The Role of Hormones in PMS
Overall stress scores for women in the no success group were A review of the current literature supports the notion that the typical western, junk food diet is a major contributory factor to male infertility and ED. The nurse gave couples detailed information about their treatment, made daily contact with the couple from the commencement of stimulation until embryo transfer and was present at oocyte collection and embryo transfer. Check out this article to learn more or contact your system administrator. Wondering just what's the deal with nightshades? If you're exercising five or more days a week, consider cutting back to three. Doing kegel exercises is very easy.
What causes infertility?
The amount of each nutrient you should consume depends on your age. In the United States, many foods that you buy in the grocery store — such as cereals, bread, and milk — are fortified with nutrients that are needed to prevent nutritional deficiency.
The most widespread nutritional deficiency worldwide is iron deficiency. Iron deficiency can lead to anemia. This is a blood disorder that causes fatigue , weakness , and a variety of other symptoms. Iron is found in foods such as dark leafy greens, red meat, and egg yolks. It helps your body make red blood cells.
The red blood cells it produces are smaller and paler than healthy blood cells. Many of these people are anemic due to iron deficiency. Vitamin A is a group of nutrients crucial for eye health and functioning and reproductive health in men and women.
It also plays a part in strengthening the immune system against infections. According to WHO , a lack of vitamin A is the leading cause of preventable blindness in children. Pregnant women deficient in vitamin A have higher maternal mortality rates as well. Beta carotene is a nutrient that functions as an antioxidant. Beta carotene can be converted to vitamin A in the body when needed. For newborn babies, the best source of vitamin A is breast milk.
Another common nutritional deficiency occurs with thiamine, also known as vitamin B Thiamine is an important part of your nervous system. It also helps your body turn carbohydrates into energy as part of your metabolism. In the United States, thiamine deficiency is most often seen in people with excessive alcohol use. Thiamine deficiency is a common cause of Wernicke-Korsakoff syndrome. This is a form of dementia. Many breakfast cereals and grain products in the United States are fortified with thiamine.
Other good sources of thiamine include:. Niacin is another mineral that helps the body convert food into energy. A severe deficiency in niacin is often referred to as pellagra. Niacin is found in most animal proteins but also in peanuts. As a result, this condition is rare in industrialized countries or in meat-eating communities. Symptoms of pellagra include diarrhea , dementia, and skin disorders. You can usually treat it with a balanced diet and vitamin B-3 supplements. Shop for vitamin B-3 supplements.
Vitamin B-9 helps the body create red blood cells and produce DNA. Folate also helps brain development and nervous system functioning. Folic acid is the synthetic form found in supplements or fortified foods. Folate is especially important for fetal development.
Folate deficiency can lead to severe birth defects , growth problems, or anemia. While beans can provide a great amount of folate, the folate content in canned beans is about half of what cooked, dried beans offer. Most people in the United States get enough folate. In these cases, while folate intake might be adequate, a supplement of methylated folate may be necessary to prevent deficiency. Deficiency in this vitamin is common among people who:. Intrinsic factor is a transport protein secreted by the stomach cells.
It binds to B and takes it to the small intestine for absorption. This is the way the body is able to absorb and utilize B Adequate calcium intake at meals is required for intrinsic factor to assist in B absorption in the small intestine. A deficiency in this vitamin may cause pernicious anemia. This is a type of anemia caused by a decreased ability to absorb B efficiently.
Trying to Get Pregnant? Getting older When a woman reaches menopause, usually in her 40s or 50s, she no longer ovulates and is unable to get pregnant. There's no official age when fertility begins to take a dive, but many doctors say that it often becomes increasingly difficult to get pregnant after age This age is different for every woman, though; some may go through perimenopause earlier, while others remain fertile through their 40s.
That's why, says Dr. Schlaff, it's important for women of any age who are having trouble conceiving to see a specialist sooner rather than later. Your mother Ask your mom how old she was when she went through menopause. If she started on the early side, then you probably will, too.
Arredondo, "and there are certain genetic factors that might make you born with more or less eggs than usual, or that may make you use those eggs faster than other average women.
External factors that don't necessarily affect you could have impacted your mom. Additionally, a Washington University study found that 15 common chemicals were associated with early menopause.
These chemicals include nine PCBs which have been banned since but still exist in older products , three pesticides, two forms of plastics called phthalates often found in personal care items and beauty products like perfumes and nail polishes , and the toxin furan, a byproduct of industrial combustion.
Smoking Smoking can hurt a developing fetus, but lighting up can also drastically affect a woman's chances of getting pregnant in the first place.
One study even found that a woman's smoking may affect the fertility of her sons. Cigarette smoke disrupts hormones and damages DNA in both men and women, says Dr. Diet Changes to Make Right Now. Plus, a Swedish study that tracked more than 7, women for 18 years found that the heaviest drinkers were more likely to have sought out fertility treatment. You probably already know you should stop drinking if you think you could be pregnant.
Drinking during the early stages of pregnancy and possibly even before conception has been linked to premature births. The practice of reporting success by pregnancy rate is contentious. Commonly, success is claimed on the achievement of pregnancy. This has been the recommendation by at least one expert panel Baird et al. The poor live birth rate in older women is, in great part, due to spontaneous abortion. A study of pregnancies from women undergoing ovulation induction found a 2.
Another study of consecutive ICSI cycles undertaken in a New York hospital found a significant decline in clinical pregnancy rate, implantation rate and delivery rate per embryo transfer associated with increasing female age Spandorfer et al.
Delivery per embryo replaced was However, they were not able to identify an effect of paternal age on the outcomes. Cigarette smoking has been association with adverse effects on fertility, although this is not widely recognized Roth and Taylor, There is strong evidence of the adverse effects of smoking on fertility operating through a range of pathways in both the general and infertile population.
In males, smoking negatively affects sperm production, motility and morphology and is associated with an increased risk of DNA damage Zenzes et al.
In the female, the constituents of cigarette smoke may affect the follicular microenvironment and alter hormone levels in the luteal phase. Cotinine and cadmium have been detected in the follicular fluid of female smokers and whose partner smokes, thus having access to the developing follicle Younglai et al. Menopause has been reported to occur 1—4 years earlier for women who smoke compared to non-smokers Baron et al.
A recent study demonstrated an increased thickness of the zona pellucida in smokers, which may make it more difficult for sperm penetration Shiloh et al. A meta-analysis of 12 studies found the overall OR for risk of infertility in the general population was 1. An OR of 1. A study of couples from 10 European countries also found a strong association between female smoking and subfecundity Bolumar et al.
A systematic review reported that 12 out of 13 studies demonstrated a negative effect of female smoking on conception Hughes and Brennan, Republished from Augood et al.
A meta-analysis of nine studies found an OR of 0. Another meta-analysis reported that almost twice as many IVF cycles were needed to achieve pregnancy for smokers compared with non-smokers Feichtinger et al. These effects were observed against a cycle-specific pregnancy rate of Similarly, a study of women undergoing IVF found that smokers did not respond as well to stimulation as non-smokers, fertilization was lower and none of the regular smokers became pregnant Crha et al.
The risk increased with each year of smoking. A recent review of lifestyle habits and IVF concluded that there was compelling evidence of the negative effect of smoking on IVF outcome Klonoff-Cohen, There is also emerging evidence of adverse effects on reproduction associated with passive smoking.
A recent study of women undergoing IVF found that fertilization rates were similar for smokers, passive smokers and non-smokers, whereas pregnancy rates were significantly decreased for smokers Smoking has been shown to adversely affect the chance of pregnancy from ART, with results of studies suggesting that smokers require nearly twice as many IVF cycles to conceive as non-smokers Feichtinger et al.
Obesity is associated with a range of adverse health consequences. Widely recognized are the increased risks of cardiovascular disease, diabetes and some cancers. Obesity and low body weight can impact on reproductive function by causing hormone imbalances and ovulatory dysfunction. The effect of adolescent BMI at age 18 as a predictor of ovulatory infertility was examined.
Compared to women with a BMI of 20— The risk of infertility with increasing BMI was apparent for women with and without polycystic ovarian disease. Relative risk of infertility by BMI at age Republished from Rich-Edwards et al. Supporting these findings is a study that investigated lifestyle factors in pregnant women. Another large study of women from five European countries Bolumar et al. Obesity has been shown to decrease the probability of pregnancy for women undergoing ART.
A large Australian study of women who underwent ART found that pregnancy rates were halved for very obese women in comparison with women with a normal BMI Wang et al.
Further evidence was found in a study of women undergoing IVF. After adjusting for age and the number and quality of embryos, the chance of pregnancy was halved for overweight women OR 0. The distribution of body fat also impacts on reproductive performance but the mechanism for this effect is unclear Norman et al. A prospective study of apparently normal women undergoing donor insemination Zaadstra et al.
These results are particularly significant as the women required ART treatment because of male factor infertility and therefore reflected a relatively normal population with few of them requiring stimulation. This contrasts with women with a normal BMI of The lower rate in the obese group was mainly due to an increased risk of early pregnancy loss.
High BMI in women has also been associated with other adverse pregnancy outcomes such as gestational diabetes and hypertension Michlin et al. The evidence for the effects of weight on reproduction from observational studies has given rise to a number of significant intervention studies. Lifestyle modification programmes that include exercise have been shown to assist women to lose weight, improve their fitness, increase psychological well-being and improve reproductive functioning Clark et al.
The women in this study attended a weekly programme for 6 months that included an exercise component and education relating to diet and psychological issues associated with being overweight. Although the number of women taking part in the study was relatively low, the positive effects of participating in the programme were outstanding. On average, the women lost Of the 67 women who completed the study, Eating a healthy diet consisting of appropriate composition and caloric intake is fundamental to maintaining a state of optimum physical and psychological health.
It is also important in preventing diseases such as obesity, cardiovascular disease, diabetes, osteoporosis and some cancers. Diet mediates body weight and composition and should be considered fundamental to reproduction. However, although a link has been demonstrated between maternal nutritional status and adverse pregnancy outcomes Fall et al. Early pregnancy is a vulnerable period for embryo and fetal development and the environment at the time of conception can impact on the developing embryo and subsequent long-term health of the child Chapin et al.
Studies directly relating dietary components to the chance of conceiving are sparse in humans. However, there is strong evidence that a well-balanced healthy diet is beneficial for general well-being and optimum body functioning Sanders, and it has been suggested that diet before pregnancy may influence fetal well-being Moore and Davies, Therefore, reproductive performance should be positively influenced by the consumption of a healthy varied diet.
Regular exercise affects an individual's general health and well-being and probably provides some protection from obesity, cardiovascular disease, hypertension, diabetes, osteoporosis and psychological stress. Research in relation to physical fitness and reproduction is primarily focused on athletes rather than women who have a moderate level of fitness.
However, there was no association with moderate exercise. This is in contrast to the Clark et al. The women in this study underwent a 6-month lifestyle modification programme that included a weekly group fitness component and at least two further exercise sessions per week.
In addition to losing weight, each participant's fitness level improved. Exercise increases insulin sensitivity, which improves ovarian function and the chance of conception Norman and Clark, Exercise during pregnancy has also been reported to increase maternal well-being Morris and Johnson, The overall physical, emotional and increased general well-being benefits of being physically fit are well documented Berlin and Colditz, ; Sandvik et al.
However, there is a need for further research regarding the effects that moderate and low-level exercise may have on reproductive performance. It is reasonable to assume that the general health benefits associated with moderate levels of exercise and the consumption of a well-balanced diet would also apply to fertility. These lifestyle practices should therefore be recommended to couples attempting pregnancy.
Further research is needed to clarify the effect that exercise may play on reproductive performance. The above evidence associated with age, smoking and weight shows that there is strong substantiation of an adverse association between these lifestyle factors and the risk of impaired fertility. Other lifestyle factors such as psychological stress, caffeine and alcohol consumption and environmental pollutants may impact on reproductive health and adversely affect fertility.
However, so far, the evidence is limited and not consistent across studies. Psychological stress may reduce female reproductive performance in various ways. The autonomic nervous system, the endocrine and immune systems have all been implicated Hjollund et al. Given that infertility and ART treatment are associated with stress Hammarberg et al. A randomized controlled trial compared a cognitive behavioural group, a support group and a control in women attempting to conceive for 1—2 years both naturally and from ART treatment Domar et al.
Women were randomized into one of three groups: The first intervention group was a cognitive behavioural group where participants were taught relaxation and cognitive restructuring techniques. They were also given information about nutrition and exercise. In light of the evidence above, providing this type of information may be a potential confounder of a direct effect on psychological factors. The second intervention group was a support group.
Participants were encouraged to discuss issues such as infertility treatment and their emotional feelings, followed by a more structured information session on a topic such as the impact of infertility on self-esteem. The women also met with a psychologist twice during the year of follow-up for testing of stress levels. An observational study Hjollund et al. Couples were followed for six menstrual cycles. Decreased conception was associated with women who reported being most stressed The effects seen in the general population carry over to women undergoing ART treatment where there is also some evidence of a negative effect of increased levels of stress and IVF success Thiering et al.
A randomized controlled trial of 60 couples attending a Turkish Hospital for their first IVF treatment Terzioglu, found a statistically significant association between providing counselling and support to couples and increased pregnancy rates. A nurse who worked closely with the couples throughout the most stressful periods provided the intervention. The nurse gave couples detailed information about their treatment, made daily contact with the couple from the commencement of stimulation until embryo transfer and was present at oocyte collection and embryo transfer.
Standard care was provided to the control group. Three standard psychological tests were used to collect data at the beginning of the treatment cycle and 4—5 days after embryo transfer. Effects of counselling and support on ART pregnancy rates. Republished from Terzioglu with permission. There have been several observational studies to assess stress levels and associations with treatment outcome. An association between stress levels prior to a treatment cycle and treatment outcomes was found Klonoff-Cohen et al.
This study examined the effect of different types of stress on a range of outcome measures including oocytes retrieved, fertilization, pregnancy and live birth. Stress was assessed using standardized psychological tests that were administered prior to treatment and during treatment. The chance of pregnancy and live birth delivery was decreased with increasing stress measures.
The number of oocytes fertilized also decreased with increased stress. A prospective study conducted in Belgium of 98 women undergoing IVF used standardized psychometric questionnaires administered prior to commencement of the treatment cycle to assess depression and coping skills Demyttenaere et al.
The study found an increase in negative emotions in the group that did not become pregnant. A recent study of Danish couples Boivin and Schmidt, examined the effects of infertility-related stress on men and women and pregnancy after 1 year. The data were controlled for potential confounders of age and length of infertility. A small increase in stress in women was associated with poorer treatment outcome, but not for men.
Overall stress scores for women in the no success group were The small difference in means and wide scatter of the data may illustrate the difficulty of quantifying stress. A Dutch study attempted to use biochemical markers of stress during IVF treatment as well as reported stress Smeenk et al.
Higher levels of adrenalin were found at stressful time points in treatment oocyte retrieval and embryo transfer in women who did not become pregnant, compared with those who did become pregnant who also showed higher levels of noradrenalin at the time of embryo transfer.
This study was blighted by missing data including the loss of urine samples. Several other studies have found stress to reduce pregnancy rates following ART treatment Thiering et al.
Distribution of waiting time to first pregnancy TTP in months by coffee drinking habits and caffeine intake of women from Denmark, Germany, Italy, Poland and Spain, August to February Republished from Bolumar et al. Other studies have found no relationship between the psychological status of women and the outcome of ART treatment Harlow et al.
On balance, reported studies support an association between increased levels of psychological stress and impaired reproductive performance. The level of precision in determining a cause — effect relationship is low because the major measurements of stress are subjective and there is lack of consensus in defining and measuring stress levels.
The stimulant properties of caffeine have led to its widespread use as a beverage coffee, tea and soft drinks and some foods such as chocolate. Its consumption has been reported to prolong the time to pregnancy; although the mechanism for this is unclear, caffeine may affect female reproduction by targeting ovulation and corpus luteal function through alterations to hormone levels Klonoff-Cohen et al.
The consumption of caffeine has been associated with reduced fecundity in the general population. A prospective study of women attempting pregnancy found strong evidence of a reduced chance of pregnancy with increasing caffeine consumption Wilcox et al. The women were reviewed at enrolment and again at 3 and 6 months and their consumption of coffee, tea and soft drinks were recorded.
The frequency of interviews allowed accurate recall of their caffeine consumption. Daily information was also recorded regarding menstrual bleeding and intercourse until a pregnancy was confirmed. The data were adjusted for variables of age, frequency of intercourse, smoking, weight and age at menarche.
Women who consumed less than one cup of coffee were twice as likely to become pregnant compared with the moderate coffee drinkers, with the risk of failing to become pregnant increasing with higher consumption. Most other studies rely on the collection of retrospective data after the period of caffeine consumption leaving them open to recall bias.
After adjusting for potential confounders of age, smoking, the use of contraceptives and country, the risk of delayed conception with large amounts of caffeine consumption remained. A study of pregnant women relied on interviews about their consumption of tea, coffee and cola between the time of conception and the date of interview Hatch and Bracken, The assumption was made that pre-pregnancy levels of caffeine consumption were consistent with levels during pregnancy.
However, with the achievement of pregnancy, women change many habits and caffeine consumption during pregnancy may not be the same as levels at the time of conception. Coffee aversion in pregnancy is frequently associated with nausea.