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Strenuous Exercise Temporarily Decreases Fertility

Thursday, February 13th, 2014

A study from NTNU (Norwegian University of Science and Technology) suggested that the combination of strenuous workouts and achieving pregnancy may be too much for the body to handle. Therefore, female athletes or heavy exercisers may want to ease up a little if they want to become pregnant.

It is well known that women who are involved in elite sports struggle with fertility more than others. Now it appears that women who participate in other types of extreme exercise may encounter more fertility problems as well. In a study that included 3,000 women, researchers at NTNU discovered that frequent and strenuous exercise may reduce fertility – but only temporarily, or while the hard training lasts.

None of the women in the study had experienced a history of problems with fertility, and all of them were of childbearing age and in good health. Two groups of women showed a higher risk of fertility problems: those who trained nearly every day, and the ones who exercised until they were completely exhausted. The ones who fell into both groups experienced the most fertility problems.

In addition, the effects of strenuous exercise on fertility appear to be transient, ending when the hard training slowed down.

The theory is that extremely demanding physical activity requires so much energy that the body can actually experience periods of a deficiency of energy, in which the amount of energy needed to maintain the mechanisms, hormonal and otherwise, to enable fertilization just isn’t there.

It is important to note that women who engaged in low to moderate activity had no fertility impairments, so there is no reason for women to stop exercising altogether while trying to conceive. In fact, exercise can reduce stress, which is good for fertility. Moderate exercise has been previously shown to improve insulin function and promote better fertility as compared to complete inactivity.

It appears that the worst choices for women trying to conceive fall at both ends of the spectrum: extreme physical activity and extreme sedentariness. Pinpointing what constitutes the perfect level of activity, however, can be tricky, because it can be unique to individual women. If your menstrual cycle is particularly long or nonexistent, this could be a sign that you are exercising enough to negatively affect your fertility.

A woman is considered to be infertile after a year of unprotected intercourse without a pregnancy occurring. In women older than 35, it makes sense to see a doctor sooner; perhaps after four to six months of trying unsuccessfully to conceive. There are many factors that can affect fertility in women, including problems with the fallopian tubes, the ovaries, or the uterus, problems with ovulation, and hormonal issues. Sometimes the reason for infertility cannot be pinpointed, and sometimes it may the male partner who has the fertility problem and not the woman. A doctor’s evaluation is the only way to find out for sure.

– Yvonne S. Thornton, M. D., M. P. H.

Preserving Fertility for Cancer Survivors

Monday, May 6th, 2013

Cancer is a devastating diagnosis for a woman of any age, but for a young woman who is hoping to eventually start a family, there can be a host of other problems associated with this disease. No matter what type of cancer a woman faces, it can have severely damaging effects on her reproductive health. Radiation therapy and chemotherapy can cause major problems with a woman’s eggs, and can even make them not viable for future reproduction. Women who suffer from ovarian and cervical cancers may even be forced to undergo a full or partial hysterectomy.

For many young women, the second question they ask after determining their prognosis is what effect their cancer will have on their future ability to start a family. Fortunately, advances in science over the past few decades have made it entirely possible for a woman to preserve her fertility after a cancer diagnosis. There are many options available for women who want to start a family after they have recovered from their illness. However, it is important to note that many of these options must be pursued early on in a cancer diagnosis—especially if the woman is choosing to freeze her eggs for future in vitro fertilization use.

Many women may see egg freezing as their only choice, and will not want to pursue this avenue when undergoing cancer treatment—this may leave them feeling as if they might never have the chance to start a family. This study shows that most women believe egg and embryo banking is their only option. This is most certainly not the case. Women who are concerned about their potential for reproduction should talk with their doctors and learn all the options before they give it up for a lost cause. There are many mothers out there who have had their children after surviving this horrible disease. I invite people to read my book, “Inside Information For Women”, for more information on the effects of breast and other cancers on the female body.


– Yvonne S. Thornton, M. D., M. P. H.

Obesity Impairs Fertility More in Black Women

Monday, November 5th, 2012

Infertility can be heartbreaking to women trying to conceive. Dreams of holding a newborn baby in the delivery room are often put on hold as women who have been diagnosed as infertile seek alternative methods of conception. Infertility is technically defined as a woman’s inability to get pregnant after a year of trying with no contraceptive methods. There are numerous causes of infertility, but sometimes doctors are unable to determine the cause on a case-by-case basis. Often, infertility is a result of obesity. A recent study showed that obese black women are often more infertile than white women.


Healthy black women do not necessarily have a harder time getting pregnant than healthy white women. However, black women who are obese will have a harder time than white women in the same situation. Specifically, a larger hip-to-waist ratio was associated with infertility. The study could not confirm why women heavier in the lower body and hips area had a harder time getting pregnant, but it could be a result of inhibited estrogen metabolism caused by a large amount of fat. An increase in the resistance to insulin might also be to blame.


The results of the study should be an incentive for obese black women looking to conceive to lose weight. In addition to increasing fertility, a healthy weight prior to conception will make for an easier pregnancy and a healthier baby. However, the results should also be taken with a grain of salt. The results failed to study the health of the potential fathers, who might also have been obese. Obesity in men could lower their sperm count, which would make it even harder for obese couples to conceive.


Obese women, whether black or white, will have a harder time getting pregnant. Though these results suggest that infertility is more common in black women who are obese, women of either race should attempt to reach a healthy weight before trying to have a baby. Fertility will be increased, and you’ll have a happier and healthier pregnancy. If you’re having trouble conceiving, you should talk to your physician about ovulation treatments and the potential for an IVF.


– Yvonne S. Thornton, M. D., M. P. H.

Infertile? It Might be Time to Go Gluten-Free

Monday, October 29th, 2012

The gluten-free lifestyle is gaining popularity in American culture. Even at some of the most mainstream cafes and grocery stores, you can find gluten-free alternatives to your favorite breads and baked goods. Many people are giving up gluten because of the known health benefits associated with cutting it out of your diet. However, some people avoid gluten for a different reason. People with celiac disease suffer from abdominal pain, diarrhea, and weight gain when they eat gluten. The disease is actually fairly common, as 1 in every 133 people in the United States are afflicted with it. Unfortunately, negative reactions to gluten are not the only side effects of the disease.

Women with celiac disease are often infertile. Infertility is defined as the inability to get pregnant within a year after discontinuing contraception. So, while you could get pregnant eventually with celiac, it will be much more difficult. If you have celiac disease, you’ve probably noticed that your periods are sometimes irregular because your body cannot spare any resources, particularly iron. This is because your body has trouble absorbing certain minerals and nutrients, especially if you’re undiagnosed and still eating gluten. In fact, women who seem to be infertile are often tested for celiac disease because the two problems are so closely related. You ovulate less frequently when you have untreated celiac disease because you are malnourished.

Luckily, diagnosing celiac is the first step in recovery. If you have been infertile for a while and realize that you have celiac disease, cutting gluten from your diet might make fertilization of your eggs easier, and you will increase your chances of getting pregnant.

If you’re having trouble getting pregnant and you’ve been experiencing abdominal pain, diarrhea, weight loss, and a general ill feeling, it’s time to get tested for celiac disease. Cutting gluten out of your diet will be difficult at first, but the benefits will be well worth the sacrifice. Besides, giving up gluten is easier now than it ever has been before. Twenty years ago, people with celiac couldn’t even think about eating anything remotely close to bread or wheat. Now, gluten-free options are bountiful. People with celiac can eat everything from cupcakes to foot-long subs thanks to the popularity of alternative baking.

– Yvonne S. Thornton, M. D., M. P. H.

PTSD from Infertility?

Monday, August 13th, 2012

Normally, when you think of post-traumatic stress disorder, you think of soldiers returning from battles with a foreign enemy, not women battling infertility.  Surprisingly though, researchers have found that women undergoing fertility treatments are highly likely to develop PTSD and are calling for a change in the definition of the disorder.

Based on a survey conducted by Allyson Bradow who is the Director of Psychological Services at Home of the Innocents, 50% of women who went through fertility treatments met the criteria for PTSD.  As a result of their stressful experiences, infertile women are 6 times more likely to suffer from PTSD than the general population.  This has led some to believe that perhaps the definition for PTSD needs to be expanded.  Currently, its definition limits its diagnosis to those who have “experienced or witnessed a life-threatening event or [an] event that could cause serious injury.”

Bradow believes that it should also be diagnosed for those who have experienced trauma due to the failure to meet expectations for life.

The ability to procreate is believed to be a fundamental life process.  Trauma is defined as a wound or injury.  The word origin of injury comes from the Latin “injuria”  (in = not + jus =  right) and its definition is to cause one to suffer hardship and loss undeservedly and unexpectedly.  Therefore, if one loses his/her ability to procreate, this satisfies the definition of trauma.  It is not uncommon for couples struggling with infertility to suffer from anxiety, depression, and other related symptoms.  Any time a person’s heart is set on something, particularly a life accomplishment like procreation, they are bound to react extremely emotionally to a negative outcome.  Some find procreation so important, that they feel they have not lived up to the expectations of life when they cannot conceive and are severely traumatized by it.  Whether or not this stress can be considered PTSD or not is yet undecided.  What is clear though is that infertility physicians and clinics need to ramp up their counseling services.  If infertility is an unfixable issue, then couples need help finding a way to be content with it, so they can live emotionally- and mentally-healthy lives.


– Yvonne S. Thornton, M. D., M. P. H.


Fertility Institute Plays God

Monday, June 25th, 2012

For many, having children is an important goal, and when they find that for some reason they cannot, it can be heart wrenching.  Couples can go through years of suffering attempting to conceive, only to find that they are infertile.  When this is discovered, some couples resort to expensive fertility procedures in an attempt to have a child.  One fertility clinic though, decided to capitalize on the desperation of would-be parents by holding a contest offering free in vitro fertilization to the winners.

According to the CDC, 11.8% of women are infertile and 7.3 million of them have used infertility services.  These services are extremely expensive though, and many couples cannot afford them.  Because the services are elective, competition for clients is fierce in the fertility market.  The Sher Fertility Institute decided to embark on a marketing campaign in which couples would compete for their services through a video contest.  Forty-five hopeful couples submitted heart-breaking videos about their struggle to conceive, hoping to woo the judges and win one free cycle of in vitro fertilization.  Only three couples could win, but the amount of attention the institute received more than accomplished their goal of marketing exposure.  Critics of the contest believe that the institute is making light of a very serious situation though, and that they are taking advantage of the desperation of infertile couples in order to boost sales.  With contestants who have suffered five or six miscarriages and even a stillbirth, it seems cruel to get their hopes up with a contest that appears to be the miracle they’ve been waiting for.  Additionally, it doesn’t cause other couples, watching the contest, to consider all aspects of making such a decision.

For the most part, experts seem to agree that in vitro fertilization is safe.  However, they also warn against complications and want would-be parents to be aware of the risks they’re taking.  Professor Nygren, a speaker at the World Congress of Fertility and Sterility in Munich, concluded that there are low levels of increased problems which can come with in vitro fertilization, but these “may be due to the fact that all patients undergoing IVF procedures are patients who already have reproductive problems.”  He also pointed out that there seem to be more complications associated with those who opt for Multiple Embryo Transfer instead of Single Embryo Transfer.

Although the winners of the Sher contest are likely ecstatic at their free IVF cycle, many others are disgusted by the institute’s advertising practices.  If you and your partner are struggling to have a child, be sure to speak with your OB/GYN about all of your options before jumping into a contest where doctors are playing god for a bigger paycheck.


– Yvonne S. Thornton, M. D., M. P. H.



Daily sex for healthier sperm?

Monday, July 6th, 2009

A new study by an Australian fertility expert, Dr. David Greening of Sydney IVF, has caused a bit of a stir. Greening studied 118 men whose sperm had greater than average DNA damage and found that, when they ejaculated daily, the resulting sperm was healthier.

All well and good so far but Greening’s prescription for greater fertility success made me cringe in empathy for my patients who are trying to get pregnant.

Greening recommends that couples engage in sex every day to improve their chances of conceiving.

Maybe it takes a woman to understand that this isn’t the greatest advice in the world. Too many women come to my office, sore and miserable, because their husbands want to do it every day. They don’t want to say no when they’re on a mission to conceive. And now, this (male, you’ll notice) doctor is saying this is the best way to go?

All right ladies, sit down (if you’re not too sore), because you don’t have to take Greening’s advice. Greening’s findings were that daily ejaculation improves sperm quality, not daily sex.

If you and the man you love want to improve your chances of conception, having intercourse three times a week is plenty.

Don’t look at clocks; don’t look at calendars and yell, “Honey, get in here quick, I’m ovulating.” That causes so much performance dysfunction for men. And it’s completely unnecessary.

All it takes is one sperm. Men ejaculate about 60 million of those little guys at a time. And the sperm hang around, ready to jump on that egg when it appears, for up to seven days. So, even though, when we ovulate, the egg is only fertilizable for up to 24 hours, it doesn’t mean that conception is now or never. With up to 60 million sperm hanging around waiting, one of them is likely to be in the right spot when the ovum shows up.

Most important for couples who want to conceive is to remember that sex, even when you’re on a baby-making mission, should never be a chore. Make sure neither of you skimps on romance, cuddling and cooing. In other words, keep the love in making love. It should be as much fun today as it was the first time (even if that first time was in the back seat of a vintage Chevy). Relax and enjoy the experience and each other. Soon enough, if neither of you has problems with fertility, baby will make three.

– Yvonne S. Thornton, MD, MPH