The following is an edited extract from ‘IVF Success: An Evidence-Based Guide to Getting Pregnant and Clues to Why You are Not Pregnant Now’ by Dr Raphael Kuhn.
Sally, who was 36, and her husband, Sam, who was 37, were desperate to start a family.
An unexpected inheritance had paid off their mortgage. They tried very hard for six months to get pregnant and were becoming increasingly stressed, especially Sally.
Sally dealt with her stress by talking to her extensive network of girlfriends over multiple cups of coffee and a cigarette or two, and relaxing with her husband over a couple of glasses of white wine in the evenings.
More often than not, they finished the bottle. Sally also tried to cope with her stress by engaging in regular, almost daily, intense gym sessions.
Sam got support from his friends over a few beers on weekends. They joked that there might be a problem with his “swimmers.” As it turns out, there was.
Listen: Meshel Laurie gets very honest about her struggle to get pregnant with a partner who wasn’t interested in having kids.
Sam’s family physician (general practitioner) arranged for him to have a sperm test. This revealed not only a low sperm count, but also a high percentage of abnormal sperm. The test was repeated, and the result was the same.
Sally and Sam were referred to a fertility specialist.
Their fertility specialist insisted on lifestyle changes because alcohol, nicotine, and excessive caffeine intake and exercise are all known to adversely affect chances of both natural and IVF conception.
Sally stopped smoking and drinking, reduced her caffeine intake, and moderated her exercise schedule. Sam stopped drinking as well.
Their fertility specialist did, however, reassure them that stress, whether related to their treatment or other factors, would not adversely affect the outcome.
It took them three months to get into good shape. Sam had another sperm test, but it was still significantly abnormal.
Their first stimulated IVF treatment cycle resulted in a pregnancy with a readily detectable, normal fetal heart rate confirmed by ultrasound.
So how do each of these lifestyle factors affect fertility?
The Facts: Stress
Stress does not affect IVF treatment outcome. A systematic review and meta-analysis of 14 prospective psychosocial studies, involving a total of 3,583 infertile women undergoing IVF treatment, concluded, “The findings of this meta-analysis should reassure women and doctors that emotional distress caused by infertility problems or other events co-occurring with treatment will not compromise the chances of becoming pregnant.”
Distress, however, can mean that patients stop treatment prematurely, before the optimal number of cycles to get pregnant have been completed. It is therefore important to address any issues early and get support, including from your IVF counsellor, to assist you in continuing treatment for the optimal period of time.
Sensible exercise improves results of IVF treatment. Moderate exercise in the female who is the source of eggs is associated with improved IVF outcomes. However, vigorous exercise is correlated with reduced IVF success. While engaging in very vigorous exercise is discouraged, 30 minutes of moderate aerobic exercise per day would be endorsed by most fertility specialists.
Simply put, do not drink alcohol if you are planning to get pregnant.
In a study involving 2,574 couples entitled “Effect of Alcohol Consumption on IVF,” women who consumed four or more drinks per week had a 16 per cent lower chance of having a live birth than those who drank less. The live birth rate was 21 per cent lower among couples who both drank four or more drinks per week, compared with those who drank less.
While weekly white wine consumption by men increased the likelihood of poor sperm morphology (physical form) by 43 per cent, red wine consumption at the same frequency was associated with a 23 per cent higher occurrence of poor sperm concentration (count).
Smoking has a very negative impact on the success of IVF treatment.
A report involving all IVF clinics in the Netherlands studied the smoking habits of 8457 women. It summed up its findings with this statement: “Our study found that the effect of smoking more than one cigarette per day for a year reduced a woman’s chances of having a live birth through IVF by 28 per cent —that’s the same percentage disadvantage that occurs between a 20-year-old woman and a 30-year-old woman.”
It went on to state, “Smoking has the greatest effect on women with unexplained infertility problems. In these patients, IVF treatment led to 20.7 per cent of non-smokers achieving a live birth, compared with 13.4 per cent of smokers. These results indicate that smoking may actually be causing the problems these women are experiencing.”
A subsequent review of the available literature confirmed the conclusions of the Dutch study.7
There is research to indicate that a number of substances found in tobacco products, including nicotine and its breakdown products, not only affect follicular development (growth of follicles) and egg maturation (ripening), but also uterine receptivity (favorability of uterine lining for embryo implantation).
You should limit your daily caffeine intake because excessive consumption may compromise the results of IVF treatment.
A 2012 Danish study involving 3,959 women found that drinking five or more cups of coffee per day reduced the clinical pregnancy rate of IVF treatment cycles by half. The live birth rate may be reduced by up to 40 per cent, compared with those who drank less.
What can I do to improve my chances of conception?
While stress reduction will help you to cope with IVF treatment, stress itself will not compromise the outcome.
Smoking increases the likelihood of IVF treatment failure, as does alcohol, excessive coffee consumption, and excessive exercise.
In conclusion, a healthy lifestyle significantly improves your pregnancy prospects.
Dr. Raphael Kuhn, was one of Melbourne's most respected IVF specialists, with more than 15 years experience, also serving as the Chair of Melbourne IVF’s Human Research and Ethics Committee. In 2014, after Dr. Kuhn left Melbourne IVF, he set up an independent second opinion service for unsuccessful IVF patients. It was this experience that prompted him to write his book, which is based on years of experience and backed by extensive research. You can purchase 'IVF Success: An Evidence-Based Guide to Getting Pregnant and Clues to Why You are Not Pregnant Now' here or find out more at www.raphaelkuhn.com