The ability to get pregnant and birth a child is a traditional expectation for all women worldwide, especially in Africa where having children is an unmistakable form of social security. When it comes to infertility most women are unaware of risk factors and their role in their own fertility; it is worth mentioning that because many of these factors are largely preventable, women should be aware of these and take active measures to ensure that exposure to them is minimised. Professor of Anatomy/Consultant Reproductive Endocrinologist, Oladapo Ashiru in his latest piece for PUNCH addressed the subject.
Read his full piece below:
Getting pregnant and carrying it to term in itself is a complex process that might be affected if anything goes wrong, ultimately leading to infertility. Infertility could result from either the male or female accounting for 40 per cent per partner.
Infertility means you have been unsuccessful in conceiving naturally after one year of trying (or six months if a woman is 35 years or older). Furthermore, women who can get pregnant but are unable to stay pregnant may also have problems with infertility.
There are numerous causes of infertility, ranging from problems with ovulation, damage to the fallopian tubes or uterus to problems with the cervix, etc. However, we would be dwelling on the preventable causes of female infertility.
How awesome would it be if we could pinpoint what prevents some women from achieving this seemingly God-given ability of women to conceive and birth a child? These factors are sometimes obvious but we sometimes don’t emphasise them.
1. Age of a woman: It is the singular most important reason for infertility in women especially in our contemporary world. It is generally known that female fertility declines beyond age 35 and it may require a little bit more effort to conceive/ deliver a child. Age can affect:
- The health of her eggs declines
- Her ovaries become less able to release eggs
- Reduced number of eggs
- More likely to have additional health problems that can affect fertility
- Higher chances of miscarriage.
2. Stress and infertility:
Infertility in itself is often a silent struggle. Patients who are struggling to conceive report feelings of depression, anxiety, isolation, and loss of control comparable to those observed in patients diagnosed with cancer. Does infertility cause stress or does stress cause infertility? The answer is unclear but interrelated. Stress can result from infertility itself or the treatment process, in another hand, infertility itself stresses the woman, thereby reducing her chances of conception.
3. Body weight: Weight of a woman can also negatively impact her fertility, for example, being overweight, BMI (Body Mass Index) > 25 or underweight, BMI <18.5. Being overweight can cause hormonal imbalances and difficulty with ovulation consequently affecting fertility.
PCOS (Polycystic Ovarian Syndrome) is a good example of this because of its association with obesity and anovulation. Obesity and excess weight gain during pregnancy is also linked with several pregnancy complications. These include increased risk of miscarriage, high blood pressure, pre-eclampsia, gestational diabetes, infection, blood clotting, the need to induce labor, cesarean birth, and stillbirth.
Being underweight, however, means the woman does not have enough body fat and hormones necessary to drive ovulation. This also is a problem for natural conception. It is advocated that for women who want to conceive to maintain a normal weight, (BMI 18.5-24.9).
4. Sexually Transmitted Diseases/Infections (STD/STI):
Untreated sexually transmitted diseases that ascend along the reproductive tract are capable of causing tubal inflammation (swelling), damage, and scarring. Chlamydia trachomatis and Neisseria gonorrhoeae are pathogenic bacteria consistently involved in reproductive tract morbidities, including tubal factor infertility and pelvic inflammatory disease. Affectation of the tubes ultimately resulting in blocked tubes and the inability to achieve spontaneous pregnancy.
5. Smoking and excessive alcohol intake:
Smoking more than 10 cigarettes/day: Chemicals (such as nicotine, cyanide, and carbon monoxide) in cigarette smoke increase the rate of egg loss, and once the eggs die off, they cannot regenerate or be replaced. This means that menopause starts 1 to 4 years earlier in women who smoke (compared with non-smokers). It can also cause complications during pregnancy especially at the placenta bed by reducing blood flow to the fetus (growing baby).
6. Excessive alcohol drinking more than six units of alcohol /week, a unit- a small glass of wine(76ml)/ half a pint of beer(250 ml)/shots of spirit:
A lot of studies have shown that even drinking lightly can increase the time it takes to get pregnant and reduce the chances of having a healthy baby.
Women who consume lots of alcohol i.e. more than seven bottles a week or more than three bottles of alcohol at one sitting are liable to experience heavy or irregular periods, ovulation and fertility problems and inability to conceive.
It is always wise to avoid alcohol consumption because the endpoint can lead to irregularity of menstrual cycles and danger to the unborn baby during early pregnancy. It is advisable to stop alcohol intake for couples who take alcohol and having difficulty in conceiving.
7. Exposure to heavy metals:
There are numerous heavy metals found in products used by various homes. These include non-stick pans, glazed ceramics, pesticides, soaps, plastic toys, eye shadow and lipstick. Exposure to heavy metals like lead, cadmium, and mercury are harmful to one’s health, Even though they are natural elements, frequent exposure or in high doses to these heavy metals can be harmful to one’s health. Ways in which one can be exposed to these metals can either be working or living close to a factory that produces substance containing cadmium like batteries, metal coatings, and plastics. People who live in old houses can be exposed to lead seen in paint, which can be released into the air and inhaled or absorbed through the skin during home renovation or its reconstruction.
All of the above seven listed risks may eventually cause a reduction in infertility rates among women in the reproductive age group (15 to 44 years).