Infertility - Lifestyle, Genetics, and the Big Picture
Updated: Mar 16, 2022
In this article we look at some of the health conditions associated with infertility and how our environment can affect fertility and offspring health. First, here are some relevant definitions:
Infertility - inability to conceive after 12 months of unprotected sex
Subfertility - prolonged time of unwanted reduced fertility
Fertilisation - joining of egg and sperm (gametes)
Implantation - embryo (joined gametes) adhere to the uterine wall
Ovulation - release of a female egg from the ovary
Anovulation - lack of ovulation
Fertile window - the few days during and around ovulation/release of an egg
Epigenetics - the study of how behaviors and environment can affect the way our genes work
In Australia up to 15% of couples will have difficulty conceiving and rates of infertility are not declining in millennials with one in six couples labeled infertile.
To be clear, having difficulty conceiving (falling pregnant) is different to recurrent pregnancy loss, which is when a person experiences three or more miscarriages in a row before week 20. In this article I will be using the term subfertility (reduced fertility) to talk about some of the reasons for having trouble becoming pregnant, however you can read more about recurrent pregnancy loss (RPL) here.
Getting pregnant is a team effort and difficulty conceiving may be due to an array of factors influencing either or both of the couple including age, environment, health, nutritional status, and lifestyle choices. Inability to conceive (fall pregnant) in people of reproductive age can also be due to health conditions such as:
PCOS
Endometriosis
Adenomyosis
Obesity
Fibroids
Structural changes e.g. fallopian tube blockage
Premature ovarian failure
Premature menopause
Alternatively, hormonal imbalances such as low or high oestrogen or progesterone in the female can result in irregular menstruation, impaired implantation, erratic ovulation or chronic anovulation (not releasing an egg) and without an egg fertilisation cannot occur. It is also important to remember that reproductive health in both males and females is impacted by other systems in the body and overall health not just the sex organs (testes, ovaries, penis, uterus). For example:
Thyroid dysfunction - thyroid hormones act on many cells in the body including those in the ovaries. Research also shows that hyper- or hypothyroidism is associated with menstrual abnormalities and reduced fertility.
Nutritional status - lack of certain nutrients can affect menstrual health and ovulation as well as sperm quality and quantity.
Toxicity levels - 1) abnormal levels of metals such as lead, mercury, cadmium, chromium, nickel, copper, lithium, vanadium are known to negatively affect reproductive health. 2) exposure to chemicals called endocrine disruptors readily found in our 21st century environment impact normal hormone regulation and function including those that impact fertility.
Body fat - obesity is associated with infertility in males and females. On the flip side lack of body weight in females is associated with fertility changes caused by hormonal imbalances.
Mental or physical stress - distress, anxiety, and depression can affect overall health, nutritional status and fertility status. Plus it doesn't take science to tell us that the practical side of getting pregnant (having sex) is strongly affected by mood and stress levels. All of these factors play a role in fertility and are driven by our lifestyles as well as our genetics.
How does our environment and lifestyle impact fertility?
Through research in the field of epigenetics we now know that certain food components have the potential to turn ‘on’ and ‘off’ our genes making us more or less susceptible to illness or subfertility. Both male and female subfertility is influenced by not only the food we put into our body but our environment, lifestyle and the environment of a one's parents even before an egg and sperm came together to create them!
Exposure to toxins can negatively impact fertility and are associated with epigenetic changes that influence egg and sperm development. Endocrine disruptors are known to directly affect sperm cells, foetal development, and female reproductive health due to their ability to act similarly to human sex hormones thereby interfering with the endocrine system and hormone levels. This means they impact synthesis of sex hormones, the menstrual cycle, and egg and sperm development.
For more information on endocrine disruptors, where they can be found, and how to reduce exposure check out this article.
Epigenetics tells us we have the power to influence our health and fertility and that of our offspring through lifestyle and dietary choices. So how can we benefit out fertility and offspring health with lifestyle choices?
Manage stress
This will look different for each individual. Stress management includes dietary, exercise, sleep, and social wellbeing support that helps to alleviate the physiological impact of stress on the body and mind. Doing what makes you happy, exercising regularly, getting adequate sleep, and eating a nutritious diet are the foundations of managing stress levels.
Quit smoking
Seek professional assistance if required to minimise side affects and associated stress
Minimise alcohol intake
Alcohol should be avoided as much as possible during the preconception phase for both mum and dad (or egg and sperm donor). Talk to your doctor or health care provider about how to reduce intake if you are struggling.
Have a healthy diet of consisting of whole foods and minimal processed foods
Exercise regularly
30 minutes of moderate exercise daily is recommended, however this may differ from person to person based on ability and fitness. Talk to your practitioner about an appropriate exercise schedule for you and your partner.
Minimise chemical exposure - see here for how-to tips
What we put into our bodies as well as the environment around us can influence our genetic expression – the way our DNA communicates with our body to make us who we are right now – this is a fun, fancy area of science called epigenetics.... and epigenetic changes can regulate both egg and sperm development.
It is important to remember that working with a health professional to rule out underlying conditions is a supportive and useful way to determine the most appropriate route of health management for you. Not all cases of infertility or subfertility are due to specific, diagnosable health conditions and if you have been told there is 'no reason' for your infertility it may be worth working with a practitioner to assess the toxic load, stress management, nutritional and hormonal status of both yourself and your partner.