It fascinates me that we seem to know more about what influences reproductive success in laboratory animals then we do in human beings…
No doubt this is because as complex creatures we humans gather an accumulative response to our modern lifestyle, which is therefore much harder to monitor and measure then the life of laboratory mouse — exposed to one stream of pollutants or one type of hormone.
Like many health issues there are some common drivers for infertility such as obesity, stress, toxic lifestyle and poor diet and there are countless other modifiable factors that I will briefly outline such personal care products to occasional cocaine use. Iencourage couples to investigate these points further. In the next post Good Health Prior To Conception I will highlight other important tips relating to pre-conceptive health.
An important explanation is needed before we embark on looking at how fertility can be influenced with regards to insulin. This may seem a little technical but it is important we understand the relevance of insulin…
Every cell in the body uses sugar. In particular, the body uses the sugar glucose as a source of energy. Glucose cannot flow freely into cells it needs a hormone insulin, made by the pancreas to do so. The pancreas makes insulin when sugar levels go beyond a safe controlled level. If the pancreas fails to produce insulin, or if muscles are resistant to insulin, then sugar builds up in the bloodstream. This health challenge is know as Type 2 Diabetes.
As far as fertility is concerned, the more insulin in the blood stream, the greater the depression in the production of sex hormone binding globulin which influences the body’s production and regulation of hormones and has unwanted effects on reproduction.
Sex hormone binding globulin escort sex hormones (such as oestrogen and testosterone) around the body quite literally making sure these they don’t misbehave (like horny teenagers) fluctuating at the wrong time for example. Specifically when sex hormone binding globulin decreases we have more “free testosterone” in the body which also creates a number of issues.
You will notice below many of the modifiable lifestyle factors create havoc with insulin and therefore hormones.
Here are some major modifiable lifestyle points to consider…
1. Get Your Weight On Track
Having an abnormal body mass index (BMI is the individual’s body weight divided by the square of their height) — including being underweight or overweight — can affect fertility in both males and females.
When we are underweight a hormone know as leptin is reduced. Leptin is important in regulating all functions that the body needs fat for including ovulation. With low levels of leptin the body naturally panics and shuts down many important bodily processes and literally turns down reproduction. Yet when we are overweight adiponectin (a protein released by fat cells that assists in burning up of fat) decreases.
Adiponectin would normally help to make the body more sensitive to insulin (which enhances ovulation). Without sufficient adiponectin, over-weight people become resistant to insulin.
There is ample evidence that female fertility is decreased by women being overweight or obese, which adversely affects hormone patterns and the menstrual cycle. Being overweight worsens all clinical features of polycystic ovary syndrome (PCOS). Obese women are also known to take longer to conceive, they have a (2 to 3 fold) increased rate of miscarriage and obesity is also known to impair Assisted Reproductive Therapy. 1
Being overweight or obese for males may cause subtle damage to sperm and in doing prevent healthy pregnancy some research suggests that fertilization was 40% less likely to succeed when the father was overweight. 2
2. Regularly Stressed?
Chronic stress is a driver for many chronic illnesses including fertility challenges. There is universal recognition that increased stress levels or chronic stress is associated with decreased sperm concentration, count and mobility3 and in female’s menstrual irregularities, prevents ovulation, implantation, adverse effects on fetal immunity and programming.4
3. Chemical Exposure at Work
Chemical exposure in the work place is broad. Links have been made between chemicals used by hairdressers who colour hair, with PCE in the dry cleaning industry and toluene in the printing business.
Males and females exposed to chemicals used with farming such chlorinated hydrocarbons e.g., DDT, PCB, pentachlorophenol, hexachlorocyclohexane methoxychlor and vinclozin have been associated with an increase in rates of miscarriage and endometriosis.5
Abnormalities in sperm production have also been found with trades-people exposed to heavy metals including electrical and electronic technicians, metal fitters, machinists, metal tradesmen, building and vehicle tradesmen and miscellaneous tradesmen, have conferred an increased risk of miscarriage. 6
Also those exposed to radiant heat, radiation, and exposure to glues, oil paints and oven cleaners have proved hazardous. Naturopaths can help arrange different tests such as urine, blood tests and hair analysis to see if heavy metal exposure or nutrient deficiency’s (due to toxicity) are a concern.
4. Look For Exposure to Toxins in Your Home
The endocrine system and the hormones it releases influence every function in our body — the glands of this system regulate mood, growth and development, metabolism, sexual function and reproductive processes. Hormone disruptors or endocrine disrupting chemicals (EDCs) found in our environment are quickly becoming known as ‘gender-benders’ as they mimic oestrogen and other important chemicals that help run our bodies. 7
There are many chemicals, which create oestrogenic activity in the body. These are chemicals that we use everyday, present in household cleaning products, body care products, furniture and building materials, and even in the food we eat.
Biting into a piece of fruit that has been treated with endosulfan, an organochloride pesticide, will give you an unintended dose of hormone disruptors otherwise known as endocrine disrupting chemicals (EDCs). These EDCs mimic oestrogen and other hormones and potentially disrupt the chain of hormone release necessary for ovulation, fertilisation, and implantation of the embryo. This is one reason an organic diet (even partial) is so imperative.
Personal Care Products
Hormone disruptors are found in many personal care products. It is not only women who utilise potentially harmful personal care products. Today’s ‘metro-males’ pride themselves on their grooming, using products such as deodorants, shaving foams, aftershave creams and hair fudges and gels.
Aluminum mimics oestrogen and has been shown to be able to penetrate through the skin and into the body. Phthalates—found in deodorants, hairsprays, fragrances, nail polish, etc. Household cleaning products, vinyl flooring, food packaging and plastic bags all contain phthalates. Research shows phthalates may impair the development of reproductive organs of babies in utero. 8
An expert panel at the European Food Safety Authority (EFSA) concluded that an acceptable daily intake of propyl pareban, a commonly used preservative in many baby products, could not be established as recent research questioned its impact on sperm production in rats. Propyl paraben is still widely used in many type of consumer products and surprisingly, in baby care products. 9
You can test your families’ personal care products at www.cosmeticsdatabase.com
Women also need to consider the types tampons and pads they use. Most brands contain hundreds of chemicals, plastics, synthetic materials, chlorine bleaches and dyes — possibly azo dyes, which use heavy metals in their production process leaving the potential for heavy metal residue. While a plastic polypropylene is melted over tampons to form a seal over the inner core of rayon fibres resulting a potentially toxic synthetic being in direct contact with the highly permeable vagina and cervix.
5. Time Focus on Wholesome Foods and Detox
There are many foods that are rich in the vitamins and minerals essential for conception. The whole B vitamin family for example are important not only for libido but making sex hormones and producing eggs and sperm. We also need zinc to make sex hormones and ovum, and for a healthy thyroid (25% female infertility relates to thyroid dysfunction). There are indeed specific nutrients we need to aid fertility and I will outline which foods are rich in these nutrients in another post Foods for Fertility.
We have also discussed how more insulin in the blood stream appears to depress the body’s production and regulation of hormones, which can have unwanted effects on fertility. In Foods for Fertility I will outline how low fat foods, refined carbohydrates and trans fats and instead focus on good fats. Our bodies thrive on ‘good fats’ — the mono and polyunsaturated fats — which are important for healthy reproduction as they improve insulin sensitivity (help control blood sugar levels), cool the body’s inflammation, and enhance healthy ovulation.
Importantly, when we are spending money on high quality foods and vitamin supplements it is imperative that we have good digestive health. To be able to properly digest foods and assimilate nutrients we need to have strong digestive health. Detox programs help to remove toxins and bad bacteria that have built up through dietary and lifestyle habits helping to renew digestive lining and healthy bacteria, which can help to rapidly improve health. Consider how long it has been since you last did a detox? There are many varied Detox programs available and your health practitioner can guide you on these.
6. Micro-Nutritional Deficiencies
While I am a big fan of sourcing nutrition through Real Foods there are certain times I believe we need to also address micro-deficiencies through herbs and vitamin supplements. Micro-nutritional deficiencies can result from many things including stress, smoking, other toxins, poor diet, some prescriptive medications and the contraceptive pill.
Micro-nutrient deficiencies are appreciated as contributors to poor pregnancy outcomes.10 It is now known that certain foods can block the absorption of important vitamins and minerals and when our diets become heavily reliant on “only a few types” of foods, deficiencies can develop. For example, vegetarian diets typically high in unrefined grains (which are a much healthier option then refined grains) and legumes contain phylates, which impact iron and zinc absorption. Others may have a diet that is too reliant on animal protein that may create similar micro-nutrient deficiencies.
Fertility Challenges (Chapter 2 of Well Adjusted Babies) outlines how the contraceptive pill is both very effective and popular but with time alters the body’s ability to uptake and utilise a number of vitamins and minerals. It is estimated that on average it takes 6 months for the body to replenish itself after long-term use of the pill. 11
A naturopath can help arrange appropriate tests for nutrient deficiencies. Naturopathic liquid herbs or Chinese Medicine herbs are extremely therapeutic and help to renourish the body.
7. Consider the Impact of Oxidative Stress — Coffee, Smoking, Moderate Alcohol, Stress
People often tire of hearing about the dangers of toxins. When it comes to appreciating how lifestyle habits affect fertility however often we more open to appreciating the process involved. Here I would like to explain one explanation for why some couples are able to conceive but frequently miscarry…
During times of illness or environmental stress created via pollution, radiation, smoking, drug use and other toxins the body cumulates oxidative stress. This may result in significant damage to cell structures. Damage the sperm’s cell membrane and sperm DNA, leading to single or double strand breaks referred to as DNA fragmentation. If DNA fragmentation is left unrepaired it can render the sperm malformed, immobile or both. Defective sperm unfortunately can also cause miscarriage. 12
For women, oxidative stress impairs follicles and ovaries, decreases fertilisation and the likelihood of implantation and increases the chance of miscarriage. Please consider the following toxins know to increase oxidative stress…
- Alcohol — Moderate alcohol intake (1 to 5 drinks per week) has been shown to increase the risk of fertility problems and miscarriage in women and create DNA fragmentation, testicular atrophy, impotence, reduced libido and decreased sperm count in men.13
- Smoking — harms sexual and reproductive health in both men and women and its damaging effects are seen throughout reproductive life. There is conclusive evidence that smoking creates sperm damage for males, primary and secondary infertility, and placental complications. There are 4,000 chemicals in cigarette smoke, including 43 carcinogens, and 300 polyaromatic hydrocarbons that can destroy follicles in the ovary, reduce fertility, and trigger early menopause. A recent study of smokers showed smokers have 1.6 greater risk of being infertile compared to non-smokers.14
- Caffeine — the verdict on whether caffeine influences fertility is slim however high levels of caffeine intake (>500 mg per day; approximately >5 cups per day) has been shown to potentially increase time to pregnancy. 15 Drinking coffee has been shown to have some health benefits. With this I am not referring to caffeinated soft drinks (which create all sorts of health issues) and it is also important to note that the downside to drinking coffee is that we become addicted to the milk and sugar (not to mention the caramel flavourings, whipped cream and other extras) many of us add to make our favourite beverage. These additions of fats and sugars are the more the problem then the coffee itself. Keep your coffee simple and if you add milk, use full fat (please see Real Foods) and if you add sugar, use sugars in their natural form — such as coconut sugar or raw sugar.
- Party drugs and illegal drugs — Heroin can cause a disturbance in a woman’s menstrual cycle, and therefore affect her fertility and can cause impotence in men. The use of cocaine in men, can lead to a low sperm count and longer-term use of can result in lower sperm motility, as well. One report stated that men with sperm counts less than 20 million/ml were two times more likely to have used cocaine within the past two years than men who had not used cocaine. For women, cocaine—like heroin—can affect the menstrual cycle and also lead to abnormalities in the fallopian tubes creating fertility issues. Marijuana can result in more sporadic ovulation making it extremely difficult for a woman to conceive and for men marijuana may cause a low sperm count.16
- Illegal steroids — can also affect fertility. For men, steroids can reduce the specific hormones that help with sperm production and have been known to cause impotence. In women, steroids can lead to annovulation, in which the woman does not ovulate at all, making pregnancy impossible.17
You may also be interested in these resources:
- Listen to my interview on fertility with The Wellness Guys
- Refer to the “Fertility Challenges” eBook for more information.
. . . . .
Dr Jennifer Barham-Floreani
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2 Homan G, et al. The impact of lifestyle factors on reproductive performance in the general population and those undergoing fertility treatment: a review. Hum Reprod Update 2007;13(3):209-233.
3 Y Li, H Lin, J Cao. Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses Fertil Steril. 2010 Jul 30. [Epub ahead of print]4 Kalantaridou SN, et al. Corticotropin-releaseing hormone, stress and human reproduction: an update. J Reprod Immunol. 2010 May;85(1):33-9 5 Oliva A, et al. Contribution of environmental factors to the risk of male infertility. Hum Reprod 2001;16(8):1768-1776.
Swan S, et al. Semen quality in relation to biomarkers of pesticide exposure. Environ Health Perspect 2003;111(12):1478-1484.
Abell A, et al. High sperm density among members of organic farmers’ association. Lancet 1994;343:1498.
National Children’s Study Workshop Expanding Methodologies for Capturing Day-Specific Probabilities of Conception May 17–18, 2004 Led by a consortium of federal agency partners: the U.S. Department of Health and Human Services (including the National Institute of Child Health and Human Development [NICHD] and the National Institute of Environmental Health Sciences [NIEHS], two parts of the National Institutes of Health, and the Centers for Disease Control and Prevention [CDC]) and the U.S. Environmental Protection Agency (EPA).
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S Tas, R Lauwerys and D Lison: Occupational hazards for the male reproductive system. Critic Rev Toxicol 26, 261–307 (1996)
7,8 Oliva A, et al. Contribution of environmental factors to the risk of male infertility. Hum Reprod 2001;16(8):1768-1776.
Sharpe RM, Irvine DS. How strong is the evidence of a link between environmental chemicals and adverse effects on human reproductive health? BMJ 2004; 328(7437):447-51
9 Chemicals in Many Cosmetics Detrimental to Your Unborn Son. Environmental Health Perspectives May 27, 2005 Cited in http://articles.mercola.com/sites/articles/archive/2005/07/02/cosmetic chemicals.aspx10 Keen C et al.The Plausibility of Micronutrient De?ciencies Being a Signi?cant Contributing Factor to the Occurrence of Pregnancy Complications. 2003 American Society for Nutritional Sciences)
11 L Chasan-Taber, WC Willett et al. Oral Contraceptives and Ovulatory Causes of Delayed Fertility. Am J Epid.1997.Vol 146, No 3. 12 Agarwal A, Sekhon LH. The role of antioxidant therapy in the treatment of male infertility. Hum Fertil (Camb). 2010 Dec;13(4):217-2513 Anderson K, et al. Lifestyle factors in people seeking infertility treatment- A review. Aust & NZ J Obstet Gynaecol.2010 Feb; 50(1);8-20. 14 British Medical Association Smoking and reproductive life: The impact of smoking on sexual, reproductive and child health Feb 200415 Bolumar F, et al. Caffeine intake and delayed conception: a European multicenter study on infertility and subfecundity. Am J Epidemiol 1997;145:324–334.
16 Fronczak CM, Kim ED, Barqawi AB. The Insults of Illicit Drug Use on Male Fertility. Published-Ahead-of-Print on July 28, 2011 by Journal of Andrology.
Bracken MB, Eskenazi B, Sachse K, McSharry JE, Hellenbrand K, Leo-Summers L. Association of cocaine use with sperm concentration, motility, and morphology. Fertil Steril. 1990;53:315-322.
Saso L. Effects of drug abuse on sexual response. Ann Ist Super Sanita. 2002;38(3):289-96.
17 Mueller BA, Daling JR, Weiss NS, Moore DE. Recreational drug use and the risk of primary infertility. Epidemiology. 1990 May;1(3):195-200.