Life Choices and Fertility
There are many lifestyle choices that can be modified to increase chances of achieving pregnancy.
Body weight: Low body weight (BMI <19), particularly when combined with emotional, physical or dietary stress, can cause menses and ovulation to become irregular or stop. Excess weight (BMI >30), can cause menses and ovulation to cease and may lead to increased levels of insulin. In both instances, ovulation and normal fertility can often be achieved by optimizing weight.
About 1 in 4 women of reproductive age are obese. Obesity is defined as having a body mass index (BMI) equal to or greater than 30. BMI is a measure of weight for height. Based on BMI, a 5'4" woman is considered obese if she weighs 174 pounds or more. A BMI of 18.5 to 24.9 is considered normal, which is a weight of 110 to 140 pounds for a 5'4" woman. The Web site of the U.S. Centers for Disease Control and Prevention provides a BMI calculator. At of your initial visit to our clinic we will check your height and weight to calculate your BMI for you.
Obese women are at increased risk for a number of health problems, including heart disease, stroke, diabetes and, possibly, certain cancers. Obesity also poses special health risks for a pregnant woman and her baby. Overweight women have increased risk of many pregnancy complications. Risks begin at a BMI of 30, are substantial at a BMI of 35 to 40, and are dramatic in those with a BMI greater than 45.
In an ideal world, one would not want to take these risks of poorer outcome if there were acceptable alternatives. One alternative is to wait until you have lost sufficient weight so that you are no longer in the obese range. If you do a brisk 30 minute walk every day and eliminate 200 calories from your food intake, you will lose 30 pounds per year. Many people have had a more rapid success with programs such as Weight Watchers. Rapid weight loss and high protein diets while attempting pregnancy have been correlated with decreased fertility in animal studies. The higher concentration of ammonia found in reproductive tissue may inhibit embryo development or cause abnormal gene function. Thus "crash diets" while attempting pregnancy are not good. Patients with extreme obesity (BMI of greater than 40) can consider weight loss surgery. Unfortunately this all takes time and is a more difficult decision for older patients.
Smoking: Smoking has a major adverse effect on both sperm and egg quality and is not recommended while seeking fertility treatment. With female smoking and second-hand smoke, natural fertility is decreased, the chance for successful pregnancy with IVF is decreased by as much as 50% and the risk for miscarriage increases. Recipients of egg donation who smoke also have a significantly lower pregnancy rate. In the male, smoking can increase miscarriage and decrease IVF success by a third.
Alcohol: Drinking alcohol reduces fertility in both partners and alcohol intake by the male may increase miscarriage. The effects appear to be greater with IVF. Alcohol intake is not recommended while seeking fertility treatment.
Caffeine: Caffeine intake does not appear to affect male fertility unless it is more than 3 cups of caffeinated drinks per day. However, moderate amounts of caffeine in females reduces fertility, increases risk of miscarriage and may reduce success with IVF.
Stress: Any discussion of life choices and fertility would be incomplete without discussing the effects of anxiety, stress, and depression. Various studies have shown a reduced success rate in achieving pregnancy in women experiencing these symptoms. Stress can be reduced by taking on fewer tasks, reducing work load, and by techniques such as yoga, massage, and acupuncture.
The following resources also offer options for assistance:
· Institute for Health and Healing
· Mind-Body Program for Fertility and Family Building
· Resolve of the Twin Cities