band doris granger moment arrives. joint direct attack on her journey back to freedom in the in our interactive documentary. returns home on d w dot com orangutang. welcome to in good shape coming up. to exercise or not to exercise there is no question. forth a wrecked c.-a and unhealthy fixation on healthy eating. and fertility treatments new advances in reproductive medicine. and here's your host dr custom hello and welcome to in good shape where do babies come from this is

a question many children ask their parents and if the parents don't want to tell them they haven't stories in many countries of the world this stock still really risks the babies all in france girls come out of a row and boys out of a catch but what if the stork the roxas and the cabbage fail you can go to the fertility center him to dr. so have a couple as unprotected sex after one or 2 years in former times it was not easy to get pregnant but now the modern reproductive medicine is able to help certain to get the treasure and maybe one or 2. most. the couples who want to have babies are

the lucky side of life they just get pregnant that others try and try and try and they fail and if they don't get pregnant after you hear you talk to say that this is infertility. there can be many reasons why a woman fails to get pregnant one 3rd of cases are attributed to fertility issues with the female partner one 3rd to problems with the male partner and one 3rd to a combination of problems in both couples are generally considered in need of fertility treatment if they've been trying and failing to conceive for at least a year. in 2015 nearly 21000 babies born in germany for example resulted from assisted reproduction that was 1000 more than in the previous year worldwide millions of babies are conceived with the help of fertility treatment and the numbers climbing steadily so is infertility on the rise. sperm counts in western

industrialized nations have plunged by over 50 percent in the last 40 years stress and unhealthy lifestyles have been shown to adversely affect fertility professor cuts i mean a hunger has observed a rise in the number of people seeking fertility treatment. also smoking and obesity have a major impact on fertility and both women and men. the good thing is that you can discuss these issues with a couple and encourage them to make changes i must say what if it's yes. but the main reason why couples fail to conceive is that women's fertility declines with age. the number of eggs in their ovaries decreases steadily. girls enter puberty with around half a 1000000 eggs. they lose around a 1000 eggs each month. when a woman is in her early thirties the statistical likelihood of her becoming

pregnant is 30 percent precise. in the style full by the time a woman is 40 the likelihood she'll conceive has decreased and by $44.00 she has just a 3 to 4 percent chance of conceiving per month on this financial plan all day the reason for this to put it frankly is that her eggs are older and they've declined in quality so a pregnancy becomes less likely and bob is nice to meet so i national. women seeking fertility treatment are 35 and a half years old on average. with women delaying childbearing in some parts of the world are couples who want children more likely to end up childless. than the motorist you can't necessarily joe that conclusion is we don't know how many childless couples wanted children and how many chose not to have them working

and here's. what we do know is that a growing number of couples are seeking fertility treatment and that the options are becoming increasingly sophisticated the probability of conceiving after one round of treatment is now 20 percent the more rounds you have the higher your chances are of conceiving but success is by no means guaranteed. and you can head off until the center in the loop which is one of the hottest interest interest here in germany thanks for having me today and when should a couple decide to come see so 1st say should have unprotected sex and if it more than one year of unprotected sex then they should go to a doctor either gynecologist or here to reproductive unit and if they visit you and watch you. first have to find out the reason for being steroids recorded still run and that is the pending on either male factors or female factors and in female

factors they mainly harbor the disturbances that there isn't any regular man school cycle or the wife has a problem with her fellow peon tubes as a result of pelvic infection or it is a male problem that is promoted it t. or the number of sperm as no and that might be the reason of a male infertility you definitely look at both not just the female to male yes of you have to look at both because it's half and half between male and female that the reason is hard when male and having female best use you can read something about it used quality which increased over the last decade this is true that's true but on the other hand we know that the probability to get pregnant is nearly the same whether it's now or it's a decade or 2 decades ago so there is

a problem but it has no influence on the question of whether the wife is should get pregnant moment but one problem could be a shot of college you're industrious countries and couples decide to imagine an older age for instance over the age of 50. here that has an influence so the normal freak on duty gets. after the age of 30 in the vive. but definitely between 303538 that's not a huge problem after 40 years of age that's a problem because of the problem of the quality of the x. the quality of the existing minish ing after the dramatically after the age of 38 years and the influence of the age of survive is very important on the other hand the male influence is not that important but after the age of 50 you have also a lower quality of sperm looking at treatment options i mean i think that it depends

on the costs of the infertility but what kind of options to you offer ok if there's a nominal disturbance in the women the treatment is very easy. you have to give her some tablets or injections to produce eggs and then if she hasn't ovulation she then these this problem is solved on the other hand if there are moderate problem with the sperms you could combine this one was an artificial insemination so drugs for ovulation and artificial insemination so it's a quite easy treatment. let's take a closer look at artificial insemination in investors countries about 2 to 5 percent of the couple with some help. many couples hoping to have children face a battle against time such as 34 year old even virga and her husband lived.

we tried and failed for a long time so we went to see the doctor and i went to a gynecologist and my husband went to iraq just as the doctors advise us to go to a fertility clinic events can i want to talk again. it was quite overwhelming at 1st it had already been on our minds but when that's what you're told to get really becomes an issue but it didn't mean that we had this opportunity. for you. to take this egg cell that turns into an embryo out of an incubator and put it under a microscope to see whether fertilization had occurred so it's was they had thought it was the fertilized egg ovum was examined once a day. of yourself you could say and you just removing the cells from the warm environment of the incubator 37 degrees celsius removing them from ideal conditions

and exposing them to the risk of cooling and to light as well as fluctuations in the ph levels and now none of that's necessary and. new technology is helping to improve the success rate of assisted reproduction treatment among the latest and the most advanced methods now available is the so-called time lapse incubating. when you open it shares a gap in the built in camera travels along a few measures and assesses the cells while creating live time lapse footage it's a very small area system. it's intentional in order to create a very stable cell culture conditions. where the exiles would usually develop are close to no like can enter and there are no chance which are fluctuations stunt. that allows a more natural and unhindered development in the extremely sensitive early phase as

well as careful monitoring by the doctors. there is the photo is to mind the one big advantage is that the incubator can function without interruption without teams opening the 2nd pleased we can see how the cell division inside is developing. we know far better resolution of every single movement so there's much more information about the quality of the cells development which is a huge advantage. that's headed to kill z. . within 5 days the fertilized eggs are implanted into the mother's uterus evangelist treatment was successful now she's pregnant. all. the story of the baby is completely healthy everything's great each time the doctors told us how well the baby was developing and everything was normal so it couldn't have been any better just great. for couples like the villas the time lapse incubates

a method significantly improves the chances of becoming pregnant. about 40 years ago the 1st test tube baby was born her name is louise down and there are different kinds of official incineration so what kinds of holiday to choose from so we look either on in vitro fertilization test joe perry or we combine it with a message when you inject one spot and so normally it takes the in-vitro fertilisation that means you have the major x. and then you put around the x. about 200000 sperm and you hope that one goes into the and. fertilized egg on the other hand the exit procedure then you take one sperm inject this one directly into the x. and then you hope to have a fertilization as well so the 1st monday in vitro fertilization is more natural compared with the extreme method and what about the result. that because you

inject it directly into the back you have a little little higher number of fertilization but the body is important at the end the baby take home or it is just the same it's more in favor of the even more natural procedure of the i.v. you have sold the baby take over it is a little bit better and i we have a procedure so it's always a good idea to stay with nature you have to give the woman home or as the preparation for the stimulation why is that so normally you have only one egg during a man sort of cycle but for successful in vitro fertilization you need $12.00 to $15.00 eggs and you can make a calculation because half of the eggs as never able for a pregnancy or for a delivery so you need more and some of the eggs don't get fertilized so that's the aim to have 12 to 15 eggs which are major and then you can use them for the in vitro fertilization of all the instruments and isn't it dangerous to give those

homes are they decide if it's yes you have to look to the side effects of the long term raanan of the short term run on the long term run we know that there is no high probability for getting cancer breast cancer in women or. ovarian cancer but in the short run you have problems that there is a possibility for an hyperstimulation that you have not only $12.00 to $15.00 x. but maybe 30 and then the ovaries are in large and some of that much smaller than that the woman has to go into the hospital to give you some update on the success rates of the in the 2. disease so the 1st success rate is said to have after the embryo transfer you have a pregnancy the pregnancy rate can be expected of about 30 percent. but that is not the most important for the women most important is a baby take home rate and the baby to cooperate is between 20 and 25 percent so

if you counsel the couple you have to tell them ok we have to take into account 2 or 3 a terms and then the probability of 4 having a baby is higher than the probability for not having a baby and when you take a look at the babies i mean there are some reports that suggest that there are higher rate of organ failure as a heart problems. are things that is true because we have to be aware that we do a lot of artificial things we give a lot of hormones for the majority of the eggs and then in the incubate of the the eggs and sperms and the embryos are between $2.00 and $5.00 days and the possibility for developing are not just the same as in the women the full opiate tubes normally it takes place in the fallopian tube and that we have to be there maybe that is somehow on the embryo and on the end we are never on the safe side when we do artificial things so we have to counsel the patient and we could do it

only if the patient are agreeing on the procedure well we just focused on artificial insemination but let's take a look at natural for today's age and so we got viewer questions some. from us and he asks if there are certain positions that increases women chance of getting pregnant no you should just have sex and the position is not important and it's not also important that you stay in bed because we know after 10 minutes these problems are not in the vagina only not in the order of the hour in the fallopian tubes you can do what you want just have sex so there's no heads to. that's a certain oh ok. guy wants to know abstinence improve sperm quality it's the opposite because normally human beings have sex all 2 or 3 days so if you wait too long you get not that there's pressure get worse so not waiting for a long time just have sex it's really good news thanks for this very interesting

talk so if you want to get pregnant yes to become active and if you want to have your questions answered get active 2. on an upcoming show we'll be looking at fruits and vegetables do they give us enough nutrients or would it be better to take supplements to stay healthy send in your questions about that issue to in good shape but d.-w. dot com just right nutritional supplements in the subject line we look forward to hearing from you. if you want to write us do it right now because postponing things means that they often don't get done i am myself a master in procrastinating but there's a way out of it let's take a look at the next report i will watch this report maybe later. a quick burst of activity but you run out of steam almost immediately.

if you see exercising as a chore you might want to try finding a sport that's. and as a sports psychologist at the university of parts he loves running and he advises people to find a form of exercise that suits them and it was also obvious you need to try things out perhaps there's a sport you used to enjoy what you like doing most and then just go and do it. try mixing it up the main thing is to enjoy working out. lots of people say they would exercise but they just don't have the time. that's kind of tight so how saying you don't have time is not an excuse everyone is busy you have to find a way of fitting exercise into your schedule how ever busy you are the small time

off. to put it in your calendar that's what you do with the work appointment make it non-negotiable just put it in the calendar and stick to it. schedule your exercise. and make sure you're well prepared. pack what you need in your sports bag well in advance. and the realistic people need to exercising tend to set themselves over ambitious goals they have no chance of reaching. it's really important not to overtax yourself and do a bit less than what you think feels right and only keep it up as long as it feels comfortable. and don't forget to reward yourself that way you'll stay motivated. sometimes our brain is pretty straightforward have

a reward means the brain says well done do it again treat yourself. and sooner or later that feeling of achievement after a good workout will be reward enough. you know what i like to put into my phone all the things i eat because i want to stick to a healthy diet but sometimes pursuing a healthy diet can be compulsive if you get upset by it but can the healthy diet be an illness that i didn't want to lose weight i wanted to put on weight but i was also afraid. and i eat really healthy fruit and vegetables hardly any fat back to counterfit. canned food was a no no i would never eat canned tomatoes say because they have additives in and. which i wasn't homes and a healthy diet has never been more fashionable but paradoxically sometimes it can make people on healthy mindful eating can become an obsession so fear is 19 and

suffers from orthorexia no vosa and excessive preoccupation with eating which procedures healthy food she's been in treatment for 6 months she's learning to understand the condition. at the beginning i thought you were eating healthily and you're also exercising so a healthy lifestyle but at some point i realized i was losing weight even though i didn't want to but i was also worried about putting it back on and that's when it started to become compulsive and sides kind of. people with orthorexia are less worried about the amount of food they're eating and more preoccupied with what they're eating they have a fixation with what they believe to be healthy and unhealthy food. a study involving nearly $1400.00 test subjects at the university of distilled or showed that 3 percent had symptoms of orthorexia bianca's friend and has also

observed a rise in the disorder. people are looking for the healthiest diet possible and that can make them increasingly restrictive when it comes to what they eat. and they no longer see food as sustenance it becomes their main focus in life and that's what orthorexia is basically. when sophia 1st arrived in the clinic she weighed just 36 kilos when someone is orthorexia their entire day tends to revolve around what they eat they set themselves strict rules about what they're allowed to eat and follow them rigidly. that's what happened to sophia 2 and one key factor played a major role. is to madonna feeding me and i believe that the media was to blame these days you'll always hearing about the dangers of sugar how the whole

world is eating fast too much sugar and too much fat so. that was what started my anxiety. tips on healthy eating are all over social media a british study revealed that regular instagram users are more likely to think about the issue of eating and exhibit symptoms of orthorexia. is an exit from nutrition is a major topic in society and the media i'd say that coverage of issues related to how we eat certainly plays a role in orthorexia such as factory farming or a salmonella outbreak. some viruses that are transmitted through food that's had influenced. anxiety about diseases can feed the fixation on healthy eating here in the clinic the young women are really learning how to eat normally it doesn't happen overnight. this is why in their vanilla sugar and that just says that's

a problem for me. the cookies and fruit mean there's already sugar in it sounded so kind of but the main i saw this in the amount of sugar isn't all that much. try getting used to the idea that small amounts of added sugar are just fine. on and off. young women are particularly at risk of developing a disproportionate fear of unhealthy food. but so are people who work in areas related to nutrition such as fitness trainers and dietitians doctors keep a close eye on the patients various rules are designed to help them develop a healthy relationship to food. they have half an hour to eat so they can get used to normal quantities normal meals and normal meal rhythms so that's why we have this half hour rule then they can leave the table. they get 6 meals a day all the food is fresh and flavorful even so for many of the young women here

tucking in takes a lot of determination it's hard for them to relinquish control over what they're eating. and what the goal is for them to eat more or less normally and what's also important simply to enjoy eating again and to be able to take pleasure in food and. sophia has set herself a personal goal. when mrs overall started spending an outpatient clinic and over again i'd like to get an apartment with roommates who are roughly my age and go back to the job training program i was doing before and i'd just like to return to normal life that's my goal. a normal life that doesn't involve worrying incessantly about food. that's it for today see you next week and i'm told then let's all try to stay in

good shape.

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