Mind-Body-Soul Wellness (Part Two)

Due to the popularity of all things Mind-Body-Soul, we decided to share some more of our wellness tips with you this week that will assist with boosting fertility, and to reiterate our mantra from last week’s blog; Natural Health Practice, Mindfulness and Nutrition are three of the most powerful tools we have to do just that:

Mind-Body-Soul Wellbeing Tip # 6: Go raw!

If you feel your body is in dire need of a cleanse and healing, pick a week a month where you consume only raw foods!  You will immediately see and feel the difference. Some benefits of going raw are:

  • Going raw will ensure your creative juices are put to use into the kitchen
  • Grocery shopping will be much more fun as you will be buying all sorts of ingredients for exotic salads and amazing smoothies/juices.
  • Eating food made with love (from your own kitchen) means you are consuming healthier ingredients and saving you money long-term!
  • Going raw will give you more insight into any food intolerances you might have.
  • You will be put of processed food for life!
  • Once you start enjoying a clean diet and you start to not only feel more alive and energetic, but you will notice your skin improve and your weight shift down a gear or three!
  • Sugar cravings will disappear and you will opt more for natural sweetness found in fruit or vegetables!

Mind-Body-Soul Wellbeing Tip # 7: Yoga

Yoga has been shown to greatly help promote general relaxation and reduce anxiety, stress and depression.  Fertility Yoga (FY) can regulate hormonal imbalances, increase circulation and stimulation of both female and male reproductive organs.  Here are key benefits of yoga for fertility:

  • FY reduces stress
  • FY increases blood flow to the uterus
  • FY strengthens the immune system
  • FY improves ovarian function
  • FY regulates hormonal imbalances
  • FY increases IVF success rate

We work closely with Harriet Came from Bloom Yoga who specialises in pre/post natal yoga. She is also a doula and uses her birthing experiences to inform and influence her teaching, working to show how conscious breathing, specific yoga postures and techniques can really help enhance a pregnancy and help birth and post-natal recovery.

Mind-Body-Soul Wellbeing Tip # 8 – Mindfulness & Meditation

Practising mindfulness and the art of meditation can also help to reduce levels of stress and anxiety and can promote conception. Mindfulness and meditation are two techniques that affect your mood and how you feel about yourself, and help to improve your mental wellbeing.

We work very closely with Dr Lulu Beyers, of The White Lotus. Dr Beyers is a natural health practitioner and has degrees in both Natural Medicine and Traditional Chinese Medicine (incorporating Acupuncture and Chinese Herbal therapy), and has extensive experience in treating gynaecological/hormonal disorders.

The White Lotus Studios in Cape Town have wonderful therapies/practitioners available, all under one roof.  Acupuncture, Chinese Herbal Therapy, Massage, Functional Medicine, Naturopathy, Osteopathy, Nutritional Therapy, Reflexology, Psychotherapy, Pilates, Yoga (Kundalini, Iyengar, Hatha, Vinyasa) and Mindfulness Meditation courses.

Mind-Body-Soul Wellbeing Tip # 9:  Super-Food Fruit – Juice your life!

Did you know?  There are many discussions about the benefits of eating pineapple when going through fertility treatment.  Although we cannot really say for certain that this is a true fact, pineapples still pack a mean nutrient punch, and have super-powers such as:

  • Immune system booster
  • Assists with bone strength
  • Assists with digestion
  • Pineapples have anti-Inflammatory benefits
  • Assists with blood clot reduction
  • Common cold and sinus inflammation

Other Super-Food Fruits out there are: Watermelon,  blueberries, strawberries, citrus fruits, bananas, acai fruit, kiwi, avocado, to name a few. Experiment with different fruits and enjoy the benefits of adding fresh juices to your life!

Mind-Body-Soul Wellbeing Tip # 10:  Get outside!

Nothing frees the soul and the mind quite like the outdoors – so get outside for a walk along the beach or through a forest nearby, or even to a local park that you love.  Just leave the confines of your own walls and mind for just an hour a day!

Love HART x

“Life is a series of a thousand tiny miracles.  Notice them.”
~ Anon

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Mind-Body-Soul Wellness (Part One)

Did you know that approximately one in seven couples have difficulties conceiving? Infertility is on the rise,  and scientists believe that infertility rates will continue to increase.  And many of the factors relating to infertility comes down to modern day lifestyle choices.

Now more than ever we are exposed to higher than acceptable stress levels; whether through work, relationship woes, financial stress.  Our quality of food is on the decline and our choice of diets are now more questionable than ever.  Convenience foods, microwave meals and on-the-go eating is an everyday occurrence that most of the population rely on, because there simply doesn’t seem to be enough hours in the day to focus 100% on our health.

It is important to note here that not all fertility issues are related to lifestyle,  and in order to get to the root cause of infertility, certain tests will need to be done by Fertility Specialists. However, this doesn’t mean that you can’t start making significant changes in your own life in order to get your fertility wellness on track!

Certain fertility issues stem from stress, lack of exercise, hormonal imbalances and poor eating habits.  Thankfully the majority of infertility issues can be solved, and by implementing lifestyle changes, this could increase your chances of falling pregnant naturally.  Fertility well-being comes from not just physical health, but from mental health and spiritual health too.

We have therefore shared our favourite Mind-Body-Soul wellness tips with you below that will assist with boosting fertility; Natural Health Practice, Mindfulness and Nutrition are three of the most powerful tools we have to do just that:

Mind-Body-Soul Wellness Tip # 1: De-Stress

  • YES YES YES!  As impossible as this may seem, this is the number one culprit for hormonal imbalance issues, menstrual cycle and ovulation issues.
  • When trying to conceive, couples end up dealing with a huge amount of stress when they have the inability to procreate. This becomes counter-productive in your efforts, and in turn adds even MORE stress to your lives.
  • The more stress you have in your life, the less likely you are going to have a menstrual cycle or ovulate, which is 100% necessary when trying to conceive.
  • It is therefore imperative that you work on finding ways to declutter your minds, and de-stress your bodies.
  • We work very closely with Dr Lulu Beyers, of The White Lotus. Dr Beyers uses Acupuncture and Traditional Chinese Herbal remedies to optimise treatment outcomes, and has extensive experience in treating gynaecological/hormonal disorders.

Mind-Body-Soul  Wellness Tip # 2:  Eat Food Made With Love!

  • It is vital that you nourish the body with nutritious whole and natural foods.  So make sure you eat food made with LOVE!  By this, we mean cooking food from scratch, and being totally connected with the food that you are cooking, and consuming.
  • It is important that while trying to conceive that you focus on their eating habits and start eliminating unhealthy eating habits.
  • Stay clear of processed or pre-cooked meals from supermarkets that are mass-produced, full of artificial ingredients and almost always laden with too much salt.
  • Having a relationship with your food and your body are the first steps to creating harmony within, starting with your hormonal balance.
  • Increase your intake of fruit, raw vegetables, organic proteins and avoid wheat and man-made products that have very little nutritional value to them!
  • We work very closely with Emily Innes who is a specialist in fertility-related nutrition and women’s health, Ms Innes is a firm believer in “you are what you eat”, and that you can change your life by changing your diet.

Mind-Body-Soul Wellness Tip # 3: Get Quality ZZZZZ’s

  • Sleep deprivation plays havoc with your body, and more so your hormonal balance!  It is therefore imperative that you create a space that is your tranquil haven at night so that you can get the quality of sleep that your mind and body deserves.
  • Avoid any stimulation at night such as your phone or laptop.  Select a curfew in the evening where you switch off all technology and create a window of “me” time where you can start to deflate from the day’s worries and stress.
  • Having a warm bath and creating a warm ambience in your room just before lights out is the perfect way to drift off into lala-land.
  • Avoid alcohol, caffeine and sugar late at night as these are stimulants and will affect your sleep.

Mind-Body-Soul Wellness Tip # 4: Detoxify!

  • Detoxing the body regularly is very important, especially for fertility wellness.  We are by no means suggesting you go cold turkey with all your vices and cheats as this will cause more harm than good, but it really is about finding the right balance.
  • If you do smoke, start working on a program where you can begin to cut-down and eventually stop completely.
  • Cut-down on alcohol consumption dramatically as this definitely impacts your chances of falling pregnant.
  • Buy yourself a juicer and make your own fresh juices at home!  There are so many fantastic recipes available online these days that you can really get creative when it comes to purifying your body!

Mind-Body-Soul Wellness Tip # 5: Be Kind To Yourself

  • This is such an important step in the fertility well-being process.  When we berate, blame or criticise ourselves, it manifests MORE stress, anxiety and hormonal imbalances, which will affect us emotionally and physically.
  • It is therefore really important to carve out time for yourselves every day, where you can truly reflect, be mindful, find your inner peace and allow yourself to focus on gratitude and acceptance, rather than what you cannot have right now.
  • Self-preservation and self-love is so important, so leave post-it notes on the fridge with mantras of love and gratitude, or leave an inspirational quote on the dashboard of your car every night so that you can read it first thing in the morning before heading to work.  Start to create a positive flow around you wherever you can so that it becomes a natural process eventually.

Always remember, you are beautiful, and strong, and you deserve to be happy.  Not everything works according to the plan you set out for yourself.  Sometimes, miracles come to you in different ways and through different sources, and we often miss these because we are too focused on our planned future that we refuse to default on.

Be sure to read Mind-Body-Soul Wellness (Part Two) next..

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New Year Fertility Fitness Resolutions And How To Keep Them

So here we are, in the first month of 2019, the Christmas and New Year Eve celebrations a not so distant blur, and there seems to be a permanent unwelcome guest named muffin-top that is following us around like a shadow! And so, after the gluttony that is Christmas, the first step now to a new you, and a new year is to create our New Year Fertility Fitness Resolution list!

As is done every January, new year resolutions lists are long with decisions and intentions that look great on paper, but many will never be looked at never mind scratched off the list.  Sound familiar? Resolutions are dreaded because we set goals for ourselves that are completely unrealistic and 99% unobtainable. But, with the right planning, and creating the perfect New Year resolutions that work for YOU, 2019 could be one of your best years yet!

We tend to create New Year resolutions that are completely unrealistic, with goals that, with even the most dedicated gym goer could never achieve,  and by doing this, we set ourselves up for failure, which leads to stress, a low self-esteem and more unnecessary weight gain.

So where should you start?   First and foremost, you need to be honest with yourself about where you see your own health and fertility fitness going in 2019.  What does a fertility fitness resolution commitment really look like to you? And although perhaps not obtainable yet, how do you ensure you get to your much needed end result?

The next step is to be grateful for your accomplishments of 2018.  Celebrate your year regardless of your trials and tribulations. You are here now, you are loved, you are supported, and you have a new year as a blank canvas to play with, so celebrate that.

it is important to understand that things may go wrong along the way – so create a contingency plan.  Life doesn’t always go to plan and often we cannot control every aspect of our strict planning regime. But, there is always a way around any obstacle, just make sure when you stray from your plan, that you find your way back!

Finally, and probably the most important step in creating your 2019 fertility fitness resolution is; set small goals at first.  Be kind to yourself along the way, and give your body time to adjust to your new way of life. Any long-term goal starts with setting smaller goals first.  So think about a goal for this week, the following week and then within the next month, and stay positive every step of the way. Small steps, make a massive difference.

Bearing all this in mind, here are our 2019 fertility fitness resolution ideas that you can definitely keep all year long:

  1. Set A Smart Goal (Specific, Measurable, Attainable, Realistic, Timely):
    This is one of the golden rules in fitness.  Setting SMART goals means you are more likely to achieve your fitness resolutions.  As discussed earlier, the best way to start is by setting a short-term goal for yourself.  This could be you setting a fitness goal where you will sign up for fertility yoga once a week and train 3x a week for the first month.  And when you achieve this goal, you reward yourself. A reward can be a facial or spa session and or a new outfit.Psychologically, it works wonders knowing that after a challenge, you have a wonderful reward to look forward to, so while planning your fertility resolutions, plan your rewards too.
  2. Create A Fertility Eating Plan:
    Eating a fertility diet in preparation for pregnancy and to boost fertility is one of the most powerful changes you can make. Studies show that changes to your diet can improve fertility, prevent recurrent miscarriage and assist with a healthy pregnancy.Please bear in mind that although changing your diet does make significant changes to your body, hormonal balance and fertility, each case is different so if you have concerns regarding your fertility, please contact us.  We work very closely with Dietician Emily Innes who specialises in women’s health & fertility and will work with you regarding your optimal fertility nutrition therapy.

    A fertility boosting diet includes:

    1. Plenty of organic fruit and veg
    2. Organic, full-fat, raw dairy
    3. Organic red meat
    4. Free-range organic chicken
    5. Omega-3 Oily Fish
    6. Whole, natural grains
    7. Dark leafy greens
    8. Drink purified water
    9. Avoiding refined sugars

  3. Stock Up On Good Quality Fertility Multivitamins:
    While eating a healthy fertility diet is of the utmost importance, it is just as important to include a whole food prenatal multivitamin in your program as well. Forget about cheap, low-cost multivitamins you find at wholesale pharmacies or grocery stores, rather seek advice from specialist health stores, your trusted health practitioner and or gynaecologist.

  4. Keep A Journal:
    Documenting your goals, your challenges, your good and bad days is a really great release.  Not only can you monitor and manage your 2019 progress, but it is also a platform to release negative or sad thoughts and create positive affirmations for yourself too.

  5. Wake Up Feeling Positive And Motivated:
    As hard as this may be on some days, wake up punching the air and purposefully stating, “Today is going to be a great day.”  Even if you don’t feel it is true, you are already setting your mind and body in a positive motion. Say it often enough, it will become your reality.

  6. Eat Protein For Breakfast:
    Breakfast really IS the most important meal of the day, and you need to nourish your body well after a full night of sleep and fasting.  So add nut butter to your oats or enjoy an 3 egg omelette for breakfast. You will feel the difference immediately and it will set your day up the right way.

  7. Ensure You Pack A Delicious And Nutritious Lunch The Night Before:
    We know how it goes, the morning starts with you hitting the snooze button 15 times before you realise you only have 20 minutes to get ready and get to work.  So you skip making lunch for yourself, and the only options you have at work are the vending machines with crisps, chocolates, fizzy drinks or the greasy take-away place across the road.Make sure you pack healthy snacks (such as homemade hummus and crudites) alongside a delicious and nutritious meal; one that you are excited to get stuck into.
  8. Show up:
    That is all.  Show up! This is not a race. Even if you are stiff or tired from your previous session, get onto the treadmill and walk it out, or do 30 mins of stretching and 10 mins in the steam room.  Just make sure you show up.

  9. Move:   
    Move. Even if you have arrived late at the gym and only have 20 minutes for a workout. Don’t use being late as an excuse to skip a session. A mere 10-20 minutes can make a huge difference and you will be proud of yourself for not giving up.  Exercise, even a short session shoots up your endorphin levels (happy hormones), so if you are having a low day, move… you will feel so much better for it.

  10. Stay Positive:
    As hard as this may be at times during your fertility journey, find your happy place within you on your darkest days.  Down days are absolutely ok too, but don’t stay there for too long and use every ounce of your strength to find a way to get back up on your feet and to move forward.  You are beautiful and powerful…. And you are stronger than you feel.

A new year brings so many possibilities, and a wonderful (and achievable) possibility, is a new miracle waiting for YOU.  So as we start cruising into the new year, create your perfect 2019 fertility fitness resolution that you can run with all year.  It’s all about taking taking the first step, and remember…

YOU’VE GOT THIS!

Love HART x

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Beating the January Blues

For most of us, this week marks the official week back to the everyday slog that is WORK! School is back, reality hits us at full force, and now, there is nothing to look forward to again until maybe Easter!  Cue….the January blues!

Believe it or not, the January blues are a real thing and nearly everyone gets them for the first couple of weeks of the year.  January is a massive jump from the chaotic fun-filled party life in December as we now found ourselves in a much more serious and pressurised new year!  Resolutions are looming, life is dull and we are starting to get the credit card bills from December.

This time of year can be a deeply emotional month as many women may have suffered loss, pain, despair over what was a festive season for others, due to fertility struggles. All in all we know how difficult this month can be; we completely understand that.  And so, bearing this in mind, we really want to take some time out to share our favourite tips on how to boost your happy mood and to get rid of the January blues:

Exercise:

We all dread that first session in the gym after the festive season, however, it is a proven fact that exercise can rid you of any mild to moderate depression; exercise releases endorphins and endorphins are your happy hormones!  The release of endorphins reduces your stress levels too, so a mere 30 minutes of activity a day will not only make you feel great, but it will take your mind off things that are consuming you.

Eat Food Made With LOVE:

We have spoken about this in previous blogs, but will reiterate this point, as it is so vitally important to nourish your body with food you have prepared lovingly, yourself.  Convenience or instant meals are high in sugars, salt and (bad) fats, with all sorts of additives and preservatives that play havoc with your hormones (and insides).

Veggies such as cabbage and broccoli, as well as Omega-3 fats such as oily fish (salmon, sardines, mackerel, tuna), flaxseed oil, nuts and seeds are all good sources of “good mood” foods.  So make sure to add plenty of leafy green veg and omega-3 fats to your diet.

To keep your metabolism running like clockwork, make sure you eat 5-6 small meals a day.  Never skip a meal and keep your body hydrated by drinking at least 8 glasses of water every day.  

Plan a Holiday or Fun Events:

This tip is one of our favourite January blues remedies!  Nothing makes the soul shine again quite like planning a holiday or fun events with friends!

Create a whatsapp group for all your favourite hearts and plan out great activities to do every month!  The anticipation and build-up to anything enjoyable will really lift your mood and it is something you can look forward to.  

Get Social:

Following on from the above point, studies have linked psychological wellbeing to socialising.  Even if in January the last thing you feel like is going out, set up a gathering amongst good friends!  You will be surprised how good you feel once you are out and about.

Get Outside:

Never underestimate the power of vitamin D and the great outdoors. It is a fact that just stepping outside for a few minutes can improve your mood.  As soon as you start to feel stressed or like the walls are starting to close in on you, just take a deep breath and take a walk. The world is not going to end if you take a 5 minute time-out.  You will feel SO much better when you get back, and you will have a clear head space to crack on with work or life!

De-stress:

Take advantage of January to focus 100% on yourself. Use the time to reflect on what you want most for yourself over the next year. Progress takes time, and anyone boasting about their January achievements is probably not telling the whole truth!

Set aside some “YOU” time where you can read your favourite book, listen to your favourite tunes or just have time to be still. Get in touch with your spiritual self and find balance and grounding. When you release anxiety and you allow yourself to be free from the “fight or flight” mode, answers and decisions fall on your lap naturally and life starts to make more sense.

Look Outside Yourself To Those In Need:

When you perform acts of kindness and giving to those in need of help, you feel fulfilled and worthy.  At this time of year, there are hundreds of charities and organizations where you can contribute or volunteer. 

With the above tips, we know that you will feel SO much better about everything.  Use this month for some true self-reflection. Be really honest with yourself about why you are feeling down and take steps to change your mindset and direction. Consider both your physical and emotional reactions to situations and begin to carve out a positive way of life!

At HART, we are dedicated in finding quality egg donors for our incredible recipients, so if you are concerned about your fertility and would like to find out more about our egg donors, please never hesitate to call or come see us.  We are here for you.

Love HART x

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Being HIV Positive Doesn’t Mean You Cannot Conceive A Healthy Baby

Very significant advances in medicine and science, HIV (Human Immunodeficiency Virus) seropositive people can live a long and happy life.  Because of this, many couples have the opportunity to consider starting their own families by using donor eggs.

What If A Male Partner Is HIV Seropositive?

If a male partner is HIV positive, our Fertility Specialists can perform a sperm washing on his sample. This is a process in which individual spermatozoa is separated from the seminal fluid. It is used to prevent HIV transmission but allow conception in serodiscordant couples, where the male is HIV positive, but the female is HIV negative (in this instance the egg donor).

A couple (where the man has HIV antibodies) are still able to carry out artificial insemination if he wishes to have a child. The artificial insemination route also decreases the woman’s chances of contracting the infection.

The washed sperm technique has been carried out successfully for HIV cases so far, and although there is a theoretical risk of infection, there have been no cases of seroconversion in women or foetuses.

In order to maximize the efficiency of the procedure and to minimise the number of insemination attempts, the woman’s cycle is controlled pharmacologically.

If A Woman Is HIV Seropositive Can She Have Children?

It is important to mention first and foremost that when a pregnant woman is a HIV carrier, and does not receive the appropriate treatment, the risk of the infection being transmitted to the child ranges between 15% – 20%.

If a female recipient is HIV positive, a CD4 count would be required (CD4 Count is a test where our Fertility Specialists will check how well your immune system is functioning).  You will also need to have a Viral Load (a VL shows how much HIV is in your body by measuring how many particles of HIV are in a blood sample).

CD4 cells are white blood cells that fight infection. These are the cells that the HIV virus kills. The higher the count the better! With the Viral Load, your count would ideally need to be low to undetectable.

IF the CD4 count is at the desired level, the female recipient will be referred to their physician for assessment and commencement of ARVs (antiretrovirals).   Our main priority is that the female recipient is fit and healthy before becoming pregnant.

How To Have A Minimal Risk Pregnancy:

The infection of a male partner must be stable with no other diagnosed illnesses – the male must be in good health. Both partners will need to undergo a full screening before the insemination to determine their general wellbeing and identify any possible unknown infertility issues.

Our Advice For Couples Who Want To Have Children:

If you, your partner (or both) are infected with HIV, if you want to start a family you will need assistance from qualified medical staff in order to ensure minimal risk to your health and that of your baby.

To find out more about the screening process, to discuss any HIV concerns you may have, infertility issues and anything more,  please do get in touch.

Love HART x

 

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Oncofertility – Testicular Cancer

Testicular Cancer and how to conceive a child

What is testicular cancer?

Men with testicular cancer may experience a variety of symptoms. Usually, an enlarged testicle or a small lump or area of hardness are the first signs of testicular cancer.  If you find a lump, enlargement, hardness, pain, or tenderness, it is very important that you immediately go and get an evaluation by your doctor as soon as possible because some symptoms of testicular cancer usually only appear once the cancer has spread to other parts of the body.

If you have been diagnosed with testicular cancer, it’s important that you see a fertility specialist before beginning treatment.

Here are five important points you need to know about testicular cancer and male infertility:

  1. Testicular cancer often affects men during their reproductive years, when fertility is most crucial
  2. A man’s testicles manufacture sperm. This means that testicular cancer and testicular cancer treatment may affect sperm health, cause low sperm count, or other male fertility problems
  3. Radiation and chemotherapy treatment of the testicles may damage a man’s ability to produce sperm. These treatments may cause infertility once cancer treatment ends
  4. Surgical treatment for testicular cancer may include the removal of one or both testicles. At times, this may lead to infertility
  5. On the other hand, testicular cancer itself can actually cause low sperm counts for some men. This means that sperm counts may improve, and fertility may return for some men following cancer treatment

What symptoms should I look out for?

  • A painless lump or swelling on either testicle. If found early, a testicular tumor may be about the size of a pea or a marble, but it can grow much larger
  • Pain, discomfort, or numbness, with or without swelling, in a testicle or the scrotum
  • Change in the way a testicle feels or a feeling of heaviness in the scrotum
  • One testicle may become firmer than the other testicle. Or testicular cancer may cause the testicle to grow bigger or to become smaller
  • Dull ache in the lower abdomen or groin
  • Sudden build up of fluid in the scrotum
  • Lower back pain, shortness of breath, chest pain, and bloody phlegm can be symptoms of later-stage testicular cancer
  • Swelling of one or both legs
  • DVT (Deep venous thrombosis)
  • Shortness of breath from a blood clot (DVT)

If I have any of these symptoms, does it mean I automatically have cancer?

No, many symptoms of testicular cancer are similar to those caused by non-cancerous conditions, so it is vital that you seek medical attention immediately when you notice anything out of the ordinary.

What are my treatment options?

Removing a testicle:

Most men have cancer in one testicle and it is removed to treat their cancer. For many men, this will not affect their ability to have children. But for some, their remaining testicle might not work so well and this could reduce their fertility.

Removing both testicles:

Some men have cancer in both testicles and this means that both will need to be  removed to treat their cancer. Unfortunately, these men will be deemed infertile and won’t be able to father children.

Removing lymph nodes:

It is extremely rare, however, it can happen that the lymph glands in your tummy (abdomen) needs to be removed by surgery to treat non-seminoma cancer.  This particular surgery means that most men will not be able to have children through natural intercourse. However, your sperm can be used to fertilise your partner through in vitro fertilization (IVF).

Chemotherapy/Radiotherapy:

Chemotherapy/Radiotherapy for testicular cancer causes temporary infertility, in most men. Usually fertility goes back to normal some months after treatments ends but for some men, it doesn’t recover, especially after high doses.

So, does this mean that after treatment, I won’t be able to father a child?

Some men are able to father children without assistance after cancer treatment while others become infertile. When it comes to testicular cancer and male fertility, however, the news can be a bit more serious. Men with testicular cancer are often at risk for infertility.

What are my fertility preservation options?

If you are at risk for male infertility following testicular cancer treatment, ask one of our specialists now about fertility preservation. Fertility preservation options for men include freezing and storing sperm in a sperm bank before treatment begins. The fertility preservation process can protect your fertility and ensure that you are able to become a father, even after testicular cancer treatment.

If you have already been diagnosed with testicular cancer and you are not able to preserve your fertility, you have the option of IVF with donor sperm.  

Conclusion:

Many men live healthy, happy lives following testicular cancer treatment. In fact, testicular cancer treatments are so effective that five-year survival rates for men with testicular cancer are above 95 percent.

What is most important when diagnosed, is to seek treatment, and for you to go on to  live a full and healthy life. If preserving your fertility is a priority for you, speak to one of our Fertility Specialists now about our sperm bank and freezing your sperm.

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Breast Cancer & Fertility

infertility is commonly defined by our esteemed Fertility Specialists as the inability of a couple to conceive naturally after having tried for at least a year.

Most people in this world will think about having children at some point in their lives.  And although, not everybody wants to have have children immediately or perhaps ever, 99.9% want to know that they at least have an option.

There are many reasons for infertility which we have discussed in detail in our blog “7 Signs of Infertility” however, a major cause of infertility that is sometimes not expected and extremely traumatic, is cancer.  As October is Breast Cancer Awareness month, we have decided to focus on this particular cancer and how you can preserve your fertility if you are every diagnosed with breast cancer, or any cancer for that matter.

What If my cancer has been caught early?

If your cancer is caught in the early stages, some treatments can cause temporary infertility or they can make it very difficult for you to get pregnant, post-treatment. Other treatments, however, cause permanent and irreversible menopause, which means you will be permanently infertile.

What if I need Chemotherapy?

Chemotherapy may damage some of the eggs in your ovaries and may cause your periods to become irregular or stop. If you are premenopausal before starting chemotherapy, your periods may come back after treatment ends. Even if your periods don’t come back, you may still be fertile. If you’re close to menopause when you start chemotherapy, your periods may never come back and you will be permanently infertile.

If I am diagnosed with breast cancer, what are my options regarding fertility?

Most Onco-Specialists will always consider treating breast cancer more important than fertility concerns, BUT, you may not have to choose one over the other. There have been many women who have successfully gone through treatment and then have gone on to have a healthy baby.

Because every cancer is different, every treatment is different and every human being reacts differently to cancer and or treatment, It is extremely important that you immediately speak to our Fertility Specialists as soon as you have been diagnosed to fully understand your fertility options. Ask the following questions at your first appointment:

  • What is my prognosis? Is it good or not so good?
  • How serious is my condition? I
  • Is there a chance I can become a parent in the future?
  • Or the prognosis mean I cannot take any risks?
  • How safe is it for me to become pregnant?
  • Can my cancer affect my pregnancy in the future?

If I can fall pregnant in the future, what happens next?

If your prognosis is good and pregnancy would be relatively safe, talk to fertility specialist about preserving your fertility. Please note, you will need preserve your fertility before you start treatment.

Questions you could ask here would be:

  • Is it better to freeze embryos (fertilised eggs) or only my eggs?   
    Just a note here, if you are in a committed relationship with a man – would he want you to be involved in the cryopreservation process?  If the answer is yes, we would strongly suggest you read the article written by our Fertility Lawyer, Andrew Martin regarding Embryo/Egg/Sperm Disposition
  • Is ovarian stimulation (with in vitro fertilization) the only realistic option for getting enough eggs?
  • Is there another type of fertility treatment that might be less risky for me?
  • Should some of your ovarian tissue be frozen instead of, or in addition to, my eggs?
  • Should I consider taking medication to suppress my ovaries during chemotherapy?
  • What are costs involved?
  • Can I  postpone treatment? Would it be safe for you to postpone treatment for 6 weeks to allow time for ovulation stimulation and in vitro fertilization?
  • Are the hormones that will be used to stimulate ovulation safe for you or are the estrogen levels risky?
  • Can I actually afford these fertility procedures and is anything covered by Medical Aid? You will need to find out if your health insurance whether they cover fertility procedures as many are not completely covered.

What if I am told I cannot ever fall pregnant due to my cancer?

If your ovaries permanently stop producing eggs after treatment, you can still be a parent if you are open to the idea of having a child without using your eggs. There are several options:

  • Egg donation: Donated eggs come from women who volunteer to go through a cycle of hormone stimulation and have their eggs collected. After the eggs are retrieved from the donor and fertilized with your partner’s (or donated) sperm, the embryo is transferred to your uterus

  • Embryo donation: A fertilized egg from another couple is transferred to your uterus

  • Surrogacy: A woman becomes pregnant through artificial insemination with your partner’s sperm and carries the baby through birth

  • Adoption: Adoption is available to just about anyone who would like to become a parent. While some agencies prefer a two-parent household, many others are happy to place a child in a loving-single parent home. It’s helpful to talk to an experienced adoption counselor who can help guide you through the process

We are on standby to answer any questions or concerns you have regarding fertility & preserving your fertility in the future, so do get in touch.

Love & Light,
The HART Team

 

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Embryo & Gamete Disposition

Article by Andrew Martin – Fertility Law

“Who owns my embryos and gametes and what happens to them should something happen to me?”

In recent years assisted reproductive technology (ART) has offered hope to those struggling with infertility in South Africa. Sperm, oocytes, and embryos can now be frozen at various stages of development, allowing for safer and more successful ART treatments as well as allowing for the cryopreservation of gametes and embryos for fertility preservation.

In addition, the length of time that embryos and gametes can be stored in a cryopreserved state has increased. Thus allowing for couples to keep trying for longer and longer periods. However, it has also had some unintended consequences. One of these unintended consequences relates to the fate of embryos or gametes that may be “surplus” or left over after couples finish their treatment or where something happens to the patients and they are no longer able to provide their informed consent.

As couples and individuals embark on the journey of assisted reproduction, with the hope of becoming parents, there are questions that these patients and couple’s might not ask or even consider – What will happen to my embryos or gametes in the unfortunate event of a divorce, separation or the death of my spouse? If I have frozen embryos or gametes can my spouse or partner use them after my death? Who is the owner of our embryos or gametes in the event of our divorce, separation or my death or that of my spouse? What becomes of our embryos or gametes on completion of ART treatment or if we take the decision to discontinue ART treatment?  What happens to our embryos or gametes if we fail to pay our storage fees?

Most couples are too busy focusing all of their energies and attention on just getting through the ART process (in the hopes of coming out the other side of treatment with what they want most, a baby (and in some instances babies).

However, the result of not considering, discussing, and correctly recording what happens to your cryopreserved embryos or gametes, should any of these unintended consequences occur, is potentially devastating.

The question of ownership of gametes and embryos answered:

The Regulations: Artificial Fertilisation of Persons promulgated in terms of the National Health Act, No. 61 of 2003, regulates ownership of gametes, zygotes and embryos, Regulation 18 states that:

  1. GNR.175 of  March 2012: Regulations: Artificial fertilisation of persons (Government Gazette No. 35099)

  2. “Gamete” means either of the two generative cells essential for human reproduction before artificial fertilisation,5  the ownership of a gamete donated for the purposes of artificial fertilisation is vested in the case of:
    1. a male gamete donor, for the artificial fertilisation of a Recipient; in the authorised institution that intends to effect artificial fertilisation;
    2. in the case of a male gamete donor, for the artificial fertilisation of his spouse, in that male gamete donor; and
    3. in the case of a female donor, for the artificial fertilisation of a Recipient, in that female gamete donor.

After fertilisation, the ownership of a zygote or embryo affected by donation of male and female gametes is vested, in both the case of a male and female gamete donor, in the Recipient.

A question you may ask is – what are the consequences of this?

  1. Where you, as a gamete donor (egg/sperm), donate gametes for the purposes of artificial fertilisation of an unknown Recipient, then the authorised institution that will be doing the artificial fertilisation procedure will be the owner of your gametes.

  2. Where you, as a gamete donor (egg/sperm), donate gametes for the purposes of artificial fertilisation of a known Recipient, then depending on the wording of your Known Gamete Donation Agreement (which you are legally required to enter into with the Recipient and his/her partner), you will either retain ownership of your gametes, or you will transfer ownership in or to any cryopreserved gametes.
    1. Where you, as an individual or spouse, provide gametes for the purposes of artificial fertilisation, including storage for the purposes of fertility preservation, and these gametes are cryopreserved prior to fertilisation, ownership is retained in your personal capacity.
    2. After fertilisation, ownership of the zygote or embryo is that of the Recipient. In most cases this means your spouse (female partner in whose reproductive organs the embryo is scheduled to be placed). For some couples, this means their surrogate is technically the owner of their embryos.

Where parties have entered into ART treatment as a couple and the intention of both parties is for their embryos to be co-owned, the Clinic that is assisting the couple, should provide them with a consent to treatment. This consent should make some mention of or attempt to confirm that ownership in of any embryos which are not used and cryopreserved, is shared and/or co-owned.

In most instances this aspect is not canvassed and/or recorded correctly in the consent that couples sign. The result of this is that questions of ownership of embryos could lead to bitter fights as to who is the owner and who is entitled to use the embryo. This is especially pertinent in situations where couples get divorced or separate or where one partner withdraws from ART.

Even more so in cases where donor gametes (egg or sperm) have been used to create a couple’s embryos and the partner wanting to use the embryos is the only genetic part of the embryo and the owner, is not. What happens to our embryos or gametes should something happen to one or both of us and we are not able to provide the necessary informed consent?

Regulation 10(2)(d) of the Regulations: Artificial Fertilisation of Persons places a positive obligation on a competent person (normally the treating doctor) to destroy an embryo that has been unclaimed by a Recipient for a period of 10 years.

The Regulations however do not mention gametes and what happens to them if they are abandoned. The law or regulations are also silent on what happens to a couple’s embryos or gametes in the unfortunate circumstance of death (either partner or simultaneous), divorce, incapacitation, withdrawal from the ART program by a partner or the patient, or the reaching of the recommended treatment age limitation set by the South African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) of between 50-55 years old.

Although hard to consider and discuss, it is important for patients and couples to decide on what happens to any embryos, or gametes, fresh or cryopreserved that remain in the laboratory and are cryopreserved for later use, and to record their decision in a formal legal document.

The law relating to ownership in South Africa is clear and unambiguous, embryos and gametes are understood to be your property, but the ability to transfer ownership in and use of, is limited, and in all honesty incomplete. Currently the law does not consider the unintended consequences that life brings. The clinic and you as the patient are legally prohibited from using or transferring these embryos or gametes without the consent of both partners (if applicable), together with a  clear indication of the intention of both partners.

It is a legal requirement that this intention is contained in a written document, which is signed by yourself, and in the case of a couple, by both partners, and witnessed by at least two competent witnesses. Without this, the embryos will be destroyed after being unclaimed for a period of 10 years and the gametes will merely remain in a cryopreserved state forever.

Without a formal legal disposition or agreement, you or your partner, whichever the case may be, will not be able to use them without first approaching the Courts. This, in most cases, is prohibitively expensive and will add unnecessary expense to an already costly and emotional journey.

Does my consent form that I sign at the clinic not sufficiently regulate this?

In most instances, the consent to medical treatment that couple’s sign with the clinic is insufficient to properly regulate what happens to cryopreserved embryos or gametes and will in all likelihood confirm that in the absence of a disposition agreement (or similar document) that any embryos or gametes will be thawed and discarded should any unintended consequences occur (death, divorce, disagreement, incapacitation, withdrawal of consent, etc.).

As this is a rapidly evolving field, both medically and legally, the clinic involved cannot guarantee what will be available or acceptable avenues for disposition at any future date.

Currently the alternatives available to couples and recipients are to:

  • Thaw and discard the cryopreserved embryos or gametes;
  • Donate the cryopreserved embryos or gametes for approved research/medical studies;
  • Donate the cryopreserved embryos or gametes to another couple in order to attempt pregnancy. This can be both as an anonymous donation or to a couple or individual that you know;
  • Allow your surviving or non-incapacitated partner to use the embryos or gametes with the contemporaneous permission of the other for that use.

What is an Embryo or Gamete Disposition Agreement?

An Embryo or Gamete Disposition Agreement is a formal legal agreement that can be compared to an antenuptial contract which couples sign prior to getting married, coupled with an advance directive for ART.

The Embryo or Gamete Disposition Agreement will regulate what happens to a patient’s or couple’s embryos or gametes, should a specific unintended consequence occur. In particular, it will regulate what happens to their embryos or gametes should the couple get divorced/separated, or should either or both pass away, or should either or both become incapacitated and unable to provide their consent, or should either or both reach the SAS REG age limit of 55 years old, or should a certain period of time elapse, or should there be a disagreement relating to any further treatments and the necessary consent of one partner is withdrawn.

Such a disposition agreement is an authoritative instruction given by a legally competent couple or Recipient, regarding the type of treatment and in this case, the disposition of any embryos or gametes, that are cryopreserved and stored at a clinic. Advance directives originated in the context of end-of-life treatment where people indicate what kind of treatment may be performed when they can no longer decide for themselves. Advance directives, and in the context of ART, Embryo or Gamete Disposition Agreements are recognised as an extension of the decision making authority of competent patients to indicate what kind of treatment may be performed using any cryopreserved embryos or gametes.

Conclusion:

The number of frozen embryos and gametes that are currently cryopreserved and in storage across South Africa is high and this is now creating a dilemma for patients who need to make disposal decisions, as well as presenting an administration dilemma for clinics who are required to store cryopreserved embryos and gametes indefinitely and don’t have sufficient dispositions from patients or where signed consents are insufficient to regulate what happens to the frozen embryos and gametes.

It is therefore important that both clinics and patients recognise the need to properly regulate and ensure that there are improved systems that allow for embryo and gamete disposition, together with appropriate counselling of couples or patients.

Article by: Andrew Martin (B.Soc.Sci LL.B)

Contact: info@fertilitylaw.co.za

 

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Oncofertility – Cervical Cancer

Oncofertility
\ ˌäŋ-kō-fər-ˈtil-ə-tē \
noun

A field of medicine concerned with minimizing the negative effects of cancer treatment (such as chemotherapy or radiation) on the reproductive system and fertility and with assisting individuals with reproductive impairments resulting from cancer therapy. Oncofertility procedures may include collecting and freezing eggs, sperm, or ovarian tissue before cancer treatment begins or using donor eggs or sperm when impaired fertility follows cancer treatment.

In the coming months, there is a huge focus on Oncofertility, so we are putting all of our energy focusing on this dreaded disease and how, when faced with a particular cancer, what treatments are available to you and whether it is possible to preserve your fertility.

Cancer is a heart-breaking diagnosis with many facing extremely difficult (and sometimes life-changing) decisions when it comes treatment, so by preserving your fertility may just be the light at the end of a very challenging tunnel.

September is Cervical Cancer Awareness month, so we have created a Q&A style article that we hope will assist you when making decisions regarding Oncofertility.

Can I fall pregnant if I have Cervical Cancer?

Unfortunately, after most treatments for cervical cancer, you won’t be able to get pregnant. This is because you may have: surgery to remove your womb (a radical hysterectomy) – radiotherapy as part of your treatment that affects the womb and may stop your ovaries working.  

What if I have the very early stages of Cervical Cancer?  Would I have a chance of falling pregnant at all?

If you have early cervical cancer, it may be possible to have surgery to remove the cancer but leave your womb in place so that you might be able to become pregnant in the future.

Should I freeze my eggs/embryos before I start my cancer treatment?

If you would like to become pregnant in the future, and you have early cervical cancer, it is important to consider preserving your fertility by freezing your eggs before your cancer treatment.  If you are married, it would be advisable to freeze your embryos rather (as embryos are more likely to survive the freezing process).

If you’re having certain types of cancer treatment, including chemotherapy or radiotherapy, you might want to consider freezing your eggs, sperm or embryos. This is because some of the drugs used in cancer treatment can cause infertility, especially in high doses.  

What cancer treatments are available if I am in the early stages of Cervical Cancer?

An option for early cervical cancer (small stage 1 cancer) is a Radical Trachelectomy.

Your doctor (gynaecological oncologist) removes most of the cervix and the upper part of the vagina. They put a permanent stitch around the internal opening of the cervix to hold it closed.

Babies have been born safely to women who have had this type of operation. But there is a risk of miscarriage or premature birth. The babies have to be born by caesarean section due to the permanent stitch.  

What cancer treatments are available if I have advanced Cervical Cancer?

If you have advanced Cervical Cancer, your only option would be radiotherapy and chemotherapy.

Having radiotherapy to treat cervical cancer will affect the womb. This means it is not possible to have children afterwards. Radiotherapy and some chemotherapy drugs can also affect the ovaries, bringing on an early menopause. Occasionally it’s possible to move the ovaries out of the treatment area before radiotherapy begins, to try to avoid an early menopause. This is done by keyhole (laparoscopic) surgery.  

Your eggs or some ovarian tissue can be removed and frozen before starting treatment. The eggs could then be used for fertility treatment and a surrogate pregnancy afterwards, but this is very rare.

To all those incredibly strong WARRIOR women who are bravely fighting cancer, who have lost their battle to cancer and those, who have fought and won.  We SALUTE YOU ALL!

Love HART x

 

For legal advice regarding freezing your embryo/gametes, speak to our Fertility Lawyer, Andrew Martin before your treatment.

To discuss options regarding preserving your fertility, do not hesitate to ask one of our Fertility Specialists now for advice.

 

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Debunking the Myths about LGBT Parents

“Because of advances in medicine, we’re able to have families, that are biologically ours, and many people think that because we’re gay, we’re infertile. We’re actually not infertile… Our process of having children is a little bit different than others, but our children are real human beings, they are sacred and they should not be marginalized.” Desmond Child

LGBT parenting has been a topic that is very close to our hearts as we are proud supporters of the LGBT community and we will continuously strive to advocate Human Rights but also share as much information as possible regarding common misconceptions about the LGBT community and LGBT parents!

Myth One:
Children need a mother and father to have a stable upbringing

  • Research has shown that same-sex parented children did as well emotionally, socially and educationally as the children of heterosexual couples
  • Studies that claim unfavorable outcomes for children of single parents compare those children to children of married heterosexual parents. These studies say nothing about the gender of the absent parent being the cause of the unfavorable outcomes
  • The gender of parents DOES NOT MATTER
  • Around the world, there are so many children waiting to be adopted – far too many than there are hetrosexual couples coming foward to adopt
  • There are large amount of adoptive families who are unmarried couples or single people, who are bringing up well-balanced, happy children

Myth Two:
Same-sex parents cannot provide stable homes

No study has EVER found that families created by gay and lesbian people are unstable. Studies show that LGBT communities can have long lasting relationships, and that these relationships are equal to heterosexual couples.  Every relationship, regardless of who you are go through the normal ups and downs, but the one remaining factor is love and commitment

  • Unfounded claims of “instability” revolve around harmful and erroneous assumptions that the LGBT community suffer emotional or psychiatric disorders. There is absolutely no basis to this generalization
  • Importantly, research has shown that parenting quality, parental well-being, the quality of and satisfaction with relationships (within the family), rather than family structures is what makes a more meaningful difference to children’s wellbeing and positive development

Myth Three:
Being raised by gay parents will cause children to be gay

  • People don’t choose to be gay
  • Likewise, no one else can dictate which sex you are attracted to – especially not our parents
  • Yes, of course, we will learn about sexuality and relationships from observing our parents and other couples in society.  But our own sexuality isn’t something we have any control over
  • Children’s sexual orientation is not determined by the sexuality of their parents. In fact, most gay people were raised by straight parents, and the large majority of children of gay parents grow up straight

Myth Four:
Children of gay parents will get picked on

  • Children of gay or straight parents WILL always get picked on for something whilst growing up.  This is regardless of their parents’ sexual orientation
  • If a child is being bullied because of her race or for living in a single-parent, or same-sex household, it is important to educate that bully and the bully’s parents.
  • It is up to us all to teach our children from an early age about human rights and equality.  We are all responsible to ensure there is a more positive learning and social environment for children both in their schools but also at home

The truth about LGBT Parents:

  • LGBT parents have an understanding of what it is like to undergo a deep exploration of one’s identity; what it feels like on the inside and what it means out in the world, which offers a huge amount of insight to their own children
  • LGBT parents are more likely to have experience with discrimination, being a member of a marginalized group
  • LGBT people may have experience with family conflict, loss, and/or difficult family relationships, which could help them help children to navigate similar challenges
  • LGBT people have often learned resilience and resourcefulness in creating support networks and family-like communities, whether or not their family relationships have been affected by their coming out. These skills are invaluable to children who are in need of developing family connections and supports outside of their biological family units
  • LGBT people may display significant open-mindedness and a deep appreciation for the importance of unconditional love and acceptance, which could be invaluable in supporting their own child’s individuality

To conclude, all a child really needs in this world is unconditional, unwavering love.  It really doesn’t matter whether you are a hetrosexual couple, a single parent, same-sex parents.  

Two invested parents are the best case scenario, but even one involved parent is better than a detached couple – no matter their sexual orientation.

If you are thinking about starting a family through surrogacy or have any questions regarding gestational IVF, contact us here.

Love HART x

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