Medical factors that influence female fertility

There are many medical factors that can influence a woman's fertility. Some of these are out of her control, while others can be managed with the help of a doctor. Here are some of the most common medical factors that can affect fertility:

Health Conditions

Endometriosis, polycystic ovary syndrome (PCOS), ovulation problems, uterine fibroids and abnormalities of the uterus can reduce fertility and increase your chances of miscarriages or ectopic pregnancies.

Other illnesses, left untreated, including kidney disease and thyroid disease may also affect pregnancy odds.

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women in their reproductive years. PCOS (which affects around one in seven woman) has a range of symptoms such as irregular periods or no periods at all, excessive hair growth (hirsutism) usually on the face, chest, back or buttocks and unexplained weight gain. PCOS is mainly due to a hormonal imbalance rather than a disease of the ovaries and therefore if the hormone levels associated with PCOS can be reduced or controlled, the ovaries can often function normally and fertility odds will increase.

In moderate to severe forms of endometriosis, scarring of the ovaries may interfere with ovulation and may also damage or block the fallopian tubes which may mean that eggs can’t travel to the uterus and sperm can’t reach the egg. Endometriosis may further increase the risk of having a miscarriage if the lining of the uterus is found elsewhere in the body such as the ovaries or vagina.

In mild endometriosis, there is no obvious reason why infertility occurs. It is thought that there may be some chemicals released from the endometrial cells that interfere with the ability to get pregnant or affect the development of the embryo.

Irregular Menstrual Cycles

If your period is irregular or not occurring at all (whether due to hormonal imbalances, weight issues or medications you take) it can be tough to accurately forecast when your ovulation will occur and thus making it harder to conceive naturally.

Autoimmune Disorders and Diabetes

It is known that autoimmune diseases such as diabetes, autoimmune thyroiditis and systemic lupus erythematosus (SLE) are linked to decreased fertility. There are three types of diabetes: type 1, type 2 and gestational which affects the blood sugar levels in the body. In women, diabetes can result in irregular or absent menstrual cycles, while in men it can cause problems getting and maintaining erections and the lowering of testosterone levels. In some cases untreated diabetes can also increase the risk of miscarriage, stillbirth or the baby needing intensive care after birth.

Sexually Transmitted Infections (STIs)

Pelvic inflammatory disease (PID) can be caused by untreated STIs (usually gonorrhoea and chlamydia). PID can cause permanent damage to female reproductive organs making it difficult or impossible to get pregnant. You may feel uncomfortable discussing this with your healthcare team but remember timely treatment of STIs can help you avoid PID and other related pregnancy complications. It is also important to ensure that neither you or your partner have any untreated STIs during conception.

Certain Cancer Treatments

Some types of cancer and some types of cancer treatment can affect both female and male fertility. If you or your partner have previously or are currently undergoing cancer treatment and would like to have a baby (now or in the future) we recommend speaking to your oncologist. They can refer you to a fertility specialist who will explain the available options for protecting your fertility both before and after cancer treatment.

Prescription/ Over-The-Counter Medications

Some prescription and over the counter medications or supplements (including herbal medicines) can affect your chances of getting pregnant, cause problems during pregnancy, or harm your baby. These medications are carried through the bloodstream or across the placenta and can interfere with the baby’s development, damage the placenta and can restrict the amount of nourishment delivered to the baby. Some can also increase the risk of miscarriage, pregnancy complications or bring on premature labour. It may be essential to continue using a medication for specific conditions such as when the medication helps to manage a long-term health condition.

Use contraception and stay on your current medication until you have had your preconception evaluation with your healthcare team. Your practitioner should provide you with a list of safe to use medications and can often suggest safe substitutes to take while you’re trying to get pregnant.

Oral Health

I bet you didn’t think your oral health could affect your fertility! Your oral health plays a vital part in keeping your future baby safe. By not keeping those pearly whites in a shiny state you could develop gingivitis (the early stage of gum disease). If left untreated gingivitis can lead to increased risk of developing pre-eclampsia, premature birth or having a baby with a lower than normal birth weight. Therefore, we encourage you to add the dentist to your preconception call list.

Here are some top tips for avoiding gum disease:

• Avoid sugary foods and drinks and opt instead for a healthy and balanced diet of fresh fruit and vegetables, lean meat, fish and whole grains
• Keep those pearls white by brushing at least twice a day or after every meal with a fluoridated toothpaste
• Avoid smoking cigarettes or cannabis
• Floss regularly to avoid plaque build up
• Visit a dentist regularly (every six months is optimal) for a hygienic clean