Fertility Awareness Week Q&A – Part 3

National Fertility Awareness Week Day 3

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.

Questions can be sent privately via our contact form, by e-mail to info@pillarhealtcare.ie, or as a private message on our Facebook page or through our Twitter feed.

Answers will be posted here each day.

Today’s Questions and Answers are

I am overweight and trying to do more exercise. Will this extra weight have an impact on my fertility?

The journal ‘Human Reproduction’ published a study which followed 3,0292 couples having trouble conceiving after a year or more of trying. They found:

  • Women with a BMI of 35 were 26% less likely to naturally conceive on their own, compared to overweight to normal weight women
  • Women with a BMI of 40 or more were 46% less likely to conceive on their own
  • Obesity in men lowers testosterone levels. Chronic low levels of testosterone affect how the testes function

Another study, compiling data on 7,327 women in 2010 stated “Obesity was associated with reduced fecundity (fertility) for all subgroups of women and persisted for women with regular cycles.” It is well established that being overweight or obese will impact on your fertility, in both men and women significantly.

I am not very good at motivating myself to exercise. Is there a benchmark I should be aiming for?

The World Health Organisation states that adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week. For additional health benefits, aim for around 300 minutes per week (including weight loss).

For the specific fertility boosting angle, the same guidelines will apply. Personally, I believe that for the person who is looking at exercise to boost their fertility or the novice trainer shouldn’t let themselves get bogged down with complicated regimes and routines. Exercise is supposed to be fun.

What does adrenal fatigue really mean?

Chronic stress is a major culprit in women’s lives, contributing to ongoing cycles of fatigue, poor nutrition, waves of exhaustion, mood swings, and hormonal imbalance. When I ask my patients what they think is the reason for their symptoms, their answers have one common thread: too much responsibility that is impossible to manage. Trying to help themselves through each day, many women find themselves overloading on caffeine, sugary snacks, alcohol, and even sleep aids to manage stress, all of which can disrupt our body’s normal rhythms.

Research shows that when we experience chronic stress, our adrenal glands, or the tiny glands that moderate the stress response as well as regulate other hormones, will suffer. The adrenals, which are the size of walnuts, have an enormous job. They produce many hormones that regulate our body’s functioning, including cortisol, a hormone activated when our stress levels rise, signalling our body to enter a heightened state of emergency. But high cortisol levels are intended to be short term, not remain elevated. Since our adrenals do not know the difference between stressors, they can continue to work hard to do their jobs, whether we are stressed due to a true emergency or are simply stressed out.

When our cortisol levels stay elevated, it interferes with many functions in our body, including immune function, digestion, sleep, and even the ability to produce other essential hormones such as oestrogen, progesterone, testosterone, and thyroid hormones. This can lead to high blood pressure, high blood sugar, excess abdominal fat, and inflammation. In the meantime, our health is compromised, along with our moods, and even our sex drive.

When the adrenal glands continue to be compromised long term, they have a decreased ability to produce cortisol, and instead produce extra adrenaline, causing us to feel irritable, shaky, lightheaded, and anxious. Adrenal fatigue is a syndrome that can, over time, cause low blood pressure, allergies, and pure exhaustion.

These issues, although very concerning, can also be relieved when adrenal dysfunction is healed. And the good news is, it can be healed. Along with decreasing chronic stress, adjusting our emotional responses to stressors, and changing what, when and how we eat, we can reverse adrenal fatigue.

What is AMH?

AMH is produced by the granulosa cells in the follicles of an ovary. The major functions of granulosa cells include the production of sex steroids, as well as growth factors thought to interact with the oocyte (egg) during its development. AMH is produced during the follicular stage. Its production is highest during the preantral and antral stages. After this point, AMH levels decrease and eventually stops as the follicle continues to grow. Therefore, the levels are fairly constant and the AMH test can be done on any day of a woman’s cycle.

Doctors use this test to measure the amount of growing follicles in the ovaries. Women with low levels of AMH indicate low levels of follicles and produce lower levels of immature eggs.

It is very normal for an older woman to have a lower AMH level. Women with many small follicles, typical in women with PCOS, usually have higher levels of AMH. A test result of high AMH may indicate PCOS and is also used to determine excessive or poor response to ovarian hyperstimulation (hCG trigger shot/IVF preparation). Low levels of AMH in women under the age of 40 may also indicate Premature Ovarian Failure.

What is an antioxidant?

Found in many foods, antioxidants fight the oxidation process, a chemical reaction that can cause damage to many cells in your body. It’s much like the chemical reaction that creates rust on a bicycle or turns the surface of a cut apple brown. It can be accelerated by stress, cigarette smoking, other toxins and alcohol. When there are disruptions in the natural oxidation process, highly unstable and potentially damaging molecules called free radicals are created. These destructive little chemicals, if left uncontrolled, can cause damage to cells in the body.

Once formed, free radicals can start a chain of damaging chemical reactions. The biggest danger to the human body is their potential to react with cellular components like DNA or the cell membrane, causing cells to function poorly or die.

Free radicals are not only generated by the body, they are present in foods you eat as well as in the air you breathe. Some even come through exposure to sunlight that can harm the eyes and the skin. Oxidative stress occurs when the production of free radicals goes beyond the protective defences in the body. Oxidative stress and free radical damage to cells may initiate the early stages of disease and infertility. The human body is not without its own defences against this damage. It creates many different types of molecules —  antioxidants — to combat these free radicals and protect the cells from attack.

Antioxidants can safely interact with free radicals and stop the chain of damaging reactions before damage is done to cells. There are several enzyme systems in the body that scavenge free radicals, but we can also gain these helpful molecules from foods that we eat. Some vitamins are antioxidants, such as vitamins C and E. Some minerals are antioxidants, such as selenium and manganese, and there are plant compounds that act as antioxidants such as beta carotene and lycopene, terms you may have heard before or seen in ads for vitamin supplements.