It would be very difficult to estimate a figure indicating as to what percentage of patients with PCOS will need ART in order to conceive, as there are PCOS patients that conceive spontaneously without any help at all.

Hypnotherapy has been around for a while and does seem to have merit for the right indication.

As to making a statement that one has a serious sperm problem or any kind of problem at all without having a proper semen analysis to base your statement upon is beyond me as well.

- Week 31 answers kindly provided by Dr. Stephan Volschenk -

Perform your original search, caffiene and sperm semen quality, in Hum. Reprod.   Search

Hum. Reprod. Advance Access originally published online on August 28, 2008
Human Reproduction 2008 23(12):2799-2805; doi:10.1093/humrep/den331

© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Semen quality according to prenatal coffee and present caffeine exposure: two decades of follow-up of a pregnancy cohort

C.H. Ramlau-Hansen^1,4, A.M. Thulstrup¹, J.P. Bonde¹, J. Olsen² and B.H. Bech³

¹ Department of Occupational Medicine, Aarhus University Hospital, Norrebrogade 44, Building 2C, DK-8000 Aarhus C, Denmark ² Department of Epidemiology, School of Public Health, UCLA, Los Angeles, CA 90095, USA ³ Department of Epidemiology, School of Public health, University of Aarhus 8000, Aarhus C, Denmark

⁴ Correspondence address. E-mail: craha{at}as.aaa.dk

BACKGROUND: A few studies have investigated the association between male caffeine consumption in adult life and semen quality with conflicting results, but so far no studies have explored the effect of prenatal coffee exposure. We studied the association between prenatal coffee and current caffeine exposure and semen quality and levels of reproductive hormones.

METHODS: From a Danish pregnancy cohort established in 1984–1987, 347 sons out of 5109 were selected for a follow-up study conducted 2005–2006. Semen and blood samples were analyzed for conventional semen characteristics and reproductive hormones and were related to information on maternal coffee consumption during pregnancy and present caffeine consumption. Data were available for 343 men.

RESULTS: There was a tendency toward decreasing crude median semen volume (P = 0.06) and adjusted mean testosterone (P = 0.06) and inhibin B (P = 0.09) concentrations with increasing maternal coffee consumption during pregnancy. Sons of mothers drinking 4–7 cups/day had lower testosterone levels than sons of mothers drinking 0–3 cups/day (P = 0.04). Current male caffeine intake was associated with increasing testosterone levels (P = 0.007). Men with a high caffeine intake had 14% higher concentration of testosterone than those with a low caffeine intake (P = 0.008).

CONCLUSIONS: The results observed in this study are only tentative, but they do not exclude a small to moderate effect of prenatal coffee exposure on semen volume and levels of reproductive hormones. Present adult caffeine intake did not show any clear associations with semen quality, but high caffeine intake was associated with a higher testosterone concentration.

Key words: caffeine/prenatal exposure/reproductive hormones/risk factor/sperm count

Submitted on May 16, 2008; resubmitted on August 5, 2008; accepted on August 6, 2008.

- Week 31 answers kindly provided by Dr. Stephan Volschenk -

I do not think that a mild case of psoriasis is necessarily a reason for a low sperm count. The question is “what is low”, as there are many other reasons for poor semen parameters. From a general management point of view I think that you have it covered with what you have mentioned.

- Week 31 answers kindly provided by Dr. Stephan Volschenk -

There is no published evidence of it being detrimental to semen quality and therefore has no associated risks for the male should conception take place.

- Bi-Week 30 answers kindly provided by Dr. Stephan Volschenk -

Semen quality is dynamic and is dependent upon general health, lifestyle, stressful periods etc and may vary as much as 40%. This fluctuation is of no significance in a healthy individual with a baseline normal semen analysis. Therefore, testing sperm on a regular basis without any indication in a healthy individual with a normal baseline analysis has no value.

- Week 29 answers kindly provided by Dr. Stephan Volschenk -

Proven supplements would be:

1.  Vitamin C
2. Vitamin E
3. Zinc

- Week 27 answers kindly provided by Dr. Stephan Volschenk -

The development of the PICSI device is based on research at the Yale School of Medicine. They found that hyaluronidase bound PICSI selected sperm are mature, have less DNA damage and are likely to have less chromosomal aneuploidies than sperm selected by visual observation as conventionally selected.

Preliminary small trials suggest that sperm selected in this fashion may improve clinical pregnancy rates and reduce the incidence of miscarriages. There are no proper randomised trials yet to support this notion and more research is required by means of proper randomised controlled trials.

- Week 21 answers kindly provided by Dr. Stephan Volschenk -

The best around is probably Silbermann in the USA. I shall get the contact details and post it  on the site.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

The count has not increased. What you are looking at when it has been prepared for AI is a concentrated count.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

Total count on full SA being 10 mil/ml is on the low side. One would therefore be inclined to move onto IVF/ICSI sooner rather than later.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -