Connection Between Your Life Style and Fertility
Do you know that your life style can also affect your fertility? The two major factors associated with fertility are exercise and your body weight.
Too low or too much over weight can affect fertility. Too low body weight indicates low on protein synthesis in the body. Most, hormones, and the releasing factors associated with reproduction are proteins. Decrease in weight leads to decrease in protein hormones, and hence the reproductive activity is reduced. Both testis in male and ovaries in the female are affected.
These reproductive hormones, gonadotropin releasing hormone (GnRH), are produced in the part of the brain called the hypothalamus. The pulsatile release of GnRH leads to the release of the hormonal messengers LH and FSH (the gonadotropins) by the pituitary gland. A delicate balance between FSH an LH ensures oogenesis and spermatogenesis and in turn, the gonadal hormones (Both testis and Ovaries) regulate accessory sex organs, uterus in female and accessory glands of reproduction. FSH and LH are critical for reproductive activity, as they synchronize the various activities of al reproductive organs. Any deficiency in protein hormone will result in infertility.
In some cases, the ovaries might be producing and releasing eggs, but the lining of the uterus is not ready to receive embryos because of the insufficient ovarian hormone. In severe cases of hormone deficiency, the menstrual cycles become irregular or may stop completely.
In men, low weight or weight loss may lead to decreased sperm function or sperm count. If low weight or weight loss has been identified as the cause of one’s infertility, the preferred treatment would be to stop losing weight or even to gain weight if needed. An alternative treatment is the use of medications.
Being overweight can also affect the hormonal signals to the gonads. Increased weight also increase insulin levels in women, which may cause diabetes due to insulin resistance and increased level of insulin will interfere with FSH and LH activity.
Natural weight loss is better but if needed, or we can use drugs like clomiphene citrate or gonadotropins to restore ovarian function. Proper exercise and diet are important for maintaining good health and proper weight.
Excess of exercise also leads to oligospermia in male and anovulatory cycles in the female. Most wrestlers are infertile.
Egg Donation-Reversing the Biological Clock
Egg quality has remained one of the major determinants of successful IVF. Egg quality and numbers diminish over the age of 35 and significantly declines over the age of 39, decreasing the chances of success in IVF cycles.
Egg donation greatly increases the chances of pregnancy. In egg donation IVF, the donor of eggs may be retrieved from another female, whether, related or unrelated. The donor eggs are fertilized with sperms from the male and the embryo formed is transferred to the uterus of the wife.
Some problems associated with egg donation:
Ovarian Hyperstimulation (OHSS)
During IVF or IVF egg donation, some females show hyperstimulation syndrome specially so in females with the Polycystic ovarian syndrome. When severe, it is serious and may need hospitalization and in other cases, it may be transient and lasting a week. Occasionally, drawing fluid out of the chest or abdominal final cavity helps. It’s better not to give HCG at the end of an hyper stimulated stimulation cycle to induce the ovulation.
Up to 20% of pregnancies resulting from IVF treatment are twins or triplets. Such multiple pregnancies are associated with increased risk of abortion, premature delivery, infant abnormalities due to incomplete development of respiratory system: consequences of very premature delivery, pregnancy induced hypertension, haemorrhage, and other significant maternal complications.
Ectopic (Tubal) Pregnancies
Ectopic pregnancies sometimes happen but their percentage is slightly more in IVF cycles, and have to be treated surgically.
The rate of birth defects after IVF treatment is as normal as in normal pregnancy. More over the children grow up absolutely normal. The studies have been carried out for up to 25 years of age.
Adnexal Torsion (Ovarian Twisting)
Less than 1% of the time, the stimulated ovary can twist on itself cutting off its own blood supply. Surgery is required to untwist or even remove the ovary.
Gonadotropins and Ovarian Cancer
Ovarian Stimulation during IVF cycle may be associated with ovarian cancer later in life. The number of times a woman is stimulated may increase the risk of ovarian cancer. Controversial data exists that associates ovulation stimulation drugs like gonadotropins with the risk of future ovarian cancer This issue is still unclear and to clarify it, the research is under process to make sure that the usage of gonadotropins is still reasonable or not? Concerning that pregnancy and breast feeding reduces the cancer risk. Stimulation 3-4 times may not pose any risk of ovarian cancer.
Intracytoplasmic Sperm Injection
Intracytoplasmic Sperm Injection is a procedure in which a single sperm is directly injected in to the freshly ovulated eggs to make an embryo in the laboratory during an IVF cycle. This helps male patients with oligospermia or sometimes azoospermia where the sperms are retrieved from testis or epididymis.
This Procedure can be Used for a Variety of Male Infertility Cases:
- Complete absence of sperms in the ejaculate (Azoospermia)
- Sperm count is very low ( Oligospermia)
- They may have poor motility (asthenospermia)
- Increased percentage of abnormal shapes and forms (teratospermia)
- Sperms cannot bind or penetrate the egg membrane.
- Ratio of dead or alive sperms is poor.
- Antibodies against sperms.
Absence of sperm due to blockage or abnormality of the ejaculatory ducts that do not allow sperm to move from the testes in to the ejaculate. In such cases the sperms can be obtained in the following ways for ICSI:
- PESA: Percutaneous Epididymal Sperm Aspiration (no incision required).
- MESA:Microsurgical Epididymal Sperm Aspiration.
- TESA: Testicular Sperm Aspiration. This includes testicular fine needle aspiration (TFNA).
- TESE:Testicular Sperm Extraction. Microdissection TESE.
- Perc biopsy: Percutaneous Biopsy of the Testis.
Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.