FACTORS AFFECTING REPRODUCTIVE HEALTH

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FACTORS AFFECTING REPRODUCTIVE HEALTH
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Pre-conceptual Health

• Pre-conceptual health is the general health
  status of a person prior to conception.
  Pre-conceptual health is the single most
  important determinant of male and female
  fertility. Good health care prior to conception
  reduces unplanned pregnancy, promotes healthier
  pregnancies and healthier births, reduces the
  risk of low birth weight, birth defects and
  premature deliveries.
• Most birth defects occur 2-8 weeks after
  conception, often before a woman knows she is
  pregnant.
•  
• Research now shows that an increased intake of
  folic acid (a B vitamin) by women before she
  becomes pregnant reduces the risk of birth
  defects called Neural Tube Defects (NTDs).
  These are birth defects affecting the brain and
  spinal cord (e.g., Spina Bifida).
•  
• Good sources of folic acid or folate are fruits
  and vegetables. The critical time to have enough
  folate is before conception occurs. 50 of all
  pregnancies are not planned.

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Environmental Factors

• i) Smoking
• Females who smoke
• are at risk for lowering folic acid, vitamin C
  and beta-carotene levels. These reduced levels
  are all associated with infertility, delay in
  conception, ectopic pregnancy and menstrual
  disorders
• have an increased risk of spontaneous abortion,
  fetal and neonatal death
• will have a child lower in birth weight due to
  reduced nutrients and oxygen to the fetus in
  utero
• Males who smoke
• may have the quality of their sperm affected
• marijuana may have the quality of the their sperm
  reduced

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• ii) Alcohol The use of alcohol
• reduces sperm quality in males
• affects ability to achieve and/or maintain an
  erection
• iii) Chemical Exposure
• A teratogen can be a drug, a chemical or an
  infection that results in the permanent damage to
  the developing fetus. There are approximately 25
  chemicals known to be teratogenic.
• The following can result in low birth
  weight, still birth and birth defects
• carbon monoxide in car exhaust
• kerosene heaters, lead and paint strippers
• Preventative measures include
• leaving the work area to eat, avoiding noxious
  substances, using gloves, washing hands, adequate
  ventilation, determining the status of hazardous
  substances at place of employment

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• iv) Medications
• narcotics (e.g., Percodan), tranquilizers (e.g.,
  Valium), anti-depressants (e.g., Prozac) and
  anti-hypertensives (e.g., blood pressure
  medications) may cause erectile dysfunction in
  males
• other drugs may affect sperm production and/or
  ovulation
• some drugs may cause fetal defects (e.g.,
  tetracycline, accutane treatment for acne,
  anti-coagulants, steroids)
• chemotherapy may affect sperm quality and
  ovulation and indirectly affect fertility due to
  nutritional status
• some herbs contain drug-like ingredients and can
  have harmful effects during pregnancy and while
  breastfeeding (e.g., can stimulate the uterus or
  cause uterine contractions, act as a diuretic,
  produce toxic effects in the developing baby,
  cause birth defects, infant deaths or be passed
  onto infant through breast milk and harm the
  baby)

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Hormone/Genetic Factors

• can affect sperm quality, production and
  ovulation (e.g., failure to ovulate regularly, or
  irregular menstrual cycle, may be caused by
  problems with the hypothalamus and pituitary
  gland)
• congenital factors may impede ability to conceive
  (e.g., born without uterus)

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Sexual Health History

• multiple sexual partners increase the risk for
  STIs (sexually transmitted infections), Pelvic
  Inflammatory Disease (PID) and cervical cancer
• some women develop antibodies to sperm, a
  condition some clinicians believe more common in
  women with multiple sexual partners
• sexually transmitted infections (e.g., chlamydia,
  gonorrhea) and pelvic conditions if left
  untreated can cause conditions in both males and
  females which can impair fertility
• Note
• genital chlamydia infection is the leading cause
  of preventable infertility and ectopic pregnancy
• 80 of women and 25 of men with chlamydia have
  no symptoms
• 50 of women and 25 of men with gonnorhea have
  no symptoms
• Pelvic Inflammatory Disease (PID) can cause tubal
  damage in women and increase risk of ectopic
  pregnancy
• inflammatory effects of infection in male
  reproductive organs (e.g., epididymitis) can
  cause scarring
• Human Papilloma Virus (HPV) is often a precursor
  to cervical dysplasia
• cervical treatments may reduce fertility by
  causing scarring or damage to cervical
  mucous-producing cells
• lifestyle choices that affect nutrition, physical
  activity and healthy sexual practices effect
  overall health and fertility status

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General Health

• endometriosis can cause scarring, tubal blockage
  and possible immune responses (Note 25-30 of
  infertile women have endometriosis)
• there is conflicting evidence that tight clothing
  may affect sperm production
• Sickle Cell disease can cause possible impotence
  due to nerve and tissue damage and may increase
  the incidence of miscarriage in women

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Stress

• psychological stress (e.g., depression,
  difficulty sleeping, anxiety) and physiological
  stress (increased muscle tension, lack of energy,
  nervousness) affect libido
• stress affects the ability to make healthy
  lifestyle choices (e.g., alcohol and other
  substance use, smoking, decrease in physical
  activity or sedentary living, poor nutrition)
  which in turn also affects fertility