I cannot end this topic without mentioning the role of lifestyle choices and female infertility. There is suspicion that the incidence of infertility is increasing and since there are many things that can affect fertility that we have control over- such as lifestyle choices of smoking, drinking alcohol or caffeine, food ingestion and weight gain, sexual practices and so forth. It is important to examine how much effect these things can have on future fertility. Many women are unaware as to how important these lifestyle choices can be with regard to future attempts to conceive.

There are certain lifestyle habits that can be put in perspective as to see how they affect fertility. Like I have stated previously, obesity has a strong association with infertility and menstrual irregularities. While some of the ovulation problems and menstrual changes are explainable by women with PCOS who are also obese, women who do not have PCOS but are overweight also have the same problems, as little as a weight loss of 6.5 kg has been shown to restore ovulation. We equally know that an improvement in insulin resistance has more to do with restoring ovulation than the actual amount of weight or weight loss itself.

I would also like to address the concerns of women who wish to put off having children until they have attained a certain career level. It is quite common for women to pursue educational and career opportunities and put off childbearing into late 30,s and early 40’s. Aging, however, brings with it many effects that will decrease fertility.

As for those who smoke, I have a word of caution. Almost all available studies show that smoking decreases fertility. Smoking causes decreased estrogens with breakthrough bleeding and shortened luteal phases. Smokers have an earlier than normal (by about one and half to three years) menopause which suggests that there is some toxic effect of smoking on the follicles of the ovary directly. There is actually some effect on t tubal motility because smoking is associated with an increased incidence of ectopic pregnancy as well as an increased spontaneous abortion rate.

I cannot forget to talk about alcohol which I expect you know is not good during pregnancy. As for its use while trying to conceive, the total effect of alcohol on fertility is not as well established as with cigarettes and other substance abuse. In one survey, women with high alcohol use reported more menstrual problems and gynecologic surgery. It has been shown to alter estrogen and progesterone levels as well as cause anovulation. Most chronic alcoholics become amenorrhea (irregular menses).

While the effects of alcohol on fertility are real, it is not clear how much must be consumed to affect fertility, or conversely, how much consumption is safe. In pregnancy, we know than an average of two drinks per day or more, or binge drinking of five or more drinks at a time can produce fetal alcohol syndrome with birth defects. Many reports show that increased caffeine consumption affects the ability to become pregnant and carry the pregnancy. Data suggests an increased rate of spontaneous abortions with increased caffeine us, but how much is too much? I’d say consumption of three or more cups of coffee per day (greater than 300mg caffeine) leads to fertility problems.

Before I sign off, I wish to mention the role of infection with a sexually transmitted disease and infertility. Tubal factor infertility accounts for about 25-50 percent of produce most of this. As many as 40 percent of untreated Chlamydia cervical infections, ascend into the tubes and pelvis causing PID (pelvic inflammatory disease). If a woman has PID, she has a 20 percent chance of being infertile. The biggest problem with the effect of PID on fertility is that it is most often contracted at a time when very little thought is being  given to the future ability to become pregnant.

Seeking Professional Help
Pregnancy brings an urgent need address weight problems or poor eating habits. This includes under- eating as well as compulsive over-eating and addictions. If your problem is due to an eating disorder you are likely to receive the help you need if your medical professional know about the problem you have. For most women it is very difficult if not impossible to resolve eating difficulties without professional help and there is no reason why you should feel obliged to sort out these issues alone. Help is out there to assist you during this time. It is important to note that a light weight gain is unlikely to place your health and the health of your baby in danger especially if you are eating well-balanced diet that would provide all the nourishment you need. If you are unsure about your weight, all you need to do is seek the right assistance from a professional.

Remember a stitch in time saves nine.