Lifestyle Advice for Fertility Patients

Lifestyle Advice for Fertility Patients

Introduction

This booklet offers dietary and health recommendations for patients who want to maximize their fertility through healthy eating and efficient lifestyle management.

Health and lifestyle choices should be considered when optimising your fertility for both women and men. Small steps can often make a big difference in improving your fertility.

Lifestyle changes which can improve fertility include:

• Maintaining a healthy weight (or BMI)
• Not drinking alcohol
• Stopping smoking
• Reducing anxiety and stress

We understand that these changes may be challenging during your fertility journey. However, they can make such a difference to your health, during treatment and continuing into pregnancy.

A HEALTHY BALANCED DIET

This includes plenty of fresh fruits, vegetables, and minimal processed foods. Red meat, in moderation, is associated with improved sperm counts and motility.  There is also some evidence to suggest that higher amounts of carbohydrates in the diet are associated with decreased sperm concentration.

A study found that in an IVF cycle, men who ate more proteins and fewer carbohydrates had better rates of eggs developing to blastocyst stage and overall pregnancy rates.

OBESITY

Women with a BMI of 29 or over may experience longer time taken to conceive, and in those who are not ovulating (releasing an egg every month), losing weight is likely to increase their chances of conception.

Men who have a BMI of 29 or over are also likely to have reduced fertility, and should therefore reduce their weight accordingly.

Group exercise & diet programmes are proven to increase the success of losing weight thus improving chances of conception and overall general health.

You will find a wealth of information on the NHS Choices website to help you achieve this.

Please note that for NHS funded IVF referrals, female partners require a BMI of less than or equal to 29.9 and Male partners less than or equal to 34.9. Other treatments may be possible if your BMI is higher than this.

LOW BODY WEIGHT

Likewise, women with a low BMI, less than 19, with irregular cycles will also have a reduced chance of success. Increasing weight is likely to improve these chances.

EXERCISE

Exercise maintains a healthy body and mind.  Regular moderate exercise is associated with healthier sperm and is a great way to help cope with the stresses of trying to conceive.  Exercising for 30 minutes, 4-5 times a week, is recommended. Group exercise & diet programmes are proven to increase the success of losing weight, improving chances of conception and general health.

SMOKING & VAPING

Smoking and vaping in both men & women will decrease the chances of conceiving and affect general health.

For men there is a link between smoking and poorer semen quality. Stopping smoking can also reduce the risk of impotence (the inability to maintain an erection) over time.

For women stopping smoking can reduce the risk of miscarriage, ectopic pregnancies, premature labour and birth and stillbirths.

Passive smoking is also likely to affect chances of conception.

• For help to stop smoking please visit www.nhs.uk/live-well/quit-smoking ,

NHS Smoking Helpline 0300 123 1044 or your local pharmacy.

Integrated care boards (ICBs) have advised that both partners must be non-smoking and not using any product containing nicotine (including E-cigarettes/vapes) for 3 months prior to referral and 6 months prior to treatment starting for NHS funded fertility treatment and must continue to be non-smoking throughout treatment.

Testing to confirm this may be performed at the treatment centre.

ALCOHOL

The NHS advise that women do not drink any alcohol when trying to get pregnant. Alcohol can be passed to your unborn baby and lead to long term harm.

If you drink too much alcohol, this is associated with loss of interest in sex, reduced testosterone and low sperm quality and quantity.  NHS England would recommend men drink no more than 14 units a week, spread out over 3 days or more.

DRUGS

There are a number of prescription, over the counter and recreational drugs which have an effect on both female & male fertility. It is important to discuss any drug that you may be taking with the doctors and nurses in the Fertility Clinic.

We advise you to avoid recreational drugs such as cannabis, cocaine, anabolic steroids and testosterone.

FOLIC ACID & VITAMIN D

It is important that women who are trying to conceive should be taking folic acid and vitamin D daily, ideally for 3 months prior to conception. This has been shown to reduce the risk of having a baby with a neural tube defect such as spina bifida, and keeps our bones and muscles healthy.

Folic Acid – Please take 400 micrograms per day up until 12 weeks of pregnancy.

If you have Diabetes, take anti-epileptic medications, suffer with malabsorption conditions such as inflammatory bowel conditions or previously had a baby with neural tube defect, please take 5mg per day – your GP should prescribe this for you.

Vitamin D – Please take 10mcg per day

FREQUENCY OF INTERCOURSE

To optimise the chances of conception, it is advisable to have regular intercourse, 3-4 times per week. Please try not to feel pressured. A recent study has shown that men ejaculating every other day can increase sperm quality.

REDUCING THE TEMPERATURE OF YOUR TESTICLES

Any increase in testicular heat can dramatically decrease your sperm count, so steps should be taken to minimise this. Try to avoid:

• Wearing tight fitting underwear, hot baths, saunas, Jacuzzis, and hot tubs
• Using a laptop directly on your lap for long periods of time
• Any activity that involves sitting for prolonged periods of time including the use of heated seats

Illness, Injury and surgery can affect sperm production and, in some cases, stop it completely.  Some infections can also affect your sperm production. This includes even a flu-type illness where your temperature becomes raised.  Mumps as a child does not seem to affect your fertility, but having this as a teenager or adult can be associated with sperm problems.

CAFFEINE

Consumption in large amounts can decrease sperm motility and has been linked to miscarriage. Caffeine is found in coffee, tea, cola-based drinks and chocolate.  Limiting to around 200mg a day may be helpful.  This is 2 mugs of instant coffee or 1 mug of filter coffee.

STRESS

Trying for a baby is often a very stressful time for you and your partner, especially if you have been trying for some time. It is important to recognise this and take steps that help you both to reduce your stress levels.  Physical exercise, mindfulness, yoga are all good ways to help.

Stress also negatively impacts on your hormones, and your libido can be affected, meaning you are having less sex. 

WORK ENVIRONMENTS

Work environments can expose you to heat, chemicals, pesticides or radiation that can be harmful to your fertility.  Steps should be taken to ensure that your exposure is minimised and you can seek help and advice if you are unsure from your employer or occupational health department.

COMPLEMENTARY THERAPIES

Further research is required to determine whether complementary therapies increase the chances of conception so they cannot be recommended for that purpose.

Some people however find that treatments can improve their general well-being during what is often an incredibly anxious and stressful time.

WEIGHT LOSS INJECTIONS (GLP-1 AGONIST)

GLP-1 agonists include medications such as tirzepatide (Mounjaro) and semaglutide that may be prescribed by a qualified healthcare professional to facilitate weight loss.

The below information shows the number of weeks recommended to have stopped the medication prior to a planned pregnancy.

Tirzepatide  – 1 month

Semaglutide – 2 months

Exenatide – 12 weeks

These medications should not be used in pregnancy.

(This information has been written by the Faculty of Sexual and Reproductive Healthcare)

Couples, especially men, can often feel very isolated and alone during their fertility journey. Sharing your feelings may seem daunting initially, but it can really help reduce some of the burden and help you feel less alone. We are here for you both, so please do get in touch if you would like further support, or access resources via websites such as The Fertility Network.

USEFUL RESOURCES

https://www.nhs.uk/livewell/Pages/Livewellhub.aspx

http://fertilitynetworkuk.org/

Lose weight – Better Health – NHS

For further information and support please contact Sarah McCammon or Gemma Ryder (Fertility Specialist Nurses) via email at:

 [email protected].

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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