CAUSES AND CURES OF FEMALE INFERTILITY
One of the major causes of female infertility is age, owing to the decreasing quantity and quality of the eggs preserved in the ovary. Population-based and clinical studies have shown that women experience optimal fertility before age 31. After 31 the probability of conception starts to drop rapidly. By are 40. Half of women will have completely lost their capacity for reproduction. By 45 years of age, the fertility rate is only 1 pregnancy per 100 inseminated women. In addition the probability of birth defects or an adverse pregnancy outcome increases with age.
Diagnosing and treating infertility will often require a very thorough health assessment by a physician and may require seeing a fertility specialist. The general recommendation in this chapter can be used along with conventional medical treatments.
It’s important to realize that there are three types of patient suffering from infertility:
• Those who achieve pregnancy by maximizing their fertility
• Those who require assistance in the form of in vitro fertilization and other assisted reproduction technologies
• Those who simply cannot get pregnant owing primarily to age, genetic disorders or various health conditions that compromise fertility
The first step to successful conception is timing the attempt of conception during a woman’s window of fertility. A widely held misinterpretation is that frequent ejaculation decreases male fertility. A retrospective study analyzed 9,489 men with normal semen quality, sperm concentrations. And motility and found that profiles remained normal even with daily ejaculation. Of more important is the finding that in men with sperm abnormalities, fertility may be improved with more frequent (Per day) ejaculation. So, in other words, daily intercourse is probably more important than trying to time it just right.
A recently ovulated egg will survive for only a maximum of 24 hours, while sperm can survive for up to five or six days. Hence, the fertility window is best defined as the six-day interval ending on the day of ovulation. Fertility charting can help identify the fertility window. A useful tool in helping to determine luteinzing hormone (LH) in the urine. This hormone increases 24 tom48 hours prior to ovulation. The LH surge triggers ovulation.
BODY FAT PERCENTAGE
For optimal fertility, women need to ensure that their body fat percentage is between 20 and 25%. A body fat percentage below 17% can result in irregular menstrual cycles, and some research suggest that even after ideal body fat level have been achieved, it can take as long as two years before regular conception occurs, while being underweight is a concern, obesity poses a similar significant risk for infertility. Obesity increases the risk for miscarriage, birth defects, and pregnancy complications. Maternal obesity carries an increased risk that the child will be overweight as an adult and have the consequent weight-related diseases.
Industrialization and the use of agricultural chemicals has contributed to increased exposure to thousands of chemicals now associated with negative impact on male and female infertility. Exposure to environmental toxins such as radiation, heavy metals, and chemicals can cause oxidative stress and damage, negatively affecting female fertility.
Cigarette smoking, whether active or passive reduces both pregnancy rates and long-term ovarian function. Additionally, smokers are more likely to have premature menopause, thus making smoking one of the easiest preventable causes of infertility. Smoking appears to reduce fertility by having a direct effect on the uterus, eggs and embryo. Overall, research indicates that smoking can prematurely age eggs by as much as 10 years considering that the average age for conception today is 30 and fertility tends to decline greatly after 38 years of age, it should be obvious that a woman trying to get pregnant needs to stop smoking. Even passive smoking is associated with reduced fertility and decrease the chance of a healthy live birth in both fertile and infertile populations.
Couples trying to conceive may want to avoid caffeine, as frequent consumption been shown to increase time of conception. As little as one caffeinated beverage per day is associated with a temporary reduction in conception in a number of studies. For example women who drink less than one cup of coffee per day are twice as likely to conceive compared with moderate coffee drinkers. Caffeine affects female hormone levels as well as stress hormones. Caffeine is also likely to interfere with adrenal function and associated cortisol secretion. In addition, diuretic properties will increase the loss of nutrients that are beneficial to fertility.
The effect of alcohol intake on female fertility is variable from one woman to the next but there is no question that it can negatively affect fertility in many women. One study estimated that as little as one drink per week could lead to a 50% reduction in conception. Frequent or excessive alcohol consumption is associated with elevations in prolactin and alterations in other hormones that could adversely affect menstrual cycles and fertility. There is also a strong association between alcohol intake and miscarriage. Obviously, as with smoking, it is critical that alcohol intake be avoided during the preconception period as well as pregnancy. It is a well-known fact that alcohol intake during pregnancy can produce fetal abnormalities.
DIET AND LIFESTYLE
There is abundant scientific research showing the importance of nutrition and lifestyle to a woman’s fertility. Specifically, researched clearly indicates that eating a healthful diet improves the chances for ovulation, conception, and the birth of a healthy child.
THE FOLLOWING FACTORS WERE ASSOCIATED WITH ENHANCED FERTILITY
• Lower intake of trans-fatty acids and greater intake of monounsaturated fats
• Lower intake of animal protein and greater intake of vegetable protein
• Higher intake of high-fiber, low-glycemic carbohydrates
• Higher intake of high-fat dairy products (high-fat dairy products reduced the risk of infertility due to lack of ovulation by more than 50% in contrast to low-fat dairy foods, which actually reduced the risk of successful conception by 11%)
• Higher intake of dietary sources of non-heme iron (green leafy vegetable and other plant foods relatively high in iron)
• High frequency of multivitamin use
• Being physically active (30 minutes or more of vigorous activity per day)
• Not smoking
• Not having long menstrual cycle
• BMI between 20 and 25
Just as in many other health conditions, researchers have noted that a diet based upon the principles of the Mediterranean diet also increase the chance of a successful pregnancy.
Iron deficiency is the most common nutritional deficiency in women and can be cause of infertility. Iron is required for the formation of red blood cells, subsequent transport of oxygen to the tissues by hemoglobin, and DNA formulation, as well as being involved in numerous enzymes systems within the body. Women who consumed iron supplements had 60% lower risk of infertility than women who did not. Measuring blood levels of ferritin, an iron-binding storage protein, is critical in assessing causes of infertility. Achieving a level of 70 to 80ng/ml is recommended prior to conception
A high antioxidant intake, both dietary and supplemental, improves fertility in women as well as reduces the risk for miscarriage. The egg cell has high requirement for antioxidant and oxidative stress has been shown to increase time to conception, decrease fertilization rate, decrease egg viability, and decrease implantation rates.
In animal studies, carnitine has been found to exert a protective effect against egg damage and embryo death associated with endometriosis. Although human studies are required, carnitine appears to be an appropriate recommendation for women with infertility due to endometriosis
Arginine is a precursor to the synthesis of nitric oxide, which is required for the formation of new blood vessels to nourish the developing fetus, as well as other aspects of fertility. In one study, arginine supplementation at a dosage of 16 g per day was evaluated in women who failed to achieve an adequate serum estradiol levels following hormonal stimulation. Result indicates that supplementation improved ovarian response, endometrial receptivity, and pregnancy rates, with 3 of 17 women conceiving in the arginine group, compared with none in the control group. Arginine is not panacea, but it may be helpful in some situations.
Alterations in the microflora of the vagina and subsequent genital and intrauterine in-fections have been linked to reproductive failure and adverse pregnancy outcomes such as preterm labor, miscarriage, and spontaneous preterm birth. In one study during the first half of pregnancy, women with altered virginal flora were four times more likely to have a spontaneous preterm birth.
The best documented herb for improving fertility id chasterberry (Vitex agnus-castus). Clinical studies have shown it to help promote healthy menstrual cycles. It seems to be especially useful when there is an elevation in the hormone prolactin, which can disrupt the menstrual cycle and contribute to infertility. Chasteberry can inhibit prolactin secretion and has been shown to correct menstrual irregularities caused by mild elevations of prolactin. In one double-blind study, chasteberry was shown to improve hormone levels, reestablish menstruation in women with amenorrhea, and help achieve pregnancy in women with fertility problems.