Friday, February 13, 2009

Health Care and Fertility

For some couples fertility and getting pregnant are as easy as eating cake according to WebMD. For others, the world of reproductive technology becomes the only hope for conception. In between, however, are a growing number of couples playing the fertility "waiting game." Some may not yet be ready to turn to technology while others may have failed to discover their problem even in a high-tech arena. It is for this group that many physicians are now looking to the everyday factors that might make a difference. Among the most important of these outside factors, say doctors, is smoking. While most folks are aware that cigarettes and pregnancy don't mix, fertility experts say fewer seem to realize the impact that smoking has on fertility.

Recently, headlines were made by a single mother of 6 children who gave successful live birth to 8 children--Octuplets!! According to CNNHealth.com, the six boys and two girls -- ranging in weight from 1 pound 8 ounces to 3 pounds 4 ounces -- were generally doing well in incubators following their Caesarean-section delivery at Kaiser Permanente hospital in Bellflower, California. Three of the babies need breathing assistance, but otherwise the eight don't appear to have had serious problems. The infants could be in incubators for six to eight weeks and in the hospital for 10 weeks. Still, according to the Los Angeles Times, fertility experts consider the birth of more than two kids with fertility medication to be not a medical triumph, but “a serious complication.” Usually, births of this kind are brought on by fertility medication, not in-vitro fertilization. Often, during the medication, several of the mother’s eggs are fertilized. In most cases, the mother chooses to reduce the number of fertile eggs to two, “to make sure the two remaining babies will have the best chance at having good health. To have all those babies, the mother would choose to have selective reduction. Apparently the mother made the decision to carry all the eight babies to viability.” In 1998, the first known set of octuplets was born in the United States. The six girls and two boys were born in Houston. One of the babies later died. The others survived and recently celebrated their 10th birthdays.

According to Fox News, The odds of survival drop off dramatically in multiple births, particularly if there are more than three babies. The risks include breathing and eating difficulties and growth problems because their lungs and other systems are often underdeveloped. They also may have hearing or vision problems and learning disabilities as they mature. In fact, the risks in multiple births are so high that when a woman is pregnant with more than three babies, doctors routinely recommend "selective reduction," or aborting some of them.

However, this decision often crosses over from a medical decision to one based on moral or spiritual grounds, and opinions on this decision will widely vary. Those individuals who believe in life begins at conception would typically not pursue this type of action and commit to carrying all the babies to full term. Many in the medical community usually will not commit to a pro-life stand, but many times will stand on the side of pro-choice. Decisions to end life pre-term can be phrased often in clinical terms that eliminate the moral absolutes of life and death decisions. Another attitude about selective reduction is that it can be viewed as a way to control the population and thereby not strain the economy or the parent based on too many children that require care. Making this type of decision should be based on divine wisdom rather than human insight as does the decision to take fertility drugs and to practice safe sex or abstinence.

WebMD gives several reasons that affect fertility:

1.) Diet: While few folks connect diet to fertility, new research shows that very often those who are infertile are also lacking important nutrients in their diet. A group of Harvard researchers found that 79% of infertile couples had a lower-than-average intake of foods high in antioxidants -- like fruits and vegetables. The finding takes on even greater importance in light of previous research showing that both vitamins C and E may play roles in male fertility. In one study published in the Annals of the New York Academy of Medicine, doctors found that after one week of daily doses of 1,000 milligrams of vitamin C, sperm counts rose by some 140%. More recently, a study published in the Archives of Andrology showed the antioxidants vitamin E and selenium improved the ability of sperm to swim -- a skill necessary to reach the egg. Also, eating less fish (due to high mercury levels in some types of seafood) and cutting down on calories overall can give fertility a boost. Additional studies show certain nutrients and plants can offer a fertility boost to both men and women. In research published in the journal Reproductive Biomedicine Online, sperm quality and function improved with the intake of complementary food supplementation using either a combination of zinc and folic acid, the antioxidant Astacarox, or an energy-providing combination containing (actyl)-carnitine (Proxeed).

2.) Pesticides: While a number of factors can help boost fertility, there are some that can diminish your chances of conception. Among one of the most important is exposure to pesticides. Exposure to the manmade chemical methoxychlor (a member of the DDT family) reduced testosterone levels, which may, in turn, reduce male fertility. In a new study just released by Yale University, researchers found this same pesticide -- which is used to kill flies, mosquitoes, and other insects -- can also impair the function of a woman's reproductive system. The good news here--Taking steps to avoid exposure -- particularly in your home and yard -- may help improve your fertility profile overall.

3.) Sleep: Although the impact is not quite as direct, another factor that could impact fertility--Getting more sleep! The link here, say experts, is the hormone leptin, known for being an appetite and weight-regulation hormone. Researchers have found that it plays a critical role in female fertility. Leptin levels falls when we are sleep-deprived. Perhaps not coincidentally, researchers have now found that in some infertile women, leptin levels are low. Research shows that women are chronically sleep deprived are likely to have some irregular cycles -- and that in turn means ovulation is being affected, which can certainly reduce the chance for conception.

Medical News Today also reports that obesity in women can be a determining factor in fertility and pregnancy. Obese women have alterations in their ovaries which might be responsible for an egg's inability to make an embryo. The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM) indicates that obese women trying to become pregnant experience longer times to conception, even if they are young and have a regular menstrual cycle. Obese women have abnormally high levels of fats and inflammation in the fluid surrounding their eggs which can impact an egg's developmental potential. The fats might alter the very sensitive metabolism of the egg and such changes are known to be harmful to embryo formation. In addition, inflammation can damage cells and when this happens to eggs it can affect embryo survival.

According to the American Fertility Association, 7.3 million American women have difficulty conceiving a child. Young women may not be quite ready to have a baby now, but they should be seeking the answers to essential questions that may determine if they’ll be able to have a baby when they are ready. The best time to seek these answers? For women in their 20s, infertility prevention is often ignored until it’s too late. Most young women have been taught to do everything possible to keep from getting pregnant without thinking about the possibility of having children in the future. Exposure to certain STD’s and environmental toxins compromise fertility. There often comes a time when a woman should move from her OB/GYN to a fertility specialist. The challenge is that most young women will not attend a fertility conference or even visit a doctor’s office to ask important questions and have them answered.

Couples who have a history of fertility issues should seek professional guidance through licensed counselors and medical professionals. Becoming pregnant is a life-altering decision. Those couples who have difficulty in conceiving children should seek advice on several levels before committing to proceed with having a family. Both husband and wife need to weigh the consequences and costs to become pregnant. Fertility can be affected by several issues, and the desire to have children should be considered in conjunction with all of them.

Until next time. Let me know what you think.

1 comment:

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