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Nutrition 2 (Semester II) > 16a. Fertility - Female Fertility > Flashcards

16a. Fertility - Female Fertility Flashcards

1
Q

What is the definition of infertility?

A

Lack of pregnancy after one year of unprotected sex

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2
Q

What are the factors involved in successful conception?

A

Release of healthy oocyte
Sperm with adequate motility
Adequate transport of sperm and egg to fallopian tubes for fertilisation
Penetration of sperm into oocyte
Implantation of embryo into uterus lining
Normal development of embryo into foetus

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3
Q

Structural abnormalities in females that can affect fertility

A

Cervical stenosis
Uterine septum
Polyps/fibroids
Fallopian tube obstruction
Ovarian cysts

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4
Q

What is cervical stenosis?

A

Narrow/closed cervix

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5
Q

What is uterine septum?

A

Poor environment for embryo to implant due to poor vascular supply of blood and nutrients

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6
Q

Why might the fallopian tubes be obstructed?

A

Pelvic inflammation
STDs
Endometriosis
Ectopic pregnancy

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7
Q

What hormonal issues can affect female fertility?

A

PCOS
Hyper/hypothyroidism
Amenorrhoea
Obesity/IR
Premature ovarian insufficiency

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8
Q

What issues in PCOS can affect fertility?

A

Elevated androgens
Anovulation
Irregular cycles
Reduced uterine lining development
Implantation issues

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9
Q

What issues in hyper/hypothyroidism can affect fertility?

A

Irregular cycles
Ovulatory disorders
Miscarriage
Pre-term birth
Pre-eclampsia

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10
Q

How can amenorrhoea occur?

A

Hypothalamic dysfunction
Pituitary tumours
Excess exercise
Undereating
Low BMI
High stress

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11
Q

How can obesity/IR affect female fertility?

A

Lack of ovulation
Increased androgen levels

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12
Q

What is premature ovarian failure?

A

Loss of ovarian function due to chemotherapy/radiation
Genetics
SLE

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13
Q

What is the hormone highest in the first half of the menstrual cycle?

A

Oestrogen

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14
Q

What is the function of oestrogen in the first half of the menstrual cycle?

A

Creates proliferative endothelium
Important for ovulation

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15
Q

What is the hormone highest in the second half of the menstrual cycle?

A

Progesterone

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16
Q

What is the function of progesterone in the second half of the menstrual cycle?

A

Maintains secondary endothelium
Implantation/survival of embryo

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17
Q

Where are oestrogen and progesterone produced?

A

Ovaries
Adrenals
Placenta

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18
Q

Where are oestrogen and progesterone stored?

A

Adipose tissue

19
Q

Conditions signified by oestrogen dominance

A

Fibroids/polyps
Endometriosis
PCOS

20
Q

Signs/symptoms of oestrogen dominance

A

Heavy bleeding/clotting
Tender/swollen breasts
PMS
Headaches
Shorter menstrual cycles (luteal phase)
Insomnia
Fatigue
Mood swings
Swelling/bloating

21
Q

Signs and symptoms of progesterone dominance

A

Breast tenderness
Water retention
Bloating
SOB
Lack of concentration
Long luteal phase
Decreased libido
Weight gain
Insomnia
Light periods

22
Q

Why is it difficult to evaluate oestrogen or progesterone dominance?

A

Symptoms overlap

23
Q

Ways to optimise O:P ratio

A

Reduce stress
Optimise liver function
Avoid endocrine disruptors
Avoid alcohol
Reduce body weight if obese
Optimise digestion/elimination

24
Q

Why is it important to optimise liver function when optimising O:P ratio?

A

To detoxify excess oestrogen

25
Why is it important to avoid alcohol when optimising O:P ratio?
Alcohol increases oestrogen levels by promoting the induction of aromatases Impairs hepatic oestrogen metabolism
26
Why is it important to reduce obesity when optimising O:P ratio?
Oestrogen is produced/stored in fat cells
27
Why is it important to optimise digestion/elimination when optimising O:P ratio?
To excrete excess oestrogen
28
Examples of medications that can affect female fertility
NSAIDs Corticosteroids Antihistamines Chemo
29
Why can NSAID use inhibit female fertility?
Inhibits ovulation Lowers progesterone levels
30
Why can corticosteroid use inhibit female fertility?
Suppresses immune function Affects gut microbiome Elevates BP Elevates blood glucose
31
Why can antihistamine use inhibit female fertility?
Dry mucous membranes
32
Why can chemo inhibit female fertility?
Damage/depletion of oocytes
33
What environmental factors can affect female fertility?
Excessive radiation Toxin exposure Chronic alcohol consumption Caffeine Xenoestrogens/endocrine disruptors
34
Sources of excessive radiation that can affect female fertility
Mobile phones X-rays Frequent flying Radiotherapy
35
Why can caffeine affect female fertility?
Increases cortisol production Slows COMT (leading to oestrogen dominance)
36
What immunological factors can affect fertility?
Tissue type compatibility Blood clotting defects High uterine NK cells AI Anti-sperm antibodies Antiphospholipid syndrome Thyroid antibodies Ovarian antibodies
37
Why can tissue type compatibility affect fertility?
If mum's immune system responds negatively to paternal HLA proteins, this can affect implantation/pregnancy outcome
38
Why can blood clotting defects affect fertility?
Increases risk of early/late term loss Increases risk of maternal embolism/stroke Placental blood flow restriction
39
Why can high uterine NK cells affect fertility?
Can trigger increase of TNF-a/cytokines
40
Why can AI affect fertility?
Immune system rejects the embryo
41
Why can anti-sperm antibodies affect fertility?
Sometimes a female's body will produce ASAs which destroy sperm
42
What is antiphospholipid syndrome?
AI disorder which causes increased risk of blood clotting Increases miscarriage/stillbirth risk
43
Why can thyroid antibodies affect fertility?
Leads to AI thyroiditis Increases miscarriage/pre-term labour risk
44
Why can ovarian antibodies affect fertility?
Affects egg/embryo development Reduces fertilisation/pregnancy rates Increases implantation failure

Nutrition 2 (Semester II) (55 decks)

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