Myths and Facts about fertility debunked
Does male and female fertility decline with age?
There is a common myth that female fertility declines only after 40 years of age. Women are born with few million eggs. These remain dormant until the female reaches adolescence or puberty. Ever since puberty, there is a slow and steady loss of these dormant eggs and only 400,000 – 500,000 follicles remain.
The process of decrease in quality and quantity of eggs carries at a slower pace ever since puberty, but gathers pace around the age of 35 years and then declines even more rapidly in 40’s. Women are most fertile in their 20’s and almost one in four will achieve successful pregnancy each month when trying to conceive. This period is rightly called the ‘Golden period of female fertility’. However, for someone in early 40’s, this chance of getting pregnant drops significantly and only 1 in every 20 women will achieve a pregnancy. This drops to almost negligible in women in mid-forties onwards.
Regarding male fertility, it is now believed that age does matter; although maybe not to the same extent as it affects female fertility. Also, the effect is not as drastic and noticeable until the man is in his 60’s.
Older men do experience changes in male fertility and sexual functioning. As men get older, they may notice that the testes tend to get smaller and softer. They may develop medical conditions, where either the condition itself or its treatment may affect the male fertility and sexual function (such as decreased libido, erectile dysfunction, etc.).
Studies have shown some effects of advanced paternal age on male fertility and reproductive outcomes, such as low sperm count, low motility or low morphology, epigenetic changes, and DNA mutations. These effects alone or in combination can lower male fertility. It has been reported that children fathered by men at later age may have higher incidence of autism, schizophrenia, bipolar disorders, certain hereditary birth defects, childhood leukemia etc.
Can certain foods boost fertility?
Whilst there are myths that eating yam increases the chances of multiple pregnancy and eating soy reduces male fertility, none of these are evidence based.
What we understand is that eating healthy balanced diet maintains both male and female fertility. A healthy diet that offers balanced intake of macro-nutrients, micro-nutrients, minerals, trace elements and antioxidants will maintain natural fertility for men and women.
It is important that you have balanced diet that provides for the daily recommended intake not only carbohydrates, protein, fats; but also vitamins, trace elements such as zinc, selenium, manganese, phosphorus, etc.
It is important that both men and women avoid high intake of salt, sugar and fats. You can choose organic fruits, vegetable, fish and meat products for consumption to avoid exposure to chemicals such as pesticides.
Does weight affect fertility?
There has been global rise in obesity. Women with BMI of over 27kg/M2 are three times more likely to experience irregular or infrequent ovulation.
The fatty tissue (technically adipose tissue) disturbs the female hormone system through special chemicals that create a hormonal imbalance both in the ovary and through the regulatory system in the brain. This changed hormonal environment prevents proper development of the follicle and ovulation each month. It is also thought that this may make the womb lining less receptive to the embryo.
This can affect women’s chances of getting pregnant when trying to conceive. When thinking of natural female fertility, even a loss of 5% of the current weight can regulate your ovulation. This will restore your chances of getting pregnant. On the other hand women with very low BMI of less than 19kg/m2 may also see adverse effect on their fertility. Very low body fat content can affect ovulation and reduce the chances of getting pregnant.
Male fertility can also be affected by high BMI. In men it is thought that this results in rise in scrotal temperature. This will damage the sperms and lead to low sperm count, movement or shape. Overall this may affect their partner’s chances of getting pregnant. Like age, it appears that the effect may not be as much as seen in women. But, to maintain male fertility it is important that you maintain BMI in the recommended rage.
Does stress affect fertility?
It has long been thought that stress may affect fertility. Whilst it is not conclusive, but studies show that couples with higher stress may take longer to conceive.
Chronic high levels of stress hormone may affect reproduction and affect the chances of getting pregnant. It is therefore important to reduce stress levels or develop better coping strategies to minimise the effect of stress on health and fertility.
This may involve pursuing hobby, regular exercise, relaxation techniques (mindfulness, meditation, etc.) or even seeking professional counselling (if appropriate).
Can I stop smoking when pregnant?/ Does smoking affects fertility?
It is well known that smoking over prolonged periods of time or heavy smoking even for short period can affect both male and female fertility.
In women it can damage the ovarian reserve and affect female fertility. It may also lead to higher risk of miscarriage.
Smoking in pregnancy can affect the growth of the baby and can result in preterm or premature birth.
In men smoking can affect the sperm health. Some of the effects of smoking can be reversed in 3-6 months, but it depends on duration of smoking. In heavy smokers some of these effects may not reversible even after giving up smoking. Hence, it is recommend to stop smoking when trying to conceive and to maintain optimum natural male and female fertility.
It is best to give up smoking completely, but this may be difficult for some. In such a situation, one can try e-cigarettes which may not be as harmful. E-cigarettes still contain nicotine and excessive consumption may still be harmful.
Does alcohol affect fertility?
Excessive alcohol consumption or binge drinking can affect both male and female fertility. It disrupts the female reproduction hormones and can give rise to irregular or absence of menstrual periods.
Based on your alcohol consumption, it can also affect the growth and development of fetus and in rare cases lead to fetal alcohol syndrome.
Also, continued consumption of alcohol in pregnancy can increase the chances of miscarriage. In men it can affect the sperms too. Therefore, like smoking ideally one should consider giving up alcohol or restrict consumption to few units a week. Women are advised to restrict alcohol intake to 1-2 units a week. Men are recommended to restrict to 2-3 units daily.
Can I continue with usual caffeine intake?
As with alcohol, smoking, excessive consumption of caffeine (from tea, coffee or cola) may affect your fertility. Some studies have associated this with higher risk of miscarriage. These effects are not seen with low levels of consumption. Hence it is recommended to consume caffeinated drinks in moderation.
Do common chemicals in environment affect fertility?
There are both persistent and non-persistent chemicals in our environment. Some of these can affect the delicate hormone systems in the human body and are called endocrine disrupting chemicals (EDC).
These chemicals can disrupt. Bisphenol A and Phthalates are two commonly chemicals that are widely prevalent in our day to day environment in many consumer goods such as water bottles, eye glasses frames, dental sealants, thermal receipts, flooring, reusable food and drink containers, CDs, impact-resistant safety equipment, liner in food cans and water supply pipes.
BPA can leach into the food products and water. But, the large proportion of our exposure is through the food and drinks.
Despite the vast amount of evidence, it is difficult either to prevent or reliably measure the exposure to these chemicals. However, one should try and reduce the level of exposure to these agents by choosing foods such as organic food products, avoiding tinned food, deep sea fish, ready to eat meals that may contain additives or processed foods as much possible.
Can use of cell phones and laptop affect fertility?
The evidence is still developing about the effects of many day to day gadgets on human health. Some studies have indicated that few hours of laptop use can raise the temperature of the body tissues in vicinity by a few degrees. The testicular temperature is generally two degrees lower than the rest of the body temperature. Hence even a little rise of temperature over prolonged periods of time can affect male fertility. It may be wise to place your laptop on the table or use a cushion or foam pad to avoid any potential harmful effect on fertility.
Similarly, we do not understand the effect of the electromagnetic radiation being emitted from the cell phones. But, it may be wise for men to keep cell phones outside pockets or off the belt. Currently, there is scanty evidence about the use of wireless technologies or virtual reality devices on fertility.
London IVF and Genetic Centre provide fertility tests for women, men and couples who are looking for clarification and insight into their current fertility strength.