By Dr Nikil Shetty & Dr Pramodha S
Mangaluru, Nov 17: Every woman dreams of becoming a mother at some point of her life. But for many couples, their chances of conceiving may be hindered by various biological and other factors, resulting in emotional and mental stress. Manipal Ankur is a joint venture between Ankur Healthcare Pvt Ltd and Manipal Hospitals that helps childless couples by assessing shortcomings and ensuring maximum chances of having a child through in-vitro fertilization and reproductive medicine. The following article sheds light on some of the major factors affecting conception, especially among women.
Following is a sequence of events necessary for conception
1. The man has to have a sufficient sperm count.
2. Intercourse must occur daily or alternate days from the 12th to the 18th day in a regular 28-30 day cycle.
3. The woman has to develop and expel an egg (ovum) from one of her ovaries.
4. The ovum has to travel through the fallopian tubes and go into the oviduct.
5. Millions of sperm must swim by wriggling and twisting through the secretions of the cervix into the uterus.
6. Hundreds of sperm have to survive the trip through the uterine cavity.
7. Tens of sperm have to get into the oviduct opening and, against the current, swim along it.
8. A single sperm has to get through the ovum's 'shell' and the head of the sperm has to fuse with the nucleus in the ovum.
9. The new fertilized cell has to form properly, dividing repeatedly in the five days it needs to reach the uterine cavity.
10. The egg has to implant itself in the uterine lining and grow.
Precautions to be taken for a successful and healthy pregnancy
Your overall health can have a significant impact on your fertility. Several things can impact the ability to conceive which are as follows.
1. Behavioral Factors
i) Smoking: Cigarette smoking may increase the risk of miscarriage, premature birth and low-birth-weight babies in women. In men, it may affect the sperm count.
ii) Alcohol: Alcohol intake can impact sperm counts in men. In women, it may contribute to an increased risk of babies born with birth defects.
iii) Caffeine: Caffeine may impact a woman's fertility and may increase the risk of miscarriage. However, there is no clear understanding of what amount affects fertility.
iv) Diet and exercise: Proper diet and exercise are important for optimal reproductive functioning. Women who are significantly overweight or underweight may have difficulty conceiving.
v) Lubricants: A number of products used for lubrication during intercourse, such as petroleum jelly or vaginal creams, have been shown to affect sperm quality and therefore it is advisable to avoid its use if you are trying to conceive.
2. Environmental Factors: Environmental and occupational exposure to chemicals or toxins may impact the ability to conceive. Exposure and use of the following chemicals and medicines should be avoided.
i) Ethylene Oxide: Exposure to ethylene oxide, a chemical used in the sterilization of surgical instruments and in the manufacturing of certain pesticides, may cause birth defects in early pregnancy. It also has the potential to cause early miscarriage.
ii) Medical Treatment: Repeated exposure to sources of radiation, such as x-rays and cancer treatments (e.g., chemotherapy), has been shown to affect sperm production and contribute to ovarian problems.
iii) Lead: Exposure to lead has been shown to impact fertility in humans. Individuals working with paints/varnishes and auto manufacturing may be at risk
3. Biological Factors: Following are the biological factors, which affect the fertility rate in women and men:
i) Blocked Fallopian Tubes: Blocked or damaged fallopian tubes may impact fertility by interfering with the egg and sperm uniting or with proper embryo development and implantation in the uterus.
ii) Endometriosis: This is a disease in which tissue from the uterus implants on the ovaries and other pelvic organs and may cause infertility.
iii) Abnormal Ovulation: About 40% of women who are infertile will suffer from ovulatory problems. Abnormal ovulation may be indicated by irregular or absent menstrual periods, which can be the result of a hormonal imbalance.
iv) Age is an important factor in the fertility of a couple. Levels decrease with age, especially in women.
v) Male infertility: Problems may be related to inadequate sperm count or abnormalities relating to size, shape and movement of sperm. About 30% to 50% of male infertility relates to the presence of a varicocele, or varicose veins within the scrotum, which affect sperm quality and quantity.
Is infertility a lifestyle disease?
Women who followed a combination of five or more lifestyle factors, including changing specific aspects of their diets, experienced more than 80 percent less relative risk of infertility due to ovulatory disorders compared to women who engaged in none of the factors.
The researchers followed a group of 17,544 married women who were participants in the Nurses’ Health Study II based at the Brigham and Women's Hospital. The team devised a scoring system on dietary and lifestyle factors that previous studies have found to predict ovulatory disorder infertility.
Among those factors were:
• The ratio of mono-unsaturated to trans fats in diet
• Protein consumption (derived from animals or vegetables)
• Carbohydrates consumption (including fiber intake and dietary glycemic index)
• Dairy consumption (low- and high-fat dairy)
• Iron consumption
• Multivitamin use
• Body mass index (BMI, weight in kilograms divided by the square of height in meters)
• Physical activity
The researchers assigned a “fertility diet” score of one to five points. The higher the score, the lower the risk of infertility associated with ovulatory disorders.
The women with the highest fertility diet scores ate less trans fat and sugar from carbohydrates, consumed more protein from vegetables than from animals, ate more fiber and iron, took more multivitamins, had a lower BMI, exercised for longer periods of time each day, and, surprisingly, consumed more high-fat dairy products and less low-fat dairy products. The relationship between a higher “fertility diet” score and lesser risk for infertility was similar for different subgroups of women regardless of age and whether or not they had been pregnant in the past.
In MARS "We analyzed what happens if you follow one, two, three, four, or more different factors. What we found was that, as women started following more of these recommendations, their risk of infertility dropped substantially for every one of the dietary and lifestyle strategies undertaken. In fact, we found a six fold difference in ovulatory infertility risk between women following five or more low-risk dietary and lifestyle habits and those following none."
Similar dietary advise is to be followed in men to improve their fertility chances and to improve their sperm defects.
About Manipal Ankur
Manipal Ankur is a fertility focused chain of hospitals delivering high quality services that ensures high pregnancy rates for patients in in-vitro fertilization and reproductive medicine. A part of Manipal Hospitals, Manipal Ankur has 12 centers across India offering state of the art technology and facility for fertility and sexual health.
The center provides services like Assisted Reproductive Techniques like IVF, IUI, ICSI; male infertility treatments like sperm extraction surgeries; men's sexual health services like treatment for erectile and ejaculatory disorders.
Manipal Ankur Mangalore has infrastructure at par with international standards with skilled expertise for comprehensive treatment in male and female infertility.
2nd Floor, Times Square Building,
Shivabagh Circle, Kadri, Mangaluru
Ph : 91-0824-2212755, 91-9731285599