Friday, November 28, 2008

Male obesity, sex hormone levels and sperm count: progress in fertility research

27 Nov 2008
Male obesity, sex hormone levels and sperm count: progress in fertility research

Three papers recently published in the same issue of the journal Fertility and Sterility dig deep into the complexities of the relationship between male obesity and infertility. Two of the papers report new findings whilst the third is a literature review summarizing work done and trends which have emerged.

The link between female obesity and infertility is much better understood, but research into male infertility has increased in recent years. In their review of the literature, Dr Hammoud and colleagues of University of Utah School of Medicine, US, conclude that there is now good evidence for a link between obesity and decreased fertility in males. However, the precise nature of this link is complex, as the other two studies make clear.

A large study, conducted by Dr Anette Aggerholm and colleagues at Aarhus University Hospital in Denmark, found no association between obesity and semen quality. The study is a new analysis of data collected in five smaller studies at Aarhus University Hospital which all involved taking blood and semen samples from all participants as well as recording lifestyle information and a record of the men’s height and weight. The 2139 men who took part in Dr Aggerholm’s study ranged in age from 18 to 66 years old and nearly half were overweight.

The researchers noted that levels of sex hormones were generally more decreased the more overweight a man was, and men who were moderately overweight had slightly lower sperm counts than men of average weight. However, obese men did not have lower sperm counts or sperm quality than men of an average weight. Dr Aggerholm concluded that, whilst there was a strong association between obesity and hormonal changes, if there is such an association between obesity and semen quality it was too small to be detected in this study. Although these findings are in direct contrast to a study conducted in 2004 by Dr Tina Jensen at Rigshospitalet, Denmark, Dr Aggerholm and colleagues suggest that this could be due to differing populations; Dr Jensen’s study recruited fewer obese males and took its sample from a generally younger population.

Dr Aggerholm’s team measured semen volume, sperm concentration, and sperm motility but did not measure DNA abnormalities of semen; previous studies (e.g. Kort et al., 2003) have shown that high BMI is associated with an increased rate of DNA fragmentation which, in turn, has been associated with reduced fertility. This may be an avenue for future investigation.

Dr Aggerholm’s study recorded levels of the sex hormones inhibin-B, follicle stimulating hormone, luteinizing hormone, testosterone, oestradiol and sex hormone-binding globulin. Work published in the same journal as Dr Aggerholm’s study in August this year by Dr Eric Pauli and his colleagues at Pennsylvania State University College of Medicine, US, also found that obese men had lower levels of most of these sex hormones in their blood. The much smaller study of only 87 men, who were recruited either because they were new fathers or because they were seeking fertility treatment due to their partners’ infertility, found that the more obese a man was, the lower his levels of hormones essential for reproduction. Dr Pauli and colleagues did not assess semen quality but suggest that hormonal changes could act to decrease a man’s fertility when acting in concert with dampened libido and increased risk of erectile dysfunction (both of which have been established by previous studies of male obesity).

It is important to note that the outcome measures in the studies summarized here are related to fertility but are not measuring conception success. Further studies are needed which investigate the links between male fertility measures, obesity and whether a couple achieve pregnancy or not. Additionally, Dr Hammoud and colleagues, authors of the review paper discussed, call for greater clinician awareness of the effects of male obesity on fertility as well as studies into the reversibility of obesity-associated male infertility with weight loss. Understanding the reason for this link could prove to be key in devising treatment strategies.


Aggerholm AS, Thulstrup AM, Toft G et al. 2008 Is being overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertility and Sterility 90, 619–626.

Hammoud AO, Gibson M, Peterson M et al. 2008 Impact of male obesity on infertility: a critical review of the current literature. Fertility and Sterility 90, 897–904.

Jensen TK, Andersson AM, Jorgensen N et al. 2004 Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertility and Sterility 82, 863–870.

Kort HI, Massey JB, Witt MA et al. 2003 Sperm chromatin integrity is related to body mass index: Men presenting with high BMI scores have a higher incidence of sperm DNA fragmentation. Fertility and Sterility 80, S232–S232.

Pauli EM, Legro RS, Demers LM et al. 2008 Diminished paternity and gonadal function with increasing obesity in men. Fertility and Sterility 90, 346–351.

RB 2008/4064

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Anti-Depressant-Associated Changes In Semen Parameters

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Anti-Depressant-Associated Changes In Semen Parameters
Editor's Choice
Main Category: Depression
Also Included In: Urology / Nephrology; Fertility; Psychology / Psychiatry
Article Date: 28 Nov 2008 - 1:00 PST

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SAN FRANCISCO, CA, USA ( - The authors previously reported an effect of antidepressants on semen parameters. The current study was designed to assess/confirm their prior report of the effects of an SSRI, paroxetine (Paxil), on semen parameters.

This was a prospective clinical trial involving 35 healthy male volunteers ages 18-65. SA were obtained prior and 2 weeks and 4 weeks after SSRI initiation. Paroxetine was given for 5weeks: 10mg QD week 1, 20mg QD week 2, 30mg QD weeks 3-4, and 20mg QD week 5. Standard WHO evaluation of semen parameters was assessed.

TUNEL assays were performed on baseline and week 4 semen samples to evaluate DNA fragmentation. Semen parameters and TUNEL assays for each individual were compared at each time point.

As opposed to prior report, semen parameters (volume, concentration, motility, morphology) were not significantly altered during SSRI treatment. However, mean DNA fragmentation TUNEL score was significantly higher on SSRI (30.3%) versus baseline (13.8%). Multivariate logistic regression, correcting for age and body mass index, confirmed that SSRI treatment was significantly correlated with increased DNA fragmentation Up to 35% of men noted significant changes in erectile function and up to 47% of subjects reported ejaculatory difficulties while on paroxetine.

Conclusions: In volunteer male subjects with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of patients. This effect occurred without a measurable effect on semen parameters. The fertility potential of a substantial proportion of men on paroxetine may be adversely affected by these changes in sperm DNA integrity.

Editorial Comment: This is an interesting study. The data refutes prior report by the same group indicating the effect on gross semen parameters and sperm transport mechanisms. None of these parameters were significantly different from baseline. However, this study noted an interesting and potentially significant change in DNA fragmentation. However, the mean DNA sperm fragmentation of 30.3% is at the upper limit of normal. The authors hypothesize that this may reflect delayed transport of sperm. The reported effect on sexual dysfunction is not surprising. Further studies are needed to assess the potential clinical significance of this interesting observation.

Presented by C. Tanrikut, et al., at the 64th Annual Meeting of the American Society for Reproductive Medicine - November 8 - 12, 2008 - San Francisco, California

Reported by Contributing Editor Harris M. Nagler, MD

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Tuesday, November 25, 2008

Sperm DNA Damage: Correlation To Severity Of Semen Abnormalities

Sperm DNA Damage: Correlation To Severity Of Semen Abnormalities
Main Category: Fertility
Also Included In: Urology / Nephrology; Genetics
Article Date: 24 Nov 2008 - 1:00 PST

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SAN FRANCISCO, CA, USA ( - Evaluation of male fertility includes assessment of the standard semen parameters (SSP) and may include assessment of DNA damage. However, the relationship between DNA damage and SSP remains controversial. This study examined the the relationship of DNA damage to SSP in patients presenting for infertility evaluation.

The authors conducted an IRB approved retrospective review of semen samples from 2586 unselected non-azoospermic patients underwent computer-assisted semen analysis and flow cytometry based sperm DNA damage assessment expressed as the DNA Fragmentation Index (DFI). DFI was significantly negatively correlated to sperm concentration, motility, and normal morphology and positively correlated to age (P<0.001). DNA damage increased in relationship to the number of abnormalities in the SSP (P <0.001).

The authors concluded:

1. DNA damage is significantly related to standard parameters of semen analysis
2. DNA damage is significantly related to age
3. The degree of DNA damage increases with the number of abnormal parameters in a sample and is most severe in patients with oligo-astheno-teratospermia (OAT).

Editorial Comments:

The authors demonstrate the relationship between progressively more abnormal semen parameters and abnormal DFI. This is consistent with clinical observations and does not appear to demonstrate any incremental value to DFI assessment, in clinical practice, in the initial assessment of the infertile male.

Presented by S. I. Moskovtsev, J. Willis, and J. White, et al., at the 64th Annual Meeting of the American Society for Reproductive Medicine - November 8 - 12, 2008 - San Francisco, California

Reported by Contributing Editor Harris M. Nagler, MD

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

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Friday, November 21, 2008

Alzheimer's link to older fathers

Alzheimer's link to older fathers
Independent, The (London), Sep 17, 1998 by Charles Arthur Technology Editor
E-mail Print Link CHILDREN BORN to fathers who are approaching middle age have a higher than average risk of developing Alzheimer's disease in later life, a study suggests.

A retrospective investigation of 206 people who have the degenerative illness, but no history of it occurring in the family, revealed a statistically significant link with the age of their father when they were born.

Some genes are known to contibute to the chance of developing Alzheimer's, but the new study, carried out by Lars Bertram at the Technical University of Munich, suggests that simply having an older father - average age 35.7 - can be a risk factor even in the absence of those genes. For those where there was a family history of Alzheimer's, the average age of the father was 31.3 years.

Though the sample is comparatively small, it is in line with the knowledge that ageing is associated with genetic damage to the sperm, which carry the father's genetic contribution to the child. That might eventually lead to Alzheimer's in the offspring. "There's an accumulation of environmental factors which somehow alter the genome of the father," Dr Bertram told New Scientist magazine.

Similar effects are already known to occur in women, where mothers over 35 have a far higher chance of giving birth to babies with Down's syndrome, which is caused by a genetic defect in the embryo. People with Down's syndrome are also more likely eventually to develop Alzheimer's.

Copyright 1998 Newspaper Publishing PLC
Provided by ProQuest Information and Learning Company. All rights Reserved.


Wednesday, November 19, 2008

Men have their own biological clock
Kazinform - Astana,Kazakhstan
An Australian study suggests men have a biological clock that signals a drop in fertility after the age of 35. Researchers at Sydney IVF said sperm and DNA ...
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Tuesday, November 18, 2008

Working Dad: An Unauthorized Guide to Parenting
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Older dads have their own biological clocks
Can you hear it? Men's biological clocks are ticking louder than ever.

I keep stumbling across evidence that older men bring their own share of problems to baby-making, just like women. I've written about connections between old sperm, schizophrenia, bipolar disorder and autism. Recently, I read about a possible connection to miscarriages in "Yo, dude, check your bio clock -- now."

A French study released in July found that women's pregnancy rates drop and miscarriages increase when the mother is over 35 and the father is over 40. Another study suggests that a man's fertility begins to decrease as early as his 20s. Researchers from the University of California at Berkeley and the Lawrence Livermore National Laboratory tested men between the ages of 22 and 80, and found that semen volume and sperm motility were both significantly compromised by aging.

-- The Ottawa Citizen. (The story came out this summer, but I haven't seen it in the United States.)

Don't get me wrong, I am not saying dads hold more responsibility for any of these problems. It is just that moms carried the biological clock on their own for a long time, and we all know it takes a man and woman to make babies.

de.licio.usDiggFacebookNewsvineRedditStumbleUponGoogle BookmarksYahoo MyWebTwitterPosted by Paul Nyhan at November 18, 2008 3:17 p.m.

'I'm 41 and childless. Is it too late to become a father?'

'I'm 41 and childless. Is it too late to become a father?'The latest science claims older dads can cause autism, schizophrenia and Down's Syndrome - and their fertility fades with age. Ian Tucker consults his biological clockComments (47)
Ian Tucker, Sunday November 16 2008 00.01 GMT The Observer, Sunday November 16 2008
Article history
Ian Tucker ponders fatherhood and fertility. Photograph: Ellis Parrinder

Last night I ate a large bowl of beetroot from my garden. This morning my urine is the colour of rosé wine and I'm worried that my semen might have taken on a similar hue. The colour of my semen is a concern because someone will be studying it in a short while. I'm considering this while sitting in the top floor 'specimen room' of the London Fertility Centre on Harley Street. Later on, when I mention where I've been to friends and colleagues they seem really interested in the interior design details of a room set aside for masturbation. So if you're planning one, here's some decorating tips. The room is on the second floor and it has two notices on its door: one saying 'Quiet Please' (in case passers-by are inclined to cheer or clap, I guess) and a sliding sign with 'Vacant/Occupied' options - I've opted for 'occupied' although I'm not, so far. Inside, the room is about 6ft x 12ft and painted in various pale non-colours. It is equipped with an ensuite shower, light-green vinyl-covered daybed and a fudge-coloured bathroom suite (including bidet). There is a sash window - which isn't overlooked. The atmosphere is more Carry On than Casualty. On one side of the sink there is a small empty plastic beaker (with my name on it). On the other a DVD player, screen and a remote. I consider all the hands that have touched the remote. Using one of the many tissues provided I pick it up and inspect it; it appears to be clean. The television doesn't show any of the normal channels.

I'm here because I'm concerned about my sperm. Not that they might be beetroot coloured, but rather that they might not be fit for purpose. That they might not be as athletic, plentiful and perfectly formed as they need to be. I'm 41 and childless, and although I'm not involved in a 'trying-for-a-baby'-type scenario I've been reading the papers and the news for fortysomething men and their sperm isn't great.

'Scientists warn that biological clock affects male fertility' warned the Guardian in July - well, scientists are always saying stuff aren't they? 'Risk of miscarriage soars once the father reaches 35' (Daily Mail) - that sounds worrying. 'Blokes going infertile aged 35' (Sun). Must have sex, pronto! The papers were all reporting in their own particular ways on the research of Dr Stephanie Belloc from the Eylau Centre for Assisted Reproduction in Paris. Dr Belloc had studied the records of 12,000 couples who visited her clinic and separated out the influence of the mother's and father's ages on the chances of conception and miscarriage.

Belloc and her team found that women whose partners were 35 or older had more miscarriages than those who were with younger men, regardless of their own age. The risk of miscarriage was on average 16.7 per cent when the men were aged 30-34, but it doubled to 33 per cent in men over 40. Moreover, her research showed that men's ages also affected pregnancy rates, which were lower in the over-40s. As the Mirror summed it up, 'Over-35? You're a dad loss.'

I can remember ridiculing my own father for being 40, so how did I end up childless at 41? To start with I went to university and became middle-class. It seems only people from council estates and people who own estates have kids young these days. The middle classes are too busy in their twenties establishing careers, climbing the property ladder and going on snowboarding holidays.

Although lack of one doesn't stop some people, I feel you need to be in a reasonably stable relationship before having kids - and I haven't been in one of those of late. But of late, many of my peers are reproducing, some are already on to their third. Even the ones who had drug problems are conceiving and, meanwhile, gay friends are cutting breeding deals with lesbians. I wonder if time is running out.

It's an easy thought to have because I can't act on it, but sometimes I think I should have had some children in my twenties. I had more energy and didn't have many material comforts to give up or much of a lifestyle to compromise. I'd be packing them off to university around now, thumbing sports car brochures and thinking about buying a peach farm in Spain. Frankly, I can't remember that much of my twenties, so maybe it would have put this decade of void to good use. I don't recall any of my peers having kids; maybe it was a hangover from the Aids era - people seemed pretty conscientious about birth control, there were no 'accidents'. So now, at 41, I wonder if I've skipped the whole kids thing.

I seem to be developing the hobbies and pastimes of a senior citizen - golf, growing beetroot, buffing my classic car. But the reality is I've got 19 years until I qualify for my bus pass - which is just enough time to raise at least one human being. So should I be worried about or believe in the 'male biological clock'?

Back in 2001, Professor Dolores Malaspina, of Columbia University College of Physicians and Surgeons, concluded that men aged 50 or over are three times more likely to father a child with schizophrenia compared with men of 25 or under. Four years later, epidemiologist Jorn Olsen at the University of California, Los Angeles, found a fourfold rise in Down's syndrome among babies born to men aged 50 and older. And in 2006 scientists from the Institute of Psychiatry at King's College, London and Mount Sinai School of Medicine in New York found that children born to fathers aged 40 and over were nearly six times more likely to suffer from autism than those with a father under 30. Meanwhile, other researchers have suggested patterns between older fathers and increased chances of bipolar disorder, dwarfism and Apert syndrome - whose unlucky sufferers have a malformed skull and webbed hands and feet, among other disfigurements. A report in 2006 even suggested 'a modest effect of advanced paternal age on the Apgar score'. And after finding out what an Apgar score is I now know this to be less than good. The evidence appeared to be stacking up.

Yet are these findings as scary as they sound? Dr Belloc's sample was made up entirely of couples presenting for infertility treatment. 'It is not evident that we can extrapolate these conclusions to a fertile population,' she tells me. And many of the incidences in the other studies are minute; so a fivefold increase is still only a five-times-minute chance of some disorder or other. Moreover, these studies only show patterns, rather than direct causal links - finding a direct link would probably require examining DNA at a detail beyond most researchers' budgets or ability. Some commentators have speculated that if a man first becomes a father in his forties or fifties that may indicate he has had trouble forming relationships earlier in his life, which may mean in a mild, undiagnosed kind of way he's a carrier of problems like bipolar disorder or autism which have a genetic element - so his paternal age is irrelevant to the outcome.

Which isn't exactly comforting, but it suggests the 'male biological clock' doesn't tick as loudly as the headlines suggest. For Dr Allan Pacey, senior lecturer in andrology at Sheffield University, the clock is nothing more than ageing. As you grow older, you lose a bit of hair and experience the odd 'senior moment', so you shouldn't be surprised if your sperm isn't as sprightly as it used to be. 'In terms of numbers it's the same, but what tends to happen is that the sperm isn't as good.' If their biological clock is ticking, men are pretty deaf to it. The age of fatherhood is creeping up: the latest figures from the Office of National Statistics show that the average age of married fathers rose from 29.1 in 1971 to 34.1 in 2003 - getting close to the 35-year point where some of the problems are alleged to kick in. I ask Dr Pacey if this is a worrying trend. 'The problem is couples are waiting until they are older. To wait until the woman is approaching 40 is the wrong time to be starting, and that will be exasperated by any problem that he has due to ageing.' Dr Pacey's advice to me is not to hang about: 'You will be more successful having a child naturally at an earlier age; it will be cheaper for you and it will be much more fun than waiting until you're well into your forties, going to an infertility clinic and having it done artificially. What we're finding are lots of people attending infertility clinics in their forties who would have succeeded in getting pregnant at 25. Rather than waiting for technology to sort it out, if you are in a position to have children early, then go ahead and do it.'

What Dr Pacey and others are quick to point out is that there's definitely a female biological clock. Women are born with a finite number of eggs and at some point they will run out. According to the Human Fertilisation and Embryology Authority (HFEA), a woman is half as fertile at 35 as she is at 25, and half as fertile again at 40.

You might be thinking, 'Why is he bothering to spell that out, everyone knows that?' Well, before researching this piece I was only vaguely aware of those blunt facts, but, more surprisingly, when chatting to single and married thirtysomething childless women about this article they start saying things like: 'My gran had my mother at 45,' 'What about Madonna?' or, most biologically incorrect: 'I'm not ready yet.' They seemed about as informed as I was. 'With the Madonnas and all the rest who seem to have children quite naturally, no one mentions IVF or egg donors, and celebrity miscarriages don't make the pages of Heat,' says Dr Pacey. 'This silence reinforces the myth that these miracle births happen, when often there's a medical intervention.' And IVF isn't a safety net: according to the HFEA, IVF has only a 12 per cent success rate for a 40-year-old woman. And it will cost you: the NHS, on the advice of the National Institute of Clinical Excellence (Nice), doesn't fund IVF for women over 40 because of the low success rate. The average cost of a cycle is £4,000-£8,000. Is it chauvinistic to question the sense of delaying having kids for the sake of a career if you're going to spend most of the extra income on fertility treatment?

However it's not only career building that is nudging the maternal age up; those commitment-phobic, nappy-changing-averse partners make a contribution, too - people like me. One could argue that this male biological clock business is providing men with another excuse to avoid having kids - we move from 'I'm not ready yet' to 'It's too dangerous now' in the time it takes to power up a Nintendo Wii. Or maybe you could blame the introduction of Viagra - which has engendered the idea that men can stay virile forever, so why rush? - as most men think the difference between virility and fertility is latex thin. But if you're looking for something that's really obscuring the hands of the male biological clock, look to famous people. When it comes to fertility, biology tells us one thing, but celebrities tell us another: ie, no matter how superannuated you are, getting your girlfriend up the duff is child's play. Middle-aged famous fellas love a baby shower.

Dr Pacey isn't impressed: 'The John Humphrys thing does distort the picture. There'll be lots of men who will read this piece and say, "I was 50 and I had a child," and it's really difficult to argue against that because they do, but statistically you are less likely to succeed and more likely to have problems. For the individual who has been successful it will seem stupid that I'm saying that, but for every 50-year-old father there'll be 10 times more thinking, "I had a lot of problems."'

Even if you, your sperm and your wife from a younger generation manage to buck the stats, there are other non-bio reasons against fathering kids late. Most obviously you might die before they graduate - if you're 65 now, on average you'll die at 82 - although for how much longer you will be capable of having a kick-about, helping them with their homework or visiting the lavatory without their assistance isn't recorded. And while it's embarrassing to be mistaken occasionally for their grandfather, it's thoughtless not to meet your grandchildren.

Am I being too hard on the older dad? I call Charlie Lewis, professor of family and developmental psychology at Lancaster University. Should we give middle-aged men the snip? 'Some men claim to be better fathers when older, but I don't see this in the majority of men. I find them saying, "I'm clapped out, I've done my bit at work, I've provided a house and comfortable living, now let me vegetate." They think it's their right to sit in front of the telly and not take part in any interaction. It's almost autistic. Older fathers tend to do less of the stereotypical activities than younger fathers do, less childcare and less kicking footballs - for fear of snapping a tendon. They think, "I'm much too old for this."'

Surprisingly, Lewis is more relaxed about the dying thing. 'I don't want to put fathers down, but if you look at the majority of evidence on loss, it does point to losing a mother before 11 being more predictive of later social/psycho disorders than losing a father. These effects are most often caused by the child absorbing the surviving partner's grief. So if the mother can manage the grieving process, the predictable death of an older father needn't be a life-changing trauma.'

Dads dead or alive, we should be more concerned about the kids, says Lewis. 'You do get studies that say old dads feel closer to their kids, but I'm not aware that kids feel closer to their older fathers.'

I wonder if I would become one of these dead-beat, distant dads. I like to think not. I don't quite understand how

that could happen. What kind of an individual would tune into a Top Gear repeat rather than read to their child or even relieve them of a shitty nappy? Maybe I'm being naive. I talk to some dad friends.

Gary, 45, first became a father when he was 23, but then remarried and had three more children, the oldest of whom is five. Would he like to compare and contrast? 'Obviously becoming a father young was a bit of a shock, it made me grow up quickly. I'm not sure at that age if you're responsible enough to look after yourself let alone a little child.' So how is it second time around: does older dad mean better dad? 'When my second wife first wanted children I did have slight panic attacks, because I had this memory of it being a total whirlwind, but this time it's completely different, it doesn't seem half as stressful as when I was in my twenties.' Gary says this isn't just because he's been a parent before - 'No, it's mainly because I'm more grown-up, more patient, more financially settled. I'm far more chilled out this time around.' So you'd advise an older option? 'It's better to have children at a later date, but myself, I'm worried about getting older. First time round I was one of the youngest parents in the playground; now I'm one of the oldest. My youngest is 10 months, so I'll be at retirement or grandfather age in her late teens. You hope to be running around in the park, doing those things that children want you to do and provide as parents. Hopefully I'll be one of those who manages it, but I will have to wait and see.'

The energy issue: I've heard this raised before. People talk about the nuclear-like amounts of energy you need to bring up a child, but I suspect it's similar to the stamina needed to squire a girlfriend half your age. Because down-ageing your just-broody girlfriends each time they start describing a new frock as 'a bit maternity' is really the only alternative to producing offspring.

Jonathan, 49, had two sons when he was 23 and 27. He says the early months were 'terrifying', and both he and his girlfriend had to abandon their career plans: 'Our embryonic lives together as a couple were entirely transformed into a fully fledged proper adult relationship. And we didn't have much money - I even used to scavenge skips for firewood.' But for all the foraging the relatively small age difference means he's closer to his kids. 'We can go to the cinema together, appreciate some of the same music, go out for a beer, they call me by my first name.' He got divorced and, a couple of years ago, he remarried. He isn't keen to become a father again: 'I'm interested in the relationship with my wife rather than with anyone else. The relationship I have with my children is established, I like the marriage and lifestyle we have, and because of my previous experience I can see how that could be compromised.'

What is his advice for someone like me, thinking of becoming a father in my forties? 'I think, you're not going to get a lot of sleep. And by the time you're my age, when you take your kids to a restaurant they'll be running around banging their heads, stealing food, whereas I'll be discussing the amount of oak in the Sauvignon with mine. I'd think about that quite carefully.'

So that's what I should have done. Bred early. Guess there's no point in crying over spilled, er, milk.

The trouble with this when-to-procreate business is it's personal. Apologies, it's not much of an insight but everyone is different. They earn lots of money, earn not much money, like kids, don't like kids, have live-in help, are still looking for The One, are given a babies-or-else ultimatum by their partners, had a shit childhood themselves, don't feel the need to have babies to preserve their relationship, are worried they'll pass on a condition, feel they've established their career, don't want a career, haven't been to Patagonia yet - the list of caveats and factors that make it the 'right time' for someone is as long as the waiting list for a Doctor Who Dalek Electronic Voice Changer Helmet.

So, to borrow a phrase from a Dragon: 'Let me tell you where I am.' For me, I think 45 is the cut-off. For biological reasons - you can't donate sperm past 45 - there must be something in those scary reports. And financially, I'd like to retire on time, if indeed I'm lucky enough to still have a career by then. Which doesn't give me much time, I guess, to meet someone, fall in love, imagine being with this person for the foreseeable future - if that's not over-romantic, delusional, too-much-like-a-John-Cusack-movie. But I'm getting ahead of myself: maybe I'm firing blanks anyhow.

For the 20-minute wait while my sperm is being tested, I chat to Dr Magdy Asaad, clinical director, in his office about the problems with semen. Mine is being tested for volume, viscosity, concentration, mobility, morphology and antibodies.

Dr Asaad uses the gold standard WHO criteria which are surprisingly generous - only 50 per cent of your sperm needs to move, for instance, and you're allowed up to 80 per cent with an abnormal form, such as funny-shaped heads or two tails, 'because 20 per cent of 20m is considered enough, it's a lot of sperm,' Dr Asaad chuckles.

I'm curious: do anxious men often pop in on their own for a lunchtime sperm test, check everything is wriggling right? 'It's not common, but when men present on their own, it's normally a problem with their ability to have an erection or ejaculation.'

Well as you can tell I have no problems in that area, I say.

'But some men don't like to give a sample,' he continues. 'They find all kinds of excuses: maybe they are worried it will not be good, or that it's an artificial thing, to press a button [is he talking about the remote control?]. I don't know how it was for you, I'm not asking. Sometimes a gentleman will have difficulty preparing manually.' Unbelievable.

The walls and desk of the doctor's office are smothered with framed photographs of beaming parents with their children - patients he's helped to fashion a bundle of joy for over the years. In your experience, I ask Dr Asaad, when is a good age for procreation? 'You're mature enough by your late twenties, early thirties, responsible enough, you probably have a job, a partner. I don't think it's a very serious problem waiting to 40-45, but beyond that you have to think about time with the child.'

With that, Dr Asaad prints off a piece of A4 containing all my sperm's vital statistics. 'It's a good sample,' he says, 'so you're all right.' I'll spare you the details.

On one hand this is a relief, but on the other it means I've no alibi, no excuses, I'm ready to breed. All I need now is a woman.

Paternity frights: ten bus-pass fathers
Julio Iglesias Sr, a dad at 89

Nobody could accuse the gynaecologist father of Julio and grandfather of Enrique, and who was head of a Madrid family-planning unit, of not taking his work home with him. After having two children with his first wife, he remarried and, at 89, when his wife was 40, produced another son. Barely out of the maternity ward, Ronna signed up for IVF and within a few months was pregnant again. Tragically, filling a test-tube turned out to be the former Franco supporter's last significant act: two months later he was muerto. His daughter Ruth was born posthumously seven months later in July 2006.

Dad-speak: 'At my age, a child is marvellous. I felt just like Abraham. It was an act of generosity towards her [Ronna]. I leave her part of my blood, of my life.'

Saul Bellow, a dad at 84

The Nobel Prize-winning novelist had four children: three sons with his first three wives, and a daughter, Naomi-Rose, with his 41-year-old fifth wife. He died when she was five, in 2005. Writing two months after his death, one of his sons, Adam, whose mother Bellow left when he was two, recalled 'a fond but highly attenuated bond with a frequently distracted, often absent and much older father.'

Dad-speak: 'Well, my wife won't be lonely when I die. She'll have somebody'

Anthony Quinn, a dad at 81

The star of more than 100 movies, including Zorba the Greek and The Guns of Navarone, enjoyed procreating. He had five children with his first wife Katherine, the daughter of Cecil B DeMille, three with the second, then at the age of 81, he got his 29-year-old secretary pregnant, married her and had two children. The double Oscar-winner also squeezed in three more children with women he wasn't married to before he died in 2001.

Dad-speak: [of his penultimate child] 'She's beautiful, she looks like me'

Rupert Murdoch, a dad at 72

The Australian-American global media mogul (real first name Keith) has been married three times. He produced one child with the first and three (Elizabeth, James and Lachlan) during a 31-year marriage to the second. Seventeen days after the $1.2bn divorce, the Dirty Digger married former photographic model Deng Wendi (she transposed her names post nuptials), a 30-year-old executive at his Asian Star TV channel. They have two children, the most recent in July 2003.

Dad-speak: 'All my children will be treated equally'

Des O'Connor, a dad at 72

The former Countdown host has been married four times and has four grown-up daughters. His current wife, the 37-years-younger singer/dancer Jodie, who he met in 1990, when they were doing panto together, provided him with a son in September 2004.

Dad-speak: 'When the baby was born the odd comment was made about my age, but I plan to play football with Adam'

Luciano Pavarotti, a dad at 67

The well-upholstered tenor had three daughters with his first wife, who he stayed with for 35 years. Then, in 1996, he left her for his secretary, Nicoletta - 36 years his junior. In 2003 she gave birth to twins, another daughter and a son; tragically, the latter was stillborn. 'The King of the High Cs' died after a long battle with pancreatic cancer just before his youngest daughter's fifth birthday.

Dad-speak: 'I never imagined that at this time of life I would have another child. But I met Nicoletta, and she is young'

Warren Beatty, a dad at 62

After years of womanising (Natalie Wood, Julie Christie, Isabelle Adjani, Vivien Leigh, Cher, Madonna, Carly Simon, Barbra Streisand, Britt Ekland, Diane Keaton, Mary Tyler Moore, Janice Dickinson and Faye Dunaway to name a few) he plumped for Annette Bening. They've had four kids, the latest of whom was born in 2000. I think we can assume fatherhood has mellowed Warren.

Dad-speak: 'We're fortunate to have a big house'

Rod Stewart, a dad at 60

The rooster-haired senior citizen has been breeding for 41 years. He's had seven children by five different women, although modest Rod often downgrades to six offspring, passing over his first, who was put up for adoption: 'You can count her if you want. I try not to,' he once said. Penny Lancaster provided him with his sixth/seventh, Alastair, in 2005. According to his brother Don, Rod prefers to leave Alastair's nappy-changing and feeding to the hired help. Unperturbed, 37-year-old Penny has dropped heavy hints she'd like a second with the 63-year-old Celtic fan.

Dad-speak: 'I didn't see my oldest kids a lot as they were growing up. I don't feel any guilt, but maybe having a family is something Rachel and Alana and I should have thought about more before we had children'

Michael Douglas, a dad at 58

The Basic Instinct star had a son, Cameron, with Diandra Luker, his wife of 23 years. She divorced him in 2000. Later that year he ran into Catherine Zeta Jones and seduced her with the admirably direct and honest line: 'I'd like to father your children.' True to his word he hasn't let the 25-year age gap stop him from impregnating her twice, when he was 55 and 58.

Dad-speak: 'It's not that I didn't enjoy it the first time, but I just didn't have the time. I'm not the only father who has felt guilty about the lack of time spent with his kids. So now I have a situation where I can savour it with my younger children. And you can see the effect of hanging out with them for three years and the security they have. And for me, it's a ball. Movie roles come and go and it's a finite period of time. This is sort of eternal'

John Humphrys, a dad at 56

The Welsh son of a hairdresser and French polisher has been married twice. The first wife provided the Mastermind host with two children, now both grown up. He remarried in 1987 and, after a reverse vasectomy, the Today programme interrogator became a proud father to a son, Owen.

Dad speak: 'I thought I might resent this little kid for buggering up my life, as it were. The opposite has happened to me because of him. He's the most wonderful thing that's ever happened to me'
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Tuesday, November 11, 2008

Older parents, epigenomics and psychiatric illness

Older parents, epigenomics and psychiatric illness
2008-11-11 — Dave Bath
Nature’s British Journal of Pharmacology has (for free!) an editorial that is getting my nose twitching, and pushes me to speed up a Balneus post that has been brewing for a while. The growing literature on the diseases of children caused by advanced parental age suggests that the societal pattern of people building their careers before having children needs to be reviewed by social policy makers.

"Epigenetic biomarkers in psychiatric disorders" British Journal of Pharmacology (2008) 155, 795–796; doi:10.1038/bjp.2008.254; published online 23 June 2008 (also as PDF is yet another paper stressing the importance of epigenetics in pathogenesis, and introduces a new word, "epigenomics" that relates to testing and markers.

Basically, the older the person (male or female) when conceiving a child, the more likely something epigenetic has gone awry and will cause problems.

Another relatively recent paper highlighted the relationship between advanced parental age and schizophrenia: "Aberrant Epigenetic Regulation Could Explain the Relationship of Paternal Age to Schizophrenia" Schizophrenia Bulletin doi:10.1093/schbul/sbm093 (advance publication 2007-08-21) contains the following:

In 2001, Malaspina et al showed that the incidence of schizophrenia increased progressively with increasing paternal age, the risk being 2-fold and 3-fold for offspring of fathers aged 45–49 and 50 or more years, compared with those of fathers aged less than 25 years.

It’s not just schizophrenia: autism, cognitive and learning difficulties, longevity … the list gets longer every year.

It’s a far cry from what we were taught at uni in the seventies: that old ova stuck in meiosis for 40 years accumulated damage (leading to increased incidence of trisomy 21 or Down’s Syndrome), but because spermatogenesis was continuous, older males didn’t cause such problems.

This raises questions about how social policy affects societal health perhaps more serious than the "diabesity" epidemic, as obesity is more easily treated than something caused at the time of conception (even before).

The easy recommendation is for ladies: ignore the flattery and bank balances of older men!

For males, it’s worthwhile trying to settle down earlier, do the parenting bit with your career on hold.

For politicians, this means that education patterns and work/life balance policies need some attention - unless we want each generation of teenagers to be nuttier than than the previous one.

Someone in Canberra should be crunching the numbers between the census details on parental age and epidemiology, taking into account greater diagnostic capabilities across the years.

I’m much relieved that at 48, my grandson is approaching 2, not only because of this research, but because I’ve got just enough energy to keep up with him for a couple of days (I stay with my daughter and grandson every second weekend on average). I’d be much less fun for him if my joints were any creakier!

Posted in Biology and Health, Politics, Society.

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Saturday, November 08, 2008

His advice? "If my son or daughter was to ask, I'd tell them to have kids early -- and that's before 30."

Yo, dude, check your bio clock -- now
New studies warn that it isn't just women who become less fertile as they age
Sarah Treleaven , The Ottawa Citizen
Recently, I've had a lot of conversations about baby-making with my male friends.

"I worry that I might be too selfish to ever have children," said my friend Joe, 29, somewhat pensively over gin and cucumber cocktails. Ditto for Colin, who just broke up with a woman he loves because she wants to have kids in the next few years and, at 35, he just doesn't feel ready yet. Kids or no, they both feel like they have all the time in the world to decide.

I, on the other hand, just turned 30 and have been making a lot of jokes about needing an apartment with a second bedroom for my soon-to-be-frozen eggs.

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Font:****Lots of women wring their hands about having a baby. Not only do we have to worry about our plummeting fertility (which begins to tank in our mid-20s), but we also have to worry about job retention and advancement once those kids (come biology, adoption or surrogacy) eventually appear. And it's the physical limitations of the female ability to procreate that have placed such a heavy emphasis on the reproductive biological clock, shaping the way many women live, work and even date.

But evidence is increasingly emerging that men, too, have a reproductive biological clock -- and that it ticks much more loudly than most of us have thought. Even as stories occasionally emerge about septuagenarian and octogenarian men becoming proud papas -- author Saul Bellow, for example, fathered a child at 84 -- several recent studies are challenging the conventional wisdom that men have an invincible ability to procreate.

A French study released in July found that women's pregnancy rates drop and miscarriages increase when the mother is over 35 and the father is over 40. Another study suggests that a man's fertility begins to decrease as early as his 20s. Researchers from the University of California at Berkeley and the Lawrence Livermore National Laboratory tested men between the ages of 22 and 80, and found that semen volume and sperm motility were both significantly compromised by aging.

Additionally, the increased odds for older fathers producing genetic abnormalities have been well documented, and studies have demonstrated that fathers over 40 are six times more likely to produce an autistic child than fathers under 30.

The numbers related to schizophrenia are similarly compelling. A study utilizing health databases in Jerusalem found that fathers over 40 were twice as likely to produce schizophrenic children as fathers who were under 25; for fathers over 50, the odds tripled when compared to fathers who were under 25.

Dr. Harry Fisch, director of the Male Reproductive Center at New York-Presbyterian Hospital/Columbia University Medical Center and the author of The Male Biological Clock, says that he's been ringing the alarm bell for years.

"There's a female biological clock; we all agree on the decline in fertility, more genetic problems and a decline in estrogen.

"The same thing happens in men -- a little bit differently, but essentially the same," Fisch says. "Why is it important? Well, demographically more men and women are waiting until they're over 30 to have a baby."

Yo, dude, check your bio clock -- now
New studies warn that it isn't just women who become less fertile as they age
Sarah Treleaven , The Ottawa Citizen
"Over 35, the women are at risk for genetic problems, the men's sperm is at risk for genetic problems; put it together and I consider it a public health concern."

Women in their mid-30s routinely panic about their odds of conception and the health of their baby. The key question associated with the emerging science is this: Is it time for men to start panicking too?

Many fertility experts remain unconvinced that these recent findings are significant. Dr. Paul Claman of the Ottawa Fertility Centre says that men do indeed have a reproductive clock, but that it pales in comparison to the biological reality women face.

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Font:****"Recent data have shown that there are some genetic issues with men as they get older, but much less profound than with women," Claman says.

Dr. Armand Zini, associate professor of urology at McGill University, agrees. "(With) women, there's a real time point where it ceases. Once you cease to ovulate, there's no fertility. In men, it's a very gradual decline from 30s or early 40s."

Women only produce a set number of eggs, and by the time they've reached their early 30s, that supply is significantly compromised. Men, on the other hand, produce sperm throughout their lives, which explains how a 90-year-old farmer in India became a father last year to his 21st child.

Both men and women who choose younger partners (under the age of 35) increase their odds for both conception and newborn health. "An older woman married to a younger man has a much higher chance of getting pregnant than an older woman married to a man her age or older," says Claman.

Interpretations of these new studies may be varied, but will any of this new evidence be enough to get men thinking about the sand running through their reproductive hourglass?

Jason McBride, a 39-year-old writer without children, says the recent studies about male fertility don't concern him in the least. He does acknowledge that he gets pressure from his family to have kids -- "mostly from my hilarious aunt who's always talking about how old my sperm is." But he believes that his option to become a biological parent will remain available for a long time yet. "My biological clock is still on snooze," he says.

Dustin Parkes, on the other hand, is a 28-year old public relations consultant who feels compelled to have kids while he's still relatively young. "I definitely don't want to be a broken-down old man chasing around a toddler." He holds out little hope that he'll meet his goal of being a dad before he's 30, but he, too, acknowledges that the recent studies are of little concern.

There are still a lot of unanswered questions about male fertility, and recent studies are far from eclipsing the well-established reproductive limitations of women. But these recent studies might serve as the start of a reproductive wakeup call for men.

For those who do delay fatherhood, Zini says living a healthy lifestyle can help to prevent the decline of sperm production and testicular function, which invariably diminish with age. He recommends avoiding environmental toxins (including smoking) and excessive exposure to heat (such as saunas and whirlpools) and certain occupational hazards (such as taxi driving, which requires sitting for prolonged periods of time).

Fisch says that having a baby over the age of 35 -- male or female -- still increases the odds of infertility and genetic disorders. His advice? "If my son or daughter was to ask, I'd tell them to have kids early -- and that's before 30."

McBride admits that the ticking of his clock occasionally becomes audible. "As I get more and more infirm," he jokes, pointing to his new orthotic, "I worry about not being able to run around with my kids."

Parkes feels it too, and anticipates that the ticking will get louder in the next few years. "It helps that my circle of friends doesn't seem to be as into having kids, but who knows how much longer that will last? If I get to 35 without a kid, I think I'll throw all my mating standards away and just try to impregnate anything."

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Friday, November 07, 2008

Male Biological Clock Also ’Ticking’: Fertility Problems Greater For Men Over 35

Male Biological Clock Also ’Ticking’: Fertility Problems Greater For Men Over 35
Friday, November 7, 2008, 1:57
This news item was posted in Health & Medicine category and has 0 Comments so far.

Dr. Belloc and colleagues followed up 21239 intrauterine inseminations (IUIs). In IUI the sperm is ’washed’, or spun in a centrifuge, in order to separate them from the seminal fluid, and then inserted directly into the uterus. If the sperm are not washed they can cause uterine cramps which can expel the semen because of prostaglandins in the seminal fluid. 12236 couples who had consulted at the Centre between January 2002 and December 2006 were involved, and the husband’s semen was used in all cases. In most cases the couples were being treated because of the husband’s infertility.

The sperm of each partner was examined at the time of the IUI for a number of characteristics, including sperm count, motility and morphology. Clinical pregnancy, miscarriage and delivery rates were also carefully recorded. Detailed analysis of the results allowed the scientists to separate out the male and female factors related to each pregnancy.

Maternal age was closely associated with a decreased pregnancy rate of 8.9% in women over 35 years, compared to 14.5% in younger women. Miscarriage rates were also typically affected by maternal age.

"But we also found that that the age of the father was important in pregnancy rates — men over 35 had a negative effect," says Dr. Belloc. "And, perhaps more surprisingly, miscarriage rates increased where the father was over 35."

The effect of maternal age on the ability to conceive and on miscarriage rates is well known, but there is still controversy about the role of the father. Although there are many reports that show an overall decline in sperm counts and quality from decade to decade, up to now there has been no clinical proof that simply being an older man has a direct effect on a couple’s fertility.

"We already believed that couples where the man was older took longer to conceive," says Dr. Belloc, "but a number of reasons had been put forward for this. Neither was there any definite evidence that miscarriage rates increased when the man was older. To undertake a complex multivariant statistical analysis of data from a large group of patients was difficult, but we thought it was a question that needed to be answered once and for all. Some recent studies have established a relationship between the results of IUI and DNA damage, which is also correlated to a man’s age, suggesting that it might be an important factor, but until now there was no clinical proof."

Even though the numbers in the study are already large, the scientists intend to include more couples in the next few years to confirm their results further. "This research has important implications for couples wanting to start a family," says Dr. Belloc, "and we need to research it in as large a group as possible."

"How DNA damage in older men translates into clinical practice has not been shown up to now," says Dr. Belloc. "Our research proves for the first time that there is a strong paternal age-related effect on IUI outcomes, and this information should be considered by both doctors and patients in assisted reproduction programmes.

"We believe that the use of IVF or ICSI should be suggested to infertile patients where either party is over 35 years of age. In IVF, the zona pellucida (the outer membrane of the egg) seems to be an efficient barrier in preventing the penetration of sperm with DNA damage, and in ICSI, the best sperm can be selected out for use. These methods, although not in themselves a guarantee of success, may help couples where the man is older to achieve a pregnancy more quickly, and also reduce the risk of miscarriage," she says.


Increased Bipolar Risk Linked to Father's Age by Joan Arehart-Treichel

Psychiatr News November 7, 2008Volume 43, Number 21, page 18© 2008 American Psychiatric Association

Articles by Arehart-Treichel, J.
Clinical & Research News
Increased Bipolar Risk Linked to Father's AgeJoan Arehart-Treichel
Older men are more likely than younger men to father children with autism, schizophrenia, or early-onset bipolar disorder.
Fathering a child later in life seems to increase its risk of having autism or schizophrenia, research has shown. And now it seems to increase a child's risk of having bipolar disorder as well, a new study suggests.
The study was headed by Emma Frans, a doctoral student in epidemiology at the Karolinska Institute in Stockholm. Results were published in the September Archives of General Psychiatry.
Sweden's Multigeneration Register, as well as Sweden's National Hospital Discharge Register, made this new investigation possible. The former, which has been in existence since 1947, gives demographic information about all people living in Sweden as well as about their parents. The latter, which has been in existence since 1973, lists all people living in Sweden who have been hospitalized for various conditions.
Using the hospital discharge register, the researchers identified more than 13,000 persons who had been hospitalized for bipolar disorder at least twice since 1973 when the hospital discharge register was started. Using the Multigeneration Register, the researchers picked out five healthy individuals who matched each of the 13,000 persons on gender and date of birth. In other words, some 13,000 persons with bipolar disorder served as subjects, and 67,000 other individuals served as controls.
The researchers then used the Multigeneration Register to determine the age of each subject's father and of each control's father at the time of the subject's or control's birth. Finally, the researchers used this data to determine whether there was any link between paternal age at the time of birth and an offspring's chances of having bipolar disorder.
A link was found. Even when some possibly confounding factors such as socioeconomic status, family history of mental disorders, or maternal age at time of birth were considered, the offspring of men aged 55 or older were significantly more likely—1.37 times more likely—to have bipolar disorder than were the offspring of men aged 20 to 24. And for early-onset bipolar disorder (defined as occurring before age 20), the impact of paternal age was even more pronounced: the offspring of men aged 50 or older were 2.63 times more likely to have bipolar disorder than were the offspring of men aged 20 to 24.

Thus, paternal age seems to be "an independent risk factor for bipolar disorder," Frans and her colleagues concluded in their study report. "Furthermore, our results indicate that the paternal age effect might be most evident in patients with an early onset of the disorder."
Why older men are more at risk of fathering children with bipolar disorder, or autism or schizophrenia, than younger men are is not known. However, Frans and her team suspect that it is genetic, especially since they found a strong link between older paternal age and early-onset bipolar disorder, which has shown greater heritability than bipolar disorder that occurs later in life.
Furthermore, Frans and her group speculated in their report, older men's genetic proneness to father children with bipolar disorder may be due to the fact that "spermatogonial cells replicate every 16th day, resulting in approximately 200 divisions by the age of 20 years and 660 divisions by the age of 40 years [and even more divisions as a man grows older. Thus] disorders associated with advancing paternal age could partially result from de novo mutations."
Women, in contrast, they explained, "are born with their full supply of eggs that have gone through only 23 replications, a number that does not change as they age. Therefore DNA copy errors should not increase in number with maternal age."
The study had no outside funding.
An abstract of "Advancing Paternal Age and Bipolar Disorder" is posted at <>.


Sunday, November 02, 2008

Mobile Phone Radiations. How Safe You Are

Saturday, November 1, 2008
Mobile Phone Radiations. How Safe You Are?

MEN who talk for hours on their mobile phones could be jeopardising their chance of fathering a child, Australian research suggests.
An experiment on semen revealed evidence of DNA damage after 16 hours of exposure to radiation similar to the output of a mobile phone.
"After 16 hours exposure, there was clear evidence of DNA damage," Prof Aitken said.
DNA damage in spermatozoa has been associated with decreased fertility, increased risk of miscarriage and various kinds of disease in offspring, including childhood cancer, and a number of neurological disorders such as autism, bipolar disorder and spontaneous schizophrenia.

read more at Australian news
Cellular phones use microwave frequncies. Various bands of frequencies are used depending on the type of service used. For example the GSM phones use the frequencies near 830, 900, 1740 and 1900 MHz. Let us consider only the 900 MHz band for our discussion. This has a quarter wavelength of approximately 7.5 cms. Hence the maximum heating takes place at a distance of 7.5 cms from the antenna. Cell phone users may try to identify the organ which is at this distance from the cell phone antenna and do not be surprised if you find your brains there. Does this imply that the brain would be ’cooked’ during cell phone usage? The answer is partly yes, partly no, partly I dont know. The brain constitues about 70% water, but the resonant frequency of water molecules is at about 2450 MHz and drops rapidly on either sides of this frequency. Hence the heating at cell phone operating frequency is quite less. However the heating of oxygen atoms, which are also present are not less!!! Does it mean the brain will be ’cooked’ slowly?
DO NOT GIVE YOUR CELL PHONE TO BABIES(the absorption rate is higher in children for microwaves).


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