Health and lifestyle

Health and lifestyle issues, such as being overweight, smoking, drug intake and excess alcohol consumption, impact in a significant way on fertility. Society is facing an epidemic of obesity and people should realise that hormones, and hence fertility, are intimately related to sugar, insulin and fat levels. Proper diet and exercise from a young age can protect and preserve fertility in men and women. Carefully managed changes in lifestyle may improve your chances of achieving a pregnancy and having a healthy baby.

Healthy diet

A good healthy diet will include fruit and vegetables each day, and good quality protein, such as in lean meat, fish, eggs, pulses (e.g. beans, lentils). You also need to consume complex carbohydrates, whole grains, plenty of calcium (preferably in the form of low fat dairy products). It is best to avoid excessive additives such as colours, flavours and preservatives. Attempt to keep to a relatively low fat diet, and to include mainly healthy fats such as olive oil. Fish oil or flaxseed oil supplements can be good for fertility and in pregnancy and may reduce risk of post natal depression.

Weight

Weight issues are important for both men and women when considering fertility. If you are overweight, your body mass index (BMI) will be > 25. Obesity increases the risk of heart conditions, diabetes and hormonal imbalances, which can lead to infertility. Even a small reduction in weight may improve fertility odds

Rapid or extreme weight loss is not good for your fertility but may be alright for a quick “kickstart” before you start trying for pregnancy.

Women who are underweight (BMI<20) are also at risk of reduced fertility. If you are underweight and your period cycles are long or irregular, a small weight gain may be beneficial, or cut back on strenuous exercise

Fitness

You will benefit from being fit prior to pregnancy. For women who are unfit, developing at least a moderate level of fitness is advisable. Perhaps build up to 45 minutes brisk walking 5 days per week. If you are very unfit, start with 10 minutes twice a week at a moderate pace, and each week increase the time and frequency of your exercise. It is best to limit intense or high impact exercise, and no more than 4 hours high intensity exercise per week is recommended. Men should also aspire to a reasonable level of fitness. 

Smoking

Smoking can affect the fertility of both males and females, causing erectile dysfunction and increased DNA damage to sperm and eggs.

Alcohol

Women must stop all alcohol while trying to conceive and during pregnancy, while men should aim to keep to current “safe drinking guidelines” – average 2 drinks/day maximum, with several alcohol free days each week and no more than 4 standard drinks in one session.

Caffeine

Both men and women need to aim for <200mg of caffeine a day, which equals a maximum of 1-2 coffees or glasses cola/energy drinks, or 2-3 teas, and not too much chocolate either! If you need to cut down, do so slowly to reduce the impact of withdrawal symptoms.

Drugs

Certain drugs have been found to adversely affect male fertility, including:
• Recreational / illicit drugs
• Antihypertensives
• Psychotherapeutic agents
• Chemotherapeutic agents
• Hormones (anabolic steroids)
• Antibiotics

Affects can include:
• Direct gonadotoxic affects which means direct harm the testes
• Alterations in the production and release of hormones
• Erectile dysfunction
• Direct effects on libido

Sexually Transmitted Infections

Sexually transmitted infections may impact a couple’s fertility.

Chlamydia

Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium, Chlamydia trachomatis.

In women, untreated infection can spread into the fallopian tubes and cause the tubes to become blocked at the very ends. This is known as hydrosalpinx. They can also develop scar tissue around the fallopian tubes that makes it more difficult for the tube to "pick up" the egg at the time of ovulation. This can lead to infertility and an increased risk for ectopic (tubal) pregnancy.

In men, if the infection is left undetected and untreated it can cause epididymitis - an infection in the ducts of the testicles where sperm mature. Epididymitis can manifest in shrinking of the infected testicle, abscesses, and infected sores in the surrounding scrotum area. This can ultimately lead to infertility.

Other infections that may impact fertility include:
• Gonorrhoea
• Syphilis
• HPV
• Herpes
• Genital warts
• HIV
• Hepatitis B

Emotional Health

Maintaining a positive state of mind also improves your health and well-being, and your chances of a successful pregnancy. A degree of stress in life is inevitable, but how you deal with it is important. At Repromed we provide counsellors for individuals and couples. Our counsellors have extensive therapeutic experience and have specialised skills and knowledge in the field of infertility.

Heat

It is best to avoid excessive heat from saunas or spas when trying to conceive and during pregnancy. Men should also avoid situations where their scrotal area is unable to keep cooler than the rest of the body. Keep laptops on the desk and off the lap!