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Reproductive Health and Fertility
Transcript of Reproductive Health and Fertility
Factors Affecting Fertility
What is Infertility?
Causes of Infertility
the woman not ovulating
the man not producing a sufficient amount of healthy sperm
•some barrier to the transport of sperm or ovum through the woman’s fallopian tube (e.g., scar tissue in the fallopian tubes)
Infertility is the malfunctioning of a man or a woman’s reproductive system. Male infertility is responsible for 40% of infertile couples and female infertility is responsible for 40%, 10% combined and 10% unexplained. It is estimated that 10-15% of couples are not able to conceive within one year of trying. However, the majority of couples do conceive whether or not they are treated for infertility.
i)Smoking: increases risk of spontaneous abortion, ectopic pregnancy, menstrual disorders, poor sperm quality
ii) Alcohol: reduces sperm quality in males, affects ability to achieve and/or maintain an erection
The following can result in low birth weight, still birth and birth defects:
•carbon monoxide in car exhaust
•lead and paint strippers
Preventative measures include:
•leaving the work area to eat
•avoiding noxious substances
•using gloves or washing hands
•narcotics (e.g., Percodan), tranquilizers (e.g., Valium), anti-depressants (e.g., Prozac) and anti-hypertensives (e.g., blood pressure medications) may cause erectile dysfunction in males
•other drugs may affect sperm production and/or ovulation
•some drugs may cause fetal defects (e.g., tetracycline, accutane treatment for acne, anti-coagulants, steroids)
•chemotherapy may affect sperm quality and ovulation and indirectly affect fertility due to nutritional status
•some herbs contain drug-like ingredients and can have harmful effects during pregnancy and while breastfeeding (e.g., can stimulate the uterus or cause uterine contractions, act as a diuretic, produce toxic effects in the developing baby, cause birth defects, infant deaths or be passed onto infant through breast milk and harm the baby)
Sexual Health History
multiple sexual partners increase the risk for STI’s (sexually transmitted infections), Pelvic Inflammatory Disease (PID) and cervical cancer
sexually transmitted infections (e.g., chlamydia, gonorrhea) and pelvic conditions if left untreated can cause conditions in both males and females which can impair fertility
can affect sperm quality, production and ovulation (e.g., failure to ovulate regularly, or irregular menstrual cycle, may be caused by problems with the hypothalamus and pituitary gland)
congenital factors may impede ability to conceive (e.g., born without uterus)
psychological stress (e.g., depression, difficulty sleeping, anxiety) and physiological stress (increased muscle tension, lack of energy, nervousness) affect libido
stress affects the ability to make healthy lifestyle choices (e.g., alcohol and other substance use, smoking, decrease in physical activity or sedentary living, poor nutrition) which in turn also affects fertility
eating disorders (eg. Anorexia) and diets that lead to low body fat affect menstrual cycle and fertility
Most birth defects occur 2-8 weeks after conception, often before a woman knows she is pregnant. Research now shows that an increased intake of folic acid (a B vitamin) by women before she becomes pregnant reduces the risk of birth defects called Neural Tube Defects (NTD’s). These are birth defects affecting the brain and spinal cord (e.g., Spina Bifida)
D. Issues Related to Infertility
depression (individual reactions and emotions)
conflict (resenting or blaming partner)
impact on sexual intimacy and enjoyment
the decision to have or not to have a child
financial strain (cost of treatment)
religious beliefs may be challenged
E. Options for Couples Experiencing Infertility
1) Get treatment
fertility drugs (increase number of eggs released)
In Vitro Fertilization (implanting an egg that was fertilized in a lab
Intrauterine Insemination (injecting healthy sperm into uterus)
Donor Gametes (using healthy eggs or sperm from a donor)
Surgery (to remove scar tissue or unblock tubes)
3) Surrogate motherhood (another female carries and gives birth to child)
4) Decide to remain childless
The inability to reproduce after having unprotected sexual intercourse over a 12 month duration.