Sleep problems tied to female infertility

UNTV News   •   December 18, 2017   •   4472

Reuters / Parth Sanyal / Reuters

(Reuters Health) – Women with sleep disorders other than sleep apnea may be more than three times as likely to experience infertility as their counterparts who don’t have trouble sleeping, a recent study suggests.

When insomnia was to blame for women’s sleeping difficulties, they were more than four times as likely as peers who slept well to experience infertility, the study also found.

Previous research has linked what’s known as apnea, or disrupted breathing during sleep, with infertility. But the current study looked only at women with other types of sleep disorders, offering fresh evidence of the need for women to pay close attention to healthy habits that can help with sleep if they’re trying to conceive, said lead study author Dr. I-Duo Wang of the Tri-Service General Hospital and National Defense Medical Center in Taipei, Taiwan.

“Women of child-bearing age should sleep earlier, avoid night shift work or cellphone use before sleep,” Wang said by email. “Moreover, a healthy diet, regular exercise and a good lifestyle are important to prevent infertility.”

Roughly 1 in 10 women of childbearing age have difficulty getting pregnant. Most of the time, it’s caused by problems with ovulation, often related to a hormone imbalance known as polycystic ovarian syndrome (PCOS). Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Less common causes of infertility in women can include blocked fallopian tubes, structural problems with the uterus or uterine fibroids.

The risk increases with age, and can also be exacerbated by smoking, excessive drinking, stress, an unhealthy diet, too much exercise, being overweight or obese or having sexually transmitted infections.

For the study, researchers examined data on 16,718 women newly diagnosed with sleep disorders between 2000 and 2010 in Taiwan as well as a comparison group of 33,436 similar women who didn’t have sleep problems.

At the start of the study, women were about 35 years old, on average, although they ranged in age from 20 to 45.

After an average follow-up of about five years, 29 participants with sleep disorders had developed infertility, as had 34 women in the comparison group.

Before researchers accounted for age and women’s other medical problems, participants with sleep disorders were about 2.7 times more likely to experience infertility, researchers report in the journal Sleep.

Once the study team factored in women’s age and other health issues, participants with sleep disorders were 3.7 times more likely to experience infertility.

Women with sleep disorders were also more likely to have a variety of chronic health problems, including high blood pressure, elevated cholesterol, lung disorders and kidney issues. With sleep disorders, participants were also more likely to have irregular menstrual cycles, thyroid issues, depression and anxiety.

The study wasn’t a controlled experiment designed to prove whether or how sleep disorders might directly cause infertility.

For its size, the study also included very few women with infertility. Another limitation is that the researchers lacked data on a variety of factors that can impact fertility like smoking, drinking and exercise habits as well as socioeconomic status and family medical history, the authors note.

“We still have a lot to learn about how exactly sleep disorders confer risk for infertility,” said Jennifer Felder, a researcher at the University of California, San Francisco, who wasn’t involved in the study.

Even so, the results suggest that women can add infertility to the long list of health reasons to get help when they can’t fall or stay asleep.

“Although we do not yet know whether treating sleep disorders improves fertility, treatment may help and is not likely to hurt,” Felder said by email. “Cognitive behavior therapy is recommended as the first line of treatment approach for insomnia, which was the most prevalent sleep disorder in this sample, and it is available in-person with a therapist or via digital applications or self-help workbooks.”

SOURCE: Sleep, online November 9, 2017.

In paragraph 9, corrects the average age at the start of the study.

Air pollution and traffic fumes tied to infertility risk

admin   •   January 18, 2016

Chimneys of a power plant are pictured from a plane, on the outskirts of Beijing January 8, 2016. REUTERS/KIM KYUNG-HOON

Chimneys of a power plant are pictured from a plane, on the outskirts of Beijing January 8, 2016.

Women who live close to major highways where the air is polluted by traffic exhaust fumes may be slightly more likely to have fertility problems than women who live further away where the air is cleaner, a U.S. study suggests.

Researchers followed more than 36,000 women from 1993 until 2003 and analyzed air pollution and traffic exhaust near their homes to see if what they breathed might be connected to their ability to conceive.

Over the study period, there were about 2,500 reported cases of infertility. Women who lived close to a major roadway – within 199 meters, or about a tenth of a mile – were 11 percent more likely to experience this problem than women who lived farther from a highway, the study found.

“The risks are slight,” said study leader Dr. Shruthi Mahalingaiah, a researcher at Boston University School of Medicine, in an email.

But even the slight increased risk can present a big global public health problem, said Mark Nieuwenhuijsen, a researcher at the Center for Research in Environmental Epidemiology and the Barcelona Institute for Global Health.

“For an individual woman the results may not be that important because the risk of infertility only increases slightly, but for society as a whole it is important because so many women are exposed to air pollution,” Nieuwenhuijsen added by email.

To look at the link between infertility and air pollution, Mahalingaiah and colleagues examined data on what’s known as particulate matter – a mixture of solid particles and liquid droplets that can include dust, dirt, soot and smoke – near women’s homes and also assessed how close their residences were to major roads.

They focused on what’s known as primary infertility, when women try to conceive for at least a year without success, as well as secondary infertility, which refers to couples who struggle with conception after having at least one prior pregnancy.

When women lived close to major roads, they were 5 percent more likely to report primary infertility, an increase in risk that wasn’t statistically significant, meaning it might have been due to chance.

But these women were 21 percent more likely to report secondary infertility than women who lived farther away, and that increase was statistically significant, researchers report in the journal Human Reproduction.

This association was found even at relatively low concentrations of particulate matter, or less polluted air, although the connection became stronger as the pollution levels increased.

One limitation of the study, however, is that researchers didn’t know the exact dates when conception efforts started or infertility was diagnosed, making it difficult to closely examine how the timing of pollution exposure might influence the odds of pregnancy.

While the study is one of the first of its kind to follow so many women over such a long period of time, more research is needed before making medical recommendations based on the results, Mahalingaiah said.

Even so, the findings add to a growing body of evidence suggesting that pollution can negatively impact conception efforts, said Dr. Sajal Gupta, a researcher at Cleveland Clinic in Ohio who wasn’t involved in the study.

“Couples suffering from infertility need to exercise caution especially if they are residing in areas with high ambient particulate matter,” Gupta said by email. “Relocating to areas with low contamination of particulate matter is an alternative to prevent adverse impact on fertility.”

Infertility is just one of many health problems tied to air pollution, noted Christopher Somers, a biology researcher at the University of Regina in Canada who wasn’t involved in the study.

“Air pollution is worse near major roads with high traffic volumes, so avoid living in these areas if you can,” Somers said by email. “If this is not an option, pay attention to air quality advisories and adjust outdoor activities accordingly.”

SOURCE: Human Reproduction, online January 2, 2016.

Smoking, secondhand smoke tied to infertility and early menopause

admin   •   December 16, 2015

A woman smokes a cigarette in a restaurant in Munich, December 31, 2007. REUTERS/ALEXANDRA BEIER

A woman smokes a cigarette in a restaurant in Munich, December 31, 2007.

(Reuters Health) – Smoking and exposure to secondhand smoke is tied to infertility in women and early menopause, according to a new study.

Compared to women who never smoked and those exposed to the least secondhand smoke, women who smoked or were exposed to the most secondhand smoke were more likely to have problems getting pregnant and more likely to enter menopause before age 50, researchers found.

Andrew Hyland of the Roswell Park Cancer Institute in Buffalo, New York, who led the research, said earlier studies had linked smoking to reproductive issues in women, but few had looked at links between secondhand smoke and infertility and early menopause.

“The literature really wasn’t clear – particularly with secondhand smoke,” Hyland told Reuters Health.

Hyland and colleagues analyzed data on 88,732 U.S. women who enrolled in the Women’s Health Initiative Observational Study between 1993 and 1998, when they were between the ages of 50 and 79.

Based on questionnaires the women completed at the start, about 15 percent met the criteria for infertility, which is the inability to get pregnant for at least a year. About 45 percent also met the criteria for early menopause, which occurs before age 50.

Compared to women who never smoked, researchers found that those who reported being active smokers at some point in their lives were 14 percent more likely to have infertility and 26 percent more likely to enter menopause early.

Women who smoked the most reported entering menopause about two years earlier than women who didn’t smoke, the researchers report in the journal Tobacco Control.

Women who never smoked but were exposed to the most secondhand smoke were 18 percent more likely to have problems getting pregnant and to enter menopause at an early age, compared to women who never smoked and were exposed to the least amount of secondhand smoke.

While an 18 percent increased risk may seem modest, Hyland said it’s large considering infertility and early menopause are not uncommon.

“There are a lot of events that could be attributed to these exposures,” he said.

Hyland cautions that the study can’t prove smoking causes these problems. The research team did, however, adjust the data to account for other factors that would be tied to infertility and early menopause.

The study also can’t say what may underlie the link between smoke exposure and infertility and early menopause, but Hyland said other research suggests that smoke exposure may affect hormone levels.

It appears the association is driven by smoke exposure throughout a woman’s lifetime, he said.

“As for a recommendation to clinicians, you should advise women of reproductive age to limit their exposure to minimize these outcomes,” said Hyland.

SOURCE: Tobacco Control, online December 15, 2015.

Weight loss, exercise may boost fertility odds for women with PCOS

admin   •   October 7, 2015

A woman is seen jogging at Cunningham Park in the borough of Queens in New York, September 16, 2014. REUTERS/SHANNON STAPLETON

A woman is seen jogging at Cunningham Park in the borough of Queens in New York, September 16, 2014.

(Reuters Health) – Women who suffer from a leading cause of infertility may increase their odds of conception if they exercise and lose weight, a U.S. study suggests.

Researchers compared pregnancy outcomes for 150 women with polycystic ovary syndrome (PCOS), a condition that occurs when the female body makes higher than normal amounts of testosterone and androgens, sex hormones associated with male traits.

Among three groups of women, those who exercised lost the most weight and had more live births than those who didn’t.

Women with PCOS often experience irregular menstrual cycles, weight gain, excess hair on the face and body and infertility. They may take birth control pills to boost female hormones and regulate ovulation for several months before trying to get pregnant. This is thought to improve their odds of success once they stop taking contraceptives and start trying to conceive.

For the first four months of the study, one third of the women took birth control pills for that purpose, while a second group was directed to exercise and follow a low-calorie diet. A third group got both of these interventions.

After that initial phase, women taking contraceptives stopped. At this point all of the women went through four cycles of medically induced ovulation, designed to help them get pregnant.

Among 49 women in the initial birth control group, five had babies. That compared with 13 babies for the 50 women assigned to diet and exercise at the start of the study and 12 infants for women who got a combination of both interventions.

The study was too small to show a statistically meaningful difference in pregnancy outcomes between the two groups who dieted and exercised, the authors acknowledge in the Journal of Clinical Endocrinology and Metabolism.

But the results suggest that exercise and weight loss might play a bigger role in conception than just regulating ovulation with birth control pills before trying to conceive, said lead study author Dr. Richard Legro of Pennsylvania State College of Medicine in Hershey.

“Based on our study, women with PCOS who are obese would derive the greatest improvement in their quality of life and reproductive parameters (body hair, androgen levels, polycystic ovaries and control of menstrual bleeding) with maintenance of their metabolic health through the combination of oral contraceptives with lifestyle modification and weight loss,” Legro said by email.

All of the women in the study were overweight or obese, which is linked to fertility problems regardless of whether women have PCOS.

Women who exercised during the study lost significantly more weight than the group assigned only to birth control pills.

At the same time, the women only taking contraceptives were more likely to develop a condition known as metabolic syndrome, a cluster of conditions including high blood sugar that have been linked to fertility challenges as well as heightened risk for problems such heart disease and diabetes.

As many as one in 10 women of childbearing age may have PCOS, according to the U.S. Department of Health and Human Services. The cause is unknown, but the condition is thought to be influenced by many factors, including genetics, with PCOS more likely in women who have an afflicted mother or sister.

While the findings confirm some earlier research linking metabolic changes achieved though lifestyle improvements to better reproductive function, weight loss can still be a tricky prescription, noted Dr. Gordon Wright Bates Jr., a specialist in reproductive endocrinology and infertility at the University of Alabama at Birmingham.

Women with PCOS who come to a weight-loss clinic at his university can struggle to achieve significant changes even when they are making the effort to conceive, Bates, who wasn’t involved in the study, said by email.

“Although the study adds considerable evidence to support lifestyle modifications and weight loss to optimize reproductive potential and the response to treatment, both of these remain elusive for many patients,” Bates said.

SOURCE: Journal of Clinical Endocrinology and Metabolism, online September 24, 2015.


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