|
There is a growing concern about fertility in the whole industrialized
world today. Almost 14% of couples have infertility problems.
There is a fear that infertility is on the increase and about
40-50% of these problems are associated with the woman. It
is amazing to note, however, that there are many things that
can affect reproductive health, that we as humans have control
over. Lifestyle choices like smoking, alcohol consumption,
caffeine healthy/unhealthy eating habits, weight, sexual practices
and so forth all have impact on fertility and it is within
our ability to control all these.
Most women are unaware as to how important these choices
can be with regard to future attempts to conceive. It will
be in order to examine these lifestyle choices and how much
they affect our reproductive health.
*Weight Problems
Over/Under weight On both sides of the scale, body weight
plays a vital role in fertility. Obesity has been associated
with infertility and menstrual irregularities. Women who are
overweight but without Polycystic Ovarian Syndrome (PCOS)
suffer the same problems with ovulation and menstrual anomalies
as women with PCOS and in most cases, this is found to be
inexplicable medically. But it has been shown that group treatment
programs that help obese women with diets and exercise plans
have caused a return of fertility in many patients. In overweight
women with ovulation and menstrual irregularity, a weight
loss of 6.5kg (15lbs) has been shown to restore normal ovulation.
Therefore, it is believed that the improvement in insulin
resistance achieved with the weight loss has more to do with
restoring ovulation than the actual amount of weight loss
itself. Several studies have shown that a Body Mass Index
(BMI) of 23-30 is considered overweight and a BMI above 30
is said to be obese.
Just as overweight is bad for fertility, extreme underweight
has also been shown to cause ovulatory dysfunction and thus
infertility. In a woman with anideal body weight (BMI of 20-25)
a moderate weight loss of 10-15% can cause menstrual irregularity
and a weight gain in such underweight women has also been
shown to restore ovulation and pregnancy in most cases. A
BMI of 17.5-20 is considered underweight and below 17.5 is
severely underweight.
*Smoking
Over the years, several reports have consistently reiterated
that smoking decreases fertility.
Smokers suffer a risk of menopause1.5-3 years earlier than
normal, decreased oestrogen with breakthrough bleeding and
a shortened luteal phase of the menstrual cycle. All these
suggest that smoking exerts some toxic effects on the follicles
directly. Also, nicotine, a component of cigarette smoke has
been shown to concentrate in cervical mucous and the metabolites
have also been found in the follicular fluid. This is believed
to be responsible for delayed follicular growth and maturation
in smokers. Smoking is also associated with an increased incidence
of ectopic pregnancy and an increased spontaneous abortion
rate which also suggests it affects the uterine tubes and
tubal motility.
*Delayed Childbearing
Civilization also comes with its consequences. It is common
to see women in industrialized nations delaying childbearing
to pursue educational and career opportunities till later
years.
What most women in this regard do not realize is that aging
brings with it many effects that affect almost every part
of the body and the reproductive system is not left out. Some
of the effects of age on fertility include:
- Depletion, over time, of the ovarian follicles affecting
menstrual and ovulatory regularity - endometriosis has more
time to produce scarring of the ovaries and tubes, reducing
free movement of these organs. It can even take the place
of the ovarian follicular tissues, if ovarian endometriosis
persists and grows.
- Fibroids can slowly grow causing endometrial bleeding
that can disrupt implantation sites or even distort the endometrial
cavity which affects the ability to carry pregnancy in the
early stages.
- Abdominal adhesions from other intra abdominal surgery
or ruptured ovarian cysts can also affect tubal motility,
required to sweep the ovaries and gather an ovulated egg.
*Alcohol and infertility
The total effects of alcohol consumption on fertility may
not be clear, but what is known for certain is that alcohol
abuse does constitute a risk of infertility. In a survey,
women with high alcohol use reported more menstrual and gynaecological
surgery. Alcohol has also been shown to alter oestrogen and
progesterone levels and also cause anovulation (menstruation
without ovulation). But what is not clear, however, is how
much alcohol consumption is bad for fertility, or alternatively,
how much is safe. It is established that during pregnancy,
an average of 2drinks per day or more can produce foetal alcohol
syndrome birth defects. Another study showed that a consumption
of more than 100gram of alcohol a week (1drink per day) is
associated with 60% increase in ovulation difficulties.
Also, increased caffeine consumption has been shown to affect
the ability to become pregnant and carry the pregnancy. This
is because caffeine clearance from the body is decreased during
the luteal phase. Animal and human research data also show
an increased risk of spontaneous abortions with increased
caffeine use and a decreased foetal growth during pregnancy
with increased caffeine intake. Consumption of three or less
servings of coffee per day may be harmless, but more than
this amount i.e. greater than 300mg per day may lead to fertility
problems.
Women with Pelvic Inflammatory Disease (PID) stand a greater
risk of infertility and untreated STDs especially gonorrhoea
and chlamydia, are the major cause of PID.
The choices we make everyday have a positive or negative
impact on our ability to conceive.
Decide to make the right decisions today and enjoy a better
reproductive health.
About the Author
Michael Russell
Your Independent guide to Infertility
|