Environment

Does marijuana cause infertility?

Marijuana and fertility: Princeton IVF blog
Marijuana effects on fertility and pregnancy

All across the country, and likely soon in our state of New Jersey, recreational marijuana us is likely to become legal in more and more places. That means that more couples than ever who are trying to conceive will be users. If you are one of them, should you be concerned?

Here is what we know now:

Does marijuana affect a woman’s fertility?

We know that pot can affect a women’s hormones and her menstrual cycle. Ovulation problems which are related to hormone imbalances are a very common cause for female infertility.

Does marijuana affect a man’s fertility?

The main test fertility doctors use to diagnose male infertility is a semen analysis. We have known for some time that marijuana can have an adverse effect on the most important things we check for in a semen analysis, the number of sperm present (the count), how well they are swimming (motility) and the percent of the sperm that are normally shaped (morphology). We also know that exposure to active ingredient in marijuana THC can cause the breakage of chromosomes and abnormalities in a methylation, a natural chemical process which is responsible for how the genetic material is expressed in the body. Again, we do not know if this directly harmful to a man’s ability to father children or may affect the health of those children.

Is marijuana safe for my baby once I am pregnant?

If you believe the studies in animals, marijuana is not safe for pregnant moms to take. Rats whose mothers were exposed to marijuana in utero were more likely to have cognitive and memory problems in multiple studies. We do not know if this is the case in humans though. Keep in mind that a century ago, alcohol was thought to be safe in pregnancy and it was even used by doctors as a treatment for premature labor. We know now that alcohol causes very specific and severe birth defects when taken during pregnancy.

Is marijuana safe to take when I am breastfeeding?

THC can be found in the breast milk for days after use. Whether this poses any risk to a newborn is not known.

What about extracts that are sold at dispensaries?

No one knows for sure if these preparations are more safe or less safe than whole marijuana smoked or eaten.

So, do I need to be concerned?

No one can say definitively that marijuana use is dangerous during pregnancy nor can it be said to be definitively safe. There are however lots of red flags that raise concern. Most prudent doctors will advise that you and your partner consider avoiding pot if a baby is in your near future

The mediterranean diet and fertility

Mediterranean diet and fertility: Princeton IVF blog
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As a fertility specialist, one of the most common questions I get is about diet, what can changes can I make in my diet to help me get pregnant?

For some patients, particularly those with PCOS that answer is relatively simple. It well know that a diet high in protein and low in carbohydrates helps women with polycystic ovaries to conceive. 

For other women with infertility, the answer is less clear.

A recent study from Greece, looked at women who self-reported at following a "mediterranean diet." Women on a Mediterranean diet had a higher pregnancy rate that those who did not.

Does this prove that a diet in low in animal fats and high in vegetables and fruit can help you get pregnant? No, but it does suggest a health diet low in carbs and red meats may help your chances of having a baby.

Is the traffic outside affecting your chances of having a baby?

Living near a highway and IVF pregnancy rates: Princeton IVF blog
Women who live in high traffic areas are more likely to miscarry

Living in a high traffic area may hurt your chances for success with IVF

Research from Harvard presented at the annual meeting of the American Society for Reproductive Medicine suggests that women with a higher exposure to automotive traffic have lower IVF success rates than other women.

The researchers looked at 660 IVF cycles done over a 14 year period and compared their success rates to  how far they lived from a class A roadway. A class A roadway means an interstate, state or US highway. 

Women who lived more than a kilometer (0.6 miles) from a major roadway were 70% more likely to have a baby than those who lived within 200 meters (about 2 football fields) of a major roadway.

Interestingly, both groups of patients had similar pregnancy rates, but the those who live closed to the highway were more likely to miscarry.

Does this mean moving to a low traffic area will improve your chances  of having a baby?

Not necessarily. It does show what we already know, that the environment we live in and the air we breathe plays a role in reproduction, as it does in other aspects of health.

 

A spoonful of sugar may may the medicine go down, but will it harm your chances for pregnancy?

Sugary drinks, articifical sweeteners and fertility: Princeton IVF blog
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Recent studies suggests that sugary drinks, even those with artificial sweeteners may harm the chances for pregnancy.

Although it is far from conclusive, several recent studies suggest that sweet drinks may have an adverse effect of a woman's chance for pregnancy, including...

  • Harvard doctors found that drinking one sugary drink a day can lower the success rate of IVF by 12% and more than one sweet drink a day by 16%

  • Brazilian researchers found that consuming sugary or artificially sweetened drinks reduced embryo quality and the chances for an embryo to implant. interestingly

Interestingly this effect did not occur with unsweetened coffee.

The reason for this is not totally clear, though we know both obesity and polycystic ovarian syndrome (PCOS), which are both associated with infertility and miscarriage, and associated with changes in how the body handles sugar, can lower the chances for pregnancy.

So, what should I do?

It is a good idea to keep sugary products to a minimum when you are trying to get pregnant, and to minimize artificial sweeteners such as Splenda, Equal or Sweet-and-Low. These sugar substitutes may be just as harmful as sugar itself.

Don't panic. Women who use artificial sweeteners and drink sweet drinks still get pregnant all the time, even if the chances are a little lower. There are many factors that go into your fertility, so it is far from clear that consuming these drinks is actually harms your chances for pregnancy.

Noise and fertility

Traffic noise may increase time to conceive: Princeton IVF blog

Could a noisy neighborhood be making it harder to get pregnant?

Danish study suggests couple who live in neighborhoods with lots of traffic noise may take longer to get pregnant.

A study from Denmark suggests that it may have some impact.

The researcher looked at 65,000 Danish women who delivered between 1996 and 2002, and interviewed them to determine, among other things, how long it took them to conceive. They also looked at the traffic volumes for their neighborhood to see if they could compare the two.

They found that for every 10 decibels of additional traffic noise, there was a 5-8% increase in the chance it would take more than six months to conceive. 

Fortunately, increased traffic noise did not affect a couples chances to take longer than a year to get pregnant. Infertility is defined as a disease in which a couple is unable to conceive after one year's time, so the traffic noise itself did not cause infertility.

They could not determine whether the delayed time-to-conception (TTC) was due to the male or female partner, and the this delayed TTC was not affected by other factors such as poverty or levels air pollution that could delay conception.

Celiac disease, fertility and pregnancy

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Is there a link between celiac disease, infertility and pregnancy complications?

Celiac disease is a relative common disorder of the gastrointestinal tract caused by an allergy to gluten, a protein commonly found in wheat and other grain products. Like many other diseases, it what we call an autoimmune disorder, a disease in which the body's immune system attacks the person's own normal cells. Treatment of this disease rarely requires any drugs and almost always is helped by changing one's diet to a gluten-free one. The disease is also known as celiac or nontropical sprue, or gluten-sensitive enteropathy. Women (and men) who suffer from celiac disease may have symptoms such as:

  • abdominal bloating and pain
  • diarrhea or constipation
  • weight loss
  • fatigue

Studies on Celiac disease have also reported higher rates of infertility, miscarriages and menstrual problems among women with the disease, and then once pregnant, higher rates of a number of pregnancy complications such as low birth weight babies. It has even been reported to affects male fertility.

So, does this mean the Celiac disease causes fertility and pregnancy problems? Not so fast. Many of these studies are really too weak and small to draw any real conclusions. Still other studies fail to show that Celiac disease causes any reproductive issues. At this time, issue is far from settled.

For those looking to find a reason for their otherwise unexplained infertility, this may not be for the answer. However, for those who are having trouble getting pregnant and have lots of gastrointestinal symptoms, it may not be a bad idea to ask your doctor about getting tested for Celiac disease.

 

Soy and fertility

Are soy products good or bad for your fertility?

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Soy products such as soy milk and tofu are high in protein and have become popular for their reported health benefits. So, why the concern?It turns out that soy products also contain chemicals called phytoestrogens. These phytoestrogens are chemicals found in plants that look and act like estrogens, the "female" sex hormones that both women and men produce naturally.  It is commonly believed (but not universally accepted) that these phytoestrogens may have health benefits such as reducing the risk of cardiovascular disease and taming the symptoms of menopause. One of the main concerns over the use of these "dietary supplements" is that if they act like estrogens, they may very well carry the the same risks as taking estrogen pills like Premarin and Estrace.

 So, how does this tie in with fertility issues? One of the key ingredients in birth control pills is a type of estrogen (commonly ethinyl estradiol) so it should come as no surprise there may that taking soy products could potentially be a problem for women attempting pregnancy.

With that in mind, researchers at Harvard's School of Public Health, looked at women undergoing IVF treatment to see if the use of soy products had any effect on the pregnancy rates. The results were somewhat surprising. IVF patients taking soy supplements were actually more likely to get pregnant. While the study was small and limited, and it is certainly to early to encourage women doing IVF to take in more soy products, it does appear to be reassuring for those trying to get pregnant and don't want to stop the soy milk and tofu.

Plastic bottles, BPA and infertility

nalgene-bpa free bottle

Bisphenol-A (BPA), a chemical found in some plastic bottles has been shown to affect egg development. Researchers at Brigham and Womens Hospital/Harvard Medical School showed that the left over eggs from IVF were less likely to develop properly if there were exposed to high levels of BPA. Click here from the story from the Boston Globe. Click here for the original article from the journal Human Reproduction. It is not clear whether the low levels seen in most plastic bottles is enough to cause any problems though.