Advice from the experts
Parenting Hub

Painful period cramps to be a thing of the past

Dysmenorrhea, the technical term for extreme period pain, is a common women’s health issue that impacts up to 20% of women with their menstrual cramping being severe enough to interfere with daily activities, according to the American Academy of Family Physicians. Symptoms typically begin in adolescence and may lead to school and work absenteeism, as well as limitations on social, academic, and sports activities. Since the start of 2020, an innovative South African based pharmaceutical company, 3Sixty Biomedicine, has been searching for treatments to assist females suffering from common but often neglected women’s health issues. 3Sixty Biomedicine’s latest product within the Salome range will hopefully be the answer to most women’s battle with painful menstrual cramping, even those as young as 13 years old. The new Salome Menstrual Pain product was launched and made available to South African consumers on Takealot.com, independent pharmacies nationwide and 3Sixty Biomedicine’s website in July, draws on natural ingredients and includes yarrow (Achillea millefolium) which has antispasmodic, anti-inflammatory & analgesic effects which may provide relief for spasm associated with menstrual periods known as dysmenorrhoea. Primary dysmenorrhoea is defined as painful cramps that occur with menstruation and although estimates of its prevalence vary widely, it is the most common gynecologic problem in women of all ages and races. Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins – hormones that make your uterus contract during menstruation and childbirth. The pain results from the release of these hormones when the lining (endometrium) is sloughing off during your menstrual period. The symptoms of menstrual pain may include lower abdominal or pelvic pain with or without radiation to the back and the pain usually occurs at the onset of menstrual flow and typically lasts 8 to 72 hours. “Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended as the first line treatment for primary dysmenorrhoea. We are delighted to now provide women, from as young as 13 years old, with a safe alternative option to manage painful menstrual cramping that includes natural ingredients and is available in a user-friendly capsule pack online and at pharmacies countrywide. As a business we are passionate about breaking the silence on common women’s health issues. Too often conditions like menstrual cramps, PCOS and heavy menstrual bleeding are often considered taboo and are not spoken about or even treated – leaving millions of women suffering in silence and worse yet – not allowing them to reach their full potential. We want to be part of the solution by not only providing natural remedies that assist women with treating their health issues, but by also offering women educational platforms that connect them to other women and health experts via our social media channels to help #BreaktheSilence and reassure them that they are not alone”, explained 3Sixty Biomedicine’s CEO, Walter Mbatha. For more information about Salome Menstrual Pain and the rest of the Salome range, go to www.3SixtyBioMedicine.co.za  or connect on social media: Facebook: Salome Range  Twitter: @SalomeRange  Instagram: SalomeRange *Sourced information from: https://medbroadcast.com/condition/getcondition/dysmenorrhea#:~:text=Primary%20dysmenorrhea%20is%20thought%20to,off%20during%20your%20menstrual%20period.

August 7, 2020
Parenting Hub

3Sixty Biomedicine rallies to #BreakTheSilence in Women’s Month

This August in a bold effort to stop women suffering in silence from common health issues like infertility, heavy menstrual bleeding and painful menstruation – 3Sixty Biomedicine through their Salome range is shining a spotlight on these conditions and appealing to all South African women and the public to help #BreakTheSilence. While both men and women suffer from various common health conditions, some health issues affect women more frequently and severely. There are also multiple instances where women bear exclusive health concerns, such as breast cancer, cervical cancer, heavy or painful menstruation, menopause, and Polycystic Ovary Syndrome (PCOS). Sadly, some of these health conditions go undiagnosed or are considered too taboo to discuss or find answers to so they are inevitably left untreated.  “30% of women suffer from often painful and debilitating heavy menstrual bleeding, and one in six couples, which equates to about 8 million people in Southern Africa alone, suffer from some form of infertility. The stats alone tell the story of how prolific these health issues are for women, which in most cases severely impacts their lives on an ongoing basis. Add to that cultural myths, unnecessary shame and stigma and now the Covid-19 pandemic adding yet another layer to the already painful secret that many women suffering with these conditions carry around with them in silence. We believe part of the solution to empower these women and potentially change their lives is to make them realise they are not alone and encourage them to reach out to each other and engage with health experts about what treatment options are available to them – like the Salome range,” explained Walter Mbatha.  The #BreakTheSilence campaign being rolled out at the start of Women’s Month in August 2020, includes digital, print and TV content starring real women sharing their stories and struggles. Two free consumer-focused webinars are taking place on the 12th and 13th August 2020 at 8pm with medical expert panelists Dr Sindi van Zyl and Dr Lusanda Shimange-Matsose providing hope to women looking for solutions and advice on infertility and menstruation issues. Salome Fertility was the first of the Salome range to be introduced to the South African market by 3Sixty Biomedicine in early 2020 followed by Salome Heavy Menstrual bleeding and the latest product within the range – Salome Menstrual Pain – only recently launched in late July. The Salome range of products contain natural, plant-based ingredients that are focused on providing treatment to women who suffer from infertility linked to Polycystic Ovary Syndrome (PCOS), heavy menstrual bleeding (Menorrhagia) and menstrual pain or discomfort (Dysmenorrhea). “We are confident that the strategy to launch these ‘first-ever’ products to the SA market meets real consumer needs and addresses a gap in the market. To launch these products at this time positions 3Sixty Biomedicine as leaders when it comes to female health-related issues and demonstrates our commitment as a business to improve livelihoods and improve lives,” concludes Mbatha. The products are available online at Takealot.com, 3Sixty Biomedicine’s website or in all Alpha Pharm outlets and pharmacies nationwide. For more information about the Salome range, go to www.3SixtyBiomedicine.co.za  or connect on social media: Facebook: Salome Range Twitter: @SalomeRange Instagram: SalomeRange

August 7, 2020
Lamelle Pharmaceuticals

Let’s change the conversation around female sexuality this Women’s Month

Did you know that 63% of women over 30 experience some form of sexual discomfort or problem? That’s more than half, or every second woman you see every day. We just don’t realise, because us women internalise so well: What’s wrong with me? All my friends seem fine, so why is it just me? The truth is it’s not just you. It’s you and almost every woman around you. And science is only now beginning to understand how our stressful modern-day lives impact our sexual drive and function.  Fortunately, knowledge is power. This Women’s Month, we can change the conversation about our sexuality. My periods are irregular – is this menopause? Probably only if you’re approaching 50. Menopause is a reality between 45 and 55, but irregular periods can happen long before that – almost at any age. Irregular periods (oligomenorrhea) can happen when your body experiences hormonal imbalances and changes in hormone levels (like when taking contraceptives or falling pregnant). But new research suggests that stress, pollution and environmental damagers trigger a cascade of damage inside the body that has a devastating effect on your sex organs, suppressing your body’s production of the vital sex hormone estrogen. Scientists believe that this is the reason behind more and more women showing symptoms of hormonal changes earlier in life. For the first time in my life, I’m experiencing vaginal dryness and sex is uncomfortable, is this normal? For too many women, yes, it’s becoming very common. Our modern-day lives increasingly expose us to internal and external damagers that create Reactive Oxygen Species and free radicals, which ravage the cells in our bodies (known as oxidative stress). And, worryingly, oxidative stress seems to have a huge impact on the organs that control our sexual drive a function. Oxidative stress depletes the vital vein- and sexual-health compound, nitric oxide, in our bodies, which causes symptoms such as dryness, discomfort, as well as lower sex drive and satisfaction. All of which can put a great deal of stress on you and your relationship. But it needn’t become the norm. We’re finding exciting new ways to counteract the damage. Why are my moods so unpredictable? Mood swings are very common when there are hormonal changes happening inside your body. That’s why we have commonly held beliefs of premenstrual mood swings, and that mood swings indicate approaching menopause. But, again, unpredictable moods don’t necessarily mean menopause. Oxidative stress depleting nitric oxide in your body can cause the type of hormonal changes that lead to mood swings at any age – or at least long before actual menopause. I really battle to “get in the mood” – is there something wrong with me? No, there’s very seldom something “wrong” personally. A decrease in libido/desire is usually a normal psychological (mental) response to the physiological (physical) damage in your organs.  The oxidative stress that’s depleting nitric oxide and causing changes in hormones and sexual drive and function – the stuff that’s causing dryness and discomfort during sex – will often trigger a natural response in your brain to try and avoid the uncomfortable situation. Your brain is very clever, and, if it realises that you feel embarrassed or uncomfortable during intimacy, it will often trick you into avoiding sex in the future. Fortunately, we have exciting new ways to treat both the physical and psychological effects around sexuality. I don’t feel confident and my sex life is dwindling. How can I improve intimacy with my partner? Firstly, this is natural in every relationship. A couple’s physical intimacy doesn’t stay constant during a relationship, it often requires work to maintain beyond the “honeymoon phase”. According to PhD Julie Jones for PsychCentral, building on emotional intimacy is a powerful key: Learn to be curious again. We often become wrapped up in defending our own opinions in relationships, losing our need to understand the other person’s point of view. Actively trying to understand (without giving up your own opinion) creates empathy, which builds intimacy. Jones also says that “surprise generosity” boosts intimacy: Make yourself available in a new or different way. You could offer to do the chore your partner always complains about or offer to go with them to the place/activity you usually skip because it’s not your “thing”. Lastly, be selfish for all the right reasons: Invest in yourself. Remember that your partner was first attracted to you because they saw something different and unique in you. That’s powerful. Nurture it. Take care of yourself. Invest in your wellness, your personal development and your mindfulness. When you’re feeling your best, you bring an important vitality to your relationship.  BOOST SEXUAL HEALTH BY 88% Lamelle Research Laboratories understands how oxidative stress impacts a woman’s sexual drive, desire, function and satisfaction. That’s why we developed a unique and remarkable product that specifically targets the things that impact your sexuality and pleasure. It’s called Lady Prelox. Lady Prelox is an all-natural supplement made with a patented formula that improves sensual pleasure, desire and comfort. The results are everything a woman needs: Lady Prelox is clinically proven to boost sexual function and satisfaction in women between 37 and 45 by 88% within one month (up to 126% in two months). It’s even proven to boost sexual satisfaction in menopausal (45–55) and even post-menopausal (50+) women by 60% and more. “Lady Prelox offers a non-prescription solution to a multi-factorial concern that affects the quality and confidence of many women of all ages” Dr Bradley Wagemaker, Medical Director at Lamelle Research Laboratories So, please remember, this Women’s Month and every day of the year, it’s not just you. There’s a scientific explanation for your tiredness, discomfort and even struggling to get “in the mood”. If you feel you need a little help, all-natural Lady Prelox is available from all leading pharmacies. You can even buy it discreetly from Lamelle’s Pharma Store online at https://lamelle.co.za/pharma-store/ RSP: R500 for 60 capsules. www.lamelle.co.za Tel: 011 465 2264

August 6, 2020
Lamelle Pharmaceuticals

Fertility Facts by Lamelle Research Laboratories

Male infertility refers to the inability of a male to achieve a pregnancy in a fertile female. In humans it accounts for 40-50% of infertility. This is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fertility.

June 24, 2020
Parenting Hub

Infertility: Don’t wait until it’s too late!

Parenthood is undeniably one of the most universally desired goals in adulthood, and most people have life plans that include children. However, not all couples who want a pregnancy will achieve one spontaneously and a proportion will need to seek medical treatment to help resolve underlying fertility problems. It’s therefore understandable that infertility has been recognised as a public health issue worldwide by the World Health Organisation (WHO).  “Infertility is when you cannot get or stay pregnant after trying for at least a year and you are under the age of 35,” says Dr Sulaiman Heylen, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG). One in every four couples in developing countries is affected by infertility, while one in six couples worldwide experience some form of infertility problem at least once during their reproductive lifetime. The current prevalence of infertility lasting for at least 12 months is estimated to affect between 8 to 12% worldwide for women aged 20 to 44. In recent years, the number of couples seeking treatment for infertility has dramatically increased due to factors such as postponement of childbearing in women, development of newer and more successful techniques for infertility treatment, and increasing awareness of available services. This increasing participation in fertility treatment has also raised awareness and inspired investigation into the psychological ramifications of infertility. It can cause stress, depression and anxiety, which is why it is important to know that there are options available for treatment. Age is a key factor “Up to 50% of all patients who visit a fertility centre are 35 or older. We cannot stress enough how important it is for people not to wait too long when they consider having children. Young women need to be aware that there is a slow decline in fertility from their 20s until the age of 35, after which it starts to decrease rapidly until the age of 45,” says Dr Heylen. “It’s extremely important for couples to investigate fertility options and fertility preservation earlier in life, rather than leaving it too late. A woman who is not ready to have a child can choose to freeze her eggs to try to preserve her ability to have a child later,” says Dr Heylen.  It’s estimated that 20 to 30% of infertility cases are explained by physiological causes in men, 20 to 35% by physiological causes in women, and 25 to 40% of cases are because of a problem in both partners. In 10 to 20% no cause is found. Infertility is also associated with lifestyle factors such as smoking, body weight and stress. A woman’s age is one of the most important factors affecting whether she is able to conceive and give birth to a healthy child. This is due to several changes that are a natural part of ageing:  The number and quality of eggs (ovarian reserve) decreases naturally and progressively from the time a woman is born until the time she reaches menopause.  It is not only more difficult to get pregnant (conceive), but miscarriage and chromosomal abnormalities in the child (such as Down syndrome) are more common in older mothers. Fibroids, endometriosis, and tubal disease are more common and can affect fertility. Women who become pregnant at an older age have a higher risk of complications during the pregnancy, such as gestational diabetes and preeclampsia. The decrease in a man’s fertility appears to occur later in life than in a woman’s fertility. In their mid-to-late 40s, men experience changes in their sperm that can cause issues with fertility, and chromosomal or developmental problems with their children. Lifestyle and family history If you have any of the following risk factors, you may also consider seeking advice earlier: Family history (i.e., mother or sister) of early menopause (before age 51) History of cigarette smoking in either partner Previous ovarian surgery Exposure to chemotherapy or radiation to treat cancer in either partner Shortening in the time between periods Skipped or missed periods History of injury to the testicles Exposure to toxic chemicals (certain pesticides or solvents) Pregnancy is a complex process Pregnancy is the result of a process that has many steps. To get pregnant: A woman’s body must release an egg from one of her ovaries (ovulation). A man’s sperm must join with the egg along the way (fertilise). The fertilised egg must go through a fallopian tube toward the uterus. The fertilised egg must attach to the inside of the uterus (implantation). Infertility may result from a problem with any or several of these steps. For the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result. Couples, dependent on the ages of the partners, are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis. “Based on the results of the specific tests, a treatment plan will be made which can include medication, surgery or assisted reproduction,” says Dr Heylen.  Treatment options Not all couples who desire a pregnancy will achieve one spontaneously and some will need medical help to resolve underlying fertility problems. It is now estimated that more than 9 million babies have been born worldwide since the first IVF baby was born in 1978. Most assisted reproductive technology (ART) treatments take place in women aged between 30 and 39. The most common fertilisation technique is ICSI

June 19, 2020
Parenting Hub

Help at hand for moms-to-be with chronic conditions

For parents-to-be and their loved ones, pregnancy is a wonderful, almost magical time, filled with joy and anticipation. For expecting women with chronic conditions though, it can also bring anxiety and discomfort.

March 20, 2020
Parenting Hub

Pregnancy and Gestational Diabetes, What You Need to Know

Pregnancy is one of the most life-altering experiences for a woman. Pregnancy Awareness Week takes place from 10 to 16 February to strengthen pregnancy education and stress the important issues that promote a healthy pregnancy and safe motherhood1. This year Life Healthcare is focusing on educating women about gestational diabetes. Pregnancy can result in various risks for both mother and baby, the most prevalent of these risks is gestational diabetes, a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Pregnancy can affect the way a woman’s body processes sugar due to a high volume of hormones produced by the placenta. These hormones block the body’s ability to produce insulin that moves the sugar from the bloodstream into the body’s cells. “Gestational diabetes is most common from 20 weeks of pregnancy and is rarely diagnosed before this. Identifying the signs and symptoms of gestational diabetes isn’t always easy as they are nonspecific, however, a urine test, which is then followed up with a fasting blood test, can ascertain whether an expectant mother has this condition,” explains Dr Liz Radloff, Obstetrician/Gynaecologist at Life Wilgers Hospital. Risk factors for diabetes include being over the age of 25 years, being overweight, having conditions that cause insulin resistance, such as polycystic ovarian syndrome (PCOS), and having high blood pressure prior to pregnancy. Gestational diabetes can result in various complications for both mother and baby, including a higher than normal birth weight, preterm labour and low blood sugar in the infant2. “Nutrition is critically important for an expectant mother and child and will assist in decreasing the risk of developing gestational diabetes. It is important for pregnant women to adopt a healthy, balanced diet and establish a regular exercise routine that is overseen and approved by their specialist. It is not recommended that women who are overweight attempt to lose weight once they have fallen pregnant. If weight loss is required, consulting with your specialist and a dietician will ensure that this is done safely to minimise the risk of complications,” explains Dr Radloff. Should diet and exercise fail in managing this condition, medication in oral or injectable forms may be necessary to manage high sugar levels. Generally, gestational diabetes clears after birth, however, mothers who have been diagnosed during pregnancy are likely to develop type 2 diabetes later. If a pregnant woman has gestational diabetes, her risk of type 2 diabetes after pregnancy rises. It is therefore recommended that mothers follow the same diet and exercise plan once their babies have been born. It is vital that expectant mothers listen to their bodies to avoid the risk of developing complications such as gestational diabetes. Life Healthcare places great importance on appointing a qualified and skilled healthcare practitioner to assist and monitor development during pregnancy. The correct medical assistance from a certified healthcare provider will ensure both mother and baby are kept healthy and safe during pregnancy. “Gestational diabetes can be a worrying diagnosis for an expectant mother. However, by managing the condition with your obstetrician/gynaecologist and making well-informed decisions related to your diet and exercise, risks can be mitigated, and expectant mothers can look forward to delivering healthy babies,” concludes Dr Radloff. For more information on pregnancy and pregnancy-related symptoms and developments visit our pregnancy guide in the link below: https://www.lifehealthcare.co.za/media/1567/pregnancy-guide-v2.pdf

March 27, 2019
Paarl Dietitians

Coffee: Good or Bad for you?

The health effects of coffee are quite controversial. Depending on who you ask, it is either a super healthy beverage or incredibly harmful. But despite what you may have heard, there are actually plenty of good things to be said about coffee. For example, it is high in antioxidants and linked to a reduced risk of many diseases as well as improved sports performance. Some studies have even shown that coffee drinkers live longer.  The truth is… there are some important negative aspects to coffee as well (although this depends on the individual). Coffee contains caffeine, a stimulant that can cause problems in some people and contribute to anxiety and disrupt sleep.  This newsletter takes a detailed look at coffee and its health effects, examining both the pros and cons. COFFEE: THE FACTS Coffee is one of the most popular drinks worldwide, with around two billion cups being consumed in a day. With Finland drinking more coffee than any other country in the world. Coffee is a major dietary source of caffeine and has received considerable attention regarding health risks and benefits. Caffeine is a chemical compound which acts as a stimulant when consumed. Many of us are aware of the effects of caffeine on our bodies as we try to wake up in the morning, or stay awake at the end of a long day. However, for some individuals, excessive caffeine consumption (more than 2-3 cups of coffee or 200 mg of caffeine per day) can have negative consequences on their bodies including an increased risk of nonfatal myocardial infarction (heart attack). Caffeine metabolism – rate of breaking down caffeine After drinking a cup of coffee, most of the caffeine gets absorbed by the body and circulates for a few hours while slowly degrading in our body. 95% of caffeine is broken down inside the liver using an enzyme called Polymorphic Cytochrome P450 1A2 enzyme (CYP1A2). How long the caffeine stays in the body is measured by the half-life of the substance. The half-life is how long it takes for half of the caffeine ingested to be metabolized or eliminated from the body. In most healthy adults, the half-life of caffeine ranges from 2 to 4 hours. The longer the half-life (or the longer it takes for the caffeine to breakdown) the more severe the caffeine related symptoms. The half-life of caffeine as well as the way you handle caffeine and the intensity of the symptoms depend on a variety of factors such as: The amount of caffeine consumed Liver function What drugs or medications are taken at the time of caffeine intake Levels of enzymes that break down caffeine (polymorphic cytochrome P450 1A2 enzyme) Overall health status Age The majority of the population can handle moderate amounts of caffeine very well (around 400ml or 2 cups of coffee) and can enjoy its health benefits with only a few minor negative effects. However, in some cases the effects of caffeine on the body and health can be more negative than positive. The positive or negative effects of caffeine on health mainly depend on an individual’s genetic predisposition. How we react to caffeine is dependent largely on genetics & varies between individuals. GENES DETERMINE HOW COFFEE AFFECTS YOU Not everyone responds to a single cup of coffee (or other caffeinated beverage) in the same way. Depending on a person’s genetic make-up, he or she might be able to guzzle coffee right before bed or feel wired after just one cup, based on research (Java gene study).   DNA plays a big part in how much coffee we can drink, to the point that some of us should avoid or at least reduce coffee or other caffeinated drinks. There are a number of genes that determine how well we can take a caffeine hit, since they influence the rate of the breaking down of caffeine, sensitivity and tolerance to caffeine and also the rate of breaking down other harmful substances induced in the body by caffeine.  There are a few genes responsible for how efficiently we deal with caffeine in our diet: Gene CYP1A2 (Cytochrome P450 1A2) is responsible for releasing the liver enzyme that determines how quickly our bodies break down caffeine. Gene COMT (Catechol-0-Methyl Transferase) is responsible for making an enzyme which controls the breakdown of stress hormones called catecholamines. Caffeine increases the release of catecholamines.  CYP1A2 There are two variations of the CYP1A2 gene which affect how quickly a person metabolizes caffeine – one that helps metabolize caffeine faster and another that helps metabolize it slower. Those who produce less of this metabolizing enzyme (polymorphic cytochrome P450 1A2) are referred to as SLOW METABOLIZERS and then take longer to rid the body of caffeine, staying longer in the system in higher amounts and making its side effects feel more intense and prolonged. Slow metabolizers are regarded as being caffeine sensitive. These individuals usually feel the effects after drinking one or two coffees. Common caffeine sensitivity symptoms include jitteriness, increased heartbeat, nausea; sweating, dizziness, diarrhea, insomnia, headache. The other variant of the gene causes the liver to metabolize caffeine very quickly – referred to as FAST METABOLIZERS. These individuals metabolize caffeine about four times more quickly than people who are slow metabolizers. COMT The COMT gene has a number of variations – one variation causes low COMT enzyme activity. So the less active the COMT enzyme is, the bigger the concentration of catecholamines.  When caffeine is in high concentrations, there is a further increase in the release of catecholamines. High amounts of catecholamines increases the probability of damage to cells in the heart muscle resulting in an increased risk of a heart attack.  The risk of a heart attack grows if you are a slow metabolizer and have low COMT activity. SLOW CAFFEINE METABOLIZERS Slow metabolizers are caffeine sensitive, thus frequent coffee consumption are associated with health risks. The increased disease risk may be due to the fact that caffeine hangs around longer in a slow metabolizer, it has

August 1, 2018
Mandy Rodrigues

Combating Stress and Taking Control of Your Fertility

In a fast paced world where people are constantly chasing time, deadlines, and are driven by the need to succeed, high levels of stress are common place. Medical research has shown time and again that chronic stress can have a negative impact on long-term health, but the implications on fertility and the ability to conceive are lesser known. However, recent literature and medical studies have shown that the reduction of stress can account for higher pregnancy rates. This is according to Mandy Rodrigues, a clinical psychologist specialising in fertility management at Medfem Clinic. Rodrigues suggests that the link between stress and fertility is multi-faceted. “Not only does stress inhibit the ability to conceive, but the constant disappointment of not being able to conceive compounds an individual or a couple’s stress levels,” says Rodrigues. “We know that stress has a direct impact on our physical health, which in turn has an impact on our fertility as well as the outcome of treatment,” adds Rodrigues. “We address a very specific type of stress called ‘Time Urgency Perfectionism Stress’. In simple terms this describes a person that is a perfectionist, is constantly chasing deadlines, and is experiencing exceptionally high levels of stress.” Dr Antonio Rodrigues, a fertility specialist at Medfem Clinic, adds that when an individual is continuously stressed, they secrete hormones that inhibit normal immune function and constrict the blood vessels, which in turn affects the body’s ability to conceive. “We recognised the link between stress and infertility about 14 years ago when we were seeing several patients that had a similar personality type,” he says. “Not only were these people extremely hard working, driven and self-confessed perfectionists, they also had other symptoms of stress including irritable bowel syndrome, spastic colon and chronic fatigue.” He explains that there is also a physiological cause, and that many of these patients tend to experience insomnia, bouts of depression, and a feeling of being out of control. Mandy Rodrigues says that there is also a difference between good stress and bad stress. “Most people are worried about normal daily challenges such as the economic situation and crime, but when it comes to the inability to conceive, we are talking specifically about people that are chronically stressed on a day-to-day basis,” she says. Studies have shown that the link between stress and infertility is quite significant with at least 30% of women being affected. Therefore, according to Mandy Rodrigues, not managing your stress might give you the same results as the next person, but managing your stress will give you a better than average chance of falling pregnant. “If we can encourage individuals to manage their stress their chances of falling pregnant are much higher.” Therefore managing stress is a definite component to treating infertility. “Changing your lifestyle is critical,” says Dr Antonio Rodrigues. “It not only increases your likelihood of falling pregnant but increases your longevity.” He explains that the same people who experience fertility problems during their 20s or 30s will have a higher risk of diabetes, conarary heart disease and cancer later on in life. “It’s all about eating properly, maintaining a moderate lifestyle, taking nutrients and managing your stress,” he adds. Another contributing factor is the stress of actually undergoing the treatment for infertility. “Recently published literature has indicated that the emotional reactions and consequences of infertility can be compared to those experienced in a post traumatic stress reaction,” says Mandy Rodrigues. “The woman or couple will experience a constant grieving cycle each month with reactions like shock, disbelief, bargaining, anger and depression. However, instead of acceptance, the couple faces a new cycle of hope again as the next cycle of treatment begins,” she says. “The causes of infertility and the processes one undergoes in diagnosing and subsequently treating infertility, have their own emotional and financial consequences for the individual and the couple. All of these have an impact on the individual and may result in depression, anxiety, helplessness and isolation.” An important suggestion for couples that are thinking of starting a family is to have a fertility plan, which maps out the stages in your treatment plan as well as possible options or reactions after each step has taken place. “This has an important psychological impact, because when people know what to expect, and they have a back-up plan, it offers them peace of mind,” says Dr Antonio Rodrigues, adding that this will also help to manage stress, and in turn promotes better results. “We conducted a study where the pregnancy rates for in vitro fertilisation in individuals that were properly managing their stress and these went up by 40%. The overall pregnancy rate in couples managing their stress was increased to 67% per cycle,” he says. Stress management really changes lives, not just in terms of treating infertility, but by actually creating long-term benefits. “We have had the opportunity to bump into some of patients whom we treated 10 years ago and it’s clear that effective stress management has actually improved their overall long-term quality of life,” concludes Mandy Rodrigues

March 26, 2017
Parenting Hub

What is Klinefelters syndrome?

Klinefelters syndrome (KS) is not as rare as one may think, it is not life threatening but has life altering consequences. About one in 500 boys are born with an extra X chromosome, this affects learning, behaviour and growth. This was identified in 1942 by Dr Harry Klinefelter who was working with male patients at a hospital in Boston Massachusetts.  This is a genetic condition where a male baby is born with 1 extra X chromosome. This due to an error in meiosis at conception known as meiotic nondisjunction. The condition is also known as XXY.  Normal boys are XY while girls are XX. The KS baby develops an abnormal pituitary gland and hypothalamus part of the brain. Klinefelter syndrome is a random disorder and it is not hereditary. It appears that its occurrence may be linked to the age of either parent. It is not more prevalent in any specific race .This is the most common sex chromosome disorder. According to research done in Australia only about 20-30% of males with KS are ever diagnosed, partly due to the hesitancy of men to seek medical attention and the somewhat non-specific nature of the symptoms. Often men only find out they are KS when they present with fertility issues.  They are almost always sterile. Unfortunately there is little awareness about the syndrome, even amongst health professionals, which often sends parents on a diagnostic odyssey trying to find out why their boys are different and the underlying cause remains unidentified. Another difficulty with it is that the symptoms are highly variable, sometimes subtle and sometimes not present at all. Only about 35% present with stereotypical symptoms but up to 80% have learning difficulties and behavioural issues. Many will have developmental delays and trouble with their muscles (low muscle tone) and motor skills. Dyslexia, reading difficulties and data retrieval problems are common. A large percentage are attention deficit (ADD) While their intellect is not compromised, their verbal IQ is below average, they often have difficulty expressing themselves. This often leads to frustration and angry outbursts.  It is unclear whether some behavioural difficulties are directly caused by the syndrome or are exacerbated by early speech and learning difficulties. KS in very young boys is especially difficult to recognise and only at puberty do some of the more obvious signs begin to show. The physical characteristic common to all KS males is that they have very small underdeveloped testicles.  It is because of this that they cannot produce enough testosterone to produce sperm. This androgen masculinising hormone is also responsible for producing secondary sexual characteristics. Other more common signs are: They are often somewhat taller than genetically expected, their limbs are slightly proportionately longer. They often have knock knees (genu valgum) and high arches (pes cavus). Taurodontism (Large molar teeth with thin enamel) is common. They will have more feminine fat distribution and rudimentary breast development, (gynecomastia) high pitched voice and sparse hair.  They usually have “softer more girlish faces and are generally more sensitive than most boys, they tend to be emotional and cry easily. 33% of KS males experience psychosocial issues particularly shyness and low self-esteem. KS men also have added complications whereby they have a predisposition to developing diabetes, osteopenia and osteoporosis It must be noted however that Klinefelter syndrome does not affect sexual orientation. When correctly  treated with supplemental testosterone KS men can have normal sexual relations in adulthood. If you suspect your son may be KS you will need to consult a geneticist. They will probably request blood tests which will include a karyotype.  An endochrinologist will monitor further treatment. Klinefelters syndrome symptoms can be mitigated by correct intervention. Testosterone supplementation must continue throughout life.  This can be administered by injection or with creams or a patch. If KS is identified early there is a better chance of normal development. A thorough psychoeducational examination will need to be conducted to determine what educational interventions are required as KS boys need assistance with the learning issues most of them have.  A speech therapist can assist them and occupational therapy is recommended. Many KS boys also have motor dyspraxia. While this all may seem alarming particularly that the syndrome is so relatively common yet somewhat unrecognised there are some positives. These are wonderful sensitive human beings. They can be encouraged that they are usually taller than average, tend to keep their youthful looks, have better intuition and emotional skills than most men and usually get on really well with women. Further reading : www.xxy47.co.za www.andrologyaustralia.org www.checkyourballs.com.au www.csvxy.org   Plus information taken from:  Lawley pharmaceuticals  KS info brochure 2016 Amy  Herlihy BSc, Grad Dip Genetic counselling : Thesis 2010  Exploration of prevalence and psychosocial aspects of KS in the context of population based genetic screening.

November 22, 2016
Paarl Dietitians

Weight, Fertility and Pregnancy

Getting your body ready for baby-making isn’t only about tossing your birth control and charting your ovulation. It’s also about laying the nutritional foundation for healthy baby building. Begin your eating-well campaign even before you conceive (technically these are your first weeks of pregnancy) and you’ll be doing yourself (and your soon-to-be embryo) a favour. Begin making healthy changes 3 months to a year before you conceive. Evidence shows that healthy nutrition and fertility is linked in both men and women. The ultimate goal is a healthy pregnancy, and this depends upon good quality eggs and sperm. There is increasing evidence to show that diet and lifestyle can directly impact on your fertility health not only for conception but also for your baby’s development. When it comes to getting pregnant, the old adage “you are what you eat” rings true. What you eat affects everything from your blood to your cells to your hormones. WEIGHT AND FERTILITY If you’re trying to get pregnant, or intend to start trying, know that weight can affect your chances of conceiving and having a healthy baby. Twelve percent of all infertility cases are a result of a woman either weighing too little or too much. Women who are overweight or obese have less chance of getting pregnant overall. They are also more likely than women of healthy weight to take more than a year to get pregnant. Research has shown that being underweight or being overweight and obese can lead to fertility problems by creating hormonal disturbances. The main ingredient in the body weight and fertility mix is oestrogen (a sex hormone produced in fat cells). A woman with too little body fat can’t produce enough oestrogen and her reproductive cycle begins to shut down. Often causes irregular menstrual cycles and may cause ovulation to stop altogether. If a woman has too much body fat, the body produces too much oestrogen and may also lead to irregular menstrual cycles and ovulation. However, even obese women with normal ovulation cycles have lower pregnancy rates than normal weight women, so ovulation isn’t the only issue. Research indicated that weight also impacts on the success of donor egg cycles. There is good scientific evidence that obesity lowers the success rates of in vitro fertilisation (IVF). Studies have further shown lower pregnancy rates and higher miscarriage rates in obese women. How do I know if I am a good weight for pregnancy? One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI).  A BMI between 19 and 24 is considered normal; less than 18.5 is considered underweight. A BMI between 25 and 29 is considered overweight and greater than 30 places you in the category of obese. Reporting in the journal Human Reproduction, researchers documented a 4% decrease in conception odds for every point in BMI above 30. For women whose BMI was higher than 35, there was up to a 43% overall decrease in the ability to conceive. Your BMI alone is not the only thing to watch, however. Your body fat percentage and waist circumference is also important. Bottom line: you need a certain amount of fat to conceive since body fat produce oestrogen. Waist circumference is an indication of visceral fat (excess of body fat in the abdomen). A waist circumference >88cm in a women and >102cm in a man is associated with reduced fertility, an increased risk for insulin resistance (associated with PCOS in women) and other chronic diseases such as diabetes, heart disease and high blood pressure. Are there fertility problems in men with obesity? Obesity in men may be associated with changes in testosterone levels and other hormones important for reproduction. Low sperm counts and low sperm motility (movement) have been found more often in overweight and obese men than in normal-weight men. How much weight should one lose? Even a small 3-5% weight loss can reduce insulin resistance by 40-60% and improve fertility. How quickly will I lose or gain weight? Healthy weight gain or loss is regarded as 500g to 1kg per week. It is therefore gradual and one can expect that six months will be required to restore normal reproductive function and pregnancy. IMPORTANT: Avoid going on fad diets, which can deplete your body of the nutrients it needs for pregnancy and find a weight-loss plan that works for you by talking to a registered dietitian. EXCESS WEIGHT AND PREGNANCY If a woman is obese when falling pregnant, it increases the risk of pregnancy complications and health problems for the baby. Obese women are at an increased risk for developing pregnancy-induced (gestational) diabetes and high blood pressure (pre-eclampsia). The risk of pre-eclampsia doubles in overweight women and triples in obese women. Overweight women have twice the risk of gestational (pregnancy-related) diabetes and obese women eight times the risk, compared with women of healthy weight. A woman who is obese is more than twice as likely to have a miscarriage as a woman of healthy weight. Sadly, there is twice the risk that her baby will not survive. Infants born to obese women are more likely to be large for their age and therefore have a higher chance of delivering by caesarean section. Afterwards the baby may need neonatal intensive care or have a congenital abnormality. Recovery following birth is also more problematic and there is the increased risk of poor wound healing and possible infections. WHAT TO DO? Eating a healthy and balanced diet is crucial when preparing to conceive or you are already pregnant. A balanced diet is one that is rich in good quality protein, low in Glycaemic Index (GI), low in sugar, salt, caffeine and industrially created trans-fats (trans-fatty acids or partially hydrogenated oil). Make clever Protein choices – choose lean protein. Rethink refined carbs and sugar – choose low glycaemic index (GI) carbohydrates and also limit your total daily carbohydrate intake based on your specific metabolic rate. This is especially important if you

April 4, 2016
Parenting Hub

Nutritional Deficiencies: Know the Signs


You might think nutrient deficiencies are a thing of the past, reserved for sailors trapped at sea. But even today, it’s possible to lack some of the essential nutrients your body needs to function optimally. Nutrient deficiencies alter bodily functions and processes such as water balance, enzyme function, nerve signalling, digestion and metabolism. Resolving deficiencies is important for optimal growth, development and function. Nutrient deficiencies can also lead to other diseases. For example, calcium and vitamin D deficiencies can cause osteopenia or osteoporosis, two conditions marked by brittle bones and inadequate iron can cause anaemia, which zaps your energy. Tell-tale symptoms are usually the first clue that you might be low in one or more important vitamins or minerals. In this newsletter we’ll try to help you detect nutritional deficiencies since knowing what to look for is part of the battle. Who is most at risk of nutrient deficiencies? A healthy diet can provide all a growing body needs, but the reality of our busy lifestyles and sometimes finicky eating habits can lead to a nutrient deficiency. Even if you do eat well, other factors – such as your age, lifestyle and certain health conditions (digestive issues e.g. Coeliac Disease) – can impact your body’s ability to absorb the nutrients in your food. Nutrient requirements are also increased during different stages of the lifecycle when the body calls for additional vitamins and minerals. Teenagers Rapid growth during adolescence requires extra nutrients to provide in the baby’s increased demands. These increased needs, coupled with dysfunctional eating or poor eating habits due to peer pressure, erratic eating times and increased activity levels, make adolescents the ideal candidates for supplementation. Elderly  The aging process may increase the need for some nutrients due to the fact that the elderly do not always eat enough of the right kinds of food or that the body is no longer able to absorb nutrients effectively. Elderly are very often at risk of developing zinc deficiency. Smoking Even moderate smoking can reduce the body’s vitamin C level significantly. Should one smoke in excess of 20 cigarettes per day vitamin C levels can be reduced by as much as 40%. Alcohol  Excessive alcohol intake will not only enable you to dance naked on table tops at parties, but can also interfere with the body’s ability to absorb B complex vitamins such as thiamine. Exercise programmes Intensive exercise regimes may increase the need for anti-oxidants, B-vitamins and protein. When a weight reducing diet is combined with an increase in exercise levels, nutrient needs are increased even more, especially that of the B complex vitamins. Stress – Living in the fast lane Busy lifestyle as well as high stress levels can increase your body’s demand for certain nutrients and if not met can cause nutritional deficiencies. Restricted diets Individuals that avoid certain foods like in the case of food allergies or intolerances or have dietary restrictions for example vegetarians may miss out on essential nutrients. Vegetarians are especially at risk of developing vitamin B12, zinc, iron or calcium deficiency. Weight loss programmes Individuals who are often on weight-reducing diets may find it difficult to meet the recommended level of nutrient intake for their age.  This is especially the case if you eat less than 1600kcal a day – placing you at risk of nutrient deficiencies. Most weight loss plans are less than the above-mentioned number of calories and therefore warrant the use of nutritional supplements such as a multi-vitamin/mineral supplement. Medication Certain medications interfere with the absorption of nutrients e.g. long term Metformin usage (seen in Type 2 Diabetics, Insulin resistance and PCOS) increases the risk of vitamin B12 deficiency. Regular measurements of vitamin B12 blood levels during long term treatment should preferably performed to detect possible deficiency. Women using oral contraceptive agents (the pill) could experience low levels of several vitamins – especially vitamin B2, niacin, vitamin B6, folic acid and vitamin C. Laxatives can reduce the absorption of fat-soluble vitamin A, D and E. Meanwhile, soil quality, storage time and processing can significantly influence the levels of certain nutrients in your food, such that even healthy produce may not be as nutrient-rich as you may think. Know the signs: Nutrient deficiencies can be sneaky, unless you are seriously deficient for some time, you may notice no symptoms at all, leading you to believe (falsely) that your body is getting all the nutrition you need. Thankfully our body gives us small warning signs, helping us figure out what nutrients we might be missing out on. Eye, hair, nail, mouth and skin symptoms are among the early outward warning signs of vitamin and mineral deficiencies. Here’s how to recognise common nutrient deficiencies. Hands If you tend to have very cold hands it may indicate magnesium deficiency or perhaps could be a symptom related to hypothyroidism or chronic fatigue. Nails If you have small white spots in your nails it may indicate the deficiency of minerals but more often, it indicates zinc deficiency. A zinc deficiency is also indicated by longitudinal ridges on the nails. While transverse ridges could be indicative of a protein deficiency. If your nails are soft or brittle it is a possible sign of magnesium deficiency. Interestingly, if you bite your nails it is usually because your body is low in minerals. Hair Coarse, dry and brittle hair is often caused by  zinc and/or vitamin A deficiency. While dandruff could be due to a deficiency in vitamins B2, B6, zinc, magnesium, biotin. Greying of the hair is usually a sign of the times but it can also be exacerbated by a deficiency in folic acid, pantothenic acid, biotin and minerals. Hair loss can be caused by a lack of protein, zinc, vitamin B6, selenium, biotin. Skin Dry skin in general is caused by a deficiency of vitamins A, C and essential fatty acids. If you have B-vitamin deficiency, your skin on your face and sides of the nose will be greasy red scaly. Seborrheic dermatitis around your

October 8, 2015
Maz -Caffeine and Fairydust

The Artificial Road To A Miracle Baby – An Inspiring Journey

I heard about Kerry and Michelle’s story through a mutual friend. Something about their story broke my heart and warmed it at the same time. I think sometimes we take for granted how easy the road to pregnancy for some of us are, without sparing a thought for those around us who might not be so lucky.  Kerry and Michelle are a wonderful couple from Cape Town going through a journey of a lifetime and I hope we can all spare them a thought and send amazing positive vibes their way. I find their strength and positivity so inspiring. This is their story as told by Kerry… In September 2013 we decided that we would start trying for our first baby. We got started right away deciding that Kerry would be the one to carry the baby and we would find an anonymous donor at the Cape Fertility Clinic. We started off with saving for the procedure and taking all of the required vitamins, healthy dieting and no drinking or smoking to get Kerry’s body in tip top shape. We managed to get our first appointment with Dr Heylen at the Cape Fertility Clinic in late January 2014 after being bumped up the waiting list. The initial check up was perfect and we were all set for our first Artificial Insemination (AI) in early February. Unfortunately for the first time in her life, probably due to a lot of stress (we had a car accident that week), Kerry did not ovulate and the procedure was cancelled. We started on Clomid which could only be found at Wynberg Pharmacy. It made Kerry very moody and caused terrible hot flushes- we were optimistic that all would go well the second time around. After four failed inseminations – all with two to three beautiful follicles and a perfect uterus lining, Dr Heylenwas not happy and suggested surgery to see what was happening… The surgery (Laparoscopy & Hysteroscopy) was scheduled at Kingsbury Hospital in June 2014. Dr Heylen is one of the very best fertility surgeons in Cape Town and he assured us that any problems he found, he would be able to fix and we would have our baby. He made us feel very confident… Unfortunately we found that Kerry’s Fallopian tubes were completely closed at the base. It was very likely that she was born with this, as there was no damage at all. This is something neither Dr Heylen or his staff had ever seen. It was pointless to fix and our best option would be IVF. We did an follow-up Hysteroscopy to see how severe the blockage was and where exactly it was located. This showed that there was 0% possibility of natural conception as all of the contrast fell out and nothing went into the Fallopian tubes. At this point we had put in about six months,  R36 000 and many emotions – still no good news. We were understandably very desperate at this stage. The IVF journey was not easy at all, we completely understand why Dr Heylen started us off on AI. The procedure cost about R42 000 and was a very painful and time-consuming process. It consisted of three painful and complicated injections daily, many vaginal scans checking the follicle growth and an extremely painful egg retrieval procedure (by far the worst part as it was very painful and Kerry could only take Panado). The egg retrieval went very well and we retrieved eight perfect eggs, seven fertilized and made it to a perfect five-day embryo. On day five we put back two of the perfect five-day embryos with the hopes of a twin or singleton pregnancy. The procedure was perfect and Dr Heylen confirmed that at most we would have was twins, but more likely a singleton. We asked what the odds of having triplets were with the two embryos and he said it was literally none, he had never seen it in the decades he has been a fertility doctor and the odds were radically against this ever happening. The two week wait began again… This time slightly shortened as we were already five days in. On 27 July 2014 we did a sneaky home pregnancy test two days early, we promised we wouldn’t as we have done so many and each time we have been utterly devastated- but this time we came back with a positive result! We were over the moon, but still nervous in case it was a chemical pregnancy. On 29 July 2014 we did the blood test and got a BHCG of 167, quite high for this stage and from here we were already suspecting that we were going to have twins. The follow up test on 1 October 2014 gave us a result of 654, which was again quite high and showed all was going well. All we had to do now was wait for the first scan at 5-6 weeks. The 2-week wait was agonizing as we couldn’t wait to see our baby and confirm if it was twins or not. This was also quite an adjustment period for us as we had expected some morning sickness and other pregnancy symptoms but not to such an severe extent. Kerry was sick every morning and evening and nauseous all day. She was losing weight rather than gaining and her belly and breasts were growing rapidly. The 6-week scan finally came and we got the extremely wonderful news that we were indeed expecting twins! Everything looked perfect – size, heartbeats and placement… we were so excited! We had confirmation that there were just two fetuses and everything was perfect as there was no chance they could split now. Another long three week wait for the final follow up scan with Dr Heylen at nine weeks was too much to handle and Michelle moved the appointment from Monday 6 October to Friday 3 October. It was at this appointment that everything changed and the pregnancy went from happy and exiting to absolutely terrifying. Dr Heylen told us that one of the embryo’s must have split shortly after implantation and as they are so small it was missed on the first scan. We now had triplets, two identical (Monochorionic-Diamniotic) and one fraternal. There was a brief moment of excitement where we were thinking ‘Wow! we have three babies!!’ but that was over as soon as Dr Heylen started talking. He explained that identical Monochorionic-Diamniotic twins by themselves is very complicated and dangerous as they share a placenta and they can get a condition called Twin To Twin Transfer Syndrome. This is

January 13, 2015
Parenting Hub

Having a Baby After Cancer

While having a baby after cancer is generally considered to be safe, there are special circumstances that can make it necessary for some couples to plan their pregnancies in advance. Along with other, more typical factors that can frustrate your attempts to become pregnant, common cancer treatments such as partial or total removal of the cervix, radiation therapy to the entire abdomen, radiation therapy for the testicles or uterus, and anthracycline chemotherapy can all play roles in determining how difficult conception and childbirth will ultimately be. Just what role those effects will play may depend on the age of the patient, but even if the treatments don’t cause permanent damage, it can still take years to fully recover. Fortunately, if you want to make sure you can still have a baby after cancer regardless of how the treatment affects you, modern technology has ensured that there are some excellent options that you can pursue in order to improve your chances of success. The Mandatory Waiting Period – Although there are no firmly established guidelines for exactly how long you should wait after your last cancer treatment to have a baby, it is usually recommended that women wait at least six months. During this time, any eggs that have been negatively affected by the cancer treatment are likely to leave the body. For both men and women, however, it is believed best to wait between two and five years before attempting to conceive. While there is no denying that this can be a heartbreakingly long time to parents eager to have a child, this broad estimate—starting from the time that all of the required treatments are received by the patient to the time when the patient tries to have a child—reflects just how difficult it can be for doctors to reliably assess the likelihood of the cancer recurring as well as for the patient to recover his or her previous reproductive virility. Getting Started – After a rough battle with any chronic illness, and especially after experiencing the terror of learning you have cancer, few things can be more uplifting than the anticipation and joy of childbirth. Yet, there are two risks that a woman should consider prior to conceiving: 1) what is her risk of cancer recurrence and 2) what is the risk of pregnancy increasing the chances of the cancer coming back? The latter is especially important for women who have hormonally driven cancers or cancers that require prolonged oral therapy. Fortunately, there are several options that will help any woman who has had cancer—even ones with the aforementioned risks—achieve the joy of parenthood. A cryobank is often the ideal solution for couples who are eager to get started on building their families right away. Both short and long-term embryo storage is available through cryobanks, as are egg and sperm banking services. Since the deposited sperm or eggs remain unaffected by the cancer treatments, aspiring parents can plan in advance for their pregnancies, whether choosing to wait until a full five years have passed or to proceed immediately after treatment. When sperm and eggs are collected prior to treatments, there is no fear of having them being negatively impacted. Ideally, when the sperm and eggs are collected prior to treatment, they would be collected as embryos versus as separate eggs and sperm. The reason this is ideal is because frozen embryos have a 15% to 30% improved chance of resulting in a healthy birth than that of frozen eggs or frozen sperm. If it is possible for couples to freeze embryos, then it is highly recommended that they do so instead of just banking frozen eggs and sperm. This extends even to women who may still be single prior to treatment, but know they want children in the future that are biologically theirs. They can freeze their eggs or even freeze embryos using a donor’s sperm for the future. While many couples will be able to conceive after freezing their embryos, not every couple is as fortunate. Yet, there are still options for them.  Couples who find that they cannot conceive after going through cancer treatment can seek out a surrogate to carry their child for them. It is important to note that couples seeking a surrogate should do careful research into the laws of surrogacy and the associated costs, which can be significant. Usually the couple is expected to cover the medical, legal and other reasonable expenses for the surrogate, which might include monetary compensation. It is recommended to pursue surrogacy through either an agency or through a lawyer to help the biological parents know their rights and keep the process as smooth as possible. Risk of the Child Having Cancer – Currently there is no evidence suggesting that a cancer diagnosis in the parent increases your child’s risk of getting cancer. The only time this should be a worry is if your cancer is genetically linked. If it is, then it is strongly recommended you meet with your doctor or a genetic counsellor to better understand your risk of passing those specific genes to your child. Yet even in these situations, there are still options.  For example, if you use in vitro fertilisation as your avenue to pregnancy, then you can screen your embryos for the cancer-causing gene to make sure you will not pass it on. When the unexpected occurs in life, people often have no choice but to make the best of what they are dealing with. Looking ahead to the creation of a healthy family unit is often a great way to promote positive emotions during a trying time. Fertility preservation can eliminate fears and reservations concerning some of the latest and more aggressive treatments, thereby supplying cancer patients with lasting peace of mind. Of all the many uncertainties that cancer survivors must wrestle with, the fear of not being able to produce or bear children should not be one of them.

November 26, 2013
Mandy Rodrigues

Myths About Infertility

Infertility is a universal problem that impacts many people across the world.  It is also a growing problem in spite of medical science developing new methods daily for improving treatment.  There are some common myths, shared by men and women alike about infertility.  These myths seem to transgress cultural boundaries, and appear to be universal. Myth 1: Infertility is a female problem While this belief is widely held, it has no factual basis.  One too easily assumes that infertility is a female problem.  However, in nearly a third of all infertility cases, a male factor is the main cause.  The most well-known causes of male infertility include: damage to the testicals from infections like mumps, failure of the testicles to properly descend, damage caused by chemotherapy and radiation, or the loss of a testicle due to torsion or trauma. In some instances, men are actually born without the vas deferens tube which carries the sperm from the testes. Myth 2: Once a woman adopts a child, she will conceive There are cases where one reads of woman adopting and then conceiving themselves.  However, this only occurs in about 5% of people who adopt, and this is not reason enough for one to adopt.  We are not sure why this happens, but it could be that the couple achieves a peace of mind about the process of infertility; and this causes a corresponding physical reaction in the body which makes one less prone to the stress related to infertility. This relationship is however very unclear. Myth 3: The more we have intercourse, the higher our chances One assumes that the more one has intercourse around time of ovulation, the more sperm, and the higher the chance of a pregnancy.  However, having intercourse every day can lower the sperm count significantly.  Every other day is probably a better option.  Similarly, abstaining for long periods of time, does not improve the store of sperm.  In fact, after three days the quality of the sperm starts decreasing somewhat. Myth 4: If a man is producing semen, then he must have sperm This is a common perception.  However, one must not confuse semen with sperm.  Semen is the fluid in which the sperm swims. It is just a vehicle for the sperm to survive in until they reach the egg.  A healthy male has millions of microscopic sperm in each drop of semen. To have spontaneous conception the sperm count should typically be more than 10million and the sperm motility should be more than 40%. In instances where a man has no viable sperm in their ejaculated sample, a fertility specialist will proceed with a testicular biopsy procedure to extract a small amount of tissue from one testicle, which can be used to fertilise the egg. Myth 5: Men can have children no matter what age they are Even though Charlie Chaplin fathered a child in his seventies, and we see many older men fathering children with their second younger wives, men also have a biological clock.  Not only does the genetic DNA start showing more problems such as in birth defects but the longer one lives, the more one is exposed to the environment and lifestyle factors.  Recent research is showing strong evidence for lifestyle factors contributing to male factor infertility such as smoking, obesity and stress.  However, the good news is that these can be managed. Myth 6: Men cannot have a vasectomy reversed A vasectomy is considered a form of permanent birth control.  During the procedure, each testicle is cut or sealed to prevent the release of sperm. Fortunately, a reversal can be effective in a huge number of cases.  And if a reversal is not possible, there are other more invasive options available.  One would need to consult with a specialist urologist to ask about further options. Myth 7: Relax and you’ll conceive When you tell someone to relax, it is impossible to obey.  The relationship between stress and fertility exists, but it is not as simple as that, or as direct as that.  Infertility is a disease, and has a physical component as well as an emotional component.  To tell someone to relax, will simply stress them more and be counter productive.  Support and empathy help; as well as a plan forward with some hope. Myth 8: It’s so easy for other couples to conceive While a couple is going through the process of trying to have a child, it does feel like everyone else is falling pregnant easily.  But the fact is that one in 10 people are battling to conceive, and even when a couple is absolutely healthy, they only have a 25% chance every month of conceiving. Myth 9: It takes months to get an appointment at a fertility clinic, and a referral letter from a doctor is needed A couple doesn’t need to be referred by a family doctor or gynaecologist to see a fertility specialist. A husband and wife are able to make that call on their own, and book their own appointment.  Even though fertility clinics are busy and appointments may take some time, ask to be placed on a cancellation list.  There are always cancellations; and one can usually get a sooner appointment. Myth 10: Does going to a fertility clinic mean we have to do invasive treatment like IVF? This is a common misperception.  Firstly, just because a couple has been struggling for only a few months, it doesn’t mean they can’t go seek a specialised opinion.  By seeking this opinion in the beginning, the basics can put right so that conception happens quicker.  Medical assistance should be considered in couples under 35 who have been trying to conceive for over a year without success, or after six months in women over 35. There are very few clinics that only do IVF, and most have a variety of less invasive options that they start off with and if conception difficulties are not identified, then more involved tests are done. Myth 11:

January 17, 2013
Kath Megaw

Secondary Infertility – A Psychological Perspective

There is much written about the journey of infertility and the emotional roller-coaster that one goes through.  There is also a lot of literature and support available, whether it be on-line or from friends and family.  There is empathy – albeit it often misplaced and unintentionally wrongly communicated. However, there is very little written and limited support for another type of infertility – secondary infertility. Once you have had one child the expectation is that you will have no problem conceiving in the future. However, this is not always the case, and secondary infertility is a common problem. When one looks at infertility in general, it causes a myriad of psychological consequences such as depression, anxiety and post-traumatic stress disorder.  These all have an effect on our daily lives, our relationships and the way we view ourselves.  When we are faced with secondary infertility, the emotional impact is sometimes worse.  Firstly, there is very little empathy from others.  They believe we are being selfish as we already have a child and should be satisfied.  This makes us feel guilty in communicating this sense of loss with others.  So, we keep it to ourselves and the result is an acute feeling of isolation. We feel guilty for wanting a second and we feel resentment that others have more than one child but expect us to be satisfied with our only child. The fact that we have “been there” and had a pregnancy and a child makes the experience of infertility bittersweet. We have experienced the joy, the feeling of being parents and loving unconditionally; and now we can’t have it again.  It makes each day and each experience with our child seem like it may be the last.  We long for those simple experiences again and feel like we are in a constant mourning process as each new developmental milestone is met with feelings of “this may be the last time…”  It puts pressure on us to actively enjoy each day with our child but this is difficult when going through the depression and anxiety that infertility causes.  Each day is met with thoughts of having to enjoy the time but longing for something more. This leads to yet another consequence – guilt. We feel guilty towards our child.  We feel they may pick up that we are unsatisfied with them.  We feel guilty that we may make them feel like they are not enough. Some older children have verbalised this when they have seen the sadness associated with their mother’s longing for another child.  The other guilt is towards the child itself, and the inability to produce a sibling for the existing child.  Even when the child is young, one worries about a playmate into the future.  When the child is older and asking for a sibling, there is a constant sadness for the child. So how do we manage it? Understand that you are entitled to feel the way you do.  Just because you have had the joy of pregnancy and parenthood does not mean you are not entitled to experience it again.  Acknowledge that the journey of secondary infertility may be worse in some ways, and easier in others.  When you do not have children, you are able to avoid certain environments in which you feel worse such as children’s parties and school functions.  When you have a child already, it is very difficult to avoid these situations. So you are constantly faced with your ‘fertility triggers’.  Understand that those around you will not necessarily understand your loss.  It is not because they are hard, selfish individuals, but they often say the wrong thing because they are really trying to say the right thing and to make you feel better.  They haven’t been through the process. In terms of your child, do not share too much of your journey with them.  You can let them know you have tried to have another child when they are a bit older, but try not to let them take on your sadness.  If it never happens, they will be okay.  They will have a life that will still be rich and fulfilling as only children. Finally, secondary infertility is a topic frequently misunderstood.  There are counselors, therapists and medical specialists who are available to talk to.  Make use of them if you are battling.  Don’t be afraid to chat to a fertility doctor, and discuss the options for assisted conception. Even though they may not be able to change the outcome, you needn’t be alone on the journey.

January 17, 2013
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