July 2020

What is fertility?

Fertility in women is the ability to conceive and produce a child. The statistics for female fertility are impressive: more than eight out of ten couples in which the woman is below forty years of age will get pregnant within one year if they have regular intercourse, ideally every two to three days without using any contraception.  More than nine out of ten of such lovemaking couples will achieve pregnancy within two years (1)

A normal level of fertility depends on the production of enough healthy, motile sperm - that is, active, mobile sperm - in the male, which are able to penetrate and fertilise a normal female ovum (egg) via the uterus and fallopian tubes. A successful pregnancy also requires the fertilised ovum to implant itself in the lining of the uterus and grow. 

There are a number of factors, many related to lifestyle, which can affect fertility in both male and female. The following four are, arguably, the most significant:

Affects of Alcohol on Fertility

There is no established safe level of alcohol for pregnant women and, a number of studies have shown that regular heavy drinking can reduce female fertility by interrupting the menstrual cycle and ovulation, and affecting hormone levels, particularly a hormone called prolactin, which, as its name suggests, supports breast milk production (2). As there is no agreed safe level doctors generally recommend complete abstinence, particularly during the first three months of pregnancy. As regards men, the effects of alcohol consumption are more apparent, often to their acute embarrassment: loss of erectile function, and lack of interest in intercourse. Levels of the hormone testosterone, an important element in the creation of sperm and maintenance of adequate sperm levels, is also adversely affected.

The Impact of Smoking
Smoking can have serious impacts on fertility for men and women. The carcinogenic toxins in cigarettes are well documented. For men, smoking can reduce the quality and volume of sperm as well as affecting erectile function over time, while women who smoke tend not to conceive as efficiently as non-smokers. The rates of infertility for men and women who smoke are about twice that found in non-smokers (3). Also, because cigarette smoke damages the genetic material in eggs and sperm, rates of miscarriage and birth-defects are higher among smokers. 

Transmittable venereal diseases can have a serious impact on fertility. Chlamydia and Gonorrhea can cause infection in the fallopian tubes or urinary tract, leading to PID, Pelvic Inflammatory Disease, which can damage reproductive organs. PID is one of the leading causes of infertility. The danger is no less significant for men, with STDs causing damage to the reproductive tract and leading to infection. 


Weight and Infertility
Being overweight can affect a woman's fertility and there is an association between obesity and infertility (4)  . Excess weight can also cause problems during pregnancy and affect the child's long term health. Men are not immune to the damaging effects of obesity in the shape of infertility and a reduction in testosterone.

How to Maintain Fertility Levels
Fertility decreases naturally with age, and there may be other, individual organic factors, which affect it. But, happily, the four factors above are all more or less controllable, and the standard advice on how to maintain our general health also applies to fertility levels. Keep alcohol consumption within safe, recommended levels, for women actively seeking conception, avoid it altogether. Reduce or, ideally, stop smoking completely. Keep an eye on your venereal health, and if you're even remotely concerned about an STD see your doctor. Keep your weight within the range which is right for you individually, this can be established by your doctor who can measure your BMI (Body Mass Index). 

The Role of the Mind in Fertility
But of course, women and men are not simply bodies, which can be looked after the way we look after the car, there is a powerful mind-body connection which scientists are only beginning to investigate seriously. Most of us already know how our moods can affect our physical well-being, a healthy mind can at least help to promote a healthy body, so when it comes to fertility, one should do whatever mental exercise or pursue whichever philosophy brings us calm, relaxation and a daily sense of well-being. 



 1 https://www.tommys.org/pregnancy-information/planning-pregnancy/fertility-and-causes-infertility#what

2 https://www.healthline.com/health/hyperprolactinemia

3 https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/smoking-and-infertility/

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456969/   Dag, Ozcan, Zeynep and Dilbaz, Berna (2015, June 1)  Impact of obesity on infertility in women. Retrieved from above site.