Female Infertility and Lifestyle Choices
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.