How successful is the environmental approach to infertility? Foresight figures
Letters to the Editors of the Journal of Nutritional and Environmental Medicine (1995) 5, 205.
PRECONCEPTUAL CARE AND PREGNANCY OUTCOME
Sirs: We would like to report the pregnancy outcomes achieved by 367 couples, average ages 34 (22-45) for females and 36 (25-59) for males, who had been enrolled on a Foresight (The Association for the Promotion of Preconception Care) preconception programme during 1990-92. Foresight clinician completed investigations of both partners which included health questionnaires, analysis of essential nutrient status in blood, hair, and/or sweat, and semen analysis. Common, but often symptomless, genito-urinary infections were sought by testing endocervical swabs, urine and post prostatic massage secretions while blood was tested for chlamydia antibodies to diagnose active pelvic inflammatory disease.
Data evaluation showed that 90% of males and 60% of females regularly drank alcohol while 45% of the men but 57% of the women smoked.
Among the 367 couples, 217 (59%) has a previous history of reproductive problems; 136 (37%) had suffered from infertility (for <1 to >10 years) and 139 (38%) had histories of from one to five previous miscarriages; 11 (3%) had given birth to a stillborn child, 40 were small-for-dates and 15 were of low birthweight ( <2500g); 7 were malformed and 3 infants died of sudden infant death syndrome. A total of 86 females reported more than one of these problems. Of the male partners, 154 (42%) had a semen analysis because of infertility and most had a reduction in sperm quality. Commonest complaints among prospective parents were fatigue, headaches/migraine, cold feet, back pain, abdominal bloating and constipation.
Written and telephone follow-ups carried out in 1993 revealed that 327 (89%) of the women had become pregnant and 327 children had been born since enrolment. There were no multiple pregnancies. In remarkable contrast to the couple's previous experiences, all their babies (137 males and 190 females) were born healthy and were well developed at birth which occurred from 36 to 41 weeks (mean 38.5 weeks). Average birthweight was 3265g (2368-4145). None were malformed and none were transferred to special baby care units. Among the 204 couples with infertility problems, 175 (86%) had achieved healthy pregnancies.
NEIL WARD PhD
Director of Research, Department of Chemistry, University of Surrey, Guildford, GU2 5XH
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