Tag: melatonin

HORMONE HAPPENINGS: Greene Guide’s News Recap

by Robert Greene, M.D., posted in Diet, Fertility Preservation, IVF, Melatonin, Vitamin D

Let’s take a few moments to review some of the latest findings in reproductive medicine. This month there is another first in reproductive medicine as well as new evidence that hormone problems may be passed to spouses. Check out the following:

Ovarian Stimulation for IVF does not increase the risk of cancer: The largest review of the data available provides more reassuring news to women undergoing advanced reproductive treatment. Included in their review was the information obtained from nearly 180,000 women that had undergone IVF therapy. They found that there was no increased risk of ovarian cancer, endometrial cancer, cervical cancer or breast cancer. Although a few isolated studies raised concerns in the past; this new information should further reassure patients and egg donors of that ovarian stimulation will not create future health risks.

First successful birth after woman receives her own ovarian tissue frozen during her childhood: In a new report, it has been proven that ovarian tissue from a child can be removed, frozen and replaced later in her life to restore lost fertility. Previously there have been about 3 dozen cases of women freezing ovarian tissue prior to receiving life-saving chemotherapy. However this was the first report a 14 year old having her fertility preserved through removing an ovary prior to the onset puberty and before receiving chemotherapy. Now at age 27—and two years after a piece of her ovary was transplanted back into her body—she conceived and delivered a healthy child naturally. This proof-of-concept should make fertility preservation a more tangible option for children faced with the need for chemotherapy.

Diet and lifestyle impact embryo quality: A research group recently looked at the quality of 2659 embryos produced by 269 patients. They had data on the diet and some of the social habits of the women that were undergoing treatment as well. They found that eating fruit, vegetables and fish was associated with higher embryo quality. By contrast consumption of red meat, smoking and alcohol reduced the chances that an embryo would develop to the blastocyst stage—the last stage before it hatches. They also found that women that consumed red meat have a lower chance for implantation as well. This is only one study so patients shouldn’t feel compelled to make dramatic dietary changes. However, it should encourage women trying to conceive to pay greater attention to their diet and lifestyle.

Fathers at risk of diabetes after their partners experience Gestational Diabetes: As we continue to seek to prevent new cases of diabetes, an emerging risk factor may be having a partner with a history of gestational diabetes. A study from Canada followed nearly 72,000 male partners after the delivery of their child. They found that the risk of developing diabetes was 33% higher following a pregnancy complicated by gestational diabetes vs. normal controls. The authors theorized that this increased risk may be likely due to shared diet/lifestyle as well as ethnocultural risks. If confirmed however it could provide support that counseling the entire family to prevent later risk may be in order.

Sunshine boosts IVF success: Many studies have looked at seasonal variations on pregnancy rates and tried to explain their fluctuations. But a new study from Belgium has taken their analysis a step further. They looked at a group of almost 11,500 women undergoing IVF at the same center between 2007 and 2013. They then analyzed what the weather was like the month prior to their cycle. Although they did not find a clear seasonal pattern; they did find that women exposed to more sunlight the month prior to their IVF cycle had a higher pregnancy rate. This boost in success translated to about a one third higher chance of conceiving. The authors theorized that the boost might be related to higher melatonin and vitamin D production. The strongest correlation was actually with live birth rate.

Men with low-normal testosterone levels have high rate of depressive symptoms: There has been a recent trend to check testosterone levels in men; most likely due to media attention and advertising. This prompted a group of researchers to study whether or not there was a higher rate of depression and/or depressive symptoms in people requesting such testing. They screened 200 men with an average age of 48 (range 20 to 77) with a validated symptom questionnaire. They found 56% screened positive. In fact, the risk that a man experienced depressive symptoms seemed highest for the younger men with low-normal testosterone levels. Follow up studies are needed to determine if testosterone replacement—instead of traditional antidepressants—would relieve these symptoms.

Robert Greene, MD, is a reproductive endocrinologist with Conceptions Reproductive Associates in Denver.

Sleeping well? Insomnia may be contributing to your infertility.

by Robert Greene, M.D., posted in Fertility

I’ve long been fascinated by how symptoms provide insight into underlying hormonal disturbances. A great example is the emerging research on sleep. Your body has a circadian rhythm or a daily cycle of when specific physiologic events are to occur. This process organizes everything from growth, digestion and repair to consolidation of memories and production of chemicals to regulate your mood. It also coordinates the growth and development of sperm and eggs. The hormone that regulates your circadian rhythm is called melatonin.

Melatonin is a hormone produced by an area of the brain called the pineal gland. Blood levels typically between midnight and about 4 am. Maybe more interesting is the fact that exposing your eyes to light can abruptly interrupt the production and release of this hormone that helps you sleep through the second half of the night. That’s also the time of night when various physiologic functions peak including testosterone production and ovulation.

This is just one of the many facts linking your sleep pattern with your fertility.

Most fertility clinics may not inquire about what role your circadian rhythm may be playing your chance of conception, a recent publication in Fertility & Sterility summarized over 200 studies on how melatonin may be influencing your reproductive function. Here are just a few key points:

  • Melatonin is a potent anti-oxidant. Studies show that the process of ovulation produces free radicals which can damage an egg. This hormone is concentrated in the fluid that surrounds mature eggs and likely serves to protect them from harm.
  • Melatonin influences the production of estradiol, progesterone and testosterone differently during varying stages of the menstrual cycle.
  • Melatonin regulates the maturation capacity of an egg. One study demonstrated that women with a history of failed IVF cycles experienced improved fertilization rates after melatonin supplementation.
  • Melatonin modulates the immune system. It is estimated that 30% of women with premature ovarian failure have an autoimmune component. Additionally, many women with recurrent early pregnancy loss also have an immunologic disorder. These situations offer potential intervention to improve outcome through normalization of the circadian rhythm.
  • Various fertility problems may be influenced by a melatonin deficiency. For instance, women with PCOS tend to have lower than normal levels of melatonin in their follicular fluid and melatonin may influence endometriosis growth.

The best way to optimize melatonin production is to establish and maintain a normal sleep pattern. In some situations melatonin supplements or the use of long acting melatonin-like medications may be of benefit. If you haven’t considered the role that a good night sleep can play in your successful conception check out this sleep assessment tool.