Infertility (Part Three)
Factors affecting both sexes
Environmental and occupational factors
Concern is growing regarding the impact of the environment on fertility. Semen analysis data from 2005 confirm a 20% decrease in sperm concentration compared to data from 1985.
Excessive radiation damages germ cells. Exposure to lead, other heavy metals, and pesticides has been linked to male infertility. Many other factors, such as excessive exposure to heat, microwave radiation, ultrasound, and other health risks are under discussion as factors causing infertility.
Toxic effects related to tobacco, marijuana, and other drugs
Smoking has been linked to infertility in both men and women. In animal experiments, nicotine and polycyclic aromatic hydrocarbons block spermatogenesis and reduce the size of the testicles. In women, tobacco affects cervical mucus and ciliary epithelium and affects the transport of gametes.
Marijuana and its metabolite, delta-9-tetrahydrocannabinol, inhibit the secretion of LH and FSH, causing disorders in ovulation and the luteal phase in women. Marijuana use affects men by lowering sperm count and sperm quality. Heroin and cocaine cause similar effects but put the user at high risk of pelvic inflammatory disease and HIV infection.
Chronic alcoholism can cause ovulation disorders, leading to infertility. Alcohol use in men interferes with testosterone synthesis and has an impact on sperm concentration. Alcoholism can inhibit sexual response and cause impotence.
Physical exercise
Physical exercise should be performed as part of a normal activity. However, excessive physical activity is harmful, especially in long-distance runners. Light running stimulates the secretion of endorphins; excessive secretion of endorphins interferes with the normal production of FSH and LH, leading to disorders in ovulation and the luteal phase, which lead to the absence of embryo implantation and first-trimester abortions. In men, excessive physical activity has been linked to oligospermia.
Irregular diet related to extreme weight loss or gain
Obesity is a major health problem in the USA. Weight has an impact on fertility at both of its extremes. Although weight loss associated with anorexia nervosa or bulimia causes hypothalamic amenorrhea, obesity can be linked to anovulation and oligomenorrhea. In men, obesity has been linked to a decrease in sperm quality.
References
1. Maruani P, Schwartz D. Sterility and fecundability estimation. J Theor Biol. Nov 21 1983;105(2):211-9. [Medscape.com].
2. Trussell J, Wilson C. Sterility in a population with natural fertility. Popul Stud. 1985;29:269-86.
3. Overstreet JW. Evaluation of sperm-cervical mucus interaction. Fertil Steril. Mar 1986;45(3):324-6. [Medscape.com].
4. DeCherney AH, Cholst I, Naftolin F. Structure and function of the fallopian tubes following exposure to diethylstilbestrol (DES) during gestation. Fertil Steril. Dec 1981;36(6):741-5. [Medscape.com].
5. Frisch RE, Revelle R. Height and weight at menarche and a hypothesis of menarche. Arch Dis Child. Oct 1971;46(249):695-701. [Medscape.com].
6. Knobil E. The neuroendocrine control of ovulation. Hum Reprod. May 1988;3(4):469-72. [Medscape.com].
7. US Congress, Office of Technology Assessment. Infertility: Medical and Social Choices. OTA-BA-358. Washington, DC: US Government Printing Office; May 1988.
8. Menken J, Trussell J, Larsen U. Age and infertility. Science. Sep 26 1986;233(4771):1389-94. [Medscape.com].
9. Speroff L and Fritz M. Clinical Gynecologic Endocrinology and Infertility. 7th edition. Lippincott Williams & Wilkins; 2004.
10. Romeu A, Muasher SJ, Acosta AA, et al. Results of in vitro fertilization attempts in women 40 years of age and older: the Norfolk experience. Fertil Steril. Jan 1987;47(1):130-6. [Medscape.com].
11. Navot D, Drews MR, Bergh PA, et al. Age-related decline in female fertility is not due to diminished capacity of the uterus to sustain embryo implantation. Fertil Steril. Jan 1994;61(1):97-101. [Medscape.com].
12. Brand AM. No magic bullet, a social history of venereal disease in the United States since 1880. New York, NY: Oxford University Press; 1985.
13. Westrom L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol. Mar 1 1975;121(5):707-13. [Medscape.com].
14. Westrom L. Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol. Dec 1 1980;138(7 Pt 2):880-92. [Medscape.com].
15. Moller BR, Taylor-Robinson D, Furr PM, Toft B, Allen J. Serological evidence that chlamydiae and mycoplasmas are involved in infertility of women. J Reprod Fertil. Jan 1985;73(1):237-40. [Medscape.com].
16. Tjiam KH, Zeilmaker GH, Alberda AT, van Heijst BY, de Roo JC, Polak-Vogelzang AA, et al. Prevalence of antibodies to Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis in infertile women. Genitourin Med. Jun 1985;61(3):175-8. [Medscape.com].
17. Robertson JN, Ward ME, Conway D, Caul EO. Chlamydial and gonococcal antibodies in sera of infertile women with tubal obstruction. J Clin Pathol. Apr 1987;40(4):377-83. [Medscape.com].
18. Strathy JH, Molgaard CA, Coulam CB, Melton LJ 3rd. Endometriosis and infertility: a laparoscopic study of endometriosis among fertile and infertile women. Fertil Steril. Dec 1982;38(6):667-72. [Medscape.com].
19. Balasch J, Creus M, Fabregues F, et al. Visible and non-visible endometriosis at laparoscopy in fertile and infertile women and in patients with chronic pelvic pain: a prospective study. Hum Reprod. Feb 1996;11(2):387-91. [Medscape.com].
20. Simpson JL, Elias S, Malinak LR, Buttram VC Jr. Heritable aspects of endometriosis. I. Genetic studies. Am J Obstet Gynecol. Jun 1 1980;137(3):327-31. [Medscape.com].
21. Shin JC, Ross HL, Elias S, et al. Detection of chromosomal aneuploidy in endometriosis by multi-color fluorescence in situ hybridization (FISH). Hum Genet. Sep 1997;100(3-4):401-6. [Medscape.com].
22. Kennedy S. The genetics of endometriosis. J Reprod Med. Mar 1998;43(3 Suppl):263-8. [Medscape.com].
23. Kosugi Y, Elias S, Malinak LR, et al. Increased heterogeneity of chromosome 17 aneuploidy in endometriosis. Am J Obstet Gynecol. Apr 1999;180(4):792-7. [Medscape.com].
24. Jansen RP. Tubal resection and anastomosis. II. Isthmic salpingitis. Aust N Z J Obstet Gynaecol. Nov 1986;26(4):300-4. [Medscape.com].
25. Martin DC, Hubert GD, Vander Zwaag R, el-Zeky FA. Laparoscopic appearances of peritoneal endometriosis. Fertil Steril. Jan 1989;51(1):63-7. [Medscape.com].
26. Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod. Apr 1991;6(4):544-9. [Medscape.com].
27. Schenken RS, Malinak LR. Conservative surgery versus expectant management for the infertile patient with mild endometriosis. Fertil Steril. Feb 1982;37(2):183-6. [Medscape.com].
28. Seibel MM, Berger MJ, Weinstein FG, Taymor ML. The effectiveness of danazol on subsequent fertility in minimal endometriosis. Fertil Steril. Nov 1982;38(5):534-7. [Medscape.com].
29. Fedele L, Parazzini F, Radici E, et al. Buserelin acetate versus expectant management in the treatment of infertility associated with minimal or mild endometriosis: a randomized clinical trial. Am J Obstet Gynecol. May 1992;166(5):1345-50. [Medscape.com].
30. Fedele L, Bianchi S, Marchini M, Villa L, Brioschi D, Parazzini F. Superovulation with human menopausal gonadotropins in the treatment of infertility associated with minimal or mild endometriosis: a controlled randomized study. Fertil Steril. Jul 1992;58(1):28-31. [Medscape.com].
31. Dmowski WP, Steele RW, Baker GF. Deficient cellular immunity in endometriosis. Am J Obstet Gynecol. Oct 15 1981;141(4):377-83. [Medscape.com].
32. Mathur S, Peress MR, Williamson HO, Youmans CD, Maney SA, Garvin AJ, et al. Autoimmunity to endometrium and ovary in endometriosis. Clin Exp Immunol. Nov 1982;50(2):259-66. [Medscape.com].
33. Muscato JJ, Haney AF, Weinberg JB. Sperm phagocytosis by human peritoneal macrophages: a possible cause of infertility in endometriosis. Am J Obstet Gynecol. Nov 1 1982;144(5):503-10. [Medscape.com].
34. Halme J, Becker S, Wing R. Accentuated cyclic activation of peritoneal macrophages in patients with endometriosis. Am J Obstet Gynecol. Jan 1 1984;148(1):85-90. [Medscape.com].
35. Chacho KJ, Chacho MS, Andresen PJ, Scommegna A. Peritoneal fluid in patients with and without endometriosis: prostanoids and macrophages and their effect on the spermatozoa penetration assay. Am J Obstet Gynecol. Jun 1986;154(6):1290-9. [Medscape.com].
Hello. Doctor, I am 40 years old and I have a problem with my menstrual cycle. My first cycle was announced at the age of 12, it lasted 7 days then I had a 6-month pause after this 6-month break until the age of 15 I had a regular cycle, but after this age, I had irregularities, sometimes happening every three months and sometimes I didn't have a cycle for even 8 months. During the time of the cycle, the blood was not red but sometimes it was the color of brown in the form of soil. In 2005 I was on vacation at the seaside, on the first day I was on my period and I didn't go into the water for 5 days, after 5 days I went into the water and the bleeding stopped, and since that time the cycle comes every 30 to 35 days. After this, I started having facial hair, for which I used Diana 35 but it increased my transaminases and I stopped it, then I started using Yasmin but I stopped it because it caused me to gain a lot of weight. It is worth mentioning that I had testosterone of 94 while the normal value was 0.09 to 0.55 and I reached the value of 0.88. Besides these, I also have cysts, DG.diff: follicle
Sent by Lindita Teneqja, më 17 January 2018 në 07:32
Hello Mrs. Teneqeja,
If your wish is to have a child then you need to come and talk closely as there are things that need clarification.
All the best!
Replay from Dr. Marsel Haxhia, më 17 January 2018 në 08:34