Fertility & Pregnancy Flashcards
What is the definition of infertility?
No successful pregnancy after 1 year of unprotected intercourse
(Try not to use the word in nutritional consults with clients - difficulty conceiving/fertility issues may be better)
4/10 fertility issues attributed to male partner
What factors are involved in successful conception?
Regular healthy cycle producing healthy oocyte
Healthy, mobile sperm
Transport of sperm and egg to fallopian tubes for fertilisation
Penetration of sperm into egg
Transport of embryo into healthy uterus lining
Development of embryo into foetus
What are some female structural abnormalities which may impact female fertility?
Cervical stenosis (narrow/closed cervix)
Uterine septum (poor blood supply = not enough nutrients for embryo to implant)
Uterine polyps & fibroids (growths in endometrium)
Fallopians tube obstruction (from inflammation, STD’s, endometriosis, abdominal/pelvic surgery, ectopic pregnancy)
Ovarian cysts (can rupture and cause infection & scar fallopian tubes)
What hormonal issues may impact female fertility?
PCOS
Hyper or Hypo androgenism
Amenorrhoea
Obesity/insulin resistance
Premature ovarian failure
What hormonal issues may impact female fertility?
PCOS
Hyper or Hypo androgenism
Amenorrhoea
Obesity/insulin resistance
Premature ovarian failure
What methods can be used to optimise oestrogen/progesterone ratio?
Reducing stress
Optimise liver function
Avoid endocrine disruptors
Avoid alcohol
Reduce body weight (if obese)
Optimise digestion & elimination
Herbs - vitex agnus castus
What medication can impact female fertility?
NSAIDs
Chemotherapy
Antipsychotic medications
Corticosteroids
Antihistamines
Toxins - tobacco, recreational drugs (cannabis consumption correlates with poor quality oocytes)
What environmental factors may influence female fertility?
Excessive radiation
Environmental toxin exposure
Chronic alcohol consumption
Caffeine
Xenoestrogens, pesticides & endocrine disrupters
What role does the immune system play in fertility?
Immunological events that need to occur to prevent foetal rejection:
Tissue type compatibility - acceptance of non-self coding of HLA proteins
Blood clotting defects
High uterine NK cells
Autoimmunity - immune system rejects the embryo
Anti-Sperm Antibodies (ASA’s)
Antiphospholipid syndrome
Thyroid antibodies
Ovarian antibodies
What structural factors affect male fertility?
Congenital defect of testes or ejaculatory tract
Undescended testes
Testicular cancer
Surgery or injury
Ischaemic damage (restriction of blood supply)
Infections
What hormonal factors influence male fertility?
Hypogonadism - ⬇️ function of gonads
Obesity
Cushing syndrome - ⬆️ cortisol = ⬇️ sperm count
What are medications that may impact male fertility?
Sulfasalazine - used in RA, UC & Crohn’s
Anabolic steroids
Chemotherapy
Medical drugs, alcohol, cigarettes, caffeine and marajuana
What environmental factors affect male fertility?
Pesticides
Endocrine disruptors
Mobile phones
Heavy metals
Heat exposure
Excessive oxidation from poor diet, smoking, obesity, alcohol
