Help
US
Help
YOU
by Dr. Patricia Monnier
As a specialist in infertility I treat both
women and men, and one sentence that my
patients often hear from me is, “Help me
help you!” This is because, in my opinion,
lifestyle has a major influence on fertility and
this fact is not sufficiently well known. This
means that you may be able, using simple
strategies, to enhance your fertility, or at least
help us make your fertility treatments more
effective.
You may be able, using
simple strategies, to
enhance your fertility,
or at least help us
make your fertility
treatments more
effective.
If you are overweight, lose a
few pounds
One aspect you can work on is weight control. We all know that obesity has reached
epidemic proportions all over the world. This
phenomenon has not spared fertility patients,
and numerous studies have shown that excess
weight damages the fertility potential. In fact,
the risk of infertility is three times higher in
obese women than in women with a healthy
weight. Indeed, fat tissue is not considered
anymore as a passive depot for storing excess
energy but as an active organ secreting several
hormones. One explanation of the negative
relationship between obesity and fertility is
that fat tissue promotes the production of
“bad” hormones which do not help the ovary
to perform its duties. If one burns fat through
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The good news is that
you do not have to be
paper thin to enhance
your fertility. A woman
with a body mass
index over 30 who
loses as little as 6.5
kilos (14 lbs.) will
improve her ovulatory
function.
losing weight, this regulates ovarian
physiology, in plain terms, ovulation.
The same is true for men. Extra pounds
hinder sperm production, especially in
overweight men whose diet is high in saturated fats, such as those found in butter, fat
cheeses and frying oil.1
The good news is that you do not have to be
paper thin to enhance your fertility – in fact,
being too thin is equally detrimental to your
reproductive health. According to several
studies, a woman with a body mass index
over 30 – a person with a BMI between 25
and 30 is considered overweight, while someone with a BMI over 30 is considered obese –
who loses as little as 6.5 kilos (14 lbs.) will
improve her ovulatory function. After losing
weight, an obese woman will have a 90%
chance of ovulating on her own, a result
which no medical treatment can achieve.2
Think of the children
Losing weight is not easy. One factor that
may boost your motivation is that by shedding a few kilos you will actually do a great
service to your future children. Indeed,
there is increasing evidence that the environment in the mother’s womb conditions
the health of the child once he or she
becomes an adult. An overweight or obese
mother will tend to produce children who
will be more vulnerable to obesity later in
life. These children will also tend to be at
risk of problems associated with sugar levels
in their blood and of developing insuline
resistance. This may lead to an array of
health problems, from diabetes to heart disease. Moreover, recently, researchers found
a preconceptional impact of paternal obesity, via spermatogenesis, on the offspring’s
future health status.3
Ban alcohol, recreational
drugs, tobacco… and sauna
baths!
Other steps which are relatively simple to
take and are totally under your control are
related to your intake of alcohol, drugs and
tobacco products. No matter what you may
hear about some positive effects of alcohol,
of red wine in particular, alcohol is toxic for
the reproductive system.4 And so is
cannabis, usually referred to as a “soft”
drug. Well, when it comes to your reproductive health, studies show that it is not
that soft5… As for tobacco, it should be
banned from any household where one
person or a couple is trying to conceive.6 Not
only does tobacco lower a man’s sperm count,
it also cuts by 50% a woman’s chances of success when undergoing IVF if her partner is a
smoker, even if she doesn’t smoke herself.
Furthermore, women exposed to passive
smoke also take longer to achieve a spontaneous pregnancy.
Why ban sauna baths?7 Men are increasingly
aware that heat is harmful to the production
of healthy sperm, but this may be worth
Tobacco should be
banned from any
household where one
person or a couple is
trying to conceive.
Not only does tobacco
lower a man’s sperm
count, it also cuts by
50% a woman’s
chances of success
when undergoing IVF
if her partner is a
smoker, even if she
doesn’t smoke
herself.
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We now know that
small doses of
endocrine disruptors,
day after day, have a
cumulative effect that
damages not only our
reproductive health, but
also our health in
general.
round of IVF is not rare, indeed even after
an appointment with the fertility clinic has
been made. We can surmise that the logic
behind this phenomenon is that patients’
level of stress goes down once they have
achieved a pregnancy or have the assurance
they will be taken care of. When my
patients ask me what they can do to maximize the chances of implantation following
embryo transfer, my answer usually is, “Do
not have a bath in the next few days, drink
plenty of water so that you will eliminate
large quantities of liquid and thus reduce
the risk of infection… and cut your head
off!” Meaning that they should do their
best not to worry.
Beware of endocrine
disruptors
repeating: hot baths, saunas, heated seats (in
cars), laptops held near their body are all
activities that men trying to conceive should
stay away from.8
“Cut your head off!”
A relationship has been established between
the head and the hormonal system, with the
result that pregnancy rates are adversely affected in women who suffer from high levels of
stress.9 This is why we offer yoga classes to
our patients at the McGill Reproductive
Centre. Indirect evidence of the influence of
stress on the reproductive system is that a
spontaneous pregnancy after a successful
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Créons des familles • FALL/AUTOMNE 2013
I will admit, however, that it is difficult not
worry about “endocrine disruptors”. An
endocrine disruptor is a natural or synthetic
molecule which interferes with the functioning of our hormones. It does that either
through mimicking our hormones or
through preventing them from taking
effect.
BFRs are everywhere…
Nowadays, the environment we live in
could be described as a “soup” of endocrine
disruptors. Unfortunately, they are found
in objects we use every day, from plastic
containers to lipstick, from computers to
hair dryers to personal care and cleaning
products. One class of endocrine disruptors
which pervades our environment are called
BFRs (for “brominated flame retardants”).
These chemicals are added to many consumer products to make them less flammable. Our clothes, our electronic devices,
even the material covering our sofa are
likely to carry BFRs. We absorb over 80% of
the BFRs in our environment in the form of
contaminated dust, while the remainder is
absorbed through food. An association
between the toxins found in BFRs and male
infertility has already been suspected, and
studies are under way – including some by
my McGill colleagues – to assess their impact
on men’s and women’s fertility and fetal
development.
Among the things we have learned in recent
years about endocrine disruptors, two stand
out. The first one is that one can no longer
rely on the age-old principle, “The dose
makes the poison”. We now know that small
doses of endocrine disruptors, day after day,
have a cumulative effect that damages not
only our reproductive health, but also our
health in general. The second thing we
learned has to do with a “cocktail effect”.
Much is still unkown about how endocrine
disruptors act, and, moreover, how they
interact.
This notwithstanding, we are nevertheless
able to analyze the impact of specific classes of
chemicals on specific targets, which may give
us indications as to how we may, if not avoid
them completely – this is unfortunately not
feasible – at least diminish our exposure
whenever possible.
…and so are phthalates
Phthalates are another class of chemicals
found in our household objects and living
spaces. To give you an idea, a survey found
that over 95% of the population in the
United States had measurable levels of phthalates in their urine.
Phthalates have been associated with fertility
problems in animals. In humans, women’s
during preparation or packaging.
- Take out your magnifying glass and shop
for cosmetics without parabens and phthalates
– they exist. Keep in mind that a woman may
put kilos of cosmetics on her face throughout
her lifetime.
The good news is that we are now more
aware of the damages inflicted on our health,
Take out your magnifying glass and shop for
cosmetics without parabens and phthalates –
they exist. Keep in mind that a woman may put
kilos of cosmetics on her face throughout her
lifetime.
exposure to these endocrine disruptors is
greater because they are commonly found in
cosmetics, particularly in lipstick, mascara,
nail polish and moisturizers as well as household products. The literature examining the
relationship between human fertility and
phthalate exposure is sparse. One epidemiological study suggests that phthalates increased
time to pregnancy (the number of menstrual
cycles required to conceive).10
What you can do
I hear you ask: Considering that endocrine
disruptors seem to be inescapable, isn’t trying
to avoid them a lost battle? As I mentioned
earlier, banishing them from your environment altogether is not easy at the moment –
you would have to give up your computer,
for one thing. In addition to the
and in particular on our reproductive health,
by endocrine disruptors. It is hoped that the
numerous studies now being carried out in
this field will lead to the replacement of
harmful chemicals with safe ones. Until we
reach this happy stage, trying to minimize
your exposure and leading a healthy lifestyle,
including losing a few pounds if need be, and
learning to manage your stress, could go a
long way in helping you achieve your dream
of becoming a parent. This is the best way
you can help us help you.
recommendations stated earlier, there are
nevertheless measures you can take in
order to reduce your daily exposure:
- Do not use plastic containers to warm
up food in the microwave oven. Doing
so would transfer some phthalates into
your dinner. Glass containers are preferable.
- Avoid wrapping leftovers in plastic film,
especially fatty foods. Phthalates are
made of “mobile” parts and they love fat.
Wrapping fatty food in a plastic film
would encourage endocrine disruptors to
migrate into your food.
- Eat home-cooked meals rather than
commercial ready-made dishes that can
be contaminated by plastic products
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About the Author
Dr. Patricia Monnier is an obstetriciangynecologist specialized in infertility at the
McGill University Health Centre
Reproductive Centre - Montreal, and an
Associate Professor at the Department of
Obstetrics and Gynecology of McGill
University - Montreal. She holds a Ph.D.
in cellular biology and immunology from
the University of Nancy, France, and her
research projects focus on the impact of
environment on reproductive health.
Norman RJ. Weight loss in obese infertile women results
7 Garolla A, Torino M, Sartini B, Cosci I, Patassini C,
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3 Soubry A, Schildkraut JM, Murtha A, Wang F, Huang
Z, Bernal A, et al. Paternal obesity is associated with
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IGF2 hypomethylation in newborns: results from a
GF. Use of laptop computers connected to internet
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4 Joo KJ, Kwon YW, Myung SC, Kim TH. The effects
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5 Battista N, Meccariello R, Cobellis G, Fasano S, Di
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Swedish women entering IVF-treatment. Acta Obstet
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