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#81
A story sent to Mensfe
Why do some men feel so underrepresented in the world of fertility ?
When I say under represented I do not mean they are not there.......... In spirit, but their role, and often their presence is often overlooked and/or undervalued.
Within fertility issues, it is clear from (my) experience that the drive is far more intense from the female. both initially as well as the endurance to undergo multiple rounds of treatment. It is usually the male who will contemplate or breach the concept of "giving up" first.
Why is this? Maybe it is the pure evolutionary bio-psychological drive that such a short period of a woman's life is the window of opportunity to give life. This itself evokes an intensity hard for some males to imagine.
Also often males may have already had children in previous relationships and the drive to spread the gene is less powerful as a result of this...... but I feel that one of the main issues that culminates in my exclusion is historically encultured values in the role of men and women.
Man the provider, man who goes and prepares to lay down his life for his homeland in war. Man the strong one and all this evolving into an unhealthy patriarchal society where any display of emotion is often still considered a weakness for men.
So all this manifests itself in the consultation room in the hospitals and in the counselling room.
As a man my role is to fix, protect and supply.
In that fertility center, I am in a position where I can not fix this problem, there are experts who have taken that control and expertise out of my hands......... I am redundant, pushed out.
My partner is unhappy and the situation is that whatever I do I can not alleviate her pain, I am frustrated and as a man I get angry and turn that in on myself
What I can do is research, I find myself gathering prodigious amounts of data from the internet, but it is futile.
So I run away, away from the shame of not fulfilling my role for my partner,   and you just do not see me.
The problem is historic and societal, the solution needs to be shaped by modern thinking and practice.
High level conferences need to recognise the need to acknowledge the plight of men struggling to come to terms with the changing expectations of a modern world.
The implications and impact of fertility crosses the gender boundary and men need to have a space to be heard.
Can you imagine any other scenario where one group was excised? where a black groups experience was relayed by an all-white panel, where the elderly's experience of care was spoken about by young people...... 
It just deepens the division and further drives men away when they are ignored, and not represented by the leaders in such important fields as fertility.
It is without doubt that the process of addressing fertility in the medical environment, the period of pregnancy, and of course the raising of children in a mutually respecting and supportive home will be better served with a couple working together. ...In a world where the male feels included and important, and where he has had a stake all through the process.
Sadly, for many reasons that is not the world of fertility and there are few so enlightened practitioners like ...... who recognize this truth.
#82
Research / A scramble for headlines or an...
Last post by mensfe_admin - 2018-02-26 10:28
12 February 2018

By Professor Robin Lovell-Badge
Appeared in BioNews 937


The problem of fertility preservation for girls and women undergoing cancer treatments has been a subject of research for many decades. The recent study by McLaughlin and colleagues from Professor Evelyn Telfer's lab at the University of Edinburgh, UK, is aimed at finding a solution to this problem, with the claim that they have produced mature human egg cells in the lab for the first time (see this week's BioNews story).

Egg cells or oocytes begin their development in the ovary as a small cell contained within a single layer of granulosa cells, together making up a 'primordial follicle'. For these to develop to a stage when they can be fertilised requires a period of growth of the oocyte (from 15 to about 100 micrometres) and development of a multi-layered and complex follicle, which after puberty usually takes a minimum of about four weeks. This is then followed by a phase referred to as maturation when the fully-grown oocyte completes the first meiotic cell division (MI) and divides asymmetrically to give a large MII oocyte and a very small first polar body, which usually dies within a day and does not contribute to any subsequent development of an embryo.

In vitro maturation (IVM) to go from a fully-grown to an MII oocyte is already a fairly common procedure (although still formally an experimental one), sometimes for cancer patients, but also for other cases where standard IVF procedures are difficult, such as polycystic ovary syndrome (PCOS). The use of this technique has led to many hundreds of apparently healthy babies. Therefore, for women who have fully grown and/or mature oocytes (eggs), it is now possible to freeze these, thaw them and carry out IVF. It is also possible to freeze pieces of ovary and then to thaw and graft these back to the ovary (or a nearby site) after cancer treatment. Care has to be taken with the latter approach, however, in case the ovary tissue contains some cancer cells, which is likely if the cancer is, for example, a leukaemia or there has been metastasis.

For prepubertal girls, however, they will not have any fully-grown oocytes; indeed they will almost all be at the primordial follicle stage. This McLaughlin et al. paper claims to have developed a method for growing and maturing these all the way through to oocytes that might be capable of being fertilised (metaphase II, or MII). Despite considerable effort form several labs, this had been done previously only in the mouse, with the first demonstration some 20 years ago, and with substantial improvements made in following years.

Nevertheless, several of the steps had already been achieved with human material, notably going from primordial follicles to secondary (multi-laminar) follicles and from secondary follicles to MII oocytes, so the novel aspect of this current work is to have joined these into one continuous process.

However, there are several problems. It was really quite inefficient, with perhaps 385 early follicles (of which about 80 percent were primordial) giving 87 secondary follicles suitable for the second stage culture method. Of these, 54 developed a typical fluid-filled cavity suggesting that they were progressing normally, but of these, only 32 gave fully grown oocytes. These were then transferred to typical IVM conditions. However, only nine gave rise eventually to mature fully-grown MII oocytes.

Critically, the pieces of ovarian tissue that the authors began with were not from prepubertal girls, but were biopsies from adult women, which clearly contained some follicles that had already begun to develop. The authors can't be certain that the ones that did make it to fully-grown MII oocytes actually arose from primordial follicles; they could have developed from later stage 'primary follicles' or even some of the already growing secondary oocytes present in the original tissue. The timing from beginning to end was also relatively fast compared with what is thought to happen in vivo, which could suggest that the mature oocytes were indeed not coming from primordial follicles. If they did originate from primordial follicles, their development may have been too fast, then this might lead to abnormal oocytes.

The characterisation of the oocytes obtained was rather minimal, but it was very obvious that they were not quite right. Usually, when the fully-grown oocyte divides to give rise to an MII oocyte, this is a very asymmetric cell division producing the large oocyte and a very small 'first polar body'. The latter contains a nucleus, but has too little cytoplasm to support its survival for long. However, the 'polar bodies' associated with the MII oocytes in this paper were very large. (The first meiotic cell division had not been sufficiently asymmetric.) In addition to suggesting that the oocytes had not developed normally, these large polar bodies could probably survive for longer and may even be capable of being fertilised.

If both the oocyte and the polar body are fertilised (by separate sperm) this can lead to the development of a mosaic individual, composed of cells with two distinct genotypes. ICSI (intracytoplasmic sperm injection) could be used to fertilise just the larger cell, but this will be smaller than normal, and it would be necessary to know that it wasn't deficient in some way. The large 'polar body' might also interfere with development of any embryo.

Moreover, although the authors showed evidence for a spindle (the cellular structure on which the MII chromosomes line up, moving to opposite ends of the cell when it divides in two), they did not check to see if there were any problems with the chromosome and their subsequent segregation. They did not see if the oocytes could be fertilised, which would have required an HFEA (Human Fertilisation and Embryology Authority) licence, or ask what would happen if they were activated. All the final IVM steps have been done before to yield normal fertilisable eggs that have given children, so the fact that the oocytes in this study were abnormal suggests that there were problems with the steps that were used to promote the early in vitro growth.

Finally, for clarification, this work is not describing the development of mature oocytes all the way from pluripotent stem cells in vitro. It is beginning with small oocytes that are already enclosed in follicles that have been obtained from adult ovaries. In this respect it is also not clear whether the methods will be of use for the purpose of allowing fertility preservation from stored ovarian tissue obtained from prepubertal girls prior to cancer treatments, which is one of the main justifications for the research. The follicles in prepubertal ovaries will be at an early stage, not yet primed for growth, and perhaps quite different from those in an adult.
The authors were aware of the limitations of their work and gave balanced comments. But the media interest seems to have been egged-on by an over-enthusiastic press release from the University of Edinburgh. This was not very responsible given the topic and the desperate need for workable solutions. A more balanced judgement might be that the paper indicates that it should be achievable, but don't count your chickens before they have hatched.
#83
30 years of declining male sperm count - some professional views - however there are others !
Well - that may come as a shock -  but there is always a HOWEVER - please read on

So are we anywhere nearer to finding an explanation for why are so many more men today are suffering from reproductive problems?
"It's most likely a reflection of the fact that many environmental and lifestyle changes over the past 50 years are inherently detrimental to sperm production," says Professor Richard Sharpe, fertility research expert at the Medical Research Council. "It may be that different factors come together to have a combined effect." A number of studies point to a connection between early development in the womb and male reproductive problems in later life, especially low sperm counts. For example, men whose pregnant mothers were exposed to high levels of toxic dioxins as a result of the 1976 industrial accident in Seveso, Italy have been found to have lower-than-average sperm counts. But men exposed to dioxins in adulthood showed no such effect. Another study found women who ate large amounts of beef during pregnancy, a diet rich in potentially damaging chemicals called polycyclic aromatic hydrocarbons (PAHs), had sons with relatively low sperm counts. But eating beef as an adult man shows no similar impact.
Meanwhile, studies of migrants between Sweden and Finland, showed that a man's lifetime risk of testicular cancer tends to follow the country he was born in rather than the country where he was brought up. It was his mother's
So are we anywhere nearer to finding an explanation for why are so many more men today are suffering from reproductive problems?
"It's most likely a reflection of the fact that many environmental and lifestyle changes over the past 50 years are inherently detrimental to sperm production," says Professor Richard Sharpe, fertility research expert at the Medical Research Council. "It may be that different factors come together to have a combined effect." A number of studies point to a connection between early development in the womb and male reproductive problems in later life, especially low sperm counts. For example, men whose pregnant mothers were exposed to high levels of toxic dioxins as a result of the 1976 industrial accident in Seveso, Italy have been found to have lower-than-average sperm counts. But men exposed to dioxins in adulthood showed no such effect. Another study found women who ate large amounts of beef during pregnancy, a diet rich in potentially damaging chemicals called polycyclic aromatic hydrocarbons (PAHs), had sons with relatively low sperm counts. But eating beef as an adult man shows no similar impact.
Meanwhile, studies of migrants between Sweden and Finland, showed that a man's lifetime risk of testicular cancer tends to follow the country he was born in rather than the country where he was brought up. It was his mother's environment when she was pregnant with him, rather than his own as a boy or as an adolescent, that seems to have largely determined a man's risk of testicular cancer.
One of the strongest pieces of evidence in support of this idea comes from studies of people who smoke. A man who smokes typically reduces his sperm count by a modest 15 per cent or so, which is probably reversible if he quits. However, a man whose mother smoked during pregnancy has a fairly dramatic decrease in sperm counts of up to 40 per cent – which also tends to be irreversible.
Professor Sharpe said such findings can be explained by understanding how the first cells of the testes form. Sertoli cells, which in the adult act as guardians for the development of sperm cells, are the very first cells to form from a "genital ridge" of the human male foetus. The number of sperm that can be produced in an adult man is critically dependent on the number of Sertoli cells that develop in his foetus, so anything that interferes with the formation of Sertoli cells in a mother's womb will affect sperm production many years later. "Maternal-lifestyle factors in pregnancy can have quite substantial effects on sperm counts in sons in adulthood, and the most logical mechanism by which this could occur is via reducing the number of Sertoli cells," Professor Sharpe says.
But the key question now is to identify the relevant lifestyle and environmental factors.
This is proving tricky. Obesity, for instance, is a growing problem and it has been linked with reproductive problems in both men and women. One study has also indicated that overweight pregnant women tend to produce sons with poor semen quality. But is it being fat that is the cause, or the environmental chemicals stored in fat?
There has been a lot of interest in chemicals in the environment, especially those that can either mimic female sex hormones – oestrogenic chemicals – or block male sex hormones, specifically testosterone which plays a critical role in stimulating the development of Sertoli cells in the womb. So far, the Seveso study provides the clearest link between human foetal development, low sperm counts and prenatal exposure to an environmental chemical. But the dioxin concentrations from this industrial accident were exceptionally high.
It is more difficult trying to establish a similar, significant link between male reproductive problems and exposure to low concentrations of the many other environmental chemicals that may have weak oestrogenic or androgen-blocking properties, including substances as wide-ranging as pesticides, traffic fumes, plastics and even soya beans. Professor Sharpe says that much of the evidence to date is weak or non-existent.
"Public concern about the adverse effects of environmental chemicals on spermatogenesis in adult men are, in general, not supported by the available data for humans. Where adverse effects of environmental chemicals have been shown, they are usually in an occupational setting rather than applying to the general population," he says.
So although scientists are closing in on the critical window of foetal development in the womb that determines a man's fertility status in later life, they are still not sure about what it is that could be affecting this change in his reproductive status. But one thing is clear, it is his mother who almost certainly holds the key
#84
Research / FDA okays test for many cancer...
Last post by mensfe_admin - 2017-12-05 11:40
04 December 2017

By Theofanis Michailidis
Appeared in BioNews 929


The US Food and Drug Administration (FDA) has approved a test which can detect cancer-causing mutations in 324 genes.

The test, known as Foundation One CDX (F1CDx), is the first FDA-approved single genetic test for large range of cancers. F1CDx, made by Foundation Medicine, has the unique attribute of looking for a mutation in hundreds of cancer genes simultaneously, searching for two genomic signatures in any solid tumour type. The results will allow physicians to identify the specific mutations from a patient's tumour sample, and find the most effective treatment.

'With the run of one test, patients and health care professionals can now evaluate several appropriate disease management options,' said Dr Jeffrey Shuren, director of the FDA's Centre for Devices and Radiological Health.

The single test will mean there is no need for multiple biopsies for successive, single-gene tests. This can help avoid 'the often invasive process of extracting tumour samples multiple times to determine eligibility for a single treatment or enrolment in a clinical trial', Dr Shuren said.

FDA Commissioner, Dr Scott Gottlieb, added that the test would give patients faster access to 'a breakthrough diagnostic' test that could 'potentially reduce health care costs'. The Centres for Medicare and Medicaid Services have proposed covering the test. As a result, tumour-gene profiling is likely to become available to a greater number of cancer patients.

Previously, private insurers were reluctant to cover similar tests, because of the lack of satisfactory evidence of benefit, Reuters reports. This is now set to change, as the approval of F1CDx sets a precedent for coverage determinations by private insurers.

'This will be a sea change' for patients, Dr Richard Schilsky, chief medical officer of the American Society of Clinical Oncology, told ABC News.
#85
Research / The infertile men who are left...
Last post by mensfe_admin - 2017-11-01 13:11
 Group speak candidly about how problems affect their mental health and relationships
Survey of infertile men found infertility hits males' mental health and self esteem
Being infertile can also affect a man's relationships, sex life and even his career
Men reported that fertility issues  were emasculating, distressing and isolating
But emotional support for men is scarce as infertility is seen as a 'women's issue'

By Colin Fernandez, Science Correspondent For The Daily Mail

Published: 00:03 GMT, 1 November 2017  | Updated: 09:22 GMT, 1 November 2017 

Being infertile can leave men feeling 'emasculated' and 'jealous' when they see another couple with a baby, a study has found.

A survey of infertile men found infertility hits males' mental health, self esteem, relationships, sex life and even their career.

But emotional support for men is scarce as infertility is seen as a 'women's issue'.

The survey of 41 infertile men found participants had been trying to conceive for five years on average, the research by Leeds Beckett University and Fertility Network UK found.
A survey of infertile men found infertility hits males' mental health, self esteem, relationships, sex life and even their career. But emotional support for men is scarce as infertility is seen as a 'women's issue'

A survey of infertile men found infertility hits males' mental health, self esteem, relationships, sex life and even their career. But emotional support for men is scarce as infertility is seen as a 'women's issue'

The majority of respondents – 93 per cent - stated their well-being had been adversely affected by fertility issues.

Men reported fertility issues to be emasculating, distressing and isolating, harming their self-identity, and causing stress, depression, anxiety, and low self-esteem.

Comments made by respondents included it was 'the most upsetting, dark and emasculating experience of my life'; 'it made me feel less of a man'; 'I now suffer with anxiety'; and 'it made me feel worthless that I couldn't have kids'.

Other comments included: 'Our sex life immediately took a hit'; 'seeing a baby I would feel jealousy, envy and anger'; and 'I pushed my wife away'.

'I started rejecting my wife and told her to leave me. I was having problems having sex.

'We have drifted from friends who have children. You feel like you're stuck in a void of society, alone on an island.'

Men often felt excluded and marginalised during fertility treatment, with some respondents reporting a lack of sensitivity from healthcare professionals.

'The whole experience has been focused towards my wife. Even consultant's letters about my genitalia are addressed to my wife. There seems to be no equality.'

Some men said their career prospects and finances suffered too.

The survey of 41 infertile men found participants had been trying to conceive for five years on average, the research by Leeds Beckett University and Fertility Network UK found

The survey of 41 infertile men found participants had been trying to conceive for five years on average, the research by Leeds Beckett University and Fertility Network UK found

'I had a good career, good money and I went from this to losing my job due to all the stress. I did not discuss this with my employer as I felt too ashamed,' said one respondent.

Another said: 'We spent around £30,000 on treatment and will be repaying the debt for many years.'

Susan Seenan, chief executive Fertility Network UK said: 'Men are half of the fertility equation. When they cannot create the family they long for without medical help they suffer and struggle physically and mentally just as women do, yet our major new survey with Leeds Beckett University shows that men's needs are far too often ignored, with support scarce before, during and after fertility treatment.

'This is unacceptable; we hope this survey will challenge the silence around male infertility and facilitate more male support groups.'

Dr Esmee Hanna, lead researcher, said: 'We know from this survey and our previous research that men find infertility an isolating and emotionally distressing experience.

'This survey shows just how impactful fertility issues can be to men's lives, including on their work, relationships and self-identities.

'There sadly still remains stigma and taboo about male infertility within society, but it is really encouraging that so many men shared their personal perspectives in this survey and that Fertility Network UK are leading the way in starting conversations about how fertility issues affect both men and women.'


Read more: http://www.dailymail.co.uk/health/article-5037441/Infertile-men-left-feeling-worthless-isolated.html#ixzz4xBXeZQMx
Follow us: @MailOnline on Twitter | DailyMail on Facebook
#86
Research / Male obesity linked to poorer ...
Last post by mensfe_admin - 2017-10-19 08:40
 

25 September 2017

By Shaoni Bhattacharya
Appeared in BioNews 919


Men with obesity are more likely to have a poorer quality and quantity of sperm than men of a healthier weight, suggests a new study.

Having a body mass index (BMI) of higher than 30 was linked to having a lower volume of semen, sperm count, concentration, and motility, and a greater number of sperm defects, compared with men of a lower BMI.

'The health and reproductive performance of spermatozoa in obese men are more likely to be compromised both qualitatively and quantitatively,' said Dr Gottumukkala Rama Raju at the Krishna IVF Clinic in Visakhapatnam, India, and lead author of the study. 'Results from our present dataset suggest that efforts focusing on male weight loss before conception are warranted for couples seeking infertility treatment.'

The team used computer-aided sperm analysis to examine the sperm parameters of 1285 men who had attended the fertility clinic in 2016. The study was published in Andrologia.

Obese men were also found to be more likely to have low sperm counts (oligospermia) and sperm with reduced movement (asthenospermia) which can have adverse effects on fertility.

'This latest research strengthens previous findings and helps us to counsel men attending fertility clinics,' Professor Geeta Nargund, medical director of Create Fertility clinics told HuffPost UK. 'A rise in sedentary lifestyle, poor diet and lack of regular exercise are contributing to obesity in men.'

She added: 'It takes up to three months for the body to create new sperm, so to guarantee their efforts are worthwhile they should be making lifestyle changes many months ahead of time.'

According to HealthDay, the study team is now examining whether losing weight will improve the quality of sperm. Early findings seem to suggest that as men lose weight, sperm quality improves, said Dr Rama Raju.




SOURCES & REFERENCES


As men's weight rises, sperm health may fall

Medical Xpress | 20 September 2017
   

Association between obesity and sperm quality

Andrologia | 19 September 2017
   

Being Overweight Could Be Affecting Men's Sperm Count And Quality

Huffington Post | 20 September 2017
   

Male obesity linked to lower sperm count

Diabetes UK | 21 September 2017
#87
Arthur Menard was discussing his testicles with friends over dinner. As you do. It was a serious discussion and not as vulgar as it might first seem.

Unconstrained by British reserve, the French entrepreneur and his pals chatted away about their balls and eventually came up with the idea for Spartan boxer shorts - a high-tech pair of pants that protects a man's most vital assets from the radiation that pervades the modern world.

This is not merely an invention for the hypochondriac. Wifi, smartphones and numerous other devices emit electromagnetic radiation which several studies have suggested damages mens' sperm.

Unprecedented legal ruling links tumour to mobile phone usage

Though a conclusive link between radiation and lower fertility has not been proven, sperm are definitely dying. Recent research found that, for a variety of reasons, some of which remain unclear, the sperm count of western men has halved over the last forty years.

Faced with the reality that men are not going to give up the smartphones that have become their second-favourite appendage, and the fact that they don't want their other favourite to stop working, Menard, along with co-founder Pierre-Louis Boyer, set about finding a way to create a world in which sperm and smartphone could live harmoniously.

You'll never wear a summer dress the same way again

Heist Studios
Best small 4x4s 2017

by Taboola

The fruits of their labours are the unique Spartan boxer shorts. The company says they take inspiration from the technology found in microwaves and space suits.

Thankfully, this doesn't mean that the pants cook a man's sperm to near-nuclear temperatures that can burn the roof of your mouth. Nor does it allow one's seed to travel to far flung galaxies (whatever strange fantasies you may have).

It means that the boxers are based on the idea of the Faraday cage, a far less space-age concept, discovered by English physicist, Michael Faraday, in 1836.

It uses a mesh of conductive material to block electromagnetic fields, thus protecting the precious goods within.

So the Spartan is, in effect, a cage for the crown jewels. And why not? But don't be fooled by the term "cage" or the name Spartan. Despite being named after the famous warriors of antiquity and being made from 50 per cent silver, these underpants "are not a suit of armour", Menard stresses. They won't protect you from a high-paced football to the gonads or a crafty below-the-belt punch.

Arthur Menard, co-founder of Google was so confident in his new underpants he pitched to Google whilst wearing them with no trousers (Spartan)

In fact, after a lot of research, the team developed a silver and cotton mesh that Menard claims is more comfortable than normal fabric. It's also highly effective, he says, blocking more than 99 per cent of mobile phone and wifi radiation. Silver also has the added benefit of having anti-bacterial properties meaning the pants should stay odour-free.

The idea has clearly struck a chord. It attracted hundreds of investors on crowdfunding site IndieGoGo last year and the founders took Las Vegas by storm in January, presenting themselves at the CES technology fair wearing no trousers, just Spartan boxers. So confident was Menard in his product, he even pitched to Google wearing the pants. The company was started at the HEC incubator at Paris' Station F startup campus. The founders also studied at HEC and the university helped with funding. Spartan has now raised over €500,000 (£440,000) and the boxers are on sale in 30 countries.

Prices range from £28 to £35 per pair so it's a premium product, competing with the likes of Calvin Klein and Prada. But Menard makes the strong argument that given what's at stake, they're probably worth the investment. 
#88
Research / Men, delayed childbearing and ...
Last post by mensfe_admin - 2017-09-13 09:13

Men, delayed childbearing and age-related fertility decline

07 August 2017

By Caroline Law
Appeared in BioNews 912


While media reports regularly remind us of women's biological clocks and warn of the dangers of women leaving it 'too late' to have children, until recently little attention has been paid to the role of men in timing when to have children, and the effect of age on male fertility. However, July 2017 saw a surge of interest in this in mainstream media, following evidence from the Beth Israel Deaconess Medical Center and Harvard Medical School presented at the European Society for Human Reproduction and Embryology's (ESHRE) annual conference. Findings from a study of 18,802 IVF cycles suggest that amongst couples undergoing the procedure, for men over 35 increasing age was associated with lower cumulative incidence of live birth. Outlets including The Guardian, the BBC (including BBC Radio 4) and BioNews picked up on these findings, bringing this discussion into the public domain. The Guardian and the BBC also reported findings from a systematic review, from the Hebrew University of Jerusalem, of recent trends in sperm counts, which reported a decline in sperm concentration and count between 1971 and 2011.

Thus the accepted wisdom that men can continue to have children into later life, easily and without consequence, has been called into question. In some articles, authors blame men's lack of awareness of age-related fertility decline, and lazy or glib attitudes towards having children, either explicitly or implicitly. Alongside this, coverage of recent research (Inhorn, Baldwin, Gurten) on egg freezing suggests that women freeze their eggs because they are not able to find a suitable male partner; there is a 'dearth of eligible men' wherein the number of qualified, professional women is not matched by an equivalent number of qualified, professional men. These accounts have added weight to the idea that men's roles in relationships, in starting a family, and in when to start a family are of crucial importance.

Prior to this, to a large extent media attention had mirrored social science research on the topic: the minimal focus on men being greatly outweighed by a focus on women. This is also reflected in our national data collection: while the Office for National Statistics (ONS) gathers data on women's ages at the birth of their first child, this is not the case for men; for men, a distinction between first and subsequent children is not made, as it is for women. Consequently, while we can track changes in the age at which women are becoming mothers, we cannot track trends in when men are becoming fathers.

Nonetheless, ONS data does suggest that the average age of men at the birth of any children has risen from 31.1 in 1993 to 33.2 in 2015. Research suggests that the majority of men want children, and being an 'older' father isn't something most desire. Men identify certain pre-conditions as necessary before embarking on parenthood, including being in a good relationship with the right partner and someone whom they feel would make a good parent; having financial and material security; and feeling emotionally and psychologically ready. Men's aspirations to be both the breadwinner, as well as a nurturing and involved father, also create added pressures.

However, scientific evidence about the impact of age on men's fertility, while still contested, appears to be a growing. A 2015 systematic review of 90 studies identified age-associated declines in semen volume, percentage motility, progressive motility, normal morphology and unfragmented cells. Elsewhere, evidence suggests that advanced paternal age is also linked with increased risk of infertility, miscarriage and various pathological conditions in offspring. In addition, the 2013 NICE fertility guidelines reported that there was now evidence of declining male fertility with increasing age, for the first time.

All these developments point towards the need to take greater consideration of the role of men in reproductive timings (and in whether, when and why women opt to freeze their eggs) and related research – both social and medical. If age does indeed play a role in men's fertility health, this needs to be taken into account in research, policy and practice.

Finally, we need to question why women's behaviours and reproductive 'choices' are routinely held to account in delayed childbearing, not men's; a greater focus on men will go some way to redress the balance. In 2013 Reproductive Biomedicine Online published a special issue on age-related fertility decline, beginning with the piece 'Cassandra's prophecy: why we need to tell the women of the future about age-related fertility decline and 'delayed' childbearing'. In the lively debate that followed, authors considered whether 'telling' women is sufficient, and grappled with how this complex issue can be addressed. Perhaps the recent media interest in men, age and fertility is a sign that the time for a full and frank debate about talking to men about age-related fertility decline – both women's and men's - will soon be upon us. 
#89



   

It is not just women who need to worry about the ticking of their biological clock.

Men who wait until their forties to try to become fathers could cut their chances by more than a third.

A US study has found that men aged 40 to 42 with a female partner who is under 30 have an average birth rate of 46 per cent.

This is more than a third below the 73 per cent rate for men aged 30 to 35.

Experts believe sperm DNA becomes damaged with age, which explains the higher risk of older men having children with autism and schizophrenia.

Dr Dodge said there was little men could do to counteract the effect of age on their sperm, adding: 'The best pre-conception advice we can offer is to maintain a healthy lifestyle'

Dr Dodge said there was little men could do to counteract the effect of age on their sperm, adding: 'The best pre-conception advice we can offer is to maintain a healthy lifestyle'

Men aged 40 to 42 are a fifth less likely to have a baby than before their 30th birthday, the results suggest.

The findings, for couples having IVF, suggest women are better off trying for children with a man their own age or younger.

Commenting on the research by the Beth Israel Deaconess Medical Centre in Boston, British expert Professor Nick Macklon, from Southampton University, said: 'I suppose from the social side the value of this is not only in counselling couples about when to move for ART [assisted reproductive technology], but it may help women encourage their male partners to get a move on.'

Scientists analysed data on 7,753 couples seen at a Boston fertility clinic between 2000 and 2014.

Experts believe sperm DNA becomes damaged with age, which explains the higher risk of older men having children with autism and schizophrenia


Experts believe sperm DNA becomes damaged with age, which explains the higher risk of older men having children with autism and schizophrenia

And females
Those aged 35 to 40 were almost 30 per cent more likely to have a child with a partner aged below 30 than one aged 30 to 35

Their results suggest women who have put off trying for a baby are much better off finding a toyboy if they want to fall pregnant.

Dr Gillian Lockwood, of Midland Fertility Services, who was not involved in the study, said: 'While a little girl is born with every egg she is ever going to have, men are making new sperm every morning all the way through their reproductive lives.

'But every time there is cell division to make the next generation of sperm, there is the possibility of error creeping in.

'It's the cumulative effect of these errors as cell division goes on and on and on that is probably causing the problem.'

The findings, for couples having IVF, suggest women are better off trying for children with a man their own age or younger

The findings, for couples having IVF, suggest women are better off trying for children with a man their own age or younger

Lead researcher Dr Laura Dodge said older men trying to conceive naturally were less likely to get women pregnant, took longer to do so and increased risk of miscarriage.

This may be due to DNA damage and changes to genes.

The US study, presented at the European Society of Human Reproduction and Embryology conference in Geneva, Switzerland, found women saw their chances of a live birth fall 46 per cent from when they are under 30 to aged 40 to 42. But men cut odds of having a baby by 20 per cent over the same time.

Dr Dodge said there was little men could do to counteract the effect of age on their sperm, adding: 'The best pre-conception advice we can offer is to maintain a healthy lifestyle.'


#90
The conceptual foundation of 05 June 2017

By Professor Vardit Ravitsky, Dr Juliet Guichon, Marie-Eve Lemoine, and Professor Michelle Giroux
Appeared in BioNews 903


In his commentary titled Donor children do not benefit from being told about their conception, Professor Guido Pennings argues there is no empirical evidence to support the assumption that it is in the best interests of children to know that they are donor conceived. In their excellent recent reply, Blyth et al refute this claim by demonstrating that such evidence does exist [2,3,4], and by pointing to the various oversights and methodological weaknesses of Professor Pennings' arguments (as also expressed in their letter to Human Reproduction, co-signed by 39 experts) [2]. We support all their arguments and would like to add another layer to the critique, by focusing not on the empirical evidence in hand, but rather on the conceptual foundation underlying the right of donor-conceived people to know their genetic origins (hereafter 'right to know').

The heated debate surrounding the right to know is based on two distinct ethical theories. The first is consequentialist. An act can be right or wrong depending on its consequences, so only by empirically assessing and demonstrating harm can we judge the ethically appropriate course of action for donor conceived people.

The second is deontological. An act can be right or wrong regardless of its consequences. Knowing one's genetic origins is considered a human right that donor conceived people should have, regardless of empirical evidence.

As argued extensively elsewhere [6,7,8,9], the deontological framework grounds the right to know in respect for people's autonomy. Violating it deprives donor-conceived people of the liberty to choose what meaning they assign to the genetic components of their identity and relationships, a choice experienced and taken for granted by most others in society. The deontological framework does not claim that all or most donor-conceived people will necessarily find their genetic origins of great importance, but rather that they are entitled to make that determination for themselves.

Professor Pennings' 'first line of information' stems from a consequentialist view. It is based on research that showed 'children who do not know about their donor conception function normally and do not show signs of psychological problems'. But this research outcome does not determine whether a person ought to have a right to know. It is inappropriate to consider empirical evidence gleaned from those who do not know, because their right has already been violated. We do not know what they would have wanted, or whether they would have been harmed if they knew.

Research should assess what is in their best interest by considering, for example, the circumstances of disclosure (e.g. at what age, in what context, using what language); their post-disclosure needs over the years (e.g. no needs whatsoever, medical information, information about the donor's personality); and the psycho-social outcomes of those who have access to the information they desire and those who do not. But it makes no sense to base the assessment of 'best interest' on outcomes of those who are unaware of what they don't know.

The deontological framework assumes that people can be wronged without being harmed. To cite Baroness Lady Warnock: 'I cannot argue that children who are told of their origins (...) are necessarily happier, or better off in any way that can be estimated. But I do believe that if they are not told, they are being wrongly treated' [10]. Dr Mhairi Cowden goes a step further and associates this 'wrongful treatment' with deception, claiming that 'truth telling is a form of respectful behaviour' and thus 'deception of this nature constitutes a wrong in that it violates the respect owed to that child' [1]. 

Let us consider an analogy: a person never tells their spouse that they were previously married to someone else (let's assume that this first marriage ended amicably and there were no children). As a result, the current husband or wife has no 'signs of psychological problems' regarding their partner's previous marriage. But would it make sense to say that this 'bottom-line outcome' is a reasonable measure to use when deciding if the current partner is entitled to know?

Indeed, different people would react differently to discovering this information. For some, it might have no importance at all and therefore no impact. For others, the news might have various meanings. But arguably, a person entering a marital relationship has the right to know something that is relevant to this fundamental relationship. Only once they know, can the partner assign meaning to it, and know what impact – if any – it would have on their identity, relationship, or couple dynamics. The partner may wish to know the identity of the first spouse or not, know more about their history or not.

The outcomes are irrelevant - not being told at all constitutes deception, a violation of their trust and the respect to which they are entitled (interestingly, it even provides legal justification for annulment). Now assume that the information in question is related not only to a partner's life history, but to your own, and to the ongoing relationship with your parents.

Professor Pennings argues that in the absence of empirical evidence, counsellors and psychologists are pushing their 'beliefs' upon people. But the term 'beliefs' is misguided, because it connotes a position that is not based on rational justifications. Those who acknowledge the right to know, including governments through legislation and professional societies through clinical guidelines, do so based on solid deontological grounds, not based on mere 'beliefs'.

The right to know is based on people's fundamental interest in having access to information that may be crucial to their identity, relationships and health – an interest well-recognised in adoption law. The debate about the nature of existing empirical evidence is not the only factor regarding the right to know. In fact, requiring arguments to be limited to empirical research findings alone [5] is harmful in itself, when they are then used to justify practice and policy. Respect for persons is central in ethics and requires clinics and governments to make it possible for people to know the truth about their origins.




SOURCES & REFERENCES


1) Cowden, Mhairi. 'No harm, no fowl': A child's right to know their genetic parents

International Journal of Law, Policy and the Family | 20 January 2012
   

10) Warnock, Mary. The Good of the Child

Bioethics | 01 April 1987