General information on fertility:
Fertility is defined as an individual's ability to procreate. About 80% of couples are able to conceive a baby in the first 6 months of trying and the fertility rate is highest in the first 3 months 1 .
In women, the possibility of becoming pregnant decreases significantly after the age of 35 , in fact, with advancing age the ovarian reserve decreases and also increases the percentage of oocytes with chromosomal alterations. Although even in men after 35-40 years sperm production gradually decreases and their quality also worsens, their fertility and is not affected until about age 50.
Infertility, on the other hand, is the inability to conceive after 12/24 months of regular , unprotected sexual intercourse due to the impairment of a subject's ability to reproduce individually or with his or her partner. The WHO ( World Health Organization) estimates that infertility affects approximately 80 million couples worldwide.
MAIN FACTORS THAT INFLUENCE FERTILITY
Age : Age is one of the most significant factors that affects fertility. As mentioned, fertility in women peaks between the ages of 20 and 30 and decreases after age 35 , and men also experience a decline in the quality and quantity of sperm as they age . In addition to a decrease in the follicular reserve in women, the ability of the endometrium to interact with the embryo may be reduced , the number of spontaneous abortions and pathologies such as , for example, endometriosis and uterine fibroids may increase .
Lifestyle : smoking, excessive alcohol consumption and drugs can negatively affect fertility in both men and women. Obesity or excessive thinness also affect hormone levels , destabilizing reproductive health and threatening fertility .
Medical conditions : Polycystic ovary syndrome (PCOS), endometriosis , thyroid problems , hyperprolactinemia , uterine fibroids, pelvic inflammatory disease, hormonal and ovulatory disorders, defects in the structure of the uterus can affect female fertility. In men, problems such as varicocele , genital malformations , prostatic pathologies or infections can reduce sperm count or function.
Sexually transmitted diseases : Chlamydia and gonorrhea increase the rate of infertility. Human papillomavirus (HPV) and Human immunodeficiency virus (HIV) can also cause infertility .
Environmental factors : Exposure to various environmental substances and toxins, pesticides , heavy metals, plastic derivatives and hydrocarbons can influence an individual's reproductive health .
Psychological stress : Chronic stress can lead to changes in ovulation , irregular menstrual cycles in women, and reduced sperm production and motility in men.
PREGNANCY
General information about pregnancy :
During pregnancy, a woman's body adapts to increased physical and metabolic demands through significant anatomical and physiological changes. These changes affect various systems, including the respiratory, cardiovascular, gastrointestinal, renal, and skeletal systems, as well as the mammary glands, to support fetal development and ensure the survival of mother and child during childbirth.
First trimester : The first trimester of pregnancy lasts from conception until the thirteenth week . During this phase, the first significant changes begin : the production of hormones such as HCG (human chorionic gonadotropin) increases to support the pregnancy. Many women may experience symptoms such as nausea, tiredness and food cravings. This period is crucial for embryonic development, as the main vital structures of the fetus, such as the heart, brain and spine, are formed.
Second trimester : from the fourteenth to the twenty-sixth week . Symptoms such as nausea and tiredness decrease . It is also the period in which the fetus grows rapidly, developing sensory abilities and starting to move actively. In this trimester, a morphological obstetric ultrasound is scheduled , with which the anatomy and development of the fetus are evaluated .
Third quarter : ( from the twenty - eighth to the fortieth ) we enter the final phase of pregnancy. The woman's body actively prepares for childbirth; the fetus assumes its final position for birth .
Factors that affect pregnancy:
Lifestyle : Diet and lifestyle have always played a crucial role: it is essential to avoid alcohol and tobacco consumption, ensure adequate folate intake, maintain an appropriate body weight, and follow a varied and balanced diet, rich in vitamins and minerals.
Medical checks regular : they are crucial to monitor the health of the woman and the baby. These ''check-ups'' can help identify and manage any health problems early (it is important to carry out a careful evaluation regarding pathologies such as diabetes mellitus, hypertension, thyroid disorders , autoimmune diseases, etc.) .
Mental health : A woman 's emotional well-being is as important as her physical health. It is important to protect her mental health and address it. possible moments of vulnerability, anxiety, depressive states appropriately through the support and therapy to avoid maternal and fetal complications.
TIPS FOR IMPROVING FERTILITY AND A HEALTHY PREGNANCY
Maintaining good health : Achieving and maintaining good health through a balanced diet and regular exercise can improve your chances of conceiving and having a healthy pregnancy.
Physical activity: Regular exercise is permitted during the conception period (in fact it helps at a hormonal level and some conditions that negatively affect fertility such as overweight, PCOS, psychological well-being).
It is advisable that pregnant women, in the absence of specific pathological conditions , practice at least 150 minutes of physical activity moderate weekly, adopting specific precautions to be able to carry it out in safety 2 . It is important to avoid exercise physical in conditions of excessive heat , maintain good hydration and favor low-risk activities, avoiding those with potential physical contact or a high risk of falling 2. It is essential to always consult your doctor , especially for those who wish to intensify physical activity .
Nutrition: During pregnancy, the diet must be varied and attention must be paid to the quality in relation to proteins, vitamins , minerals and type of fats . It is important that the doctor evaluates the nutritional status of the woman, adjusting the energy and nutritional intake during pregnancy.
For proteins, you should prefer foods such as fish, lean meats, milk, cheeses, dairy products but also whole grains that guarantee an adequate intake of fiber and legumes . Also enrich your diet with foods rich in calcium, iron and folates (wide variety of fruits, vegetables , yogurt etc. ) . One should never neglect the daily consumption of seasonal fruit and vegetables , in addition to the need to wash them thoroughly before handling and consuming them .
It is essential to resort to folic acid supplementation (400 mcg /day ) to reduce the risk of neural tube defects (from before conception until the end of the first trimester of pregnancy). Also cover the increased need for long-chain omega-3 fatty acids by eating fish. cooked (3-4 servings per week) and choosing small fish .
Reduce caffeine consumption (max 2 coffees per day) and avoid both prolonged fasting and overly abundant meals and excessive consumption of sugar and salt. Furthermore, during pregnancy, it is essential that the woman consumes an additional quantity of approximately 350 ml of water per day compared to that recommended for an adult woman, to cover her own needs and those of the fetus, including amniotic fluid and fetal appendages.
Monitor your fertility windows : Knowing your fertile window significantly increases your chances of success when trying to get pregnant. Using tools such as ovulation tests, fertile day calculators and more can help you even the simple observation of cervical mucus can help to have more precise data on the fertile window and ovulation, optimizing the chances of conception and reducing stress and uncertainty. Furthermore, for women, understanding their menstrual cycle can lead to the discovery of any fertility problems, allowing timely interventions.
Reduce stress : Stress impacts sperm activity in men , menstrual cycle and ovulation in women, so it is necessary to control this element. Yoga , meditation and mindfulness can reduce it and improve overall reproductive health.
Avoid exposure to oxin : It is important to limit contact with pesticides, chemical solvents and heavy metals, both at home and at work, as exposure to these substances can pose a risk to the health and reproductive capacity of both men and women, as well as harming fetal development. It is also important to avoid smoking and passive exposure to smoke, as it negatively affects fertility.
Seek professional help : If you are having trouble conceiving, consider seeing a specialist who can recommend extensive tests to evaluate the reproductive health of both partners and identify any problems. Your doctor may suggest specific treatments such as in vitro fertilization , intrauterine insemination, or hormone therapy if necessary. Expert support not only improves your chances of conceiving , but also provides guidance and comfort during the process. all the path .
Disclaimer: The information provided is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Every health situation is unique; therefore, it is essential to consult with your doctor for advice that is appropriate for your situation .
REFERENCES:
1. Optimizing natural fertility: a committee opinion, Fertility and Sterility , Volume 117, Issue 1 , 2 0 2 2 , page s 5 3 - 6 3
2. WHO guidelines on physical activity and sedentary behavior r , 2020
