Dr Kshitiz Murdia
Your lifestyle today defines your family tomorrow, if you are lucky to have any that is! The link between lifestyle diseases and infertility is progressively gaining validation, thanks to the everyday examples that walk in at clinics seeking pregnancy advice. And from what the stats suggest, the three most commonly found lifestyle diseases among young women that lead to infertility are Adenomyosis , Endometriosis and PCOD (Polycystic ovary diseases).
Adenomyosis is a disease characterized by migration of inner lining of uterus (Endometrium) into the wrong place (muscle of uterus) that decreases endometrial receptivity, elevates the chances of miscarriage and perturbs uterine contractions. Similarly,in Endometriosis the tissue that normally lines the inside of your uterus grows outside your uterus (endometrial implant) leading to severe pain in some cases. A polycystic ovary disease leads to enlargement of ovaries and mostly occurs in females of reproductive age.
Fortunately, there are some warning signs for these diseases that if paid heed to, can ring the right bells in your head so you can pay a timely visit to your doctor. The symptoms of these diseases are almost the same owing to their connection with menstrual cycle, whether infrequent/ prolonged or excessive bleeding and pain during menstruation and ovulation. The disease signs also entail abdominal cramps and blood clots. In case of PCOD excess hair growth, acne, and obesity too can be witnessed and its early diagnosis and treatment may as well reduce the risk of long-term complications, such as type 2 diabetes and heart disease.
These conditions are typically found in women between the ages of 35 and 50 but there is a good enough chance of a young girl falling victim to it. Hence missing periods every now and then during your early twenties suggests that you see a medical practitioner immediately to avoid future trouble.
There is strong evidence that factors like age, weight and smoking have an impact on the general health and adverse on the reproductive performance of an individual.
Oxidative stress increases and the level of antioxidants in semen decreases with age. Sperm DNA fragmentation also increases as men get older. Men having reduced semen quality have a significantly lower intake of dietary antioxidants. Antioxidants improve sperm motility and oxidative stress has been shown to increase in the semen of men whose sperm don’t move well and have augmented fragmentation of their DNA. Smoking by the female furthermore decreases the chance of success by 50% and increases miscarriage.
And the list doesn’t end here! While there is still space for more research into the matter, experts have started quoting psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants as some other reasons leading to lifestyle disorders and ultimately to infertility.
The same research however also opens ways to treatment methods that can be opted by women suffering from these lifestyle diseases. New imaging techniques like 3D ultrasonography and MRI have made non-invasive early diagnosis of Adenomyosis possible.
Once diagnosed, the disease can be cured with a variety of drugs and medical and combined medico-surgical treatments that have been employed over the last 20 years. The first agents utilized for this purpose were gonadotrophin-releasing hormone agonists (GnRHa) and have a high success rate so far. Several such reports have published that speak to successful treatment of adenomyosis-associated infertility with GnRHa, given alone or in combination with surgery.
In addition Adenomyosis is present even in younger women and can be associated with pelvic endometriosis and infertility, which warrants IVF treatment as soon as it is detected. Meanwhile it is advised that the female partner curbs the intake of caffeine before and during an IVF cycle.
Neither partner should drink alcohol during an IVF cycle; studies have shown a decreased pregnancy and possibly an increased rate of miscarriage. Finally, any discussion of life choices and fertility would be incomplete without discussing the effects of anxiety, stress, and depression. Various studies have shown a reduced success rate in achieving pregnancy in women experiencing these symptoms.
The choices we make in our everyday life certainly determine our future prospects. Potential parents must bear these things in mind to be able to have a family in the coming years.
* Its cliché but it’s true, excess of everything is harmful! Excessive intake of caffeine is very harmful in the longer run and it is a well known fact that women who consume a lot of caffeine, equivalent to five cups of coffee per day, take longer to get pregnant.
* Both alcohol and smoking reduce conception rate and increase risk of miscarriage. Also the chemicals in cigarette smokes is said to reduce a man’s ability to conceive. Also marijuana and cocaine may reduce sperm count and motion, and increase the percentage of defective sperm
* Studies suggest that prolonged exposure to heat in hot tubs, saunas or steam rooms produces high scrotal temperatures. This affects the number and function of a man’s sperm.
* Obesity (BMI over 30) decreases a woman’s fertility, increases the chance of miscarriage, and most importantly, increases the chance of premature birth with all of its attendant risks for the offspring. Weight loss of 5% to 10% can dramatically improve ovulation and pregnancy rates.
* A “prudent” diet improves fertility for partners, i.e less red meat and saturated fat, more seafood, and more fruits and vegetables, often referred to as the “Mediterranean diet”. Trans fats should be avoided entirely, for example, doughnuts, Danish pastries, french fries and fried foods in general. Studies point to antioxidants, monounsaturated oils, and omega-3’s as factors involved in these benefits.
* Moderate exercise increases both male and female fertility (e.g. a brisk walk) for 30 minutes most days of the week is the current recommendation for all adults and this level is fine for fertility.
* Stress can interfere with pregnancy, the link however is not straightforward, which is why this very important factor is mentioned last in the article. While stress, depression or anxiety does not directly affect your fertility, they bring in some hormonal disturbances that can affect your menstrual cycle and also lead to production of fewer eggs.
(The author is working at Indira Infertility Clinic Test Tube Baby Centre, Udaipur)
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