MAXIMIZING NATURAL FERTILITY
Laura Smith, MD, Reproductive Medicine and Surgery Center of Virginia
Fertility problems have been estimated to affect as many as one out of every six couples. There are numerous factors which can be at play in such situations, as each couple is different. The good news, however, is that there are a few important lifestyle practices that anyone seeking to conceive can put into place to maximize their reproductive health and natural chances of conception.
Maintain a Healthy Weight
Beyond the clear benefits of lowering your risk of heart disease, diabetes, stroke, and several cancers, achieving and maintaining a healthy weight has reproductive benefits. Evidence in support of any specific “fertility diet” is limited, but the end goal of maintaining a healthy weight is critical to optimizing natural fertility. Studies have shown that both women who are underweight with a body mass index (BMI) < 19 and women who are obese with a BMI > 30 take longer to conceive and have less success with fertility treatments.
Take a Vitamin Containing Folic Acid
Although folic acid supplements do not appear to improve fertility, folic acid is extremely important for anyone considering pregnancy. Folic acid is a B vitamin that is critical for the development of the fetal neural tube, which ultimately becomes the fetal brain and spinal cord. A neural tube defect occurs when the fetal neural tube does not close properly. Taking a daily vitamin containing 400 micrograms of folic acid can help prevent neural tube defects. In order to prevent neural tube defects, folic acid must be taken as early as possible, ideally starting at least 2 months before conception and continuing during pregnancy. If you have already had a pregnancy complicated by a neural tube defect, you should talk to your doctor about the recommended amount of folic acid for subsequent pregnancies.
Do Not Smoke
Smoking causes damage to almost every organ, leading to diseases that are incurable and premature death. The health consequences of smoking extend to reproduction. Smoking significantly decreases both female and male fertility. Studies have shown that it takes female smokers approximately twice as long to achieve natural conception compared to nonsmokers. Smoking shortens a woman’s reproductive window by leading to menopause approximately one to four years earlier. Smoking also decreases the success of fertility treatments, and smokers undergoing in vitro fertilization have a 50% lower live birth rate per cycle and 250% higher miscarriage rate than nonsmokers. Talk to your doctor about ways that you can stop smoking.
Studies on alcohol consumption and fertility have shown that women who drink alcohol have a significant decrease in fertility. One study found between a 25% and 50% decrease in pregnancy per cycle in women who drank alcohol daily. Other investigators showed that women who drank alcohol had 50% more doctors visits for infertility. Given that alcohol should be avoided altogether during pregnancy due to well-known harmful effects, it is generally recommended to avoid alcohol when attempting to conceive both naturally and during fertility treatments.
Consume Caffeine in Moderation
Fortunately, for those who rely upon coffee to get a jump-start in the morning, you can still enjoy your cup. However, be aware that caffeine is associated with infertility when consumed in large quantities, defined as greater than 5 cups of coffee daily (or the equivalent of 500mg of caffeine). During pregnancy, caffeine intake greater than 200mg daily (approximately 2 cups of coffee) has been shown to be associated with an increased risk of miscarriage. Therefore, the best overall approach in caffeine intake is moderation both when attempting conception and while pregnant.
By committing yourself to achieving these lifestyle changes, you are maximizing your natural fertility now, increasing your future fertility potential, and improving your overall health.