Thursday, August 22, 2013

Why are we so obsessed with WOMEN and fertility? Rise of male-only clinics as 'sperm whisperers' help to combat sperm crisis

Why are we so obsessed with women and fertility? Rise of male-only clinics as 'sperm whisperers' help to combat sperm crisis, writes Ashley Pearson
Why are we so obsessed with women and fertility? Rise of male-only clinics as 'sperm whisperers' help to combat sperm crisis, writes Ashley Pearson

Tall, blonde, slim and successful, it was hard to imagine that Kate had any problems. 


At 38, she’d just had a big promotion at the glossy magazine she worked for, and was newly married to the man of her dreams. She was also excited about the idea of having a baby.  
Except that it didn’t happen. Month after month we’d meet up for our regular girls’ nights at a trendy bar in Manhattan, and I expected a happy announcement.
But time after time, none was forthcoming. She began to talk openly about a battery of tests she was having, eliciting massive sympathy from the rest of us. 
Until one day she casually mentioned that her husband had had some tests too; the rest of us sort of giggled at the idea. It seemed so silly. 
Nearly 10 years younger than she, at 29, Alex was a tri-athlete and the picture of perfect health. 
Clearly if something was wrong it had to do with her nearly 40 year old eggs. 
We were all wrong.
It seems it was Alex who had the issue that was scuppering their efforts. It was several painful months before the problem was discovered, and once it was, they were told to go directly to ICSI and IVF. 
Alex’s case if far more common than you may think. A recent study found that sperm concentration has decreased by a third since the 1990s. 
The findings were so significant that experts are calling it ‘a sperm crisis,’ cautioning that action should be taken immediately. This comes on the heels of a prominent study from the 1990’s which suggested that sperm count has decreased by half over the past 50 years. 
What seems clear is that the media focuses almost entirely on female fertility issues; bombarding us with the dangers of ‘leaving it too late’ or articles about how our diet and drinking, weight or smoking may keep us from conceiving. But that’s not the whole picture. 
It’s time we started another conversation.
 

Dr Sheryl Homa operates the only HFEA licensed UK fertility clinic dedicated entirely to men. 
She says ‘having worked in academia and then at IVF clinics, it struck me how marginalised the male side of things is. 
'In this country, 95 per cent of IVF clinics, (or more) are run by gynaecologists. And yet 50 per cent of the genetic material that makes up a baby is derived from the male. Why are we so obsessed with women and fertility?' Dr Homa, who is a clinical scientist, adds, 'Women are the ones seeking help, and being proactive about it – but men contribute 50 percent at the end of the day. With women it’s a yes or no proposition.  
'When you ovulate you either have a good egg or you don’t. With men it’s more complex. And if you don’t start with the correct genetic material from the beginning you will have a problem.'
Mr James Nicopoullos, who is a consultant Gynaecologist at the Lister Clinic says: 'Unfortunately in the majority of men with a fertility issue the underlying cause is never identified. It’s true that the vast majority of fertility clinicians are gynaecologists and even amongst those of us (like myself) who have done heaps of research in male fertility our clinical expertise is still with the female partner. And unfortunately, many urologists who specialise in the male urological tract know little about fertility so men often never get worked up as well as they should!'
'Why are we so obsessed with women and fertility?' asks Dr Homa as male-only clinics begin to pop up
'Why are we so obsessed with women and fertility?' asks Dr Homa as male-only clinics begin to pop up

Dr Homa says, ‘When a couple is faced with an "unexplained infertility" diagnosis, she gets sent to her gynaecologist for a battery of tests; but for the man, nothing else, apart from a semen analysis is done. They should be should be sent to a Urologist or an Andrologist. 
IVF clinics are run by Gynaecologists; would you send someone with a heart condition to an Ear, Nose and Throat Specialist?'
And it seems that while your basic semen analysis checks sperm count and motility, increasingly studies are showing genetic abnormalities in sperm, particularly in older men. Indeed recent studies suggest a higher miscarriage risk in pregnancies from men who are over 45. It’s two times higher than in those men under 25.
Mr Nicopoullos says, ‘Even if sperm numbers are great, a high proportion of men may have DNA damage that significantly impairs the chances of natural conception and also of many types of fertility treatment. This is not something that is widely known and probably not all fertility doctors are really are up to speed with it ether. It may therefore be a factor in many of the couples previously thought to have unexplained infertility.’
Dr Homa says, ‘If you look at the evidence it is clear that male sperm deteriorates with age, the way it does for women. I see DNA fragmentation in the sperm of a number of older men – which can raise the risk of autism and schizophrenia.' She adds, 'There are also silent infections such as Chlamydia and Gardnerella, both of which can be linked to recurrent miscarriage. And there are no symptoms.'
Interestingly, when it comes to age - it seems there may be a biological reason for older men seeking out younger women.  
Doctors have recently reported a rise in eligible bachelors enquiring about having their sperm frozen
Doctors have recently reported a rise in eligible bachelors enquiring about having their sperm frozen

‘Younger eggs can actually repair DNA damage from older sperm more effectively, whereas older women’s eggs are unable to repair the DNA damage of older men’s sperm.’ 
So what can be done about this ‘sperm crisis’?  
Dr Homa adds, 'Getting men thoroughly investigated including some basic lifestyle changes such as no smoking, drinking, wearing boxer shorts, and not cycling can make a difference. It’s something that is within your power. 
Sheryl Homa adds, 'After all, having a baby is a major decision and event. And if you were going to play Wimbledon wouldn’t you want the best tennis racket and balls to work with? No pun intended.'
Emma Cannon, author of ‘Total Fertility’ agrees. 
'Fertility preservation in both men and women is my big message. There needs to be more awareness that fertility is precious and needs preserving. For too long we have been indoctrinated to think we can fall pregnant at the drop of a hat - but for so many it's just not that simple.'
She adds, 'I see more and more men wanting to be involved in the fertility journey in a really proactive way - I think it's great that men are engaging in it. After all it really does take two.'
Cannon, who is a pregnancy and fertility expert advises, 'I believe that an integrated approach for men is very helpful, including acupuncture and nutritional information on anti oxidants etc. For sperm issues a three month programme is required to improve sperm quality (morphology ).'
And, like a woman’s eggs, you can always put it on ice. 
Urologist and superstar sperm doc Joseph Alukal, is known as Manhattan’s ‘Sperm Whisperer.’ He told the NY Post, 'People keep asking me, "Doc, should I freeze my sperm? What if I meet the right girl 10 or 15 years from now?" It's absolutely something I'm seeing more of in my office.'
The director of reproductive health at NYU says the men he sees are some of Manhattan’s most eligible bachelors: 'A number of my patients are financial types, architects, physicians, etc – many are high-achieving, successful, professional guys.'
Dr Alukal adds, 'There's no risk in banking frozen sperm, just a financial cost. And you can't put a price on peace of mind.'

 'People keep asking me, "Doc, should I freeze my sperm? What if I meet the right girl 10 or 15 years from now?" It's absolutely something I'm seeing more of in my office'
Sperm freezing is also happening in the UK.  
Sheryl Homa says that there’s been an increase in men requesting this service at her London clinic: ‘I have one chap who is a very successful hedge fund manager and although he’s in his early 40’s, he and his partner don’t want children at the moment.  He read that autism and schizophrenia is linked to older fathers and thus decided to freeze his sperm.’  
And there really needs to be more education about both male and female fertility issues. 
'Our schools in the UK teach students how not to have children – birth control and the importance of wearing a condom. But while we teach prevention of pregnancy, no one is taught about fertility; how to preserve it for when you ARE ready. There’s a real lack of information,’ says Dr Homa.  
And she cautions, 'If faced with an unexplained infertility diagnosis- don’t go straight to IVF.  
'IVF is an emotional rollercoaster and hugely expensive, and I should know as I’ve been through it myself.  It really should be the last resort.'


Read more: http://www.dailymail.co.uk/femail/article-2397871/Rise-male-clinics-sperm-whisperers-help-combat-sperm-crisis.html#ixzz2cigQqt2I 
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