Laptops & reduced spermatogenesis

An article that came up in my news page today quoted Dr. Suzanne Kavic, director of the division of reproductive endocrinology at Loyola University Health System as saying that "...the heat generated from laptops can impact sperm production and development making it difficult to conceive down the road."

Since they didn't quote any research that backed that, I went to check it out. I found this abstract from Human Reproduction where Yefim Sheynkin, Michael Jung, Peter Yoo, David Schulsinger and Eugene Komaroff tested men for scrotal hyperthermia when working on laptops.

They tested 29 volunteers and found that indeed the use of laptops raised the temperature between 2.6-2.8 degrees celsius. Based on the abstract, "scrotal hyperthermia has been identified as a risk factor for male infertility" - so they've shown that laptop computers cause scrotal hyperthermia and since that's a known risk factor for male infertility, it definitely sounds like something even young boys should be made aware of.

I see there are already patent applications and products to help solve this problem.

Egg & Sperm - Lock & Key?

I finally opened a twitter account for Fertility Stories (feel free to follow me - http://twitter.com/fertilitystorie) and someone sent me a message asking me if I'd seen this article.

The article mentions Dr. Martin Brinkworth, Dr. David Miller at the University of Leeds and Dr. David Iles (but doesn't mention where -if anywhere- results of the study are being published). It summarizes their findings:

The study researchers have found out a mechanism called lock-and-key mechanism by which reproduction takes place.
In living organisms, sperm and egg cells unite in a distinct way. The sperm cells have keys (genetic signals or codes) and the eggs have locks (genetic signals or codes) and only the most suitable key signal can fit into the lock of an egg.

OK. Sounds interesting, but how does this help, I asked myself... Later in the article comes their explanation:

The scientists could use the newer understanding to develop some test to screen infertile man. This would cut down the failure rate of IVF by 75 percent as filtering out male candidates who can never produce children would become possible.

To this, all I can say is, "Yeah, right". Who's going to take a sperm sample that looks fairly normal and then run it by a lab that stamps a big "FAIL" on the results and decide, "oh, OK, so I'll just never have a biological child"? And what happens if the woman, even just once, got pregnant naturally and, even if it ended in miscarriage, are they really going to accept that his sperm isn't able to fertilize her ova? I just don't believe that a lab test, without ever actually going through the process of IVF is going to convince the average couple...

Now, if these guys could find a way to fix the 'key' mechanism, I'd be the first to say they were on to something...

Testing fertility in the comfort of your home

About three years ago, a British company, Fertell released a home fertility test kit for couples - it includes tests for both the man and the woman ($89.99). The men's test was the first home test that shows whether the sperm motility is within the "normally expected levels needed to reach and fertilise the egg". Until then, the most popular home sperm test you could buy was the FertilMarq Male Fertility Sperm Test (also known as PreConceive) ($36.95 & free shipping), but what FertilMarq can tell you is just whether the sperm concentration is above or below 20 million sperm cells per ml. It doesn't tell you anything about the motility. Another test on the market is Micra Sperm Test - At Home Test for Sperm Count and Motility ($79.95) which got mixed reviews on Amazon.

The women's test is an FSH test, which is a good indication of ovarian reserve (i.e., whether the eggs produced are likely to be of good, fertile quality or not). This type of test isn't new - Estroven Menopause Monitor Kit - 2 tests ($18.10 + shipping, currently out of stock) and obviously it's important to pay attention to the sensitivity of the test. ETA - see comment below

I find Fertell's test for men fascinating. I wonder if it will bring around the revolution that they expect - more men will test at home to know if there's a problem. Is the reason that men aren't going to the lab because they're embarassed to carry the sample in (from my experience they usually just palm this off to the woman anyway) or because they're afraid of the results? Maybe it's a combination of the two and the Fertell sperm test will make it just a little bit easier for reluctant men to test themselves.

I do wonder what you do with the results? I guess you go to your fertility specialist (assuming the results are bad) and say, "My Fertell came out lousy." or something like that and then he sends you for a lab test. If the Fertell test comes out good & you end up pursuing fertility treatments anyway, you'll end up having to give a sample somewhere down the line.

I'm glad to see that there's continued work to make the life of those struggling with the first steps of trying to conceive easier. I hope that it will save a lot of couples a lot of time and heartache. They say it can save you up to a year. That's exactly right. If the test is poor, you can go ahead and make an appointment without ever trying to conceive. That does sound cool, at least in retrospect.

Too bad it's such an intimate item, otherwise it might quickly become a popular wedding present.

Every other day? Maybe not...

In Israel, I sell discount ovulation kits, along with telephone support - so the question as to whether to have sex every day or every-other-day during the fertile time comes up a lot. Being unable to take any sort of responsibility, I quote a doctor (who gave me permission to quote him) and say that if they don't suspect a problem with the quality of the sperm, then every day is fine too. Now it seems that even if there is a problem with the quality of the sperm, sex every day might be better than sex every-other-day.

A pilot study (see article) led by David Greening, of Sydney IVF tested 42 men whose sperm showed significant DNA damage and found that daily ejaculation reduced this damage by 12%. These results were presented at the American Society for Reproductive Medicine conference in Washington yesterday.

Abstaining from sex increases the number of sperm cells that are ejaculated - leading to the recommendation for couples who are trying to conceive to only have sex every two to three days - but the article says that beyond this time period, although the quantity may rise, its quality declines; a trade-off.

I wonder if such DNA damage is tested in a normal sperm analysis, if so, what parameters show it and how common is such damage? If it makes an important difference (knowing whether there is or isn't DNA damage), it seems like information couples should have - and may even make it sensible to have two sperm analyses day-after-day to check if the sperm quality improves.

Donor Insemination Movie - And Then Came Love

Eric over at di-dad sparked my curiousity about the movie And Then Came Love in this post. He raised some very interesting questions and I wondered if there was any way to get an answer to some of them.

I sent a letter to Caytha Jentis, the writer and producer of the film, asking her to share any information she could regarding the donor insemination aspect of the movie (specifically mentioning that I would share her responses with the readers of my website).

Here's her response:

Dear Rachel,

Thank you so much for contacting me to learn more about our film. As you know our film is about a donor inseminated single mother, and I would describe it more as a romantic dramedy than comedy. While it certainly has a romantic fantasy element with humor and is a "feel good" film, it was very important to us to deal with the subject matter in a sensitive, thoughtful way and introduce issues that are not only relevant to DI single mothers, but the broader post feminist issues today's women face pertaining to balancing career and family - as well as even broader topic of "what is a family?"

I am the writer and producer of the film, and this is my first film. I hope that you and members of your group can see the film, as we always hoped that our film would invoke discussion. In fact one of our Behind the Scenes featurettes is about the "issues" and includes interviews with Jane Mattes, the founder of "Single Women by Choice" and Amy Harmon of the NYTimes who wrote extensively on DI.

While I am not donor inseminated nor a single mom, I did a tremendous amount of research on the subject matter, and do feel a strong connection to our protagonist as the film is really about the "search for love" as much as "search for the father." By the way, it was important to the director and I that the film should not have all the answers, and in the end was a film about people that any audience would care about.

All the best,
Caytha Jentis

I was glad to read that the topic hadn't been taken lightly and it will be interesting to see the movie.

Male factor infertility

Here are some letters I got recently:

"We had been trying for a baby for a year and found out that my husband has azoospermia. Even ICSI and IVF cannot help us. Right now I am so angry and sad. And I am not sure who to be angry with. We have talked about donor insemination but my husband is not sure how he feels about this. I feel that there is so much more to being a parent than providing the genetic start-up. I know that if I donated eggs I would never feel that a resulting child was mine..."

"We have been trying to conceive a baby for a little over a year now and recently found out that my husband has a zero sperm count. We have tried numerous tests and very expensive options but nothing has worked... we are literally falling apart."

I wanted to take this opportunity to recommend some blogs dealing with male factor infertility:

Manana Banana - Amanda, who just gave birth to her son Adam
DI-Dad - Eric, who is raising his 2 children born by donor insemination
ProgJen - An orthodox Jewish woman dealing with male factor infertility

Got any blogs or books to recommend? Let me know!

DI Dads speak up

Eric Schwartzman who runs a Yahoo group called DI Dads dropped me a line a while back to let me know about an article in USA Today about dads to kids born by donor insemination who are speaking up. It's about dads (and families) who've chosen to tell their children about the way in which they were conceived. Eric himself was interviewed for the article.

I found it interesting that Eric says that the term 'father' is used for the donor and dad for the social parent (the male parent raising the child). I like the separation between formal and functional... I really understand why it's important for these dads to speak up - they're making it legitimate to have children with the help of a donor. This will make it easier for future couples contemplating using a sperm donor and will make it easier for children who were conceived in this way.

When I was a kid, most adopted children didn't know they were adopted. Today, I think it's rare for a child not to know. I doubt that this change will happen as quickly with children born using donor insemination, but the work Eric and others like him are doing seems like a step in the right direction.

Stem to Sperm - A future solution for male infertility?

A team of scientists led by Professor Karim Nayernia in Newcastle University successfully grew sperm cells from embryonic stem cells. This article (from The Age) describes the research in further detail. A picture of the mice who were born as a result of the sperm grown in the lab can be seen here. The second article (from Daily Mail) says that the technique could allow men suffering from certain types of infertility to 'grow' their own sperm. One way in which this could be done is by surgical removal of immature sperm cells from a man's testicles and then growing them in the lab and replacing them. The article discusses additonal possible applications of the research.

Interestingly, the first article fails to mention that the resulting mice were far from healthy and suffered from a variety of medical conditions.

As with any new technique, this one too is at least five years from being available to men suffering from infertility, but it may offer hope for the future.

--- Unrelated Note ---

For all those who are interested, I've added the option to get an RSS feed for this blog. See the link on the right - clicking it allows you to choose where you'd like your feed to go.

Pre-ICSI treatment for men

In last week's European Society of Human Reproduction and Embryology meeting, A. Farrag from the Grimaldi Medical Group, IVF/ICSI Unit, Rome, Italy presented a study done in the Grimaldi Medical Center. The study wanted to show the effect of treating patients going through ICSI due to idiopathic male infertility (male infertility, the cause of which is not known) and oligospermia (very low sperm count) with recombinant human FSH (gonal-F) before the IVF-ICSI cycle.

The men who were treated received Gonal-F shots 3 times a week for 3 months.

The results were good. Compared to the control group, the clinical pregnancy and implantation rates were higher and the early pregnancy loss rate was lower.

I wasn't able to find where the research was published, but if you're going through ICSI for one of the above reasons, it seems worth looking into.

Sparing men from infertility after chemotherapy

At the European Society of Human Reproduction and Embryology meeting in Prague, last week, Alon Carmely from Bar-Ilan University (Israel) said that his work (select Tuesday from the top and then click the 2nd to last link. Finally, look for A. Carmely - there's a summary of his presentation) showed for the first time that the injection of AS101, a drug that enhances the immune system, could protect the testis from the effects of paclitaxel (Taxol), a widely used chemotherapy drug.

Alon Carmely and his team knew that AS101 had been shown to have chemoprotective effects in both animal and human studies, and they decided to investigate whether it could help avoid testicular damage in mice treated with Taxol. The results showed only minimal testicular damage in the group that had been injected with AS101. Mature sperm was also found, as opposed to the control group, in which the testicles showed severe atrophy and empty seminiferous tubules (where the sperm-producing cells are) .

This provides hope even for those men who did not freeze sperm prior to beginning chemotherapy - some for lack of time, some because they were simply unable to think that far ahead while dealing with the uncertainty of cancer.

Husbands & Sperm Donation

I got the following letter recently and I must say I found it infuriating. Fertility Stories has received many tens of stories from women (and even one from a man, Jim - which he updated recently, after the birth of his daughter) who either contemplated or went through with sperm donation and this is the first that expressed this opinion. Our page on donor thoughts also paints the picture entirely differently and I was very surprised to receive this:

"I have been prompted to share my experience following Joan's story (posted January 20, 2006). They have been married for almost 4 years and just discovered that the husband has no sperm.

Joan, and others struggling out there, I got married in 1994 and 4 years later the doctors said that I have no sperm and will not be able to father a child. We have been living in tears for more than 11 years in this condition. It is important to understand what your partner goes through, especially if it is only one of you with a problem. Let us not be selfish and try to get a solution that satisfies only one partner. Children are meant to be for 2 people - husband and wife.
Friends and family have offered many options, all of which will never replace biological children. While we could have gone for donor sperm, I feel that the child will be for my wife (and another man!!) and not ours. Adoption may seem neutral but such children usually find their biological parents when they grow up. And this can be so frustrating.

Many times, people around us do not understand what we go through. On several occassions we have been blamed for delaying childbearing (we are now 37). We have failed to forget the whole matter. Sometimes we feel desperate and other times we are so hopeful through prayer. But the desire for biological children is unquenchable.

As a way forward, we have decided to sink ourselves in prayer. There is nothing impossible with God. We believe that soon we shall have children and our tears of sorrow will be replaced with tears of joy. Let us continue the struggle prayerfully. Miracles still happen, and ours will happen soon. Keep your hopes high, irrespective of your age."

Though I can understand the desire to have the same biological connection to your child (as your spouse does), I find it difficult to comprehend how someone with such a strong desire for children could also be so against adoption.

Please feel free to share your comments.

Donating Sperm for a Sibling? A Brother's Thoughts.

I got an interesting letter a while ago from a young man who I'll call Joseph.

"Hi. My sister & her (lesbian) partner have asked me to be a sperm donor. They joked about it five years ago. We kind of left it in the air for a bit then, as I was living abroad at the time. They turned to other possible donors, somewhat to my relief. Three possible donors later, each backing out after talks and meetings etc, they decided to try a fertility clinic.

We live in Ireland where no such service exists or (I think) is legal - for lesbians. In the last year they have gone 7 times. Each time was unsuccessful, each time with less and less trust in the system - there is no personal touch, no feeling of getting good service from the clinic...the prices are going up, and they feel - being 'foreigners' they are being ripped off. That's all tied up with the anguish and emotions, the fertility drugs etc., etc.

About five weeks ago they came back to me - their original first preference. I've grown up, am 34 and have very different views to 7 years ago, but I am very worried. Being a donor is one thing, being the child's uncle and father is another. They gave me a book which is very much from a woman's point of view. I'm not finding much sensitivity for the man, the donor. Even the donor's experiences seem to be coming from men who are very unattached to their sperm.

I don't think I sound crazy. But I am afraid that if I donate I will be part of something very real, a reality I will want to be part of. But what happens then? I want to help my sister, I want to help her partner. But what about my parents? What about me? I've never been given the opportunity to be a dad before. I thought that was taken from me once I came out to myself 17 years ago. I need to talk to someone who has had similar experiences, those who did it and those who didn't. I'd appreciate your comments.

Joseph - Ireland."


This was my response:

"Dear Joseph,

Thank you for contacting us. I read your story and I think that it's very good that you're taking the matter so seriously.

I would be happy to post your question on Fertility Stories along with any answers we receive. Let me know if you are interested.

Personally, I think that there are a lot of issues involved: You would be placed in an un-natural relationship with your sister, being a co-parent to her child (which, actually, biologically would be your child). What would your legal obligations be? What would your sister and her partner's expectations be from you? What would happen if your sister and her partner decide to dissolve their relationship? Would you have visitation with the child? Have to pay child support? What if you disagree with the education they choose for the child?

It seems the matter is very complicated and would have very long-term effects on your life.

I also think you are correct in that most donors have no desire to have any sort of connection with the children born of their sperm - this has its advantages, such as keeping just the 'parents' in the picture (particularly in heterosexual couples).

I look forward to hearing from you.

Rachel"

Joseph's response:

"Hi Rachel,

Thank you for your reply. I think posting my query may be a good thing, as I need some real life experience feedback. My friends are differing very much in their opinions. Some flat out no's. Others are envious.

I'm not sure if I was clear - I am gay as well as my sister. My sister is 2 years older than I and we are very alike in looks, mannerisms and personality - strong family line hey! No wonder I am their number one choice. Since I have taken on this consideration seriously my mind has wavered and weaved from positive to negative, from fear to excitement. Each step has ramifications in each and every direction. Yep, I'm feeling a little overloaded. I'm not under pressure, although a 'no' is not going to go down well.

The need, want, to have a child I think has heightened this year with the treatments and drugs, I think my sister's girlfriend is more than ready and 'wants a baby'. I was worried about my sister. I was leaning towards a negative gut feeling up until we actually sat and talked about it. I was concerned my sister was being pushed into this, her partner is persuasive and I wondered if, like me, my sister had never really thought about having kids before. It's so hard to know...maybe if I was lucky enough to be in a long term relationship and my partner was the family kind, and I loved him dearly, then yes I think I would want to have a family.

There is so much uncertainty… And that's before the legalities. I already know that there are no legalities. I mean, there is nothing in place to protect me, as a donor - to remain just a donor. No law exists in Ireland to prevent my sister &/or her girlfriend from claiming child welfare. Would I argue it? If things were to change? How could I? The child would be biologically mine. But trust is the bind. I trust my sister, her girlfriend. I trust their ability to bring a child up well. I trust them that should circumstances change, they would not turn on me.

I know to anyone reading this I may sound very selfish, but I am trying to get to the heart of why I want to do it, why I don't. Part of me thinks - stop thinking, just do it, you can't know the outcome - who knows the outcome of a child, the conception, the birth, the life. The changing of all relationships as time passes. None of it can be controlled. Is that a positive or negative?

Thanks for listening,
Joseph"

We look forward to your comments.

Sperm Donation

Q - My friend wants me to carry her baby and we would be using a sperm donar. I would really appreciate it if could send us some information on procedures, cost, doctors, and payment plans, any information would help!!! Thank You!

A - We're not affiliated with any medical center or sperm bank that provides these services. The procedure used is referred to as IUI or Intrauterine Insemination. You can read more about sperm donation on our sperm donor page.

Your friend might also be interested in the book Helping the Stork : The Choices and Challenges of Donor Insemination.


Q - I was interested in perhaps becoming a sperm donor. Can you tell me the procedure for becoming a sperm donor?

A - Read more about sperm donation on our sperm donor page. The HFEA (UK) also has an interesting publication - What You Need to Know About Donating Sperm, Eggs or Embryos