Factors That Affect Fertility

Women's Issues

Having a baby is a happy occasion that many couples look forward to. Yet more than five million Americans, both men and women, have problems with infertility. If you're trying to get pregnant now, or planning to in the future, it's wise to identify any potential risk factors you or your partner may have, and to tell your doctor right away. The sooner you detect, address, and treat problems that may affect fertility, the better your chances of achieving a successful pregnancy.

General health factors

Here a few of the more common health factors that can affect a woman's ability to ovulate, conceive, or carry a pregnancy to term.

• Being overweight: Body fat levels that are 10 to 15 percent above normal can overload the body with estrogen, throwing off the reproductive cycle.
• Being underweight: Body fat levels 10 to 15 percent below normal can completely shut down the reproductive process.
• Having a hormonal imbalance: Irregularities in the hormone system (characterized by irregular menstrual cycles or short, long, or heavy periods) can affect ovulation.
• Having an autoimmune disorder: Diseases such as lupus, diabetes, thyroid disease, and rheumatoid arthritis can interfere with fertility.
• Taking medication: Antidepressants, antibiotics, painkillers, and other drugs used to treat chronic disorders may cause temporary infertility.
• Using tobacco or alcohol: Smoking may increase the risk of infertility in women; and even moderate alcohol consumption (as few as five drinks a week) can impair conception.
• Being exposed to occupational or environmental hazards: Prolonged exposure to high mental stress, high temperatures, chemicals, radiation, or heavy electromagnetic or microwave emissions may reduce a woman's fertility.

You should also tell your doctor if you've had a history of multiple miscarriages, painful menstrual cycles that require medication for pain relief, or abnormal Pap smears that have resulted in surgical treatment, as these factors can also affect fertility.

Fallopian tube disease

Fallopian tube disease accounts for about 20 percent of infertility cases treated, according to RESOLVE: The National Infertility Association. Since tubal scarring or blockage is often caused by sexually transmitted diseases (STDs), pelvic inflammatory disease, or certain surgeries, alert your doctor if you've had:

• An STD, such as gonorrhea, syphilis, or chlamydia
• Pelvic pain, unusual vaginal discharge, and/or bleeding, with or without a fever
• Pelvic surgery for a ruptured appendix, ovarian cysts, or an ectopic pregnancy (a pregnancy that takes place outside of the uterus, usually in the fallopian tubes)

If a doctor suspects a problem, he or she can perform a hysterosalpingogram -- an X-ray that can evaluate the condition of the uterus and determine if the fallopian tubes are obstructed.

Endometriosis

Endometriosis is a condition in which tissue from the uterine lining grows outside the uterus, on the ovaries, fallopian tubes, bladder, and/or bowel. Research indicates that it accounts for between 5 and 30 percent of female infertility. Several factors may contribute to infertility, including:

• Scar tissue: Rigid webs of scar tissue may form between the uterus, ovaries, and fallopian tubes, preventing the transfer of the egg to the fallopian tubes.
• Cysts: Endometrial cysts may grow inside the ovaries and prevent the release of the egg or its collection by the fallopian tube.
• Poor egg implantation: Endometriosis may prevent the fertilized egg from adhering to the uterine wall.

Early detection of the condition is key to its successful control and to preserving fertility, so tell your doctor if you've had:

• A family history of endometriosis
• Painful menstrual cramps or pain at ovulation
• Extremely heavy menstrual flow
• Diarrhea or painful bowel movements, especially around your period
• Painful sexual intercourse

In some cases, women with endometriosis have no painful symptoms. In these instances, the condition can only be confirmed with an outpatient surgical procedure called a laparoscopy.

Sexually transmitted diseases

More than 65 million Americans, including teenagers, are infected with at least one STDs. Some STDs are asymptomatic and lie undetected in women. (For instance, 70 percent of women with chlamydia show no symptoms and consequently don't seek treatment.) The bad news is that STDs can lead to tubal scarring, ectopic pregnancy, other reproductive problems, and ultimately infertility if left untreated. To reduce this risk:

• Use latex condoms to stop diseases from spreading
• Consider that people with multiple sex partners are at the highest risk for STDs
• Detect and treat infections early if possible (both partners should be treated if either has an infection)

Men's Issues

About 35 percent of fertility cases can be traced to a problem in the man, and an additional 20 percent to a problem in both partners. The following is a partial list of risk factors that may contribute to male infertility:

• Being a smoker: Smoking impairs the ability of sperm to move (its motility).
• Using alcohol: Having more than one or two drinks a day can affect the quality and quantity of sperm, lower testosterone levels, and contribute to erectile dysfunction.
• Taking illegal drugs: Cocaine or heavy marijuana use may temporarily reduce the number and quality of sperm by as much as 50 percent.
• Taking prescription drugs: Some medications, such as those for ulcers or psoriasis, can slow or prevent the production of sperm.
• Being exposed to toxic substances or hazards on the job: Chronic exposure to elements such as lead, cadmium, mercury, hydrocarbons, pesticides, radioactivity, and X-rays may have an impact on sperm count and quality.
• Exposing genitals to heat: The frequent use of saunas, steam rooms, hot tubs, whirlpools, and hot baths can temporarily impair sperm production and reduce sperm count.
• Having certain conditions or illnesses: Men with a history of prostatitis or genital infection, mumps after puberty, surgery on their hernia, undescended testicles, or scrotal varicose veins (varicocele) may also experience a decrease in fertility.

Sources: MayoClinic.com; RESOLVE: The National Infertility Association; The Couple's Guide to Fertility by Gary S. Berger, MD, Marc Goldstein, MD, and Mark Fuerst (Broadway Books, 2001); National Women's Health Information Center

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.