L is for Lifestyle: Is your lifestyle affecting your fertility?

We’ve all heard it before. The L word: lifestyle. And when it comes to fertility, this buzzword has done the rounds. Understanding that the choices you make towards better health are important, is a first step. But what does it mean to have a healthy lifestyle, and how exactly does this affect our fertility? In this post, we explore 7 ways to modify your lifestyle.


1. Check your fertility hormones and start tracking your cycles

Our fertility test is a good place to start if you’re curious about your fertility. Plus, knowing when you’re likely to ovulate will guide you on the right time to have sex. You can read more about this here.


2. Quit smoking, limit caffeine and watch your alcohol

Sounds like one hell of a party pooper, but all three are factors to reconsider if you are trying to get pregnant.

One unit of alcohol is half a pint of beer, a small glass of wine or a shot of spirits. If you do drink alcohol and are thinking of trying to get pregnant, aim for no more than 6 units per week for women or 12 units per week for men. That said, there is no clear evidence that any amount of alcohol is safe in pregnancy so it may be best to cut it out completely while you are trying.


The facts are even clearer when it comes to smoking; there is a lot of evidence that smoking affects your chances of getting pregnant and having a healthy pregnancy. Both the UK’s National Institute for Health and Care Excellence and the Royal College of Obstetricians and Gynaecologists advise against smoking both before and during pregnancy as it not only could take you longer to get pregnant but it also increases your risk of ectopic pregnancy (a pregnancy outside the womb), miscarriages, stillbirths and more. Smoking has also been shown to reduce the success rates of fertility treatments, such as IVF (12). The same is true for the air we breathe in. Research has shown that being exposed to air pollution has very similar effects to our health and should be avoided or reduced where possible (14). Things you can do to reduce your exposure to air pollution range from avoiding busy roads or cities on heavily polluted days (you can now see city air quality on your weather app), to opening a window when frying up your bacon.

If that isn’t enough of an incentive – consumption of alcohol and caffeine and being exposed to smoke or air pollutants has also been linked to impact the development of the unborn baby, which can impact their health throughout their life.


3. Your diet and weight

The relationship between weight and fertility is complex as many factors affect fertility and conception.There are plenty of women who successfully conceive despite being overweight or underweight. That said - if you want to optimise your chances, it’s worth trying to get away from either extreme. What we do know is this: research has shown that our weight can influence our fertility (4,10). This is because being under or overweight can cause an imbalance of your hormones, eventually disrupting ovulation and affecting your periods.

One particular hormone that highlights this is Oestrogen. It is produced in the ovaries, adrenal glands and in fat cells, and has a variety of functions. One is to regulate the menstrual cycle. Oestrogens also thicken the lining of your womb, causing heavier periods. Women with a higher proportion of fat cells will therefore produce more oestrogens and are more likely to develop diabetes or polycystic ovarian syndrome because the hormone also affects how well your body responds to insulin.

Conversely, being underweight can also lead to hormonal imbalances that affect your ovulation and cycle. This is because having a low body-fat percentage means less energy available to your body for it to regulate your hormones efficiently. While there is no specific threshold for when this occurs, it really depends on what is normal for you.


4. Take folate and prenatal vitamins

Generally speaking, a good multivitamin and mineral supplement can be helpful when trying to conceive, particularly if you are on a restricted diet e.g. vegan. But this works best combined with a healthy, balanced diet.

Folate - also known as Vitamin B9 - naturally occurs in certain foods (3). This includes spinach, broccoli, kidney beans, bananas and even dry-roasted peanuts. The vitamin plays an important role in repairing DNA and making other genetic material in our bodies. It also helps the body develop new red blood cells.

You can get both Folate or Folic acid (which is the manmade form of this glorious vitamin) as supplements. Women should take this vitamin for at least 12 weeks before pregnancy to minimise the risk of brain and spinal abnormalities in the fetus (4,7). Research has also demonstrated that pregnant women with low levels of folate have a higher risk of miscarriage. The standard dose is 400 micrograms per day, but some women may require a higher dose (7), for example if you have diabetes, have a family history of spina bifida, are on certain epilepsy medications. It’s worth speaking to your GP about this; they will be able to prescribe a higher dose if appropriate.


Another great reason to speak to your GP before trying to conceive, is if you have an existing thyroid condition. You can read more about how the thyroid gland affects fertility here.


5. Stress reduction

There have been multiple studies into the effects of stress on both male and female fertility but findings remain inconsistent. For instance, in women stress has been proved to impact symptoms of PCOS due to its connection to our hormonal feedback mechanism (15).


In men, there is some evidence that stress may affect sperm production (2). Stress also disrupts sleeping patterns, and this can lead to hormonal imbalances and poor eating habits, causing irregular or absent periods (8, 9, 10). Stress also affects our libido i.e. our sex drive. And if you are having less sex, your chances of getting pregnant are reduced further.


6. Limit plastic

The chemicals found in plastics have been linked to both male and female infertility (1). Phthalates, added to plastics to make them more flexible, have not only been proven to disrupt sperm quality and count, but there is also evidence that antenatal exposure to these chemicals can be harmful to a developing fetus.

Similarly, Bisphenol A (or BPA) is used to make plastics more durable - especially plastic bottles - but has been shown to affect fertility in women. Some changes you could make to avoid these effects include: using glass jars or containers instead of plastic, and stop microwaving food in plastic containers.

Unfortunately, these chemicals are also found in commonly used products like hair sprays and nail polish. One way around this is to look out for BPA-free and phthalate-free labels on products. You could also check out this list of resources for more guidance.

To put it simply, reducing your plastic use is not only important for the environment, it turns out it’s better for your fertility too!

7. STI/STD screening

A part of maintaining good sexual health is to have regular STI check ups if you are sexually active. Sexually transmitted infections, such as chlamydia, put you at higher risk of conditions like pelvic inflammatory disease and can affect how quickly you get pregnant. They also put you at higher risk of ectopic pregnancy and complications in pregnancy.

In summary, the road to conception is not a one size fits all but one thing is certain: the changes you make to how you eat, how you live and your choices towards better health, all contribute positively.




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References

1. Chan, E., 2021. Is The Plastics Crisis Really Affecting Our Fertility?. Vogue, [online] Available at: <http://Is The Plastics Crisis Really Affecting Our Fertility?>.

2. Epstein, R., 2021. Does Stress Actually Affect Fertility?. New York Times, [online] Available at: <https://www.nytimes.com/2020/04/17/parenting/fertility/conception-stress.html>.

3. Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2002. Folate Deficiency Associated with Higher Early Miscarriage Risk. [online] https://www.nichd.nih.gov/. Available at: <https://www.nichd.nih.gov/newsroom/releases/miscarriage_risk>.

4. Gaskins, A. J., & Chavarro, J. E. (2018). Diet and fertility: a review. American journal of obstetrics and gynecology, 218(4), 379–389. https://doi.org/10.1016/j.ajog.2017.08.010 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826784/>

5. Heazell, A., Timms, K., Scott, R., Stacey, T., Roberts, D. and Thompson, J., 2020. Associations between consumption of coffee and caffeinated soft drinks and late stillbirth—Findings from the Midland and North of England stillbirth case-control study. European Journal of Obstetrics and Gynaecology, [online] 256, pp.471-477. Available at: <https://www.ejog.org/article/S0301-2115(20)30645-X/pdf> .

6. National Institutes of Health, Office of Dietary Supplements, 2020. Office of Dietary Supplements - Folate. [online] Ods.od.nih.gov. Available at: <https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/>.

7. NHS, 2019. Folic acid. [online] nhs.uk. Available at: <https://www.nhs.uk/medicines/folic-acid/>.

8. NHS, 2020. Infertility. [online] nhs.uk. Available at: <https://www.nhs.uk/conditions/infertility/>.

9. Reproductive Biology and Endocrinology, 2018. Lifestyle and fertility: the influence of stress and quality of life on female fertility. [online] 16(113). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275085/>.

10. Royal College of Obstetricians and Gynaecologists, n.d. Lifestyle and fertility for men and women. [online] Royal College of Obstetricians & Gynaecologists. Available at: <https://www.rcog.org.uk/en/patients/fertility/lifestyle/>.

11. Royal College of Obstetricians And Gynaecologists, 2015. Smoking and Pregnancy. [online] Rcog.org.uk. Available at: <https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-smoking-in-pregnancy.pdf>.

12. Tommy's, 2021. How smoking affects female and male fertility. [online] tommys.org. Available at: <https://www.tommys.org/pregnancy-information/planning-a-pregnancy/are-you-ready-to-conceive/how-smoking-affects-female-and-male-fertility>.

13. Top 10 Conception Tips for him and her. [ebook] British Fertility Society. Available at: <https://www.britishfertilitysociety.org.uk/wp-content/uploads/2016/10/top.10.pdf>


14. Royal College of Physicians (RCP). (2016). Every breath we take: the lifelong impact of air pollution. Royal College of Physicians of London.


15. Mezzullo, M., Fanelli, F., Di Dalmazi, G., Fazzini, A., Ibarra-Gasparini, D., Mastroroberto, M. & Gambineri, A. (2018). Salivary cortisol and cortisone responses to short-term psychological stress challenge in late adolescent and young women with different hyperandrogenic states. Psychoneuroendocrinology, 91, 31-40.