A Lifestyle Perspective on Infertility and Pregnancy Outcome

Abstract

American dietary patterns have shifted over the past 100 years, resulting in a diet based on animal foods and highly processed carbohydrates. This shift has produced the current epidemics of obesity, type 2 diabetes, heart disease, as well as many cancers. In addition, the Western diet is also negatively affecting the reproductive capacity of the population. The birth rate is in decline and infertility and subfecundity are on the rise secondary to both ovulatory infertility and declining sperm quality. Pregnancy outcomes and maternal morbidity and mortality are also being affected. This diet, high in fat and sugar, is also contributing to the epidemic levels of autism.

21. yüzyılın en önemli sağlık problemi: Yaşam dönemlerine göre obezitenin incelenmesi

“…Following IR and hyperinsulinemia, changes occur in the secretion of gonadotropins secreted from the hypothalamus. Especially LH increases and FSH decreases (78). Hepatic production of SHBG is prevented in obese women following hyperandrogenism.…”

Lifestyle Intervention for Obese Women

“…Furthermore, as obesity is associated with anovulation, irregular menstruation, polycystic ovary syndrome, and altered uterine receptivity and implantation [ 3 ], the probability of becoming infertile is three times higher for obese women of childbearing age than for women of normal weight [ 4 ]. Obese women can also develop insulin resistance and hyperinsulinemia and experience changes in the secretion of gonadotropin-releasing hormone by the hypothalamus, which can increase the secretion of luteinizing hormone by the pituitary gland and reduce the level of follicle-stimulating hormone (FSH) [ 5 ]. In addition, the levels of androgens (testosterone, dehydroepiandrosterone (DHEA), and androstenedione) and estrogen increase in obese women because the concentration of sex hormone binding globulin (SHBG) decreases [ 5 ].…”

“…Obese women can also develop insulin resistance and hyperinsulinemia and experience changes in the secretion of gonadotropin-releasing hormone by the hypothalamus, which can increase the secretion of luteinizing hormone by the pituitary gland and reduce the level of follicle-stimulating hormone (FSH) [ 5 ]. In addition, the levels of androgens (testosterone, dehydroepiandrosterone (DHEA), and androstenedione) and estrogen increase in obese women because the concentration of sex hormone binding globulin (SHBG) decreases [ 5 ]. The increase in these sex hormones ultimately increases the free androgen index (FAI) [ 5 ].…”

“…In addition, the levels of androgens (testosterone, dehydroepiandrosterone (DHEA), and androstenedione) and estrogen increase in obese women because the concentration of sex hormone binding globulin (SHBG) decreases [ 5 ]. The increase in these sex hormones ultimately increases the free androgen index (FAI) [ 5 ]. As a result, the fertilization ability decreases, and even when pregnancy is achieved, there is a much higher abortion rate and a lower birth rate of normal newborns among obese women [ 5 – 7 ].…”

“…The increase in these sex hormones ultimately increases the free androgen index (FAI) [ 5 ]. As a result, the fertilization ability decreases, and even when pregnancy is achieved, there is a much higher abortion rate and a lower birth rate of normal newborns among obese women [ 5 – 7 ].…”