Blog 2008

Pre-Seed Mentioned in 2008 Practice Committee Report on “Optimizing Natural Fertility”

We were very excited to discover that the Nov 2008 Fertility and Sterility supplement of the 2008 Compendium of Practice Committee Reports, included a report on “Optimizing Natural Fertility”. In this article, Pre~Seed was the only commercial lubricant specifically mentioned for use while TTC, and as not harming sperm. This is an exciting recommendation of our Pre~Seed and Pre’ isotonic products, as well as a confirmation of the science and regulatory review behind them.

These reports represent best practice guidelines from the American Society of Reproductive Medicine. Specifically, the article abstract states “This Committee Opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples attempting conception who have no evidence of infertility”. Fertil Steril 2008;90:S1-6.

Besides recommending Pre~Seed, this report had the following Summary Points for TTC couples:

• Frequent intercourse (every 1 to 2 days), although 2-3 times a week is nearly equivalent.

• The fertile window spans a 6- day interval ending on the day of ovulation and correlates with the volume and character of cervical mucus.

• If you can’t or do not prefer to time ovulation, having frequent intercourse (as defined above) from the end of the woman’s menses (period), throughout the rest of the month, until her period starts again, can increase your chance of conception.

• Devices designed to predict ovulation may be useful in couples with infrequent intercourse.

• Positions and resting after intercourse had no impact on fertility.

• Time to conception increases with age. Women over 35 should seek a reproductive specialist after 6 months of trying.

• One to two drinks of caffeine or alcohol does not effect fertility.

• Smoking, >2 drinks of alcohol a day, and most commercial lubricants should be avoided when TTC.

Pre~Seed Cousins Times Two!

Wow, I loved this note from sisters who have now been pregnant TWICE, several weeks apart using Pre~Seed. My sister and I were pregnant with our youngest boys at the same time. These boys were born two weeks apart and are now 11 yrs old. They are totally different but totally love each other! Enjoy this story! ~ Dr. E

Hi, I wrote you a while back (”Success from a Loyal Customer”- Emily). I just wanted to give you an update on things. I had one tube of Preseed left when I found out I was pregnant. Well, then my sister told me they were trying as well. If you’ll remember we both got pregnant at the same time 2 years ago using preseed and delivered our babies within 2 weeks of each other. This time around I gave her my remaining tube to try and voila! I’m almost 12 weeks now and she’s almost 10 weeks. Just thought you might want to know that we are both hooked for good. Thanks again!!! ~ Emily

Sperm from Older Men Can Lead to Poorer Pregnancy Outcomes

A recent study by Frattarelli et al., 2008 (Fertility & Sterility) found that using sperm from men who were older than 50 yrs old resulted in fewer developing embryos and fewer live births than that seen for younger men. This study included in vitro fertilization of donor oocytes, so partner age and oocyte quality were not an issue. Fertilization and early cleavage (or divisions) of the egg were not different between the two age groups of men. This study suggested a significant decrease in embryo development past early cleavage stages for sperm from older men. The pregnancy loss rate went from 24% for pregnancies from the < 50 year old men, up to 42% in the over 50 group of men. The live birth rate per cycle went from 56% in the younger group to 41% in the older group. Pregnancy loss increases and live birth rate decreases started to shift in patterns around age 51 years.

Other studies have found that sperm DNA damage increases with age in men (Wyrobek et al., 2006 Proc Natl Acad Sci). And this may be a part of the poor embryo development and pregnancy losses observed in this study. At any rate, it is important that men realize they have a “biological clock” too when it comes to optimizing the chances of a normal pregnancy. If you are an older man seeking to father children, I would strongly recommend that you have your sperm DNA quality evaluated to ensure it is within normal limits, beginning around age 45 (learn more at www.scsadiagnostics.com).

Take Care-

Dr. E

You’ve Made us Happy with Your Magic!!

This was a fun letter from across the ocean! Thought I would share it with you all.
Blessings ~ Dr. E

Dear “pre-seeder’s” I’m writing to you from Spain, so than you also have testimonials from other parts of the world. After almost a year TTC I heard about your product in a Spanish fertility website. We had nothing to loose so, I ordered Pre-seed and some ovulation tests. We used just two of the six applicators. Just two!! That was two weeks ago!!! And now I have on my table a positive pregnancy test!!!! I can’t believe it!!! I look at it every minute to check it is for real!!! When I came by your website I couldn’t believe such “first-use-positives” amount, but, here I am making statistics grow even more!!! Thank you!!! Thank you with all our hearts. Your “magic” has traveled all the way to Europe. We really hope this pregnancy ends up in a baby; but if it’s not that way, at least we know the miracle is possible for us!! WE COULD NEVER THANK YOU ENOUGH!!! ~ L.O.

Can Pre~Seed or Pre’ be used for Semen Sample Collection?

Pre~Seed and Pre’ share the same isotonic, pH neutral formula. Pre~Seed is packaged with applicators for moisturizing inside the vagina including around the cervical opening where sperm are deposited.

Pre’ is packaged in a more traditional lubricant tube, for application on the external genitalia to facilitate entrance during intercourse.

Because they share the same formula, it is not a problem to apply Pre~Seed externally for semen sample collection or foreplay during love making. Both of our isotonic lubricants contain no oils or small molecules such as glycerin, this makes them safe for sperm, but it also makes them absorb quickly into skin, when used externally. The best way to work around this is to use twice the volume of product you would use with a leading lubricant. For example, if a man is planning to use Pre~Seed or Pre’ for masturbation and semen collection, he should start with an amount of product at least the size of a quarter if not more. This should provide lubrication without having to reapply product during collection.

Several independent studies (see our science page) have shown that the Pre~Seed/Pre’ formulas do not harm sperm following contact, as do leading lubricants. This has allowed our products to receive the first, and currently only, FDA authorized indications of use during fertility interventions, such as semen collection.

Dr. E

The Role of Genetics in Female Sexual Behavior

An article in May 2008 Sexuality, Reproduction & Menopause reviewed current genetic information on the sexual behavior of women. The author Burri, discusses female sexual responsiveness in light of different gene studies using twins. I thought the study was very interesting, because it provides information as to why different women experience their sexuality in such varied ways.

In particular, the study reported that 32% of women never or rarely achieve orgasm during intercourse, and about a third of the difference between women who readily orgasm during intercourse and those who do not, is linked to genetic differences between these groups of women.

In contrast, about 18% of women reported difficulties with orgasm during masturbation, but 50% of the difference between these women and those who easily orgasm during masturbation was hereditary.

In general, whether a woman could readily orgasm during intercourse was not well related to ease of doing so during masturbation.

Take Home Messages:

If orgasm is a tricky event for you, don’t rule out self pleasuring during love making, especially if it rarely works for you during intercourse itself. No guy is going to mind watching his wife take care of this. And NO having him do the hand play is not the same thing, unless you have spent a lot of time coaching him. Masturbation can be a great way to liven up your mutual sex life. And this is especially true for those of you out there doing this later by yourself, once he falls asleep. Be brave it will pay off!

A good proportion of those women not having an orgasm during intercourse, are likely not because of technical issues, and not genetics. It takes communication and courage to try different positions or tell them “that is too rough or not enough or…”. Most women orgasm more easily on top and it can make the man last longer, too!

We should share our sexual history/knowledge with our daughters. The media shows such ridiculous portrayals of female sexuality. Girls think they are supposed to be feeling like a cat in heat from one kiss, and that love making should look like arena Wrestling moves, rather than the actual gentle touching and licking that actually turns women on. I recently spoke to a group of women in their 30’s. I was sad to hear many of them say that it just took “too long” for them to orgasm so it was just easier to let the man “go for it” and get it done. When I asked them what kind of time frame, they were saying “oh fifteen minutes…half an hour”. This is too long to caress, kiss or touch each other, so that female desire has time to catch up to the man’s arousal?

Turn off the TV folks – your body and pleasure are worth a half an hour or so of intimacy several times a week.

Take care-

Dr. E

Another Multiple Seedling Family

It is always fun when we hear from families with multiple Pre~Seed children, which we refer to as “Seedlings” I believe our record is 3 Seedlings (in one family) and we also had 3 Seedlings from one 6 pack (across three families). Fun! Anyway, you will enjoy Emily’s journey.

Take Care ~ Dr. E

Hello, I just wanted to write in and tell you my story. I’ve been meaning to do it for 2 years now, but was busy being pregnant and raising a now 14 month old boy! When we started thinking about trying to conceive I wanted to be as informed as possible. I read Toni W.’s book, “Taking charge of your fertility” and started to chart my cycles after going off birth control. After charting a few cycles I realized I have a short luteal phase, which can lead to miscarriages if not treated either before pregnancy with clomid or after becoming pregnant with progesterone pills. My Dr. put me on Clomid and while researching the side effects I discovered dryness as one of them. Not good if TTC! I knew we couldn’t use regular lubricants and even tried an eggwhite one month (as Toni suggested in her book)!

After being unsuccessful, I started “googling” and came across Pre-seed. I ordered it right away and we used 4 tubes our first month TTC and came up with a BFP 2 weeks later! My sister was also TTC so I gave her our remaining 2 tubes and she had a baby girl 2 weeks after my boy was born! I really didn’t expect such immediate success, especially because I’d been diagnosed with endometriosis before getting married. But I am happy to write in as one of your many thrilled customers for whom preseed worked the first month!

Fast forward 2 years…..my husband and I decided to start TTC again this month (Sep). I really wanted to get pregnant this month because I didn’t want to have another late summer baby….well, it worked again–the first month! I am due June 1st and we are so happy! Needless to say I am hooked and have told many of my friends about your wonderful product. The $17.00 was totally worth it! Thank you so much preseed for taking the stress out of TTC and making it fun! ~ Emily–a loyal customer

Do Antidepressants Impact Sperm Function?

A recent study presented at the Reproductive Medicine meeting this year (Tanrikut et al., 2008), suggested that an SSRI antidepressant significantly increased sperm DNA damage to levels that have been well associated with poorer reproductive outcomes (over 30% damaged sperm). This study mirrored the results from a 2005 study that my group presented. In our study, men who smoked saw a dramatic increase in the percent of sperm with damaged DNA, while taking SSRIs.

It is my opinion that the potential impact of SSRIs on men who are trying to conceive, is a hugely under-discussed issue. Approximately 4-6 million men of reproductive age in the US are on SSRIs. These medications can cause 1/3 – 1/2 of men to have sexual dysfunction including erectile dysfunction and delayed ejaculation, which can also interfere with TTC.

The cause of this is most likely disruption of the hypothalamic-pituitary-gonadal axis. These medications can elevate prolactin, which due to a cascade, suppresses testosterone production in the testicles and disrupts sperm production. Although, the sperm damage may also be caused by increased levels of oxidative stress on the sperm from the SSRIs.

There are other types of antidepressants that can be discussed with your physician if you are trying to conceive. Another option would be to have a sperm chromatin test done if you are taking SSRIs and TTC. This way, you can find out if your sperm’s DNA has been impacted. Please read my FAQ about
sperm chromatin testing to better understand what this involves.

Take care-
Dr. E

Wow, A Great Pre~Seed Story

We get so many heart-warming stories from all of you, but occasionally someone writes us with a truly amazing TTC journey, such as this…dr.e…

OMG Thanks! I never write into companies, but this experience is too good to be true. For over six years, we had tried to conceive and we had seen specialist after specialist. We were told my husband has 99% bad sperm and low counts and I have PCOS, so it was very unlikely that we would ever get pregnant together without IVF. The first and only time we used your PreSeed product, much to our surprise we conceived. That was the only change that month. I’m telling all my fertility challenged friends about the magic goop that worked. Thanks again. We’re now 4 months pregnant and are hoping for a healthy baby. Kind regards, ~ K

New PCOS Support Blog from Someone Who Lives It!

We just got this great message from a new PCOS support blog. Check it out and give Pam our support! Three Seedling kids that may be a record!

Good afternoon, I have used PreSeed for my past 3 children/conceptions, I swear by it and tell everyone I know about it because of its amazing results for me (I wish I would’ve known about it sooner!!!). I have recently started a blog on PCOS (I was diagnosed over 7 years ago). My plan is to provide loads of information (that is often withheld or ignored) for those who: have recently been diagnosed, think they may have it, and have PCOS. I have been on various forums and mentioned PreSeed a lot through my posts. Although a good number of women have heard of it, or are using it, the majority I spoke to had no idea what it was and were excited to know there was such a product. I only recently came upon it from a web search. I really want to share the product with my visitors because it’s helped me SO much, and I believe they’d be interested as well since most PCOS’ers take Clomid to increase fertility, and we all know what Clomid does to your cervical mucus and environment!!…My plan is to write a post about hostile CM and include information about PreSeed as a helpful suggestion to combat the problem! Sincerely, pcosinfo.com

Pre~Seed for Women with Vaginal Dryness after Breast Cancer Treatment

In the August journal of Sexuality, Reproduction & Menopause (a publication of the American Society for Reproductive Medicine) Pre~Seed is mentioned for use by women with painful intercourse and vaginal dryness following breast cancer treatment. We are pleased to see our isotonic product mentioned in this medical journal. Pre~Seed or Pre’ can be used by women in all stages of life for isotonic, mild moisture & lubrication. Limiting irritation caused by lubricant products during love-making is important for all women, but especially those that are already having pain at intercourse. A recent study published by researchers at Ghent University discussed the potential for different lubricants to cause mucosal irritation, (referring to the tissue of the vagina). Most physicians are not aware of how hypertonic (or hyperosmotic) the leading brands of lubricant are formulated, which can lead to irritation. The study abstract is cited below.

Mucosal Irritation Potential of Personal Lubricants Relates to Product Osmolality as Detected by the SMI (Slug Mucosal Irritation Assay)
Sexually Transmitted Diseases, 2008 May;35(5):512-516
Els ADRIAENS, PhD; Jean Paul REMON, PharmD. Laboratory of Pharmaceutical Technology, Ghent University, Harelbekestraat 72, 9000 Ghent, Belgium

BACKGROUND: The slug mucosal irritation assay has recently been used as a sensitive measure of mucus membrane tolerance for vaginal microbicide products and carriers. In the current study, it was determined whether mucosal irritation potency of personal lubricants is related to varying product osmolalities.

METHODS: Five commercial lubricants with an osmolality range were evaluated using the previously validated slug mucosal irritation assay. Specifically, Arion lusitanicus were treated with lubricants over 5 days to quantify mucus production and tissue damage, allowing assignment of each product into an irritation potency category (none, mild, moderate, or severe).

RESULTS: The irritation potency (assessed by the mucus production) of the lubricants showed a significant, quadratic relationship with the product osmolality (P = 0.001; R (2) = 0.99). Femglide, a hypo-osmotic lubricant (32 mOsm/kg), caused a negative mucus production. Pré, an iso-osmotic lubricant (316 mOsm/kg), caused no changes. Two moderately hyperosmotic lubricants, Replens and K-Y jelly (2143 and 2463 mOsm/kg), induced mild and moderate irritation, respectively. The highly hyperosmotic lubricant Astroglide (5848 mOsm/kg) resulted in severe irritation and tissue damage.

CONCLUSIONS: Commonly used personal lubricants show a full range of mucosal irritation potential, which is related to product osmolality.

Pre~Seed is in Woman’s World this Week!

See the great mention of Pre~Seed this week (August 25, 2008) in Woman’s World under their “Ask America’s Ultimate Experts” section. The Pre~Seed mention came from Toni Weschler, the international bestselling author of Taking Charge of Your Fertility.

Toni’s book is a MUST read for every woman, whether trying to avoid or achieve conception. I have bought this book for all the young women in my life (sisters, son’s girlfriends, etc…). Most of us gals do not understand our cycle and how to use cervical mucus to track your fertility. Toni’s book will show you how.

I really enjoyed this Woman’s World magazine also! I hadn’t read it before, but I learned to eat English muffins instead of bagels (well unless I do the Oprah detox diet they recommend).

Only two weeks until I go to New York to be in a Discovery Channel sperm special, maybe I better start that diet!!!

Take Care-

Dr. E

Cute Success Story!

Hello,

We are a doctor and dentist couple and were trying to conceive a baby naturally, and succeeded on the second month of using Pre~Seed. We also used a fertility monitor at the same time. By this time, we had been trying for 6 months in total. We really believe that Pre~Seed helped us, and are very thankful. We had no idea that trying something so simple would be so effective. I am sure I am voicing the thoughts of several couples who have tried this product. Just wanted to express our appreciation to Drs. Ellington, Oliver, Clifton and the team.

Semen sample quality improved when collected at home

A recent article in Fertility & Sterility (2008:89;1718) found that semen sample quality was statistically improved if men collected their samples at home versus in the clinic. In fact, the number of men with abnormal sperm counts (<20 million/ml) dropped from 30% with semen collection in the clinic to 18%, with collection at home. The percentage of men with normal progressive motility (or swimming sperm) also increased with home collection. The samples in this study were collected by masturbation.

This information is consistent with several studies that show a beneficial relationship between how relaxed and sexually stimulated a man is, at the time of ejaculation, and sperm quality. This is important for couples who are trying to conceive for several reasons.

1) Having a sample that accurately reflects the man’s sperm sample saves everyone from the grief and added costs or interventions that may occur with an incorrect diagnosis of male factor infertility. You must always have two samples one month a part to diagnose a male factor. And it would be best if at least one sample was collected at home.

2) When doing procedures such as IUI or IVF, you want the very best sperm quality and count you can have. Your results are directly related to these parameters. Collecting at home and following some of the subsequent recommendations can optimize this.

3) Even if you are trying naturally at home to conceive, make sure one of your “baby-making” sessions is GOURMET– Take your time, try something a little different, keep it spicy! Basically make sure that at least once in your fertile time you go that extra mile for great sex, not “have to” sex. This will help him produce more sperm.

Finally, whether you are collecting a semen sample for the lab, or baby-making at home, you can use Pre’ and/or Pre~Seed, to make things feel better, and add extra slippery, while providing an optimal sperm environment. Some labs will tell men to use no lubrication for sample collection. This doesn’t feel good! We have many sperm labs that use our products for semen collection, and Pre’ has a specific indication of use for semen collection. So have no concern in using our isotonic formulation.

Be aware though that labs, do NOT like messing with samples from home. It is a hassle for them. You may have to just straight up tell them, you will be collecting it at home and bringing it in. They can complain, but they need to accommodate you in this request or you should find a different lab. And you must get the sample to the lab within an hour. If you can’t, rent a hotel room- the effect of the two of you having fun collecting this sample together versus DH standing in a white room, will pay off!

Also remember the VERY best way to collect a semen sample is with a special non-spermicidal condom made from polyurethane. This has been shown in many settings to dramatically improve sperm quality and count for all the reasons discussed above.

Happy Collecting!

Dr. E

Low Incidence of Irritation or Yeast Infection with Pre~Seed

I just signed off on our annual quality review, where we look at all complaints from users with regards to individuals experiencing irritation or infection after using Pre~Seed or Pre’. I am very pleased to report that we had a very, very low rate of consumers contacting us with symptoms of irritation or yeast infection following the use of our products. Only0.002% of users reported problems, or 1 occurrence for every 55,500 applicators sold.

This is in contrast to leading lubricants, where irritation rates as high as 20%, have been reported in the literature. This review supports the recent publication by Adriaens et al (Sex Trans Dis, 2008) that found that our isotonic formula caused no irritation in laboratory studies, whereas the leading three lubricants (KY, Astroglide, and Replens), all which contain glycerin did cause irritation and even tissue damage.

Please help us spread the word on the very mild nature of our glycerin free product!

Take care-

Dr. E

Pre~Seed in July 21st First Magazine!

We were very pleased to see a nice mention of Pre~Seed in First Magazine on page 103, in the July 21, 2008 edition. The “Handy Info” section discusses the Cleveland Clinic study published in Fertility & Sterility earlier this year, where Pre~Seed was the only vaginal dryness relief product (lubricants etc…) tested that didn’t decrease the sperm’s ability to swim.

This is a great resource magazine; I spent an hour getting great ideas browsing through it after a friend showed me our product mention!

Dr. E

Pre~Seed in Dr. Greene’s Book “Perfect Hormone Balance for Fertility”

I was very honored and pleased to learn that Pre~Seed gets its own highlighted mention in Dr. Robert Greene’s new book “Perfect Hormone Balance For Fertility: The Ultimate Guide to Getting Pregnant”. You can find Pre~Seed in the Fertility Fact box on page 122, as a vaginal dryness product that won’t reduce fertility.

Dr. Greene is the medical director of the Sher Institute for Reproductive Medicine in California. They use Pre~Seed and Pre’ in their clinic for all their procedures, including ultrasound, as well as handing out samples to patients for them to try at home.

Dr. Greene’s book is very well written and understandable. It deals with an area that many people and even physicians do not understand, namely the role of hormones in fertility and what one can do to maintain a healthy balance. Hormone balance can be a challenge to maintain in our society but it is still critical for conceiving, for having a joyful sex life, and for being happy to be alive!

I am always impressed when I read physician’s writings that help patients understand their bodies and journey in a clear and interesting way. This book will help you understand how to optimize conception; what to rule out if it is taking a while, and what all the options are if you need to seek further help.

I highly recommend Dr. Greene’s book and we are grateful for his mention of Pre~Seed! Check it out!

Dr. E

Pre~Seed in Men’s Health Best Life This Month!

There is a great mention of Pre~Seed in Men’s Health Best Life this month! We were very excited. and it is good to see the increased awareness about the sperm damage from other products. You can see a nice write up on page 40, discussing the Cleveland Clinic study published in February, showing Pre~Seed as the only vaginal dryness product tested that did not harm sperm.

This is a great “guy’s” magazine, lots of interesting little bits of news! DH enjoyed flipping through it last night.

Take Care-

Dr. E

An Incredible User Story

We just got this wonderful email in at info@ingfertility.com . Wow!!! I sent it to one of my closest friends who is a physician and who only ovulates a few times a year. Her husband also has a low sperm count. I wanted to remind her to not give up trying natural intercourse even if you are getting ready for assisted reproduction. As an aside, this friend told me that she ovulated this month taking the FertilAid vitamins I had sent her (no relationship to our business). Another doc for vitamins me thinks!

Here is A.M’s wonderful story….

05/12/2008 Preseed is a miracle worker. We have been TTC for almost 3 years now and were told based on my husband’s motility and sperm count that we had a 1% chance of getting pregnant on our own and IVF with ICSI was our only option. I was supposed to begin the birth control pills and hormone stimulation June 1st. As a last hope, I ordered Preseed after reading all of the testimonials. We have tried everything you can think of to make this happen. After one month of using the Preseed I found out today that I am pregnant. I did not think this would ever happen for us on our own. We feel so blessed and owe it to our faith and Preseed. I would recommend this product to anyone that has given up hope and think the odds are against them. God willing this will be a healthy happy pregnancy. I know next time we try to get pregnant I will be placing my order of Preseed again first thing! ~ A.M.

Vitamins for Men While TTC

Should men with poor semen quality, or any TTC man, take vitamin supplements, in particular vitamins designed to “support” fertility? The rationale behind this is that most men with low fertility have very low levels of antioxidants in there semen. Antioxidants (like Vitamins C & E, as well as others) protect cells from damage. Sperm from men with low antioxidants in their semen can have a breakdown of the DNA, or genetic material in the sperm, and it may be a reason for some infertility. So taking vitamins, especially those blended to support antioxidants in semen should be a straightforward approach.

However, the study outcomes in this area are confusing. This has led some doctors to recommending people to not take vitamins. This is throwing the baby out with the bath water—for sure! To summarize, fertility studies can be hard to do because there are so many reasons for couples to not conceive. It is kind of like asking “what is the best cure for cancer?” without knowing what kind, how long etc… you simply can not answer this. In addition, antioxidants are tricky, more is not better. You can OVER supplement and this can CAUSE sperm damage.

In spite of the difficulties in getting a study that says – “a man with this kind of sperm defect needs to take this kind of vitamin”, in general, TTC people should take a supplement. This is because nutrients have declined in many plant crops over the last 50 years (http://www.sciencedaily.com/releases/2004/12/041203100522.htm), this is likely even more true for trace minerals that are critical for normal reproduction that weren’t measured 50 years ago (Zinc…). As a former veterinarian, I always thought it was interesting that we feed our animals less processed grains than we eat (corn, soybean etc…), but all the feeds add trace minerals and vitamins, to optimize the animals function, including reproduction.

Taking a vitamin blended for TTC folks, is a good place to start getting some of the nutrients associated with improved sperm count, without going over board and causing damage. There are several products out there (FertilAid for Men, Fertility Blend etc…). However, I did want to share with you all a study that our Company did on sperm quality in men after taking FertilAid, versus a placebo. The study was done under contract with the manufacturer, Fairhaven Health, but our company retained the rights to disclose the data no matter the outcomes, meaning we had no incentive to find a favorable outcome.

This 90-day, double blind, placebo-controlled study found that FertilAid for Men supported an increase in the total number of normal motile sperm, in the ejaculate. Most of the men that had increased sperm counts while taking FertilAid for Men, showed improvements of 20% or more in the number of healthy sperm. Previous clinical studies have suggested a relationship between the “total normal-motile sperm count” in an ejaculate and the fertility of the man. Specifically, the greater the number of normally shaped sperm that are able to swim (motile), the higher the incidence of pregnancy among trying-to-conceive couples.

There aren’t many simple things to do to help men with poor sperm quality. Taking a vitamin/antioxidant supplement for at least 90 days, to see if sperm counts and function can be improved… Why not!!! We have put a manufacturer’s mail-in rebate for FertilAid in our Pre~Seed cartons to help remind people to take their vitamins Let me know how they work for you.

You can learn more about this product at Fairhaven Health (http://www.fairhavenhealth.com), a leading manufacturer of fertility products for both women and men.

Take Care-

Dr. E

The Optimal Exam of the Man (Part 3)

A physical exam by a fertility urologist or male specialist is an important part of evaluating the man for fertility issues. A general physical exam needs to be done to make sure there are no underlying issues that might impact his health and sexual function. This includes making sure his blood pressure is normal and he doesn’t have diabetes. In addition, a careful exam of his “parts” (genitalia) should be done.

The physician should evaluate: the penis, including where the urethra opens; the size, shape and consistency of the testicles, the vasa (or cords) and the epididymides; if a varicocele is present; any signs of hormone disruptions; and a digital rectal exam for the prostate and internal organs. Remember TWO semen analyses one month a part are required for adequate review of the man’s semen. This is because many men are nervous with their first sample, and the quality can be quite poor even with normal men. The clinic that does the semen analysis should adhere to World Health Organization guidelines for the analysis

If they don’t use these standards, it suggests they may not be very experienced at male factor work ups and you may not be given good information. Abstinence should be 2 days, longer than this can be counterproductive. Semen can be collected by masturbation or during intercourse using a special semen collection condom. Pre~Seed or Pre’ can be used to lubricate the collection process. Remember here, the better the experience feels for the man, the more sperm he can produce. So do every thing you can to make collection enjoyable. For many men, this means not doing it at the clinic.

As long as you can get the sample to the clinic so they can begin examination in less than one hour, and you can protect it from temperature extremes, there is nothing wrong with collecting the sample at home, or even in a local hotel, near the clinic. If it is very hot or cold out, and/or you have travel, which traffic and life’s delays push that 1 hour time frame, then go ahead and make the best of the clinic’s “men’s room”. If you are transporting samples, wrap them in a good sized towel to protect them from temperature changes during transit. The laboratory should have a quality control program with standards set by CLIA. Again it is good to ask if they use WHO guidelines and if they conform to CLIA standards.

A semen analysis provides information. It can not tell you (in general) if a man is fertile or not. Men can have a normal semen analysis and still not be fertile. But most of the time, a semen sample that doesn’t meet the reference range suggests a male factor fertility issue and indicate a need for further evaluation.

Failing to meet the reference range doesn’t mean this man is “sterile” or will never cause a conception (unless he is not making any sperm). It can mean that his chances of fathering a child are, in general, less than a man with results in the reference range. Semen analysis Reference Values are:

1. Ejaculate volume = 1.5 to 5 ml

2. pH = > 7.2

3. Sperm concentration = > 20 million/ml

4. Total sperm number = > 40 million/ejaculate

5. Percent Motile = > 50%

6. Forward Progression = > 2 (0-4 scale)

7. Normal Morphology = >30% WHO 1992 or >14% Kruger/Tygerberg Strict Criteria WHO 1999

8. Sperm agglutination = < 2 (Scale 0-3)

9. Viscosity = <3 (Scale 0-4)

New studies on intrauterine insemination

Inseminating sperm directly into the uterus (intrauterine insemination or IUI) is often used in male factor infertility, either with or without giving medication to stimulate the ovaries. There have been a couple of papers this year of interest to me on this topic. Many couples don’t fully realize how low the per cycle pregnancy rate with IUI can be, especially in conditions as noted below, or in clinics that aren’t very experienced in dealing with male factor patients (read more of my FAQs to learn about this).

Specifically, Badawy et al., 2008 showed declining pregnancy rates following IUI with male factor if: the female partner was over 35 yrs old; the number of motile sperm inseminated was less than 5 million ( a 5.5%, pregnancy rate versus 24% if there were more than 5 million motile sperm); or if normal sperm morphology (WHO guidelines) was under 30%. Another recent study (Dovey et al., 2008) with over 4,000 couples found pregnancies from women under 35 years of age at 11.5% per cycle. Women 35-37 had a pregnancy rate of 9%, which declined down to 1.8% in women over 42.

This is why we recommend if you are 35 or older; do not wait for one year without conceiving to get assistance!

Many people do not believe that a doctor’s intervention is the right thing to do in conceiving, or perhaps they just can’t afford it. It is interesting to note that although the percentage of women having a baby tends to be higher following intra-uterine insemination, it has not been able to be proven to be more effective in clinical studies versus well timed natural intercourse (Cochrane Database Syst Rev., 2007). This is likely due to the lack of well designed studies, rather than an ineffectiveness of IUI (done by experienced clinicians), BUT it does suggest that good old, natural love making at least every other day throughout your ovulation time, can be effective even after a long time of trying! So even if you can’t or won’t do IUI, keep timing your ovulation and keep love making “that time” as enjoyable as you can! Sometimes miracles do happen

Dr. E

PS: I will continue my male work-up series later this month!

An amazing story…

I appreciate when all of our users write to us, but occasionally we receive a story that is unique. Having suffered from chronic pain during intercourse when I was younger, I know what it can do to your self esteem and your life as a whole. I am really honored to have helped this family! Dr. E

“I just wanted to tell every couple out there about how amazing Pre~Seed intimate moisturizer really is. After giving birth to my first child, I was diagnosed with PID, and sex since then has been somewhat painful and not enjoyable. After years of trial and error, my husband and I had given up on finding a personal lubricant that made sex worth having. Even the most expensive lubricants were sticky, wore off to quickly and we always had to stop to reapply, and even had a scent that wasn’t complimentary to my personal body chemistry. For the past year we had been trying to conceive again and finally came across a sperm friendly personal moisturizer named Pre~Seed, so we decided to give it a try. Not only did it exceed my expectations, I will continue to use this long after I’m done conceiving. No more sticky hands, reapplying, and most of all… No more painful sex. Pre~Seed is so natural feeling, I can’t tell the difference between the natural me and the enhanced me! I thank you so much for creating this… my husband thanks you even more!”

The N Family Chisholm, MN

Optimal Evaluation of the Man in Fertility Evaluation (part 2)

Continuing on summarizing the best way to evaluate the man’s reproductive status (according to Male Infertility Best Practice Policy Committee of the American Urological Association and the Practice Committee of the American Society for Reproductive Medicine in Fert & Ster 2006;86:S202).

Once you have decided to have a male fertility work up, the “required” elements are a physical exam, a reproductive history and TWO semen analyses, preferably one month a part.

A physical exam by a male fertility specialist is important. It can identify problems that may be impacting reproduction such as diabetes, varicoceles (a “plumbing” problem), erectile dysfunction or even if there is some kind of hormone imbalance (for example from exposure to toxins at work or supplements for body building). It is important to know if the man is taking certain antidepressants, or even if he has been ill with a fever recently. Knowing what types of problems can negatively impact male reproduction is a specialty, and General Practice docs may not always know all the subtle things to look for.

The reproductive history is VITAL, but often overlooked. Go ahead and write these things down before you go in, unless some of it is for your doc’s ears only.

1. how often and when in the month do you have intercourse

2. how do you figure out when the woman is ovulating and when to have intercourse

3. how long have you been trying to conceive

4. has the man ever caused a pregnancy- did it result in a baby or end in some other way (terminated pregnancy or a miscarriage)—tell everything here, even if it is something the man doesn’t want his wife to know ( you can tell the doc this)

5. any childhood illness or problems developing (such as one testicle not descending)

6. prior major illness or surgery- especially anything having to do with hormones or a lot of medications (thyroid, heavy medications for allergies or asthma, cancer, antidepressants)

7. sexual history – especially sexually transmitted diseases—no one likes to talk about them, lots of people have had them- tell your doc!

8. Exposure to toxins, including heat – such as working in a factory or agriculture or even just exposure to a lot of heat, like working outside in the southern US in the summer time.

This history tells the physician if you have likely always been infertile or if it is maybe something new. It really can help pinpoint what is going on. So choose someone that wants to hear all this, and write it down before your appointment.

Did you see at the top of this post that you need TWO semen analyses for an adequate evaluation? We will come back to that after I am back April 8th…

Send me lots of energy. We are having a big family reunion at the beach (my parents 50th), and I still can’t walk and am in a lot of pain from my January accident …Not sure how it will go…

Take care-

Dr. E

Optimal Evaluation of the Man in Fertility Evaluation (part 1)

I thought it might be helpful to review Best Practice Guidelines for evaluation of the male half of a couple – according to the Male Infertility Best Practice Policy Committee of the American Urological Association and the Practice Committee of the American Society for Reproductive Medicine (Fert & Ster 2006;86:S202). In general there is a lot of misinformation out there about men and fertility. Men are responsible for a couple’s infertility 20% of the time, with another 30-40% of the couples having both a male and a female portion. So male fertility problems are not uncommon! It is important for men to be evaluated before the couple has gone through that magic “one year of trying without success” if:

• * a problem with his fertility is suspected (e.g. family history of a problem, history of problem with the parts – such as testicular trauma, previous cancer etc…)

• * female infertility risks are known—this includes partners over 35 years of age or more; or,

• * the man is concerned about his fertility potential.

The goals for evaluating the man are to identify:

• * things that can be fixed;

• * irreversible conditions where assisted reproduction with the man’s sperm can be used;

• * irreversible conditions where this can’t be done, and rather donor semen or adoption may be the option;

• * health threatening conditions that underlie the infertility and require medical attention; and,

• * genetic conditions that could impact a baby if assisted reproduction is done.

Often when a person who is not an andrologist or fertility urologist talks to couples about male fertility, they won’t even exam the man, and just look at a sperm sample. This is not appropriate. Remember he/you is/are more than just a sperm donor, and if someone isn’t talking to you about identifying a pathway with the outcome goals mentioned here….find someone who does. Most often, that someone will not be the woman’s ObGyn. Male fertility is a specialty and deserves specialized attention

Continued later…

Dr. E

Survey on Lubricant Use in General & Irritation

Last month’s enews asked you about your lubricant use and if you found irritation to be a problem. Here is what 107 of you told us:

73% of you were 25-35

21% of you were 36-45

91% of you were female

91% married

During non-trying-to-conceive intercourse, 36% of you always, & 9% of you – over three quarters of the time, use lubricants.

During trying-to-conceive intercourse, 47% of you always, & 25% of you – over three quarters of the time, use lubricants.

41% of you have had irritation following lubricant use-

19% (of the total respondents) have it sometimes, and 10% often

The most commonly irritating lubricants were KY® & Astroglide®.

13% of you have had yeast infections following lubricant use – 6% sometimes or often. The most commonly associated lubricants were KY®, Astroglide®, & mineral oil.

What was most important to have in a lubricant were the properties of Slippery, Long Lasting & Non-messy. What you want least in a product is irritation or stickiness, Thanks! This data prompted us to do an online survey, because the level of irritation you all experienced is MUCH higher than the medical community is aware of, but not a surprise to me –as a fellow sensitive! We had 1100 respondents to that survey in a few days, and are now tweaking it for an even larger survey. Watch our website for this in the next week or so. Then you can help spread this survey link to your communities. The more people we have that complete it, the more we can get the medical community to notice. This may help limit the practice of medical staff recommending irritating lubricants to women who suffer from irritation during intercourse. Basic concept I know, but until we bring this issue to light—the practice will continue — as it did for me when I was younger. The more burning or pain I had with intercourse, the more lubricant my doctor suggested I use. And since they all were hyperosmotic from glycerin and propylene glycol –they all made me sore. I thought it just came with the act.

Take care-Dr.E

Great New Site for Young Families

Our friends at BabyHopes.com have now expanded, with a new website called Down the Lane, which I really like. Downthelane.com offers products for anyone in that “all consuming” stage of life from preconception to infants to toddlers and beyond. Their cart offers practical solutions for fertility and parenting issues that are bound to come up along the way; such as assistance in trying to conceive, dealing with morning sickness and pregnancy discomfort, as well as colic help and beyond. Boy did I need all of the above with our youngest!! Down the Lane offers healthy, natural products and they are awesome folks to work with. Check it out!

Does MY Lubricant Harm Sperm??

We have received several emails from people who wanted to know if THEIR vaginal dryness product harmed sperm, in light of the published Cleveland Clinic study. This study, published last week in the official journal of the American Society of Reproductive Medicine, showed Pre~Seed to be the only product that didn’t harm sperm motility as compared to Astroglide, Femglide, & Replens; or damage sperm DNA as compared to Femglide or KY.

In general, the following ingredients are associated with the hyperosmotic conditions (high ion concentrations) that are so damaging to sperm –glycerol, glycerin, propylene glycol, mineral oil. In addition, glycerol itself has been shown to directly damage sperm. These ingredients should be avoided when you are trying to conceive.

The main lubricantproducts that are hypo-osmotic (or have too low of an ion concentration for sperm) are the Femglide & Slippery Stuff products. Although Femglide was tested in the Cleveland Clinic study, Slippery Stuff (made by the same company) is more commonly sold to non-medical people. Femglide and Slippery Stuff share the same ingredients, in the same order (general concentration), and they share the same effect on sperm (based on our in house studies).

Another study done by Ghent University’s Pharmacology Department, to be published later this year, showed that the more hyperosmotic (the higher the ion concentration) a product was the more irritation it caused in a laboratory model. So again, if your product has glycerol, glycerin, propylene glycol or mineral oil in it, it has more chance of causing irritation–if you are prone this way.

In this Ghent study, the Femglide with the hypo-osmotic formula (low ion concentration), caused a decrease in secretions. A property that is likely shared with Slippery Stuff, again based on them having the same ingredients in the same order (so a very similar formula, if not the same).

In contrast, our isotonic formula (just the right ion concentration–same as your body’s fluids), caused no irritation or changes in secretions which is what you want out of a vaginal dryness treatment. Just moisture–and nothing else!!

Cheers-

Dr. E

Paper on Pre-Seed by Cleveland Clinic Published This Week

We are very pleased to let you know that a full paper has been published this week in the official journal of the American Society of Reproductive Medicine “Fertility & Sterility”, citing that Pre~Seed alone did not cause changes in sperm function as compared to several other products including Astroglide, Femglide, Replens and KY. This study is titled “Effect of vaginal lubricants on sperm motility and chromatin integrity: a prospective comparative study”, and was done by the Urological Institute and Department of ObGyn at Cleveland Clinic. The complete reference is Fertility Sterility 2008;89:375-379. This independent validation of PreSeed is a valuable milestone for us! If some of you still have physicians who: a) are not aware of the potential for sperm harm with other products; or b) haven’t yet heard of Pre~Seed, this is a great article for them to review.

Take Care-

Dr. E

Pre~Seed User Survey Jan 2008

Subscribers to our e-news letter last month completed an opt-in self reporting survey. Therefore, it is not a scientific study and represents information only, from those people who chose to respond. Often in these cases people who feel that the product worked well for them are more likely to respond than are people that didn’t care for the product. That said….

161 of you completed the survey for us. Thank You!

85% were using Pre~Seed primarily because you were trying to conceive

15% were using it as your routine intimate moisturizer because it didn’t cause irritation or infections as did other products.

Although 27% of you said that after using Pre~Seed, you would use it in the future whenever you needed extra moisture, not just during your fertile time.

Of the people responding:

30% became pregnant the first 2 months of using Pre~Seed

9% became pregnant after 3 or more months of using it

4% became pregnant but didn’t remember how long it took

43% of users had become pregnant at the time of this survey

22% of these pregnancies were sadly lost; however, this is a standard loss rate for early pregnancies.

 

20% of responders had a girl

17% had a boy
(not all pregnancies reported gender)

 

14% used Pre~Seed after trying to conceive for 0-2 months

31% after 3-6 months

18% after 7-12 months

32% after more than a year

21% had undiagnosed infertility

15% had a male factor issue (semen quality, etc…)

24% had a female problem (abnormal ovulation etc…)

23% were taking some fertility medication

What you liked best about Pre~Seed was that it didn’t harm sperm, and how it felt.

What you liked least was the pre-filled applicator (although many people, in contrast, actually liked these).

Great feedback! Be sure and sign up for the enews letter to stay up to date on all our news!

Dr. E

Cell Phone Use and Sperm Counts

Dear Friends-

It’s that time of year when we all want a little more romance and fun from our intimate relationship. As is my usual way, I want to recommend a few things you can try to surprise your DH (darling husband). A somewhat graphic post so don’t read on if that will offend you, please!

1) My first suggestion can be fun for all body types, but especially gals that have put on a little weight, and may be uncomfortable trying new things, might enjoy this. Have the Pre’ ready and the Pre~Seed loaded if you are trying to conceive (TTC). You can also use the left over Pre~Seed in the tube –shake it all out– to help with this. If you are NOT trying to conceive you can have a glass of water by the bed as well. Begin “messing” around once DH has an erection, sit against the wall or bed headboard with pillows behind you. Then have DH kneel in front of you. Apply LOTS of product to him and begin using your hands to stroke him. You will want to use your thumb firmly along the outside ridge of his penis, and use a good bit of pressure, with the rest of your hand wrapped around him. You can use a mix of long slower strokes, as well as shorter strokes where you mostly just flick your thumb over his glans (the tip). During this DH can have access to play with your breasts, and if you are well endowed, he can press your breasts together, with both his hands, so that your hand is wrapped around his penis stroking him below your breasts, while his tip is thrusting up between your breasts. NO matter what size you are, DH will enjoy the view of your face, your hand stroking him and your breasts. If you are not TTC, DH can finish here. If you are, be sure and switch things up in time! Also, if you are NOT trying to conceive, and the Pre’ starts to dry just dip your fingers in the water glass, and add the water drops to you or him. This will reactivate the product making it slippery again. Don’t do that if you are TTC, b/c water is toxic to sperm.

2) For a little longer romantic interlude, have DH start on his stomach, candles, music etc… plus a nice massage oil. Avoid any massage oils with propylene glycol, or glycerol. They will get sticky! Natural food stores have some nice ones with grape, rice, jojoba or sesame oil. I like the one Pier 1 sells too. If you are TTC be careful not to get the oil around private parts, as some oils can disrupt sperm function. You will need to have a soft pillow ready, and some hand wipes if you are TTC. Either way, also have some Pre’ ready and get the Pre~Seed loaded!

Give DH a nice back rub, and then when you are ready, wipe the oil from you hands with the wipes. Ask DH to elevate his hips slightly by placing the pillow underneath his pelvis. He stays face down. Then gently access his “package” and maneuver it so that it is pulled back and is lying on the bed between his legs, with his penis pointing down towards his feet. This step will NOT work if he is already erect, but he CAN develop a nice erection in this position, with some different sensations. Apply Pre’ or left over Pre~Seed to his shaft, and other areas you would like to slip and slide around. You can wrap your hand around his shaft to stroke him in this position, or you can just use your fingers to trace up and down his shaft, and all around his back side! If you aren’t TTC, you can use your tongue to access these same areas. This is a unique position and will give him different sensations whether you choose to finish him this way, or switch up to take care of you!

Happy Lover’s Day!

Dr. E

A Great Resource

For the past 15 years I have worked with Dr. Jane Helle, a wonderfully warm, talented, very spiritual hypnotherapist on issues from stress to pain management. My kids have all worked with her too…for their concerns such as to help them with taking standardized tests to improving self esteem in middle school.

Dr. Helle has had to help me RELAX with being on bed rest this past two weeks, with LOTS more to come… I have been using her relaxation, meditation CDs. They are awesome!!! She has lots of different CDs for everything from hypnosis for weight loss, to decreasing the stress of parenting.

I had never used CDs like this before, and didn’t really knowhow or if they would work. But I can tell you, one of my favorite parts of my day is listening to Jane’s voice talking me through a time of relaxation and release. All her products are guaranteed, so if they don’t bless you, you can return them for a refund.

If you are looking for away to take a little better care of yourself on your journey, whether you are trying to conceive or just busy or in pain…try one of Dr. Helle’s CDs.

Let me know what you think of them, too!

Take Care-

Dr. E

Dr. E Recovering

Last Monday, Dr. E was walking and petting her four dogs (all at the same time), when she slipped on the ice and severely broke her ankle. She had to undergo major reconstructive surgery (e.g. plates, screws, cast etc). She is home now and we at INGfertility are trying to limit her narcotic induced blogging; ~

Dr. E wanted to say thanks for all the uplifting email she has received this week. These have included some awesome Pre~Seed User Stories that have really given her something to be happy about the past few days! She also wanted to let you all know, you don’t have to become pregnant to write to us with your Pre~Seed & Pre’ stories. Dr. E had vulvodynia in her 20’s, and was very sensitive to other lubricant products. Although her doctors never helped her understand how these products were making her MORE painful! She knows what it is like to have something, as seemingly straightforward as an intimate relationship, become a source of daily frustration and pain. So she loves to hear from ALL of our Users, whether it is those for whom Pre~Seed is helping to make love-making better, or those for whom it is helping on the conception journey. Even those of you who have ideas for product improvement, now is a great time to write! Whatever you would like to discuss, Dr. E will have MUCH MORE time for the next 12 weeks to blog and write FAQs - after we get her brain cleared up next week.

Blessings-

Dr. C (Dr. E’s better half)

Top 4 Reasons for Failing to Conceive

Over 75% of the time couples that are not conceiving (that are infertile), have one of the following four problems. If you are younger than 35 yrs of age (for the woman) - have these checked out if you have not conceived in a year. If you are 35 yrs old or older, after 6 months of trying you may want to get checked out!

1) Poor sperm quality At least 50% of the time, when a couple is not conceiving there is some component of abnormal or poor quality sperm. This may be all of the problem, or partially the problem (so that both the man and the woman are contributing). A sperm analysis should be done by an ANDROLOGIST or a fertility Urologist. Many RE clinics do not do sperm analyses correctly (read our other FAQs about this). IF his test is abnormal, repeat it once more to confirm the results. Also, remember with guys, quality counts! The better intercourse feels for him and the more foreplay the MORE sperm he can make. Pre~Seed can help here to make things slippery fun!

2) Abnormal Cycle This often has to do with hormonal abnormalities, and can be seen as failure to ovulate or cycle normally, or chemical pregnancy and losses. Working with an ObGyn or RE to evaluate how your ovaries are functioning is critical. While you are waiting, keep a careful, detailed log of when you have your period, when you have any ovulation mucus, and any other information on your cycle. The very best book on monitoring this is Toni Weschler’s book “Taking Charge of Your Fertility”.

3) Tubal Problems Many women have blocked tubes that keep the sperm and egg from meeting. The only way to know if this is the case is to have special testing done. In general, couples often wait too long to have this testing. It can be helpful to know what is going on, and in some cases the testing itself can help promote conception. Especially if you have had a history of Chlamydia or bacterial vaginosis, have this checked!

4) Poorly Timed Intercourse Many couples do not have intercourse at the right time. Specifically, some women ovulate a little later than OPKs suggest. So they are quitting the baby dance too soon. If you are unsure at all, regular intercourse 2-3 times a week has been shown to be almost as effective as every day well timed intercourse. Too many couples have daily sex for 2-3 days early on at ovulation and then stop, only to have actually missed her peak time.

If you have ruled all these out, then I also suggest you have a sperm chromatin assay done, to make sure the DNA in his sperm is of an adequate quality to support conception. There is a FAQ on this at our site also.

Take Care-