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Nutrition 2 (Semester II) > 16a. Fertility - Female Fertility > Flashcards

16a. Fertility - Female Fertility Flashcards

1
Q

What is the definition of infertility?

A

Lack of pregnancy after one year of unprotected sex

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2
Q

What are the factors involved in successful conception?

A

Release of healthy oocyte
Sperm with adequate motility
Adequate transport of sperm and egg to fallopian tubes for fertilisation
Penetration of sperm into oocyte
Implantation of embryo into uterus lining
Normal development of embryo into foetus

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3
Q

Structural abnormalities in females that can affect fertility

A

Cervical stenosis
Uterine septum
Polyps/fibroids
Fallopian tube obstruction
Ovarian cysts

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4
Q

What is cervical stenosis?

A

Narrow/closed cervix

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5
Q

What is uterine septum?

A

Poor environment for embryo to implant due to poor vascular supply of blood and nutrients

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6
Q

Why might the fallopian tubes be obstructed?

A

Pelvic inflammation
STDs
Endometriosis
Ectopic pregnancy

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7
Q

What hormonal issues can affect female fertility?

A

PCOS
Hyper/hypothyroidism
Amenorrhoea
Obesity/IR
Premature ovarian insufficiency

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8
Q

What issues in PCOS can affect fertility?

A

Elevated androgens
Anovulation
Irregular cycles
Reduced uterine lining development
Implantation issues

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9
Q

What issues in hyper/hypothyroidism can affect fertility?

A

Irregular cycles
Ovulatory disorders
Miscarriage
Pre-term birth
Pre-eclampsia

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10
Q

How can amenorrhoea occur?

A

Hypothalamic dysfunction
Pituitary tumours
Excess exercise
Undereating
Low BMI
High stress

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11
Q

How can obesity/IR affect female fertility?

A

Lack of ovulation
Increased androgen levels

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12
Q

What is premature ovarian failure?

A

Loss of ovarian function due to chemotherapy/radiation
Genetics
SLE

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13
Q

What is the hormone highest in the first half of the menstrual cycle?

A

Oestrogen

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14
Q

What is the function of oestrogen in the first half of the menstrual cycle?

A

Creates proliferative endothelium
Important for ovulation

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15
Q

What is the hormone highest in the second half of the menstrual cycle?

A

Progesterone

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16
Q

What is the function of progesterone in the second half of the menstrual cycle?

A

Maintains secondary endothelium
Implantation/survival of embryo

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17
Q

Where are oestrogen and progesterone produced?

A

Ovaries
Adrenals
Placenta

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18
Q

Where are oestrogen and progesterone stored?

A

Adipose tissue

19
Q

Conditions signified by oestrogen dominance

A

Fibroids/polyps
Endometriosis
PCOS

20
Q

Signs/symptoms of oestrogen dominance

A

Heavy bleeding/clotting
Tender/swollen breasts
PMS
Headaches
Shorter menstrual cycles (luteal phase)
Insomnia
Fatigue
Mood swings
Swelling/bloating

21
Q

Signs and symptoms of progesterone dominance

A

Breast tenderness
Water retention
Bloating
SOB
Lack of concentration
Long luteal phase
Decreased libido
Weight gain
Insomnia
Light periods

22
Q

Why is it difficult to evaluate oestrogen or progesterone dominance?

A

Symptoms overlap

23
Q

Ways to optimise O:P ratio

A

Reduce stress
Optimise liver function
Avoid endocrine disruptors
Avoid alcohol
Reduce body weight if obese
Optimise digestion/elimination

24
Q

Why is it important to optimise liver function when optimising O:P ratio?

A

To detoxify excess oestrogen

25
Q

Why is it important to avoid alcohol when optimising O:P ratio?

A

Alcohol increases oestrogen levels by promoting the induction of aromatases
Impairs hepatic oestrogen metabolism

26
Q

Why is it important to reduce obesity when optimising O:P ratio?

A

Oestrogen is produced/stored in fat cells

27
Q

Why is it important to optimise digestion/elimination when optimising O:P ratio?

A

To excrete excess oestrogen

28
Q

Examples of medications that can affect female fertility

A

NSAIDs
Corticosteroids
Antihistamines
Chemo

29
Q

Why can NSAID use inhibit female fertility?

A

Inhibits ovulation
Lowers progesterone levels

30
Q

Why can corticosteroid use inhibit female fertility?

A

Suppresses immune function
Affects gut microbiome
Elevates BP
Elevates blood glucose

31
Q

Why can antihistamine use inhibit female fertility?

A

Dry mucous membranes

32
Q

Why can chemo inhibit female fertility?

A

Damage/depletion of oocytes

33
Q

What environmental factors can affect female fertility?

A

Excessive radiation
Toxin exposure
Chronic alcohol consumption
Caffeine
Xenoestrogens/endocrine disruptors

34
Q

Sources of excessive radiation that can affect female fertility

A

Mobile phones
X-rays
Frequent flying
Radiotherapy

35
Q

Why can caffeine affect female fertility?

A

Increases cortisol production
Slows COMT
(leading to oestrogen dominance)

36
Q

What immunological factors can affect fertility?

A

Tissue type compatibility
Blood clotting defects
High uterine NK cells
AI
Anti-sperm antibodies
Antiphospholipid syndrome
Thyroid antibodies
Ovarian antibodies

37
Q

Why can tissue type compatibility affect fertility?

A

If mum’s immune system responds negatively to paternal HLA proteins, this can affect implantation/pregnancy outcome

38
Q

Why can blood clotting defects affect fertility?

A

Increases risk of early/late term loss
Increases risk of maternal embolism/stroke
Placental blood flow restriction

39
Q

Why can high uterine NK cells affect fertility?

A

Can trigger increase of TNF-a/cytokines

40
Q

Why can AI affect fertility?

A

Immune system rejects the embryo

41
Q

Why can anti-sperm antibodies affect fertility?

A

Sometimes a female’s body will produce ASAs which destroy sperm

42
Q

What is antiphospholipid syndrome?

A

AI disorder which causes increased risk of blood clotting
Increases miscarriage/stillbirth risk

43
Q

Why can thyroid antibodies affect fertility?

A

Leads to AI thyroiditis
Increases miscarriage/pre-term labour risk

44
Q

Why can ovarian antibodies affect fertility?

A

Affects egg/embryo development
Reduces fertilisation/pregnancy rates
Increases implantation failure

Nutrition 2 (Semester II) (55 decks)

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