Ooi SL Amy, See KS Kris, Osel Clinic, Osel Group
Abstract: As the city is progressing towards a luxurious lifestyle, with swanky cars, numbers of maids and servants, and machine to do our work, it is also seeing a surge in various disease, earlier unknown to the public, but now becoming relatively common. One such disease is infertility.
Infertility is affecting more and more couples nowadays due to lifestyle related causes.
Though many people still think of infertility as a woman's problem, close to half of all cases of infertility involve problems with the men. In fact, about 20% to 30% of the time, a man's low fertility is the main obstacle to conception, say expert. In the past, female infertility accounted 60% cases, male infertility for 25%, while combined factor were responsible in the remaining cases.(1)According to a report by the International Institute of Population Sciences, infertility was growing at an alarming rate, especially in the city. It has been estimated that, globally of the 60-80 million couples suffering from infertility.(2)
Infertility is considered an 'adult problem', as this is when it manifests itself. However, many factors that impact on fertility have their origins much earlier in life, commonly during foetal development. To understand how (and when) infertility can arise, and what environmental factors can affect it, a useful starting point is the identification of key factors that determine whether a man or woman will be fertile, and when these are established.(3)
Lifestyle and environmental factors
Research consistently shows that lifestyle factors-what you eat, how well you sleep, where you live and other behaviours- have profound effects on health and disease, fertility is no exception. A number of lifestyle factors affect fertility in women, in men or in both. These include but are not limited to nutrition, weight, and exercise; physical and psychological stress; environmental and occupational exposures; substance and drug use and abuse and medications.(3)
For example, research shows that:
· Obesity is link to lower sperm count and quality in men.
· Among obese women who have polycystic ovary syndrome (PCOS), losing 5% of body weight greatly improves the likelihood of ovulation and pregnancy.
· Being underweight is link to ovarian dysfunction and infertility in women.
· Strenuous physical labour and taking multiple medications are known to reduce sperm count in male.(4)
· Excessive exercise is known to affect ovulation and fertility in women.
· Research shows that using body-building medications or androgens can affect sperm formation.
· Substance use, including smoking tobacco, using other tobacco products, heavy drinking and using illegal drugs such as heroin and cocaine reduce fertility in both men and women.
· Having high blood pressure changes the shape of sperm, thereby reducing fertility.(5)
· Radiation therapy and chemotherapy can cause infertility in females and males.
Lifestyle Choices impact Infertility
Expert point out an alarming growth of infertility among young women over the last decade. The rising statistics is due to social changes that have been taking place over the past decade-and-a-half. More women are focusing on their careers and are marrying late and more couples opting to have children later in life. The very process of planning a baby is delayed. Even today, most women are unaware of the exponential decline of fertility after age of 35.
Infertility is definitely impacted by age, only 4% of women in their 20s have problems getting pregnant while 80% to 90% of women older than 38 struggle to conceive.(6)Women are born with a finite number of eggs, so there is a decline in the quantity and quality of these eggs over time, which decreases exponentially after a woman reaches the age of 38.
Conclusion with Future Perspectives
Environmental and lifestyle factors look set to become increasingly influential on human fertility if increasing trends in obesity, female smoking and sedentation at work/leisure continue. Such factors, coupled with a trend to delay first pregnancies to an older age, are likely to result in an increased incidence of infertility, especially in women. However, as many of these effects are on the foetus during pregnancy, their manifestation may be 'hidden' for several decades. Arguably, all such effects are preventable by changes in diet and lifestyle. Ultimately, all environmental/lifestyle effects on fertility, whether induced in foetal or adult life, result from hormonal changes.
Understanding the complex pathways through which these ripples work, and how common environmental chemicals can affect them, present intriguing challenges to biomedicine in an age when the focus is on genes rather than the whole body. A failure of science to meet this challenge and of individuals to amend their diet/lifestyle will hand the poisoned chalice of infertility to the next generation.(3)
REFERENCES
1. Umesh Isalkar. Lifestyle-related infertility on the rise. The Time of India. 2012
2. Sarah Hodin. The burden of infertility: Global prevalence and Women’s Voices from Around The World. Women and Health Initiative, Harvard T.H. Chan School of Public Health. 2017
3. Richard M. et al. Environment, Lifestyle and Infertility-An intergeneration Issue. MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology, university of Edinburgh. 2002
4. Sharma, R., et all. Lifestyle factor and reproductive health: taking control of your fertility. Reproductive Biology and Endocrinology, 11,66. 2013
5. NICHD. Physical Labour, hypertension and multiple meds may reduce male fertility.2015. http://www.nichd.nih.gov/news/releases/pages/030915-,ale-fertility.aspx
6. Buck, G.M., Sever, L.E., Batt, R.E. & Mendola, P.Life-style factors and female infertility. Epidemiology8, 435–441 (1997).
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