A healthy body and mind are key components to successful conception, but what is the definition of healthy and well? We explore the dietary and lifestyle factors that play a role in fertility based on the latest research. Written by BYY expert, Dr Joanne Pottow.
Let’s have a look at how weight, exercise, caffeine and environmental pollutants and well as stress, smoking and alcohol, play a role with regards to fertility to fall pregnant.
Weight
Fertility rates are definitely decreased in women who are either underweight or overweight, but there is a lack of clinical trials with regards to the normal variation in weight. A BMI (body mass index) between 20-24 is considered normal, but little is known about the fertility rates within the variation between 20 and 24.
Low-fat diets, vegetarian diets, vitamin-enriched diets and herbal remedies used to “improve” fertility do not have enough evidence to state that they do in fact improve fertility.
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Exercise
For both men and women, regular exercise has always been taught to have a beneficial effect regardless of age or body shape/type. With an increased participation in serious training or endurance sports, we have to ask the question, how much exercise is enough and does this affect fertility?
There is a large population study dating back to the 80’s, with a follow up 10 years later, which showed that increasing the frequency, intensity and duration of exercise can negatively affect your fertility – but of course that all depends on the starting point.
Women who reportedly exercise on most days have a 3.2-fold greater chance of being infertile and these findings were independent of other risk factors such as smoking, age and BMI.
Nineteen percent of women presenting to a fertility clinic in Germany who practiced sports to an excessive degree suggested that more than seven hours of exercise per week could negatively affect fertility. Moderation is key. Exercise and keep fit and healthy but do not overdo it!
Caffeine
High levels of caffeine consumption of around 500mg per day (more than 5 cups of coffee per day) has been associated with a decrease in fertility. During pregnancy, it has been found that more than 2-3 cups per day could increase the risk for miscarriage.
Moderate caffeine consumption of 1-2 cups per day before and during pregnancy has no apparent adverse effects on fertility and pregnancy outcome.
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Environmental pollutants
Exposure to certain environmental pollutants is being recognised as a potential cause of reduced fertility. Chemicals used in the dry-cleaning and printing industries, as well as exposure to heavy metals (working in paint factories, etc.) may affect both men and women with regards to their ability to reproduce.
Currently there is ongoing research with regards to pesticide use and change in sperm parameters. It is advised to avoid these substances, if possible. Impact may also be minimised by wearing a mask when exposed to airborne toxins.
Stress increases the risk of infertility… and being infertile causes stress
It is generally accepted that infertility causes significant levels of psychological distress. However, does stress cause infertility and will stress management improve fertility? A number of studies have shown that anxiety has an effect on fertility and that reducing anxiety results in increased pregnancy rates.
Depression appears to increase infertility rates. There are a number of studies that indicate that psychological interventions lead to increased pregnancy rates.
We carried out a study in which 54 women underwent an IVF cycle after completing the TUPS cognitive behavioural management programme. The positive fetal heart rate was 67% in this group of women compared to the normal rate of 33.4% in women younger than 35 years of age.
Women who voluntarily participated in the TUP stress cognitive behavioural intervention had significantly increased IVF cycle viable pregnancy rates compared to women undergoing an IVF cycle who had not carried out the programme.
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The possible reasons for the increased pregnancy rates:
- A decrease in psychological factors including depression and anxiety.
- Reversing the immunological causes of endometriosis.
- Managing TUP stress decreases excessive cortisol levels and this will manage the level of insulin secretion which, when raised, has a negative effect on ovarian function.
- Women who undergo TUPS management learn to cope with the added learned stress of infertility and are able to cope with the learned stressors of daily life, including home, work and social stress related to infertility. The TUPS psychological intervention also provides a way of managing fertility difficulties by having a realistic plan of action in terms of treatment options, as well as backup plans should the current treatments fail to yield results.
Managing stress appears to enhance cell-mediated immunity. Our study demonstrated an increased pregnancy rate when managing a specific stress: time urgency perfectionism stress. This specific psychological intervention is not only effective but also cost-effective.
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Smoking
The negative effect of smoking on fertility has been proven over and over again and is substantial. Smoking women are significantly more likely to be infertile than non-smoking women.
There is no “safe amount” of smoking that can be considered, and therefore kicking the habit is the best solution for your fertility, as well as for your health.
Alcohol
The effect of alcohol on female fertility shows contradictory findings; however, the large majority of studies have concluded that alcohol has a detrimental effect.
Higher levels of consumption (more than two alcoholic drinks per day or more than 10g of ethanol per day) is best avoided when trying to fall pregnant. Alcohol consumption must completely stop once pregnant as there is no “safe” level of alcohol intake during pregnancy.

Frequently asked questions (FAQ’s) about infertility
Q1. What are the common signs that you may have difficulty getting pregnant?
A1. Common signs that you may have difficulty getting pregnant include irregular menstrual cycles, absence of menstruation, severe menstrual cramps, abnormal bleeding, pelvic pain, and experiencing no pregnancy after one year of regular unprotected intercourse.
Q2. How does having irregular menstrual cycles affect fertility?
A2. Irregular menstrual cycles can indicate ovulation problems, making it difficult to predict fertile windows and reducing the chances of conception. Conditions like polycystic ovary syndrome (PCOS) are often associated with irregular cycles.
Q3. What does it mean if you have no menstruation at all?
A3. The absence of menstruation, known as amenorrhea, can signal underlying health issues such as hormonal imbalances, thyroid problems, or severe weight loss or gain. These issues can impact ovulation and fertility.
Q4. Can severe menstrual cramps indicate fertility problems?
A4. Yes, severe menstrual cramps can be a sign of conditions like endometriosis or fibroids, which can affect fertility. Persistent, painful periods should be evaluated by a healthcare provider.
Q5. How does abnormal bleeding relate to fertility issues?
A5. Abnormal bleeding, such as heavy periods, spotting between periods, or unusually light periods, can indicate hormonal imbalances or structural abnormalities in the uterus. These conditions can affect the ability to conceive.
Q6. What is the significance of pelvic pain in relation to infertility?
A6. Pelvic pain can be a symptom of conditions like endometriosis, pelvic inflammatory disease (PID), or fibroids, all of which can impact fertility. Persistent pelvic pain should be assessed by a healthcare provider.
Q7. What should you do if you’ve been trying to conceive for a year without success?
A7. If you’ve been trying to conceive for a year without success (or six months if over the age of 35), it’s advisable to consult a fertility specialist. They can perform evaluations and recommend appropriate treatments based on the findings.
Q8. How can a healthcare provider diagnose fertility issues?
A8. A healthcare provider can diagnose fertility issues through a variety of tests, including blood tests to check hormone levels, ultrasound examinations to assess reproductive organs, hysterosalpingography to check fallopian tubes, and laparoscopy to look for endometriosis or other issues.
Q9. Can lifestyle factors affect your ability to get pregnant?
A9. Yes, lifestyle factors such as excessive weight, smoking, excessive alcohol consumption, and high stress levels can affect fertility. Adopting a healthy lifestyle can improve your chances of conceiving.
Q10. When is it necessary to seek medical advice regarding fertility?
A10. It’s necessary to seek medical advice if you experience irregular periods, severe menstrual cramps, abnormal bleeding, pelvic pain, or have been unable to conceive after one year of regular unprotected intercourse (or six months if over 35). Early consultation can help identify and address potential fertility issues.
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