Anna Darrock BA (Hons) MBAcC Lic. Ac,

Recommendation: Oral Test

From the answers you have submitted an oral test would be required. Our oral health can have an impact on fertility and pregnancy outcomes.

The Oral Microbiome and fertility 
  
Periodontal disease (or periodontitis) is a prevalent oral health condition which has been estimated to affect 20-50% of the global population and is regarded as one of the greatest threats to oral health it is characterised by chronic inflammation of the periodontium (the tissues which surround and support the teeth) Early signs and symptoms to be aware of include swollen gums which bleed easily and halitosis (bad breath)  

Periodontal disease it is linked with fertility issues, as inflammation in the gums can be spread throughout the whole body, which in turn can go on to prevent ovulation through the inhibition of hormone signalling that is required to trigger ovulation. Research has also shown the link with negative pregnancy outcomes such as miscarriage, preterm birth, and low birth weight. This may partly be driven by translocation of oral bacteria and/or their by- products into maternal circulation, which may then cross the placenta, reach the foetus, and stimulate an inflammatory response in the foetus. In turn, this may increase the risk of miscarriage or premature birth. 
 
The Oral Microbiome and Male Reproductive Health 

Periodontal disease has also been shown to negatively impact male reproductive health

•Sperm health: men with periodontal disease have been shown to have poor sperm quality, including sperm with poor motility.  The intimate relationship between oral health and male reproductive health has been further elucidated by identification of oral pathogenic bacteria in the semen of men with fertility issues 
• Erectile function: men with periodontal disease have been shown to be 2.85 times more likely to experience erectile dysfunction. An erection is caused by an increased flow of blood to the penis following sexual arousal, facilitated by increased production of nitric oxide (NO) in the local blood vessels which allows them to dilate, increasing blood flow. Chronic inflammation, which can be derived from the oral cavity as in the case of periodontal disease, may inhibit NO signalling and thus, drive erectile dysfunction.