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Drugs - including alcohol, cocaine and marijuana - are all poisons. They can reduce sex drive; damage sperm production; and interfere with ovulation - and sometimes this damage is irreparable. Smoking tobacco also affects reproductive function - by depleting egg production; increasing the risk of PID; and lowering sperm counts. Often, the adverse effect is temporary, so that when these are stopped, the harmful effects on reproductive function are likely to be reversed. However, since abstinence is easier than moderation, the best option is not to smoke, drink or use drugs!
Occupational hazards can also decrease sperm counts. Many toxic drugs - including radiation, radioactive materials, anesthetic gases, and industrial chemicals such as lead, the pesticide DBCP and the pharmaceutical solvent ethylene oxide can reduce fertility by impairing sperm production. Intense exposure to heat in the workplace (for example, long-distance truck drivers exposed to engine heat; and men working in furnaces or in bakeries) can cause long-term and even permanent impairment of sperm production. You should be aware of these hazards and may need to control your exposure if fertility is a concern.
Wearing loose cotton underwear and trousers is advisable - tight clothes increase testicular temperature and may harm sperm production.
X-rays can be harmful to gonads. If X-rays are needed, the scrotum should be covered with a lead shield.
Unnecessary surgery can also cause harm to fertility. For example, appendectomy for chronic abdominal pain in young women can create pelvic adhesions that damage the tubes. It is also important to educate doctors and patients about the necessity (or the non-necessity!) of certain operations in young women. Procedures like ovarian cystectomy to remove small ovarian cysts; myomectomy to remove small fibroids; and D&Cs may actually cause more harm than do good. If surgical procedures are needed, then these should be performed meticulously, preferably using microsurgical techniques. Minimally invasive surgery (laparoscopic surgery and ultrasound guided procedures) offers an alternative to conventional surgery in these patients, where conserving fertility is a major concern.
For some young men with cancers (such as Hodgkin's lymphoma or testicular cancers), the therapy for the cancer (chemotherapy and radiation) can destroy sperm production and render them sterile. For these men, sperm preservation (by freezing in a sperm bank) is an option to maintain their fertility.
Some young couples use abortions as a method of family planning when they inadvertently get pregnant - either very soon after marriage - or even before. These unwanted pregnancies are then removed by medical termination of pregnancy MTP. A MTP is usually a safe and easy surgical procedure but it can have complications. One of these is infertility because of blocked tubes following an infection after the surgery. Contraception should be easily available for couples - and they should be taught how to use it effectively.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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