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We are currently witnessing a decline in male and female fertility: since 1978, infectious tubal indications for fertility have been declining, giving way to tubal lesions linked to endometriosis. Since 1990, when ICSI first appeared, male indications have been on the increase.
So we can say that fertility is the result of the couple's environment and living conditions, with effects that can be trans-generational:
The fertility of a generation is thought to be linked to toxic factors acting during the mother's intrauterine life and factors acquired in adulthood linked to the quality of life: tobacco, alcohol, cannabis, antidepressants, weight, diet, profession, intense sport, stress: in both men and women.
Current fertility assistance care should be couple-related, taking into account quality of life factors, in order to help improve fertility and optimise fertility journey results to avoid repeated stimulation and reduce the length of the treatment.
There are 2 types of toxic factors affecting fertility:
Effects of behavioral factors on fertility
THE EFFECTS OF TOBACCO ON FERTILITY :
The impact of smoking on the future fertility of an unborn child:
The impact of smoking on adult fertility :
The impact of smoking on your fertility journey:
THE EFFECTS OF ALCOHOL ON FERTILITY :
In men: an increase in FSH, LH, and E2 and a decrease in Testosterone with an alteration in the spermogram. In women: a reduction in the time to conception with moderate wine consumption of more than two glasses a day. Rates of spontaneous miscarriage 2 to 3 times higher have been described.
THE EFFECTS OF CANNABIS ON FERTILITY :
Cannabis use is clearly on the increase, and a reduction in sperm count and an increase in morphological abnormalities have been described, along with an increase in hyperactivity leading to a reduction in fertility capacity. Unlike tobacco, cannabis is very slow to be eliminated and the deleterious effects are more significant. It should be noted that the two factors are most often associated: tobacco/cannabis.
Effects of environment-dependent factors on fertility
THE EFFECTS OF INSECTICIDES ON FERTILITY :
DDT and other organochlorines concentrate in breast milk and the placenta, causing urogenital malformations such as cryptorchidism and hypospadias. Intrauterine contamination is more worrying because it occurs earlier than in milk.
THE EFFECTS OF DIOXINS ON FERTILITY:
The most toxic would be TCDD, which acts as an endocrine disruptor.
THE EFFECTS OF CHEMICAL POLLUTANTS ON FERTILITY:
As non-biodegradable agents, they interfere with the endocrine system because of the estrogenic-mimetic tendency of our hormones. Their androgenic activity enables them to oppose male hormones.
THE EFFECTS OF OXIDATIVE STRESS ON FERTILITY :
Oxidative stress occurs when the production of free radicals (ROS and RNS) exceeds the body's defense capacity:
It is thought to be involved in cancer, degenerative diseases, cardiovascular disease, Alzheimer's disease, aging, and reproduction! Groups at risk of oxidative stress: smokers, unbalanced diets, and the elderly.
THE EFFECTS OF SLEEP ON REPRODUCTION:
Recent studies (Tanamura, Fertil Steril 2009), show the effects of melatonin depletion on ovarian regulation. Lowered melatonin concentrations have been found in small follicles and during oxidative stress at the end of the follicular phase, altering ovarian regulation and reducing fertility. Melatonin administration is thought to improve oocyte quality and the fertilisation rate by treating oxidative stress (Buscemi, Yan), but correcting the cause is also essential (TANAMURA, Melatonin and Ovary, Fertil Steril 2009).
How can couples suffering from infertility be cared for?
Establish a "joint" strategy with the couple concerning toxic factors linked to behavior and quality of life in order to help them reverse their infertility.
Reducing the number of ovarian stimulations and fertility attempts, in order to obtain a faster result, is an essential objective for couples wishing to have a child. Screening for toxic factors and improving quality of life will help optimise fertility and fertility journey results.
If all these factors are taken into account, we should be able to prevent infertility in adolescents and take action on preconception, not only in women but also in men. Raising the awareness of society and healthcare staff would help to improve fertility. Medical training and consideration of the quality of life of couples consulting us for infertility is currently proving necessary.
Today, the work of the reproductive physician must take all these factors into account when providing care for infertility.
Written by:
Dr. Sylvia Alvarez, Obstetric gynaecologist specialising in reproductive medicine,
Assisted Reproduction Department, Clinique de la Muette
