Fertility / infertility
In order to support fertility treatments and not make them ineffective by counterproductive behaviour, there are behaviours that patients should consider. By leading an appropriate lifestyle, fertility can be improved and infertility can be prevented.
The following three factors are in principle important for a pregnancy:
- A healthy egg
- A healthy sperm cell
- Functional fallopian tubes and uterus
How to positively influence your fertility
To a certain extent, patients can directly and indirectly impact the health of the egg, sperm and uterus through their lifestyle, thus increasing the chances of successful IVF treatment. Just taking some consideration of the following recommendations is of benefit.
So-called free radicals frequently play a major role: these are highly reactive atoms or molecules that are created by poor diet, or physical or mental stress. They cause damage to proteins, fats, carbohydrates and also DNA in the body. This leads to cell damage and inflammation (oxidative stress). Vitamins (vitamin C ...), trace elements (zinc, selenium ...) and antioxidant enzymes like (glutathione ...) can neutralise these free radicals.
The recommendations we make are directed at women and men. In principle, it is easier to make certain changes together. This also improves egg cell and semen quality at the same time. The biggest effect is achieved through a long-term change in one's lifestyle for at least three months in the run-up to a fertility treatment. Try not to consider the run-up to IVF treatment as an annoying wait, but as a time for beneficial pre-treatment!
All factors have already been studied to a sufficient extent in studies to be able to make recommendations. However, the results vary between studies, and so the values given below for the relative reduction in live birth or pregnancy rates are only indicative.
What behaviours are beneficial for fertility?
Sleep: Sufficient, regular sleep – but not too much.
The optimal amount of sleep is about 7 to 8 hours. Of course, individual variations in the amount of sleep needed are possible.
Why? An irregular sleep rhythm negatively affects the hormonal system and lowers mental resilience.
- Studies on sleep deprivation have shown that shift work adversely affects the female cycle and increases the rate of miscarriage. Sleep deprivation also releases stress hormones that affect fertility.
- Too much sleep, on the other hand, disturbs one's internal clock and thus one's hormonal rhythms. As a result, one's prolactin level increases, and this inhibits the formation of the hormones FSH and LH, which are important for one's cycle, and thus suppresses ovulation and egg maturation. Prolactin is a hormone made in the pituitary gland and is usually released in increased levels during lactation, especially, as it is necessary for milk production.
- However, a high need for sleep is also often a sign of hypothyroidism, which is often accompanied by an increase in one's level of prolactin, and so the thyroid gland should always be checked when trying for a baby.
- Pregnancy rate: 15% ↑ compared to those who get too little sleep and 25% ↑ compared to those who sleep too much [Park 2013]
Healthy Diet: A well-balanced diet, with plenty of fruits and vegetables rich in vitamins, as well as fish and certain edible oils (for example, linseed and rapeseed oil) containing plenty of omega-3 fatty acids is conducive to pregnancy and child development.
Why? A healthy, balanced diet with an appropriate number of calories is important for physical and mental health. Both for the mother and, as a consequence, also for the child. There are a few important points that should be made here:
- Excessive calorie intake increases insulin levels and, among other things, influences metabolic processes dependent on testosterone, which in turn negatively influence the female cycle (so-called PCOS). Sperm production may also be affected, since excess fatty tissue produces too much oestrogen and is disadvantageous for the male body.
- Fruits and vegetables contain vitamins and free radical scavengers that kill off free radicals caused by unhealthy lifestyles.
- Nowadays, oils are recommended whose fatty acids have the lowest possible Omega 6 to Omega 3 ratio. These include linseed oil (1: 3), rapeseed oil (2: 1), hemp oil (3: 1), walnut, wheat germ and soybean oil (6: 1) and olive oil (8: 1). By contrast, corn oil has a ratio of about 50: 1, sunflower oil 120: 1, and thistle oil 150: 1. A high Omega 6 to Omega 3 ratio is associated with inflammatory processes. An important Omega 3 fatty acid is linolenic acid. It is a "raw material" in the body for the production of prostaglandins, which in turn are important for the development of follicles in the ovary.
- Fish oil is also an important source of Omega 3. Fish is therefore very healthy in itself. However, recent studies show that, depending on the origin of the fish, a varying degree of mercury contamination is found. Caution is therefore required in the case of excessive consumption!
Exercise: Sporting activities (if not excessive) during fertility treatment are allowed and promote well-being. However, men should avoid intensive cycling.
Why? When undergoing physical stress, the body essentially creates free radicals.
- Through regular and moderate training, however, the activity of antioxidant enzyme also increases at the same time, which then results overall in a decrease in oxidative stress.
- Extreme physical training, on the other hand, increases the production of free radicals, damaging DNA and cell membranes. Heavy physical exercise also leads to a relative lack of blood supply in the internal organs for the muscles. This may also affect the development of egg cells in the ovaries.
- When cycling, tight cycling shorts will overheat the testicles, but saddle pressure may also interfere with their blood supply.
- Live birth rate: 40% ↓ with more than 4 hours of sports per week [Morris 2006]
Dietary supplements and herbs: these can be helpful, but please consult your doctor on this issue.
Why? There are specially optimised preparations to improve male and female fertility. However, these should not be taken without medical advice, to avoid incorrect dosing. These often include:
- Antioxidants (vitamins C and E, alpha-lipoic acid, glutathione, zinc, selenium) to fend off the damaging influence of free radicals.
- Coenzyme Q10 is also an antioxidant, but also important for energy production in the mitochondria.
- Folic acid is important for cell growth and division.
- L-arginine, because sperm contain a high proportion of this amino acid.
- Vitamin D appears to increase birth rate.
- Maca: maca root increases semen concentration and motility. It is also said to have a positive effect on female fertility.
- Herbs: are said to sometimes contain ingredients that promote fertility.
Three sample recipes to make:
Tea for the 1st half of one's cycle: 20 g lady's mantle, 20 g of verbena, 20 g elderflower, 10 g raspberry leaves, 10 g basil, 10 g rosemary
Tea for the 2nd half of one's cycle: 20 g lady's mantle, 20 g of monk's pepper fruit, 20 g yarrow, 10 g lemon balm, 10 g lavender, 10 g nettle leaves, 10 g rose petals
For men: 20g angelica root, 20g nettle root, 20g lovage root, 20g lobelia erinus, 20g parsnip root
Sex: is recommended.
Why? Sexual intercourse has no negative impact on fertility treatment.
- On the contrary, frequent ejaculations improve sperm quality. Semen that lingers less in the body is less exposed to free radicals. There are fewer DNA breaks.
- In addition, the seminal plasma (fluid of the ejaculate) is like a Trojan horse, which activates the woman's immune cells not to reject an embryo as a foreign body.
And last but not least, it might lead to things working out :)
What should be avoided to counteract infertility?
Smoking: Nicotine consumption should be stopped if possible, or at least reduced. Wanting children offers a great opportunity for a big goal and can motivate it.
Why? Active and passive smoking have many negative effects on fertility.
- Cigarette smoke contains a variety of toxic substances (such as nicotine, carbon monoxide, heavy metals and polycyclic aromatic hydrocarbons) and produces free radicals. These have a negative effect on the menstrual cycle, one's egg reserve/quality and the uterine lining.
- Smoking reduces semen density and semen motility in men and also influences the genome (DNA), subsequently increasing the rate of miscarriage.
- In addition, smoking should be off-limits during any pregnancy that hopefully occurs, and likewise later, in the presence of a baby or child.
Live birth rate: 46% ↓ [Waylen 2009]
Alcohol: Up to two glasses of wine per week are acceptable, but it is best to abstain from alcoholic beverages.
Why? There are numerous studies that have examined the influence of alcohol on fertility.
- The majority of these studies have demonstrated that alcohol has a negative effect, which is dependent on dosage. It leads to increased stress on the liver and the formation of free radicals. Due to this heavy liver load, hormonal dysregulations are created in women, and no ovulation occurs in the natural cycle.
- In the case of men, however, increased alcohol consumption leads to deterioration in semen quality, with increased rates of miscarriage.
- During any pregnancy that might later occur, alcohol is an absolute no-go – even the obligatory single glass of sparkling wine is strongly discouraged.
Live birth rate: 16% ↓ with more than 4 drinks per week [Rossi 2011]
Being overweight or underweight: One's so-called "Body Mass Index" (BMI) should optimally be between 20 and 25 (kg/m²).
Why? Excess weight has negative effects on ovulation, on the development of the egg and embryo, and on the lining of the uterus.
- An underlying mechanism for excessive food intake is controlled by so-called leptins, among other things. These are proteins that are produced by fat cells and give the brain a sense of satiety. When one is overweight, however, this leptin level is permanently too high, which begins a vicious circle. Once again, free radicals may play a role, as their formation is promoted by leptin, which leads to damage to the inner walls of the blood vessels, including the follicles. As a result, the eggs are not optimally supplied, and their maturation is impeded. It is clear that embryos that emerge from such ova have less chance of implanting and developing.
- Obesity also reduces fertility (semen quality) in men!
- Long-term weight optimisation (no "radical diets"!) thus demonstrably promotes pregnancy rates. A value that is independent of BMI, in women, is the so-called waist-hip ratio: there is a lower pregnancy rate for values of 0.8 an above.
- We want to motivate you to reduce excess kilos, but this must at all costs be done in advance and not during IVF treatment! A reduction of even a few kilos can bring the hormone system back into balance and promote embryo implantation.
- Regular exercise and a healthy, vitamin-rich diet should form the basis of these measures. If necessary, diet counselling is very helpful! Beware of excessive consumption of sweeteners, as aspartame (among others), which is often used as a sugar substitute, can affect embryo quality!
Live birth rate: at least 25% ↓
Stress: Stress reduction through relaxation techniques and conscious optimisation of professional work processes.
Why? Physiological and psychological stress should be considered as causes of infertility where no other reason can be found. The hormone epinephrine, which is formed in increasing measure when under stress, reduces the blood supply to the internal organs, as well as the ovaries and uterus. This leads to reduced egg maturation (fewer oestrogens) and reduced growth of the uterine lining. Stress also reduces the formation of progesterone in the corpus luteum (the follicle after ovulation), which impedes implantation of the embryo. Stress-induced increased secretion of the hormone prolactin by the pituitary gland also inhibits ovarian function. The increase in free radicals already mentioned above further worsens the overall situation.
However, stress reduction improves well-being, the treatment process and pregnancy rates! Sometimes psychological counselling sessions are also helpful here.
Pregnancy rate: 22% ↓ [Hjollund 1999]
Caffeine: We recommend a maximum of one to two cups of coffee or tea (black, green, white). Be careful! Even chocolate, cola and energy drinks contain not insignificant amounts of caffeine!
Why? The exact mechanism is unclear, but it is believed that caffeine confuses one's hormone balance.
- It increases the concentration of oestrogen in the early follicular phase of the female cycle. In addition, caffeine damages cell membranes and leads to DNA damage and cell cycle arrest.
Sperm quality does not seem to be negatively influenced by caffeine, or only in very high dosages.
- The time to pregnancy is prolonged [Homan 2007]
Plastic softeners: Contact with plastic softeners is hardly avoidable these days. Try to reduce exposure by buying drinks in glass bottles and using paper packaging. Do not use plastic items when storing, processing or – above all – heating food!
Why? Bisphenol A is a chemical similar to oestrogen. This disturbs the hormone balance.
- In addition, it has been shown that bisphenol A adversely affects important mechanisms involved in egg maturation, and thus increases the number of eggs with incorrect chromosome distribution! The number of mature eggs also decreases.
- Men with high levels of bisphenol A produce lower quality embryos.
Egg count 12% ↓ per 10-fold increase in urinary Bisphenol A levels [Ehrlich 2012]
Environmental toxins: One has an influence here to the extent that one can buy organic food, clothing and furniture.
How? Here are just a few more easy-to-follow tips:
- You should always wash fruits and vegetables thoroughly and cook food gently.
- Wash clothes several times before putting them on for the first time.
- Rooms should be well aired and room sprays avoided, but also perfumes. Use mild detergents!
- Prudent use of cell phones and Wi-Fi is also advisable (not in your trouser pocket!).
- New amalgam fillings should be avoided during fertility treatment. It is advantageous not to replace existing fillings immediately before or during IVF treatment, as their removal can release a great deal of mercury. Timely and safe removal by a specialised dentist, and subsequent detoxification, may, however, be prudent.
Men: beware of high outside temperatures! Do not expose yourself to high temperatures in the three months prior to IVF treatment (for example, sauna visits). When ill, do not allow your fever to rise too much, if possible! Avoid tight pants and hot baths. Laptops on one's lap also heat it up too much.
Why? The optimal temperature for sperm production in the testes is about 2° C below body temperature.
- Too high temperatures (high fever) have a negative effect on sperm concentration and motility.
- Since the time from creation to optimal maturation of the sperm cells is about 72 days, optimal sperm quality can only be expected again after about three months following a febrile infection.
Of course, we are happy to advise you individually in our fertility clinics. Get in touch with us today.