Jeb Kinnison on Life and Love

Welcome to my blog. In between promos for my books, I write on topics from the news and cover the research reports on relationship, diet and health issues, as well as whatever I think is interesting and likely to be new to my readers. I respond to all reasonable comments and invite you to add your email to the mailing list or add the RSS feed to your reader so you’ll see new posts.

I’ve started a new blog about my science fiction books and related topics, so please visit SubstrateWars.com for more.

Dissident artist Soba's work

Long Hiatus: Google Search Cut Views

I see I have not posted here in years. It turns out having three children born in three years takes up a lot of one’s time!

It was also becoming pointless to post because Google was steadily reducing organic traffic to the site. For years now, Google has increased its own revenue yearly by pushing only content that feeds their own near-monopoly ad networks. This is why Youtube results became so prominent, paid ad links and commercial ads took up most of the search results, and sites like mine (informative, well-written with high quality indexes and few/no ads) have been abandoned by creators. The latest straw is “AI generated” answers, often wrong, as Google tries to compete with OpenAI etc in a panic as Search users dwindle. The entire edifice of Google is starting to crumble as the effects of abusing their monopoly on web search and advertising gradually choked off good websites.

I tried starting a substack (which can be directly sent to subscribers via email) but by then the kids were taking all the time I might have used to write. I have no regrets about this (they are a joy *most* of the time), but it’s hard to see all of the work I put into this site wasted because no one can find it now.

You can follow me on Twitter/X as @jebkinnison, where I am able to write small pieces in the limited time when I’m eating or stuck waiting somewhere. When the kids are in school, perhaps I will write more about the IVF experience and child raising, which I only had second-hand knowledge of when I wrote the attachment books.

Thanks for supporting my work here! I hope to find a better platform for later contributions. I should probably have a Patreon-like site where subscribers can interact with my work and sign up for advance copies of books to come. I’ll announce it when I get to it. And again, thank you all so much for reading.

Avoidant: How to Love (or Leave) a Dismissive Partner

Mailbag: “Avoidant”

I get a lot of good feedback on my attachment books, even seven years after publication. This one was really touching.

I hope you’re well.

I read your book, Avoidant. I normally don’t do this… I mean, reach out to people, like this. I am on the tail end of a short-lived marriage with a dismissive avoidant. The whole ordeal was an explosion of emotional dysfunction. I, at one point, had completely lost it. I was doing frantic things I never do, because of the trauma. Your book helped me more than any of the therapy (there was a lot of therapy) I went through. The analytic in me sent me into heavy research mode. Of course, I had to learn what was wrong with this man (in hindsight, that idea seems a bit humorous). I learned about attachment styles and somehow found your book. OMG, you were so on point. I mean, like an Exacto knife. You helped me find out what was going on with him, as well as myself. THAT part was the most beneficial. I learned that I have preoccupied tendencies, but my partner choices can tip me more. Anyway, you probably don’t want to hear all of my small explanations. Long story short, I really want to impress upon you how much your book mentally helped me. I don’t remember when I’ve been so in tune with a piece of literature. I bought and just finished reading your book Bad Boyfriends. More solid advice. I gave it to my 25-year-old daughter. I want her to completely bypass any of the poor companion options altogether.

Again, I am so grateful I came across your books. Blessings to you and your husband.

— [name redacted]

IVF Journey: On SDF and Antioxidants, Sorting Chips
Zymot sperm sorting chip (photo credit: Zymot)

Zymot sperm sorting chip

I offer up my own experience here since it may help older/infertile men seeking to be fathers. It’s anecdotal, not statistical, but I did go from zero sperm to 4 to millions in a year. And my first try turned out badly with the eight eggs assigned to me — only two developed, and they were genetically abnormal, which meant more cost and delay to have our egg donor back again. By then more time had passed and presumably the Zymot sorting chip picked out better sperm for ICSI, so it was successful — four good embryos from 20 eggs, which is more than usual.

Disclaimer: this is not medical advice, just what happened to me, so if you are persuaded to follow a similar regimen, there is no guarantee it will work. If you are infertile in middle age and are seeing the clock run out, you would be wise to consult a fertility specialist.

My first try at IVF didn’t result in any viable embryos, presumably because there was SDF (Sperm DNA Fragmentation) — damage to the DNA of the sperm, thought to be the result of oxidative stress on the way from production to delivery and rustiness of the sperm production process in older males. The IVF doctor warned me that such cases can be permanent or take over a year to remedy with medical assistance.

Sperm DNA Fragmentation (SDF):

Men with sperm motility defects often have high levels of sperm DNA fragmentation. The degree of DNA fragmentation in sperm cells can predict outcomes for in vitro fertilization (IVF) and its expansion intracytoplasmic sperm injection (ICSI). The sperm chromatin dispersion test (SCD) and TUNEL assay are both effective in detecting sperm DNA damage. Using bright-field microscopy, the SCD test appears to be more sensitive than the TUNEL assay.

Its main units of measurement is the DNA Fragmentation Index (DFI). A DFI of 20% or more significantly reduces the success rates after ICSI. (more)

I never had an actual test for SDF, but the failure of 8 eggs to produce one viable embryo with my sperm strongly suggested SDF. One of the many causes of SDF is oxidative stress, so it can help (and do little harm) to up your intake of antioxidants.

March 27 2020

We had a great Zoom teleconference with Dr. [Redacted], who’s quite knowledgable (world expert and of course not cheap.) He commended me on my self-help recovery treatment. He also badmouthed compounding pharmacy rHCG and offered to prescribe the regular pharma variety (high-priced, no doubt.)

He’s plugging use of a “Darwinian selection” chip which selects the best by making them compete to swim down a microfluidic channel. This is the culmination of similar ideas in a Petri dish. I may be a good candidate for such since the last test showed 300K sperm, half motile. The more drastic collection from the testicles may not be necessary. The doctor consults for the chip company [Zymot], and he also suggested a line of antioxidant supplements he developed. I checked the ingredients of his branded supplement, and I had already been taking all of them with one exception, so it was less costly to just buy the missing ingredient and add that to my usual vitamins.

Dr. [Redacted] name-dropped [gay Silicon Valley billionaire], who he said “is in the same boat,” not wanting to have his sperm selected by a community-college-educated technician. I appreciate *justified* elitism… but people do come from around the world to our IVF doctor. It costs little extra to use the Zymot or similar sorting chips, so it would be wise for all older men to consider it.

I rarely meet anyone who knows more about much of anything than I do, so that was refreshing. And no one knows when the ASRM will relax the “no procedures unless ongoing” restriction. There’s more data on pregnancy effects (limited) and transfer of the virus to the baby (doesn’t seem to happen), so it’d be nice if they allowed the plans of millions to proceed. Which reminds me of the “no cataract surgery because it’s not critical” ruling. Postponing trans surgery (medically unnecessary, should be discouraged for minors) is no loss, but this is a taste of M4A: some high council will decide on political grounds whether your treatment is necessary or not.

As it turns out, implantation of the first boy was delayed over six months by the ASRM guidelines, which were in turn guidelines of the CMS (Centers for Medicare and Medicaid Services) which decided hospitals and clinics should postpone all non-emergency procedures to keep beds and staffing free for COVID-19 patients. This emptied hospitals and laid off staff, postponing important surgery (cancer biopsies, for one) and causing worse outcomes for millions of people. And how many tens or hundreds of thousands of IVF babies will now never be born?

Repeating the drug regimen from the previous post:

    Clomiphene, 50 mg / every other day – inhibits the feedback loop that suppresses natural testosterone. It’s a “selective estrogen receptor modulator (SERM)”

    Anastrazole, 1 mg /day – suppresses estrogen production via aromatase inhibition.

    hCG, .25 ml / every other day – chemically similar to luteinizing hormone, so shields testosterone and sperm production from negative feedback loops. Restored my levels of FSH (follicle-stimulating hormone) to normal in six months.

Antioxidant Supplements: One commercial supplement (FH Pro for Men) has this ingredient list:

Vitamin A (as beta-carotene) 1500 mcg, Vitamin C (as ascorbic acid) 120 mg, Vitamin D (as cholecalciferol) 30 mcg, Vitamin E (as d-alpha tocopheryl succinate and mixed tocopherols) 134 mg, Vitamin K1 (phytonadione) 40 mcg, Vitamin K2 (menaquinone-4) 40 mcg , Thiamin (as thiamine HCl) 3 mg, Riboflavin (as riboflavin 5 phosphate) 3.4 mg, Niacin (as niacinamide) 20 mg, Vitamin B6 (as pyridoxal 5 phosphate) 25 mg, Folate (from L-5-Methyltetrahydrofolate, calcium) 1360 mcg DFE, Vitamin B12 (as methylcobalamin) 1000 mcg, Biotin (as d-biotin) 600 mcg, Pantothenic acid (as d-calcium pantothenate) 20 mg, Iodine (as potassium iodide) 150 mcg, Zinc (as zinc citrate) 30 mg, Selenium (as selenomethionine) 140 mcg, Copper (as copper sulfate) 1 mg, Manganese (as manganese bisglycinate chelate) 2 mg, Chromium (as chromium picolinate) 120 mcg, Molybdenum (as molybdenum glycinate chelate) 75 mcg, L-carnitine L-tartrate 2000 mg, L-arginine HCl 350 mg, CoQ10 (as ubiquinone) 200 mg, N-acetyl cysteine 200 mg, Grape seed extract 20 mg, Lycopene 10 mg, Benfotiamine 1 mg, Vegetable capsule (hypromellose), Microcrystalline cellulose, Magnesium stearate, Silicon dioxide.

See this study for results with this commercial supplement. Some of these ingredients are questionable. Taking an array of antioxidants is normally not especially beneficial (results of studies are mixed — no effects or even deleterious effects), but in case of SDF, six months of these will probably help.

You can buy this high-priced premixed formula as capsules here (FH Pro for Men) or do it yourself at lower cost (but less convenience.) If you don’t mind taking lots of pills twice a day in hopes it will help with SDF, here’s what I took:

    Daily multivitamin for older people (“Spectrum Silver” equivalent)
    Vitamin C (500 mg)
    Vitamin D (2000 IU)
    Vitamin K2
    Niacinamide
    Methyl Folate
    Cal-Mag-Zinc
    Acetyl-L-Carnitine
    L-Arginine HCl
    coQ10 (ubiquinone)
    NAC (N-Acetyl-Cysteine)

Amazon links for these (note that if you buy through these Amazon affiliate links, a tiny percentage of your purchase costs comes back to me; it’s always appreciated.):

Typical multivitamin for older people

A “Spectrum Silver” equivalent

Kirkland 50+ Multivitamin

Vitamin-C-1000mg

Antioxidant Vitamin C

Vitamin C 1000mg

Vitamin-D-3-2000iu

Vitamin-D-3-2000iu

Vitamin D-3 2000IU

Vitamin-K-2-100mcg

Vitamin-K-2-100mcg

Vitamin K-2 100 mcg

Niacinamide-500mg

Niacinamide-500mg

Niacinamide 500mg

Methyl-Folate-1000mcg

Methyl-Folate-1000mcg

Methyl Folate 1000mcg

Calcium Magnesium Zinc

Calcium-Magnesium-Zinc

Calcium Magnesium Zinc tablets

Acetyl-L-Carnitine bulk powder

Acetyl-L-Carnitine bulk powder

Acetyl-L-Carnitine bulk powder. This is more cost-effective; add to a protein shake or other strongly-flavored liquid to cover the taste.

L-Arginine-Powder

L-Arginine Powder

L-Arginine Powder. This tastes so foul it spoils anything liquid. I found it best to dissolve it in warm water to drink quickly, then immediately rinse.

Coenzyme Q10 (Ubiquinol)-100mg

Coenzyme Q10 (Ubiquinol)-100mg

CoEnzyme Q10 (Ubiquinol)

N Acetyl Cysteine

N Acetyl Cysteine (NAC)

N Acetyl Cysteine (NAC)

The drugs in the list previously mentioned all require prescriptions. The HCG in particular is used not only by men restoring fertility, but by women doing an IVF cycle; a diet fad (which is now fading) had people injecting themselves with large bootleg quantities to lose weight.

Here’s what a packaged pharmacy bottle looks like — inside the box is a vial of lyophilized (dried and preserved particulate) HCG and a vial of sterile water. Since the FDA no longer allows compounding pharmacies to do this for you, you have to mix it yourself by using a syringe to move water from the water vial to the hCG vial. The result is a water-based, injectable HCG that begins to spoil immediately, so use it in 30-60 days at most.

Packaged HCG

Packaged HCG

The syringes for these subcutaneous (just beneath the skin) injections are readily available because they are used in the billions for self-administered insulin shots. The procedure is to find an area underlain by fat (often around the naval) and pinch the skin to insert the very fine and short needle before injecting. This is usually nearly painless. The syringes look like this:

B-D .3 ml syringe

B-D .3 ml syringe

IVF Journey: Genetic Screening of Parents and Embryos
Genetic testing of human samples

Genetic testing – (credit NIH)

[Continued from Remedies for Male Factor Infertility – Azoospermia]

The additional cost and unnatural nature of IVF has some benefits — both parents and embryos can be genetically tested in advance. If the parents have certain recessive genes, they can either use donor sperm or eggs to avoid offspring with significant defects, or roll the dice and check the resulting embryos for the issues they’d like to avoid. Most testing is motivated by a family history of genetic disease for one or both parents — it can be demonstrated that a certain inherited disease is not likely, or the opposite (in which case IVF

Our process involves both an egg donor and a separate gestational carrier (GC.) Both intended fathers and the egg donor were Counsyl tested; husband’s passed with no problems, while my genetic tests showed two fatal recessives and one “problematic” recessive (not fatal for years if ever, but weakening the adult.) Fortunately the egg donor’s test combined with ours showed no bad combinations.

The modern IVF process can freeze both sperm, eggs, and the embryos resulting from fertilization after 5-7 days; this reduces the difficulty of timing each element. Instead of rushing to inseminate fresh eggs with fresh sperm, the eggs and sperm can be frozen and thawed later for combination. The resulting embryos are typically cultured for 5-7 days and frozen as soon as they develop enough. In an echo of the quiet natural winnowing process, often only half or less of the eggs develop at all, and around a quarter look like good candidates for implantation.

The embryos are graded (letter grades!) A-D for development of the part of the cell mass that will be the child, and separately for the cells destined to form the placenta and accessories. This can be augmented by PGT-A (Preimplantation Genetic Testing for Aneuploidies) to determine which embryos are most likely to be viable. This is accomplished by taking out one or two cells from the less-critical part of the embryo and testing them. This is controversial because it is expensive, may possibly harm the embryo, and is not necessarily reliable because it’s not uncommon for cells in the embryo to have different genetic makeups (“mosaic.”) Nevertheless, choosing embryos that pass this test greatly improves the live birth rate for IVF. Desperate for offspring of their own, couples sometimes direct implantation of apparently unsound mosaic embryos, which can sometimes develop normally, but usually don’t.

Embryos that are missing entire chromosomes or major segments will either not make it to term or suffer serious defects that limit their lives. Since we are already intervening in the natural process and each attempt at pregnancy is very costly, using these tests to improve the odds is very much worth it.

While I was unable to produce viable spermatozoa, [husband’s] were fine and so we went forward with the egg donor and directed half the harvested eggs to be fertilized with his contribution.

Oct 18 2019

So they centrifuged my pathetic sample and found 4 live (if not terribly healthy) spermatozoa. Not really enough to work with!

Nov 21 2019

Egg donor at IVF doctor’ office in LA. Got an Amex charge notice, $16K, billed for the next few days until the extraction on the 23rd. 15 follicles ready, so harvest will likely be good (avg is around 10.) They will immediately fertilize half with Paul’s sample (frozen months ago) and freeze the rest of the eggs (waiting on my less-than-robust spermatozoa, which may have to be handled one-by-one.)

This first stage [husband’s] went well enough, though in hindsight we were both old enough to have benefitted from the Zymot sorting chip, which would have improved the health of the spermatozoa used for ICSI. Then we waited for reports from the culture lab to see how the little buggers did.

Nov 24 2019

Update: Got a report from the lab. Darwinian selection (which occurs silently in the normal process) underway. Of 9 oocytes, 2 rejected as immature. They thawed [husband’s] sample and selected sperm cells from a microscopic examination, then used ICSI to fertilize seven of the fresh eggs. Two of the remainder were discarded for not developing a healthy profile of pronuclei (PNs). Research has shown that the most healthy look is 2 normal-sized PNs, but other configurations (0, 1, 2.1 [one of the two is small]) have some chance of healthy development, so they are grown for more days in case they turn out fine (it turns out the male’s DNA can still be incorporated without the obvious signal of two PNs.) That leaves 5 growing. They weren’t specific about the 0N-1N-2N status of each. Kind of nerve-wracking.

Technology has improved a lot, but expect by a century from now that it will have progressed past “screening” to libraries of genetic material that can be recombined at will, and probably an artificial womb for gestation. Brave New Worldish. Costs will drop and it may eventually be seen as retrograde to have children the old-fashioned way. We’ve already seen lots of world-building where that cultural struggle is a theme.

BTW, any “super race” ideas (e..g., Star Trek’s Khan) will require a lot of arm-waving to explain how gene engineers can improve on the best/luckiest naturally born people. I don’t think (other than splicing out obviously damaging defects) anyone will be able to tailor the perfect combination of traits, and one thing we do know is that the natural diversity of talents contributes to the advantages of human teams….

Nov 28 2019

IVF update: the tech was rushed and so the report for Day 5 came in early. 3 embryos looked good enough for genetic testing (there was a differentiated clump of cells that will end up as the fetus and surrounding cells that end up as placenta, and it’s safe to remove one of those for the gene testing (shipped frozen to the lab.)) The 3 candidate embryos were then frozen. Testing comes back < 10 days. We haven’t heard from the surrogate wranglers about who might be available. I hope there’s more data to decide with. nov 30 2019 Day 7 report: the two zygotes not frozen didn’t develop and so were disposed of. 3 survivors were frozen Day 5, so that’s the choice for [husband's] kid. Kinda sad but as expected (the beyond-5-days embryos rarely develop enough). Was just reading about a PA bill that supposedly requires burial certificates for disposal of any fertilized egg. This is, of course, silly. Whether the bill actually says that is unclear, the usual amplification to get people outraged for clicks being in play. Dec 9 2019 Monday morning news: genetic tests done, 1 of the 3 embryos failed. Awww. I resent they don’t send us the report, but we can talk it over with the doctor if we schedule a Skype call. [later edit]: We got the genetic test results. Two euploid XYs (boys) and the aneuploid XY (female) who lacked the full complement of 16 chromosomes. Eek. The lottery odds favor us (only 16% chance neither XY will be carried to term) but still that worries me. [further note: I think they mean one Chromosome 16 is absent or incomplete, not 16 missing chromosomes.]

[Current state 2-1-2021: [husband’s] best embryo was implanted 7 months ago and is likely to be born to our surrogate in mid-April. We’re getting ready by buying all the equipment, clothes, diapers, etc.! We’ll get to mine later in the saga, which took much longer and had more issues with “Sperm DNA Fragmentation” (SDF) because I am older. Half of our first batch of eggs were fertilized with my sperm, and none survived culturing and screening.]