Improving Fertility through Healthy Lifestyle

By Dr. Andrew Harper

Infertility is a disease of men’s and women’s reproductive systems that impairs one of the body’s most basic functions—the ability to have children. And although 6.1 million people (or approximately 10% of the reproductive-age population) in the United States are infertile, unlike lung cancer or HIV/AIDS, people are often given little information or misinformation regarding the link between lifestyle and reproductive health. This article intends to address some of the common questions dealing with lifestyle and reproduction.

Caffeine
Caffeine is a stimulant found in many foods and beverages. It is also found in prescription and over the counter medications. Caffeine is a naturally occurring substance found in the leaves, seeds, and fruits of more than 60 plants.

How much caffeine is in common foods and drinks?
The amount of caffeine in some common items (amounts are approximate and may vary between products):

• 5oz. cup of coffee 40-180 mg
• 5oz. brewed tea 20-90 mg
• 12oz. Coke 46 mg
• Red Bull energy drink 67 mg
• 1 cup of coffee ice cream 58 mg
• Hershey chocolate bar 10 mg
• 8oz. hot chocolate 5 mg
• 2 tablets of Excedrin 130 mg

I am trying to become pregnant. Is it true that drinking caffeinated beverages will lower my chance to become pregnant?

Results from studies have been mixed. Some studies have suggested that high levels of caffeine (>300mg/day) may make it harder to conceive, but these findings are not proven. Low to moderate caffeine consumption (<300mg/day) does not seem to reduce a woman’s chance of becoming pregnant.

I am pregnant. Is it safe for me to continue drinking coffee and soda?

Most experts agree that moderation and common sense are the keys for consuming caffeinated items during pregnancy. “Moderate” caffeine consumption is approximately 200-300 mg/day, which is similar to 2-3 cups of coffee. It is also important for pregnant women to drink enough water, milk and juice. These fluids should not be replaced with caffeinated beverages (which can act like a diuretic).

Does caffeine cause or contribute to miscarriage?

Researchers have had difficulty determining whether there is a relationship between caffeine and miscarriage since miscarriage is very common. Recent reports suggest that low to moderate consumption of caffeine does not increase the risk for miscarriage. A few studies have shown that there may be an increased risk for miscarriage or fetal death with high caffeine consumption (>300 mg/day), particularly in combination with smoking or alcohol, or with very high levels of caffeine consumption (>800 mg/day).

Weight Control
Body fat plays a critical role in human reproduction. Both an excess and also a deficiency of body fat lead to reproductive failure. Body weight disorders are one of the first potential causes of reproductive failure in both men and women. With the epidemic of obesity in the United States, excess body weight (greater than 120% of predicted ideal weight) is a contributing cause to infertility for a large number of couples.

Fertility issues with severe obesity
• Irregular or infrequent menstrual cycles.
• Increased risk of infertility.
• Two-to-three fold (2-3x) increased risk of miscarriage.
• 2x decreased success with fertility treatments.

Potential pregnancy complications with severe obesity
• 3x increased risk of high blood pressure.
• 2-3x increased risk of diabetes in pregnancy.
• 3x increased risk of birth defects.
• 2x increased risk of high birth-weight infant.
• 3-4 fold increased risk of Cesarean section.

Healthy diet, exercise, and weight optimization are critical aspects in the overall approach to the treatment of infertility.

Smoking and Infertility
The health risks of tobacco smoking are well known with regard to diseases of the heart, lungs, and blood vessels, but the harmful effects of cigarette smoke on fertility is generally unappreciated.

Virtually all scientific studies support the conclusion that smoking has an adverse impact on fertility. The prevalence of infertility is higher, and the time it takes to conceive is longer, in smokers compared to nonsmokers. Research indicates that cigarette smoking is damaging to a woman’s ovaries, and the degree of harm is dependent upon the amount and the period of time a woman smokes. Smoking appears to accelerate the loss of eggs and reproductive function and may advance the time of menopause by several years.

Components in cigarette smoke have been shown to adversely increase the metabolism of estrogen as well as have direct toxic effects to a woman’s eggs. Smoking is strongly associated with an increased risk of spontaneous miscarriage and ectopic pregnancy as well.

The negative effects of smoking are not easily overcome with fertility treatment. Nearly twice as many in vitro fertilization (IVF) attempts are required to conceive in smokers than in nonsmokers. Additional IVF studies show that female smokers require higher doses of medication to stimulate their ovaries, have fewer healthy eggs obtained, and lower pregnancy rates.

STRESS

Is stress causing my infertility?
Probably not. Even though infertility can be very taxing, there isn’t any clinical proof that stress itself directly causes infertility. Only in cases of extreme stress (e.g. war, famine, etc.) have studies clearly demonstrated a direct cause-and-effect relationship between stress and infertility.

Is infertility causing my stress?
Maybe. Many women who are being treated for infertility have as much stress as women who have cancer or heart disease. Infertile couples experience stress each month: first they hope that the woman is pregnant; and if she is not, the couple has to deal with their disappointment.

Why is infertility stressful?
For many couples, infertility represents the first time in their well-planned lives that they haven’t been able to will into being their desired goal by simple determination and hard work. So when it’s hard to get pregnant, they feel as if they have lost some control in their lives. Additionally, infertility tests and treatments can be physically, emotionally, and financially stressful. .

What can I do to reduce my stress?

• Talk to your partner.
• Realize you’re not alone. Talk to other people who have infertility, through individual or couple counseling, or support groups.
• Educate one’s self on infertility, which will show you that your feelings are normal and can help you deal with them.
• Learn stress reduction techniques that work for you.
• Avoid self-medication with excess caffeine or alcohol.
• Exercise regularly to release physical and emotional tension.

Summary: Fortunately, there are some simple, healthy lifestyle approaches that can go a long way in improving one’s chances for successful conception including good nutrition, exercise, weight control, smoking cessation, moderation of caffeine consumption, and stress management.

References: American Society of Reproduction, American College of Obstetrics and Gynecology, and Organization of Teratology Information Specialists.