Fertility Fact File

Life-style and nutritional factors

There are many ways to prepare for starting a family, for some there’s no planning involved at all, yet, for others it can be a little trickier. One thing is for sure, getting yourselves in the best shape possible is a great first step. Preparing well before conception enhances the chances of a successful pregnancy. Good nutrition and a healthy life-style help implantation and embryo growth. Part of pre-conceptive care is to design a nutritional and life-style programme that will enhance your chances of a falling pregnant and staying healthy throughout the pregnancy. Here are some facts and figures surrounding fertility to help you make the right choices.

NUTRITION

A mother’s nutritional intake is essential for the health of the baby as well as for the adult that baby will become. It also increases fertility by helping the implantation and early development of an embryo. Chances of a miscarriage are reduced. Good nutrition to the womb will increase the weight of the baby and thus decrease the risk of poor health later in life.

FISH

Danish women who ate no fish in pregnancy were found to have a 7.1% occurrence of early (preterm) delivery, compared to 1.9% in those eating fish once a week. Overall, low birth weight and preterm birth tended to decrease with increasing fish consumption, and average birth weight and length of gestation tended to increase with increasing fish consumption BMJ 2002;324:447).

FISH OIL

Fish oil pills may help prevent premature delivery in women who are at high risk for this pregnancy complication, according to research carried out at the Epidemiology Science Center in Copenhagen. Fish oil was first connected to pregnancy when investigators found that babies born in the Faroe Islands, where diets are largely fish-based, had the highest average birth weights in the world. In a fish oil group, 21% of the women gave birth prematurely compared to 33% of those in a control (olive oil) group did (British Journal of Obstetrics and Gynaecology 2000;107:382-395).

Meanwhile a large study in Finland has found evidence that people who eat fish less than once a week run a 31 percent higher chance of mild to severe depression than people who eat it more often.

GINGER FOR NAUSEA

A small double-blind, placebo-controlled randomised clinical trial has demonstrated the benefits of ginger syrup for reducing symptoms of nausea and vomiting of pregnancy. Subjects in the study group took 1g of ginger syrup (undetectable by taste) mixed with honey and water, whilst the placebo group took a water, honey and lemon oil syrup. After 9 days, 10 of 13 (77%) of the study group reported at least a 4 point improvement in the nausea scale, as against only 2 of 10 (20%) in the placebo group. 8 of 12 (67%) women in the study group who were vomiting daily at the beginning of the study stopped vomiting by day 6, compared to only 2 of 10 (20%) in the placebo group. (Alternative Therapies in Health and Medicine, vol. 8, no. 5, 89-91).

WEIGHT

Fertility is highest and pregnancy most successful when the body mass index (find out what your BMI is...) is between 20-25. Overweight women (BMI 27) are 300% less likely to conceive, and much more likely to miscarry if they do conceive. But even losing a little weight can increase the chances of a pregnancy significantly. One in three women who are overweight and lose weight get pregnant, and the risk miscarriage is reduced by 2/3. Underweight women (BMI 17) are 50% less likely to conceive.

For you to achieve an improved weight and thus for you to enhance your chances of natural fertility we again advise you to follow a certain food programme. You may also receive treatment that aims at increasing or decreasing your metabolic rate or the activity of certain organs.

LIFESTYLE

STRESS, SLEEP

Life-style stress or depression is implicated in ovulatory irregularities and abnormal sperm development. Lower levels of measurable physiological stress indicate a higher chance of conception. Sleep plays a major role in maintaining good homeostasis and wellbeing. Lack of sleep has shown to lead to physiological disruptions. It inhibits the release of growth hormones which is essential for tissue growth and the maintenance of the body’s metabolism.

In Chinese medicine the link of stress and lack of sleep to infertility is well recognised, and any treatment will always aim to improve stress response and sleeping pattern.

ALCOHOL

Even modest consumption of alcohol by woman can delay conception. Alcohol is poorly metabolised by women and can lead to a disturbance of the oestrogen/ progesterone balance. In both men and women alcohol should be avoided during IVF as it can lead to a reduced egg production for egg retrieval as well as an increased risk of miscarriage in women and alcohol consumption before sperm collection reduces the success more than 8 times in men.

SMOKING

Female smokers have markedly lower levels of oestrogen than non-smokers, which could lead to a delay in conception. It is also implicated in tubal factor infertility, and can cause early menopause. In men, the toxic components in tobacco have damaging effects on sperm production. After stopping smoking, the sperm count increases quickly.

Both active and passive smoking have been shown to significantly increase female and male infertility, as well as the incidence of early spontaneous abortion, preterm labour, ectopic pregnancy, multiple pregnancy, poor embryo development following in-vitro fertilisation treatment, delivery of low birth weight infants at added risk of neonatal morbidity and mortality, and early menopause. New research has now thrown light on the mechanism by which smoking affects infertility. Polycyclic aromatic hydrocarbons (PAHs), released in tobacco smoke as well as the burning of fossil fuels, have been shown to attach to and kill eggs in mice. The research also indicates that long-term egg reserves - those due to be released from the ovary in several years’ time - are the most vulnerable which indicates that the effects of exposure could therefore take years time to appear, as well as explaining the early menopause (Nature Genetics on-line, vol. 28 no. 4, 355-360).

COFFEE

Coffee consumption is closely linked to fertility rates: the risk of infertility is 55% higher in women who consume one cup of coffee per day, 100% higher in those who drink 1.5-3 cups, and 176% higher in women who consume more than 3 cups per day. Coffee can also retard foetal growth and increases the risk of miscarriage. That means if you consume 1-3 cups of coffee per day you take twice as long to get pregnant. Your average natural conception time would increase from 7-9 months to about 1-2 years.

Danish research into 18,478 pregnant women booked for delivery at Aarhus University Hospital during 1989-96 found that those who drank eight or more cups of coffee a day during pregnancy had a 300% greater risk of stillbirth compared with women who did not drink coffee. The risk was 80% greater in those who drank four to seven cups a day (BMJ 2003;326:420).

A joint US/Swedish study of 562 women who suffered miscarriage at between six and twelve weeks into their pregnancy has shown that the equivalent of one to three cups of (relatively weak) US coffee increases the risk of miscarriage by 30%. At three to five cups, the risk is increased to 40%, and more than five cups doubles the risk. The director of the study suggested that pregnant women reduce their coffee consumption to the equivalent of 2 cups of American coffee a day (200mg of caffeine) (New England Journal of Medicine).

MEDICATIONS

Painkillers or aspirin, commonly taken by women for menstrual pains, reduces fertility by interfering with ovulatory signals. Thus looking for alternatives to painkillers is essential if you plan to get pregnant. Both acupuncture and herbal medicine are highly effective in relieving pain.

There are, of course, exceptions to every rule but if you are committed to starting a family then getting yourself into a healthier routine as soon as possible will facilitate conception, ease the pregnancy and positively focus you in the right direction.