«Lifestyle» and reproduction

As lifestyle we consider here the general way of life, not an indulgence in luxury. It has been recognized that some lifestyle factors like smoking have significant impact on fertility, while others like «stress» are probably unimportant.

On the right, we recall the - quite explicit and thought-provoking - reproductive health campaign in the United States which was held by the American Society for Reproductive Medicine ASRM as early as 2001.

Whether the wish to start a family is fulfilled, depends on the following aspects of lifestyle:

Lifestyle factors

Delayed childbearing: In Holland the age at birth of the first child increased from an average of 25 in 1965 to almost 34 in 1999; a similar development can be found across Western Europe. In the denomination of the Hutterites, who reject any contraception, female fertility was demonstrated to decline from a maximum at the age of 21 to just fifty percent with 35 years. With increasing age, the number of available eggs decreases (to a different extent from one woman to another). In all women, the remaining eggs are of poorer quality, i.e. prone to errors (so-called meiotic non-disjunction) at the moment of conception (see also dedicated page on age and fertility)
Smoking: Nicotine use deteriorates all sperm qualities (number, motility, shape) and inflicts damage to the genetic material (chromosomes). In women, the egg shell (zona pellucida) hardens. IVF patients who smoked (either partner or both) needed on average twice as many attempts to achieve success and had twice the risk that treatment failed for good. This holds true for passive smoking as well: in a Canadian study, the success rate of IVF treatment was 48% in non-smokers, 20% in passive smokers and 19% in active smokers!
Nutrition and body weight: There is no such thing as a reproduction-promoting diet. It is established that in women, both overweight (body mass index BMI > 25) as underweight (BMI < 19) are bad for fertility; same is true for overweight in men. A moderate reduction in body weight is very favorable for conceiving, while excessive daily workout is counter-productive. Professional athletes often have fertility problems.
Coffee: It probably pays off to reduce consumption of coffee, tea and Coke to less than one portion per day. This is only valid for women, who achieve less pregnancies and suffer more miscarriages if consuming coffee regularly. In men there appears to be no difference.
Alcohol: The only comprehensive study from California showed that both man and woman should abstain from alcohol during the month prior to IVF treatment. Even moderate amounts of alcohol seem to reduce success rates and to increase miscarriages.
Sexually transmitted infections: Unprotected sex with multiple partners can induce infections of Fallopian tubes in women that often go undetected, and affect fertility in later years.
«Stress»: The infertility situation in itself increases the stress level, especially in women. However, it is uncertain whether this stress - which is not entirely avoidable - worsens the success rates of fertility treatment at all.
Choice of contraceptive method: After hormonal contraception with a pill or hormone coil, it can take a few months longer until conception. The duration of the prior contraception makes no difference. For short-term contraception, barrier methods like condoms are thus appropriate, and women can go off the pill in due time.