National Fertility Awareness Week 2016 runs from Monday October 31 to Sunday November 6, and to mark the event, Pillar Healthcare’s founder and Managing Director Mark Whitney is available to expertly answer any fertility-related questions you may have.
Answers will be posted here each day.
Today’s Questions and Answers are
How common are fertility issues?
The statistic from the World Health Organisation is one in six. This incorporates all women of child bearing age. This figure is thought to be closer to one in four, from the age of 28 and above (a more reflective age for people trying to conceive). Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained.
In 2013, the last report from the UN states that, “Fertility has declined significantly since the 1994 International Conference on Population and Development.” Fertility in developed countries has been decreasing steadily from the 1950’s. We are also starting to see fertility crises being highlighted in the developing world, with Kenya the most recent country highlighting a fertility problem on its horizon.
What are common reasons for this?
Causes of Male Infertility include:
- Varioceles (a condition in which the veins on a man’s testicles are large and cause them to overheat, damaging the cells)
- Medical Conditions (diabetes, cystic fibrosis, trauma, infection, including STI’s (Sexually Transmitted Infections), testicular failure, chemotherapy or radiation)
- Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use and illicit drug use
- Nutritional Deficiencies that impair sperm and hormone creation
- Environmental toxins including exposure to pesticides and lead
Causes of Female Infertility include:
- Damage to the fallopian tubes, not allowing the sperm cell and egg to meet
- Ovulatory problems (insufficient ovulation will impair fertility)
- Endometriosis & PCOS (Polycystic Ovary Syndrome)
- Conditions affecting the uterus (Polyps & Fibroids)
- Gynaecological problems such as previous ectopic pregnancy or having had more than one miscarriage
- Medical conditions such as diabetes, epilepsy, and thyroid and bowel diseases
- Lifestyle factors such as stress, being overweight or underweight, and smoking
- Nutritional Deficiencies that can impair egg development and reproductive function
In a fascinating study conducted in Harvard University over an 8 year period, a cohort of 17,544 women. What they realised from the study was that adhering to a “fertility diet” pattern was associated with a lower risk of ovulatory disorder infertility. A combination of five or more low-risk lifestyle factors, including diet, weight control, and physical activity was associated with a 69% lower risk of ovulatory disorder infertility.
This would indicate that nutritional, diet and lifestyle factors have a major influence on our fertility. Overall cellular health and function, toxicity, circulation, hormonal health including xenoestrogens all impact on our fertility, both male and female.
When should a person seek advice from a nutritional therapist?
Prevention of chronic disease, and an increase in healthy ageing require improvement in the nutrition of girls and young women. Many babies in the womb in the Western world today are receiving unbalanced and inadequate diets. Many babies in the developing world are malnourished because their mothers are chronically malnourished. Protecting the nutrition and health of girls and young women should be the cornerstone of public health. Not only will this prevent chronic disease, but it will produce new generations who have better health and well-being through their lives. – D.J.P. Barker of the University of Southampton
I would suggest that anyone planning on conceiving should optimise their health and nutritional intake, at least ninety days before conceiving. The sperm cell that ultimately fertilises the egg cell helps to create the DNA of the embryo. This is the DNA for the newly developed embryo, foetus, baby etc. It is imperative that we make sure this DNA is as strong as it possibly can be! It is our responsibility to ensure we have the healthiest cells as possible for the immediate and future health of our children.
What lifestyle recommendations could a practitioner make to help?
- Number One – Reduce Alcohol Intake
Alcohol is a toxic substance that can have a dramatic impact on our fertility parameters. A relatively moderate intake of alcohol, of just 5 units per week is linked to poorer sperm quality in otherwise healthy young men suggests research.
- Number Two – Stop Smoking
According to Dr Geetha Venkat, director of the Harley Street Fertility Clinic, “when you smoke, more than 7,000 chemicals spread through your body, which hinder ovulation, damage eggs and sperm motility.” It interferes with DNA of both sex cells, nutrient absorption, hormonal patterns and so on. It just has to stop and for non-smokers, be wary of second hand smoke if you are in such social circles.
- Number 3 – Eat Proper Meals
We have all done it – skip breakfast for the bit of extra ‘snooze,’ time, missed lunch because of deadlines or gave in to the take away on the way home. When you don’t eat wholesome meals (or consistently eat refined foods), your body releases adrenaline and cortisol. Over time, both these hormones when used in excess can cause hormonal problems in men and women. Proper meals are the building blocks to create proper cells and providing the body with energy. If you are a serial skipper of meals, pack the car with healthy snacks and fruits, smoothies and juices (home-made) and go for a healthier take away than the chipper.
- Number 4 – More Exercise and Activity
At times, I dislike the phrase word exercise. I am more fond of asking people to be more active. Exercise conjures up images of gyms and running miles etc. What I am thinking about is getting more active. Yes, some strenuous exercise is always going to be of benefit to your overall health, but in many cases, being active and breaking a sweat is more than enough. I was speaking to a nurse last week who was trying to conceive but didn’t have time to exercise. Already one of her favourite pastimes is running up and down her staircase – as often as she can. With long hours and depleted energy after her shift, going to the gym or getting outside was unlikely. There was even a receipt for a set of ankle weights sent over to me. Simple things like this can make a big difference.
- Number 5 – Be mindful of your Stress Levels
Stress, reducing stress, stop being so worried etc. etc. I imagine that most of you are relatively fed up of being told this. I know I am when it comes to work – you need to relax more, take breaks and reduce stress. Well sometimes that just isn’t possible. For those of you in this boat, it is all about maximising efficiency. IF you have to work, you have to maximise the time you are in work and the times when you are not. Meditation (even for 5 minutes), Deep Breathing, a walk from away from the computer, reaching out to friends/ counsellors, laughing, music/ reading and darkness (providing you are ok with this) can all reduce stress which can be done at your desk or in the car. Where possible, take that break and unwind, even if it’s just a little – It will make a big difference!
A lot of these tips were used in our recent clinical study and go hand in hand with improving male and female fertility.
What vitamins/minerals are essential during pregnancy?
All of them! In modern times, we tend to focus on specific nutrients in an individual manner. However, this is not the way nutrition works or is designed i.e think about your food, several nutrients are contained within one food. We all know how important folic acid is to help protect from neural tube defects. For example Biotin, not a very popular nutrient for pregnancy, is involved in cell division, which is crucial during pregnancy. We recommend not focusing on a specific nutrient but make sure you are getting enough of them all.
I think most of us believe that we eat healthily, which might be true on the face of it, but are you getting substantial nutrition that is going to make a difference for you. The fact of the matter is, the food we eat today is refined and processed to have a longer shelf life and to be that bit sweeter – think brown rice and white rice for example.
According to a 1995 National Food Survey, nine out of 10 people are grossly deficient in the essential mineral Zinc, which outlined earlier is found in egg and sperm cells and itself is a potent antioxidant. This reduction in nutritional intake is because many foods are stripped in the process of being refined and because of depletion of the soil due to intensive farming (McCance and Widdowson 1940 & 1991). Wheat, for example, contains zinc, but 80 per cent is removed in the manufacture of bread to extend its shelf life. In Scotland in the 1940’s, the average sperm count was 113 million/ml. When re-examined in 1990, that value had dropped to 66 million/ml. In many cases infertility is the result of multi-factorial conditions, in both the female and the male, but nutrient intake has to be considered as a part of the problem and ultimately the solution.