What do mental health, HIV, and erectile dysfunction have in common? These are just some well-known medical conditions that are still highly stigmatised. Why are some medical conditions stigmatised and how did some of them manage to break the stigma? Upper GI and Bariatric Surgeon Dr Reynu Rajan shares her experience dealing with bariatric patients in the face of weight-bias and discrimination, while Fertility Specialist Dr Helena Lim shares what it’s like to help patients overcome the taboo of infertility.
Parenting Adventures is about brutally honest discussions in the world of parenting. In this sixth episode, we explore the subject of infertility. How do couples recover from the grief of knowing they may never have children? Why are they not open to the option of adopting or using a donor? We find out from a fertility specialist and, we will also hear from someone who didn’t take her infertility diagnosis as the final result, and did everything she could to become a mother.
Do click on this link to hear the podcast:
Dr George Lee returns to discuss the latest medical news. Expect deep insights delivered with generous humour. Dr Helena Lim joins him this week to discuss period-tracking apps and whether it makes her work as a Consultant Obstetrician and Gynaecologist easier, or more difficult.
Dr George Lee is a renowned Urologist who dealt with male issues, whereas Dr Helena Lim is a Fertility Specialist
Find out more about what they have to say:
How alcohol affects fertility in both men and women
You’ve probably heard of the saying, “Drink to your health,” but when it comes to safeguarding your fertility, moderation is definitely key in alcohol consumption. Women usually swear off alcohol once they find out they’re with child, but in truth, it is best for them to abstain from alcohol as soon as they’re ready to start a family. And it’s not just women who should keep tabs on their alcohol intake!
A growing number of scientific studies have shown that as little as one alcoholic drink a day can lead to detrimental effects in one’s chances at conceiving. For example, according to a study published in the American Journal of Epidemiology in 2004, alcohol can shorten a woman’s follicular phase and menstrual cycle.
Meanwhile, a 2009 study conducted at Harvard University found that in couples undergoing IVF, women who drank more than six units of alcohol per week were 18% less likely to conceive, while men were 14% less likely. This finding was supported by a study published in 2011 in the Annals of Epidemiology. Entitled ‘Alcohol, Smoking, and Caffeine in Relation to Fecundability, with Effect Modification by NAT2,‘ it concluded that alcohol intake was significantly associated with reduced fertility.
The study, which followed 319 women over an average of 8 menstrual cycles and 124 pregnancies, discovered that women who drink alcohol once a day can experience a 30% reduction in fertility, while those who took more than one alcoholic drink a day experienced a 50% reduction.
Another study published in 2011, entitled ‘Effect of alcohol consumption on in vitro fertilization,’ published in the Journal of Obstetrics and Gynecology found that drinking before becoming pregnant can lower live birth rates by up to 21% in IVF patients.
This prospective cohort study involved multicycle analyses with final models adjusted for potential confounders that included cycle number, cigarette use, body mass index, and age. From the 2,545 couples studied, it was found that women who drink at least four drinks per week had 16% less odds of a live birth rate compared with those who consumed less alcohol.
Although there is a link between drinking and fertility, researchers still do not know exactly how alcohol impairs fertility, says Dr Anthony Rutherford, a consultant in reproductive medicine and Chairman of the British Fertility Society.
However, it is clear to researchers that alcohol doesn’t just affect female fertility. According to Dr Patrick O’Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists, “Excessive alcohol lowers testosterone levels and sperm quality and quantity in men. It can also reduce libido, and cause impotence.”
Fortunately, however, any damaging effects alcohol has on fertility can be quickly reversed by reducing alcohol intake or abstaining from it, as well as getting proper nutrition and leading a healthier lifestyle. Therefore, before you raise your glass next time, spare some thought over how it can stand in the way of your goals of starting a family.
Fight Oxidative Stress
The effects of alcohol, smoking and pollutants on women’s fertility
We all know that the excessive intake of alcohol, smoking and environmental pollutants are bad for our health, but can they negatively impact a woman’s chances of getting pregnant? The answer is a resounding (and unsurprising) yes! Here’s why – Firstly, as toxicants, they cause our bodies to produce Reactive Oxygen Species or ROS, which are highly-reactive ions and molecules that contain oxygen. ROS are a lot like free radicals, and they are both known to wreak havoc in our bodies by damaging proteins and impairing their function.
Usually, our bodies are able to neutralise the harmful effects of ROS and free radicals with antioxidants. However, when an imbalance in the production of ROS and free radicals occurs, our bodies are unable to cope. As a result, our bodies undergo what’s called – oxidative stress. Oxidative stress is a physiological condition that’s linked to a variety of health issues, including neurodegenerative disorders such as Alzheimer’s disease; cancer; heart problems; blood vessel, gut and vision disorders; lung conditions; chronic fatigue syndrome; kidney, autoimmune, arthritis and inflammatory disease; diabetes; pancreatitis and more.
There is also mounting evidence on the negative effects of oxidative stress on male subfertility, including decreased sperm motility and numbers. And now, findings indicate that oxidative stress can increase the risk for female infertility, as well as delaying pregnancies and lowering pregnancy rates. It can even lead to pregnancy complications like preeclampsia and even miscarriage.
While the field is currently understudied and there is so much more to discover, there is no denying that it is crucial for us to gain a better understanding of how to combat oxidative stress. “If we can identify factors that can be modified to decrease oxidative stress in women, it may be an inexpensive and non-invasive treatment for infertility,” states a study called The Impact of oxidative stress on female fertility by Elizabeth H. Ruder, Terryl J. Hartman, and Marlene B. Goldmanc.
But does this mean we have to play the waiting game for more research to be conducted on the subject? While it may be a few years time before scientists can identify the factors that can be modified to fight oxidative stress, there are steps you can take right now.
We know that oxidation occurs when we’re exposed to toxins, chemicals and stress. Therefore, it would be highly beneficial for you to minimise your exposure to triggers that are present in your lifestyle, foods and environment. Numerous studies have also shown the benefits of a healthy and varied diet, which is supplemented with multivitamins and antioxidants.
In addition, you can maintain your reproductive health by limiting caffeine and alcohol intake, quitting cigarettes, getting adequate exercise, learning ways to manage daily stress and maintaining a healthy body weight. By taking these steps and making crucial lifestyle changes, you can significantly enhance your fertility and boost your chances of conception. Not sure where to begin? Don’t hesitate to speak to a healthcare professional to get on the right track.