Fertility Preparation
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Preconception fertility care is based on helping your body produce the healthiest
eggs and sperm possible. In a woman it takes approximately 100 days for the egg
to develop towards ovulation and in the male it’s approximately 116 days for sperm
production to be completed. A proactive way to utilise this time involves couples
adapting a healthy diet and environment in the four months prior to a possible conception.
Although the focus is often on women in fertility issues, the reality is that men
share 50% of the responsibility in the creation of a healthy embryo.
Recommendations for both partners include;
• Refraining from cigarette smoking and other social drugs such as marijuana.
• Avoiding the consumption of alcohol.
• Avoiding caffeine based products.
• Avoiding pesticides and chemicals where possible for example; hair dyes, chemical
household cleaners, nail polish remover, garden sprays, and paint fumes.
• The use of organically grown, unsprayed produce, additive-free foods, free range
eggs, fresh fish and organically reared meat and poultry where possible.
The following studies suggest areas of special concern
Smoking
A report prepared by the British Medical Association had the following key findings
• Men who smoke have a lower sperm count and a higher proportion of malformed sperm.
• Women who smoke take longer to conceive.
• Women who smoke are twice as likely to be infertile as non smokers.
• Men and women who smoke have a poorer response to fertility treatment
• Women who have stopped smoking take no longer to become pregnant than those who
have never smoked.
• Stopping smoking improves sperm count and quality.
British Medical Association 2004 www.bma.org.uk
Coffee
• A study of 1,909 women in America found the risk of not conceiving for 12 months
was 55% higher for women drinking 1 cup of coffee per day. It was 100% higher for
women drinking 1 and one half to 3 cups and 176 % higher for women drinking more
than three cups per day.
Yale University School of Medicine. Epidemiologic Reviews Vol 14, Pg 83, 1992
Coffee drinking before and during pregnancy was associated with over twice the risk
of miscarriage when the mother consumed 2 to 3 cups of coffee per day.
Journal of American Medical Association December 22 1993
A Caffeine intake of 3 or more cups a day by women or their partners doubled the
rate of miscarriage in a Danish study.
American Journal of Epidemiology Vol 160 No 7 2004 661-67
Pesticides
In a study of Danish greenhouse workers, an unexpectedly high sperm count was found
among organic farmers. Their sperm count was more than twice as high in those men
as in a control group of blue-collar workers, suggesting that consuming organically
grown foods may enhance fertility.
Abell A, Ernst E, Bonde JP. High sperm density among members of organic farmers’
association. Lancet 1994;343:1498.
Men experiencing infertility were found to be employed in agriculture/pesticide
related jobs 10 times more often than a study group of men not experiencing fertility
problems.
American Journal of industrial medicine Vol 24; 587-592, 1983
Miscarriage increases in women (2.1 to 4.7 times) were found after exposure to chemical
solvents. The major risk chemicals were those used in dry-cleaning, paint, paint
thinners and paint strippers.
American Journal of Industrial Medicine Vol 20; 241-249, 1991
Body Weight
A body mass index (BMI) of 25 to 29.9 in women is considered overweight and has
been linked to irregular or infrequent menstrual cycles, an increased risk of infertility,
an increased risk of miscarriage and decreased success with fertility treatments.
The positive news is that small amounts of weight loss (5-10%) may dramatically
improve ovulation and pregnancy rates.
American Society for Reproductive Medicine Meeting October 2004
A study of Danish men found that sperm counts were lower in those men that were
overweight (21.6 %) and those that were underweight (28.1%)
American Society for Reproductive Medicine Meeting October 2004
Alcohol
A study from the Universality of California of 221 couples undergoing fertility
treatment found;
• For women alcohol consumption in the month before IVF attempt reduced success
nearly 3 times with alcohol consumption in the week before egg pick up (one glass
per day) increasing the chance of miscarriage by 2 times.
• For men alcohol consumption the month before IVF reduced success 2 and a half
times and alcohol (one glass per day) in the week before sperm collection reduced
success more than 8 times. The recommendation was made that couples abstain from
alcohol consumption at least one month before the attempt to maximize the effectiveness
and success of the IVF and GIFT procedure.
Fertility and Sterility 2003;79:330-339
Alcohol consumption in the week prior to conception was associated with an increased
rate of miscarriage. For women ten or more drinks a week was associated with 2 to
3 times greater risk of miscarriage while for men it was 2 to 5 times greater risk.
American Journal of Epidemiology Vol 160 No 7 2004 661-67
Lap tops and Male fertility
Men sitting with their legs together and working on a laptop computer can rise the
temperature by up to 2.8 degrees C. An amount sufficient to affect testicular function
and impair spermatogenesis.
Human Reproduction Advance Access published online December 9 2004
Further information on preconception programmes can be found at http://www.foresight-preconception.org.uk/