Microbiome and General Fertility

Question 1

Periodontal disease and fertility

Answer 1

MOTHER: Periodontal disease can lengthen the time to conceive by approx. 2 months:
* It can prevent ovulation - increases inflammatory markers (IL 1). IL 1 inhibits GnRH production.
* Metabolic waste products from oral bacteria and inflammatory markers can cross the placenta and affect the foetus .
FATHER: Causal links exist between oral infections and infertility. Treatment of oral infections = 20% improvement in spermatic parameters.

Question 2

The Seminal Microbiome (SMB)

Answer 2

• Semen has its own microbiome that is thought to come from the GIT, mouth, vagina (sexual partner and mother!).
• Aids conception, supports offspring health and modulate immune responses.
• More diverse with lower concentrations than vagina. Helps expose and train the VMB and immune system to aid pregnancy and conception.
• Lactobacillus dominant
• Low quality semen is associated with STIs

Question 3

The Vaginal microbiome (VMB)

Answer 3

• Lactobacilli species dominant, with a low diversity of other species. Lactobacilli create an acidic, inhospitable environment which prevents the overgrowth of potential pathogens.
• The presence of bacterial vaginosis when coupled with low lactobacilli (higher pH), can increase the chance of miscarriage.
• The vaginal microbiota can be negatively impacted by
  STIs , alcohol, smoking, poor vaginal or oral hygiene, increased blood glucose levels, copper IUD coil, a low vitamin A, D, C and E status etc.
• A low oestrogen environment can impact the growth of the VMB.

Question 4

Fertility: Exercise and Stress

Answer 4

Moderate exercise improves circulation and insulin resistance which increases the likelihood of conception:
* Intensive exercise is bad for fertility, as it raises cortisol production = ↓progresterone
* Excessive endorphins interfere with FSH and LH , -> ovulatory disorders and luteal phase dysfunction-> lack of embryo implantation and first trimester miscarriages.
* In males, excessive exercise has been associated with oligospermia (oligo = ‘few’).

Question 5

Fertility: Age

Answer 5

Age is a contributing factor to lowered fertility.
* Oocyte numbers / quality diminish with age
* Chromosomal abnormalities, poor embryonic development, implantation failure and miscarriage risk increase with age.

Question 6

Fertility: Methylation

Answer 6

• MTHFR is crucial for reproductive function. C677T elevated homocysteine -> poor egg maturity and egg quality, ↑ oestrogen
• Increased risk spina bifida, pre-eclampsia and gestational hypertension.

Question 7

Fertility: Methylating Nutrients

Answer 7

Folate (B9)
Vitamin B12
Vitamin B6
Vitamin B2
Methionine

Question 8

Fertility: Methylating Nutrients - Folate (B9)

Answer 8

Food sources: Foliage

Question 9

Fertility: Methylating Nutrients - B12

Answer 9

Food sources: Meat, chlorella

Question 10

Fertility: Methylating Nutrients - B6

Answer 10

Food sources: Whole grains, green vegetables

Question 11

Fertility: Methylating Nutrients - B2

Answer 11

Food sources: Mushrooms, greens

Question 12

Fertility: Methylating Nutrients - Methionine

Answer 12

Food sources: Brazil nuts, beef