Studies based on 11 years of data on more than 5,000 men being treated for fertility problems found that men are more fertile in the middle months of the year, sperm is twice as active in July and August compared to January.

Researcher’s at the Centre for Reproductive Incapacity of the University Hospital of Parma, in northern Italy analysed data collected from 5,188 men, looking for possible seasonal pattern in sperm quality.

Results showed that motility of sperm peaked in the summer, and was at its lowest in the winter. They also showed that the number of men with a sperm motility or movement greater than 40 per cent averaged 65.3 percent in summer, and only 50 percent in winter. “We have shown the existence of a seasonal variation in some functional aspects of human semen,” confirmed Dr Alfredo De Giorgi, who led the study.

In the evolution of nature and for most animals, light plays an important part in the regulation of reproduction; this ensures that the birth of their offspring occurs at the most favourable time of the year, and when food is in abundance and the days are long and warm. For humans, there can be seasonal variations in our cycle of sleeping patterns, which can affect the stress hormone cortisol.

Keeping cool in the summer heat!

Men need to remember to stay cool in the summer to avoid overheating their testicular area. This can temporarily cause low sperm count, for as long as the testes are overheated. Testicles secrete male hormones and also help in sperm production. Testes function properly only when they are cooler than the rest of the body. That’s why they are anatomically structured to hang outside the body. If the testes are exposed to high temperatures, then the increased heat could kill the sperm and cause a low count.
There are further factors which can increase the temperature of testicles, aside from the weather which include:

1. Wearing tight underpants
2. Wearing trousers too tight around the crotch area
3. Taking hot baths or saunas
4. Sitting for a long time
5. Keeping a lap top on the lap for long periods

Although it is proven that men are statistically more fertile during Summer, it is important to keep cool to avoid lower sperm count.

I hope you’ve found this latest post helpful. If you’re currently trying to conceive, why not read about my story here to find out how fertility yoga can help you.

Obese women are less likely to become pregnant through IVF and assisted reproduction as carrying excess weight can affect the function of the ovaries, due to changes in hormones and metabolism rate. They also have less success with assisted fertility treatment because of the poor response to fertility drugs that stimulate ovulation. The same can be said for being underweight, as this can also affect your hormone levels and therefore impact on your fertility.

Maintaining an optimum weight is good for both partners experiencing infertility, and this has been the current focus within NHS proposals. In the South West of England, they propose to refuse NHS funded IVF treatment if the male partner has a BMI of 30 plus, as this is classed as medically obese and could affect fertility chances.
The proposal by the clinical commissioning group is to change NHS funded fertility treatment policy to ensure men get to a healthy weight, before the NHS fund investigations and fertility treatments with their partners.

BMI and Body Fat Percentage

Whilst your BMI is important, your body fat percentage is the vital element when it comes to your reproductive function. The BMI measurement is based on height and weight, but it doesn’t distinguish between fat and muscle meaning that if you are an athletic male you can carry a lot of lean mass, giving you a disproportionately high BMI compared to your actual health and levels of body fat.

The best way to measure body fat percentage is with a skin-fold calliper, with measurements usually taken at your waist, hip and neck, as well as other areas of your body. Once you determine your body fat index, you can then track your weight-loss progress if needed as unlike using standardised scales, it tells you how much of your weight is fat and how much is muscle.

Founder of Colorado Center for Reproductive Medicine in Denver Dr W Schoolcraft, often sends some of his patients to an exercise physiologist to measure their body fat percentage. According to Dr Schoolcraft ovulation is impaired if body fat is less than 12 percent or more than 30 to 35 percent. He states “Women take getting their periods as a sign they are at a healthy BMI and have normal fertility,” “However, you can have regular or somewhat regular periods and not ovulate, though it’s unusual.”
So be sure to measure your basal body temperature and track it on a basal body temperature chart to see if you’re ovulating.

Calories count

If you are underweight aim for between 2,400 to 3,500 calories a day to gain the weight you need for a normal BMI range. If you’re exercising five or more days a week, consider cutting back to three. Dr Alice Domar, of Centre for Mind/Body Health at Boston IVF, states that hatha yoga, such as Fertility Yoga appeals to many women in this category as “It keeps them fit and toned without the potential adverse impact of vigorous exercise.”

If you’re overweight reduce calories gradually in order to reduce your BMI and get fertility fit. A combination of cardio and strength exercises, that builds up tolerance slowly and not too vigorously to the point of exhaustion should form the core of your exercise.

For men don’t over heat the testicular area, as this can temporarily cause low sperm count. The testicles secrete male hormones and also help in sperm production, and for the testes to function properly they need to be cooler than rest of the body. That’s why the testes are anatomically structured to hang outside the body. The ideal temperature for sperm production is around 34.5C, which is slightly below body temperature (around 37C). If the testes are exposed to high temperatures, then the increased heat could kill the sperms and cause low sperm count.

For better sperm production avoid:

• Wearing tight underwear
• Tight trousers around the groin area
• Sitting for long periods of time
• Having laptops or tablets resting on your lap
• Taking hot baths and saunas

Whilst exercise makes you feel good it can affect your fertility, so you need to find a balance between under or over exercising in order to optimise your own body’s functions. So, if you need to lose a few pounds, or gain a few, it’s important to review your lifestyle, diet and exercise levels in order to get healthy and boost your fertility.

If you would like to know more about what types of exercises you can practice in order to get fertility fit, you can read this blog post which will provide you with helpful tips.

Good exercises for fertility

Regular, moderate exercise is essential for preparing the body for a healthy conception and pregnancy outcome. Choosing exercises that help to regulate hormones and detoxify the body will also:

• Strengthen muscles
• Increase flexibility
• Improve stamina
• Increase circulation
• Reduce stress
• Calm the mind

It’s recommended that women who are trying to conceive should take up moderate exercise for 30 minutes a day for three times a week, with two of these sessions based around strengthening your muscles (either through yoga or another low intensity activity such as Tai Chi). My own fertility Yoga sessions are used to enhance your fertility chances and designed to improve reproductive heath and breathing in order to reduce your stress levels.

Moderate exercises to get fertility fit:

• Brisk walking
• Light jogging
• Cycling
• Swimming
• Tai chi
• Yoga
• Dancing
• Aerobics, low impact

What about exercising during IUI or IVF fertility treatment?

If you’re currently having fertility treatment then exercise can be particularly effective in managing and reducing your stress levels at what can be a very anxious time. However, you do need to be careful and it’s always best to consult your fertility doctor for advice on which exercises you should be doing, if any at all. This will depend on the stage of the fertility treatment you’re currently at, but if you feel the need to de-stress then try gentle yoga or go for a walk to enhance your body and mind’s wellbeing.

Exercises to avoid while trying to conceive:

• Running long distances
• Strenuous regular training sports such as gymnastics
• Extreme ‘boot-camp’ training
• Bikram or power yoga (as this raises body temperature)
• Exercise for over an hour’s session, 7 days a week

Don’t despair if you currently have a strenuous exercise regime or have so in the past as the good news is that a study carried out by the Norwegian University of Science and Technology, led by Dr Gudmundsdottir and his team, found during their recent study that many women who trained the hardest at some point in time, still went on to have children by lowering their physical activity to a moderate level.

Infertility due to high intensity exercise may be reversed by a reduction in physical activity and increasing body fat to rebalance hormones disrupted by extreme exercises.

If you would like to keep active but are looking for less strenuous forms of activity, come along to one of my fertility yoga classes. You can find out more here.

A cohort study was carried out by the Norwegian University of Science and Technology, led by Dr Gudmundsdottir and his team. This investigated the association between the levels of physical activity and the group’s fertility rates against the number of children they had in a group.

Over 24,000 healthy women participated (those with poor health or previous fertility problems were excluded from the research as this was looking at a sample of currently healthy women) with their levels of exercise assessed and categorised as:
• Never
• Less than once a week
• 2-3 times a week
• Almost every day

Along with the frequency of exercise, the intensity was categorised as:
• Taking it easy
• Loss of breath
• To exhaustion

The group’s fertility was assessed at the follow-up assessments, where the women reported on:
• Their age they had children
• The number of children they had
• Whether they had difficultly conceiving within one year of trying for conception.

Other factors that affect fertility where considered in the study to include:
• Age
• Marital status
• Body mass index (BMI)
• Smoking
• Alcohol consumption

The fertility status of the group was compared and the results showed that:
• “Increased frequency and intensity of physical activity was associated with increased infertility”
• “Women who were active on most days of the week were 3.2 times more likely to be infertile than inactive women”
• “Women who exercised ‘to exhaustion’ were 2.3 times more likely to be infertile than women who said they ‘take it easy’”

The researchers concluded that “fertility is negatively affected by physical activity of an extreme intensity and frequency”

Studies show that high-intensity, prolongs strenuous workouts can:
• Increase cortisol levels
• Lower thyroid hormones
• Affect metabolism
• Disturb ovulation
• Menstrual cycle

Both low thyroid hormones and high cortisol levels have been linked to poor adrenal health, which can directly impact thyroid function and affects how the body handles stress long-term, all of which can negatively impact overall hormonal balance and fertility, so by reducing stress and reviewing your exercise regime, you can rebalance your hormones.

By practising fertility yoga you can indeed reduce stress, and still be active but in a positive way which won’t hinder your chances of conceiving – it can actually help!

To find out more about available classes you can visit this page http://www.fertilityyoga.co.uk/yoga-classes/

Exercising too strenuously can be as damaging to fertility as doing too little exercise; it can trigger the release of the stress hormone cortisol, which can interfere with reproductive functions. Gentle exercise, on the other hand, has been found to improve your chances of conceiving. Try low impact activities like walking, yoga, tai chi and pilates, and aim for little and often.
 

Breathe

Abdominal breathing is a great way to de-stress and build the inner strength so often needed when trying for a baby. Either sit or lie in a comfortable position and place your hands lightly on your abdomen. Close your eyes and focus on the natural rhythm of your breath, feeling the abdomen expand and release. Relax your shoulders and facial muscles and, as you begin to breathe more deeply, feel the expansion in your rib cage and chest. Focus on clearing your mind of negative thoughts with each exhalation.
 

Rest in a fertility-boosting position

Moon Pose (Shashankasana) gently massages the abdomen area and has been found to alleviate disorders of both male and female reproductive organs. Sitting on your heels raise your arms above your head, shoulder-width apart. Exhale and bend your trunk forward from the hips, keeping your arms and head in line with your trunk. Place the hands and forehead on the floor (or a cushion), bending your arms slightly to relax them and rest the elbows on the floor.
 

Exercise your pelvis

Cat Pose (Marjariasana) not only reduces tension and improves your spine’s flexibility, but also brings blood flow and energy to the pelvic area and gently tones it. Come onto all fours, with your hips over your knees and your hands under your shoulders, arms straight. Inhale, tilting the tailbone up, arching your back and looking up – this is upward cat. Exhale, bringing your head through your arms, chin to chest, and rounding the spine as you tuck the tailbone under – this is downward cat.  Repeat upward then downward cat 10 times if you can.
 

Get outside

Research shows that being out and about in nature lowers stress levels and boosts well-being, which will impact on your fertility. Try to spend some time outside each day, even if it is just ten minutes on your lunch break sitting in a nearby park.

Research shows that the quality of health and wellbeing of patients experiencing infertility is greatly reduced. So with the greater understanding of the experience of infertility and related health issues, the fertility treatment plan can be centred on the individual patient’s wellbeing. This will optimise the many factors that could potentially reduce the patient’s success, by dedicating a treatment plan that is in the best interest of the patient’s wellbeing and health.

Associated Factors that affect fertility

• BMI obesity or under weight
• Lifestyle
• Nutrition
• Age
• Female reproductive issues to include PCOS

A survey was undertaken by the Fertility Network UK, published in October 2016, to study the impact of fertility problems had on the psychological and emotional impact of fertility treatment, along with funding and support issues. They found that only 52% of the 865 participants, fully understood the nature of their fertility problems and only 26% felt their GP provided sufficient information.

Over half of the numbered surveyed had to pay for at least part of their fertility investigations or treatment, and on average spent over £11378, with 21% spending around £20k to £100k. Patients mainly self-funded, due to the lack of NHS funding, and the key reasons for being denied NHS treatment included: already having a child or partner having a child, the patient’s body weight and BMI, and for single patients being denied funding due to the absence of a partner.
Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments plans. Infertility is defined by the absence of conception following one year of unprotected sexual intercourse. With factors affecting fertility to include biological, genetics, infections, environment and lifestyle factors that can associate risks with both female and male fertility. After the primarily investigations by GPs and gynaecologists, assisted reproductive technologies (ART) or IVF may be used to treat infertility. For patients that experience financial, psychological, moral and ethical challenges they might discontinue their medical fertility treatment plan.

Studies show the effects of infertility has on patients include:

• Distress
• Depression
• Anxiety
• Low self-esteem
• Feelings of blame guilt
• Somatic complaints
• Reduce libido
• Relationship issues

Research by the Bio Med Central in 2014, led by E O’Reilly at the University of Ottawa, Canada stated that “CAM practitioners played an active role in both the treatment and support of infertility, using a holistic, interdisciplinary and individualised approach”. CAM practitioners of the study recognised that not just the biological, but also environmental and psychosomatic are determinants of infertility. CAM practitioners used diagnostics investigations, clinical and physical questionnaires and laboratory test results for fertility hormones, along with stress and lifestyle issues to create treatment plans.

As western medicine continues to become more technologically advanced, patients of many illnesses are choosing complementary and alternative medicine (CAM) to treat conditions. CAMs are used either instead of, or alongside, main stream conventional medical treatment. For fertility patients with the advancements in technology, patients perceive a more natural approach with less side effects can help their fertility.

In O’Reilly’s research treatment of infertility patients using CAM, patients participated from many countries around the world, which reflected “the patient’s acceptance and interest in alternative approaches to infertility treatment”. The study showed in Australia up to 75% of infertility patients reported using CAM, in the USA 29% and in the UK 40% used CAM to treat infertility.

CAM patients are predominately female and extremely motivated to have baby, and that more women are open to CAMs and actively seek treatments than men, for infertility and for other healthy issues. Whilst men and women experience infertility differently, in the O’Reilly study “men express strong desires to conceive and subsequent grief with infertility”
In all countries the participants of the study stated, that CAM therapies’ had led to patient trust, and a sense of control and empowerment whether they was trying to conceive naturally or through ART or IVF. Patients of complementary and alternative medicine used the internet, word of mouth and previous personal experiences of using CAM, to help select CAM providers for their fertility treatment. CAM practitioners identify their individualistic approach to each patient’s fertility-related emotional distress. There is often a negative perception of CAM and conventional medicine, so if the patient’s doctor does not support CAM due to lack of scientific evidence, many patients continue to pursue CAM support during their fertility treatment, funded privately.

In the O’Reilly’s study “many aspects of women’s reproductive health, including menopause, infertility and pregnancy have been identified as ideally treated by an integrated CAM-conventional medicine approach”. By accrediting CAM providers, factual research, education and the sensitivity of the cultural philosophies of the types of complementary and alternative medicine, the study concluded that CAMs are strategies to enhance CAM-conventional medicine collaborations. Research continues to increase at academic medical centres and universities worldwide, to understand and study the results of the integration of CAM and conventional medicine in education and clinical care.

Stress of fertility treatment, the 2 week wait and the outcome of pregnancy testing

Research has shown that not all patients respond to the stress of fertility treatment in the same way. Factors affecting this include a person’s physical responses to stress, the treatments themselves, personality types and their relationships, so their individual coping strategies will all be different. With such variation the individual patient should be encouraged to communicate to their fertility specialists, in all aspects of their own specific needs of support along with a CAM treatment plan.
Studies show that many patients need extra emotional support during the 2 week wait, the time to wait to take a pregnancy test after an IVF embryo transfer. CAM therapies can support this difficult time along with pre-treatment, during treatment and with patient recovery, especially if there is a negative result. There are CAM strategies to manage this period of stress to improve the wellbeing of the patient through stress management and psychological support to reduce stress and anxiety on the patient’s fertility journey.

Top Tips for preparing for and coping with fertility treatment

• Do you research to help plan your treatment options
• Ask questions so you understand your treatment procedures
• Prepare yourself physical and mentally before you start treatment, ideally six months ahead
• Stay flexible for appointment time’s changes etc. plan ahead for changes to treatment, to minimise stress
• Prepare for the test result days and build time for recovery, for either a positive or negative result.

What is complementary and alternative medicine?

CAM’s are classified as therapies that work on the physical, emotional and spiritual body. They work on mind and body medicine using a holistic approach and integrate the energetic and biological body, with manipu/lation and body base practices. Energy flows through the body and when this energy is blocked or unbalanced, this can present as sickness in the mind and or body. To re-balance the mind and body CAM’s therapies use and variety of therapies to bring the mind and body into harmony and balance, to include:

• Ancient healing systems form the East, such as yoga and Ayurveda from India and acupuncture and Chinese medicine
• Homeopathy. Using small doses of remedies that cause symptoms to stimulate the body’s self-healing process.
• Naturopathy. Treatments to help the body heal using a variety of practice to include exercise massage, relaxation, herbal medicine, counselling.

Complementary medicine are not usually taught or used in Western medical schools or hospitals. Mainstream western medicine has yet to adopt complementary medicine as part of an integrated health care system due to the variety of cultural, social, economic, or scientific reasons. Whilst doctors can help support you in your choices and may be able to direct you to a certified and licensed practitioner. There are governing bodies or associations for standards of CAM training and providers, so talk to your doctor or fertility specialist about using CAM’s as part of your fertility treatment

Types of Complementary and Alternative Medicine

Complementary medicine is a group of diagnostic and therapeutic disciplines that are used together with conventional medicine. Complementary and alternative medicine (CAM) include the following:

• counselling
• homeopathy
• hypnotherapy
• massage therapy
• yoga
• meditation
• nutritional therapy
• reflexology
• traditional Chinese medicine (TCM)
• acupuncture

CAM providers in the O’Reilly study stated that “An integrated infertility patient care through both collaboration with complementary and alternative medicine practitioners and incorporation of CAM’s holistic, individualised and interdisciplinary approaches would greatly benefit infertility patients.” And that a “greater understanding of CAM approaches to infertility and treatment will enhance cross-professional relationship for integrated infertility patient care”

Many more health professionals and fertility clinics are now working alongside CAM practitioners to help improve the chances to conceive for infertile couples. So if you are experiencing fertility issues for the first time or been on your fertility journey for a while, then perhaps try a CAM treatment that appeals to you and that you are comfortable with. Take your time to build trust and a relationship with your CAM practitioner who specialises in working with infertility patients, to support you and your partner on your fertility journey.

Feeling devastated and a failure, as each month passes without falling pregnant can put pressure on you and your family. How do you cope when you feel everyone around is happily having babies. Do you feel resentment and start to isolate your shelf from family and friends. Infertility can cause emotional issues, how can you learn to manage your feelings and thoughts on your fertility journey?

By learning stress reduction techniques you can not only learn tools to help you mange stress in everyday life, but also to empower you in situations when your fertility is in the hands of the fertility clinics and doctors managing your fertility treatment.

By nurturing the mind and body through relaxations and complementary therapies you can focus more positively, stay calm and accept where you are at each stage of treatment. This will aid your recovery of distress and disappointment to enable you to move forward to the next stage, with hope to thrive mentally and physically. By feeling better your can have a more positive outlook and look at different perspectives on a situation, as you many have to live and cope with your fertility journey for months or even years. This is when complementary therapies to manage stress and improve mental clarity and can benefit the patient alongside western medicine, to heal and focus on the wellbeing of the patient on their journey to having a healthy pregnancy and baby.

Participants on the Mind Body Program at the Mind Body Institute in the US, state that they can make better decision and manage stress, by developing coping strategies by learning relaxation techniques to gain better control over their health. Alice Domar the director of Mind/Body Centre for Women’s Health at Harvard Medical School demonstrated the evidence of stress relief is a study of 110 women trying to get pregnant for up to two years. They were split into three groups, the first receiving only fertility support, the second group focused on relaxation therapies to include yoga and meditation and the third group was just given fertility treatment. “After a year, only 20% of the women on medication alone became pregnant compared to about half the women in both types of support groups” For men to benefit to, studies show that men who have a regular yoga practice can enhance their reproductive health, by improving the success rate of conception by increasing sperm count and motility.

Domar’s research suggests that stress can delay menstrual cycles and create abnormal levels of pituitary hormone prolactin, which is responsible for ovulation. Domar found that infertile women are significantly more depressed than their fertile counterparts.

Today it is accepted that there is mind-body connection, such as our emotions, mental, social and behavioural factors affect our health and wellbeing. Our thoughts, attitudes, beliefs and feelings can positively and negatively affect our biological functioning. The mind-body connection can be defined as the information flow of biology regulators, a network of interconnections by the nervous system that regulates organ functions and hormones. The brain and the immune system continuously signal each other, often along the same pathways, which can explains why our state of mind can influences our health. In acupuncture and Chinese medicine there are pathways called meridians in the body along which vital energy to flow. In yoga philosophy there are energy centres within the human body known as chakras, which help to regulate the body processes, from organ function to the immune system. Yoga breathing and yoga postures – asana yoga benefit the body by calming the nervous system, reduced blood pressure as well as improving lung capacity and circulation, to help distribute nutrients and oxygen around the body and organs including the reproductive organs.

‘Your body responds to how you think, fell and act, this is one type of mind/body connection when you are stressed, anxious, or upset , your body reacts in a way that might tell you something isn’t right’

So how can you improve your emotional health?

• Calm mind and body – relaxation techniques, meditation, yoga, Tai Chi
• Lifestyle – nutrition and diet, work life balance, getting enough sleep
• Develop resilience – Coping strategies to manage stress, CBT -cognitive behavioural therapy
• Expressing your feelings – able to release emotions and let go, support from counsellors.

Clinical research indicates 55% women attending a mind body program conceive (Alice Domar, PH.D & Herbert Benson, MD 2005) Dr Benson work integrates modern scientific medicine, physiology, nutrition, exercise physiology and belief to enhance the natural healing capacities of body and mind According to the NHS, “mindfulness helps mental wellbeing by becoming more aware of the present moment can help us enjoy the world around us more and understand ourselves better.
Evidence suggests there are five steps we can all take to improve our mental wellbeing.”

Five steps to mental wellbeing:

• Connect – connect with the people around you
• Be active – some people find that it is easier to cope with an over-busy mind if they are doing gentle yoga and walking
• Keep learning – learning new skills to give you a sense of achievement and confidence.
• Give to others – even the smallest act can count
• Be mindful – be more aware of the present moment, including your thoughts and feelings, your body and the world around you.

The NHS recognised that many patients find the experience of fertility treatment as one of the most stressful experiences of their lives. So it is important for patients to be encouraged to communicate about their fertility treatment to find support for their specific needs. Justin Bold writes in her handbook “Integrated approaches it infertility, IVF and recurrent miscarriages”. That professionals working in fertility treatments need to beware that supportive therapies can integrate in the overall treatment strategy and to be mindful of the importance of stress management itself, at each stage particularly at the two –week wait stage. If the results are negative, how do you manage your recovery emotionally and physically, to then decide on the next course of action on you journey?
It has been recognised that complementary therapies play an important role in fertility patient’s health and wellbeing. Scientific evidence shows that a range of alternative therapies from acupuncture and reflexology, nutrition and yoga can help boost fertility. Fertility expert Zita West, states “although complementary therapies are not necessarily a cure for infertility, they can help encourage conception by bringing the body back into balance. With people working harder and becoming more stressed, these days it can take longer to get pregnant,’ she says. ‘Helping the body to cope with the demands of modern life such as by employing acupuncture or sound nutritional advice can do wonders to stimulate the reproductive organs into action.’

Yoga and meditation can help with infertility, by practicing relaxation techniques you can increase your clarity and focus of the mind and body connection, this can improve your wellbeing. Physical and mental therapy is important accomplishments of a yogic practitioner, as it works holistically to bring balance and harmony with union between the mind and body. Fertility Yoga is a tailored yoga practice to help with infertility issues and mange stress and anxiety through breathing and relaxation techniques, specify yoga postures are also used in Fertility Yoga sessions to enhance fertility.

Fertility Yoga will:

• Increase blood flow and energy to the pelvic area
• Stimulate the reproductive system
• Reduce stress
• Calm the mind of negative thoughts
• Balance hormones
• Enhance mind and body connections

Embrace the connection between the mind and body, to reduce your stress and optimise your fertility treatment. Whatever stage you are at on your challenging path to parenthood, feel empowered and positive on your journey and that you have made the right choices for you and your partner on your journey!

Click on the image above or the link below to read my article in ‘My Fertility Specialist’ Magazine.

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