Oral health is more than an indicator of overall well-being: it may also impact fertility and outcomes of IVF. Women who struggle with infertility find themselves investigating root cause in hopes of successfully conceiving. While doctors may quickly turn to IVF or other fertility treatment options, there are still underlying causes that must be uncovered for successful conception and carrying to term.
One of the potential contributing factors to prolonged infertility could be periodontal disease, an inflammatory disease of supporting tissues of teeth caused by specific microorganisms. The infection, caused by bacteria, can negatively impact many parts of a woman’s body. Reproductive failure can be caused by the numerous complications, including inflammation, that arise from poor oral health.
While more research is required for fertility, specifically, this article will review three, peer-reviewed bodies of research that indicate a connection between fertility and dental care. We recommend collaborating with your OB/GYN or Reproductive Endocrinologist (REI) and dentist for more information.
Oral Health and IVF
Studies begun in 2017 have tracked the success of fertility treatments in relation to oral health. Periodontal health has been definitively connected to diseases like Type II diabetes and issues like preterm labor or low birth weight. Now, medical researchers are finding that failure rates in fertility treatments, including IVF, are connected to periodontal health. Based on these studies, periodontitis and reproductive health are linked because of bacterial infections.
The educated assumption of researchers is that women who have periodontitis also have bacteremia in the uterus. This spread of bacteria activates the immune system, which causes an overproduction of proinflammatory prostaglandins and cytokines. This leads to longer timelines for conception that tends to result in fertility treatments, hormonal supplements and IVF.
Infertility and Inflammation
The pathogens of periodontal disease can circulate throughout the body. This causes an increase in inflammatory markers. Systemic inflammation negatively impacts the reproductive system in women and some men. This inhibits conception in two ways:
Preventing ovulation
Preventing implantation/not sustaining implantation
Without ovulation, no conception is possible. Without sustaining implantation, childbirth is impossible. Prolonged infertility should lead women to ask the right questions to their doctors about possible causes.
Porphyromonas Gingivalis and Conception
In one study, periodontitis was studied on connection to conception for 256 women who were not pregnant. Oral and gynecological examinations determined a baseline. When periodontal pathogens were detected in saliva, these were analyzed. Women were reassessed after 12 months. Porphyromonas gingivalis was more common in the saliva of women who did not become pregnant. Of the women who were unable to conceive during the 12-month period, 8.3% of them had this microbiological marker of periodontitis. Researchers concluded that P. gingivalis was associated with an inability to get pregnant. Additionally, they found that “those who did not become pregnant were older, more frequently current smokers, and had higher median C-reactive protein (CRP) concentrations compared to those who became pregnant.”
Dental Health and Fertility
How do you know if dental health is impacting your fertility? You should follow basic standards to maintain oral hygiene, including regular cleanings and x-rays as well as daily flossing and brushing. What’s more, if you have gum disease or periodontitis, you should ask your doctor about this connection.
Symptoms of periodontitis include:
Puffy, swollen gums
Red or purple gums
Blood that comes out after brushing or flossing
Pus
Bad breath
Tender gums
The good news is that periodontitis is largely preventable with improvements in your oral hygiene. Talk to your reproductive health doctor and dentist to learn more.
Resources
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