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 ID: 554711
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Slide1
Preserving your fertility
Laura L. Tatpati, MD
Clinical
Asst
Professor, Obstetrics and Gynecology
Live and Learn Lecture Series
KU School of MedicineSlide2
Reproductive Endocrinology and Infertility
Obstetrics and GynecologySlide3
Preserving - Protecting:
Our goals today-
The Biological Clock
External factors impact on fertility
Protecting fertility - old and newSlide4
Almost 1 in 8 couplesSlide5
www.reproductivefacts.org
InfertilitySlide6
Causes of Female Infertility
Egg factors
Quality
Number
Tubal factors/Pelvic scarring
Infection
Endometriosis
Cervical/Uterine factors
Genetic
AcquiredSlide7
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
EnvironmentalSlide8
AgingSlide9
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 difficultySlide10
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 & environmentSlide11Slide12
modifiable risksSlide13
“Goals for a healthier Me and baby-to-be”
http://www.cdc.gov/preconception/showyourlove/documents/Healthier_Baby_Me_Plan.pdf
FERTILITY GOALS
HEALTH GOALS
BE AWARE OF GOALS AND COMMUNICATE THEM TO YOUR DOCTORSlide14
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
yo
females have Chlamydia
Avoidance
Early Detection and treatment
http://
www
.cdc.gov/std/healthcomm/the-facts.htm
Slide15
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”
Don’t Wait!
Smoking
Quitting makes a difference
http://women.smokefree.govSlide16
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 syndromeSlide17
WeightSlide18
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 weekSlide19
Obesity/
Elevated
BMI
Irregular menses
Regular menses
Still reduced fertility
Pregnancy complications
Health complicationsSlide20
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*Slide21
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 Slide22
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/CommunicateSlide23
Health ConditionsSlide24
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 ...Slide25
Gynecologic issues
Fibroids
Polyps
Endometriosis
PCOS
Primary ovarian insufficiency
Irregular periods?
See your doctor
Prevent a bigger
Problem!Slide26
ChemotherapyRadiationwww.fertilehope.org
Cancer treatmentsSlide27
Cumulative effects
Each new issue Builds on the lastSlide28
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 Slide29
ToxinsSperm 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
Lead
Dibromochloropropane
Welding
Sevin
Toluenediamine, Dinitrotoluene
Ethylene Dibromide
Plastic Production
Ethylene Glycol
Perchloroethylene
Mercury Vapor
Heat
Military Radar
Kepone
Bromine Vapor
Radiation (high level)
2,4-D
Carbon disulfideSlide30
State
of the
rt
:
Egg freezingSlide31
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.orgSlide32
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