Fertility and Lifestyle
In a world that has to deal with extreme population growth, the existence of infertility and the need to address it seems strange.
However, according to the WHO, infertility is recognized as a disease of the reproductive system and is defined as the failure to achieve pregnancy after 12 months of systematic, unprotected sexual intercourse.
It is estimated to affect 8-12% of couples of reproductive age worldwide.
In Greece, there are approximately 250,000 – 300,000 couples with infertility.
Scientific research has shown that the modern lifestyle can negatively affect male and female fertility, as well as the effectiveness of methods assisted reproduction.
These factors are obesity, childbearing at an advanced age, lack of physical exercise, increased scrotal temperature (sedentary life, tight underwear, frequent hot baths and saunas), radiation (exposure through mobile phones and computers), alcohol, smoking, drugs, poor diet, sexually transmitted diseases, psychological stress.
These “lifestyle” factors, which seem to affect spermatogenesis, sperm quality, ovulation and egg quality, endometrial receptivity, probably have a common pathophysiological mechanism by increasing inflammation and oxidative stress in the body and are variable.
High BMI in women has been associated with delayed conception, anovulation, cycle irregularities, poor egg quality and effects on the endometrium. The likelihood of achieving pregnancy after IVF is lower.
Obesity can also negatively affect male fertility by reducing sperm concentration and motility. It also reduces the likelihood of pregnancy after IVF. In overweight and obese women, weight loss is associated with an increased likelihood of pregnancy after natural conception.
In men with unexplained infertility, reducing abdominal fat results in increased pregnancy rates after natural conception and intrauterine insemination. The rate of sperm DNA fragmentation also improves.
Social changes and the economic crisis of recent decades have led women and couples in general to postpone starting a family.
Advanced age has an impact on fertility. Female and male age are associated with a prolongation of the time to pregnancy. Female fertility declines gradually, starting at approximately 32 years of age and sharply decreasing after 37.
It is initially expressed by a decrease in egg quality accompanied by a gradual change in hormone levels. The birth rates after IVF in women younger than 35 years of age are 41.5%, while 12.4% at the age of 41-42 and 5% at 43-44 years.
The mechanisms involved include multiple gene-coded factors, on the autosomal and X chromosomes.
In men, total sperm count and motility decrease after 34 years of age.
It is reported that regardless of the woman’s age, the likelihood of pregnancy decreases after contact with a man >34 years old.
Lifestyle modification through a structured program of educational, environmental, dietary/physical exercise and psychological support can help couples achieve a better quality of life and improve the likelihood of natural conception.
