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Could the answer to the male fertility crisis be lurking in your cat's litter tray?

Could the answer to the male fertility crisis be lurking in your cat's litter tray?

Telegraph18-06-2025
It may come as a surprise but there's about a one-in-three chance that a parasite for which there is no cure has invaded your body and is lying dormant inside you.
Your chances of having picked it up are higher if you have a cat, as the parasite only reproduces inside the feline intestinal tract and its eggs end up in the litter tray, or wherever else your pet does its business. From there, it spreads through the environment to other animals, including ones we eat, so those partial to a steak tartare ought to be careful too.
Yet there is no reason to panic. The vast majority of people infected with Toxoplasma gondii, the single-celled organism that causes toxoplasmosis, will never know they've had it. It can be dangerous to pregnant women and the people with compromised immune systems. But for the rest of us, any symptoms that do emerge tend to be mild and flu-like – unless you're a sperm.
A growing body of evidence suggests toxoplasma gondii may be contributing to a dramatic global decline in male fertility counts.
The discovery came by accident.
Dr Zahady Velásquez, a researcher from the Institute for Parasitology at the University of Giessen in western Germany, was investigating how toxoplasma takes control of cells when she peered into her microscope and saw what looked like the aftermath of an execution. Dozens of sperm lay dismembered in the petri dish. They had clearly been decapitated after coming into contact with toxoplasma.
'The first thing that I saw was a lot of heads and tails,' she said of the scene.
Dr Velásquez's initial reaction was that something had gone awry with the experiment. 'I thought: 'Oh my god, I did something wrong!',' she told The Telegraph.
When it happened again, she decided to consult with a colleague who persuaded her that something interesting was going on. Then the work began.
Sperm samples were exposed to the single-celled parasite for differing lengths of time, and the damage done was measured. After just five minutes in a test tube with the parasite, almost a quarter (22.4 per cent) of the sperm had been decapitated, and the number of beheadings rose the longer the sperm were exposed.
Some of the sperm that survived were left misshapen and scarred by the encounter, their tails curled up or bent at right angles. Others bore characteristic puncture wounds to their heads suggesting the toxoplasma had tried to invade them in the same way they do other cells.
The researchers also carried out experiments on mice and found that the toxoplasma were able to reach the testes and epididymis – the coiled tube at the back of the testicle where the sperm are stored – within two days of infection.
It is the Toxoplasma gondii's mostly benign relationship with its hosts and ability to infect almost every warm-blooded animal on Earth that explains why toxoplasma has been so successful.
However, the new research suggests that the parasite may just be acting slowly.
The findings, coupled with the high prevalence of the parasite in the global population, suggest toxoplasma could be having 'an underappreciated impact on male fertility,' the researchers conclude in their report, which was published in the Federation of European Biochemical Societies journal in April.
For years scientists have been grappling with an apparent crisis in male fertility, particularly after a 2017 meta-analysis (a statistical technique for combining the results of multiple studies) estimated that global sperm counts had fallen by 59 per cent since 1973.
To be clear, this is a separate issue from declining birth rates. While the belief that civilisation faces oblivion because people are no longer interested in having children is currently in vogue, in fact, a range of factors including the high cost of parenthood and housing, as well as fears for the future, are to blame for declining birth rates, a recent major UN study found.
The issue of sperm counts is similarly controversial. The reason behind the decline has so far eluded scientists. Numerous culprits have been put forward, from pollution, microplastics, food additives, obesity and even radiation emitted by mobile phones and microwaves.
The discovery by Dr Velásquez and her colleagues has helped to open up a new line of enquiry, building on a handful of previous studies that suggested a correlation between toxoplasma infection and male infertility.
A 2002 study in China, for instance, found that infertile couples were almost three times more likely to have a toxoplasma infection than fertile couples, while a 2005 study, also in China, found that sterile men were more likely to be infected.
'There's enough evidence out there from different independent labs across the world to pique my interest,' said Dr Bill Sullivan, a professor of pharmacology and microbiology at the Indiana University School of Medicine.
'I think we need to be vigilant and look at every possibility – because it's probably not just one thing,' he told The Telegraph. 'I think it's worthy of further investigation.'
Dr Velásquez agrees: 'I really love our results, but I believe that [toxoplasma] is not the only issue that is inducing infertility in men.
'You need to consider that the diet that we have now is deficient in a lot of different minerals and vitamins, also the stress that we live in every day [...] we are not sleeping enough. It's a really big package and I believe that Toxo is just one part of it.'
The discovery by Dr Velásquez and her team is the latest in a series of surprising findings about Toxoplasma. Studies have shown that infected mice lose their fear of cats, making them more likely to become prey, as the parasite causes inflammation in parts of the brain that process anxiety.
Dr Velásquez is currently applying for grants for further research into the effects toxoplasma have on sperm.
Of particular interest is the extent to which the parasite can interfere with sperm production while it is in its dormant stage. After spreading around the body, the organism forms cysts that can survive for long periods within the tissue of the host, including in the testes but also muscle tissue, the heart and the brain.
It's these cysts that are excreted by infected cats, and that then find their way into the bodies of other mammals, including grazing cattle, sheep and domestic cat owners.
The 'spy in your body'
In another sign of how widespread the parasite is, a recent study from the UK suggested that 80 per cent of all sheep in the country carried the infection.
While most people can easily overcome the initial infection and force the parasite into dormancy, removing these cysts entirely and ridding the body of the infection has so far proved impossible, largely because the parasite is so similar to the cells it infects, said Dr Velásquez.
'The Toxo, in this case, is like a spy in your body. It's exactly like your cells – they have almost exactly the same proteins inside, they do division as our cells do. So if I try to cut the life of the parasite, I'm probably going to affect your body a lot, and I could kill you.'
Blood tests can identify whether a person has a latent toxoplasma infection which, as it can be passed from mother to child, can pose a serious threat to pregnant women. The parasite, in its active phase, can cause miscarriages and birth defects.
People with compromised immune systems are also at risk. When the immune system goes down, the dormant parasite can reawaken and attack the body, leading to serious complications – a particularly sinister feature of the parasite that came to the fore during the height of the Aids epidemic.
'There's no cure to get rid of the tissue cysts that could be in your brain and your heart, and those are like time bombs ready to go off if your immune system should falter,' said Dr Sullivan.
For the time being our best course of action to mitigate against the spread of the infection is by fostering greater awareness.
'Educational measures have gone a long way to diminish seroprevalence in more developed countries that are aware of the problem,' said Dr Sullivan.
'In France, the seroprevalence in the past was upwards of 80 to 90 per cent – an outrageous number [which] was believed to be through the consumption of a lot of rare meat, steak tartare, for example,' he said.
But thanks to educational campaigns and improvements to food hygiene, rates of infection have come down to about 50 per cent. 'Still a huge number, but almost cut in half.'
And what about pet cats? Should we be more careful about sharing our homes with these carriers of the parasite?
'There's certainly an element of risk that people need to be aware of in taking care of cat waste properly. But you certainly don't need to throw the baby out with the bathwater, so to speak. You don't need to get rid of your cat.'
In its advice for avoiding toxoplasmosis, the NHS recommends wearing gloves when emptying your cat's litter tray and washing your hands afterwards.
You should also wear gloves while gardening, thoroughly cook meat 'especially lamb, pork and venison' and wash fruit and vegetables thoroughly.
Dr Velásquez would like to see more attention given to the potential effects of toxoplasma infection on male fertility.
We know that it can be dangerous for pregnant women, but no one is paying attention to how it could affect men, she said.
In some countries, including Austria, France and Uruguay, pregnant women undergo mandatory screening to detect Toxoplasma.
But most countries do not test for it in women and none test for it in men, meaning families around the world are having children without ever knowing whether they carry the parasite, potentially putting themselves and their offspring at risk.
'When I was pregnant in Chile, we didn't have any test for us to know – but probably I was infected,' she said. 'I'm a little bit scared now, because what happens if it's in my brain?'
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Eight simple, seasonal recipes by Abby Allen
Eight simple, seasonal recipes by Abby Allen

Daily Mail​

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  • Daily Mail​

Eight simple, seasonal recipes by Abby Allen

SPELT WITH CHARRED SUMMER VEG, HALLOUMI & KEFIR DRESSING I really enjoy the ritualistic aspect of following this recipe – there's something calming about the grains simmering and sending up steam. There is mindfulness required in ensuring each vegetable strip turns perfectly charred instead of, 'Whoops that's burnt', and in building a layered mountain of texture and flavour your gut microbes will thank you for. It's good for you in so many ways. 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Set aside. 3 Set a saucepan on the barbecue, fill with the measured water and bring to the boil. Add the spelt and cook for 30 minutes. Once cooked, add a big pinch of salt and pepper and set aside. 4 Put a frying pan on the barbecue and add the tomatoes and garlic, along with a drizzle of oil. Allow to sizzle away for 8 minutes, or until the tomatoes have almost collapsed and the garlic has caramelised. 5 Generously drizzle the remaining veg with olive oil and season with a good pinch of sea salt. Char over the coals for around 5 minutes, until tender and beautifully caramelised. Tip into a large mixing bowl, add the tomatoes and garlic, drizzle with more oil and set aside. 6 Slice the halloumi and put on the barbecue. Grill for 3 minutes on each side. Remove and set aside. 7 Add the spelt to the vegetable bowl along with the rest of the chopped herbs. Give everything a really good mix so all the flavours combine. Serve on a plate or platter, scattered with the grilled halloumi, generously drizzled with the kefir dressing. PICANHA WITH ROASTED CARROTS & HARISSA CARROT HUMMUS As the season slides merrily into its swan song, the garden is so abundant I am spoilt for choice. I settle on some beautiful carrots, pulling them from the soil and releasing the scent of warm earth. Everywhere I turn there are flowers filled with bees and butterflies. SERVES 4-6 For the roasted carrots 12-15 carrots, trimmed and scrubbed extra virgin olive oil, for drizzling 2 red onions, finely sliced 4-5 peeled garlic cloves, bashed 3 tsp fennel seeds, lightly crushed 2 tsp smoked paprika ½ tsp chilli flakes 2 tbsp pumpkin seeds 2 tbsp sunflower seeds 2 tbsp honey 2 sprigs rosemary flaky sea salt For the carrot hummus 6-8 roasted carrots (see above) 1 garlic clove 2 tsp harissa paste 250g canned or jarred chickpeas, drained 3 tbsp olive oil For the picanha 1kg beef picanha steak (available at Ocado and Sainsbury's) a drizzle of organic rapeseed oil flaky sea salt and freshly ground black pepper To serve 4-6 flatbreads 200g feta-style cheese (a British option is Fetish by White Lake Cheese) leaves of a few thyme sprigs a large handful of nasturtium leaves and flowers 1 Preheat the oven to 180C/ 160C fan/gas 4 and light the barbecue. 2 Put the carrots (halve larger ones lengthways) in a large roasting tray and drizzle with oil. Add the onions, garlic, fennel seeds, paprika and chilli flakes. Roast for 30 minutes, shaking regularly. Remove from the oven, add the pumpkin and sunflower seeds, honey, rosemary and a pinch of salt to the tray and roast for 10-15 minutes more, or until tender. Remove and set aside. 3 For the hummus, put 6-8 of the roasted carrots in a blender. Add the garlic, harissa paste, chickpeas, olive oil and a pinch of salt. Blitz, loosening the hummus, if you want, by adding more oil. Set aside. 4 Season the picanha steak with salt and pepper and drizzle with the rapeseed oil. Lay the steak on the barbecue grill and cook for 8-10 minutes each side. If using a meat thermometer, aim for an internal temperature of 50C. Leave to rest then slice thinly. 5 To serve, take each flatbread and slather on a spoonful of hummus, pile on the roasted carrots and onions, then add strips of beef on top. 6 Finish with the crumbled feta-style cheese, thyme sprigs and nasturtium leaves and flowers. ROASTED RED MULLET WITH CHERRY TOMATOES, AUBERGINES & THYME Red mullet are in abundance when the water is warmest, so we find them off the southwest coast in late summer and early autumn. They are easiest to catch at dawn or dusk, when the seas are still. You'll find them more commonly off sandy beaches. I adore red mullet. It perplexes me why it isn't more popular in the UK. It is beautiful with its glossy red sparkling jacket on and tastes like a cross between lobster and mackerel. SERVES 4 extra virgin olive oil, for drizzling 500g cherry tomatoes 1 aubergine, diced 1 red onion, finely sliced 3 bay leaves a few sprigs of thyme (reserve a few leaves for garnishing) 4 sustainably caught red mullet fillets a knob of butter balsamic vinegar, for drizzling flaky sea salt and freshly ground black pepper 1 Preheat the oven to 220C/ 200C fan/gas 7. 2 Drizzle a generous glug of olive oil into a roasting tray and shake it to coat the surface. Season with a good pinch of salt and pepper, then add the tomatoes, aubergine, onion, bay leaves and some of the thyme. Shake well so that the vegetables are coated in oil and well seasoned. 3 Season the fish and lay it over the vegetables, skin side up. Drizzle over a bit more oil and add the butter in small chunks around the pan. Place in the hot oven and roast for 20 minutes. 4 Remove from the oven, scatter over the reserved thyme leaves and drizzle with some balsamic vinegar plus a little more olive oil. Serve straight away with crusty bread. SCALLOP, CHORIZO & PADRÓN PEPPER ROSEMARY SKEWERS This recipe is simply fun – after all, cooking should be fun, drawing out your creative side. It's also delicious, pairing diver-caught scallops with spicy chorizo chunks and the Russian roulette of extras, padrón peppers. If you can't find them, use mild chillies or peppers. SERVES 4 6-8 thick stems of rosemary (reserve some leaves for flavouring) 200g cooking chorizo 12 sustainably caught British scallops 200g padrón peppers extra virgin olive oil, for drizzling flaky sea salt For the dressing 75g butter 2 garlic cloves, finely chopped ½ red chilli, seeds removed and finely chopped a handful of parsley, chopped 1 To make the skewers, select a few long, thick rosemary stems. Strip off almost all the leaves, setting some aside for later. Put the stems in a bowl of water to soak for 30 minutes to 1 hour. 2 Light the barbecue and let it get to a nice, steady heat. 3 Set a small saucepan over the barbecue grill and make the dressing by heating the butter, garlic, chilli and some of the rosemary leaves. When the garlic is caramelised and the oil released from the rosemary, move the pan to the coolest part of the barbecue, add the parsley and keep warm while you make the skewers. 4 Slice the chorizo into discs a similar size to the scallops. Thread the scallops, chorizo and peppers onto the skewers, then season with salt and drizzle with a little oil. Using tongs, lay the skewers on the barbecue with the leafy end away from too much flame. Cook the skewers for 2-3 minutes on each side. 5 Once they are charred, remove from the heat and pile onto a platter, dress with the warm garlic and herb butter and serve. CHICKEN LEGS WITH LEMON, POTATOES, THYME & ORGEGANO After reading Gerald Durrell's My Family And Other Animals, I grew enchanted by stories set on Greek islands. Through his tale of life on Corfu, I could feel the dry heat and smell wafts of wild oregano. I had to go. This recipe captures some of the magic of the Greek islands, wherever you are. 6 free-range chicken legs 1 bunch of lemon thyme 1 bunch of oregano 4-5 tbsp extra virgin olive oil, for drizzling 800g marfona or other waxy potatoes 1 bulb of garlic, halved 1 large unwaxed lemon, sliced small glass of white wine flaky sea salt 1 A day ahead, remove the chicken legs from the fridge and pat dry. Season with salt, scatter over some of the lemon thyme and oregano and drizzle with a good glug of olive oil, massaging the meat well. Put the dish back in the fridge and leave to marinate overnight. 2 Next day, bring a pan of salted water to the boil over a high heat. Add the potatoes and cook for 8 minutes, or until just tender. Drain and leave to cool for a minute or two, then cut into 3cm-thick slices. 3 Preheat the oven to 180C/160C fan/gas 4. 4 Drizzle a little oil into a large roasting tray, add the chicken legs, potatoes, garlic and lemon slices, season and scatter over a little more thyme and oregano. Roast for 1 hour in the hot oven, shaking the tray halfway through. Once the chicken skin is golden and the potatoes crisp, take out of the oven. 5 Put the chicken, potatoes, garlic and lemon slices on a platter. Set the roasting tray over a medium-high heat, tip in the wine and let it bubble away for 5-6 minutes, while scraping the delicious bits from the bottom with a wooden spoon to pour over the platter. Tip Serve with a sharply dressed fresh garden salad and a cold summer drink of your choice. ROASTED TOMATOES WITH ZA'ATAR LABNEH & OREGANO You might look at this recipe and think it would make a lovely side dish for a summer party. Sometimes looks can be deceiving; it's so good and so filling, it deserves to be the main event. For the carnivores among you, some perfectly charred lamb chops would make a perfect addition to this feast. SERVES 4 400g mixed cherry tomatoes on the vine 1 bulb of garlic, cloves separated and peeled 200ml extra virgin olive oil 200g labneh flaky sea salt a few sprigs of fresh oregano For the za'atar spice mix 1 tbsp cumin seeds 1 tbsp coriander seeds 1 tbsp sesame seeds 1 tbsp sumac 1 tbsp dried oregano ¼ tsp chilli flakes ½ tsp flaky sea salt 1 First, make the za'atar spice mix. Put a small cast-iron frying pan over a medium heat. Once warm, add the cumin, coriander and sesame seeds and toast for a few minutes until fragrant. Tip the seeds into a mortar and add the sumac, oregano, chilli flakes and salt. Grind with the pestle until you have a fine powder. This can be tipped into a sterilised jar and stored for 6 months. 2 Preheat the oven to 180C/160C fan/gas 4. Tip the tomatoes and garlic into a shallow cast-iron roasting tin, pour in enough olive oil to cover, then put in the oven for 35 minutes. 3 Alternatively, set the tin over the grill of a barbecue and leave to sizzle away for around 35-40 minutes. Either way, you are looking for the skins to have just started to blister and the tomatoes should be on the verge of collapse. 4 Once cooked, you can either use the tomatoes straight away, or transfer them to a sterilised jar. As long they're stored under oil, they'll keep in the fridge for at least a month. 5 Mix 1 tbsp of the za'atar into the labneh, stirring it in well. Generously spoon the pillowy mixture onto a plate or platter, then pile the blistered tomatoes over the top, ensuring you include some softened garlic cloves and plenty of the fragrant oil. Finish with a pinch of sea salt, another scattering of za'atar and a few sprigs of fresh oregano. Tip Serve with crusty bread or flatbreads to scoop up the tomatoes and labneh. MUTTON CHOPS WITH BEETROOT HUMMUS & DUKKAH There is a misconception that mutton has to be reserved for the slow cooker. A well-lived life combined with humane slaughter, dry ageing and meticulous butchery mean that this is some of the most delicious and ethical meat you can eat. Seek out the good stuff and don't be afraid; once you've rendered the fat, cook it fast and keep it rare. I love to serve mutton with freshly pulled beetroot from the garden. There's something so harmonious to be enjoyed from the pairing of tender earthy beets with grassy herbal mutton. SERVES 5 a drizzle of organic rapeseed oil 5 cull yaw mutton chops 2 large red onions 100g sheep's cheese For the beetroot hummus 570g jar chickpeas, including the liquid (I use Bold Bean Co Queen Chickpeas) 500g beetroot, peeled and chopped 4 garlic cloves, peeled and chopped 5-6 tbsp extra virgin olive oil 1 tsp tahini 2 tbsp lemon juice flaky sea salt and freshly ground black pepper For the dukkah 2 tbsp coriander seeds 1 tbsp cumin seeds 3 tbsp sesame seeds 75g hazelnuts 100g brazil nuts 1 tsp flaky sea salt a pinch of freshly ground black pepper a few sprigs of thyme, leaves picked 1 Preheat the oven to 200C/180C fan/gas mark 6. 2 To make the hummus, line a roasting tray with foil, leaving enough to fold over and seal the contents. Tip in the chickpeas along with their liquid, then add the chopped beetroot and garlic. Fold over the foil and seal by lightly scrunching the edges together. Bake for 1 hour. 3 Meanwhile, make the dukkah. In a dry frying pan, toast the coriander and cumin seeds until dark and fragrant, making sure you don't burn them, then transfer to a mortar. Toast the sesame seeds for a couple of minutes and tip them into the mortar. Crush to a coarse powder with a pestle. Finely chop the nuts and add to the mortar along with the salt, pepper and thyme leaves. Give it all a good bash to mix together, then set aside. 4 Check the beetroot are tender and remove from the oven. Once cooled, transfer the contents of the roasting tray to a food processor and blend to a smooth purée. Slowly add the olive oil to the blender along with the tahini and lemon juice, then check the seasoning, adding salt and pepper if required. Scrape into a serving bowl and set aside. 5 For the chops, place a cast-iron pan over a medium-high heat (or light your barbecue) and drizzle in the rapeseed oil. Season the chops and add to the pan, placing them on the fat side first, allowing the fat to render and caramelise. Cook for 2-3 minutes on each side, depending on the thickness of the chops, then remove from the heat and leave to rest for 5 minutes. 6 Slather the beetroot hummus over a platter, pile on the chops and roasted red onions, then scatter over the crumbled sheep's cheese and dukkah. GRILLED AUBERGINES WITH HONEY, GOAT'S CURD, HERBS AND SEEDS This recipe was inspired by a very special tapas bar we visited in Barcelona. The aubergines had been deep-fried and were crisped to perfection. They were doused in honey and sprinkled with herbs, one of the most joyous ways I have ever eaten them. We asked for thirds. SERVES 4 3 small/medium red onions 2-3 aubergines 4 tbsp extra virgin olive oil flaky sea salt For the dressing 200ml extra virgin olive oil 5 tbsp balsamic vinegar 2 garlic cloves, crushed to a paste To serve 2 tbsp roughly chopped walnuts 2 tbsp pumpkin seeds 2 tbsp sunflower seeds 1 small bunch of parsley, roughly chopped a few sprigs of thyme 4 tbsp fresh goat's curd 2-3 tbsp local runny honey a drizzle of extra virgin olive oil 1 Fire up your barbecue ready for two-zone grilling so that you can cook directly and indirectly – simply light charcoal on one side of your barbecue and leave the other side of the grill fire-free. This gives you heat flexibility and instantly puts you more in control of the fire. Make sure your fire has settled down to glowing embers; a nice steady heat, nothing too fierce. 2 Wrap the onions tightly in foil and throw them into the coals of the fire. Leave to roast in the embers for around 30-40 minutes. Using tongs, remove the onions, peel off the foil and leave to cool slightly. 3 Slice the aubergines into strips, then lightly prick the flesh with a fork. Cover with a generous amount of olive oil and a good pinch of sea salt. Using tongs, carefully lay the aubergines over the grill and cook for about 23 minutes, or until they have become tender and lightly charred. Once cooked, move to the back of the barbecue where they can keep warm. 4 In a clean jam jar, combine the olive oil, vinegar and crushed garlic. Twist on the lid and give the dressing a good shake. 5 The red onions should now be cool enough to handle. Remove the tough outer skin, then slice the flesh into quarters. 6 Arrange the onion quarters on a platter. Drape the aubergines over them and drizzle with the dressing, allowing the flesh to really soak it up. Serve sprinkled with the nuts, seeds and herbs, then dollop on the goat's curd. Finish with a generous drizzle of runny honey and some really good olive oil. Now buy the book Our recipes are from The Farm Kitchen by Abby Allen, with photographs by Matt Austin (which will be published on 28 August by Kyle Books, £30). To preorder a copy for £25.50 until 31 August, go to or call 020 3176 2937. Free UK delivery on orders over £25.

‘I would gamble my wages away as soon as I got them': How I lost £50,000 – and my marriage, family and home – to an online gambling addiction
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Daily Mail​

time28 minutes ago

  • Daily Mail​

‘I would gamble my wages away as soon as I got them': How I lost £50,000 – and my marriage, family and home – to an online gambling addiction

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Natural conception nearly 50% more likely after weight loss, study
Natural conception nearly 50% more likely after weight loss, study

BBC News

timean hour ago

  • BBC News

Natural conception nearly 50% more likely after weight loss, study

Obese women who participate in weight loss programmes before starting in vitro fertilisation (IVF) are 47% more likely to conceive naturally than those receiving minimal or no weight loss support, according to a recent University of Oxford-led research, funded by the National Institute for Health and Care Research, analysed 12 international trials involving 1,921 study also found the interventions increased the odds of any pregnancy - naturally or by IVF by 21%.But research lead, associate professor Nerys Astbury, said there was a need for "larger, high-quality trials to confirm the effect on live births". The researchers said the findings were particularly significant as NHS commissioning bodies across England restrict access to NHS-funded IVF for women with a Body Mass Index (BMI) over from a wide range of interventions were used, including diet programmes, exercise and weight loss average, women in the intervention groups lost 4kg (9lbs) more than those in the comparison the researchers stressed that while the review provided "the clearest picture yet of the benefits for conception", the effect on the ultimate goal – a healthy baby - "is still unclear".Prof Astbury said the evidence on live birth rates "was of very low certainty because many studies did not follow the pregnancies through to birth and report this outcome"."It was also interesting that when we restricted the analysis to low-energy diet replacement programmes, which lead to greater weight loss, there was an increase in live births, but this needs to be confirmed in larger trials," she said."Policymakers should consider whether integrating structured weight loss support into fertility services could improve outcomes for patients, while potentially reducing overall costs by increasing the number of women who conceive naturally."Dr Moscho Michalopoulou, lead author from Oxford's Nuffield Department of Primary Care Health Sciences, said the findings "suggest that offering structured weight loss support could improve the chance of conceiving naturally, which may avoid the need for IVF treatment"."Programmes that help women achieve greater weight losses have the potential to help more women achieve a successful outcome, and should be tested in larger high-quality trials." You can follow BBC Oxfordshire on Facebook, X (Twitter), or Instagram.

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