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.
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.
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.
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.