Ensuring your body is baby ready with targeted
natural pre-conceptive care can dramatically increase your odds of falling
pregnant faster and with unexplained infertility affecting up to 28% of women, there
is no better time than now to get started. Although hormonal influences are well
documented to influence fertility, the effects of oxidative stress due to free
radical damage is often overlooked. So
what are free radicals?
By definition, free radicals are the
by-product of oxygen use. An oxygen molecule becomes unstable and has the
potential to do damage to cells and DNA. Anti-oxidants, on the other hand, are
substances that bind to this unstable molecule and thus stop it from doing
harm. In a healthy body, there is a balance between anti-oxidants and free
radicals, but when there is more free radical production or levels of
antioxidants are low, the scales tip towards free radicals and oxidative stress
occurs.
In very simple terms, oxidative stress
damages DNA, and as a consequence cells become damaged, self-destruct or die.
This affects your whole body, including the entire reproductive tract, from egg
production to fertilization, embryo development and pregnancy. Numerous studies
have shown that oxidative stress plays a role in infertility, including the
development of endometriosis and possibly PCOS.2
How
do free radicals affect fertility?
In men, free radicals are responsible for
abnormal and non-viable sperm cells, poor sperm motility and low sperm count.1,2,6
This accounts for roughly 50% of all infertility cases, but often it is the
woman who first comes in for investigations when there are difficulties
conceiving. So what harm can free radicals do in women?
Let’s start in the ovaries. Various types
of free radicals can lower the quality of the eggs.1,2,6 That means
that you already start with a disadvantage. Then there is the fact that free radicals inhibit
secretion of progesterone,2 a
hormone that prepares the uterus for implantation of a fertilized egg. Low
progesterone levels lead to poorer quality of the lining of the uterus,
decreasing the chances on implantation and a viable pregnancy.2
But they not only affect progesterone
production, they can also reduce or inhibit oestrogen production2,
even further reducing the quality of the lining of your womb. The chances on a viable
pregnancy are much reduced by now.
But let’s assume that an egg is released
into your fallopian tubes and your womb is preparing for implantation. Free
radicals then create a hostile environment in the fallopian tubes, making it
harder for the sperm cells to reach and fertilize the released egg.2,6
If the sperm cells themselves are already damaged, have poor mobility or are
low in number due to oxidative stress in the male partner, the chances that a
healthy sperm cell reaches the released egg and actually fertilizes it, are not
great.
Let’s be optimistic and assume that sperm
and egg cell meet and merge, and make it down to the womb. Once there, they
encounter nitric oxide, a free radical which inhibits implantation by
increasing inflammation in the uterus.2,6 The fertilized egg, that
has beat the odds so far, has nowhere to implant, and no option but to die off
and flush out with the menstrual flow.
This means that from start to finish, free
radicals fight fertility all the way. And that is just in women without any
underlying medical conditions that impair fertility. In those who suffer
endometriosis or PCOS, free radicals make conceiving even harder.
Free
radicals and endometriosis
As already mentioned before, the presence
of free radicals triggers inflammation. Via a complicated chain-reaction, this leads
to increased growth and adhesions of endometrial tissue outside the uterus,
contributing to the development of endometriosis. 2,3 It has been
suggested that iron from blood that flows up into the peritoneal cavity rather
than down the fallopian tubes (a process called retrograde flow) instigates
this inflammation, but it is very possible that more factors play a role, as high
levels of specific free radicals are found in women suffering from endometriosis
regardless of high iron levels.1-5 These free radicals are not found
in healthy women, indicating that endometriosis is at least partly caused by
free radicals.
Free
radicals and PCOS
It is not fully understood yet how free
radicals contribute to the development of PCOS, but their levels s are much higher
in blood of women with PCOS than those without.8,9,10 One possible explanation for this might be
the fact that oxidative stress significantly increases blood sugar levels,
resulting in impaired glucose tolerance and insulin resistance.8,11
Insulin resistance then further contributes to oxidative stress by generating more
free radicals, perpetuating the cycle.8,12,13,14 It is well known
that insulin resistance is a major contributing factor in the development of
PCOS. Up to 60% of women with PCOS have insulin resistance, with this number
climbing to 75% if they are overweight.8
Can
free radicals still do harm after you have conceived?
The short answer to this question is: yes.
In women who miscarry in the first trimester, higher markers of oxidative
stress (in response to presence of free radicals) were present in the placenta
than in women who had a healthy pregnancy.1 Not surprisingly, these
same women had lower levels of antioxidants.
This means that free radicals not only
fight you all the way with conception, but continue to fight you during
pregnancy and even labour. By now it should be clear that you want the levels
of free radicals to be as low as possible if you want to conceive and have a
healthy pregnancy and baby. That brings us to the next question.
What
causes high levels of free radicals?
Free radicals are normal part of oxygen use.
You could consider them a by-product of it. Under healthy circumstances they
are not harmful. It is only when your body doesn’t have enough anti-oxidants to
counteract them, or when they are present in higher levels, that they become a
problem.
As mentioned before, inflammation is a major cause for increased levels. But there are
other factors are well that contribute:
-
Cigarette smoke is known to contain many
toxins that act as free radicals and damage DNA. It has been linked with
increased risk on infertility, ectopic pregnancy, miscarriage, low birth weight
and delayed conception during IVF. This
applies to second-hand-smoke, too.1
-
Regular coffee and
alcohol consumption lowers levels of
antioxidants and increases oxidative stress. It promotes cell death and damages
DNA, delays conception, increases risk of miscarriage and contributes to poor
development of the embryo.1
-
Recreational drugs generate free
radicals that impair egg formation, inhibit implantation and disrupt embryo
development.1
-
Pesticides are well known to have a
negative influence on all stages of fertility, from poor egg and sperm quality
to poor implantation and impaired embryo development.1
-
Everyday products like makeup
and varnish contain Polychlorinated
biphenyls (PCB’s), which are linked to increased risk of miscarriage and
poor endometrial quality.1
It is obvious that any of these factors
should be avoided well before you start thinking about starting a family.
What
can you do for this?
Anti-oxidants are substances that can help
make free radicals harmless again or counter their effect. The most well-known
anti-oxidants are vitamin C and vitamin E. Zinc, selenium and copper are needed to
activate some antioxidants, but are not antioxidants in themselves.1
Coloured vegetables, especially purple ones, are known to be high in
anti-oxidants; while several herbs can act as anti-oxidants, too. Including
these types of foods regularly in your diet could be a good place to start.
How
can you measure if you’ve got free radicals?
Free radicals are not picked up on standard
blood tests, but the good news is that you can do a test in the convenience of
your own home simply by collecting a urine sample and processing this in the
OraxX test kit. The urine will react with a
substance provided, and the colour that appears, shows you in which levels free
radicals are present: low, moderate, high or excessively high.
If you are interested in this test, please
contact our clinic on 1300 133 536 or via info@bumpfertility.com.au . We can
send this kit out to you, help you with the assessment of the test results and
develop a treatment plan for you to lower these free radicals and improve your
fertility.
Narelle
Stegehuis, is a
practicing medical herbalist and naturopath specializing in restorative
endocrinology for women, with over 14 years clinical experience in natural
fertility care. She is both an
accomplished writer, editor and technical training advisor for the media. A recipient of the Australian Naturopathic
Excellence Award, Narelle adopts an integrated approach of both medical science
and traditional complementary health care principles. www.bumpfertility.com.au
References:
1.
Agarwal A, Aponte- Mellado A et
all, “The effects of oxidative stress on female reproduction: a review” –
Reproductive biology and endocrinology, 2012, 10:49
2.
Agarwal A, Gupta S, Sharma RK,
“Role of oxidative stress in female reproduction” – Reproductive biology and
endocrinology, 2005, 3:28
3.
Jackson LW, Schisterman EF,
Dey-Roa R, Browne R, Armstrong D, “Oxidative stress and endometriosis” – Human
reproduction, vol 20, no7, p 2014-2020, 2005
4.
Lousse JC, van Langendonckt A
et all, “Peritoneal endometriosis is an inflammatory disease” – Frontier in
Bioscience, E4, 23-40, Jan 2012
5.
Osman Hussein G, El-Refaey AAA,
et all, “Role of some trace elements in the physiopathology of endometriosis” –
Journal of Endometriosis, vol 4, issue 2, April-June 2012
6.
Hammadeh ME, Hamad M et all
“Effect of oxidative stress on ART outcome” – Oxidative stress in applied basic
research and clinical practice, 2012, part 2, 449-483
7.
Santanam N, Kavtaradze N,
“Antioxidant supplementation reduces endometriosis-related pelvic pain in
humans” – Translational research, May 2012
8.
Joo Yeon Lee, Chin-Kun Baw et
all, “Role of Oxidative stress in Polycystic Ovary Syndrome” – Current women’s
health reviews, 20120, 6, 96-107
9.
Aponta Am, Agarwal A,
“Oxidative stress impact on fertility of women with Polycystic ovary Syndrome”
– Oxidative stress in applied basic research and clinical practice, 2013
(published online in Sept 2012), 169-180
10.
Zhang D, Luo WY, Liao H, Wang
CF, Sun Y, “the effects of oxidative stress to PCOS” – Sichuan Da Xue Xue Bao Y
Xue Ban, 2008 May; 39 (3): 421-3
11.
Xin Wang, Chunshan Gu et all,
“Glucose oxidase induces insulin resistance via influencing multiple targets in
vitro and in vivo: the central role of oxidative stress” – Biochimie, vol 94,
issue 8, August 2012, p 1705-1717
12.
Holvoet P, “Relations between
metabolic syndrome, oxidative stress and inflammation and cardiovascular
disease” – Verh K Acad Geneeskunde Belgie, 2008, 70 (3), p 193-219
13.
Evans JL, Maddux BA et all
“Antioxidants and redox signalling” – July/August 2005, 7(7-8), p 1040-1052
14.
Evans JL, Goldfine ID, Maddux
BA, Grodsky GM, “Are oxidative stress activated signalling pathways mediators
of insulin resistance and B-cell dysfunction?” – Perspectives in diabetes, vol
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