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of coffee upon the success of infertility treatments. They found that for women undergoing IVF, coffee consumption did not affect the chance of achieving a clinical pregnancy or live birth. Good news! Women using IUI and consuming 1–5 cups of coffee a day had an increased chance of achieving a clinical pregnancy and live birth. So, if you’re suffering a severe morning headache and lethargy, go back to your coffee.

      Saying no to drugs

      Undoubtedly you know that illegal drugs are taboo when trying to become pregnant! Here are the problems that some common drugs can cause when you’re trying to get pregnant.

      Cocaine

      Cocaine use during pregnancy occurs in over 750,000 pregnancies per year. Cocaine causes constriction of the blood vessels, which can result in early miscarriage, preterm delivery, and problems with the placenta, the organ that nourishes the baby. In addition, cocaine can cause menstrual irregularities, possibly making it harder for you to become pregnant.

      Marijuana

      One of the trending topics of late has been cannabis use and its effects. Marijuana is the most commonly used recreational drug in the United States with an estimated 22 million using the drug in the preceding month and over 117 million lifetime users. Cannabis has been around a long time, but recent changes in legislation and societal attitudes have led to a rise in the use of cannabis. Almost every evil imaginable has at one time or another been linked to the use of cannabis. However, now that so many people are using cannabis — and many legally — efforts are underway to accurately determine the dangers and benefits of cannabis use, including those involving male fertility.

      Marijuana lowers sperm count; decreases sperm’s motility or sperm’s ability to move forward; and lowers the amount of testosterone in males. The problem is that semen study results don’t always correlate with pregnancy rates. So while the numbers in the results of a a semen analysis may be worse after marijuana use, the actual chance of conceiving may not be changed. But, does marijuana decrease the chance for males to father a child? The truth is that we just don’t know. There is no credible, large study that addresses this issue. That is truly disappointing.

What about women and marijuana? There is some evidence that some women who use marijuana when they are pregnant may have an increase in growth restriction of the fetus and preterm labor. However, there is very little evidence to date about how marijuana affects the ability to conceive. A recent study looked at the use of marijuana and the time it took to conceive for both men and women. The study reported that there was no change in the time it took to conceive based either upon use of marijuana or frequency of use of marijuana.

      

So, what is a couple to do? Much like alcohol and cigarette smoking, cannabis may decrease a couple’s chance of conceiving. So, until better evidence is obtained, prudence would say to use these substances in moderation, if at all. This would be particularly true for a male, given the reduction in the semen characteristics.

      Anabolic steroids

      

Some studies show that as many as 6 to 7 percent of all males have used anabolic steroids before age 18 to build muscle mass. Anabolic steroids are really variations on testosterone. Taking these steroids is like a woman taking a birth control pill. In males, anabolic steroids tell the brain the testis is overworking and thus the brain reduces the release of FSH and LH, both of which are needed for normal sperm production. Extensive and extended use of anabolic steroids can result in permanent loss of sperm production and cause a man to become sterile. Many men will have return of sperm production, but it may take months. So anabolic steroids need to be avoided when a man is trying to father a child.

Understanding Common Infections That Can Cause Uncommon Results

      The onset of the sexual revolution in the 1960s caused a lot of fallout, and some of it fell on future fertility. Sexually transmitted infections, or STIs, (formerly called STDs or sexually transmitted diseases) have increased dramatically in the last 20 years. More than 13 million Americans each year are affected, and many STDs pack a major anti-fertility wallop for both sexes. The 2017 CDC data on STIs reported that three STIs had a record all-time high. The report stated that gonorrhea rose by 67 percent, syphilis by 76 percent, and chlamydia by 21 percent from the previous year. In 2018, the World Health Organization (WHO) reported an estimated 376 million new cases of STIs each year (namely, chlamydia, gonorrhea, syphilis, or trichomoniasis). One researcher speculated that while people were having less sex, they engaged in riskier sexual habits such as condom-less sex and opioid addicted–related sex.

You may not even know that you have a sexually transmitted disease. Some STDs cause a vaginal or penile discharge, others cause itching or small sores, but some cause no symptoms at all. Most are easily treated with antibiotics. The problem is that many women don’t realize they have an infection because most have no clear symptoms. The following sections describe a few of the most damaging STDs and provide some statistics about the diseases in the United States.

      HPV: The most common STI

      Human papilloma virus (HPV) is the most common STD in the United States, now surpassing chlamydia and gonorrhea. HPV is different from human immunodeficiency virus (HIV). HPV is transmitted through vaginal, oral, or anal sex. Most often, HPV will go away because the immune system eradicates the virus. However, certain variations of HPV can cause genital warts or cancer. The cancers associated with HPV infection include cervical, vaginal, anal, penile, and throat cancers.

      Like the situation with many viruses, there is no cure — but there is a vaccine. Beyond that, safe sex limits the risk of transmission. While cancer is the major concern with a positive HPV test, newer studies suggest that HPV may also affect fertility. A recent study evaluated the incidence of HPV in couples undergoing IVF. The study detected HPV in 19 percent of the females and 20 percent of the males. For the males who tested positive, there was a reduction in semen concentration, motility, and shape. The authors did not comment about whether this results in a lower pregnancy rate.

      Currently, the gold test standard for HPV in women is the PAP smear (a swab of your cervix), as HPV can cause cervical cancer. Cervical cancer develops slowly in the cells that mark the border between the vagina and the inside of the cervix. The initial infection causes cells to change their appearance, and this can be seen by taking cells from this region of the cervix, staining them, and looking at them under the microscope.

      Treatment for PAP smears where a number of cells look abnormal includes further investigating the cervix with a device called a colposcope. This device (and the colposcopy procedure) is just a way to magnify the area of the cervix where cervical cancers start. The areas identified by the colposcope can be biopsied, and potential cervical cancer cells identified through this early detection method can be removed. (The removal procedure is commonly called a LEEP procedure, Loop Electrosurgical Excision Procedure).

Prior to knowing that HPV causes cervical cancer, the PAP was the best way to identify these early precancerous changes. But now, it is known that certain variations of the HPV, called serotypes, can identify which people are at risk for developing cervical cancer. So, the more modern PAP is done so that the HPV can be typed and the risk assessed. The use of serotyping has allowed those people who are either HPV negative or have one of the safer variants of HPV to have less frequent PAP smears, such as every three years. Early treatment and more frequent screening can reduce the risk for developing cancer.

      There is little data to suggest that HPV has a huge impact on your ability to conceive and, even if you were treated for HPV, the cervical procedures themselves should not increase your infertility risk. So, cancer is a concern with HPV — but impact on fertility, not so much.

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