How Your Lifestyle Can Affect Your Fertility
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How Your Lifestyle Can Affect Your Fertility

How Your Lifestyle Can Affect Your Fertility

January 17, 2022

Getting pregnant can be challenging. You might have friends who seem to have no problems falling pregnant while your own journey seems much more difficult.

There are lots of things about fertility that you can’t control, which can make you feel powerless and contribute to stress in your fertility journey.

But, there are certain things that affect your chances of getting pregnant that are within your power to influence. To put a little bit more power in your hands, we’ve broken down the important lifestyle factors you can influence in an attempt to optimize your fertility.

The Things You Can’t Change

First, the factors that are out of your control. It’s important to know these things so you can plan well, but it's also important to understand that these factors often can’t be changed and not to dwell on them.

Age

All of the eggs you produce which you need to become pregnant are with you from birth. As you age, this number naturally decreases and you don't make more eggs. This is often referred to as your “ovarian reserve” and, as you approach menopause, this reserve becomes diminished. There are other factors which affect ovarian reserve, but age is one of the most consistent indicators of egg count.

Genetics

Like so many factors about our health, your fertility is influenced to a significant degree by your genetics, inherited from your parents. Your genetic code is unfortunately fixed. Of the 10-15% of couples who experience fertility issues, approximately half are due to inherited genetic causes¹.

Medical history

If you’ve experienced certain medical issues in your past, these could have a negative impact on your fertility. Surgery on or near the ovaries can also cause damage or scar tissue that negatively impacts your egg count and the ability for them to become fertilised. Similarly, chemotherapy and radiotherapy can have serious negative effects on your fertility². There are multiple other medical conditions that can affect fertility including thyroid disease and polycystic ovarian syndrome.

What to try and control

Now, for the good news.

There are a host of lifestyle factors that can affect your fertility. Below are some of these factors, the effect they have on fertility and how to what you can do about them.

Weight

The Facts

It might not be the answer you want to hear but the link between being either overweight or underweight are established with fertility problems.

While Body Mass Index (BMI) isn’t a perfect measure of health, there is a statistical link between having a BMI that is outside what is considered ‘healthy’ and struggling with fertility.

Overweight and Fertility

There are differences in the recommended BMI in certain ethnicities. However, being categorised as overweight has evidence linked to issues with fertility.

One study saw that as you increase your BMI by 1 over the threshold of 29, there is an associated 4% decrease in your chances of getting pregnant³. So, for example, if your BMI is 34, you’re 20% less likely to get pregnant when compared to people with a BMI of between 21 and 29.

What happens

The evidence is still not clear on why obesity and being overweight causes issues for ovulation and fertility. However, there are studies that have shown a link between infertility, imbalances in certain hormones and increased weight.

  • Leptin

There are a number of studies¹⁴ ¹⁵ that have explored the link between unexplained infertility, BMI and the hormone leptin. These studies have found a correlation between women who are struggling with fertility having higher leptin levels and a higher BMI.

Leptin is a hormone that is involved in appetite – if your blood leptin levels are low, you’re likely to feel the desire to eat and if you have higher levels, your appetite will be reduced. It has another role in fertility though – higher levels tell your body that there is enough nutrition or ‘fuel’ to prepare to have a baby and this interaction is involved in fertility¹⁶.

Leptin is produced by certain fat tissues, and studies show that if you are overweight your leptin levels are likely to be higher. This seems to cause your body to be less receptive to the signal of high leptin – so while an overweight person is producing more than enough leptin to tell the body it's suitable to conceive, the body isn’t receiving that signal in the right manner.

  • Insulin

Being obese or overweight is also associated with higher insulin levels. Higher insulin levels can have a detrimental impact on fertility in some people.

High levels of insulin can lead to irregular or absent ovulation and periods which lead to fertility issues.

What to do

The most important thing you can do is begin to manage your weight – eat healthily and be active.

Taking steps to reduce excess body fat, especially visceral fat around the abdomen, will reduce the likelihood that you’ll experience hormonal imbalances which affect your fertility.

The good news is that you don’t have to lose huge amounts of weight to start improving your chances. So start small and you could see the benefits quickly. If you are still having issues losing weight it would be worth discussing this with your GP to see if they can help, as well as test for other conditions which may be impacting your ability to lose weight, such as Polycystic ovary syndrome.

Underweight and fertility

There is also a balance to be met in terms of weight and fertility. A BMI below 18.5 has also documented issues when trying to conceive.

What happens

In medical conditions such as anorexia nervosa¹⁷, there are changes to the hormones that would normally be released in a woman's natural menstrual cycle. This can lead to difficulty in conception as well as increasing risk of miscarriage.

What to do

Maintaining a healthy balanced lifestyle is key as well as ensuring you have enough calorie intake for the level of exercise you undertake. Keeping your BMI with the recommended range will prevent your weight being a factor that impacts your fertility chances.

Smoking

Fertility is yet another thing which is affected by smoking and is a significant cause of infertility or pregnancy complications worldwide. Infertility is defined as not being able to become pregnant after 12 months of trying and is twice as likely in women who smoke⁴. Female smokers also go through menopause 1-4 years earlier than non-smokers⁴.

What happens

Smoking cigarettes can have a number of effects related to fertility⁵ ⁶.

- Damaging eggs and ovaries

- Fallopian tube blockages (including higher risk of ectopic pregnancies)

- Increased risk of miscarriage

What to do

Unsurprisingly, stopping smoking is the best thing you can do. Quitting can often be extremely challenging and there are a host of resources available to anyone looking to quit smoking.

If you’re considering switching from cigarettes to an e-cig, remember that while e-cig vapour doesn’t seem to contain many of the unhealthy chemicals of cigarette smoke, it typically does still contain nicotine, which can be damaging in itself. All of the effects of e-cig however are still not well established and there may be detrimental effects.

The good news for smokers is that things improve pretty quickly once you’ve stopped. It’s recommended for both men and women to stop 3-4 months before you start trying to get pregnant⁶ .

Alcohol

Standard guidance from the government recommends that anyone trying to conceive doesn’t drink any alcohol – both because of the effects alcohol can have on conceiving and on the development of the baby.

However, the actual impact alcohol has on someone’s fertility isn’t particularly clear. A study published in the British Medical Journal⁷ stated two important findings:

1. Women who reported drinking more than 14 units of alcohol a week were 18% less likely to become pregnant than women who drank less than 14 units per week

2. There was no clear negative effect between drinking less than 14 units per week and 0 units per week

However, a separate study⁸ referenced by the Chair of the British Fertility Society stated that drinking between 1 and 5 drinks per week could reduce your chances of conceiving.

Although the picture is not clear, there have been links made between drinking alcohol and struggling to conceive.

What happens

Alcohol has been shown to lower testosterone, sperm count and sperm quality in men. When it comes to women, there is less evidence as to what causes the drop in conception rates. However, excessive alcohol consumption has been known to affect ovulation, cycle regulation and ovarian reserve⁹. On top of that, it can affect implantation leading to early loss before anyone realises they’re pregnant.

What to do

While the effect of drinking a few glasses of wine each week (a.k.a. ‘moderate consumption’) is up for debate, excessive alcohol intake has been shown to be negative for both fertility and pregnancy.

Therefore the best thing you can do is cut alcohol out of your diet or significantly reduce your intake in the lead up to trying to become pregnant.

Stress

Stress is often the hidden factor that affects our general health day in, day out. It can impact everything from your immune health to your chances of having a heart attack.

Another downside to stress is that it also affects your fertility.

Studies¹⁰ have shown that women who have higher levels of an enzyme called alpha-amylase are less likely to get pregnant than those who have lower levels. Alpha-amylase is an enzyme that’s excreted in the saliva when the body has a stress response to stimuli. It’s been used as a proxy for ‘stress levels’ by researchers.

What happens

Again, research doesn’t have a clear picture of the physiological issues that cause people suffering from stress to struggle to conceive. However, different studies as posited different potential causes:

1. A study¹¹ published in 2015 found that women who reported higher levels of daily stress were more likely to experience anovulation (when no egg is released during your menstrual cycle). The study found that women experiencing more stress had lower estradiol and luteinizing hormone while having higher levels of FSH – which can lead to anovulation

2. Another paper¹² suggested high cortisol levels, which can be brought on by stress, could also affect the ovulation process.

3. A third found that high levels of corticotrophin-releasing hormone, a stress hormone, could affect the uterine lining and placenta and disrupt implantation

What to do

Stress can not only cause fertility struggles, but fertility struggles can cause stress, especially between two partners, which can leave you feeling like you’re in a viscous cycle. This makes it extremely important to address any anxiety, stress or depression you’re experiencing.

There are methods you can adopt to manage stressful symptoms and situations. Exercise has consistently been shown to reduce stress¹³, while methods like mindfulness and meditation can also help relieve the symptoms.

While these methods can be helpful, it’s also important to address the causes of stress. Taking positive steps to, for instance, reduce stressful, high-pressure work environments, find more personal time or spending more time with friends can all result in reduced stress levels.

As mentioned, fertility problems when you’re trying to get pregnant can take a toll on both partners so it’s important to recognise this and be open to taking steps to address this, including individual and couples therapy.

References

1. https://natalist.com/blogs/learn/is-fertility-genetic

2. https://extendfertility.com/6-factors-affecting-female-fertility/

3. https://pubmed.ncbi.nlm.nih.gov/18077317/

4. https://www.tommys.org/pregnancy-information/planning-a-pregnancy/are-you-ready-to-conceive/how-smoking-affects-female-and-male-fertility

5. https://www.verywellfamily.com/female-fertility-and-smoking-1960254

6. https://health.clevelandclinic.org/how-stopping-smoking-boosts-your-fertility-naturally/

7. https://www.bmj.com/content/354/bmj.i4262

8. https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/alcohol-fertility-and-pregnancy/is-alcohol-harming-your-fertility

9. https://www.fertilityfamily.co.uk/blog/drinking-when-trying-to-conceive/

10. https://www.nih.gov/news-events/news-releases/nih-study-indicates-stress-may-delay-women-getting-pregnant

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315337/

12. https://www.glowm.com/section-view/heading/the-hypothalamic-hypophyseal-ovarian-axis-and-the-menstrual-cycle/item/282#.YeBiJNHP2Ul

13. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427383/

15. https://pubmed.ncbi.nlm.nih.gov/12551775/

16. https://fertilityeggspurt.com/leptins-surprising-role-in-fertility-part-1/

17. https://pubmed.ncbi.nlm.nih.gov/821959/