Fertility and Pregnancy Flashcards
Name the factors involved in successful conception.
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.
List structural abnormalities in females that can affect fertility.
Cervical stenosis
Uterine septum
Uterine polyps and fibroids
Fallopian tube obstruction
Ovarian cysts
Name hormonal issues in females affecting fertility and mention a syndrome associated with elevated androgens.
PCOS: associated with elevated androgens.
Other hormonal issues include hyper/hypothyroidism, amenorrhea, obesity/insulin resistance, and premature ovarian failure.
What are the symptoms and signs of oestrogen dominance in females?
fibroids, uterine polyps, endometriosis, heavy bleeding, fibrocystic breasts, PMS, headaches
How can the oestrogen/progesterone ratio be optimized naturally?
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
List medications, drugs, and environmental factors that can affect fertility in both males and females.
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.
Explain how stress can impact fertility in both males and females.
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.
Why does age contribute to lowered fertility in both males and females?
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 can poor methylation, specifically the MTHFR polymorphism, impact fertility?
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 does the diversity of the Seminal Microbiome compare to the vaginal microbiome?
The SMB is more diverse but has lower bacterial concentration
How does the Seminal Microbiome contribute to the process of conception?
prompting the cervix to release immune signaling molecules, supporting implantation during intercourse.
List three factors that can negatively impact the quality or diversity of the seminal microbiome.
Factors include antibiotic use, sexually transmitted infections (STIs), and poor penile hygiene practices.
What characterizes a healthy composition of the vaginal microbiome?
A dominance of lactobacilli species, creating an acidic environment that prevents pathogenic overgrowth.
A low oestrogen environment can impact the growth of the VM.
Identify three factors that can negatively affect the composition and health of the vaginal microbiome.
STIs, alcohol, smoking, poor vaginal or oral hygiene, increased blood glucose levels, copper IUD coil, a low vitamin A, D, C and E status
Name some key methylating nutrients for fertility? Name some Testing, food sources and other recommendations for each one.
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.
Orthodox fertility investigations?
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.
Name some functional testing for fertility investigations
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)
How does caffeine impact conception, and what are the associated risks?
Caffeine increases cortisol production, slows COMT (→oestrogen dominance), and is associated with early miscarriage and increased time to conception.
List three antioxidant-rich foods recommended for reducing oxidative stress and improving sperm quality
Foods high in Vitamin C, E, carotenoids.
Male fertility supplements and dosages? Name 3.
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
Female fertility supplements and dosages? Name 3.
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.
Herbs for fertility?
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.
How can clients enhance fertility when cervical mucus is scanty?
Increase fluid intake, use evening primrose oil (prior to ovulation), or use fertility-friendly lubricants.
Why is adequate intake of pure filtered water important during pregnancy?
It accommodates increases in blood volume, replenishes amniotic fluid, reduces the risk of pregnancy-related problems, and supports overall health.
