Preconception and Pregnancy - Exam 1

impact aging has on female fertility

women are born with a fixed number of eggs, which naturally decrease over time.

older eggs have a higher chance of chromosomal abnormalities due to genetic mistakes in cell division

impact aging has on male fertility

less semen is released and the number fo sperm cell decreases

sperm lose their swimming strength, making it harder to reach and fertilize an egg

older men can produce irregular sperm

aging can cause higher rate of DNA fragmentation in sperm

in males and females the hormone ______ stimulates the release of ______ and _______ in the pituitary gland

GnRH stimulates the release of FSH and LH

functions of estrogen

stimulates release of GnRH in follicular phase and follicle growth. it also stimulates vascularity and storage of glycogen and other nutrients within uterus

functions of progesterone

prepares uterus for fertilized ovum, increase vascularity of endometrium, and stimulates cell division of fertilized ova

difference between egg and sperm production

egg production (oogenesis) and sperm production (spermatogenesis)

eggs: females are born with a set number of eggs at birth and stops producing at menopause

sperm: males produce sperm continuously from puberty to the rest of their lives

biological basis for infertility for obese individuals

obesity causes infertility by disrupting reproductive hormone production and impairing egg or sperm quality

Nutrition related factors that impair fertility in males and in females

obesity and overweight

underweight and EDs

trans fat and sat fats

refined and high glycemic diets

sugary beverages

hormones related to BF and effect GnRH signaling

thyroid hormones- decrease in metabolism by hypothyroidism

insulin- increases synthesis and storage of fat

leptin- increases satiety

ghrelin- increases intake, and reduced metabolism and fat use

these hormones can inhibit GnRH signaling

biological basis for being underweight on fertility and treatment

Weight loss >10-15% of usual weight decrease estrogen

Results in amenorrhea, anovulatory cycles, and short or absent luteal phases

treatment with fertility drug Clomid not effective in underweight women

Non-nutrition factors that can impair fertility in males

Heavy metal exposure

• Lead impacts testes and sperm

• Mercury decreases sperm and semen

Halogens- pestecides

• synthetic estrogens

Glycols- from antifreeze

Heat- sperm count can be reduced by elevating the temp of scrotum and testes

Steroid abuse- side effects include atrophy of testicles, absence of sperm, decreased libido

High insulin levels and impact on fertility in women

high levels disrupt reproductive hormone balance and impair ovulation, making it difficult to conceive

3 factors in Relative Energy Deficiency in Sport (RED-S)

low energy availability

menstrual/reproductive function impairment

impaired bone health

Risk factors for insulin resistance

excess weight, physical inactivity, poor diet, smoking, poor sleep and stress

Leading cause of female infertility

PCOS

BMI ranges for underweight, normal weight, overweight and obese

<18-20 underweight

20-25 normal

25-30 overweight

30+ obese

Difference between Type 1 and Type 2 diabetes; how are they diagnosed, issues with glycemic index

Type 1: the body destroys insulin producing cells, so little to no insulin production

Type 2: the body makes insulin, but cells resist it, or the pancreas does not make enough

the glycemic index ignores portion size, has inconsistent data, doesn’t capture glycemic load, and ignores meal composition

Caffeine recommendations for preconception and pregnancy

less than 200 mg per day

SGA

small for gestational age

dSGA

disproportionately small for age

pSGA

proportionately small for age (undernutrition for whole pregnancy)

can lead to obesity and overweight

LGA

large for gestational age

anabolic and catabolic stages

anabolic- fat stores and glycogen stores

catabolic- second half of phase is using those stores for growth of the baby

pro oxidative state

increased oxidation and free radical formation results in:

increased energy production in mitochondria

insulin resistance, diabetes, preeclampsia, obesity and infections

excess iron supplementation

iron reqs

27 mg/day

supplements

critical period of CNS and heart

embryonic period

Recommended weight gain range for pregnancy for a person in the healthy BMI range

Healthy weight: gain 25-35 lbs

hCG

stimulates corpus lute to produce estrogen and progesterone. stimulates growth of endometrium

hCS

increases insulin resistance to maintain glucose; promotes protein synthesis and breakdown of fat for energy