• Reducing Your Risk of Infertility in Women

    About 10%-20% of couples in the US experience infertility. Although little can be done to prevent physiologic and genetic causes of infertility, it is estimated that 50%-75% of infertility cases can be prevented through changes in lifestyle.
    Women who are very thin as well as those who are substantially overweight may have fertility problems. Low body weight disrupts hormonal function and can cause anovulation (no ovulation) and amenorrhea (the absence of a menstrual period). Being overweight can also disrupt hormone levels and can lead to irregular menstrual cycles. Before attempting to change your weight, you should consult with your physician or a registered dietitian. These trained health professionals can help you determine what weight range is right for you and the best way to attain it. And if you do become pregnant, eating a healthful, balanced diet in the months before pregnancy can help to ensure that your baby is healthy, too.
    Chronic, heavy drinking negatively affects ovarian function and can lead to irregular menstrual cycles, loss of ovulation, and cessation of menstruation. Even moderate drinking (five or fewer drinks per week) has been associated with reduced rates of conception and increased risk of miscarriage. It is well documented that drinking alcohol during pregnancy increases the risk of birth defects.
    The more sexual partners you have, the greater your chances of contracting a sexually transmitted disease (STD). Many STDs produce few or no symptoms in women. They are often left untreated, which can lead to pelvic inflammatory disease and scarring of the fallopian tubes. Other STDs, such as human papillomavirus (HPV), can cause cells in the cervix to grow abnormally, necessitating treatments that can make the uterus less able to carry a fetus. Limiting your number of sexual partners and using a condom during intercourse can help to prevent the transmission of many STDs.
    Depression and high levels of stress hormones can affect ovarian function. Try to develop a system for managing stress and depression, either through regular exercise, yoga, or fulfilling leisure activities. To help reduce mental and emotional stress in your life, consider learning relaxation exercises, yoga or tai chi, or talking to a counselor about problems or stressful relationships in your life. Talk to your healthcare provider about which stress management options may be best for you and request a referral to a stress management program.
    Regular physical exams can identify hormonal abnormalities that could reduce your fertility. In addition, gynecological exams, including a pelvic exam and Pap smear , can help to identify any structural abnormalities that can influence fertility. These exams can also detect reproductive tract infections that, if left untreated, can lead to pelvic inflammatory disease and scarring of reproductive structures.

    When to Contact Your Healthcare Provider

    Contact your healthcare provider if you:
    • Are not sure if you need to gain or lose weight
    • Need help designing a healthy, balanced diet
    • Need help quitting smoking
    • Need help eliminating alcohol
    • Need help with depression or other mood disorders
    • Have pelvic pain or evidence of unusual discharge from your vagina

    References

    American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient%5Feducation/bp136.cfm . Accessed November 2009.

    American Society for Reproductive Medicine website. Available at: http://www.asrm.org/ .

    Reproductive Health Outlook (RHO) website. Available at: http://www.rho.org/ .

    RESOLVE: The National Infertility Association website. Available at: http://www.resolve.org/ .

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