About UWH
Lifestyle tips to promote fertility
Approximately 12% of women in the United States have difficulty conceiving. There are numerous reasons, but for 10% of couples the causative factor will not be found. How much of a patient’s fertility is under her control? What can a couple do to ensure a successful pregnancy? Below is a brief summary of important lifestyle factors that can be modified to enhance a couple’s fertility and increase the likelihood of a healthy pregnancy for both the mother and her child.
Maintain A Healthy Weight!
Since 2008 Kentucky had the highest rate in the country of overweight and obese residents with 67% of the population being overweight (Body Mass Index ≥ 25 kg/m2), and 28% of the population classified as obese (Body Mass Index ≥ 30 kg/m2). Being obese is a significant risk factor for BOTH infertility and poor pregnancy outcomes. Calculate your Body Mass Index (BMI) at www.nhlbisupport.com/bmi.
Several research studies have shown that being obese can cause infertility, decrease the likelihood that infertility treatments will result in a pregnancy and increase the risk of miscarriage in women who do become pregnant. Because of these associations it is recommended that women lose weight prior to undergoing fertility treatment. The Fertility Center at University of Louisville works with the Attain IVF financial program that enable a couple to have multiple in vitro fertilization (IVF) cycles for a discounted fee, but one of the qualifications is that a patient’s BMI be less than 37 kg/m2 in order to maximize success.
Though weight loss is not easy for anyone, even a modest 5-10% weight loss will significantly improve pregnancy outcomes. Exercise, independent of weight loss, will enhance overall health and thus increase the likelihood of a successful pregnancy. When trying to get pregnant we do not advise eating less than 1500 calories a day. This minimum caloric requirement will help maintain your fertility. At University Women’s HealthCare we have a registered and licensed dietician on staff, Patricia Harris, RD, LD, CDE, who will devise a dietary strategy that will work for you. Working with Ms. Harris will enable you to follow an effective and safe weight loss program. Call for an appointment at (502) 271-5999.
A scientifically proven weight loss technique is to keep a food journal that will track your intake. They can be found at www.prevention.com (click on My Health Tracker), www.caloriesperhour.com, and www.livestrong.com. Bringing your food journal to your appointment with Ms. Harris will help her target your problem areas.
Besides improving fertility and lowering miscarriage rates, losing weight will also lower the two-fold increased risk of pregnancy complications that occur in obese women; high blood pressure, preeclampsia, diabetes, large babies, long labors and risk of wound breakdown with a cesarean delivery.
For those persons who are very obese (>100 pounds above ideal weight or a BMI > 40 kg/m2), long-term success of maintaining weight loss is unfortunately low. These patients should consider surgical (bariatric) intervention. Though there are still significant risks associated with bariatric surgery, new minimally invasive methods have improved outcomes while minimizing surgical complications. Patients who have undergone bariatric surgery should plan on delaying conception for at least 12 months in order to maximize their weight loss.
Stop Smoking!
In 1999 Kentucky took first place with the highest rate of cigarette smoking in the United States. Ten years later we are still in the lead with 29% of adults using tobacco products. Smoking can have a significant impact on fertility; decreased ovulatory rates, limited tubal function (which will interfere with sperm fertilizing the egg), increased risk of miscarriage and decreased sperm production. Any tobacco products, smoking cigarettes or cigars as well as chewing tobacco, will result in decreased fertility in both women and men. In addition, adverse pregnancy outcomes such as small babies or sudden infant death syndrome (SIDS) are increased in households where either the mother smokes or is exposed to smoking.
All couples where one or both of the partners smoke need to quit. It is not easy to stop smoking but the Cooper/Clayton Method has proven success. This free program uses nicotine replacement therapy that increases the likelihood of success and though these products have been linked to small babies in mothers who use them the risk is less when compared to smoking. Information about the Cooper/Clayton Program can be found at (502) 574-STOP (574-7867) or 1-800-QUIT-NOW and their website; stopsmoking@louisvilleky.gov.
In terms of marijuana use, men who smoke marijuana have significantly decreased sperm production and sperm motility and women who smoke marijuana have lower rates of egg fertilization secondary to marijuana’s metabolites localizing to the female reproductive tract.
Decrease Alcohol!
Alcohol is known to have dose related toxic effect on a pregnancy and is related to reduced conception rates even at modest intake levels before conception. Study results have varied as to how many alcoholic beverages will have a negative impact on female fertility but we recommend women limiting intake to less than two alcoholic beverages a day. Women should stop drinking as soon as they find out they are pregnant as there is no safe level of alcohol consumption during pregnancy. In terms of male fertility more than three alcoholic beverages at one time can significantly lower sperm production.
Limit Stressors!
Life is stressful especially in times of economic turmoil. Trying to get pregnant can increase already high stress levels. Stress can interfere with ovulation and impact other reproductive aspects such as an embryo’s ability to implant in the uterus or sperm production. Many stress reduction techniques are available with no method having been shown to be superior to another. Whatever lowers your stress can enhance your fertility be it meditation, yoga, hypnosis, massage, acupuncture or exercise.
University of Women’s HealthCare has a nurse psychologist on staff, Sheila Ward, CNM, PMHNP who can help you deal with the emotional challenges that might be impacting your psychological and physical health. Ms. Ward has years of experience working with the unique stresses that can affect a couple undergoing fertility treatments. You can make an appointment with her by calling (502) 271-5999.
Stress can be physical as well; vigorous exercisers, physically demanding work or a severely restricted diet can interfere with reproductive functions just like emotional stressors and limiting these behaviors can improve fertility outcomes.
Maintain proper nutrition!
We all know that we should eat healthy and take our vitamins. Most diets provide us with all of the necessary essentials needed for daily living however, in planning for a pregnancy, it is a good idea to build up the body’s stores ahead of time. Folic acid is the most important nutrient needed prior to conception. Adequate body stores of folic acid assist in the proper development of the early embryonic brain and spinal column that occur prior to many women realizing they are pregnant. The recommended daily dosage is 400 micrograms (mcgs) or 0.4 milligrams (mgs) which is found in most prenatal vitamins. However, many prenatal vitamins have recently increased their dosage to 800 mcg or more to ensure proper body stores. Women who have had a child with spina bifida (a spinal cord development problem) are recommended to take 4 mgs (4,000 mcgs) per day. Women with specific diets devoid of certain foods, such as a strict vegetarian or vegan diet, should also take vitamins and may want to discuss other dietary supplements with our nutritionist, Ms. Harris.
More Information:
Choose slow carbs instead of fast carbs
Slow Carbs |
Fast Carbs |
| Brown rice | White rice |
| Dark bread | White bread |
| Pasta | Potatoes |
| Whole grains | Regular soda |
| Beans | Tea sweetened with sugar |
| Vegetables | Cold breakfast cereals |
| Whole fruits |
Increase unsaturated fats and decrease artificial fats
Unsaturated Fats |
Artificial Fats |
| Canola, olive, peanut, Enova oils | Trans fats |
| Vegetables | Partially hydrogenated |
| Nuts and seeds | Fully hydrogenated |
| * Aim for 0 grams of trans fat per day | |
Decrease total protein intake —Increase plant protein and decrease animal protein
Aim for a total of 70-80 grams of protein a day. More than that can decrease your chances of fertility.
Plant Proteins |
Animal Proteins |
| Beans | Chicken |
| Peas | Beef |
| Tofu | Pork |
| Soy | |
| Nuts | |
| * Adding 1 serving of plant protein per day, about 1/2 cup, may increase your chances of fertility | |
Use whole milk products instead of skim or low fat products
- Whole milk products include full fat yogurt, cottage cheese and ice cream
- Aim for 1-2 servings per day of whole milk products. One serving equals one cup of milk or yogurt , 1/4 cup of cottage cheese or 1/2 cup of ice cream.
Work toward a body mass index (BMI) of 20-24
- If you are overweight, losing just 5-10% of your body weight may improve your chances of fertility
- If you are underweight, gaining a few pounds may help
- Calculate your body mass index (BMI)
Plan to exercise daily
- A good target would be about 30 minutes per day
- If you are overweight, up to 60 minutes per day may help you lose weight and increase your fertility.
- Exercise should include aerobic, (walking, dancing, swimming, biking, etc.), strength (weights or bands), stretching, and activities of daily living.
