Mar
11
2023

Hormone Imbalance can Impact Health

By | birth control pill, Hormones, Insomnia, irregular periods, lifestyle, mitochondria, sleep, stress

Dr. Erika Schwartz spoke at the 30th Anti-Aging Conference in Las Vegas about “hormone imbalance can impact health”.  The talk was scheduled early in the morning on Dec. 10, 2022. She pointed out that when hormones are in balance people have energy, they sleep well, they have normal sexual functioning and they are fertile. But in contrast, when hormones are not in balance, their weight goes up, they suffer from fatigue, depression, and anxiety. In addition, they often have skin and hair changes, changes in menstrual regularity, acne, infertility and decrease in libido. Finally, they may have problems in building muscle mass, women develop vaginal dryness and men erectile dysfunction. However, people also can develop autoimmune conditions and various cancers.

Symptoms of hormone imbalance at various ages

Teens

Most importantly, acne is an embarrassing, but common symptom. Depression, PMS, mood swings and headaches are also very common. By the same token, weight gain occurs frequently from faulty diets (fast food, lack of vegetables and fruit and sugary soda drinks).

The twenties and thirties

The birth control pill interferes with the normal function of LH and FSH resulting in lack of ovulation and infertility. Other symptoms are bloating, constipation, weight changes, libido changes and postpartum depression.

The forties and fifties

Mood changes and irritability, weight problems, menstrual changes, and changes in sexual desire are typical for this age group.

The sixties and over

Hot flashes are common in this age group, but they can start in women from the age of 50 onwards. Other symptoms are night sweats, insomnia, skin and muscle changes. Many diseases of the aging occur like diabetes, arthritis, cardiovascular disease, dementia, degenerative and autoimmune diseases.

Diagnosis of hormone imbalance

The doctor takes a detailed history about exposure to environmental pollutants, the birth control pill in women and medications. In addition, the doctor wants to know whether the patient consumed meat from animals that were treated with antibiotics. Next the physician inquires about physical changes, symptoms of hirsutism, menstrual

irregularities and infertility. There are three steps to diagnosing hormone imbalances:

  1. Listen to the patient and inquire about the subjects just mentioned.
  2. Order extensive laboratory tests including hormone levels.
  3. Review all of the medications and supplements the patient is taking.

How do hormone imbalances affect our bodies? They affect our mental health, our sleep, brain function, libido, energy, weight, digestion (leaky gut), joints and the immune system.

Two clinical examples about hormone imbalances

Dr. Schwartz gave two clinical examples showing how correction of hormone imbalances led to normalization of the hormone imbalance.

Example 1

A 17-year-old female complained about acne in her face, had no periods, was fatigued and had migraine headaches. She was in senior high school and wanted to look and feel better before graduation. Her periods started at age 12, but were irregular. Her physician started her on the birth control pill at age 14. Within one year she stopped having any periods and also started getting hyperpigmentation in her face. Dr. Schwartz noted that she had no allergies and that she did not take any supplements. She took Estarylla (ethinyl estradiol/ norgestimate), a BCP formulation and Excedrin for migraines. Her ferritin level was 12 (11 to 307 micrograms per liter is normal for women). TSH was 5.16 (normal now 0.5-2.5). This meant she was borderline iron deficient and also mildly hypothyroid.

Diagnosis and treatment plan

Dr. Schwartz diagnosed a hormone imbalance. The treatment schedule consisted of stopping the BCP, start a low dose 30 mg NP thyroid in the morning. In addition, the doctor prescribed adrenal support pills and low-dose iron pills with vitamin C. The doctor also addressed lifestyle and self-awareness issues with the patient. 4 months later she was seen again and had regular periods, no more migraines and she felt more energy. The face pigmentation was gone and she felt great.

Example 2

A 42-year-old woman presented to Dr. Schwartz with psoriatic arthritis, weight gain, problems sleeping, brain fog and irregular periods. Her last menstrual period was 6 months ago. Her doctor had recently placed her on a statin drug and put her on the BCP Mirena. This is a progestagen releasing IUD placed in the uterine cavity, which was given to her in an attempt to regulate her periods. She was divorced and a mother of 3 children. At work she was a business partner in a high stress law firm. Personally, she was trying to date, but has been unsuccessful so far. She would like to lose weight and gain more energy. What she was hoping for was that her doctor address her overall health.

Medication and blood tests

She did not have any allergies. Her medications consisted of Rosuvastatin 10 mg daily and Mirena for the last year. As supplements she took Turmeric. Blood tests showed that her hemoglobin A1C was 5.7, the vitamin D blood level was 17 ng/mL (very low). The TSH level measured 1.29 (in the normal range). Estradiol blood level was in the lower range, progesterone level the same. Finally, her testosterone level was low as well. The other blood tests were all normal.

Diagnosis for this patient and treatment plan

Dr. Schwartz diagnosed hormone imbalance due to natural and environmental factors.

She ordered Mirena to be removed and to stop Rosuvastatin. Instead, she started the patient on vitamin ADK ( a mix of vitamin A, vitamin D and vitamin K)– 5000 IU daily. She also started her on Omega3 1000mg daily. In addition, she discussed a well-balanced diet, regular exercise and sleep issues (7-8 hours every night) with her.

Hormone replacements

As blood tests showed a low estradiol level, she started her on Estrogel, a form of estrogen. She also started her on progesterone tablets (Prometrium) 100 mg at bedtime as well. This keeps progesterone and estrogens balanced. As her testosterone was on the low side, she started her on Testosterone cypionate 100 mg/ml (0.4 cc per injection) intramuscularly once a month. Dr. Schwartz also started adrenal support, 2 capsules in the morning. Further she was told to start 3 capsules of NMN (Nicotinamide Mononucleotide Supplements) daily and 5 units of Semaglutide subcutaneously weekly. The latter medication helps the pancreas to release the right amount of insulin when blood sugar levels are high.

Follow-up at 6 months

The doctor reassessed he patient after 6 months. She had developed increased self-awareness. She lost 30 pounds and she slept for 7.5 hours most nights. Her energy level has increased and she improved her dietary choices. She had started regular work-outs. Overall she was now happier at work and at home with her children. She feels now more like an age of 25, and she has been starting to date.

General remarks about hormone imbalance

When hormones are in balance, we are healthy. Hormones can get out of balance at any age; the examples above involved 17 and 42 year old patients. Keep in mind that it is impossible to have optimal health without balanced hormones. Dr. Schwartz said that the more pieces of the puzzle you address, the more likely you are going to truly help improve quality and quantity of life. Lifestyle factors that must be addressed are:

  • Diet
  • Exercise
  • Stress Management
  • Sleep
  • Breathing
  • Mitochondrial and cellular integrity
Hormone Imbalance can Impact Health

Hormone Imbalance can Impact Health

Conclusion

Hormone imbalances occur frequently when our lifestyle factors are slipping. Often untoward side effects of medication are also contributing to the hormone imbalance. The holistic doctor takes a thorough history, examines and takes blood tests including key hormone tests. When imbalances of hormones are detected, this has to be addressed with supplements and hormone replacements. At the end the hormones balance each other and the patients’ abnormal symptoms disappear. It only takes a few weeks before the patient will feel normal again.

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Dec
23
2017

Birth Control Pill Increases The Risk Of Breast Cancer

By | alcohol, breast cancer, diagnostic X-rays, heart attack, Hormones, Menopause, Stroke

A recent study showed that the birth control pill increases the risk of breast cancer. This publication did research on 1.8 million of women of Denmark who took various forms of contemporary birth control pills (BCP). They were under the age of 50 and the observation of the participants continued for about 11 years.

Risks for breast cancer

When a woman took the BCP for less than one year, the risk of developing breast cancer was 9% higher compared to controls. But this rate increased even more to 38% after the use of the BCP for over 10 years. Women who had used progestin only intrauterine devices had a risk of 21% to develop breast cancer. It did not make a difference whether the BCP was a mix of estrogen and progestin or progestin. Researchers expressed the risk in the following fashion:

  • Less than one-year exposure to BCP: a 1.09-fold risk to develop breast cancer
  • Over 10-years use of BCP: a 1.38% risk to develop breast cancer
  • IUD with progestin in uterus: a 1.21% risk to develop breast cancer

Strokes and Heart attacks from the BCP

At the 86th Annual Meeting of the Endocrine Society in New Orleans/Louisiana a Canadian delegation presented this data. They had done a meta-analysis of 14 trials regarding side effects of the birth control pill (BCP). These women had taken the BCP on a prolonged basis (Ref. 1). The researchers monitored the risk of heart attacks and strokes. They found an association with the prolonged use of the low dose estrogen BCP. Researchers examined all of the studies between 1980 and October of 2002. 14 independent studies qualified for the meta-analysis.

Metaanalysis of BCP caused heart attacks and strokes

The strength of such a meta-analysis lies in the pooling of data and the fact that the data comes from a much larger patient population, which generally makes the results more reliable. Dr. J. Baillargeon from the Centre Hospitalier Universitaire in Sherbrooke, Quebec/Canada, stated that they found a

  • 85-fold risk for developing heart attacks with long-term use of the BCP and at the same time there was a risk of
  • 54-fold of hemorrhagic strokes with long-term use of the low-dose BCP.

It is important that women who contemplate going on the BCP know not only about the dangers of developing breast cancer, but also about the dangers of heart attacks and hemorrhagic strokes.

Lessons learnt from the Women’s Health Initiative

The Women’s Health Initiative in 2002 showed that women who were on Premarin and progestin for hormone replacement in menopause came down with breast cancer, heart attacks, stroke, and thromboembolic events. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127562/

They were using the synthetic hormones, namely conjugated equine estrogen and medroxyprogesterone acetate. The reason these women had to suffer these side effects was because their physicians insisted on using “pure hormones that a drug company had manufactured”. But these synthetic hormones were not pure hormones; they were hormones adulterated with side chains so that pharmaceutical companies could patent them.

Misfit of synthetic hormones with hormone receptors

These side chains made the synthetic hormones not fit the body’s hormone receptors. And this is the reason why the synthetic hormones created chaos in the body with breast cancer, strokes and heart attacks. In essence the mix of conjugated equine estrogen and the medroxyprogesterone were functioning like estrogens. So, there was an overdose of estrogenic hormones when taking these hormones and this use resulted in the development of breast cancer, heart attacks and strokes. The BCP is very similar to these hormones that are in the medication for hormone replacement therapy in menopause, but the hormone dosage in the BCP is much lower.

Other high-risk settings for women taking the BCP

There are other higher risk subpopulations of women who should avoid the BCP:

  • Had 1st degree relative with breast cancer on one breast :5-fold relative risk ; there is a genetic reason for breast cancer here
  • 1st degree relative with breast cancer on both breasts : 9.5-fold relative risk ; genetic risk more obvious.
  • No relative, but patient had history of breast cancer : 4-fold relative risk ;
  • First child born later than 30 years of age : 1.9-fold relative risk ; in comparison with a woman who has her first child prior to age 20
  • If woman consumes 3 oz. of alcohol per day : 2-fold risk; in comparison with woman not using alcohol or BCP
  • Prior radiation for Hodgkin’s disease (age 10 to 19) : 10- to 75-fold risk; radiation exposure during time of breast development leads to an enormous risk ratio about 15 years later

Mechanism of the BCP

The BCP or OC (oral contraception) utilizes the fact that ovulation (=release of a fertile egg) requires a complex interaction between hormones to occur. The gonadotropin hormones LH and FSH from the pituitary gland must stimulate the ovaries. The right mixture of estrogen and progesterone from the ovaries achieves this. Without that proper hormonal interaction ovulation will not take place leading to an infertile cycle. With contraception scientists were able to suppress ovulation for as long as patients are taking the birth control pill regularly. By giving a small amount of estrogen and progesterone like substance (called “progestin”) in the oral contraceptive form (the birth control pill) ovulation stops, the lining of the uterine cavity becomes stable through estrogen, and the mucous plug in the cervical canal thickens, making it much more difficult for sperm to enter.

Estrogen dominance from the BCP

The Women’s Health Initiative has taught physicians a tough lesson: you cannot mess with nature’s hormones or else you create a risk of strokes (41%), heart attacks (29% more), blood clots (twice as many), breast cancer (26% more), colorectal cancer (37% more) and the patient will have a higher risk for Alzheimer’s disease (76% more often). This was a trial involving over 16,000 postmenopausal women.

Although the hormones used in these women were slightly different in concentration, structurally they were very similar to the ones used for birth control purposes. What nature seems to tell us is that you cannot mess with hormone receptors, or you set up the body for one of the diseases mentioned.

Hormonal disruption

The truth is that the combination of  synthetic estrogen-like and progesterone-like substances  in the BCP are not bio-identical hormones. They suppress ovulation, which means they are creating progesterone deficiency in the woman who takes these synthetic hormones. The end result is that physicians create estrogen dominance in these women, which according to Dr. Lee is the reason for the above listed complications (Ref.2).

It makes more sense to use less invasive alternatives for birth control methods instead of the BCP. A well-fitted IUD (inserted by a gynecologist) is a good alternative. This will not create havoc with the woman’s hormones and will not create infertility after contraception is no longer needed. Bio-identical progesterone replacement using creams is being used to rebalance the original hormones when the BCP is discontinued.

Birth Control Pill Increases The Risk Of Breast Cancer

Birth Control Pill Increases The Risk Of Breast Cancer

Conclusion

The birth control pill (BCP) is a popular form of contraception. But there are significant risks of breast cancer, heart attacks and strokes associated with its use. According to the previous literature the risk of complications associated with the BCP was between 1.3- and 1.6-fold. The present study with smaller concentrations of hormones in the more modern BCP still showed a risk of 1.38-fold regarding breast cancer. It did not mention heart attacks and strokes as additional risk factors. The Danish study was supported by a grant from the Novo Nordisk Foundation. Novo Nordisk is a major producer of BCP’s in Europe and in the world. It would be in their interest to minimize the risks associated with the BCP. Any woman using the BCP should use it only as long as she really needs it. Ultimately she would be better advised to use alternatives like IUD’s and condoms.

References

  1. https://www.askdrray.com/birth-control-pill-increases-strokes-and-heart-attacks/
  2. John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. Page 360 to 374 explains xenohormones.

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Nov
12
2016

Stress Drives Our Lives

By | Alzheimer’s disease, Diabetes, headache, heart attack, Heart Disease, Infertility, sleep, Smoking, stress, Stress management, Substance abuse

Every year the American Psychological Association (APA) monitors the American public how stress drives our lives. This yearly report has been compiled since 2007. About 75% of the people questioned reported that they have experienced moderate to high stress over the past month.

Symptoms when stress drives our lives

What kind of symptoms can stress cause? It can cause sleep deprivation, anxiety, headaches and depression. But there can be more symptoms from any disease that stress may cause. The “Stress in America” report from February 2016 shows on page 5 that unhealthy life habits are used by low-income Americans to cope with stress. A bar graph shows that watching television or movies for more than 2 hours per day is common. Another way of coping is to surf the Internet more often, take more naps or sleep longer. Eating more, drinking alcoholic beverages and smoking more are other unhealthy ways to cope with stress.

As the stressed person gains extra weight and eventually becomes obese, there is a higher rate of diabetes that can develop with all of its complications.

Causes of stress in our lives

The “Stress in America” survey was based on 3,068 adults in the US who completed the survey during August 2015. 72% were stressed out about financial issues. 22% of these said that they were extremely stressed in the past month as a result of money concerns. Other common concerns were work, the economy, family responsibilities and concerns about personal health. Average stress levels among Americans decreased when compared to 2007. On a 10-point stress score respondents rated their stress at 4.9 in 2016 compared to 6.2 in 2007. But according to the American Psychological Association this is much higher than a stress rating of 3.7 considered to be a healthy level.

Stress affects people from all walks of life, workers, women, young adults, students and those with lower incomes.

“Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us” Stevan Hobfoll, PhD, a clinical psychologist from Rush University Medical Center said. “So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health…” is what causes stress.

Stress drives our lives causing disease

When stress is too much for our system, we are starting to see pathology develop. “Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease” professor Hobfoll says. The following are common diseases that can result from chronic stress.

Heart attacks and strokes

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for a mean of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There were a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives our lives and causes substance abuse

In order to cope with stress many of us treat daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it puts on extra pounds. As you know it is easier to put weight on than get it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This deteriorates your health outlook.

Diabetes

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition unhealthy eating habits associated with stress can cause weight gain and high blood sugars leading to diabetes.

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had a  elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless.

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least a contributing factor. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to women did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Remedies for stress

Before you can attempt to remedy stress, you must first detect that you are under stress. You can recognize this when you have problems sleeping, you suffer from fatigue, when overeating or undereating is a problem, and if you feel depressed. Others may feel angry or are irritable. Some bad lifestyle habits may also make you aware that you are under stress. You may smoke or drink more in an attempt to manage stress. Some people abuse drugs.

Here are some suggestions how to remedy stress:

  1. Seek support from family, friends or religious organizations. If you engage in drugs or alcohol overuse or you feel suicidal, it is best to seek the advice from a psychiatrist or psychologist.
  2. Engage in regular exercise. This produces endorphins, the natural “feel-good” brain hormone. This reduces symptoms of depression and improves sleep quality.
  3. Do something that increases pleasure, such as having a meal with friends, starting a hobby or watching a good movie.
  4. Positive self-talk: avoid negative thoughts like “I can’t do this”. Instead say to yourself “I will do the best I can”. Psychologists have developed a technique where they teach patients how to turn negatives into positives. Psychologists call this therapy “cognitive therapy”. You may want to seek the advice of a psychologist to have a few cognitive therapy sessions.
  5. Daily relaxation: you may want to use self-hypnosis, tai-chi exercises or meditation to reduce your stress levels.
Stress Drives Our Lives

Stress Drives Our Lives

Conclusion

Stress is very common. Diverse diseases like heart attacks, strokes, diabetes and Alzheimer’s disease can all be caused by stress. It is important to minimize the impact of stress by seeking family support and support from friends. Engaging in regular exercise will release endorphins and make you feel better. Relaxation exercises and seeking counselling can all help you to manage stress. You cannot ignore or simply tolerate this force in your life. Stress is indeed there, but we can make a difference by managing it to avoid that stress manages us.

Sep
21
2013

In Vitro Fertilization As A Last Resort To Get Pregnant

By | Infertility, Women’s Diseases

Since its invention in 1978 there have been 5 million babies born through in vitro fertilization (IVF). According to the World Health Organization there are about 120 to 160 million couples worldwide struggling with infertility problems.

Assisted reproduction technology (a fancy name for artificial insemination) has been helped a lot by the breakthrough discovery in the US with regard to ultrasound identification of mature follicles in the ovaries. The second technical breakthrough, another ultrasound method done trans-vaginally to recover eggs from the identified mature follicles, has also helped the IVF technology (Ref.1).

When all of the cases of infertility in the United States are broken down into what causes them, the following was found (Ref. 2):

20% of cases of infertility were caused by anovulation, about 35% were due to abnormal semen production in the male, 30% by pelvic disease (fibroids, tubal blockage, polycystic ovaries), and 15% of cases were unexplained.

Process of artificial insemination

There are a number of steps that have to be followed to be successful with IVF.

a) Hormonal stimulation of the ovaries: The first step in getting eggs from a woman who desires IFV is to stimulate her ovaries to produce several mature follicles. This is achieved with gonadotropins, which are hormones that lead to ovarian overstimulation. Over the years this has been fine tuned with gonadotropin-releasing hormone (GnRH) analogues given first (stimulating release of LH and FSH from the pituitary gland). Subsequently follicle-stimulating hormone (FSH) is given, which causes the ovaries to produce follicles that can be identified on a TV screen using ultrasound technology. When follicle maturity is established with the ultrasound method, human chorionic gonadotropin can be given to trigger ovulation. However, when this is done and combined with artificial insemination through depositing sperm via a catheter into the uterus, the pregnancy rates judged by today’s standards to be too low (in the order of 15 to 20% per cycle).

b) Harvesting of eggs:

Nowadays the 2 or 3 follicles that have been identified as mature by ultrasound are used for follicular aspiration. With transvaginal sonography and a long needle that comes out from the ultrasound probe, the specialist will be able to harvest the mature eggs from the follicular cysts.

c) In vitro fertilization methods:

There are basically two methods for fertilization. First the standard IVF method is simply to add sperm to the eggs in a Petri dish with growth medium. After spontaneous fertilization the eggs undergo cell division. Compared to this standard IVF the success rates have been found to be higher with a newer method, called intracytoplasmic sperm injection (ICSI). In this case a single sperm is injected through a fine needle into the egg. On the 2nd or 3rd day of in vitro culture with either of these methods of fertilization the embryos consist of 6 to 8 cells. The embryos (typically one or two) are now introduced into the uterus of the mother by the specialist.

In Vitro Fertilization As A Last Resort To Get Pregnant

In Vitro Fertilization As A Last Resort To Get Pregnant

Success rates of in vitro fertilization (IVF)

Approximately 10% of all U.S. couples with women of the reproductive age are infertile, approximately more than 7 million women; the incidence of infertility steadily increases in women after the age of 30. Among fertile couples who have sex during the week before ovulation, about 20% achieve a pregnancy.  If regular unprotected sex does not lead to a pregnancy within one year, the couple is considered infertile (that is the medical definition of infertility). With infertile couples using intrauterine insemination there is a pregnancy success rate of about 8 to 9% per cycle. However, IVF has a success rate of 30% per cycle. The chance of a pregnancy after six cycles of IVF is 72% provided the woman is in close contact with the IVF specialist and follows all of the instructions carefully. If the woman does not adhere to the program (this includes some dropouts), the pregnancy rate for IVF is only 51% in 6 months (Ref.2).

In 2010 the Nobel Prize for Physiology and Medicine went to Bob Edwards for his outstanding work on IVF. His work has improved the success rate for pregnancy of infertile couples significantly.

Costs of in vitro fertilization (IVF)

The conventional IVF cost is about 60,000$ to achieve a successful pregnancy; a newer, simplified IVF version costs only 265$, a method which has been developed for development countries. In the simplified version fertility drugs are given as generic tablets. The pregnancy rate for IVF is about 34% in this study from Belgium involving 100 infertile couples so far with the women being under the age of 36.

Gender selection and genetic abnormalities

Gender selection is highly controversial and is not being practiced. However, there are gender specific genetic abnormalities that can be identified in the 2 to 3 day old embryo after a few in vitro cell divisions. If DNA analysis shows an X-linked abnormality, this genetic abnormality would not be implanted into the womb. An embryo with a normal DNA test would be implanted instead (male or female). There are obvious ethical guidelines that have to be followed and these have been in place for a number of years.

The following overview of IVF contains a mini video showing a single sperm injection into an egg (the intracytoplasmic sperm injection method or ICSI). This is the latest in IVF technology, but also the most expensive option.

Complications with in vitro fertilization (IVF)

A review article in the Journal of Obstetrics and Gynecology in March of 2004 (Ref. 3) compared the complications and outcomes of single baby pregnancies (=singletons) that were either conceived normally (control group of 1.9 million spontaneous singletons) or conceived by IVF (12,283 IVF singletons pooled from 15 studies). Compared to normally conceived babies the group of IVF conceived babies had a perinatal mortality rate, which was 2.2-fold higher, the rate of preterm deliveries was 2.0-fold higher, low birth weight was 1.8-fold higher, a very low birth weight was 2.7-fold more common and the classification of “small for gestational age” based on birth weight was 1.6-fold higher. The medical researchers found a number of reasons for this: compared to normally conceived babies, the rate of IVF conceived babies had a higher rate of placenta previa, early preterm delivery, spontaneous preterm delivery, gestational diabetes, preeclampsia, and neonatal intensive care admissions were also significantly more common.

Other observations

If anovulatory cycles are the reason for infertility, clomiphene treatment can often restore regular menstrual cycles, but according to Ref. 2 there is an 8% risk for multiple gestations (twins, triplets) with a higher infant mortality rate.

For women with tubal obstruction IVF is better than attempting to do tubal reconstruction.

Women with unexplained infertility (no cause found despite thorough investigations) are treated by controlled ovarian stimulation as mentioned above and by inserting semen from the husband into the uterine cavity through a small plastic catheter (intrauterine insemination). With this combination pregnancy success rates of 10% per cycle can be achieved and this should be the first approach to cases of unexplained infertility (Ref.2)

Fibroids in the uterus are from estrogen dominance, so are polycystic ovaries. Replacement of missing progesterone with bioidentical progesterone cream will often shrink or melt the fibroids away, cure the ovaries of polycystic disease and restore fertility (this is not taught in medical schools and will not be told to most women attending fertility clinics). There are countless numbers of women attending fertility clinics needlessly; had they only checked their hormone status with saliva hormone tests and corrected the hormone imbalances with bioidentical hormones.

In vitro fertilization with or without ICSI has a pregnancy success rate of 50% per cycle for women less than 30 years of age. Above the age of 30 these numbers are lower and genetic abnormalities are higher necessitating the more expensive ICSI fertilization method. The pregnancy rate is also directly related to how many embryos are transferred into the womb. Usually 1 or 2 embryos are inserted. Twins are not uncommon with IVF.

Conclusion

In 35 years in vitro fertilization has developed into a sophisticated tool that helps women who previously were considered to be permanently infertile to conceive a normal pregnancy. Despite these technical advances we should not lose sight why infertility is such a problem today. Two main factors come to mind: sexually transmitted diseases can scar up the Fallopian tubes making it impossible for the sperm to reach their goal, the fertile egg. Men can also get scarring of their collecting ducts for the sperm (from epididymitis) from Chlamydia and other VD. Secondly, couples are settling into marriage much later in life, often well beyond their 30th birthday. Ideally a woman should have her first pregnancy between 20 and 25, when she is most fertile. If these things don’t fall into place, there is a cost to IVF and there are the associated risks discussed.

More information on infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

References

1. Adam: Grainger & Allison’s Diagnostic Radiology, 5th ed. © 2008 Churchill Livingstone, CHAPTER 53 – Imaging in Obstetrics and Infertility.

2. Lentz: Comprehensive Gynecology, 6th ed. © 2012 Mosby: Treatment of the causes of infertility.

3. Review article in the Journal of Obstetrics and Gynecology in March of 2004 (March 2004, Volume 103, Issue 3: pages 551-563) examined the complication rates of IVF.

Last edited Nov. 7, 2014

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Feb
01
2007

Lycopene Benefits Backed By Science

By | Cancer, Diabetes, Health, Heart Disease, Nutrition, Osteoporosis

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms “bioflavonoids” and “antioxidants”. Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.
Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the “bad” cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.

Lycopene Benefits Backed By Science

Lycopene Benefits Backed By Science

For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer’s disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe “natural coloring agent” and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

More info about lycopene and prostate cancer: http://nethealthbook.com/news/lycopene-reduces-prostate-cancer-risk/

Reference: The Whitehall-Robins Report, December 2006, Volume 15, No.4

Last edited November 2, 2014

Dec
01
2006

Cinnamon And Multivitamins May Boost Fertility

By | Health, Nutrition, obstetrics, Vitamins and supplements, Women’s Diseases

Prenatal vitamin supplements are the norm, as folic acid has been known to play a role in the prevention of neural tube defect. Generally they are taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard School of Public Health in Boston pointed out, that multivitamin supplementation has its place earlier than just after the pregnancy test has become positive. In one of the largest studies involving 18,000 married pre-menopausal women, regular use of multivitamin supplements were associated with a decrease of infertility. The key is in the regular use. Women who took two multivitamin tablets per week had similar infertility rates as women who did not take supplements at all. Those who took 6 or more multivitamins had a 40% lower risk of anovultation, a condition where no eggs are released by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront in reproductive medicine. One condition known as polycystic ovary syndrome (PCOS) is often a reason for infertility. It is one of the red flags that point to the condition of insulin resistance, and it manifests itself in menstrual irregularity and higher levels of androgens, often showing as increased facial hair. As the metabolism is headed for trouble, diabetes, high blood pressure, high cholesterol and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot study to see if insulin sensitivity in women with PCOS could be improved. Cinnamon, a well-known spice, has been known to have a favorable effect on the insulin response of the body. Researchers found that eight weeks of treatment with cinnamon extract significantly decreased fasting glucose and insulin resistance in women with polycystic ovary syndrome.

Cinnamon And Multivitamins May Boost Fertility

Cinnamon And Multivitamins May Boost Fertility

Dr. Jeff Wang who conducted the study reported that no side effects or adverse reactions were reported throughout the study period. If large-scale prospective studies confirm these findings, then recommending cinnamon as a dietary factor may be a simple, inexpensive lifestyle change that can be easily followed. Reducing insulin resistance is a key to improve the overall health status in patients with PCOS, and it ties in with reproductive health benefits as well.

More information about infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: The Medical Post, November 14, 2006, page 32

Last edited November 2, 2014

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Jun
01
2006

Uterine Artery Embolization Against Fibroids

By | Health, obstetrics, Women’s Diseases

Uterine fibroids are the most common uterine tumors that affect women in North America. At least 25% have the symptoms that point to a diagnosis of fibroids, and as many as 77% may have fibroids that are asymptomatic. Symptoms of fibroids can be a feeling of fullness in the pelvic area, heavy periods and bleeding between the periods resulting in anemia. Infertility and miscarriages can also be a consequence.
About 60% of women with fibroids will undergo surgery, but the trend is moving towards nonsurgical treatment. 40% of fibroid patients will receive uterine artery embolization (UAE).

The advantages are significant, reports Dr. Sanjoy Kundu, a radiologist at Scarborough General Hospital in Toronto. Compared to the less invasive UAE, fibroid surgery has a higher rate of major complications like infection and pulmonary embolism. None of the patients undergoing uterine artery embolization experienced any complications of infection or pulmonary embolism. UAE patients also have shorter hospital stays ranging from 1 to 4 days, whereas surgical patients had hospital stays ranging from 2 to 25 days.

Uterine Artery Embolization Against Fibroids

Uterine Artery Embolization Against Fibroids

Due to these positive findings, 60% of treatments for uterine fibroids at Scarborough General Hospital are now done exclusively with the less invasive procedure, and researchers suggest that UAE for the removal of fibroids should become first-line therapy.

More information about fibroids: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/abnormal-vaginal-bleeding-common-menstrual-abnormalities-2/abnormal-uterine-bleeding/fibroids/

Reference: The Medical Post, April18, 2006, page 16

Last edited Nov. 1, 2014

Feb
01
2006

Lubricants May Suppress Fertility

By | Women’s Diseases

Surprising results from a prospective controlled study of vaginal lubricants were presented at a meeting of the American Society For Reproductive Medicine and the Canadian Fertility And Andrology Society in Montreal.
Four products, FemGlide, Replens, Astroglide and Pre-Seed have been routinely recommended to couples that are trying to get pregnant. Dr. Ashok Agarwal and colleagues from the Cleveland Clinic in Cleveland, Ohio took a closer look at the effects of the four products and their influence on donor sperm. It turned out, that FemGlide, Replens and Astroglide all reduced the sperm motility and integrity. When mixed in vitro (in a test tube) quality and movement of the sperm showed a sharp decline. Activity in untreated sperm amounted to 66%. A presence of only 10% Astroglide led to a rock bottom 2% mobility. The other product, Pre-Seed, did not slow the sperm down.
A second test measured DNA damage in sperm that had been exposed to lubricant solution for four hours. Again, only Pre-Seed had the lowest impact. It showed 7% more chromatin damage than untreated sperm. KY had 10% more damage and FemGlide showed 15% of damaged sperm.

Lubricants May Suppress Fertility

Lubricants May Suppress Fertility

The researchers caution that problem lubricants are likely to cause additional hurdles for couples struggling with infertility, as chances for fertilization decrease with certain lubricants.

More information on infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: Parkhurst Exchange, page 31,Vol.14, Nr.1 January 2006

Last edited October 30, 2014

Jul
01
2003

New In Vitro Fertilization (IVF) Gold Standard Declared

By | Women’s Diseases

At a recent conference in Montreal/Canada about “Measuring Human Embryo Quality” several IVF research groups exchanged the latest on single embryo transfer, which has become the standard for in vitro fertilization. These techniques are important for treating infertile couples.

In the past an in vitro fertilized egg was implanted into the woman’s uterus, but the success rate of a normal pregnancy was extremely low (in the order of 15% to 20%).

Subsequently more than one fertilized egg was implanted to improve the success rate, but this led to twins, triplets and multiple pregnancies with a high complication rate and death due to premature deliveries. Subsequently it was found that the success rate was much higher after a few cell divisions, which were allowed to take place outside the uterus in vitro cultures. Dr. William Schoolcraft (director of the Colorado Centre for Reproductive Medicine at a private clinic in Englewood, Col.) reported that embryos that were cultured for 5 days until the blastocyst stage in vitro are much more stable for implantation.

New In Vitro Fertilization (IVF) Gold Standard Declared

New In Vitro Fertilization (IVF) Gold Standard Declared

For the past 5 to 6 years they and other groups have only employed this technique, which according to him is now the gold standard. Although they were largely still using two embryos for transfer into the uterus for IVF. It has become increasingly clear that the risk of twin pregnancies in these already high risk situations is ranging from 4- to 10-times the risk of a single embryo transferred (singleton) into the uterus. Because of this his group has decided to only do singleton transfers. The other new finding is that it matters tremendously what culture medium is used for incubating the fertilized egg for the 5 day period in culture and what the exact conditions are. They found that for optimal results they have to use two different growth media, the first 3 days a low glucose or glucose free medium that mimics the environment of the fallopian tube. On day 4 and 5 the medium must mimic the environment inside the uterus, which requires it to be rich in amino acids and contain glucose.

An embryologist, Dr. Barry Behr from the Stanford University Medical Centre in California, reported that the same culture medium is not necessarily suitable for all patients, but individualization and close observation of the wellbeing of the embryo and the mother is necessary. To optimize maximum quality of the embryos growth factors may also have to be introduced into the culture medium and further research is going on in this direction.

This report is based on a summary in The Medical Post , June 24, 2003, page 8.

Here is a useful link regarding the topic of infertility: http://www.nethealthbook.com/articles/infertility.php

Last edited December 9, 2012

Feb
01
2003

Coffee — What’s The Scoop…

By | Health, Nutrition, Prevention, Women’s Diseases

In a recent issue of The Medical Post, a weekly news magazine for Canadian Physicians (The Medical Post, Jan. 28, 2003), Dr. Suzan Biali has revisited what is medically known about the effects of coffee on health.

This doctor is a family physician in Vancouver/B.C., but also has a degree in dietetics. Here is a summary in table form of what this medical review found.

Dr. Biali also mentioned the recent publication in the November issue of the Lancet by the Dutch investigators that coffee consumption of more than 7 cups per day would cut diabetes in half.

Summary: It would appear that coffee consumption is better than previously thought of. Most people can benefit from it. But this is a personal preference issue. Some groups of patients should refrain from coffee consumption entirely such as patients with rheumatoid arthritis.

Coffee -- What's The Scoop...

Coffee — What’s The Scoop…

Others such as women in early pregnancy (particularly the first 3 to 4 months) should refrain from it. When infertility is a problem it is wiser to refrain completely from coffee as well. Patients with a tendency to ulcers likely should refrain or cut down the coffee consumption. The majority of the population likely could enjoy a cup of coffee and prevent degenerative neurological diseases (Alzheimers and Parkinsons disease). Some patients with psychiatric illnesses (phobias, anxiety disorders) likely should stay away from coffee as should patients with high blood pressure or heart rhythm irregularities.

Coffee — what’s the scoop?
Effects of coffee on: Comments:
first trimester pregnancy 5 or more cups a day can cause miscarriages
infertility women who drink 250 mg of caffeine per day (5 to 6 cups) experience infertility
no hip fractures a large Minnesota study showed in 2001 that there were NO hip fractures with coffee consumption
calcium in bones despite the rumors otherwise, there is NO link of coffee consumption to calcium loss
rheumatoid arthritis (RA) This is the patient group where osteoporosis has been found to be present with coffee consumption; a Finland study found a 2-fold risk with more than 4 cups per day, and a 15-fold risk with more than 11 cups per day (in RA patients only)
Alzheimers and Parkinsons the cells in the basal ganglia that produce dopamine get stimulated by coffee; this is also the seat of the addiction (though mild) to coffee and the cause for headaches when coffee is suddenly withdrawn. This effect  prevents Alzheimers and Parkinsons, both bad degenerative neurological disorders.
stomach problems anybody with a tendency for stomach ulcers or duodenal ulcers tends
to get worse with coffee. Arabian type coffee is less acidy than South American coffee. Coffee does not cause ulcers, but may stimulate existing acid production and in higher doses may stimulate H.pylori growth.
panic attacks and insomnia more sensitive people tend to feel anxious with a single cup of coffee per day, others can tolerate many cups. When a patient complains about panic attacks or insomnia the physician will likely inquire about how much coffee the person drinks.
high blood pressure long term coffee users show almost no effect on blood pressure, it does not cause high blood pressure. Those with high blood pressure
or a history of a stroke still should refrain from drinking coffee

Last edited December 10, 2012