Female Infertility: Prevention

To prevent female infertility, attention must be paid to reducing individual risk factors. Behavioral risk factors

  • Diet
    • Malnutrition* – diet that is not complete and low in micronutrients (vital substances).
    • Micronutrient deficiency (vital substances) – see prevention with micronutrients.
  • Consumption of stimulants
    • Alcohol* * – ≥ 14 alcoholic drinks/week decreased the probability of conception by 18%.
    • Coffee* * * , black tea.
    • Tobacco (smoking)
      • The conception rate was significantly higher in the nonsmoking or occasional smokers than in the heavy-smoking oocyte recipients (52.2% versus 34.1%), meaning that high tobacco use reduces endometrial receptivity. Furthermore, multiple pregnancies occurred more frequently in the heavy smoking participants (60% versus 31%).
      • Decreased conception and implantation rates were noted in the transfer of embryos subjectively judged to be morphologically sound in smokers versus nonsmokers.
  • Drug use
  • Physical activity
    • Excessive sports
  • Psycho-social situation
    • Stress
  • Overweight (BMI ≥ 25; obesity* ).
    • BMI > 25 kg/m2 reduces the chance of conception within 1 year (89.4% for BMI 20-25 kg/m2 vs 82.7% for BMI > 25 kg/m2; n = 10 903)
  • Underweight

Attention. * Scientific studies show that circa 12% of primary infertility is due to severe deviations from normal weight, that is, due to overweight or underweight:

  • Obesity (BMI > 35) → 4-fold prolonged TTP (“time to pregnancy“; time to pregnancy onset).
  • Underweight (BMI < 19) → 2-fold prolonged TTP.

These weight problems also reduce the prospects of successful infertility therapy. The reason is that body fat affects the formation of gonadotropin releasing hormone (GnRH). This triggers the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both of which are important for the development of follicle maturation (egg maturation) and thus for ovulation (ovulation). * * Drinking alcohol (> 2 drinks per day) leads to a 60% increase in risk for infertility. * * * Drinking > 2-3 cups of coffee (160-240 mg caffeine) daily leads to a 45% decrease in fertility. X-rays

Environmental pollution – intoxications (poisonings).

  • Occupational contact with anesthetic gases
  • Triclosan (polychlorinated phenoxyphenol; exposure to solar radiation, ozone, chlorine, and microorganisms can produce chlorinated dioxins from triclosan); triclosan is found in disinfectants, toothpaste, deodorants, household cleaners or detergents, and in textiles and footwear

Prevention factors (protective factors)

  • Younger nonobese women (BMI <30) who followed a “Mediterranean” diet in the 6 months before assisted reproduction had significantly better odds of carrying a pregnancy to term in a prospective cohort study. The third of women with greater adherence to the Mediterranean diet achieved 50% pregnancy/48.8% carried pregnancy, while the pregnancy rate in the third of women with the lowest adherence to the Mediterranean diet was only 29%/carried pregnancy 26.6%.The Mediterranean diet likewise improves sperm quality in men.
  • Sports: moderate endurance training

Fertility preservation for oncology patients

  • Radiatio (radiotherapy) of the pelvis.
    • Ovarian tissue cryopreservation and/or ovarian stimulation and cryopreservation of fertilized (fertilized) and/or unfertilized oocytes (eggs)
    • Ovarian transposition/ovaropexy (procedure that surgically relocates the ovaries (ovaries) out of the radiation field).
  • Chemotherapy (time window ≥ 2 weeks).
    • Tumor not estrogen dependent: Cryopreservation of ovarian tissue and/or ovarian stimulation and cryopreservation of fertilized (fertilized) and/or unfertilized oocytes (oocytes) and/or GnRH agonists.
    • Tumor estrogen-dependent: Cryopreservation of ovarian tissue; Individual risk-benefit assessment: if necessary, ovarian stimulation for cryopreservation of oocytes and GnRH agonists.
  • Chemotherapy (time window <2 weeks).