9 Good, Bad And Straight Up UGLY Things That Affect Your Fertility

By Dr. Daniel Rychlik 

In your 20s, having a baby is the often the last thing on your mind. Despite how you feel about conceiving at this specific time in your life, there are a few things you should know about your fertility and your egg reserve.

You were born with all the eggs you will ever have. That's it. You don't lose them one by one — you lose them exponentially. You're born with 1 million eggs, but by the time you reach puberty, you are down to about 300,000, even though you're never ovulated in your whole life!

As you get older, the number of eggs decreases, along with the quality of the remaining eggs — just because you don't have your period every month doesn't mean you aren't losing your eggs.

The good, the bad, and the ugly: To make sure you're making the most of your eggs, whether you want a child now or later, you should pay attention to these nine things that can affect your fertility now and in the future.

The Good:

1. Birth control pills

Although birth control pills are designed to prevent pregnancy, "the pill" can actually help protect future fertility.

Not only do they reduce the risk of ovarian cancer, they can actually decrease the risk of upper genital tract infections by thickening cervical mucus and increase the activity of the ovary.

The Bad:

2. Smoking

In addition to taking years off your life, smoking affects several aspects of your fertility. It directly kills off eggs, and it also affects the motility or movement of the fallopian tubes, making it harder for an egg to move through the tube.

3. Alcohol

Alcohol leads to a couple of things. First, excessive alcohol use damages the liver. However, it can also lead to risky and unsafe sexual practices, which may leads to sexually transmitted infections (STIs). STIs can cause future infertility.

4. Overexercising

Exercise is great for the mind and body. Excessive exercise, however, such as too-frequent and long-distance running, can cause an unhealthy decrease in body fat.

When your body fat is decreased past a certain limit, your ovaries begin to "believe" (OK, the ovary doesn't really have beliefs, but you get the point) that you are starving to death and lose their ability to function normally.

5. HCG Diet

With the trendy HCG diet, a woman does two things: she takes HCG injections and goes on a severely low-calorie regimen. The HCG injections are supposed to mimic thyroid hormone. What they can also do is cause the ovary to make cysts, which may require surgery.

Even if the ovary isn't removed during surgery, the procedure to remove the cyst can damage the ovary itself, affecting your reserve of eggs.

6. Marijuana

While it has been known for a while that marijuana smoking in men can affect sperm motility, recent studies have found that it also affects women.

Women who smoke marijuana can absorb THC not only in the lungs, but also in the pelvic organs, which can affect sperm motility later on.

7. Excessive weight loss/gain

As previously discussed, ovulation requires a certain amount of body fat. Excessive weight loss can cause permanent damage, like losing the ability to ovulate.

However, excess weight gain can also cause problems, leading to insulin resistance and diabetes, which can cause irregular menstrual cycles as a result of poor ovulation.

The Ugly (and Uncomfortable):

8. Abnormal periods

With the exception of women who are on birth control, are pregnant, or are menopausal, women should have regular periods every month. Irregular periods should be evaluated as they can indicate more serious problems affecting the ovary.

9. Endometriosis/pelvic pain

During a normal menstrual period, endometrial tissue is expelled through the cervix into the vagina. However, endometrial tissue can also be expelled "backwards" through the fallopian tubes and deposited into the pelvis. When this tissue implants and grows, endometriosis occurs.

These implants can cause indirect damage to the fallopian tubes via adhesions or direct damage to the ovary by implantation on the ovarian surface. Even in the absence of endometriosis, abdominal or pelvic pain of unknown cause can be associated with infectious diseases that can damage the fallopian tubes.

References:

Burkman, L.J. "Marijuana Impacts Sperm function both In Vivo and In Vitro: Semen analyses from Men Smoking Marijuana," Conference, American Society of Reproductive Medicine, San Antonio, Texas, Oct. 11-15, 2003.

Collaborative Group on Epidemiological Studies of Ovarian Cancer. Beral V, Doll R, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008;371

Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. British Journal of Clinical Pharmacology. 1995;40(3):237-243.

Mikkelsen EM, Riis AH, Wise LA, Hatch EE, Rothman KJ, Sorensen HT. Pre-gravid oral contraceptive use and time to pregnancy: a Danish prospective cohort study. Hum Reprod. 2013 May; 28(5): 1398-405.

Am J Obstet Gynecol. 1982 Mar 15;142(6 Pt 2):809-16.