of old resentment. Your Liver will thank you.
Don't be stagnant - Get out for a walk and smell the Spring flowers.
Cleanse - the Liver is responsible for detoxifying the system. Give it a helping hand by avoiding processed foods and staying hydrated. You could also try drinking milk thistle tea.
Anti-Müllerian Hormone (AMH) has been used in fertility clinics for a long time to predict a woman’s chances of conception due to ovarian reserve and is even used to determine how many follicle stimulating drugs they should be taking during IVF cycles. But researchers have called for a more reliable test as their evidence shows that the tests are widely inaccurate.
A further US study, which has been reviewed by NHS England, showed that the chances of getting pregnant naturally were no different for women with low AMH and FSH compared to women with normal readings.
So my biggest plea to women who have been given what sounds like the nail in the coffin for fertility is, please don’t worry! IVF clinics can sometimes scare women into believing that their time is running out and that they must have treatment now before it’s too late. Listen to your intuition and do what feels right. Don’t let fear become the deciding factor on your fertility pathway.
Levels of AMH and FSH being found to have little effect on fertility isn’t really new to me. I’ve known patients with a poor prognosis go on to naturally conceive very happy babies. What is concerning me is that IVF clinics are using these results to predetermine the amount of drugs and the types of fertility treatments available to you.
Data from the 2012 study by the NIHR Manchester Biomedical Research Centre into AMH tests showed that unless the samples were stored in a very specific way, the results of the tests could differ to produce readings up to 72% higher. The difficulty is that with clinics storing and transporting their samples in varying ways, the quality of the test result is somewhat open to interpretation.
I have always advised patients to have three AMH samples and take an average score, but the NHS will only grant patients a single test. So unless you’re prepared to pay, you have a number on your head that you carry around with you. This number then determines which doorways are open to you and whether you will be expected to take a very high dosage of follicle stimulating drugs. I therefore urge women who are in this boat to have further blood testing so that you can be armed with a number that might be truer to your actual reading before you go worrying yourselves that your fertile days are numbered.
Anti-Müllerian hormone: poor assay reproducibility in a large cohort of subjects suggests sample instability, Oybek Rustamov, Alexander Smith, Stephen A. Roberts, Allen P. Yates, Cheryl Fitzgerald, Monica Krishnan, Luciano G. Nardo, Philip W. Pemberton, Human Reproduction, Volume 27, Issue 10, October 2012, https://doi.org/10.1093/humrep/des260
Hormonal fertility tests, ‘waste of time and money’, October 2017, reviewed by NHS England, https://www.nhs.uk/news/pregnancy-and-child/hormonal-fertility-tests-waste-time-and-money/
5 Element Acupuncture. It sounds so mystical and I can hear each and every one of you thinking WHICH ELEMENT AM I??? But unlike in the world of the zodiac where the only prerequisite is knowing your birthday, it requires a trained 5 Element Acupuncturist to diagnose your Element. However I might just let you in on a few cheats so you can figure it out for yourselves. Sssh… don’t tell the other acupuncturists!
First, a bit of theory. Chinese philosophy describes the Universe and all who live in it as the Dao. The Dao then splits into Yin and Yang, which are the positive and negative forces which keeps the Universe balanced. Yin and Yang then divide into the 5 Elements of Wood, Water, Fire, Earth and Metal. This completes the cycle of life and can be seen in nature as the 5 seasons, (yep, Chinese philosophy believes there are 5 seasons) with Metal being Autumn, Water being Winter, Wood being Spring, Earth being Summer and Fire being Late Summer. You can see below that the Elements are all interlinked and have the capacity to nourish or control the other. If you’re very interested you can visit an old video blog of mine which talks more in depth about Chinese Medical theory and the 5 Elements.
So now onto the stuff you really want to know. Every person has an Element which they can call their own. It’s their dominant Element which stays with them for a lifetime. The jury is still out as to whether you’re born with your Element or whether early life experiences dictate it but I know that my little boy was a Water from day 1 so I’m sitting with the ‘you’re born with it’ camp.
Your individual Element dictates the way you view the world. It shapes your emotional intelligence and interaction and it also effects your physical organs. In short, your Element defines you and your entire life, including your fate.
So how do you know which Element you are?
An acupuncturist would use a diagnostic method called face reading to look at the different colours on a person’s face. Sounds weird I know, but there are actually 5 different colours that could be showing on the face - blue/black, green, yellow, white and red. We are trained to be able to spot the difference.
Smell is another one. Every Element has its own unique smell and we will be picking up on that too.
The sound of the voice is another. Whether you have a sing-song, lilting voice or a short, clipped voice. All these things inform us of your Element.
But the key one. The one that you might be able to work out at home, is in recognising the emotions. Each Element will have an emotion that pertains to it. Fire is joy and love, Earth is sympathy and compassion, Water is fear and willpower, Wood is anger and determination, Metal is grief and respectfulness.
So how many of you want to be a Fire? It does sound like the best one and I’d be lying if I didn’t think so too. No marks for guessing which Element I am! But there is a down side. Not only do Fire Elements smell of burnt toast, but they care so much about wanting to be loved and liked that they spend all their resources on other people. Your best friend, your colleagues, the lady in the petrol station. It’s exhausting! So Fires will often retreat from society because they’ve burnt up all their energy and they need to refuel. Have you ever had a friend who is the life and soul of the party but then at a certain point in the night they’ve disappeared home without a goodbye. That’s a Fire. They’ve used up all their energy on entertaining you and now they’re spent. But they’ve gone home happy knowing that they’ve done their best at making you like them. There is a physical aspect to this too. Some of the organs that pertain to the Fire Element are Heart and Small Intestine. The Small Intestine is responsible for sifting out what’s needed in the body and getting rid of what’s not necessary. A Fire Element person who is out of balance will be your flaky friend who continues to miss the point.
Whichever Element you are, there are positives and negatives. If you’re a Water Element for example, you’re so scared and fearful of what could go wrong that you’ve already thought about your game plan for every possible eventuality. That’s exhausting for you, but great for everyone else! If you’re in a crisis you want a Water by your side. They’re loyal and protective and for a Fire Element they’re useful to have around as they balance you, and vice versa. Waters are calm on the exterior but inside are bricking it. They’re so bothered about survival that they would never want to show a weakness. The Water energy is also responsible for bone marrow and also governs the Bladder and Kidneys. Water Elements will often have chronic knee or back pain and usually a history of a weak bladder or recurrent bladder infections, or in women often have Endometriosis. They’re your friend who is brutally honest, that has been loyal to you for years, and who you call in a crisis.
Wood Elements. Now you’re the ones that the other Elements don’t mess with. You can be angry individuals. When you lose your temper all other Elements want to run for the hills. But you’re very passionate people and fairness is at the root of all things that you do. You can make exceptional leaders. Wood Elements are seen in Chinese Medicine as little bamboo seeds. Your determination and drive is so strong that you push your way through the soil to get to sunlight. So if you’re trying to get a work project done you want a Wood on your team. These guys just love a list. If you have a notebook next to your bed, chances are you’re a Wood. But beware of addictive behaviours. The Liver is the organ which pertains to the Wood Element and so particularly alcohol addiction can be a big problem for you guys. A Wood Element is your friend that will call you out when you’re being unfair but will bite their tongue for everything else… They don’t want you to see their rage!
Metals are the spiritual guys. They spend a lot of time reflecting on the big questions of life and often have some form of spiritual practice to connect them to the heavens. They’re the type of person that doesn’t ever say too much but when they do it’s bound to be profound so make sure you’re listening. These guys are like the wise owls of the Elements. However their thirst for knowledge and understanding can make them workaholics. They always feel as though they’ve never quite achieved enough and so will go on endless courses and have a list of qualifications as long as your arm. But if you ever complimented them on their education they would stare blankly at you because it feels inadequate to them. Because of this they can be prone to burnout, which is why Metals so often have a meditative practice. The reason for this endless quest to find something is because they always feel as though something is missing from their lives. Grief is the emotion they struggle with the most and so if they lose somebody close to them, these guys will have a difficult time coming to terms with the loss. They’re your friend that will always give you something to think about.
I feel like as women turn into 80-something year olds we all turn into Earth Elements. These are the ones who are always concerned with how you’re feeling. They’re desperate to look after you, bake you cakes, and fluff up your pillows for bed rest. They’re the carers of the Elements and often work in the caring profession. They are martyrs to the very core and thrive on it, so much so that it can be detrimental to their health. Earth Elements find it almost impossible to look after themselves. They’ll sometimes struggle with eating disorders, either failing to nourish themselves or using food to fill a hole in their stomachs that always feels empty. You guys have the nicest sounding smell as you are said to smell fragrant but in truth, that’s just a bad translation… Sorry about that! In reality it’s a clawing, sickly-sweet smell. Because Earth’s are so obsessed with how everyone is feeling they will, if out of balance, often have chronic health complaints that they crave sympathy for. By giving sympathy it feeds the craving and so often, Earth Elements will find themselves locked in an endless cycle of feeling unwell, whether they have physical symptoms or not. They are the Element that gets stuck in a rut and can’t quite pull themselves out. They’re your friend that you want around when you’re poorly, but don’t try returning the favour.
So that’s the 5 Elements in a very rudimentary nutshell.
As it’s Autumn now we should celebrate the Metal Element in all its shiny glory. The Lungs and Large Intestine are the organs pertaining to Metal and so during the Autumn months these organs are a little more fragile than other times of the year. This is why we often catch more colds in the Autumn. The colour for Metal is white and so we must make sure we have plenty of white foods in our diet. As an example, onions, garlic, cauliflower, milk, parsnip, mushrooms, butter beans, chicken, white fish & shrimp. You could make an argument for white bread and pasta but I’m not sure it’s what the ancient Chinese physicians had in mind.
And finally, the link to the hot topic for this month’s newsletter… skin! Every Element has an external organ which can highlight to a practitioner if there are any underlying internal pathologies. 5 Element Acupuncturists will look at a person’s skin to see the state of their Metal/Lung energy. If the skin is dry and flaky your lung energy is deficient. If it’s red and itchy your lungs are hot. If it’s pale and dull your lungs are cold, and if it has puss filled spots your lungs have phlegm. By balancing your energy between the 5 Elements we can correct skin problems with acupuncture. It can really be that simple! So eat white foods, look after your lungs, have some acupuncture and your skin will shine.
Author - Sarah Bayliss
Nutritional Therapist with clinics in Clifton, Bristol.
In short, the answer is it could be? It’s important to provide context, so what is histamine and what does it do?
Histamine is a chemical response and required for a number of biological processes including muscle contraction, gastric acid secretion (for optimal digestion), it acts as a neurotransmitter as well as supporting the immune system and wound healing.
So we need it but how much do we need? Our bodies’ work on equilibrium, the key is finding your unique balance to achieve homeostasis. It helps to think of a bath we want the bath to be full, not too full that it may overflow; therefore we need to be able to remove any excess water to stop it from overflowing and causing damage (everyone’s bath is different!).
Our bodies work similarly when looking at histamine and potential intolerance we need to consider two things, a) how much we are putting into our bodies through diet and b) how well our body is removing the excess to minimise irritation, allergic reactions and inflammation.
Elevations can be caused by high dietary exposure and poor elimination, driving an allergic reaction, genetics may also play a role. Individuals with allergies tend to have a higher baseline histamine level.
There are a number of broad symptoms that could be due to histamine intolerance, to name a few these include:
The best way to determine if you have an intolerance is firstly to eliminate high histamine foods from your diet for approximately 4 weeks and review your symptoms. High histamine foods include:
Secondly, sufficiently supporting your detoxification pathways in your liver and ensuring your gut is functioning well, enabling good elimination. Histamine is detoxified in both your liver and your gut. Removing substances that impair our liver and gut function will be helpful and eating foods that support our liver and our gut:
Essentially through on-going support of our detoxification pathways will help improve our resilience and improve symptoms. Diet is critical not only in minimising problematic foods but maximising healing foods that support our organs and help to drive down inflammation. Minimising stress on the body, looking after our organs, eating well and sleeping well will all help to improve our overall resilience and therefore reduce the allergic reactions.
Laura Maintz, Natalija Novak, Histamine and histamine intolerance. (2007). The American Journal of Clinical Nutrition, 85 (5),1185–1196.
Tuck, C. J., Biesiekierski, J. R., Schmid-Grendelmeier, P., & Pohl, D. (2019). Food Intolerances. Nutrients, 11(7), 1684.
By Sarah Bayliss, Nutritional Therapist, CNHC registered mBANT
How Men and Women Sleep Differently by guest blogger Christine Huegel - Sleep Expert for Mattress Advisor.com
We all know that men and women tend to do things differently, and this couldn’t be truer when it comes to their sleeping behaviors. Do you ever wonder why your partner’s sleeping habits are significantly different than yours, making it hard to be in sync at night? We’ve got an answer for you! From sleeping habits, positions, and difficulties, we see just how different men and women can be.
Women experience insomnia more than men
Insomnia is one of the most common sleep disorders, which involves the inability to get restful sleep or suffer from an irregular sleep pattern. Research has shown that women experience this significantly more than men.
Why is that? The leading cause of sleeplessness is stress, anxiety, depression, and pain. Women tend to go through all these more than men do. For example, women experience discomforts, pain, and stress during menstruation and pregnancy.
However, men can experience their fair share of sleeplessness as they are more likely to suffer from sleep apnea than women – a condition preventing restful sleep due to difficulty breathing.
Men Sleep Late, Women Wake Early
A man’s biological clock is naturally set one hour later than a woman’s, meaning that they are more likely to stay up later and sleep in longer. Additionally, women have slightly shorter circadian rhythm cycles compared to men – making it easier to wake up and feel ready for the day earlier in the morning than their counterparts.
Sleep Deprivation Impacts Men and Women Differently
Studies show that when women lack proper sleep, they are more prone to negative emotions like depression, anger, or short temper compared to men. To emphasize the importance of proper sleep for women even more, additional research shows that women who experience chronic sleep deprivation have a greater risk of things like heart disease and type-2 diabetes than sleep deprived men.
Men who don’t get enough sleep each night are more likely to experience attention and performance deficits at work and school, as they have a more difficult time coping and recovering from lack of sleep compared to women.
Women get cold feet more than men
Have you ever wondered why many women tend to be tucked into blankets all night while men can sleep soundly with their feet exposed, and hanging off the bed? The nerves responsible for the control of blood flow to the feet and hands are more sensitive in women than men. When it is time to sleep, a woman's blood vessels constrict, thus slowing down the flow of warm blood, leaving the feet freezing. This messes with the women's ability to fall asleep, but it is rarely the case for men.
Men and women may seem to be from different planets in a lot of situations, and sleep is clearly one of them. However, despite their sleeping preferences, many couples are able to enjoy restful sleep with their partners. Sleep is critical to your short term and long-term health, so it’s important to work together to ensure that both individuals in the relationship are getting the quality sleep they need each night. If you’re thinking about a sleep divorce, don’t worry. Many mattresses and bedding accessories are made to allow men and women to coexist during bedtime.
Furthermore, sleep is critical to your short term and long-term health and understanding these differences can not only help you understand your partner better but create solutions to get restful sleep each night.
It is now well researched and documented that the Western man’s sperm count has plunged by 60% in the last 40 years compared to that of men in lesser developed countries. Sperm morphology is also at an all time low and researchers in America are finding that sperm DNA fragmentation is an area that is gathering more interest for embryologists and reproductive health specialists.
It’s an area that I too am taking more seriously as I’m finding more and more of my fertility patients being diagnosed with “unexplained” infertility or struggling with recurrent miscarriage. Therefore I’ve taken some time to swat up on this growing area of research and have been reading a fascinating book, “A Clinician’s Guide to Sperm DNA and Chromatin Damage”, by Armand Zini and Ashok Agarwal, Professors of Montreal, Canada and Cleveland, USA. It’s a pretty hefty read but I’ve tried to pick out the more salient points for you.
Sperm DNA fragmentation is caused by oxidative stress, which is an imbalance between free-radicals and antioxidants in your body. “Approximately, one in every six couples suffers from infertility (17%), and male factor contributes to 40-50% of these cases. The cases of almost half of these male factor associated infertilities are unexplained/idiopathic, and within this group, 5-10% of men had a high amount of sperm DNA fragmentation despite having normal semen parameters.” “Today, routine semen analysis is the “gold standard” test used in the evaluation of male infertility; however, it is unable to identify the causes of some of the cases. Therefore, in order to distinguish infertile men from the fertile population and to predict the success of in vitro fertilisation (IVF) cycle outcomes, a new diagnostic test is required. The use of DNA fragmentation tests as a part of the routine analysis in fertility investigation remains controversial, despite the fact that many research groups are greatly in favour of these tests.”
The difficulty that many couples face is that they are given the standard routine sperm test and then told that their results were slightly below normal, without any real explanation of what this means. Firstly, given that “normal” is 60% worse than that of sperm 40 years ago, a below normal reading is really something that shouldn’t be taken too lightly. That said, I’m not here to worry anyone. More that some men should be taking the health of their sperm more seriously and be putting measures in place to protect and preserve it.
“Although a few reports have indicated a slight or non-significant association between semen parameters (sperm count, motility, progression and morphology) and sperm DNA damage, many studies show that sperm from abnormal sperm parameters have a higher percentage of DNA damage.” Therefore, if a man has a lower than average morphology, it is possible that they will have DNA fragmentation.
The thing I struggle with the most is that men with lower than average sperm results are told that there’s nothing they can do to change it, and to just ‘keep trying’! Worse still, women that are able to get pregnant but suffer recurrent miscarriage are told that their partners don’t need a sperm test because they’re able to conceive. I have known in my practice that a missed miscarriage, or an embryo that fails to develop can often be linked to poor sperm quality. Clinicians really do need to adjust the way they address fertility and not offering couples even the basic sperm testing as a matter of course is just nonsensical.
We know that lifestyle and dietary choices plays a massive role in improving sperm and yet this advice is often not descended down to the patient. Women are switching on to the fact that they must preserve their fertility health but I think it’s time men had a little wake up call too as “unexplained” infertility might be explained, if further testing is made available to men.
“Some studies have shown that sperm DNA fragmentation is correlated with poor reproductive outcomes including miscarriages, chromosomal aberrations, congenital malformations, genetic disorders, neurological defects and cancer in offspring. Understanding the mechanisms after fertilisation in the zygote is therefore important.”
So what is causing these higher levels of sperm DNA damage?
“Some environmental factors including radiation, smoking and alcohol consumption contribute to male infertility. Untreated cancer patients as well as those who have been exposed to chemotherapy and radiotherapy, environmental pollutants and certain cytotoxic medications may be prone to sperm DNA fragmentation.”
It is also true that Western couples are coming to baby-making much later in life and so age does play a role here too. Up until recently it was considered that only women had a reproductive body clock that starts ticking at age 35. “Some studies have indicated that men with advanced age have an elevated sperm DNA fragmentation, while DNA fragmentation is considerably lower in younger men (<35 years)”. We also know that a younger oocyte [egg] can make do with a lesser quality sperm, which is why we have these preconceived ideas that men can still conceive no matter how old they are. It’s all to do with the quality of the egg and if the sperm is old but the egg young, then the maternal genes are able to repair and make do with much of the damaged DNA strands. However if both partners are in that plus 35 age bracket then it will be harder to conceive.
“The scrotal temperature is 2-8 °C lower compared to the rest of the body, and this is essential for proper spermatogenesis in mammals. In a mouse model study, a high level of DNA fragmentations was observed in spermatocytes retrieved from testes exposed to 40-42 °C.” Therefore men that are regularly exposed to extreme temperatures may have more sperm damage.
Varicocele, which is a mass of varicose veins in the spermatic cord, “affects approximately 15-20% of males and is one of the commonest causes of poor sperm quality. Significantly higher DNA fragmentation has been observed in patients with varicocele.”
Chlamydia and urinary tract infections also cause higher levels of sperm DNA fragmentation.
So if a man has been diagnosed with high level sperm DNA fragmentation, what are their chances of success?
One sperm DNA fragmentation test (SCSA) study showed that “If the level of spermatozoa with DNA fragmentation is higher than 30%, the probability of natural conception is almost zero.”
And what are the chances of success using assisted fertility (IVF or ICSI)?
“Results of several clinical reports have proposed an association between sperm DNA damage/poor sperm quality and embryo development/maturation. The impact of DNA damage on the embryo seem to be related to the development of embryo more than embryo quality.”
Certainly in my clinic I see couples who have gone through the ICSI process who are able to gain Grade A blastocyst embryos but are unable to sustain a pregnancy. Many women blame themselves for being unable to carry the embryo to the next stage, but sperm DNA will affect the embryo much later and so it could be DNA fragmentation that is affecting the development. This is because the “blastocyst development is controlled by maternal genes during the first cell stage (approximately 48-56 hrs after the fertilisation process)”. “Interestingly, a study has demonstrated that the adverse paternal effect on the development of an embryo may occur at a later stage even if there are no morphological anomalies at the zygote stage. Repeated failures of assisted reproduction without any evident defective zygote formation and cleavage [the division of cells in the early embryo] of embryos are frequently correlated with high sperm DNA fragmentation levels.” “DNA fragmentation also has an impact on sperm parameters, embryonic development, chromosomal aneuploidy, implantation, and recurrent miscarriages.”
So what can be done?
“The favourable impact of antioxidants including reduction of DNA fragmentation level in ejaculated spermatozoa can be detected following 2 months of oral antioxidant therapy. Additionally, dietary antioxidants are an appropriate therapeutic option to alleviate sperm DNA damage for infertile men.” This is why I am increasingly annoyed when men receive the results of a lower than average sperm assay and are told that there’s nothing that can be done. It’s just not true! Plenty can be achieved with better diet and lifestyle choices, reducing stress, reducing exposure to pollutants and chemicals and lest we forget, regular acupuncture!
Some studies have suggested that sperm that is stored for a shorter duration in the epididymus (a duct behind the testes) had less DNA fragmentation because their intracellular antioxidants have not been fully consumed. “Hence, recurrent ejaculations can potentially be an approach to reduce sperm DNA damage and improves IVF treatment success rate… Therefore, frequent daily ejaculations can be utilised as an alternative treatment option in male infertility cases with high oxidative stress.” This does go against Chinese medical theory that men should ejaculate less to preserve their kidney energy. So that one does pose a bit of a dilemma for me!
Couples who have had unsuccessful rounds of assisted fertility (ICSI) and who have diagnosed sperm DNA fragmentation could go for an, albeit more invasive technique, called TESA. This is where a needle is inserted into the testicle and sperm are aspirated. “The pregnancy rate using testicular and ejaculated spermatozoa was 44% and 6%, respectively. Implantation percentage was found as 22% and 2% using testicular spermatozoa and ejaculated spermatozoa, respectively.” So you can see here the results are vastly better using the TESA technique above the normal ICSI procedure.
There are other ways of selecting the best sperm for IVF, such as magnetic-activated cell sorting (MACS) or (IMSI) which uses sperm selection under a very high magnification, but in my experience I have not come across these techniques and so assume they are not available in this country.
What should you do if you suspect you have sperm DNA fragmentation?
Well unfortunately, a DNA fragmentation test is not available on the NHS and is unlikely to be any time soon. The test I tend to recommend to patients is the Sperm Comet Test. The patient would need to travel to London to deposit their sample. The test itself is fairly inexpensive (as far as tests go!) at £249. The patient will then receive a user-friendly report giving them the percentage of DNA fragmentation seen in their sample. I really would recommend this test to couples who have:
Details of the Sperm Comet Test can be found here: https://examenlab.com/the-test/
I hope you have found this blog useful. It’s not meant to scare all struggling couples into having a DNA test… I promise I’m not working on commission! But more to help couples who have been trying to conceive but with no medical answers as to why they’re failing. Sperm DNA fragmentation is not a phrase you will ever hear in your IVF consultations but it is something we need to be more aware of and be proactive in arming ourselves with all the facts before we pay for endless ICSI cycles that may never be fruitful because of damaged sperm.
Verity Allen - BSc, BA, MBAcC, Lic Ac