Having a baby is a major milestone. The process can be mentally and emotionally challenging, especially if you aren’t falling pregnant as quickly as you had hoped. Infertility is the inability to become pregnant after a year of engaging in regular sexual intercourse without the use of contraception. The reasons for infertility vary widely and include conditions such as ovulatory disorders, problems with the fallopian tubes, endometriosis, issues with sperm, and unexplained infertility.
In recent times, there has been growing interest in the crucial impact of lifestyle factors on fertility. Many different lifestyle factors can influence fertility, and it is important to consider these when trying to conceive. Some factors, such as smoking, drug use, and excessive alcohol and caffeine consumption, can have negative effects on fertility, while others, such as a healthy diet and regular exercise, can improve fertility. Additionally, factors like age at the time of trying to conceive, and environmental pollution and occupational exposures can also have significant impact on fertility.
Age and fertility
Ageing is a fact of life and a decline in fertility with age is also a fact of life. Hence ‘age’ maybe a factor to take into consideration when deciding the ideal time to start a family.
A woman is born with all the oocytes (eggs) she will ever have. With advancing age, there is a decline in the number as well as the quality of the eggs. Advanced maternal age (AMA) is defined as the age of 35 years, beyond which, the risk of adverse reproductive outcome increases.
Advanced paternal age (APA) is not as well-defined. As men grow older, testicular function and metabolism deteriorate as the testis undergoes age-related morphological changes. Aging causes a decline in sperm quantity and quality and also lowers testosterone levels.
We can’t stop ageing, nor can we go back in time. Awareness about the fact that advancing age is a potential risk factor for infertility, negative pregnancy outcomes and impaired offspring health can help in better planning and decision making.
Impact of diet and exercise
Eating a healthy diet with proper calorie and nutrient balance is crucial for optimal physical and mental health and preventing diseases such as obesity, heart disease, diabetes, osteoporosis, and some cancers. It also affects body weight and composition and is important for reproduction.
Maintaining a balanced diet consisting of plenty of vegetables, whole grains and fruit is great for your fertility health. Eating fish several times a week can be beneficial as it is a good source of omega-3 fatty acids (although fish with high levels of mercury such as swordfish, tuna should be avoided). Foods like processed meats, high fat dairy, trans fats, packaged foods, soft drinks etc all have a negative impact on fertility (for men and women) and should be avoided.
Early pregnancy is a crucial period for embryo and fetal development, and a healthy diet before conception may positively influence fetal well-being.
Exercise has a positive impact on your overall health and wellbeing and may offer protection against obesity, heart disease, hypertension, diabetes and osteoporosis.
Couples trying to conceive are advised to maintain a healthy lifestyle, including a nutritious diet and regular exercise, for overall health benefits and improved fertility.
Your weight is linked to your dietary choices and level of physical activity. Body Mass Index (BMI) below 18.5 is considered underweight, normal BMI falls between 18.5 and 24.9, BMI above 25 is considered overweight, and BMI over 30 is classified as obese. Maintaining a healthy weight is important for overall health and can affect the risk of developing diabetes, heart disease and also infertility.
Overweight and obese men are more likely to have low sperm counts than their normal-weight peers. Male obesity is linked with lower testosterone levels which can lead to reduced sperm production and also reduced sex drive and erectile dysfunction.
Obesity can affect fertility in women in several ways. Excessive weight can disrupt the delicate balance of hormones that regulate ovulation. Obesity and PCOS often go hand-in-hand. In addition to having fertility issues, obese women are also at an increased risk of complications during pregnancy, such as gestational diabetes, pre-eclampsia, and premature delivery.
Smoking and recreational drugs
Cigarette smoke is injurious to health. There is a long and exhausting list of health problems caused by smoking.
Smoking has a negative impact on sperm count, motility and morphology. Increased levels of ROS (reactive oxygen species) in the semen of smokers exposes sperm to oxidative stress impairing sperm function and compromising fertility. Smoking also leads to sperm DNA damage.
The chemicals in tobacco smoke can damage the ovaries and lead to a reduced egg reserve. Smoking can also cause hormonal imbalances that can lead to ovulatory dysfunction. There is risk of damage to fallopian tubes, causing them to function less effectively leading to infertility and an increased risk of ectopic pregnancy.
Marijuana, cocaine, anabolic steroids and methamphetamines have a negative impact on male fertility. They affect the hormonal axis, testicular hormone function and sperm function.
In women, illicit drug use can lead to impaired hormonal function and disrupt ovulation. They can damage ovarian reserve and interfere with normal functioning of fallopian tubes. They can also increase the risk of complications during pregnancy, such as preterm delivery, low birth weight, and behavioural problems in the child.
There is evidence that suggests a connection between alcohol and infertility, but the ‘amount ‘of alcohol that leads to an increased risk is not well established.
In men heavy drinking can lead to reduced testosterone production, impotence, testicular atrophy and decreased sperm production.
The way in which alcohol negatively impacts female fertility is uncertain, but it is believed to impair follicular growth, ovulation, development of the blastocyst and implantation.
It is advisable that women who are trying to conceive limit their alcohol consumption or avoid it altogether. This can help reduce the risk of fertility problems and improve the chances of having a healthy pregnancy and a successful outcome.
Caffeine is widely consumed in beverages like coffee, tea, soft drinks, as well chocolate. While moderate consumption is not likely to affect fertility in most women, excessive caffeine intake can increase the time to pregnancy and potentially increase the risk of infertility.
It is recommended that women who are trying to conceive limit their daily caffeine intake to about one cup of coffee.
Stress is an undeniable aspect of modern life and can have a significant impact on fertility. The diagnosis of infertility itself and the various treatments to overcome it can also be a source of stress. The testing, procedures, treatments, failures, familial and societal expectations, unmet desires, and even the financial burden associated with it. The definition and measurement of ‘psychological stress’ lack a clear consensus and it is difficult to determine whether stress is a cause or an effect of infertility and ART treatment.
Fertility is an emotional journey with its ups and downs and it is important to recognize that the stress, pressure and anxiety associated with trying to conceive are often inevitable. Therefore, it is advisable to prioritize your overall health and well-being (physical and mental) while trying to conceive and undergoing fertility treatment. Building a strong support system can be helpful.
Environmental pollution and occupation exposures
Studies suggest that reproductive health is deteriorating in industrialized regions. There is rising infertility and need for ART due to poor semen quality / oocyte failure.
Countless pollutants are released into the environment via manufacturing and agricultural processes. Air pollution has a negative impact on all aspects of health including fertility. Diesel exhaust particles contain PAHs and heavy metals (Cu, Pb, Zn, etc.) with endocrine disrupter activity. NO2, O3 or PM (through the heavy metals and PAHs they contain) can generate ROS which cause alterations in DNA, proteins and membrane lipids.
Endocrine disrupting chemicals (EDCs)are hormone-hijacking chemicals which mimic and antagonize the actions of endogenous hormones. EDCs like phthalates, bisphenol A (BPA), flame retardants etc are ubiquitous in modern life and are present in water bottles, food packaging, electronic devices, personal-care products, cleaning supplies and many other items we use regularly. The key endocrine disruption impairing fertility is loss of blood-sugar control manifesting clinically as metabolic syndrome, diabetes, abdominal obesity and PCOS.
Occupational exposure to pesticides, chemicals or x-rays can have an impact on fertility. Exposure to chemicals like PCBs and DDT is known to decrease fertility and increase miscarriage risk. Contaminated food and groundwater are known to increase risk of infertility and miscarriage.
While further research is needed to fully understand the extent of the impact of pollution on fertility, it is important to be aware of potential risks and take steps to reduce exposure to pollutants.
In conclusion, lifestyle factors can have a significant impact on fertility. While lifestyle changes are not a guaranteed solution to infertility, they can improve overall health and increase the chances of conceiving. Consulting with a fertility specialist and making healthy lifestyle choices can be a beneficial step for anyone looking to improve their reproductive health.
Views expressed above are the author’s own.
Views expressed above are the author’s own.
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