There are many health benefits associated with weight loss for those with obesity, but regaining fertility may not be the first you’d think of.
Yet a study suggests bariatric surgery — commonly known as gastric bypass surgery — may provide hope for morbidly obese women of child-bearing age who are currently infertile.
The reason is that the surgery can be used to treat polycystic ovarian syndrome (PCOS), a hormone imbalance that affects up to 10% of women and between one-third and a half of overweight and obese women.
“Not many patients come to a bariatric surgeon to treat infertility problems,” said Mohammad Jamal, MD, FACS, study co-author and Clinical Assistant Professor of Surgery at the University of Iowa Hospitals and Clinics in Iowa City. “But this study suggests that women with morbid obesity, who are infertile secondary to PCOS, may have a new surgical option. Many other studies have shown bariatric surgery can improve or resolve a multitude of diseases and conditions. It appears that infertility now joins that list.”
In the study, researchers from the University of Iowa Hospitals and Clinics report that 100 percent of the morbidly obese women who were diagnosed with PCOS related infertility, and desired children, became pregnant within three years following gastric bypass surgery.
A review of medical records of 566 morbidly obese women who had gastric bypass surgery over a period of nine years revealed 31 patients between the ages of 22 and 42 who had PCOS before surgery. Six post-menopausal patients, and five patients lost to follow-up, were excluded. The remaining 20 patients, average age 32, were contacted by telephone. Fourteen of them were fertile prior to surgery or did not desire to become pregnant after surgery.
The remaining six women, who had been diagnosed with infertility before surgery, and still desired pregnancy, became pregnant within three years of gastric bypass surgery. Doctors advise women not to try to conceive until at least 18 months after bariatric surgery due to surgery-related changes that could affect fetal development.
Before surgery the women had an average body mass index (BMI) of 52, and after surgery had an average excess weight loss of nearly 60 percent. Menstruation corrected in 82 percent of the women and nearly 80 percent no longer had Type 2 diabetes.
You can read more about the study at Newswise.
Three in four NHS trusts are not offering infertile couples three chances at IVF, with some not funding the treatment at all.
That’s the finding of a cross-party group of MPs who found it’s a real postcode lottery as to who receives the treatment, Channel 4 News reports.
For example, some PCTs might have an upper age limit at which IVF is no longer offered, whereas others (such as Bury) only treat women aged between 39 and 40, despite chances reducing with age.
Warrington, West Sussex, Stockport, North Yorkshire and York, and North Staffordshire PCTs don’t even offer IVF.
NICE (National Institute for Clinical Excellence) guidelines suggest couples should be given three cycles of IVF between the ages of 23 and 39, but these have never been implemented across the country. Current budget cuts certainly can’t be helping matters.
Here are some other resources which you might find useful:
- Female age affects fertility but doesn’t rule out pregnancy
- The secret life of sperm: may aid contraception and male fertility
- Study Shows New Therapy Opens Blocked Fallopian Tubes, Returns Fertility Without Surgery
- Delaying childbirth ‘defies nature’; can lead to complications
Experts more usually accustomed to tracking CCTV footage have partnered with Action Medical Research to try to find a way to prevent stillbirth.
Advanced technology could help track changes in foetal movements towards the end of pregnancy.
Bereaved mothers often say that their baby’s movements in the womb seemed to decrease in the days leading up to the stillbirth.
Sadly, about 4,000 babies are stillborn each year in the UK alone.
A three-year grant from the charity should allow developers to create a sophisticated monitoring system that can analyse movements recorded during ultrasound scans.
The research team are in the early stages of the project and will be taking one-minute long ultrasound scans of around 100 healthy women, who are five to six months pregnant, and recording what they see on DVD.
The scans provide moving pictures of the babies in the womb. The researchers are then using the surveillance expertise to see whether it is possible to recognise and analyse the babies’ movements using state-of-the-art computer programs, which incorporate pattern-recognition software.
Ultimately the researchers hope to develop a mobile device which pregnant women, at risk of stillbirth, could use in their own homes. They envisage relaying data from the device wirelessly to a computer. This could give doctors a chance to intervene in a way that could save the baby’s life, for example, delivering the baby early.
Age and fertility
In the last couple of days, two news stories have appeared that, at first glance, might seem to contradict one another.
One warns women of age 35 and over not to stop taking contraception, with the Family Planning Association launching its “Conceivable?” campaign that reminds women to remain vigilant.
The other cites fertility doctors who suggest that age is still the most critical factor in whether couples can conceive, despite the wealth of new reproductive techniques emerging each year.
Contraception until menopause
The abortion rate for women aged 40-44 is now the same as for under-16s — four per 1,000 women — in England and Wales.
This suggests there is a real issue with women who believe that, past 35, they have next to no chance of becoming pregnant.
There are many reasons why some women opt for an abortion – including birth abnormalities in the baby, which are more common when the mothers are older.
But FPA says its anecdotal evidence suggests some of the abortions are because women wrongly assumed they could not get pregnant because they were too old.
The FPA’s chief executive, Julie Bentley, said, “Whilst the message about fertility declining with age is an important one, it is often overplayed, alongside disproportionate messaging about unplanned teenage pregnancies.
“It sends an inaccurate message to women and society that only the young fall pregnant and is leading older women to believe their fertility has gone long before it actually has.”
The advice for older women who don’t wish to fall pregnant is simple: continue taking contraception until after the menopause.
Fertility doctors suggest that there are no more people needing fertility treatment than a decade ago.
What’s changed is the anxiety levels surrounding having a family.
Fertility clinics are full of patients who have delayed starting a family and believe that assisted reproductive treatments such as IVF offer them a guaranteed insurance policy of becoming parents.
Unfortunately, these expectations may not be realised, and a quick glance at the latest HFEA national data in the UK shows that only 24% of all IVF cycles resulted in a birth. This drops to 12% for women aged 40-42, and a heart breaking 3% for women age 43-44.
These cold statistics hide an emotional rollercoaster of stress, anxiety and often enormous financial strain.
They do, however, very effectively demonstrate the huge impact of female age on the chance of conceiving.
It does seem unfair, and you can bet there are plenty of women experiencing the “wrong” thing.
There will be those who fall pregnant unexpectedly who are aghast at the prospect, while others desperate for a family watch the years tick by without children coming.
It proves that there are no hard and fast rules when it comes to fertility.
Fertility treatments aren’t guaranteed, and while age plays a factor it’s not conclusive.
In a national survey carried out in the United States, seven out of ten women said that infertility made them feel flawed, while half of all men said they felt inadequate.
Six out of ten couples said that they try to hide their fertility troubles from family and friends, while a third admitted their ability to confide in others has decreased since they began trying to get pregnant.
Over half said that it was easier to tell people that they weren’t planning to have children rather than to share the struggles they faced.
Disbelief and Delay
Disbelief is also a common issue, for despite one in eight couples of childbearing age do struggle with fertility problems, two-thirds of those surveyed said that they never thought they’d have difficulty in conceiving.
Over half of the couples said they wish they had started trying sooner, with a staggering nine out of ten respondents already seeking fertility treatment saying this.
Relationships with family and friends can also suffer, with six out of ten couples admitting to becoming tired of people asking them how the process is going or offering suggestions on how to conceive.
Unsolicited advice — such as being told to “relax”, get more exercise, sleep or a different diet — aggravated many couples.
Intimacy & Sex
Infertility issues seemed to affect intimacy in different ways, though more couples (58%) said it had brought them closer together than hurt (36%). Having said that, men suggested time arguing had increased, while both sexes said stress and tension had increased.
Added to this, 55% said that fertility issues had made sex a physically and emotionally anxious time, while a similar number (53%) said fun and spontaneity had gone, and four out of ten said they felt sexually unattractive.
The survey interviewed 585 people in relationships where conception had been an issue for two or more years. Full results are available at the Plan For Some Day web site.
I can certainly vouch for a lot of the results in this survey. What has been your experience?
By Andy Merrett
Jul 17, 2009
Miscarriage is a tragedy, however statistically common it is and at whatever stage of pregnancy it happens.
It is of course natural and right that any woman who has experienced a miscarriage should be given all the medical help and emotional and physical support and comfort possible.
It’s also important to consider that the male partner / husband is also very likely to be grieving the loss of an unborn child, and also needs support and the space to come to terms with his own emotions.
This article draws together some helpful advice for men on how to cope with miscarriage and how best to support their partner/wife, based on resources from around the web and from personal experience.
I hope it helps you. If you have any thing to add, please feel free to leave a comment at the end of the article.
How “should” you be feeling?
Some articles on this subject, such as Men and Miscarriage: How Men Handle Miscarriage, suggest that men emotionally “move on” quicker than women, but the fact is that everyone is different.
You may find that you don’t react much when you first find out about the miscarriage, and that emotions — ranging from deep sorrow to anger to frustration to feelings of helplessness — come on weeks or even months later.
There’s no right or wrong answer. This is grief, and you have to deal with it in your own way. Typical feelings men experience after miscarriage is a useful primer for both men and women on this.
Communication is Key
No matter how you or your partner may be feeling, reacting and coping with the miscarriage, it is vital that you don’t stop communicating with one another.
The fact is that you are the only two people who know exactly what you’re going through, and though it can be helpful for one or both of you to talk to friends, family or counsellors, you can also be each other’s strength.
The fact is that communication is key to creating and maintaining strong relationships, but particularly during stressful, highly emotional situations like coping with miscarriage.
Grieve alone, and grieve together. Tell your partner how you are feeling and allow her to tell you the same — and acknowledge and empathise with her.
Is It My Fault?
Attributing blame to one or other partner after a miscarriage is extremely unhealthy and should be avoided.
There may be a medical reason which increases the likelihood of a miscarriage, but unfortunately pregnancy loss (particularly early, such as in the first three months) is also considered fairly “normal”.
Laboratory research shows that it is possible for abnormalities to cause a pregnancy to fail — often had the pregnancy gone to full term the baby may well have had a disability anyway so it can sometimes be seen as nature’s way of disallowing unhealthy foetuses to live.
That’s all very clinical, though.
If you and your partner have experienced several miscarriages, it is definitely worth consulting your doctor and having tests to establish whether anything is wrong, and whether some forms of medication may help during pregnancy.
In any case, in the general run of things it’s not really anyone’s “fault”, and even if there is a medical condition it’s often something that can be sorted out.
How can I best support my partner?
The article Miscarriage: how men can deal with it offers advice for supporting your partner after a miscarriage:
- Understand that she will be upset and you can’t fix the problem. You need to be supportive, understanding and appreciate that there will be a grieving process which will take time.
- Understand that even if it’s very early stage pregnancy she will feel like she has lost a baby, even if you don’t. Saying things like “don’t worry it was only the size of a tic-tac” isn’t going to be much help.
- Give her lots of support. She needs to know that you love her.
- It’s important to re-enforce that it’s not her fault. It’s quite possible she may try and blame herself for something she did or didn’t do but it’s highly unlikely the loss had anything to do with her actions. I could write a whole article just on this point but from listening to many men talk about miscarriage, almost all said that their partners felt like she was to blame.
- Encourage her to talk to her female friends and family who have had children. It’s very likely some will have been through the experience and will be able to offer support and advice.
- Understand that a pregnant woman is a sea of hormones and those hormones are still running wild after the loss. Know the signs of depression and seek medical advice if you feel she isn’t coping well after a week or two.
- As guys we like to try and fix problems but sometimes you just need to provide a shoulder to cry on and an ear to talk to. Don’t take it personally or get frustrated that you can’t make her forget about it.
- Spend as much time with her as you can and remain positive about having kids. Having one miscarriage isn’t necessarily a sign that you will have more so focus on staying healthy and having another go when the time is right.
My male friends are unsympathetic
Sometimes it may seem that your male friends aren’t particularly sympathetic to how you’re feeling.
We could put some of this down to the stereotypical guy who doesn’t like to share or show emotions much, or it could just be that you haven’t told them how you’re feeling.
Don’t forget that every man is in a different situation. Single guys may well not understand, married-with-kids guys may well have experience of miscarriage but find it difficult to come alongside you unsolicited.
How do you cope with the sarcastic or seemingly unhelpful comments? I guess it depends on how much it bothers you.
If you can just brush off the “oh well, you don’t really want kids yet” or “you can have my kids” comments (and their many derivatives) then fine — remember that your partner is probably your main confidant and strength anyway.
If not, you need to politely explain that some of their comments aren’t helpful, that you’re happy to talk about the situation with them (if indeed you are) but that the jokes, however well-meaning (bloke diversionary tactics) aren’t helping you.
Don’t let anyone try to cajole you into “moving on” – your grief takes as long as it takes.
What about “trying again” after miscarriage?
At some time after a miscarriage you will both be ready to try to conceive again.
It is really important not to rush things, and to try to understand how each other is feeling.
Conceiving after miscarriage is a really useful article looking at the subject from both female and male perspectives.
Here are some useful resources and interesting articles for further reading around this subject:
- Men and Miscarriage: How Men Handle Miscarriage
- How men cope with miscarriage: John Itsagwede explains how he and his wife dealt with the pain of losing three babies
- Miscarriage coping guide for men
- Typical feelings men experience after miscarriage
- Conceiving After Miscarriage
- Men and Miscarriage
- Miscarriage: How men can deal with it
- Men and miscarriage: Information on support groups
- Helping Men Get Through A Miscarriage
- What Are Men’s Reactions To A Miscarriage?
Empty Arms is a beautiful video created by Susan Robinson. In a simple way using music, images and words it tries to share some of the pain that couples with fertility issues face every day.
It’s a poignant video, not judgmental or accusatory, but of encouragement to friends and family to stand alongside and simply love.
Not fully understanding, not always having words, not trying to problem solve … these are all things that are just fine. Being there as a shoulder to cry on, a friendly face, someone who says “I’ll stand by you and support you as you journey through this” – that’s what’s really needed.
Take a look at TearsAndHope.com to play the video.
By Andy Merrett
Feb 10, 2009
Everyone seems to have an opinion on Nadya Suleman, the 33-year-old who now mothers fourteen children.
One of the latest to weigh in is medical director of Georgia Reproductive Specialists, Dr Mark Perloe.
He believes that the physician who treated Suleman is guilty of “criminal negligence” because American Society for Reproductive Medicine guidelines were breached when six embryos were implanted.
Generally only one to two embryos should be transferred via IVF to women under age 35, to a maximum of five for women over 40.
“Transferring six embryos was outside any existing standard,” he said, claiming that his company would not have considered IVF treatment on Suleman at all, due to her back problems and number of existing children.
“There are safe, proven methods for successful single births that significantly reduce the chances of having multiple births,” he said.
I’m sure Perloe isn’t hoping to gain any exposure for his own company from lashing out at another one of his profession, so I won’t link to his web site.
By Andy Merrett
Feb 10, 2009
Having a baby won’t save a bad marriage.
In fact, some couples report reduced satisfaction in the relationship with their partner after starting a family.
That may sound depressing, even fatalistic, but the truth is that parents who plan a family and collaborate with parenting are much less likely to experience this dip. It’s even likely to lead to a happier marriage and better-adjusted children.
Thinking about it for a moment it may seem obvious, but I’m sure there are still plenty of couples teetering along their precarious relationship path that believe that having a child together will improve their marriage.
A New York Times article by Tara Parker-Pope quotes from the most recent studies that point to the time bind facing new parents and the burden on women resulting from increased household work as factors in reducing marital bliss. She holds out hope to her readers by reporting the finding from a 50-year longitudinal study of Mills College women that couples are likely to reconnect once their children leave home.
For parents of young children, that’s a very long time to wait. And it’s not good news for the children either, because children are more likely to have social, emotional, and academic problems when their parents’ marriage is in distress.
Many of these findings on marital distress in the early childrearing years are based on the uncritical use of averages. More in-depth examination reveals that the averages hide considerable variation. Detailed interviews with 96 couples, followed for 6 years after their first babies were born, revealed four different pathways that couples take in deciding to become pregnant and carry the pregnancy to term:
- First are couples who agree about when to begin trying to become pregnant (about half of the sample).
- Then there are the couples who “find themselves pregnant” and decide to “accept fate” and go ahead (about 15%).
- Another set of couples (about 20% of the sample) are still ambivalent when they reach the 7th month of pregnancy.
- Finally, for some couples who are at serious loggerheads about the decision, one spouse agrees to become a parent only because the other threatens to go it alone (about 10%).
The average decline in marital satisfaction was almost completely accounted for by couples who
- slid into having a baby without planning
- were still ambivalent about becoming parents in late pregnancy, or
- disagreed about having a baby but went ahead and conceived without resolving their difference.
About half the planners showed increased marital satisfaction or maintenance of their initially positive level in measurements taken when their babies were about 18 months old. All the couples where one partner had given in (usually the man) were either separated or divorced by the time their first child entered kindergarten.
The study concludes that it’s very unwise to rush into parenthood before both partners are ready. Partners need to start by having a discussion or a series of discussions – by making a decision. If both partners can express both sides of their feelings, it is less likely that one partner will carry all the ambivalence for the couple.
When both partners feel they are part of this major family decision, they are more likely to be able to meet the challenges of balancing the needs of both partners in terms of work and family. All this bodes well for their developing relationship with each other and with their child – and ultimately for their child’s sense of security and well-being.
By Andy Merrett
Oct 17, 2008
Four in five women are concerned about the current method of contraception used for birth control, yet two in five have stayed with their chosen method for five or more years.
That’s according to a new survey carried out in the US by Schering-Plough, which also found that well over half of women using a hormonal contraceptive had increased stress levels when having sex if they’ve not used their birth control product correctly.
Women using birth control say they worry more about their own or their partner’s satisfaction (29%) and body image (24%) than pregnancy (10%) or contracting a sexually-transmitted disease (8%).
Of women aged 18 to 34 who currently use birth control, four in five use contraception primarily to prevent pregnancy. However, 93 percent of women aged 18 to 34 (both on and off birth control) do not know that half of unintended pregnancies in the United States occur with couples that used some method of birth control.
Sixty-two percent of women indicated they discuss birth control with a potential partner. Women of all ages who currently use, or have previously used hormonal contraceptives, reported that a physician’s recommendation was among the top five attributes that are most important to them in choosing a birth control method.
Nearly a quarter of 18-34 year-old women said that a daily method of birth control would be most convenient for them, though 46 percent of women in the same age group who currently use a hormonal contraceptive have more difficulty remembering to use their current method correctly when their daily routine is interrupted.
“The findings from this survey signal that while we may be living at a time when women have many contraceptive options and are empowered to make their own informed decisions, many are either dissatisfied with or have concerns about their method,” says clinical professor of obstetrics and gynecology at Yale University School of Medicine, Dr. Minkin. “Overall, this is a wake-up call for women to evaluate how happy they really are with their current method and recognise that they don’t have to settle for the status quo when it comes to birth control options.”
Men who eat a diet containing even modest amounts of soya products could be adversely affecting their sperm count, according to a recent medical study by scientists in the United States.
Even small amounts of soya products, now frequently used in the Western world as meat and dairy substitutes, as well as popularly used in Eastern cuisines, lowered the sperm count, and those with the highest intake of soya-based food had almost half the level of active sperm in their semen.
Scientists believe that isoflavones, a compound found in soya, mimics the female sex hormone oestrogen, which could therefore explain the reduction in sperm levels.
Soya products which can cause this affect include tofu, tempeh, soy sausages, bacon, burgers and mince, soy milk, cheese, yoghurt, ice cream, and soya-based roasted nuts, drinks, powders, and energy bars.
However, it’s not a cut-and-dried case, because researchers also believe that obesity plays a major factor in determining sperm count. That is probably why Asian men, who will often have a diet rich in soya products, are still fertile – obesity is much less of a problem in Asian countries, whereas in the US and other Western countries it is a serious, and increasing, issue.
(Via Yahoo! News)
“Whether you’re planning to have a baby, are already pregnant, or your new baby has just arrived, our new interactive pregnancy planner is for you,” the site opens.
It’s the perfect way to find out all you need to have a healthy and happy pregnancy and to make sure you get the care that’s right for you. It contains over 250 pages of NHS accredited information, including pictures, videos and planning tools. You’ll also find all the facts you need to choose the best maternity services in your area.
The NHS is no stranger to offering medical advice online, and already runs the NHS Direct health information web site.
The site offers help on pre-pregnancy, pregnancy and labour, parent and baby advice, and general pregnancy information.
Pregnancy can be a huge mystery, and with the Internet’s myriad of information – some accurate and some wholly misleading – on the subject, it’s good to know that a trusted medical organisation is providing comprehensive coverage.