A healthy body and mind are key components to successful conception, but what is the definition of healthy and well? We explore both the dietary and lifestyle factors that play a role in fertility and de-myth statements with a presentation of the facts, based on the latest research.
Today we will look at weight, exercise, caffeine and environmental pollutants and well as stress, smoking and alcohol, as all these factors are known to play a role with regards to fertility – or do they?
Fertility rates are definitely decreased in women who are either underweight or overweight, but there is a lack of clinical trials with regards to the normal variation in weight. A BMI (body mass index) between 20-24 is considered normal, but little is known about the fertility rates within the variation between 20 and 24. Low-fat diets, vegetarian diets, vitamin-enriched diets and herbal remedies used to “improve” fertility do not have enough evidence that state that they do in fact improve fertility.
“The negative effect of smoking on fertility has been proven over and over again and is substantial.”
For both men and women, regular exercise has always been taught to have a beneficial effect regardless of age or body shape/type. With an increased participation in serious training or endurance sports, we have to ask the question, how much exercise is enough and does this affect fertility? There is a large population study dating back to the 80’s, with a follow up 10 years later, which showed that increasing the frequency, intensity and duration of exercise can negatively affect your fertility – but of course that all depends on the starting point. Women who reportedly exercise on most days have a 3.2-fold greater chance of being infertile and these findings were independent of other risk factors such as smoking, age and BMI. Nineteen percent of women presenting to a fertility clinic in Germany reported to practice sports to an excessive degree and it has been suggested that more than seven hours of exercise per week could negatively affect fertility. Moderation is key, to keep fit and healthy but not to overdo it!
High levels of caffeine consumption of around 500mg per day (more than 5 cups of coffee per day) has been associated with a decrease in fertility. During pregnancy, it has been found that more than 2-3 cups per day could increase the risk for miscarriage. Moderate caffeine consumption of 1-2 cups per day before and during pregnancy has no apparent adverse effects on fertility and pregnancy outcome.
Exposure to certain environmental pollutants is being recognised as a potential cause of reduced fertility. Chemicals used in the dry-cleaning and printing industries, as well as exposure to heavy metals (working in paint factories, etc.) may affect both men and women with regards to their ability to reproduce. Currently there is ongoing research with regards to pesticide use and change in sperm parameters. It is advised to avoid these substances, if possible; alternatively, the impact will be minimised by wearing a mask.
Stress increases the risk of infertility and being infertile causes stress
It is generally accepted that infertility causes significant levels of psychological distress. However, does stress cause infertility and will stress management improve fertility? A number of studies have shown that anxiety has an effect on fertility and that reducing anxiety results in increased pregnancy rates. Depression appears to increase infertility rates. There are a number of studies that indicate that psychological interventions lead to increased pregnancy rates.
We carried out a study in which 54 women underwent an IVF cycle after completing the TUPS cognitive behavioural management programme. The positive foetal heart rate was 67% in this group of women compared to the normal rate of 33.4% in women younger than 35 years of age. Women who voluntarily participated in the TUP stress cognitive behavioural intervention had significantly increased IVF cycle viable pregnancy rates compared to women undergoing an IVF cycle who had not carried out the programme.
The possible reasons for the increased pregnancy rates:
- A decrease in psychological factors including depression and anxiety.
- Reversing the immunological causes of endometriosis.
- Managing TUP stress decreases excessive cortisol levels and this will manage the level of insulin secretion which, when raised, has a negative effect on ovarian function.
- Women who undergo TUPS management learn to cope with the added learned stress of infertility and are able to cope with the learned stressors of daily life, including home, work and social stress related to infertility. The TUPS psychological intervention also provides a way of managing fertility difficulties by having a realistic plan of action in terms of treatment options, as well as backup plans should the current treatments fail to yield results.
Managing TUP stress appears to enhance cell-mediated immunity
Our study demonstrated an increased pregnancy rate when managing a specific stress namely time urgency perfectionism stress. This specific psychological intervention is not only effective but also cost-effective.
The negative effect of smoking on fertility has been proven over and over again and is substantial, as smoking women have been found to be significantly more likely to be infertile than non-smoking women. There is no “safe amount” of smoking that can be considered, and therefore kicking the habit is the best solution for your fertility, as well as your health.
The effect of alcohol on female fertility shows contradictory findings; however, the large majority of studies have concluded that alcohol has a detrimental effect. Higher levels of consumption (more than two alcoholic drinks per day or more than 10g of ethanol per day) is best avoided when trying to fall pregnant. Alcohol consumption must completely stop once pregnant as there is no “safe” level of alcohol intake during pregnancy.