Fertility and Pregnancy Flashcards

1
Q

Name the factors involved in successful conception.

A

Release of a healthy, non-damaged oocyte.

Production of sperm with adequate motility,

DNA integrity, count, and morphology.

Adequate transport of sperm and egg to the fallopian tubes.

Penetration of the sperm into the oocyte.

Implantation of the embryo into a healthy uterus lining.

Normal development of the embryo into a fetus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List structural abnormalities in females that can affect fertility.

A

Cervical stenosis
Uterine septum
Uterine polyps and fibroids
Fallopian tube obstruction
Ovarian cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name hormonal issues in females affecting fertility and mention a syndrome associated with elevated androgens.

A

PCOS: associated with elevated androgens.

Other hormonal issues include hyper/hypothyroidism, amenorrhea, obesity/insulin resistance, and premature ovarian failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms and signs of oestrogen dominance in females?

A

fibroids, uterine polyps, endometriosis, heavy bleeding, fibrocystic breasts, PMS, headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can the oestrogen/progesterone ratio be optimized naturally?

A

Reduce stress
Optimize liver function
Avoid endocrine disruptors
Avoid alcohol
Reduce body weight if obese
Optimize digestion and elimination
Consider herbs such as Vitex agnus castus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List medications, drugs, and environmental factors that can affect fertility in both males and females.

A

Medications: NSAIDs, chemotherapy, antipsychotics, corticosteroids, antihistamines.

Environmental factors: Excessive radiation, environmental toxins, chronic alcohol consumption, caffeine, xenoestrogens, pesticides.

Male-specific factors: Heat exposure, lubricants, excessive oxidation, infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain how stress can impact fertility in both males and females.

A

Stress can ↓ release of gonadotropin-releasing hormone (GnRH), → ↓sex hormones LH and FSH.

In females, stress can disrupt gonadal function, ↓ progesterone, and affect implantation. In males, stress can lower sperm parameters.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why does age contribute to lowered fertility in both males and females?

A

In females, oocyte quantity and quality diminish with age, leading to chromosomal abnormalities, poor embryonic development, and increased miscarriage risk. In males, sperm morphology and motility can decrease with age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can poor methylation, specifically the MTHFR polymorphism, impact fertility?

A

The MTHFR polymorphism, particularly C677T, → impaired folate metabolism, ↓ homocysteine, and poor egg maturity and quality in females.

In males, this polymorphism may be associated with DNA hypomethylation and changes in sperm maturation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the diversity of the Seminal Microbiome compare to the vaginal microbiome?

A

The SMB is more diverse but has lower bacterial concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does the Seminal Microbiome contribute to the process of conception?

A

prompting the cervix to release immune signaling molecules, supporting implantation during intercourse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List three factors that can negatively impact the quality or diversity of the seminal microbiome.

A

Factors include antibiotic use, sexually transmitted infections (STIs), and poor penile hygiene practices.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What characterizes a healthy composition of the vaginal microbiome?

A

A dominance of lactobacilli species, creating an acidic environment that prevents pathogenic overgrowth.

A low oestrogen environment can impact the growth of the VM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Identify three factors that can negatively affect the composition and health of the vaginal microbiome.

A

STIs, alcohol, smoking, poor vaginal or oral hygiene, increased blood glucose levels, copper IUD coil, a low vitamin A, D, C and E status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name some key methylating nutrients for fertility? Name some Testing, food sources and other recommendations for each one.

A

Folate:
Testing: Blood testing. Low folate and high homocysteine
is a functional indicator of an MTHFR polymorphism.
Food sources: Dark green leafy vegetables, asparagus,
avocado, Brussel sprouts, legumes and poultry.
Other recommendations: Methylated folate
supplement. Avoid folic acid fortified foods (e.g., cereals).

Vitamin B12:
Food sources: Chlorella, nutritional yeast,
nori, kombu, fish, organic eggs, meat and liver.
Other: A methylated B12 supplement /
a B complex. Supports HCl / pancreatic enzyme levels.

B6: Food sources: Whole grains, green vegetables, sunflower seeds, pistachios, liver, turkey and fish.

B2: essential coenzyme for FAD → a
cofactor for MTHFR enzyme.
Food sources: Mushrooms, spinach,
organic soybeans, beet greens, organic
tempeh, almonds, avocados, liver, venison, eggs.

Methionine: Food sources: Brazil nuts, sunflower seeds, beans,
whole grains. Beef, eggs, chicken, turkey, fish.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Orthodox fertility investigations?

A

Ultrasound scans: To rule out any structural abnormalities.

Serum FSH, oestrogen and
progesterone:

Thyroid function. Usually
check for TSH only. Best to have
a full thyroid panel (TSH, T3,T4,
thyroid antibodies, possibly rT3).

Glucose levels/ IR: can affect ovulation / cycle length.

AMH combined with: AMH a marker of ovarian reserve. ↑ AMH could be PCO. ↓ AMH / reserve is likely to respond poorly to IVF drugs. AFC is done via ultrasound scan to check numbers of follicles in both ovaries.
Sperm sample: sperm motility/ morphology, semen volume
Testing for infections such as STIs, UTIs etc.

17
Q

Name some functional testing for fertility investigations

A

Toxic metals profile
MTHFR/COMT variations
Homocysteine (methylation issues?)
Adrenal stress profile (-ve effects of cortisol)
RBC minerals: Tests intracellular levels of minerals (zinc, mg) instead of blood.
Oxidative markers (e.g. Genova Oxidative Stress test or DUTCH)
Immune investigations
Serum/urine analysis of amino acids (male)
Vaginal ecology
Comprehensive hormone panels: DUTCH
DNA Fragmentation (sperm)

18
Q

How does caffeine impact conception, and what are the associated risks?

A

Caffeine increases cortisol production, slows COMT (→oestrogen dominance), and is associated with early miscarriage and increased time to conception.

19
Q

List three antioxidant-rich foods recommended for reducing oxidative stress and improving sperm quality

A

Foods high in Vitamin C, E, carotenoids.

20
Q

Male fertility supplements and dosages? Name 3.

A

Selenium (100 mcg):sperm motility (↓ ROS)

Zinc (15-45): Anti-Ox. Spermatogenesis

CoQ10 (200): Antiox. ETC. Sperm concentration/motility

Fish oil: Cell membrane fluidity

L-Carnitine (1000): Sperm metabolism/ maturation, motility. Antiox.

N-Aceytl-cysteine (600): glutathione prod. antiox

Folate, B12, B2, B6 (Complex): Methylation supp

21
Q

Female fertility supplements and dosages? Name 3.

A

Vit A (1tsp): Antiox, cell division. Embryo devlpt.

CoQ10 (200): oocyte dvlpt, IVF supp

Myo-inositol (2000): ovarian function, oocyte quality, regular cycles.

Arginine (1000-2000 x2): No precursos. Fertility, hormone secretion, cell division and embryo dvlpt.

L-carnitine (500-1000): endometrial thickness, oocyte ATP, frozen trfr

Alpha Lipoic Acid (600): Antiox, helation HM, IS.

Vit C & E (500/200): oocyte quality, protect against ovarian decline. Avoid vit E if taking aspirin.

Folate (400mcg): RND/DNA synthesis. Neural tube dvlpt, methyl folate if MTHFR.

B3 (100): protective from miscarrige and birth defects.

22
Q

Herbs for fertility?

A

Vitex Agnus Castus - irregular periods, regulate prolactin levels, for progesterone def. 15-20 drops AM (3-6 months) or 1tsp dried berry

Ashwagandha: Male - ↑ DHEA, LH, testosterone. Semen/sperm quality. Anixiety, anti inflam. Energy, stamina, libido.Not in pregnancy. t tsp powder

Shatavari root: Female fertility tonic. Hormonal balance. Low sperm count. 1-2tsp powder.

23
Q

How can clients enhance fertility when cervical mucus is scanty?

A

Increase fluid intake, use evening primrose oil (prior to ovulation), or use fertility-friendly lubricants.

24
Q

Why is adequate intake of pure filtered water important during pregnancy?

A

It accommodates increases in blood volume, replenishes amniotic fluid, reduces the risk of pregnancy-related problems, and supports overall health.

25
Q

How does smoking impact pregnancy, and what are associated risks?

A

moking significantly increases the chance of premature delivery, low birth weight, childhood obesity, cleft lip/palate, childhood cancer, and sudden infant death syndrome (SIDS).

26
Q

Pregnancy nutrients?

A

Protein: (foetal placental, maternal growth tissue) Extra 6-10g/day.

Ca (1000): ossification of foetal skelelton, teeth, neural development, maternal nones protection.

Mg (360-400)@ pregnancy/lactation, ↓ preeclamsia, pre-term labour etc. Almonds, pumpkin seeds, spinach, cashews, legumes, eggs.

Iron: erythrocyte prod. O2 transport. Spinach, quinoa, legumes, pumpkin seeds

Vit A: foetal growth devlpt. respitory, beta carotene. Neural plasticity. BCO1 gene.
Carrots, GLV, spinach, sweet potatoes.

Vit D: C homeostasis, cell diff, immune function, preeclampsia risk. 2000IU

EPA/DHA: healthy birth weight, length, BMI, vidual performance, ↓ allergy. Neurodevelopment.

27
Q

How is the newborn’s gut initially colonized, and what factors influence the baby’s microbiome?

A

Colonized by microbes from the mother during passage through the birth canal. Birth method (vaginal vs. caesarean) and perinatal care (e.g., breastfeeding) influence the baby’s microbiome.

28
Q

What gut flora changes are associated with excessive pre-pregnancy weight or weight gain during pregnancy?

A

Increased Bacteroides, increased E. coli, decreased Bifidobacterium, predisposing the child to obesity.

29
Q

How can supplementation of Lactobacillus rhamnosus GG benefit infants in relation to weight gain and eczema development?

A

Supplementation 4 weeks before labor to 6 months postpartum can moderate weight gain and reduce eczema development.

30
Q

What protective effect do Lactobacillus rhamnosus GG and Bifidobacterium lactis have against allergy development in infants?

A

protective effect against allergy development, especially in families with a history of allergies or infants delivered by caesarean.

31
Q

List other methods to encourage optimal gut flora in infants.

A

Natural childbirth, breastfeeding, avoiding antibiotic use, having pets at home, avoiding a hyperclean environment, and encouraging outdoor activities.

32
Q

What is pre-eclampsia, and what are its risk factors and symptoms?

A

Pregnancy-induced hypertension with protein in urine and edema. Risk factors include advanced maternal age, first pregnancy, twin pregnancy, family history, hypertension, and BMI >35. Symptoms include water retention, severe headaches, vision problems, and pain below the ribs.

33
Q

How can nutrition and supplementation support women at risk of pre-eclampsia?

A

Focus on foods rich in calcium, magnesium, zinc, vitamin D, and omega-3s. Supplementation suggestions include 2g calcium in T2/T3, 200mg CoQ10 from week 20 onwards, and 500-750mg magnesium.

34
Q

Define gestational diabetes mellitus (GDM) and list associated risks and risk factors.

A

when pregnancy hormones make the body insulin resistant. Risks include an increased chance of mother and infant developing diabetes mellitus, larger birth weight, caesarean birth, and neonatal hypoglycemia. Risk factors include a family history of diabetes and obesity.

35
Q

Why do pregnant women often experience constipation, and what measures can help alleviate it?

A

Enlarging uterus and increased progesterone contribute to constipation. Measures include increasing fluids and fiber, ground flaxseeds, probiotic-rich foods, magnesium citrate, and avoiding aloe vera.

36
Q

What investigations should be considered postpartum, and why are they important?

A

thyroid function testing, anaemia screening, ‘Mum MOT’ pelvic floor examination, diastasis recti, and screening for bladder, bowel, or sexual dysfunction.