3 Common Issues That Affect Fertility

June 18, on Fox 35 News Health Watch, I discussed the impact of three common issues affecting patients trying to conceive – cigarette smoking, cell phone usage, and stress.  Each of these topics will be summarized below in our “talking points” feature!

Cigarette Smoking

  • even 1/2 pack per day will decrease fertility
  • within year of stopping  smoking you may be able to return to normal fertility
  • Second-hand smoke is just as bad as first-hand smoking!!
  • 13% of female infertility is due to smoking and increases with higher amounts of smoking causing:

–  Early menopause  by accelerating the loss of eggs
–  Higher rates of miscarriage
–  Higher rates of ectopic pregnancy (a pregnancy implanting outside the uterus, usually in the fallopian tube)
–  A decrease in sperm function
–  Possible genetic damage to eggs &  sperm
–  Reduced sperm in son if mom smoking while she is pregnant
–  Lower pregnancy success with IVF

TAKE HOME MESSAGE:
If you do not smoke, please don’t begin; if you or your partner smokes, both of you need to stop in order to improve your fertility

Cell Phone Usage & Male Infertility

A recent summary of multiple studies demonstrated impaired sperm motility in men who use cell phones due to potential harmful effects of electromagnetic radiation.  The study findings:

  • Reduces sperm motility by 8%
  • Reduces sperm viability
  • Unclear of an effect, if any, on sperm count

TAKE HOME MESSAGE:
Any negative impact from cell phones on sperm function has not yet been shown to reduce a man’s ability to father a child.   It would be prudent to reduce cell phone exposure in men, particularly in those desiring a child, until there is definitive evidence.

Stress and Infertility

A recent study looked at a stress hormone salivary alpha-amylase (SAA) in women trying to conceive over a 12 month period.  The findings:

  • 29% of women who had the higher levels of SAA experienced a longer time to conceive
  • women with the highest SAA levels had a 12% less likely chance to conceive each month

MULTIPLE CRITICISMS

–  SAA not always involved in stress
–  Saliva is not always accurate method of testing
–  Major stress hormone – cortisol – levels, unaffected

My Take on all this: Has a woman who expresses difficulty conceiving ever not been advised to “just relax so it will happen?”  Not only have lay people offered this advice but, unfortunately, woman have been subject to this baseless suggestion by physicians, presumably for generations.

The authors make significant flaws raising substantial questions concerning the validity of their conclusions.  The authors’ premise is SAA is a measure of the sympathetic nervous system.  However, SAA, as a digestive enzyme, is also stimulated by the parasympathetic nervous system or the “rest and digest” system, the polar opposite from SNN.  Methodological problems also surface, namely, the lack of standardization of salivary flow rate, absorption of saliva, and the effect of chewing on saliva production.

TAKE HOME MESSAGE:
Whether stress actually causes infertility will expectedly be debated for subsequent generations.   Infertility certainly can cause stress and reduce the quality of life.  More important and concerning is the impact of such an unsubstantiated suggestion on the patient.

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