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Preserving your fertility

Preserving your fertility. Laura L. Tatpati, MD Clinical Asst Professor, Obstetrics and Gynecology Live and Learn Lecture Series KU School of Medicine. Reproductive Endocrinology and Infertility. Obstetrics and Gynecology. Preserving - Protecting: Our goals today-. The Biological Clock

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Preserving your fertility

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  1. Preserving your fertility • Laura L. Tatpati, MD • Clinical Asst Professor, Obstetrics and Gynecology • Live and Learn Lecture Series • KU School of Medicine

  2. Reproductive Endocrinology and Infertility Obstetrics and Gynecology

  3. Preserving - Protecting:Our goals today- • The Biological Clock • External factors impact on fertility • Protecting fertility - old and new

  4. Almost 1 in 8 couples

  5. Infertility • www.reproductivefacts.org

  6. Causes of Female Infertility • Egg factors • Quality • Number • Tubal factors/Pelvic scarring • Infection • Endometriosis • Cervical/Uterine factors • Genetic • Acquired

  7. Causes of Male Infertility • Sperm production problems • Genetic • Born without ability for sperm development • Born without tubes to release sperm • Acquired anatomical changes • Polyps obstructing outflow • Vasectomy • Environmental

  8. Aging

  9. Fertility and Aging • Born with all the eggs we’ll ever have • 20% of women have their 1st child after 35 • 5% had their 1st child after 30 in 1975 • At least 1/3 of those trying to conceive after 35 have difficulty

  10. Fertility and Aging • Fertility always declines with age • For most, major acceleration of decline = late 30s • Individual rate vs. Age group rate • Impact from genetics & environment

  11. modifiable risks

  12. FERTILITY GOALS HEALTH GOALS BE AWARE OF GOALS AND COMMUNICATE THEM TO YOUR DOCTOR “Goals for a healthier Me and baby-to-be” http://www.cdc.gov/preconception/showyourlove/documents/Healthier_Baby_Me_Plan.pdf

  13. Sexually transmitted infections • Tubal Factor: 18% of infertility • Chlamydia: 2.9 Million cases and 1.5 Million cases treated annually • Gonorrhea: 8 Million cases annually • 1 in 15 sexually active 14-19 yofemales have Chlamydia • Avoidance • Early Detection and treatment http://www.cdc.gov/std/healthcomm/the-facts.htm

  14. http://women.smokefree.gov Smoking • 54% higher chance of infertility • Accounts for up to 13% of infertility • 50% lower chance of pregnancy with IVF! • Increased risk with increased amounts • Damages the ovarian “egg pool” Quitting makes a difference Don’t Wait! Smoking

  15. Alcohol • 1 in 8 women binge drink (4 or more in 2-3h) • Infertility may be more likely with over 5 - 8 drinks / week or repeated binge drinking • beyond infertility - breast cancer, heart disease, unintended pregnancy, and fetal alcohol syndrome

  16. Weight

  17. Low BMI • Body fat is key • Low BMI • Normal BMI, low body fat • Excessive intense cardio may result in hormone problems • Menstrual irregularity • Infertility with regular menses • Goal 150 minutes moderate intensity per week

  18. Obesity/Elevated BMI • Irregular menses • Regular menses • Still reduced fertility • Pregnancy complications • Health complications

  19. Eat healthy • Fruits/Vegetables • Lean meat, small portions • Beans, eggs, nuts • Whole grains • Avoiding saturated / trans fats • (Possibly) 1 full fat dairy every few days*

  20. Environmental toxins • Medical term: Endocrine disruptors • Interrupt hormones in our body • Cumulative effect • work toxins, solvents, plastics, cosmetics, detergents http:/www.prhe.ucsf.edu/prhe/pdfs/ToxicMatters.pdf. http://www.marchofdimes.com/pregnancy/stayingsafe_indepth.html

  21. Stress / Mental Health • Infrequently the sole cause of true infertility • Sexual dysfunction • Ovulatory disturbances • Some meds can affect hormones • Conflicting data • Definitely associated with stopping treatments • Can affect relationships • Seek support/Communicate

  22. Health Conditions

  23. Contributing Medical Conditions • Insulin resistance/Type 2 Diabetes • Thyroid disease • Pituitary disease • Depression/anxiety • Vaginismus, painful intercourse, sexual dysfunction • Cancers (1/8 are reproductive aged or younger) • Gynecologic • Many more ...

  24. Gynecologic issues • Fibroids • Polyps • Endometriosis • PCOS • Primary ovarian insufficiency Irregular periods? See your doctor Prevent a bigger Problem!

  25. Cancer treatments • Chemotherapy • Radiation • www.fertilehope.org

  26. Cumulative effectsEach new issue Builds on the last

  27. Men • Steroids/Testosterone • Supplements, topical, injections, pills • Tobacco • First and second-hand smoke issues! • Alcohol • Obesity • Illness/Injury • diabetes, severe kidney damage, paraplegia • High heat environment • Varicoceles - consider monitoring or treatment • Toxins

  28. Toxins • Sperm background • Sperm are made in about 72d • They live in storage for about 15-25 days in the epidymus • 1,000 shown to be harmful to animal reproduction and nearly 4 Million untested • Safety • Avoid skin contact • Store in sealed containers • Wash hands • Change clothes (don’t bring it home!) • Safety gear

  29. State of thert:Egg freezing

  30. Infertility is not an inconvenience; it is a disease of the reproductive system that impairs the body’s ability to perform the basic function of reproduction www.reproductivefacts.org

  31. Resources • www.asrm.org • www.reproductivefacts.org • www.cdc.gov • www.perinatalweb.org • http://www.cdc.gov/preconception/showyourlove/documents/Healthier_Baby_Me_Plan.pdf • www.fertilehope.org • www.resolve.org

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