Preconception Flashcards
data for proportion of women who had a healthy weight before pregnancy has _______.
decreased
data for the proportion of women of childbearing age who get enough folic acid is _______.
staying the same
percent of women aged 20-44 years at risk of unintended pregnancy using concraceptive has ________.
improved/increasing
data for females aged 15 to 19 years at risk of unintended pregnancy using contraception has _____.
stayed the same
healthy couples have a ___% chance of getting pregnant within a given menstrual cycle
20-25%
if couple fails to conceive within ____ of attempting pregnancy they can be considered infertile. ___% of couples struggle with this.
1 year
15%
____% of couples diagnosed as infertile with conceive within ____ without use of fertility treatment.
44%
3 years
chances of conceiving decreases as men and women age beyond _____
35 years old
reduced level of fertility characterized by an unusually long time (over a year) for conception
subfertility
what percent of couples are subfertile?
18%
subfertility can improve with changes in ______
diet and weight
examples of subfertility
sperm abnormalities
infrequent ovulation
having multiple miscarriages
what is miscarriage and what percent of conceptions experience this?
loss of embryo in 1st 20 weeks
9%
what are some known causes of miscarriages?
severe defect in fetus (most common)
maternal infection
structural abnormalities of the uterus
endocrine or immunological distribuantes
men sperm production begins in ____, and continues until _____ somewhat decreases after age of ____
puberty
death
35
females are born with _____ immature ova, and _____ remain by the onset of puberty. _____ ova will mature and be released for possible fertilization during fertile years
7 million
1 million
400 - 500
menstrual cycle involves a 4 week interval in which hormones direct build up of ______ in uterus. ovum matures and is released.
blood and nutrients
female gonads that make eggs and secretes female sex hormones
ovary
tubes through which oocytes are propelled from an ovary to the uterus. usual site of fertilization
fallopian tube
oviduct
chamber in which embryo develops, includes myometrium muscle layer and endoetrium lining near opening. secretes mucus into the vagina
uterus
birth canal
vagina
what hormones are involved in the menstrual cycle
Gonadotropin-releasing hormone (GnRH)
Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)
estrogen
progesterone
Gonadotropin-releasing hormone (GnRH) is produced by __________. what does it do?
hypothalamus
stimulates pituitary gland to release FSH and LH
what does Follicle-stimulating hormone (FSH) do? when?
stimulates ovarian follicle growth & maturation
estrogen secretion
endometrial changes
first part of menstrual cycle
what does Luteinizing hormone (LH) do?
stimulates ovulation and the development of the corpus luteum, which secretes progesterone
what is a follicle?
fluid filled sac containing the egg
what does estrogren do?
stimulates release of GnRH in follicular phase
stimulates thickening of uterine wall
what does progesterone do?
prepares uterus for fertilized ovum and to maintain a pregnancy
stimulates uterine lining buildup
stimulates cell division of fertilized ova
where is estrogen found?
ovaries
testies
fat cells
corpus ludem
placenta
where is progesterone found?
ovaries
placenta
what are the two phases of the menstrual cycle?
follicular phase
luteal phase
what is the follicular phase and what occurs in it?
first half of menstrual cycle
- follicle growth and maturation
- estrogen and progesterone prompt uterine wall to store nutrients and to expand the growth of blood vessels and connective tissue
around 14 days = surge of LH = ovulation
what is the luteal phase?
last half of menstrual cycle
begins after ovulation
- formation of corpus luteum
- estrogen and progesterone further stimulate the development of the endometrium
- if ovum not fertilized, estrogen and progesterone drop and menstrual flow occurs
ovulation is the biological fertile window defines as the ____ days up to and including the day of ovulation
the 2 day ovulation window is _____
6 days
day before and day of ovulation
how to tell if your ovulating?
extra cervical mucus that is stringy and long
temperature slightly higher that before
in male reproductive system _____ signals release of _______, which trigger production of _____ by the _____.
_________ stimulate the maturation of sperm which takes _____
mature sperm are stored in the ______ and releases as _____.
GnRH
FSH & LH
testosterone
testes
testosterone and other androgens
70-80 days
epididymis
semen
How does nutritional factors affect fertility?
modify levels of hormones
alter the environment in which eggs and sperm develop
- this is temporary and will return to normal once problem is corrected
how does acute undernutrition affect fertility?
modifies hormones that regulate menstrual cycle
impairs sperm maturation
- recovers when food intake increases
how does chronic undernutrition affect fertility
birth pf small and frail infants with high likelihood of death In the first year of life
BMI of greater than ____ is required to have enough body fat to have a normal reproduction in women
Underweight results in ______ and ______
low levels of body fat in adolescence in linked to _____
20
amenorrhea and delayed time to conception
reduce fertility later in life
what drug is used to help women get pregnant, but doesn’t work if underweight. what does it do?
clomid
double amount of eggs released
in normal weight women, weight loss more than ____ % decreases estrogen FSH and LH concentrations. this results in _____ and _____. it is estimated that ____ of cases of impaired fertility is related to weight loss
10-15 %
ammenorrhea and anovulation
30%
how does underweight affect male fertiloty?
lowered libido
reduced sperm prodcution
decreased sperm viability and motility
Obesity is associated with ________ in
men and women due to alterations in
hormone
subfertility
how does obesity affect ferility in women
insulin resistance and increased insulin levels cause more androgens by the ovaries
-anovulation
-irregular menstrual cycle
-delayed time of comception
how does obesity affect fertility in men?
lower levels of testosterone
higher estrogen
-low sperm production and erectile dysfunction
elevated blood glucose, insulin, and free fatty acids increase production of reactive oxygen molecule that trigger oxidative stress
-leads to sperm damage
Increasing _________, even without
weight loss, can decrease the negative
metabolic effects of obesity
physical activity
Adequate intake of __________ nutrients may help to prevent oxidative stress
___________ is beneficial for improving insulin resistance
antioxidant
Aerobic exercise
after bariatric fertility, can fertiliy improve?
what are some risks?
how long should women wait?
yes
micronutrient deficiencies
12-18 months
what is oxidative stress?
when production of free radicals is greater than the body’s antioxidant defenses
how does oxidative stress affect fertility in mean and women?
men
- decrease sperm motility and ability to fuse with egg
women
- harm egg and follicular development
- interfere with corpus luteum function and implantation of the egg
oxidative stress found in about ____% of infertile men
50%
what protects eggs and sperm from oxidative stress
antioxidants
-vitamin E, C, beta-carotene, selenium
- dark green veggies, orange and red veggies, citris frutis
what micronutrients plays a role in MEN in sperm maturation, testosterone synthesis, reduction of oxidative stress?
zinc
- osters
- shell fish
- legumes
what micronutrient is important in fertility in WOMEN to prevent lack of ovulation
iron
_____% of U.S. women of childbearing age
have iron deficiency and ___ have low
iron stores
9-16%
14%
what is the affect of alcohol on fertility?
decrease fertility by disrupting menstrual cycles and decreased sperm count
effects of excercise of fertility
INTENSE physical activity
-low fat=low estrogen
-lack menstrual cycles
inadequate ____ very early in pregnancy can cause neural tube defects (NTD)
what role does it have
folate
required for DNA replication and amino acid synthesis
low folate levels tend to be higher in _____
african american women
Excessive vitamin_____ intake increases the
risk of fetal facial and heart abnormalities
________ deficiency in early pregnancy
associated with increased risk of impaired
intellectual and physical development in
offspring.
A
Iodine
____ deficiency can cause risk of preterm birth
iron
If pregnant, Consume ______ of folic acid from fortified foods or supplements in addition to dietary folate
If on vitamin A supplements, take no more
than _______ of Vitamin A (______) from supplements daily
400 mcg
retinol or retinoic acid
10,000 IU
cessation of menstruation related to changes in hypothalamic signals that maintain secretion of hormones required for ovulation
- causes suppressed activity of ___
hypothalamic Amenorrhea
GnRH
what is sports-related amenorrhea
relative energy deficient in sports (RED-S)
risks of diabetes mellitus prior to pregnancvy
high blood glucose levels during the first 2 months of pregnancy are teratogenic
- associated with 2-3 fol increase in congenital abnormalities
- malformations of pelvis, CNS, and heart
- higher rate of miscarriage
- large babies, born earlier, c section
nutrition management of DM (diabetes miellitus)
consistant carb intake
low SFA and TFA
reduce sodium intake less than 2300 mg
enough fiber
what is polycystic ovary syndrome (PCOS)?
rotterdam criteria (2 of the 3 symptoms)
- irregular or no ovulation
- high androgen male hormone) levels or symptoms of high levels
- multiple immature follicles on the ovaries
PCOS is a leading cause of female infertility including ____ % of women in reproductive age
5-10%
what is the cause of PCOS
unknown but appear to be insulin resistance, inflammation, hormone imbalance, and gut imbalance
genetic
nutritional management of PCOS
primary goal is to increase insulin sensitivity
weight loss
excercise
insulin sensitizing drug used for PCOS
metformin
what is celiac disease
autoimmune disease characterized by a sensitivity to prolamins found in wheat, rye, and barley
- chronic T-lymphocyte mediated inflammatory response
what happens if ppl with celiac disease eat these prolamins
inflammation and damage to the mucosa in small intestines
celiac disease in males with fertility
untreated causes alteration in androgen action, delayed sexual maturation, and hypogonadism
females fertility with celiac disease
untreated is associated with amenorrhea, increase chance of misscairage, and LBW infants
-from malabsorption and inflammation
nutrition management of celiac disease
eliminate all sources of gluten in diet
educate on hidden sources of gluten and cross contamination
correction of vitamin and mineral deficiencies
Common condition occurring among
women of reproductive age characterized
by life-disrupting physiological &
psychological changes that begin in the
luteal phase & end with menses
PMS or premenstrual syndrome
____ % of menstruating women have PMS
20-40%
What is a severe form of PMS characterized by mood swings, depression, irritability, anxiety, disruptions of personal relationships, and physical symptoms
Premenstrual Dysphoric Disorder (PMDD)
PMDD occurs in ____% of menstruating women
5%
how is PMDD diagnosed?
when 5 or more symptoms of PMDD occur during most menstrual cycles
what is the cause of PMS/PMDD
unclear but related to hormonal changes
PMS treatment
use of hormones and drugs that suspend ovulation by modifying levels of estrogen and progesterone or address specific symptoms
daily physical activity and stress reduction
what nutrition interventions (supplements) can help PMS
calcium 500 mg/day
vitamin B6 100 mg/day
