What to know about fertility
Reproduction is the function of the human body without which humanity simply could not exist. The United Nations guidelines on reproductive health refer to reproductive health as “a state of complete physical, mental and social wellbeing and not merely the absence of reproductive disease or infirmity,” dealing with the reproductive processes, functions and system of all stages of life. Statistics from the Centers for Disease Control and Prevention state 11 percent of all women between the age of 15-44 have impaired ability to become pregnant or carry an infant to term – 6.7 million women and six percent of all women within that age range are infertile.
Dr. Catherine F. Vanderloos is a gynecologist practicing in Shreveport.
Vanderloos said, “Reproductive health should include concerns regarding achieving pregnancy as well as preventing pregnancy and everything in between. A major threat to reproductive health today involves not being in good health in general. With obesity being such a topic of health today, I have concern for diabetes and high blood pressure affecting conception and then maintenance of a healthy pregnancy for the mother and the fetus and then for the child’s long-term health later in life from fetal environments. Smoking is another threat both for conceiving and a healthy pregnancy.”
Reproductive health risk factors listed by the CDC for women include:
• age.
• smoking.
• excessive alcohol use.
• extreme weight gain or loss.
• excessive physical or emotional stress that results in amenorrhea (absent periods).
• transmission of sexually transmitted diseases infections such as chlamydia.
• presence of various chronic diseases, such as depression, hypertension and diabetes.
Conditions which the CDC states may directly cause infertility include:
• Pelvic inflammatory disease – an infection of the female reproductive system which can lead to irreversible damage to the uterus, ovaries and fallopian tubes.
• Polycystic ovary syndrome – a hormone imbalance problem that can interfere with normal ovulation.
• Diminished ovarian reserve – the ability of the ovary to produce eggs is reduced.
• Functional hypothalamic amenorrhea – relates to excessive physical or emotional stress that results in the absence of periods.
• Menopause – a natural decline and end to reproductive function as a function of aging.
To best maintain reproductive health, Vanderloos recommended regular exercise and maintaining a healthy weight and diet control, while urging avoidance of smoking, alcohol and drug exposure. Vanderloos said, “Women can maintain their exercise routines followed before conceiving and will naturally find their comfort levels during the pregnancy as long as they do not develop high risk issues. If the patient has diabetes or high blood pressure, they should work on good control prior to conception and get consultations with a perinatologist to have realistic goals. Prenatal vitamins to increase folic acid are very important for developing a health pregnancy. Starting prenatal vitamins before trying to conceive is very helpful.”
The National Fertility Association estimates 30 percent of infertility is due to women being either overweight or underweight, both extremes of which cause shifts in hormones which can adversely affect ovulation. In the case where the woman is significantly overweight, the NFA states that even a 5 percent reduction of body weight can enhance fertility.
Reproductive health risk factors listed by the CDC for men include:
• variocele, a mass of varicose veins in the spermatic cord, a condition which results in two-thirds of the office visits for male factor infertility in the United States
• use of tobacco products
• exposure to toxic chemicals in the workplace
• obesity
• chronic diseases such as diabetes and cystic fibrosis
• testicular trauma
• infection
• radiation therapy or chemotherapy
• environmental toxins, including pesticide and lead.
Vanderloos said, “How long before considering seeking help to achieve pregnancy can be a very individual issue. If a woman has had lifelong irregular periods (intervals between periods of six to eight weeks), then seeking help for ovulation evaluation and management should be considered much earlier than if periods are every month. Also important is that it is a couple issue and should be approached as a couple. Often, no one issue is a source to infertility, and to correct only that issue may prolong getting to the ultimate goal of pregnancy.”
The one thing Vanderloos recommended most about reproductive health prior to attempted pregnancy is, “Planning, planning, planning,” Vanderloos said.
“Addressing current medical issues before conception, being at a healthy weight and having some understanding of a healthy diet. Avoiding smoking, alcohol and drug exposure to an early pregnancy, you should assume you might be pregnant for two weeks before the first period is missed and you can avoid such exposures.”
