Monthly Archives: June, 2018

Marijuana has been known to mankind for millennia. For the first time, it wasmentioned in manuscripts from Ancient China dating from 2373. BC. It was used both as a recreational drug and as a medicine. Marijuana is banned in many countries, including Bulgaria. In others, it is decriminalized in some form (for example, medical marijuana). Today, marijuana is more widespread than ever before, which makes us wonder if its use can affect fertility.

It is known that chronic use of marijuana can lead to addiction and, in the worst case scenario, to psychiatric problems. Precisely because it is forbidden in so many places, there are not many studies about its  connection to infertility, but experts believe that it may have an impact.

MARIJUANA AND MALE FERTILITY

The effects of marijuana on fertility are better studied in men. Regular use can reduce libido and lead to problems with erection and ejaculation. Semen analyses of these men also show abnormalities. They usually have a smaller number of sperm cells whose motility is also altered. Exposed to THC (tetrahydrocannabinol – the substance that makes you high), sperm initially show hypermotility (move very quickly). Consequently, their speed decreases and, as a result, they can hardly reach the egg.

WHAT ABOUT FEMALE FERTILITY?

In women, marijuana also reduces libido. Its frequent use is also associated with irregular ovulation. After smoking marijuana, THC is found in the female reproductive which affects sperm and thus the chances of fertilization to occur. The use of marijuana is also associated with an increased risk of miscarriage due to its effects on rapidly dividing cells such as the embryo’s cells. THC can indeed relieve the feeling of nausea, but its embryotoxicity makes it contraindicated in pregnant women.

THC can be found in the body for up to 8 days after a single marijuana use. Regular “consumers” need 2-3 months to clean marijuana from their bodies. If you plan to become pregnant, it is important to stop using marijuana. If you or someone you know has a problem with marijuana or other illegal substances, you can find help.

One of the conditions most commonly associated with weight gain and difficulty conceiving in women over the age of 30 is Hashimoto’s thyroiditis. That is not surprising given that 5 percent of the world’s population is or has been affected by the autoimmune condition, with over 80 percent of those being women.

WHAT IS HASHIMOTO’S THYROIDITIS?

In women with Hashimoto the immune system attacks the thyroid gland, which secretes the hormones Triiodothyronine (T3) and Thyroxine (T4). Due to structural and functional damage, over time the thyroid gland starts to secrete smaller amounts of T3 and T4. The medical term for this condition is “hypothyroidism” (“hypo” – sub, low). The main function of both hormones is to regulate basal metabolic rate, heart rate and body temperature. When T3 and T4 levels are low, the metabolic and heart rates drop and body temperature decreases. This leads to a number of other symptoms, most notably constipation, fatigue and weight gain.

GETTING PREGNANT WITH HASHIMOTO

As we have discussed in previous articles, being overweight by itself makes conceiving more challenging because of the hormonal imbalance it causes. The increased amount of fatty tissue converts male sex hormones (androgens) into female sex hormones (estrogens). Often this is accompanied by insulin resistance (cells do not react to insulin), which in turn leads to elevated levels of insulin and androgens (male sex hormones). All of these factors have a negative effect on ovulation. It can become irregular or stop completely, which makes getting pregnant more difficult.

Even if they are not overweight, women with Hashimoto have a hormonal imbalance associated with decreased levels of T3 and T4. This can in itself lead to ovulation disorders and difficulty getting pregnant.

Even after getting pregnant, hormone levels in women with Hashimoto have to be monitored much more closely, because pregnancy has higher demands on the thyroid gland. If those are not met complications and even miscarriage can ensue. However, close monitoring of the pregnancy and good management of the autoimmune condition greatly improve chances of an uncomplicated pregnancy carried to term.

All this may sound alarming but remember that modern medicine offers very good management of Hashimoto’s thyroiditis. The most important thing is early diagnosis! In February 2018, the famous American supermodel Gigi Hadid announced on social media that she was diagnosed with the autoimmune disease. However, that did not stop her from becoming the 5^th highest paid model in 2017, with $ 9.5 million annual income.

Emotions and mood swings are something that almost every pregnant woman encounters at some point. This can be quite stressful especially for those of you who are more reserved and not used to expressing their emotions.

WHY ARE PREGNANT WOMEN MORE EMOTIONAL?

Many factors, both external and internal, affect emotionality during pregnancy. On the one hand, are estrogens and progesterone, whose levels are higher in pregnant women. They can also affect the mood of women in the different phases of the menstrual cycle. On the other hand, all the other factors – the joy of becoming a mother, worrying whether you will be financially stable after the baby is born or the fear of the birth itself. In some women even the change in appearance can be a source of stress and unpleasant emotions.

HOW CAN YOU HELP YOURSELF?

1. Accept that this is normal. All the emotions you feel are fully understandable and do not mean “there’s something wrong with you”. If they do not prevent you from doing your daily activities, there is no cause for concern.
2. Be generous about your sleep. Good sleep can do miracles for physical and mental health. Some pregnant women, however, have trouble sleeping because of the size of the abdomen, difficulty breathing or heartburn. It is advisable to sleep sideways, and putting a pillow between the legs and under the abdomen relieves discomfort. If you suffer from heartburn, lift the upper part of the body with more pillows.
3. You are not annoying if you share. Surround yourself with the people who understand and support you and do not worry about telling them how you feel. If you prefer to share your thoughts with a stranger, do not be ashamed to look consult with a psychologist.
4. Mind your diet. When we do not feel well, we often resort to candy and junk food, a.k.a. comfort food. In fact, many of these foods are rich in salt, which can raise your blood pressure and make you hold fluid, which is unlikely to improve your mood.

Pregnancy comes with a lot of changes and everything happens so fast that makes adjustment difficult. Emotions, though sometimes inexplicable, are part of this great journey. They are not harmful, as long as we treat them in a healthy way.

Premature ovarian failure – a relevant topic for a growing number of young women

Premature ovarian failure (POF) is a condition characterized by reduced ovarian function. The ovaries produce mature oocytes less frequently than normal (every month). It is called “premature”, because women affected by this condition are under 40 years of age. It is important to know that although difficult, it is possible to conceive with POF.

CAUSES

In a large number of cases, the causes for the condition are unclear. The main culprits include autoimmune disorders, genetic predispositions, surgical intervention of the ovaries, chemotherapy and radiation therapy. Among the autoimmune disorders the most common cause is Hashimoto’s thyroiditis. Polycystic ovarian syndrome and endometriosis are also considered possible causes.

There’s a difference between “premature ovarian failure” and “premature menopause”. Premature menopause means a complete cessation of ovulation. In POF ovulation does occurs albeit much less frequently. However, it should also be noted that the quality of the ovulated oocytes is reduced.

DIAGNOSIS

The treating obstetrician-gynecologist will examine you and will refer you for hormonal tests. These include: estradiol, follicle-stimulating (FSH) and luteinizing (LH) hormone. The Anti-Müller Hormone test provides information on the ovarian reserve. The values of these hormones are instrumental for the correct diagnosis.

SOLUTIONS

Depending on the precise diagnosis your obstetrician-gynecologist will lay out the possible solutions.

If you are going to be treated for an oncological condition, we encourage you to cryopreserve your oocytes before the treatment begins. According to the latest update in the statute book of the Center for Assisted Reproduction (CAR), the state will subsidize the cryopreservation of reproductive cells of cancer patients. This will significantly improve the chances of those patients for starting a family after receiving treatment. Cryopreserved oocytes can be stored for years and their quality still corresponds to your age at the time of freezing. In other words they are better quality, not only because they were not subjected to the toxic effect of the cancer therapy but also because of their younger biological age.

If the treating physician considers it suitable, an IVF procedure with own oocytes is one option. You have to bear in mind, however, that both the number and the quality of the oocytes are going to be reduced.

Doing an IVF procedure with donor eggs is another option. You can use eggs from an anonymous donor or a relative (sister or cousin). New Life Medical Center has a donor egg program. We work with one of the largest donor egg banks in Europe in order to offer you, our patients, more opportunities to make your dream come true.

If you want to plan starting your family, it is a good idea to check your ovarian reserve first. Anti-mullerian hormone is considered the most objective indicator of ovarian reserve. It can be tested at any clinical laboratory, regardless of the day of the menstrual cycle.