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Lifecycle Nutrition > Preconception > Flashcards

Preconception Flashcards

1
Q

Fertility

A

the actual production of children

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2
Q

Fecundity

A

the biological capacity to bear children

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3
Q

Infertility

A

lack of conception after 1 year of unprotected intercourse

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4
Q

Subfertility

A

reduced level of fertility characterized by unusually long time for conception such as having multiple miscarriages, sperm abnormalities, or infrequent ovulation

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5
Q

Gonadatropin Releasing Hormone (GnRH)

A

Stimulates pituitary to release FSH and LH

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6
Q

Follicle Stimulating Hormone (FSH)

A

Stimulates maturation of ovum & sperm

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7
Q

Luteinizing Hormone (LH)

A

Stimulates secretion of estrogen, progesterone & testosterone

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8
Q

Estrogen

A

Stimulates release of GnRH in follicular phase

Stimulates vascularity & storage of glycogen & other nutrients within uterus

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9
Q

Progesterone

A

Prepares uterus for fertilized ovum

Increases vascularity of endometrium

Stimulates cell division of fertilized ova

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10
Q

Follicular Phase

A

First half of cycle

Follicle growth & maturation

Main hormones: GnRH, FSH, estrogen, & progesterone

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11
Q

Luteal Phase

A

Second half of cycle, after ovulation

Formation of corpus luteum (hormone secreting cyst)

Decrease in estrogen & progesterone stimulate menstrual flow

Prostaglandins & cramps

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12
Q

Testosterone and androgens

A

stimulate the maturation and release of sperm from the testes (spermatogenesis)

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13
Q

Physiological factors contributing to normal fertility

A

Normal menstrual cycle (Production of ova)

Sperm maturation, production and storage

Sperm motility

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14
Q

Nutrition related disruptors in fertility

A 
Under nutrition
Weight loss
Obesity
High exercise levels
Intake of specific foods & food components
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15
Q

Undernutrition

A

Chronic

  • Small impact on fertility and fecundity
  • Higher likelihood of small frail infants and infant death

Acute

  • Results in dramatic decline in fertility but is recovered with recovered food intake
  • Reduces reproductive capacity by modifying hormonal signals that regulate -ovulation and menstrual cycles in females
  • Also impairs sperm maturation in male
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16
Q

Adipokines

A

Cell signaling proteins secreted by adipose tissue important to many metabolic processes (estrogen, androgen, leptin specifically for preconception)

17
Q

Body fat and fertility

A

Excessive and inadequate body fat levels will alter the hormone balance and affect the reproductive cycle
Adipose tissue converts androgens to estrogen by aromatization
Body fat is thus a significant extragonadal source of estrogen
Obese men have significantly lower circulating levels of testosterone
Adiposity influences the direction of estrogen metabolism to more potent or less potent forms

18
Q

Low body fat can lead to…

A

Delayed onset of menstruation
Amenorrhea
Lowered libido
Reduced sperm production

19
Q

High body fat can lead to…

A

Increased leptin and insulin levels and a preferential increase in LH, but not FSH, levels.
High insulin levels increases ovarian testosterone production/action.
The net effect of these changes is to stimulate the partial development of follicles that secrete supranormal levels of testosterone, but which rarely ovulate (hence low progesterone).

20
Q

Exercise and fertility

A

Exercise is associated with positive fertility outcomes
Mechanism: Exercise increases insulin sensitivity, which is related to ovarian function
Moderate-intensity exercise is more beneficial that high-intensity exercise

21
Q

Oxidative stress and fertility

A

Free radicals can harm:

  • Sperm motility and ability to fuse with egg
  • DNA within the sperm cell
  • Egg and follicular development
  • Implantation of egg in uterine wall
22
Q

Free radicals

A

reactive oxygen species formed during regular metabolic processes containing extra valence electrons and therefore making them more prone to react with other molecules and cause damage (oxidative stress)

23
Q

Antioxidants

A

neutralize free radicals by donating extra valence electrons

24
Q

Caffeine and fertility

A

High intakes are linked to reduced fertility (definition of high intake is not clear <200-300mg/day)
Adenosine receptor antagonist that may influence fertility in women but not men

25
Q

Alcohol and fertility

A

Alcohol intake alters the hormonal milieu

  • Decreases estrogen and testosterone levels
  • Disrupts menstrual cycle
  • Disrupts testicular function

How much? Not entirely clear.
1-5 drinks/week = ~40% decreased chance of conception
Over 10 drinks/week = ~66% decreased chance of conception

26
Q

Folic Acid

A

Neural Tube Defects (NTD) such as Spina Bifida and Anencephaly are a very common birth defect due to the neural tube developing and closing at 4 weeks

Folic acid functions as a coenzyme during the synthesis of nucleic acids and therefore is required for cell division and formation of the neural tube

All processed grain products were mandated to be fortified with folate beginning in 1998

27
Q

Iron

A

Many women have low iron stores due to menstruation or low iron intakes

Improvements in iron status associated with improved fecundity.

Possible role in oocyte development?

28
Q

Calcium

A

Associations between dairy intake and fecundability were generally small and inconsistent across cohorts, maintain RDA

29
Q

Vitamin A

A

Retinoic acid is used in dermatology to cure acne and psoriasis

Should not be prescribed during pregnancy or in women planning to become pregnant

30
Q

Teratogenicity

A

the ability to cause defects in a developing fetus

31
Q

Vitamin D

A

Supplementation associated with

  • Increased endometrial thickness
  • Improved serum lipids
  • Decreased risk of endometriosis

Important to correct insufficiency and deficiency

32
Q

Conditions impacting conception

A

Premenstrual syndrome (PMS)

Obesity
Underweight
Female athletic triad
Eating disorders
Diabetes
Polycystic ovary syndrome
Phenylketonuria, Celiac disease

Lifecycle Nutrition (4 decks)

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