Fertility Flashcards
Puberty trends
Starting earlier
Decreases about 3 months every decade
Critical fat hypothesis
To be able to reproduce/ hit puberty need to hit a critical fat amount
Not just about volume of fat it is also fat to lean mass ratio
Accepted value 24%
Metabolic signal hypothesis
Fat availability triggers hypothalamus resulting in a change of hormones
Availability and oxidation of fuel links to being ready to reproduce
Certain metabolites available and being sensed by brain and liver
Links to leptin
Undernutrition Females
Diminished energy stores post puberty leads to irregular menstruation or amenorrhoea
Happens as it prevents pregnancy where a foetus wouldnt survive and protects mother who needs to preserve own energy
Potential mother in BMI index of 14.9 kg/m2
Spontaneous abortion
Congenital abnormalities
Perinatal mortality
UUGR (intra-uterine growth retardation)
If eats enough to support baby ad mother then there is potential for mother to deliver healthy baby
Famine and Pregnancy
If a child is conceived before famine but born during famine reduce risk of defects
If conceived during famine and born after the higher chance of defects
Conceived up to 4 months after famine then most likely to have defects
Conceived after 4 months famine return almost as if normal
Famine and Pregnancy explained
Shows that there is a critical point of returning mother to health status in order to be able to have a healthy pregnancy
Around 4 months
Males and undernutrition
Loss of libido Loss of prostate fluid Decrease sperm motility Decrease sperm longevity Once 25% body weight gone sperm count is reduced
Weight gain reversers issue in the reverse order
Obesity and Male fertility link
Obesity
Reduced lipolysis, lipid mobilisation
Increased adipogenesis
Leads to Insulin resistance and metabolic syndrome
Reduces androgen secretions
Alters androgen status leads to subfertility
Obesity in males overall effect of sexual activity
Psychological handicap Gross obesity alters sex hormones Associated with erectile disfunction Increased oligospermia Interfere with the physical performance
Overweight and female fertility
Increased ovulatory disorder infertility - BMI over 30
Increased incidences of miscarriages
NTDs offspring seen more even if have adequate folate
How much has semen Quality declined
50-60% over 40 years
Mcrolevel how to increase sperm quality
Selenium Zinc Omega-3 Coenzyme Q10 Carnitine
What foods to eat to increase male fertility
Fruits Veg Nuts Whole cereal Fish Seafood Poultry Low fat dairy
Antioxidant and male fertillity
Sperm at risk of oxidative stress
Selenium increases glutathione peroxidase-1 and helps remove free radical
Zinc and male fertility
Zinc acts as a membrane stabiliser
Prevents oxidative components binding to membrane such as NAD+
Omega-3 and male fertility
Anti-inflammatory and anti-oxidant
Carnitine and male fertility
Transport long chain fatty acids into the mitochondria – increasing motility
Fruit and veg and male fertility
Increase anti-oxidants Increase folate (less chance of sperm aneuploidy)
Cereal and fibre
Reduce plasma estrogenic levels which mess with homeostasis
Seafood
Omega-3
Poultry
Lower risks of sperm motility
Low fat and skimmed milk effect on male fertility
Increases insulin
Increasing levels of insulin-like growth factors - increase sperm motility
Nuts
Increase sperm motility, morphology, vitality
Increase omega-3 in blood serum
Eating walnuts for 12 weeks show significant difference
Male fertility diet suggestions
Prudent
Mediterranean
Vitamin D and female fertility
Vitamin D receptors along reproductive system
If no vitamin D it reduces fertility
However, if have enough then increasing past required does not impact
Carbohydrates and female fertility
High load leads to more insulin.
Good if have PCOS but no impact in general population
Whole grains and female fertility
Anti-inflammatory
Increase chance of live-birth
Dietary fibre and female fertility
Reduce oestrogen levels
Does not impact fertility
Omega 3 and female fertility
Lowers risk of endometriosis
Increases fertility
Omega 6 and female fertility
If obese increases chance of fertility
Dairy and female fertility
high galactose content has a negative impact on ovarian physiology. However, no significant impact on fertility outcome
But if high fat then decreases fertility
Dairy however for IVF seemed to have ap positive effect on live-birth
Soy and female fertility
– theory that it effects fertility, however, soy doesn’t cause early menopause so probably actually not true
Breakfast cereals with high folate
Bran flakes - 400μg per 100g - 120 μg (30g)
Special K – 334μg per 100g – 100.2 μg (30g)
Cornflakes - 166μg per 100g – 46.48 μg (28g)
Folate and Bioavailability
Natural sources have to be converted polyglutamate to monoglutamate
Supplement is just mono so better bioavailability
Folate function
cofactor for enzymes required for DNA and RNA synthesis and required in transfer of methyl groups in methylation cycle
What reduces folate levels
Smoking
No vitamin supplement
Pregnancy
Oral contraception
Neural Tube
Flat neural plate in a tube
Becomes brain and spinal cord
Closes by 7th week of pregnancy
Folate involved in closing process
Spina Bifida
Incomplete spine formation
Anencephaly
Effects baby brain growth
Encephalocele
Incomplete closure of skull
Folate consumption for pregnant women
400μg of folic acid per day for at least three months prior to conception and continuing until the 12th week of pregnancy
Male overall recommendations for Fertility
Ideally, at least 2 - 3 months prior to intended time of conception
Consume balanced and varied diet
Moderate alcohol intake
Correct grossly abnormal weight to at least upper end of normal range 2-3 months before
Female overall recommendations
Balance diet
Correct grossly abnormal weight well in advance of conception (4 months)
Stop smoking
Moderate alcohol intake
Commence folate supplementation at least 3 months prior to conception
Psychological stress men’s fertility
Two stress in lifetime make significant impact
Psychological stress female fertility
Working more than 32hrs week impact fertility
Alcohol and Male fertility
Testicle atrophy and decrease libido
Alcohol and female fertility
Have issues if drinking is extreme
Air polution
Males - impact fertility
Female - More likely to have preterm delivery
