ICSI is best for male infertility

ICSI works best when used for male infertility

Over 2 decades ago, ICSI (intracytoplasmic sperm injection) revolutionized the treatment of male infertility. The ICSI procedure involves injection of a single sperm into each egg at the time of IVF (in vitro fertlization). Before the development of ICSI, couples with sperm issues, what we call “male factor,” had very low fertilization and pregnancy rates, even when undergoing IVF. Now a days, because of the use of ICSI, poor sperm quality is a very unusual reason for an IVF cycle to be unsuccessful or to blame for poor fertilization. Over concerns about potentially poor fertilization, many fertility centers have chosen to use ICSI routinely to ensure optimal fertilization even when the male partner’s sperm is perfectly normal. At Princeton IVF, our philosophy has always been to allow fertilization to happen “naturally” in the dish when there is no history of sperm issues or poor fertilization. While ICSI had been shown to be quite safe, we feel that a more natural selection process makes more sense and research in the past has suggested that ICSI is only beneficial in male factor patients. A recent large-scale study recently published in the Journal of the American Medical Association has borne this out. ICSI  when used in IVF cycles used in couples without sperm issues had lower fertilization and lower implantation rates than non ICSI cycles.

Smoking and grandchildren- What’s the connection?

Smoking while pregnantThere are plenty of reasons to quit smoking. The health effects of smoking are well known and well documented, not just on your fertility, but a whole number of health issues including heart disease and cancer. Now, there’s yet another reason to quit smoking if you are pregnant  or trying to get pregnant. Cigarettes may actually affect a woman’s male offspring’s sperm quality. As reported in Human Reproduction, the male offspring of pregnant mice exposed to high levels of cigarette smoke had sperm with lower counts, lower motility and more abnormally shaped sperm (low morphology), and these male mice took longer longer to impregnate female mice who in turn gave birth to fewer mouse pups. So, what does this all mean? While we don’t yet know if this is true in humans (or even 100 % sure it is true in animals), exposure to tobacco smoke could not only harm your fertility (among other things) but also could harm your unborn son’s chances of fathering children. This is another good reason to quit.

Cell phones and male fertility

Sperm-motility-cell-phoneA recent study suggests that men who keeps their cellphones in their pants pockets, may have lower sperm motility. Researchers at the University of Exeter in the UK, found that men who kept cell phones in their pockets had lower sperm motility than those who did not, about an 8% reduction. Is this an issue? It remains to be seen whether this decrease really affects a couple’s chances for pregnancy and truly causes infertility.

 

Stress and infertility- have we finally found a link?

stressMost fertility specialists, obgyns and midwives (and probably even your mother-in-law), know that stress can cause infertility. We see this in practice all the time, and numerous studies have shown that stress reduction techniques can help couples with infertility. Still, we do not quite understand the connection even though we know it exists. A recently published study from Ohio State looked at women trying to conceive and the levels of an enzyme called alpha amylase in their saliva. Alpha amylase is a considered a marker for stress, and the researchers found that women with higher levels had lower monthly pregnancy rates. Is this the missing link? Probably not, but it may be a first step in finding out how the mind affects fertility.

Plastics and male infertility

nalgene-bpa free bottleThere has been a lot of chatter about effects of BPA in the news, an additive in plastics bottles and their effects on reproduction. The NIH decided to look into plastics additives effects on female and male fertility, and they found something interesting. Men who were exposed to pthalates, additives used to softer plastics such as vinyl took longer for their partners to conceive than those who did not; 20% longer. Surprisingly, BPA exposure in either partner and phthalate exposure in women did not affect fertility.  While this does not prove that these chemicals cause infertility in men, it is another piece in the unsolved puzzle about how that environment may be affecting our reproductive health.

Bacon, Fish and Sperm

semenPatients are always asking me are there dietary changes they can make to enhance their chances for pregnancy. In the case of men with low sperm counts, the answer is often no. However, researchers from Harvard School of Public Health looked at men’s diet and the quality of their sperm in a study presented at the American Society for Reproductive Medicine (ASRM) meeting. Interestingly, they found that men who consumed lots of processed meats such as bacon and sausage had poorer quality sperm and those who consumed lots of dark meat fish such as salmon and tuna had better quality sperm. While these findings are preliminary; the study size is small and the data has not been published yet, this does suggest that nutrition may play a real role in male infertility.