Prevention Of Infertility

Dr. Hrishikesh Pai,
Gynaecologist & Infertility specialist
A-791,
Bandra Reclamation, Bandra (W)
Mumbai - 400050

Infertility primarily refers to the biological inability of a person to contribute to conception. The couple not having conceived after twelve months of contraceptive-free intercourse if the female is under the age of 34 or the couple not having conceived after six months of contraceptive-free intercourse if the female is over the age of 35 (declining egg quality of females over the age of 35 account for the age-based discrepancy as when to seek medical intervention).

Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term.

Generally, worldwide it is estimated that one in seven couples have problems conceiving, with the incidence similar in most countries independent of the level of the country's development. Global incidence of infertility is about 13-18%. In India, the incidence of infertility is between 10 and 20%.

In India, although population growth is a major concern, there are a substantial number of infertile couples. Thus, infertility is considered as an important national problem concerning reproductive health.

Infertility is commonly due to some contribution from both the male and female partners.

There are many biological causes of infertility, some which may be bypassed with medical intervention. Majority of infertility cases are caused by genetics and are not preventable. However, it is possible to prevent some potential kinds of infertility by bringing about certain changes to our day-to-day lifestyle.

The environment we live in has a huge impact on our potential fertility along with our day-to-day lifestyle. Infertility has lately become more of a lifestyle problem than a medical problem.

Knowing what compromises one’s fertility and devising ways to avoid potential hazards is the best way one can help prevent infertility.

1] Firstly, certain habits, such as smoking or drinking alcohol, could have a detrimental effect on one’s fertility.

Smoking has been linked to low sperm counts and sluggish sperm movement in men, and an increase in miscarriage in women.
Alcohol (especially binge drinking or chronic abuse), affects the fertility of both men and women trying to conceive either naturally or through infertility treatments. Alcohol is toxic to sperm; it reduces sperm counts, can interfere with sexual performance, disrupt hormone balances and increase the risk of miscarriage.

2] A well-balanced diet consisting of carbohydrates, protein and fibre should be consumed. A diet rich in proteins from vegetables rather than from animals combined with a good amount of fiber and iron, less trans fat and sugar from carbohydrates, more high-fat dairy products and less low-fat dairy products, along with taking multivitamins decreases the relative risk of infertility due to ovulatory disorders in women. Dietary imbalances leading to deficiency of Vitamin C, folate, selenium or zinc can increase the risk of infertility. All women should increase folic acid intake (found in green leafy vegetables, fruit, cereals, but also available as supplements) prior to and during the first three months of pregnancy, to reduce the risk of neural tube defects such as spina bifida.

3] A moderate amount of physical activity and exercise can help make a large difference in one’s probability of becoming fertile.
Although, excessive exercise can lead to menstrual disorders in women and affect sperm production in men due to the heat build-up around the testicles.

4] One should maintain a healthy weight through diet and consistent exercise. One should maintain a body weight close to the ideal for one’s height to reduce the possibility of hormone imbalances. Avoiding excessive weight gain is one of the best ways one may be able to prevent infertility. Obesity is known to cause infertility in males by lowering sperm count through overheating and in females through suppression of ovulation.

The key message here to make the right dietary choices and include the right amount of physical activity in one’s daily life which can make a large difference in one’s probability of becoming fertile if one is experiencing problems with ovulation.

5] One should get yearly check-ups for certain medical conditions affecting fertility. Early diagnosis of conditions like pelvic inflammatory disease (PID), endometriosis and cervical cancer may prevent infertility. In addition, detection and treatment of sexually transmitted diseases may also help safeguard one’s fertility.

6] Certain medications or herbal remedies (prescribed or over-the-counter) could also affect fertility. Such drugs should be discussed with one’s gynaecologist.

Additionally, one must give up recreational drugs such as marijuana and cocaine as these have been linked to low sperm counts in men and infertility in women.

7] One should also avoid environmental poisons and hazards such as pesticides, lead, heavy metals, toxic chemicals and ionizing radiation.

8] The city’s fast-paced lifestyle is leaving its mark. Infertility amongst working couples is on a rise. High levels of stress and lack of consistent sleep may increase the risk of infertility. Meditation, yoga and adopting other relaxation techniques like deep breathing and progressive muscle relaxation may also help alleviate stress.

Along with these lifestyle modifications, recent advances in assisted reproductive technologies (ART) have provided greater possibilities for successful infertility treatment. Examples of new technologies include intracytoplasmic sperm injection, oocyte donation, and embryo cryopreservation.

So if all one’s efforts to conceive a child have been unsuccessful over a period of six months or longer, it is best that the couple consult a doctor. A proper diagnosis of the specific cause of infertility in one’s case will enable the doctor to prescribe appropriate management.

Yes, many drugs can cause impaired fertility in both men and women, including antidepressants, tranquilizers and narcotics. Anti-cancer drugs can cause ovarian and testicular failure temporarily or permanently. Additionally, many drugs can cause miscarriage or fetal defect once pregnancy has begun.

Sulfasalazine, a drug that is used in Crohn's disease, is well known to have an effect on sperm production. Most hormonal supplements, including anabolic steroids, as well as other street drugs, can have an adverse effect on fertility. Antibiotics, alcohol and tobacco also have been shown to have some effects on fertility.

Avoiding all medications while attempting to conceive and during pregnancy is best whenever possible.

Smoking is not only dangerous for your heart and respiratory organs but also your reproductive functions. Smoking or consumption of substances that contain tobacco reduces sperm production in men and affects the quality of eggs in women, causing infertility in the course of time.

Smoking also decreases the production of testosterone in men, thereby causing impotence. Smoking in women causes changes in the cervical mucous, which prevents the sperm reaching the egg and induces infertility.