Lifestyle Modifications and IVF

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Dr. Sulbha Arora

Posted By : Dr. Sulbha Arora - MD, DNB

Posted On : Apr 12, 2010 (Views : 2385)

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The process of increasing fertility is not a complicated one, however, it can be a moderately difficult one as it requires sometimes drastic lifestyle changes.



Lifestyle modification to tackle obesity, tobacco smoking and alcohol consumption, have been proposed as crucial in influencing the outcome of both natural and assisted conceptions. A recent statement released by the European Society of Human Reproduction and Embryology (ESHRE) further substantiates this association.



Obesity: The reduced ovulation frequency and chances of conception observed in obese women could be attributed to the negative influence of obesity on hormonal and metabolic mechanisms. Such patients undergoing IVF possessed reduced chances of pregnancy (around 30%) as they required increased doses of gonadotropins for ovarian stimulation compared to women with recommended body mass index (BMI). The literature study reported enhanced risks for the following during both natural and assisted conceptions in obese patients:



In pregnant women:

• Increased miscarriage rate of around 30%

• Pre-eclampsia

• Gestational diabetes, with the risk ranging from 2-fold in overweight patients to 8-fold in those suffering from morbid obesity (BMI =40)



In offspring:

• Birth complications and perinatal death

• Congenital abnormalities, including 80% increase in neural tube defects and 30% rise in cardiovascular anomalies



Smoking: The study identified a strong association between the number of smoking years in a woman’s lifespan and the enhanced risk of conception failure after IVF. The adverse effect of smoking on IVF outcome was quite significant; and comparable to an increase in 10 years of female age. Additionally, the number of IVF cycles needed for successful conception was found to be two times more in women smokers than in nonsmokers. The study also reported an increased risk for the following in offspring born through spontaneous and assisted conception to smoker mothers:

• Preterm birth, growth restriction, stillbirth, and early neonatal death

• Low birth weight, oral facial clefts, and sudden infant death syndrome

• Adverse impact on the seminal parameters of male offspring



Alcohol consumption: There is limited data substantiating an association between female alcohol use prior to the IVF cycle and adverse pregnancy outcomes, and male consumption and higher rate of miscarriages and reduced live births. Also, these associations were reported to be dose-dependent and considerably higher when the time of intake was close to the treatment cycles.



The study linked prenatal alcohol consumption with enhanced risk for the following adverse effects:

• Reduced chances of conception, low pregnancy rates, and increased miscarriages

• Physical anomalies to behavioral and cognitive deficits in offspring, which can be included under the broad term, Fetal Alcohol Spectrum Disorders (FASD)

• Fetal death, fetal growth restriction, and preterm birth



Considering the negative impact of these lifestyle factors, the ESHRE task force has put forth five key recommendations for the physicians practicing in the ART field.



• Fertility treatment should not be provided to women whose alcohol consumption is more than moderate levels, and to those unwilling or unable to reduce their consumption.



• Special justification is needed to treat women who are severe or morbidly obese. Weight loss is reported to exert a positive effect on the reproductive potential. However, further data are mandatory to make the IVF treatment conditional to prior lifestyle modifications in obese and smoking women.



• If the ART treatment is made conditional upon lifestyle changes, the physicians should assist the patients in achieving the required results.



• Before initiating the treatment, physician counseling should be directed towards insisting patients to take serious efforts to reduce weight and stop smoking. However, this is not recommended in the case of women approaching the end of their reproductive years, due to implied time delay in attaining these results.



• Further evidence and increased contribution from fertility specialists involved in scientific research are mandatory to substantiate the reproductive effects of alcohol consumption, obesity, smoking, and other lifestyle-related factors.



Control of Obesity, tobacco smoking and alcohol consumption to imporve the fertility will be great,which can further be enhanced by important tips below.



Coffee, energy drinks, soda, and chocolate all contain caffeine. However, caffeine has been shown to affect the DNA of sperm and decreasing their motility if it is consumed on a regular basis. If you consume any caffeine on a regular basis, stop doing so now.



Consuming many drugs, legal and otherwise, can have a negative effect on male fertility.



Some occupations have been directly related to lower male fertility, including those that work with pesticides, cleaning chemicals, and other toxins. If you work at a job that involves working with chemicals, evaluate your options and what alternatives you may have concerning exposure to them.



Exercise has been shown to boost male fertility, however, activities such as biking and cycling have done the opposite. Due to the bicycle seat impacting the testicles in a negative way, sperm quality and quantity are lowered. Avoid activities where physical trauma can occur to the testicles to ensure higher fertility.



For much of the same reason listed above, sitting or driving for long periods has also shown to decrease male fertility. Avoid sitting for long periods, and if necessary, get up or out of the car and walk around for a few minutes to avoid damage to the sperm.



Diet is important to male fertility, but something to avoid when trying for a successful pregnancy is MSG. MSG has been shown to lower the success rates of impregnation in test subjects by 50% when it was consumed prior to testing. MSG is present in many potato chips, soups, and seasonings. Be sure and check the labels of any processed foods before buying or consuming them.



Avoid hot tubs, hot showers and baths, and saunas when trying to boost male fertility. Exposure to high temperatures causes severe damage to the sperm that must maintain a very regulated temperature to survive and be healthy.



The final tip here isn't something to avoid like the others above, but just the opposite. New recent studies have shown that having sex more often leads to higher quality sperm. This is likely due to the sperm not being subjected to environmental and physical harm in the testicles. This can lead to higher quality sperm in males in only a few days.



Lifestyle modification should be the preferred initial treatment of infertility.


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