Lecture 23 – Fertility and Reproductive Health Flashcards
What is the current fertility rate in Canada?
average age woman at first birth: 29.2
average age of man at first birth: 32.8 (this is a 2013 stat)
total fertility rate: 1.54 this is below the cohort replacement level of 2.1
average age
Fertility trend
Early 1900s: decline: transition to greater urbanization - dependency on wages and rising cost of childbearing + Great Depression -> WWII
1946-1960: strong post-war economy - baby boom, high marriage
1960s: religion on daily life was in decline + contraception was more effective and available + women participation in higher education and in the labor force
decline ever since: divorce legislation
What are the main predictors of fertility in women?
Age is the most important factor - natural decline in reproductive abilities
fertility mainly depends on the number and quantity of her eggs
ages -> eggs degenerate
40yo+ fertility higher risk of health complications:
pre-eclampsia (high blood pressure, can impact kidney function, liver function, health of fetus)
gestational diabetes
genetic conditions (e.g. autism, Downs Syndrome)
What is fragile fertility in men?
Spern count and quality declining
Men facing reduced fertility 1 out of ?
20
sperm production takes up to ? days;
74 days in testicles
Causes of infertility (shared in both men and women)?
Environmental
occupational
medical factos
cause unknown/idiopathic factors
lifestyle factors: age, extremes of weight, physical activity/weight loss, stress, tobacco, diet, alcohol,caffeine, drugs, STI
Hormone balance
Cellular Inflammation
DNA regulation
cellular integrity/health
Factors impacting fertility
Health: comorbidities like obesity, insulin resistance, hypertension low-grade cellular inflammation and shifts in hormone balance infertility
Moderate obesity predominantly decreases total testosteronedue to insulin resistance
Exercise at polar ends of the spectrum (sedentary and excessive exercise) are associated with infertility
Tips for maximizing fertility
discontinue birth control
boost sperm function (reduce alcohol, cigarette)
maintaining a healthy lifestyle: take prenatal vitamins, exercise, don’t smoke, reduce caffeine, eat more fruits and veggies
Remove lubricants (because they slow sperm down)
Have sex 2-3 days before ovulation and during ovulation
Lie in bed after sex
Get a check up and ask for help
Epigenetics
is the study of how your behaviors and environment can cause changes that affect the way your genes work
Unlike genetic changes, epigenetic changes can be reversible and do not change your DNA sequence, but they can change how your body reads a DNA sequence.
Environment, emotions, traumatic events, behaviours, can change gene expression, turning genes “on” and “off.” These epigenetic changes can be inherited.
Perinatal
Perinatal isthe period of time when you become pregnant and up to a year after giving birth.
Perinatal mental health symptoms
negative thoughts
daily functioning affected
persistent high agitation
changes in appetite
sadness
sleep difficulty even exhausted
difficulty concentrating
anger
anxiety and panic
excessive guilt
difficulty bonding with baby
Depression triggers during perinatal
history of abuse or trauma
relationship problems
previous pregnancy loss
young pregnancy (under 20)
family history of depression
stressful life events
lack of support
infertility
pregnancy complications
? percent of women will experience perinatal mental illness.
14-23%
