welcome to in good shape coming up. to exercise or not to exercise there is no question. and unhealthy fixation on healthy eating. and fertility treatment 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 risk the baby's own friends girls come out of the road and boys out of a cabbage but what is the stork the roses and the cabbage failed you can go to the fertility center here in berlin to talk that.

sort of 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. to get their children maybe one or 2. most of the couples who want to have babies are in the lucky side of life they just get pregnant but 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 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 in time estimate 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 fall 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 and is this rational on 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 babus least met so i nationalise of. 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. down in the books just as 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. 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 a t.v. center in the loop which is one of the hottest interest interests here in germany

thanks for having me today and what 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 going to college just or here to reproductive unit and if they visit you and i should. first have to find out the reason for being steroids recorded steroids and that it's a pending on either male factors or female factors and in female factors it mainly harbottle disturbances that there is an every 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 was promoted to be of the number of sperm as low 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's the reason it's hard when male and hard female best use you really need something of the power to be 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 whether the wife is should get pregnant moment one problem could be a shock your industrious countries couples decide to have children an older age for instance over the age of 50. here that has an influence so the normal ficken duty gets. own after the age of 30 in the wife. but definitely between 303530 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 x.'s the 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 looking at treatment options i mean i think that it depends on the costs of the infertility but what kind of options do you offer ok if there's an all male disturbance in the women the treatment is very easy. you have to get for some tablets or injections to produce eggs and then if she has an ovulation she then 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 other official insemination so it's a quite easy treatment let's take a closer look at artificial insemination in investments countries about 2 to 5 percent of the couple need some help. many couples hoping to have children face a battle against time such as 34 year old even villa and her husband. 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 your ologist the doctors advised us to go to a fertility clinic events can i want to gentle to get in our discussions and. it was quite overwhelming at 1st it would already be on our minds but when that's what you're told because it really. it becomes an issue sure but it didn't mean that we had this opportunity. to look for. we used 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 a view of what it was the fertilized egg ovum was examined once a day. you could say and she 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 this minute issue. knowledge is helping to improve the success rate of assisted reproduction treatments. among the latest and the most advanced methods now available is the so-called time lapse incubate. going to the lung when you open it shares a gap the built in camera travels

a lot if it is and if measures and assesses the cells well creating live time lapse footage it's a very small area that's intentional in order to create very stable cell culture conditions for the for the opium tubes where the egg cells would usually develop are close to no lead can enter and there are no temperature fluctuations this stunt . that allows a more natural and unhindered development in the extremely sensitive early faith as well as careful monitoring by the doctor says. it is easy for terrorists to mind the one big advantage is that the incubator can function without interruption without being open to the 2nd pleased we can see how the cell division inside is developing. we know of 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. you can see. within 5 days the fertilized

eggs are implanted into the mother's uterus evangelist treatment was successful now she's pregnant. discus the story on the baby's 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 as. the time lapse incubates a method significantly improves the chances of becoming pregnant. it was 40 years ago the 1st test tube baby was born her name is louise brown and there are different kinds of efficiency missions and so what kinds of how they to choose from so we look either on in vitro fertilization test tube baby or we combine it with the exit method when you inject one sperm into the egg so normally it takes in vitro fertilization that means you have the major eggs and then you put around the

eggs about 200000 sperm and you hope that one goes into the egg and fertilized the egg on the other hand the extra procedure then you take one sperm inject this one directly into the eggs and then you hope you have a fertilization as well so the 1st one the in vitro fertilization is more natural compared with the extreme methods it what about the result is the. better because you inject it directly into the you have a little a 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 all the other you have sold the baby take home or it is a little bit better in i we have procedure so it's always a good idea to stay with nature you have to give the woman home or as a preparation for the simulation why is that so normally you have only ovulation of

one egg during a menstrual 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 fertilisation all for the masses and isn't it dangerous to beef those homes are they decide if it's yes you have to look to. the side effects of the long term run into the short term run on the long term run we know that there is no high probability for getting cancer breast cancer in woman or utils cancer or ovarian cancer but in the short run you have problems that there is a possibility for and hyperstimulation that you have not only $12.00 to $15.00 eggs but maybe 30 and then the ovaries are enlarged and something that much smaller than

that the woman has to go into the hospital to me give me some update on the history of the in-vitro fertilisation souls of 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 and but that is not the most important for the women most important as a baby to cooperate 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 it to 2 or 3 attendants 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 baby lisa i mean there are some reports that suggest that there are higher rate of organ failure as a heart problems is true are things this is true because we have to be a very 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 the 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 fallopian tubes normally it takes place in the fallopian tube and that we have to be there may be there is some harm on the embryo and on the end we are never on the safe side it when we do artificial things so we have to counsel the patient and we can do it only if the pain. or agree or the procedure well we just focused on artificial insemination but let's take a look at natural for it's a decision so we got viewer questions from donald from us and he asks is 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 we are in the fallopian tubes you can do what you want just have sex for us no headstone necessary no ok. wants to know that abstinence improves 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 better spreads or get worse so not waiting for a long time just have sex it's really good news thanks for the very interesting talk so if you want to get pregnant you have to become active and if you want to have your questions answered get active to. be in good shape your weekly health show on d w that covers many aspects of health care we look at what's new in medical treatment nutrition fitness and. we just does these topics in depth with specialists and a few opportunities to post your questions so get in touch.

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 this 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. poz and as a sports psychologist at the university of putz tom he loves running and he advises people to find a form of exercise that suits them and you need to try things out perhaps there's a sport you used to enjoy what you like doing most 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. 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 however busy you are. going 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 exercise intend to set themselves over ambitious goals they have no chance of reaching.

advice that 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 rewarded not. 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

a 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 actually counterfeiter. canned food was a no no i would never eat canned tomatoes say because they have additives in and. which i did my whole as a means 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 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 conk 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 shrine 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. in one way i think 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 too and one key factor played a major role. is to madonna feeding believe that the media was to blame these days you'll always hearing about the dangers of sugar it's how the whole world is eating fancy 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 and is 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. skills. 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. and this is why they're vanilla sugar and that says that's a problem for me. the cookies and fruit mean there's already sugar in it sounded so kind of down but the main that said this is 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 offer. 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 and 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. 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. sophia has set herself a personal goal. when mrs over all started tending an

outpatient clinic and i would not 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 until then let's all try to stay in good shape.

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