In conversation with Dr. Swati Kumari, MD-MS in Obstetrics and Gynaecology (TUTH-Maharajgunj) and MBBS (KUMS-Dhulikhel) at Vatsalya IVF “For you are a woman, and you shall bring to this world a miracle; your child.”

A woman's fertile health is determined by a multitude of factors. In this fast-paced world, with the advent of technology, fast-paced lifestyle, environmental pollution and lack of self-care, it is becoming common for women to develop issues in regards to their fertile health. We spoke with Dr. Swati Kumari at Vatsalya IVF to better understand a woman's fertility and learn more on methods of care.

How does a female’s body weight affect one’s fertility? Are there any lifestyle changes she needs to make to maintain fertile health?

Having an unhealthy weight can affect a woman’s fertility by causing hormonal imbalances and triggering problems with ovulation (releasing an egg from the ovaries). Obesity is also associated with polycystic ovary syndrome (PCOS), a common cause of low fertility or infertility. 

While the facts about obesity and reproductive outcomes can seem daunting, there is some good news. In women who are obese, even a small weight loss (approximately even 5%) improves the chances for pregnancy. Also, some dietary and lifestyle changes aimed at limiting weight gain during pregnancy can improve health outcomes for both the mother and the baby.

However, the other end of the spectrum i.e. being underweight is also not ideal for pregnancy. Being underweight (BMI under 18.5) can reduce a woman’s fertility by causing hormone imbalances that affect ovulation and the chance of getting pregnant.

Compared to women in the healthy weight range, underweight women are more likely to take more than a year to get pregnant. If one is underweight and trying to conceive, a dietician can work with her to change her diet and help her put on the ideal weight.

 

How does the mental health of a female affect her fertility?

Women with infertility complain of elevated levels of anxiety and depression. So it is clear that infertility has an association with mental health. What is, however, less clear is whether or not stress causes infertility. Some latest research underscore the efficacy of psychological interventions in reducing stress with significant increases in pregnancy rates.

How big is the interrelation between women’s fertility and her age? What is the most suitable age for a woman to conceive?

A woman’s peak reproductive years are between the late teens and late 20s. By the age of 30, fertility (the ability to get pregnant) starts to decline. This decline becomes more rapid once one reaches her mid-30s. By the age of 45, fertility declines so much that getting pregnant naturally is unlikely for most women.

Is there anything a woman can do to increase her fertility health? How big of a role does the environment play in this?

Diet and lifestyle changes can help boost fertility by up to 69%.I would recommend that one makes lifestyle changes before one thinks of getting pregnant. These include:

  1. getting back to a healthy weight
  2. improving diet/exercise habits
  3. eliminating alcohol
  4. quitting smoking, if one smokes
  5. cutting back on caffeine

Overexposure to certain environmental factors such as pesticides, chemicals, pollutants, and radiation can cause decline in fertility.

Are there any other factors besides these that affect a woman’s fertility? What other tips would give to maintain a working woman’s fertile health?

Another important factor is the timing of intercourse. Couples that have regular sex 2-3 times a week are most likely to get pregnant because this frequency ensures that a good volume of fresh sperm will be present in the female reproductive tract at the time of ovulation.  If couples are only having sex once a week, the chance of getting pregnant is less because there will be less fresh sperm present in the female genital tract at the time of ovulation.

Non-steroidal anti-inflammatory drugs such as ibuprofen can interfere with ovulation. Aspirin may interfere with implantation. Recreational drugs such as marijuana and cocaine may interfere with ovulation and/or the function of the fallopian tube which is important for transporting the egg from the ovary where it is released to the womb (uterus), where an embryo will hopefully implant. 

Fertilization occurs in the fallopian tube.  Anabolic steroids, which are abused by some body-builders, inhibit the production of sperm and this may be permanent even if the drug is stopped.

Medical illnesses also impact a woman's fertility. Some women may have medical conditions that can affect their fertility.  These may or may not be known about when starting to try for a family.  Some of these conditions may be more general, for example, thyroid disease and vitamin-D deficiency, whilst others may be more specific, for example, polycystic ovary syndrome and endometriosis.

Some tips I would like to give are as follows.

  1. Avoid the above-mentioned agents.
  2. Prevent sexually transmitted infections. Infections such as chlamydia and gonorrhoea are a leading cause of infertility for women; and
  3. Avoid the night shift, if possible. Regularly working the night shift affects hormone production. If one has to work the night shift, try to get enough sleep.

We are well aware that smoking and alcohol has a negative effect on a female’s fertile health, what other food or beverages does a woman have to watch out for in general?

Trans-fats are responsible for Infertility. Trans-fats can be found in foods like potato chips, fast food, and pre-packaged sweets like cakes and pies. Hence it’s best to avoid these foods if trying to get pregnant. Also, try to watch out for sugary snacks, cold drinks and fish rich in Mercury (like tuna).

 

Tips for healthier weight before pregnancy:

  1. Swap sugary drinks and alcohol for water.
  2. Eat fast food less often and make healthier choices when you can. Replace half of your full partition of the lunch and dinner cereals (rice or roti) with green vegetables cooked in low fat.
  3. Use a smaller plate to help reduce your portion sizes.
  4. Fit in regular physical activity like walking to the shops, climbing up the stairs and walking with a friend.
  5. Choose healthy snacks like fruit, low-fat yoghurt or a small portion of plain nuts, reduced-fat dairy products and lean meat (chicken breast).
  6. Set a realistic weight goal. It can help you feel motivated and active. Aiming for weight loss of half to one kilogram per week is a good goal.