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Here are basic factors influencing fertility: 1) Weight (underweight or underweight) 2) Smoking 3) Alcohol 4) Drugs 5) Stress 6) STI’s (Sexually transmitted infections) 7) Anovulation 8 ) Age over 35 9) Uterine fibroids and polyps 10) Inaccurate timing of intercourse Endometriosis is a painful condition associated with tissue from the lining of the uterus (endometrium) in other areas of the body, such as ovaries, tubes, behind the uterus, even distant areas as lungs or kidneys. It is likely due to heredity, immune system, lymphatic or vascular system. These areas cause cramps, severe pain, painful intercourse, pelvic and lower back pain, heavy menses, irregular menses, painful bowel movements or pain during urination. It is estimated that 5.5 million women in the US have this condition. It is one of the most common causes of infertility. 35% of women with endometriosis have infertility. Treatment is medical and surgical. Most common reasons for infertility are related to the dynamics of ovulation, ovum pick-up, fertilization, transport and implantation. If after one year of unprotected intercourse pregnancy fails to occur, infertility is a concern. The chances of conception during a month of regular intercourse is about 20 %. Infertility could be due to the failure of the egg (ovum) to be released from the ovaries. This is called anovulation and is treated medically. If the Fallopian tubes are blocked or interrupted, this requires intervention. If fibroids are present, these can be removed. If there are autoimmune, infectious or hormonal issues these can be addressed. By Joseph Hazan,M.D., FACOG
Overweight, smoking, alcohol, drugs, caffeine, stress are shown to be related to infertility. While lifestyle factors alone do not entirely explain or account every case of infertility, they are significant nevertheless. Stress reduction for instance has been shown to relate to normalized levels of GnRh, FSH, LH, estrogen and progesterone, blood pressure and improved pregnancy rates. Overweight and related increased levels are associated with increased testosterone and lack of ovulation. Also the elevated levels of insulin and leptin associated with overweight lead to increase in LH but no increase in FSH . This and elevated androgens will stimulate unripe follicles that fail to ovulate. Positive changes in lifestyle factors are proven to improve fertility. By Joseph Hazan,M.D., FACOG It is very important to have adequate intake of vitamins and minerals especially during pregnancy. The main ingredients required as building blocks are essential aminoacids along with the following vitamins and minerals which must be taken as supplements even though foods contain these nutrients to some extent. FOLIC ACID is highly important in the formation of cells and neurological development. Deficiency leads to neural tube defects and low-birth weight. 800 mg daily required. It is also found in oranges, green leafy vegetables, pinto beans and asparagus. It is absolutely necessary for the prevention of neural tube defects and low-birth weight. IRON is essential in blood formation. Helps prevent anemia. 27 mg daily are required. It is found in lean red meat, tofu and chickpeas. CALCIUM is essential in bone formation. 1000mg daily required. Helps prevent leg cramps and preeclampsia. It is found in milk, yogurt and cheese. MAGNESIUM is essential for bones. Helps prevent leg cramps and headaches. It is found in almonds and artichokes. 340 mg daily required. ZINC is essential for the immune system, vision and normal growth. It is found in pumpkin seeds and meat. 15 mg daily required. VITAMIN A is essential for skin, eyes and immune system. It is found in carrots and spinach. 800 micrograms ( less than 1 mg) required. High doses can be harmful to the baby during pregnancy. VITAMIN B1 is essential for the nervous system and brain. Helps growth and energy production. 1.4 mg daily required. It is found in peas and beans. VITAMIN B2 is essential for energy production and blood formation. It is found in beans and dairy products. 1.4 mg daily required. VITAMIN B3 is essential for growth and development. It is found in fruits and bran. 17 mg daily required. VITAMIN B6 is essential for the brain. 2 mg daily is required. It is found in bell peppers and bananas VITAMIN B12 is essential for blood and the nervous system. It is found in dairy products and eggs. 2.4 mg daily required. VITAMIN C is essential for healing and bones. It is found in onions, broccoli,papaya and oranges. 70 mg daily required. VITAMIN K is essential for blood, liver and bones. It is found in okra, cabbage and broccoli. 65 mg daily required. All of the listed nutrients are essential and should be supplemented by daily intake of Prenatal Vitamin Pills. There are many formulations available. Please start taking them while planning pregnancy. By Joseph Hazan,M.D.,FACOG
The typical US diet has a ratio of 1:20 of omega-3’s versus omega-6’s. This ratio should be 1:1 to help prevent most of the degenerative diseases such as heart disease, cancer, arthritis, degenerative brain diseases and autoimmune disorders. Also depression and allegies can be greatly decreased by having the right ratio. A study in the Journal of the American Medical Association (JAMA) has shown that by increasing the omega-3’s in the diet it is possible to cut down the risk of heart attack by 50%. The ideal diet should contain organic, nutrient dense foods that are high in vitamins and minerals. By Joseph Hazan,M.D.,FACOG
When we say Baby Blues this is not confined to the postpartum period. It is known that 20 % of women have depression during pregnancy. Pregnancy related stresses added to the preexisting ones bring new sets of anxieties and depression. This can be manifested in appetite and mood changes. Also irritability, lingering feeling of sadness, remorse, guilt, too much or too little sleep, lack of joy, energy and concentration are signs of depression and anxiety. Antepartum depression, like postpartum depression impact the normal caring for the baby. It is also known to impact your physical health. Antepartum depression is found to be related to preeclampsia, abnormal weight gain (excessive or inadequate). It is also known to be related to alcohol and drug abuse or suicidal thoughts. Other stresses such as family or relational issues, job loss, financial difficulties increase the level of anxiety and depression. If you have these problems it is best to talk to your doctor. By Joseph Hazan,M.D.,FACOG
Obesity and Smoking cause 40% of premature deaths in the US. Obesity and Smoking also are the cause of 70% of chronic diseases like diabetes, emphysema, heart disease and disabilities. They cause 75% of the cost of healthcare costs. It is obviously imperative to prevent and treat obesity and smoking if we want to lower healthcare costs. By Joseph Hazan,M.D.,FACOG
There are genetic factors associated with Alzheimer’s disease. These genetic markers are identified at Washington University School of Medicine by Alison M. Goate and John C. Morris. The genes recently identified are called clustrin (APOJ) on chromosome 8 and PICALM on chromosome 11. The clustrin gene is thought to be associated with the tendency to accumulation of amyloid and plaques. The PICALM gene is thought to be related to the breakdown of synapses and could lead to amyloid deposits. This research encompassed DNA samples of 19000 individuals and 600,ooo markers. A gene called APOE4 was found to be related to the late onset form of the disease. Association with chronic sleep deprivation identified as a risk factor. By Joseph Hazan,M.D., FACOG
Condyloma is also known as genital warts. Whereas Chlamydia is the most reported STD, Condyloma is the most common STD. This is due to the fact that most HPV infections which are related to Condyloma do not cause symptoms. This is most common for those under 25. Condyloma is the most common lesion of HPV (Human Papilloma Virus), but many HPV types do not cause condyloma. There are over 100 types of HPV and 15 of these types are high risk for cervical cancer. The most important hiph risk HPV types are HPV-16, -18, -31, -33, -35, -39, -51, -52, -58, and 61. One third to one half of women who have condyloma also have high risk HPV types. External genital warts are more common in women than men. It is estimated that there are 1 million new cases of external genital warts every year and two thirds of these occur in women. The incidence of HPV is increasing. Over the past few decades the incidence has increased and there was a four-fold rise in reported cases during the sixties, seventies and eighties. HPV is sexually transmitted and most lesions appear within two months after exposure. Smoking is a risk factor, due to both behavioral and immune response factors. There are numerous treatment options that help eliminate the warts, but there are no treatments that directly target the virus. It is important to screen for other STDs when HPV is detected. There is no evidence that the partner is at increased risk for being reinfected by HPV after being exposed or treated. There are situations in which the external genital warts clear up without being treated. It is important to use safe treatment options especially during pregnancy since there are cases of warts that form in the throat of the baby due to exposure during labor and delivery. Some of these warts require several treatments. |
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