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Monday, October 18, 2021

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OPINION: Why it's important for college students to understand infertility

<p>Graphic by Annie Scalet/The Collegian</p>

Graphic by Annie Scalet/The Collegian

Editor's Note: The views and opinions expressed in this article do not reflect those of The Collegian. 

Infertility is a challenge that many people are not prepared to face financially or emotionally, especially adults in their late 20s and early 30s. Additionally, there is a lot of information college-age students are not aware of in terms of their reproductive abilities. In the United States, sex education is often limited to middle and high school years and stops once students enter college. The basis of sex education focuses primarily on contraception and lacks in preparing adults for when they want to plan pregnancies later in life. 

Although fertility may not be one of the main worries of a college student, it is important for young adults to be educated on the prevalence of infertility issues if they plan on starting a family one day. Through this education, it is key that there is an understanding that lifestyle factors such as a healthy diet and body composition could prevent future stress and expenses caused by fertility treatments. It is also important for college students and people who are trying to start families to know there are alternatives to traditional pregnancies such as adoption, surrogacy or deciding not to have children.

There is a large movement among college-educated adults to pursue graduate studies and prioritize careers during their 20s and 30s. Over the past several decades, people have been choosing to start families much later in life. In response to these lifestyle changes, it is important that students educate themselves on the corresponding fertility issues they may face in the future. 

With people starting families at older ages, infertility rates have been rising simultaneously over the past several decades. 

Researchers have found that “the use of assisted reproductive technology by infertile couples is increasing by 5% to 10% per year,” according to the United Nations. In vitro fertilization is one example of ART that involves combining eggs and sperm outside of the body to create an embryo which is then transferred back into the female's uterus for pregnancy. 

Despite the fact that one in eight couples struggles with infertility, the average fertility treatments are extremely expensive, with IVF treatments costing more than $20,000 on average. Consequently, many wish to pinpoint low-cost fertility treatment alternatives. 

Because of the cost of fertility treatment and other alternatives such as adoption or surrogacy, it is important for young adults to know that starting to learn about infertility in college and changing lifestyle factors could lower the chances of running into infertility later in life. These lifestyle factors include diet and weight. 

One indicator of someone's health is their body mass index, which is a value used to estimate a person’s body fat. Having a high BMI may be associated with a negative impact on  many health factors in the long term, including fertility. 

However, BMI has also increasingly been recognized in recent years as a flawed -- and sometimes inaccurate -- metric for health that is not representative of all demographics. A 2021 Washington Post article explains that “assumptions, practices and policies based on BMI adversely affect Americans of color by shaping the diagnoses they receive, treatment they access and stigma they may face.” 

Despite these disparities, BMI is the current metric most commonly used to define obesity. Current research indicates a roughly “J-shaped relationship between BMI and fertility, such that the risk of infertility is highest among those at the lowest and highest ends of the BMI distribution.” 

Minority communities with low income and educational attainment face higher rates of infertility outcomes, according to the AMA Journal of Ethics.

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A high BMI could be associated with lower fertility treatment success rates. For example, a Mayo Clinic research study found that a higher- or lower-than-average BMI is associated with a higher risk of IVF failure. 

Another study found that females considered overweight, which is determined by a BMI greater than 25 kg/m², have lower pregnancy and live birth rates and higher miscarriage rates than females in an average weight category, which is defined as a BMI range of 18.5-24.9 kg/m²

Researchers found that females with higher or lower than average BMI do not ovulate normally. This is due to changes in the levels of reproductive health hormones, such as those released in the hypothalamic-pituitary-ovarian axis. 

Similarly, a high BMI in males could be associated with lower sperm count and lower semen quality, which can cause infertility. Therefore, it is important for males and females to maintain a healthy body composition for various health-related reasons, including fertility.

As college students enter a new and busy time period after graduation, monitoring their diet and body composition could improve fertility if they consider delaying reproduction until later in life. Diet can be a low-cost, significant factor that impacts fertility. 

Research has found that there are certain diets that correlate with better reproductive health, and one diet in particular that may be beneficial to fertility is the Mediterranean diet. For both males and females, research has found that diets with whole grains, oils, vegetables, fruits, and fish correlate with positive results in fertility, including improved semen quality. 

Further research suggests that eating foods with lower levels of pesticides and primarily eating organic fruits and vegetables can have a positive effect on fertility. Foods that have been identified with negative effects on male reproductive health include processed meats, trans fats, soy products, foods with high amounts of pesticides and bisphenol, foods with high fat and dairy products. 

Understanding the impact of diet and body composition on fertility may make it easier for people to have children later in life once they are ready. It is also important to acknowledge that natural birth is not the only option to have children. Surrogacy, adoption or choosing to not have a child are alternatives to IVF or other infertility treatments. 

Though infertility may seem like a future problem to college students, it is important to proactively educate students on the causes, risks and treatment options relating to infertility.  

Contact contributor Cortney Klein at cortney.klein@richmond.edu

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