Will infertility be listed as one of the three major diseases of mankind in the 21st century? Obesity is the direct cause?

Expert in this article: Wang Yi, attending physician at Hangzhou Gongshu District Maternal and Child Health and Family Planning Center

Milk tea, sparkling water, juice... There is always one high-sugar beverage on the market that you will love. Subsequently, the obesity rate caused by high-sugar foods has also been rising steadily.

Recently, an obstetrician and gynecologist from Union Hospital said: High-sugar beverages can lead to obesity and are also one of the potential factors for infertility.

High-sugar drinks cause obesity, affect women's endocrine system and ovulation, and increase the incidence of oligospermia and asthenospermia in men.

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The World Health Organization has predicted that infertility will be listed as one of the three major diseases of mankind in the 21st century, second only to tumors and cardiovascular and cerebrovascular diseases. Now is the time to pay attention to it.

Can obesity cause infertility?

Obesity refers to excessive accumulation and abnormal distribution of fat in the body, accompanied by weight gain. It is a chronic metabolic disease caused by the interaction of genetic and environmental factors.

The body mass index (BMI), which is weight (kg) divided by the square of height (m), is used for judgment: Currently, adults in my country with a BMI of 24≤BMI＜28kg/m2 are considered overweight, and a BMI≥28kg/m2 are considered obese.

Of course, this also includes some hidden obesity where the BMI is within the normal range but the visceral fat is abnormally increased.

The main hazards of obesity, in addition to the ones we are familiar with, are that it can cause chronic diseases such as cardiovascular disease, diabetes, osteoarthritis, certain cancers such as breast cancer and colon cancer, and it can also increase the risk of female infertility.

Studies have shown that the fertility of overweight women decreases by 8%, and that of obese women decreases by 18%. In addition, the higher the BMI value, the older the age of conception.

Obesity can interfere with the body's endocrine system, causing a decline in sperm and egg quality, anovulation, and difficulty in natural pregnancy. The most common polycystic ovary syndrome in women is a disease characterized by hyperandrogenism, ovulation disorders, and polycystic ovaries, with clinical manifestations of anovulation, infertility, obesity, and hirsutism.

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Even if pregnant, obese mothers have abnormally increased risks during pregnancy. Short-term effects include gestational diabetes, preeclampsia, thrombotic diseases, macrosomia, cesarean section, fetal or neonatal death and other adverse pregnancy outcomes. Long-term effects can increase the risk of obesity and diabetes in offspring.

What other causes of infertility are there?

Infertility is actually a general term for infertility and sterility. Those who do not use contraception after marriage, have normal sexual life, and have not conceived after living together for one year are called infertility. According to the cause, it can be divided into primary infertility and secondary infertility. Infertility refers to miscarriage or stillbirth due to some reasons after pregnancy, or infertility caused by the man.

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There are many reasons for infertility. Female factors account for 40-55%, including fallopian tube factors, ovulation disorders, cervical and uterine factors, vulva and vagina factors, etc. Male factors account for 25-40%, including sperm production disorders (oligozoospermia, asthenozoospermia, teratogenesis, azoospermia) and sperm transport disorders. Male and female factors account for 20-30%, including male and female sexual life disorders, immune factors, etc. Unknown reasons account for 10%. Of course, the general postponement of childbearing age, increased mental stress and environmental pollution are also inducements.

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How to treat infertility

If you have infertility, both husband and wife need to have a comprehensive check-up at the same time. The key is to find the cause and treat it in time.

If it is caused by reproductive tract malformation or fallopian tube obstruction, tubal insufflation or surgery can be used for treatment.

If it is caused by obesity, you can lose weight, regulate your endocrine system, and induce ovulation.

If it is caused by immune factors, it can be treated by avoiding antigen stimulation and immunosuppressants. If necessary, artificial insemination or assisted reproductive technology can be used.

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How to maintain reproductive health?

Obesity is a major contributing factor to infertility. Couples planning to have a baby should actively manage their weight before pregnancy and adjust their body mass index to an appropriate level (18.5≤BMI＜24kg/m2).

Scientific and reasonable nutritional therapy combined with exercise intervention is still the safest and most effective method. According to your own situation, adopt a low-energy balanced diet and a low GI (glycemic index) diet to effectively manage your weight. At the same time, exercise is recommended, and aerobic exercise and resistance exercise are recommended at the same time.

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In order to maintain fertility, in addition to losing weight to increase the pregnancy rate, in order to better promote eugenics and good parenting, you should also pay attention to the following points:

Before planning to get pregnant, the couple should do a pre-pregnancy check-up to understand the family history of both parties and rule out any genetic or infectious diseases that are not suitable for pregnancy. For some chronic diseases, it is best to consider pregnancy after treatment.

Make good environmental preparations, including staying away from toxic and harmful environments such as radiation, chemical plants, newly renovated houses, and avoid places where people gather.

Develop a regular schedule and a healthy lifestyle, do not smoke, drink, or stay up late, avoid long periods of sitting, exercise regularly every day, change the habit of snacking, and eat three meals a day well.

Keep a relaxed and happy mood. Anxiety and tension will not only increase obesity, but also inhibit ovulation, thus affecting conception. You can communicate more with your partner, family, and friends to vent your emotions in time.

Three months before pregnancy, folic acid supplementation of 400ug/d is recommended. Obese women are recommended to supplement folic acid 800-1000ug/d until three months after pregnancy. Weight gain should be properly controlled during pregnancy. Normal women gain 8-14kg during pregnancy, overweight women gain 7-11kg during pregnancy, and obese women gain 5-9kg during pregnancy.

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