Preseed.com Blog

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 lfe 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

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

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

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

Our friends at BabyHopes.com have now expanded, with a new website called Down the Lane, that 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!

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 lubricant products 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