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Caffeine

Alcohol

Smoking

Stress

Weight

Vitamins

Illness

Exercise

Age

OTC medications


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Lifestyle Issues and Infertility

Our objective in providing infertility care is to make pregnancy occur more quickly than it otherwise would. Some of the techniques we use are quite powerful, but I believe that it is the sum total of all of the details that makes a difference. What follows is a brief discussion of some of the details that individuals can use to improve their chance of becoming pregnant. For many questions that our patients ask, there are no good scientifically-derived answers. The optimum approach is to make the same lifestyle choices that you would make during pregnancy, while you are trying to get pregnant. For example, excessive artificial sweetener consumption might not be a good idea.

Caffeine

Data on caffeine is mixed but it likely prolongs the time it takes to achieve pregnancy. We would recommend avoiding high caffeine intake and especially avoiding all caffeine around the time of ovulation.

Alcohol

Most data suggests that even modest alcohol intake (one glass of wine/week) makes it more difficult to become pregnant. This impact is relatively mild, but if you wish to do everything possible, avoid all alcohol while trying to get pregnant. The most likely impact of alcohol on getting pregnant would be from mid-cycle to the time of the expected period.

Smoking

Smoking has both a long-term and a short-term toxic effect on the ovary. It doubles the risk of miscarriage and of ectopic pregnancy. It decreases the amount of blood flowing to the uterus. Stopping smoking in some settings will double or triple your chances of having a baby.

Mind/Body Issues (Stress, Anxiety, Depression)

Infertility is emotionally distressing. The amount of distress varies from patient to patient. Treatment sometimes increases this distress. Time management, financial, and work issues also play a role. Multiple studies show that both therapies to decrease this stress or education in stress reduction techniques enhance the likelihood of achieving pregnancy. Telling someone to "relax" or "take a vacation" is counterproductive (and hurtful). However, meditation, yoga, massage, acupuncture, individual therapy-counseling, or mind/body education (relaxation training) would be helpful to about 40% of our patients. Please contact our office for recommendations for individuals/programs that provide help in this area.

Diets and Weight Reduction

People who are significantly over- (or under-) weight are more likely to have difficulty conceiving. However, severe calorie restricted or carbohydrate restricted diets should not be used while trying to get pregnant (or during pregnancy). The impact of age is usually more important than taking the time to loose/gain a large amount of weight. Never the less, weight loss/gain is a good approach for the younger patient.

Nutritional Supplements/Vitamins

All people wishing to get pregnant should take 400-800 mg of folate (folic acid). Vitamin C (250-500 mg) and calcium (1200 mg/day including diet) are also desirable. Many patients take a multivitamin or prenatal vitamin (multivitamin with extra folate, calcium and possibly iron). I recommend avoiding herbal medications or fertility supplements containing things other than food products. Supplements that are intended to effect female hormone production either don't work or interfere with the complex regulatory mechanisms that we are trying to utilize to help you get pregnant. Some commonly used herbal medications, when tested scientifically, have been shown to harm fertility. Generally our knowledge of non-pharmacy products is limited, but there is clearly no "magic bullet" for fertility and it is likely that there will never be one.

Fever and Illness

Elevated body temperature does not appear to be good for an establishing a pregnancy. We recommend Tylenol if you appear to be developing a fever at the time of conception or in early pregnancy. Also do what you can to avoid becoming sicker (fluids and rest).

Exercise

In the first part of the menstrual cycle, you may continue any exercise that you are used to. If you are on a therapy that enlarges your ovaries, there is a theoretical risk of some types of exercise either rupturing a cyst or twisting an ovary (which could cause the loss of that ovary). From conception to early pregnancy, I recommend not increasing your internal temperature significantly.

Age

Age is the biggest enemy of getting pregnant. Fertility drops by 50% from age 35 to age 40 and drops by 50% again from age 40 to 42. About 10% of women have ovaries that act about five years older than their chronological age. Advanced ovarian age is more common in women with a history of smoking, but may occur without any apparent cause. Once you have decided to pursue pregnancy seriously, if you really want to have a child, you need to stick with it. Many more people don't get pregnant because they don't pursue therapy long enough rather than don't get pregnant because the therapies don't work.

It is obvious that you can't go back in time and if your ovaries happen to be more effected by age than others, it is essential to act. Generally, infertility is defined as not achieving a baby after one year of unprotected intercourse. Women 35 years old and above should consult a reproductive endocrinologist (fertility specialist) after six months of not achieving a baby. Women aged 40 and above should consult an expert as soon as they decide to pursue pregnancy.

Over-the-counter Medications

Most non-steroidal anti-inflammatory medications (advil, aleve, aspirin) can prevent ovulation if taken at mid-cycle. If you need something for pain during mid-cycle, take acetaminophen (Tylenol).