sağlıklı yaşam biçimi gebelik şansını arttırır
Lifestyle Management Before Infertility Treatment Peter Kovacs, MD, PhD Peter Kovacs, MD Clinical Reproductive Endocrinologist, Research and Scientific Coordinator, The Kaali Institute-IVF Center, Budapest, Hungary It is well known that women who are under- or overweight have difficulty with reproduction. Obese women are at risk for miscarriage, gestational diabetes, gestational hypertension, preterm delivery, macrosomia, low birth weight, stillbirth, delivery via operative route, and postoperative complications. Underweight women are also at risk for miscarriage, low birth weight, preterm delivery, and stillbirth. Therefore, preconceptional counseling about weight and lifestyle management is very important. During this counseling, one should evaluate the patient’s diet, frequency and intensity of exercise, toxic habits, and use of drugs that affect body weight. The best way to assess weight is to calculate the body mass index (BMI) using the following equation: weight (kg)/height2 (m2). A BMI between 18.5 and 24.9 kg/m2 is considered normal. Women with a BMI < 18.5 kg/m2 are underweight, whereas women with a BMI > 25 kg/m2 are overweight, and those with a BMI > 30 kg/m2 are obese. Underweight women should be screened for eating disorders and thyroid dysfunction. In some cases, it may be appropriate to work together with a nutritionist and a psychologist. Low body weight is associated with ovulatory dysfunction. Usually, minimal weight gain (3 to 5 kg) is sufficient to restore ovulation and to improve the outcome of a subsequent pregnancy. Overweight women also need to undergo a throrough endocrinologic evaluation (thyroid function, Cushing’s syndrome, polycystic ovary syndrome [PCOS]). They should be screened for diabetes, lipid abnormalities, and hypertension and should be advised about a lower-calorie diet with approriate nutrients. Women with PCOS may benefit from a diet that is low in saturated fat and high in low-glycemic-index-carbohydrate. Besides adhering to a healthy diet, regular exercise is needed to burn excess calories and to help to maintain a lower weight. Daily moderate exercise for about 30 minutes is recommended. Very often ovarian activity is restored by losing 5% to 10% of weight, even without reaching the ideal range. Drugs that improve insulin resistance also improve reproductive outcome among women with PCOS. They should not be used alone, however, but rather should be combined with a healthy diet and regular exercise. Adequate folic acid intake is essential for reproductive-age women, as it can reduce the incidence of fetal neural tube defects and cardiac anomalies. Weight control is very important...
Daha Fazlasıyağ alımı arttıkça endometriosis artıyor
From Human Reproduction A Prospective Study of Dietary Fat Consumption and Endometriosis Risk Stacey A. Missmer; Jorge E. Chavarro; Susan Malspeis; Elizabeth R. Bertone-Johnson; Mark D. Hornstein; Donna Spiegelman; Robert L. Barbieri; Walter C. Willett; Susan E. Hankinson Abstract Background: Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifiable risk factors have been identified. Fish oil consumption has been associated with symptom improvement in studies of women with primary dysmenorrhea and with decreased endometriosis risk in autotransplantation animal studies. Methods: To investigate the relation between dietary fat intake and the risk of endometriosis, we analyzed 12 years of prospective data from the Nurses’ Health Study II that began in 1989. Dietary fat was assessed via food frequency questionnaire in 1991, 1995 and 1999. We used Cox proportional hazards models adjusted for total energy intake, parity, race and body mass index at age 18, and assessed cumulatively averaged fat intake across the three diet questionnaires. Results: During the 586 153 person-years of follow-up, 1199 cases of laparoscopically confirmed endometriosis were reported. Although total fat consumption was not associated with endometriosis risk, those women in the highest fifth of long-chain omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis compared with those with the lowest fifth of intake [95% confidence interval (CI) = 0.62–0.99; P-value, test for linear trend (Pt) = 0.03]. In addition, those in the highest quintile of trans-unsaturated fat intake were 48% more likely to be diagnosed with endometriosis (95% CI = 1.17–1.88; Pt = 0.001). Conclusion: These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food...
Daha Fazlasıstresli yaşam olayları ivf başarısını olumsuz etkiliyor
Stressful Life Events are Associated with a Poor In-vitro Fertilization (IVF) Outcome: A Prospective Study S.M.S. Ebbesen; R. Zachariae; M.Y. Mehlsen; D. Thomsen; A. Højgaard; L. Ottosen; T. Petersen; H.J. Ingerslev From Human Reproduction Abstract Background: There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months. Methods: Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms. Results: Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval. Conclusion: A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval...
Daha FazlasıPentoxifylline embryo hasarını azaltıyor
Effect of pentoxifylline in reducing oxidative stress-induced embryotoxicity1 Xiaoyan Zhang,2 Rakesh K. Sharma,2,3 Ashok Agarwal,2 and Tommaso Falcone2 Submitted May 13, 2005; accepted July 6, 2005 Purpose: To 1) evaluate the embryotoxic effects of hydrogen peroxide on mouse embryo development and 2) examine if pentoxifylline can reverse hydrogen peroxide induced embryotoxicity. Methods: Prospective in vitro study examining the effects of varying concentrations of hydrogen peroxide and pentoxifylline on the blastocyst development rate alone as well as in combination. Results: A dose-dependent decrease in % BDR was seen with increasing concentrations of H2O2. High concentrations of hydrogen peroxide (>60μM) were embryotoxic. Pentoxifylline (500μM) was able to reduce the embryotoxic effect of hydrogen peroxide. Percent blastocyst development rate increased from 44% in hydrogen peroxide alone to 85% in hydrogen peroxide and pentoxifylline coincubation. Conclusions: Pentoxifylline may be beneficial in reducing hydrogen peroxide induced embryo damage and improve IVF outcome. Patients with endometriosis-associated infertility may benefit from the use of pentoxifylline without significantly affecting embryo...
Daha FazlasıArtmış serbest radikaller gebe kalma şansını azaltır
The Impact of Reactive Oxygen Species on Early Human Embryos: A Systematic Review of the Literature — Sajal Gupta, Jashoman Banerjee, Ashok Agarwal Abstract: Oocytes and embryos are constantly exposed to oxidative stress which influences their developmental competence. But, the antioxidants present in the reproductive tissues protect the embryos in vivo. The effects of oxidative stress in Assisted Reproductive Technology (ART) is amplified by lack of physiological defense by the antioxidants and also due to abundance of potential sources that can generate Reactive Oxygen Species (ROS) in culture media. Certain levels of ROS are necessary for sperm function,normal activity in the ovarian follicle, normal sperm-oocyte interaction and sperm capacitation. But, excessive levels may have adverse effects on sperm DNA, fertilization and embryo quality. ROS not only accelerate apoptosis in the cell by direct DNA damage, but also affect the DNA repair mechanisms along with alterations in important check points in cell cycle. In-vitro developmental arrests are documented in mammalian embryos that are exposed to oxidative stress. Hence blastocyst development in vitro lags behind blastocyst development in vivo. Sperm DNA damage caused by elevated ROS levels results in embryo development arrest and poor fertility outcomes with ART. This article reviews the literature on the sources of ROS generation in ART setting and enumerates strategies to overcome oxidative...
Daha Fazlasıcd56 yüksekliği gebe kalma şansını azaltıyor düşük şansını arttırıyor
Food intake and its relationship with semen quality: a case-control study Jaime Mendiola, Ph.D.,a Alberto M. Torres-Cantero, D.P.H.,b Jose M. Moreno-Grau, Ph.D.,c Jorge Ten, Ph.D.,a Manuela Roca, M.D.,c Stella Moreno-Grau, Ph.D.,c and Rafael Bernabeu, M.D.a,d a Department of Reproductive Biology and Medicine, Instituto Bernabeu, Alicante; d Reproductive Medicine Chair, University of Miguel Hernandez de Elche-Instituto Bernabeu, Alicante; b Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Espinardo (Murcia); and c Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain Objective: To compare dietary habits in normospermic and oligoasthenoteratospermic patients attending a reproductive assisted clinic. Design: An observational, analytical case-control study. Setting: Private fertility clinics. Patient(s): Thirty men with poor semen quality (cases) and 31 normospermic control couples attending our fertility clinics. Intervention(s): We recorded dietary habits and food consumption using a food frequency questionnaire adapted to meet specific study objectives. Analysis of semen parameters, hormone levels, Y microdeletions, and karyotypes were also carried out. Main Outcome Measure(s): Frequency of intake food items were registered in a scale with nine categories ranging from no consumption to repeated daily consumption. Result(s): Controls had a higher intake of skimmed milk, shellfish, tomatoes, and lettuce, and cases consumed more yogurt, meat products, and potatoes. In the logistic regression model cases had lower intake of lettuce and tomatoes, fruits (apricots and peaches), and significantly higher intake of dairy and meat processed products. Conclusion(s): Frequent intake of lipophilic foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality. (Fertil Steril 2009; 91:812–8. 2009 by American Society for Reproductive...
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