Andrology & Men’s Health

Phimosis is narrowing of the foreskin. It can occur commonly in adults and is caused by recurrent balanitis, inflammation and trauma.

The presenting symptoms are variable and include poor stream, spraying, ballooning, recurrent attacks of balanitis and pain, although sometimes patients may present because of cosmesis concerns. A phimosis itself can lead to recurrent infections and also predisposes to penis cancer, which is rare. Additionally it can cause problems with sexual function, especially intercourse.

The foreskin itself, but not phimosis, predisposes to HIV infection. Randomised controlled trials have shown circumcision to reduce the risk of contracting HIV but only in heterosexual males; this has led to widespread circumcision programmes in Africa, led by the WHO. In the UK this is currently NOT recommended because of the lower incidence. In cases of symptomatic phimosis a circumcision is commonly undertaken.

If you have problems with the foreskin we can advise you on what treatment is best. This may include topical treatments, frenuloplasty, preputioplasty and circumcision.

Learn more about our Andrology & Men’s Health services.

Professor Vijay Sangar, Consultant Urological Surgeon

Advice regarding Coronavirus

In light of the updated advice from the Government, I would like to provide you with the current guidance for staff and patients with regards to Coronavirus. We are required to risk assess staff and patients travelling from potentially affected areas and attending the Reproductive Health Group.

If you have returned to the UK from any potential affected areas within the last 14 days and develop symptoms of cough and/or fever and/or shortness of breath, then the individual should stay indoors, avoid contact with other people and call NHS 111 to discuss the recent travel history. If the above symptoms develop in the workplace then the individual should isolate themselves, inform their Line Manager and go home.

I would encourage everyone to follow the updates on the Public Health England website which offers sensible and unbiased information to anyone who may be worried. Based on the current evidence from the World Health Organisation and the Public Health England, there is no immediate cause for concern; however, I would like to take the following precautions:

  1. Confirm that no staff or patient attending the Reproductive Health Group has been to China, in the Wuhan region since the outbreak.
  2. All are aware of the signs and symptoms of the novel Coronavirus and should they experience any of these, they will not attend work and return home immediately.

The wellbeing of our staff and patient community is of the upmost importance at this time and I am sure that you will all join me in supporting the culture for a healthy and safe work environment. I will certainly continue to keep you informed as the situation and official advice changes but if you have any questions please do not hesitate to contact me.

Professor Luciano Nardo
Clinical Director | Reproductive Health Group

Fertility and Chronic Conditions

It is a matter of little debate that some chronic conditions may affect fertility potential. There is some growing evidence to suggest that thyroid disorders, for instance, can affect fertility as well as impact pregnancy outcome.

Generally speaking, the impact of chronic conditions can be systemic or more often localised to the reproductive organs, such as the uterus in the case of endometritis or the fallopian tubes in the case of hydrosalpinx. Of note, chronic conditions which may affect the body systemically are either hormonal or autoimmune. These may affect the ability to conceive but also affect the stages of pregnancy.

Pregnancies achieved by women with underlying chronic conditions may be at higher risk and as such should be overseen by a dedicated team of Fetal Maternal Medicine Specialists, linked with a wider Multidisciplinary Team.

Not all chronic conditions negatively affect the reproductive outcome of IVF-ICSI cycles, however appropriate investigations should be carried out before women are advised to embark on fertility treatment and where appropriate tailored treatment strategies should be employed.

In this day and age the advances in embryo cryopreservation allow for deferred embryo transfer procedures, so to ensure that the endometrial environment is optimal for successful implantation in women that have a chronic condition which may impact on the ability of an embryo to successfully implant.

Innovations in the field of assisted conception have also helped to overcome some seemingly insurmountable barriers to enhance the chances of successful pregnancy outcome. The introduction of surgical sperm retrieval procedures associated with ICSI have provided effective treatment for male infertility. The advent for preimplantation genetic testing has provided couples with genetic linked diseases and those at increased risk of having aneuploid embryos with the possibility to have healthy children.

Expanded access to international data sets will further enhance the knowledge on the impact that certain chronic diseases have on fertility outcome and the potential benefits of IVF based techniques in creating healthy children.

Professor Luciano Nardo
Clinical Director | Reproductive Health Group

Egg Freezing FAQs

The likelihood is that you already know what egg freezing is, however, it can be quite overwhelming researching and making the decision to go ahead with the process. 

We’ve had hundreds of patients walk through our doors with many questions and rightly so! This is a big decision but the possible end outcome is the same for each and every one.  

Here at Reproductive Health Group HQ, we’ve put our heads together following patient feedback and answered the most frequently asked questions on egg freezing to help you with your decision process. Have a look:

 

Why should I freeze my eggs?

Egg freezing allows you to preserve your eggs at a time when your fertility is at a higher level. Although you may not be interested in starting your journey to motherhood now, that doesn’t mean you can’t start to plan. 

With age being a major factor in fertility, doing this earlier gives you more options in the future if you decide to start your journey to parenthood.  

 

What can I expect when freezing my eggs?

The method used can be broken down into five simple separate steps found on our egg freezing page found here: 

http://bit.ly/2Rgu0dp

 

Is the egg freezing procedure painful?

The procedure of removing your eggs is not painful and is carried out under intravenous sedation. 

However, the hormone injection that takes place 9-12 days into the process can hurt, but this depends on how sensitive you are to injections. 

 

How many eggs are frozen?

This number can be dependent on several factors, and one of the most important is age.

If you are 34 years or younger you’re likely to be able to freeze between 10-20 eggs. If you are older then we’ll work with you to aim for the optimum amount of eggs possible to help you on your journey to parenthood.

 

How much will freezing my eggs cost?

Egg Freezing costs £3,200, this includes counselling, monitoring scans, medications, egg collection, egg freezing and the first follow up consultation.

Egg storage is priced separately. For each year this will cost £300 where your eggs will be stored in our state of the art lab until you are ready to use them.

 

How long can my eggs be stored for?

Your eggs can currently be stored for 10 years, but if you are ready to start your journey to motherhood earlier then the eggs are ready when you are.

 

What happens when I want to use my eggs?

When you’re ready, we will work with you to put together a treatment plan unique to you.

 

Within our onsite embryology lab, your eggs are thawed out for fertilisation and with the sperm of either your partner or a donor, your eggs will then be fertilised to create embryos.

The embryos will then be transferred to your uterus and will hopefully implant. We’ll monitor you following this and advise you to take a pregnancy test. 

Although we’ve answered quite a few questions, we know you may have more questions unique to your personal situation. Why not contact our specialists on 01925 202 180 or fill in our contact form to speak to a specialist and start your egg freezing journey with Reproductive Health Group.

Premature ejaculation

Premature ejaculation is common. It is when ejaculation occurs too soon during intercourse. The normal duration of intercourse is between 5 and 6 minutes, but this can vary.

It is not unusual to have premature ejaculation once in while. If it occurs frequently then you may need help. Premature ejaculation can be caused by prostate problems, medications, anxiety, stress and relationship issues.

It is important to seek help to ensure there are no underlying medical conditions.

We now offer new therapies for premature ejaculation including Fortacin Spray. To find out more about our Andrology and Mens Health services, please call us on 01925 202180 or email us at info@reproductivehealthgroup.co.uk

Vasectomy reversal

We undertake vasectomy reversal on a regular basis using magnification techniques which provide success rates of up to 95% for those patients who are within 10 years of vasectomy.

A consultation is usually undertaken with your partner; sometimes it may be that your partner will need a female fertility opinion. If the latter is the case then your partner will be referred to a female fertility specialist, before any vasectomy reversal is undertaken.

What is a vasectomy reversal?

You have previously had a vasectomy for contraception. You have now decided that you wish to have this reversed so as you can try to have children with your partner. The tube that carries the sperm from the testis to the penis is called the vas deferens; this is what is cut at the time of a vasectomy. A vasectomy reversal procedure involves putting the previously cut ends of your vas deferens back together.

This is done under a general anaesthetic and takes approximately 2 hours. The scrotum is opened to access the area. At the time of surgery your surgeon will try and put back together the tubes in the most appropriate place so as to allow sperm to travel through again. Several stitches are placed to join the tubes on each side. These stitches are very fine, almost as fine as your hair, so to ensure that they are placed properly we use magnification. If this operation is done using the naked eye then the result may not be as good.

Why do I need a vasectomy reversal?

With your partner, you have chosen to have a child. Having had a vasectomy before, this is not currently possible using natural methods. If you wish to have children using natural methods this is the best option for you.

What are the alternatives?

  • Sperm retrieval and ICSI
  • Adoption
  • Donor Sperm
  • Not to have children 

To find out more about vasectomy reversal and our other Andrology and Mens Health services, please see here: https://www.reproductivehealthgroup.co.uk/andrology-mens-health/

Unexplained Infertility

It can be very confusing for patients to be told by their IVF specialist that they have ‘unexplained infertility’. They find it hard to believe that infertility can still be unexplained despite the medical and technological advances that exist today.

The truth is however that despite cutting edge medical technology, there are some things which still cannot be accurately determined or diagnosed. But the good news is that despite not knowing the exact nature or cause of infertility, it can still be overcome. Unexplained infertility can be treated and couples can become parents. Sometimes, specialists may not know the full reasons behind a problem but are still able to offer a solution and this is certainly true of unexplained infertility.

Only after conducting all the relevant investigations first should unexplained infertility be diagnosed and an appropriate treatment plan considered.

Learn more about unexplained infertility here.

The role of antioxidants in male infertility

Whilst several causes of male infertility have been recognised, in the majority of men the precise mechanism remains unknown. Many studies of such idiopathic cases at the molecular level have highlighted the significant role of “Oxidative Stress”.

This entails a state of imbalance between reactive oxygen species (ROS), aka “free radicals”, and antioxidants as an established factor in male infertility. Sperm are particularly vulnerable to DNA damage and accelerated cell death.

Antioxidants exhibit a beneficial effect in reversing sperm dysfunction. Supplementation may include the Vitamins C, E and B9 (Folic Acid), the trace elements Zinc and Selenium and the substances Carnitine, Coenzyme Q10 and N-Acetyl Cysteine. They have been shown to:

  • improve semen parameters (concentration, motility and morphology)
  • reduce sperm DNA fragmentation
  • improve clinical pregnancy rates
  • improve live birth rates

However, the heterogeneous nature of various studies, including the use of different antioxidants at different concentrations and in different combinations, hamper our ability to implement an ideal treatment modality. Proper diagnosis and treatment are difficult.  Antioxidants must be chosen so that they work in synergy and with some selectivity for the male reproductive tract. Overdoses and self-medication with antioxidant formulations that use random ingredients and dosages may be counterproductive and impair fertility. At RHG, we provide advice on when and how to use supplement combinations.

Egg Freezing FAQs

1. How does the clinic decide which treatments to choose?

Through a thorough consultation with the individual or couple involved, including examining medical and reproductive histories, and by carrying out relevant tests and investigations, your consultant will be able to identify which course of treatment is the right one for you.

View RHG’s range of  fertility assessment packages here.

2. What tests will I have to have?

There are a number of tests that you can expect to have as your consultant looks to identify what may be causing any fertility issues. An initial fertility assessment on either one or both partners in the relationship can help to ensure any issue is dealt with without paying for needless treatment if a simpler or more cost-effective solution can be found.

3. Does the clinic work with patients to ensure the treatment for them is the most suitable?

Some fertility clinics are simply IVF clinics, with this being the treatment option offered to all patients. However, this may not be the best option for everyone. At RHG we will only recommend the best care pathway once we have carried out all the appropriate investigations.

4. What treatments are available?

There are a variety of treatments available, from IVF (In vitro fertilisation), where eggs and sperm are brought together outside the womb in a laboratory, to IUI (intrauterine insemination). For IVF treatment, there are also a number of different techniques, such as ICSI (intracytoplasmic sperm injection) and IMSI (intracytoplasmic morphologically selected sperm injection).

5. What success rates does the clinic have?

Before you start out, you want to know that you have chosen a clinic that has high success rates in helping people to achieve their goal and become successfully pregnant.

View RHG’s latest success rates here.

6. What are the costs involved?

You can view our clear and transparent fertility price list here.

7. Are women with specific conditions accepted at the clinic?

If you are affected by a specific issue, you may find that not all clinics are able to offer you treatment. At RHG we are able to treat all gynaecological and infertility conditions under one roof at our Cheshire based Centre for Reproductive Health.

8. What makes the clinic different to the others?

In our case, it is our dedicated integrated fertility and women’s health hospital, one of the first ever in the UK. Every detail was designed by our consultants and embryologists, using their extensive experience to ensure that our patients receive the best possible care, using the very latest technology in a state of the art environment.

If you would like to organise a fertility consultation with us to discuss any of the above, or additional questions you may have, please do contact us on 01925 202180 or email us at info@reproductivehealthgroup.co.uk

Polycystic Ovary Syndrome (PCOS) and Fertility

Polycystic Ovary Syndrome (PCOS) is a common cause of infertility in women due to its impact on ovulation. Changes in hormone levels affect the way in which your body produces and releases eggs and can cause irregular periods. If regular ovulation is not occurring this can make it difficult to achieve a successful pregnancy.

Can I still get pregnant if I have PCOS?

This is a question that we are asked regularly at RHG and the answer is yes! PCOS is one of the most common types of female hormone disorder and is one of the leading causes of infertility, but that is not to say that you can’t have a baby if you suffer from PCOS. The question is, which treatment is right for you?

Treatment options for PCOS and infertility

There are a number of potential treatment options including conventional fertility treatments, such as IVF, but also natural, nutritional measures, improving diet and making changes to lifestyle.

For some women, simply making changes to their weight is enough to completely resolve their symptoms and restore a regular menstrual cycle. The best diet for women with PCOS who are overweight is one that promotes stable levels of blood sugars and lowers insulin levels. It is recommended to see a nutritionist who can recommend an appropriate programme.

For other women whose lack of ovulation is the main issue, ovulation induction can be used to help stimulate the development of mature follicles at just the right time in the cycle.

Improve your fertility potential

RHG’s experienced specialists can advise on the best treatment programme to help alleviate symptoms and improve fertility potential.