Many couples thinking about fertility treatment are concerned that they might need to dramatically change their lifestyle or take special care of themselves while receiving treatment. For most healthy men and women, the changes will be minimal. However, there are some important modifications that you may need to make to maximise your chances of conception. Most of these issues also apply to women hoping to conceive naturally, which may well happen before you begin treatment. Issues discussed on this page include:
Smoking and alcohol
Folic acid and iodine
Medication and medical problems
Women who are overweight or underweight are less likely to conceive following most forms of infertility treatment, particularly IVF. This is reflected in the Ministry of Health’s eligibility criteria for accessing publicly funded fertility treatment, which is only available to women with a body mass index (BMI) of 32 or less.
Being overweight during pregnancy also increases your chances of having a baby with a congenital abnormality, developing diabetes or pre-eclampsia
, and requiring delivery by caesarean section.
The most effective lifestyle change you can make to improve your chances of conception and having a healthy baby is maintaining a healthy body weight. A BMI of 20 to 25 is ideal. Calculate your BMI from our BMI table here.
There is also increasing evidence that male obesity is associated with reduced sperm concentration and motility.
Smoking and alcohol
Tobacco reduces sperm quality and numbers. The chances of an embryo implanting after an IVF embryo transfer is also reduced in smokers. Smoking in pregnancy can increase the risk of ectopic pregnancy
, bleeding in pregnancy, having a low birth weight baby and delivering prematurely. Cot death and childhood asthma is significantly more likely in families where one or both parents smoke.
Smokers are not eligible for public funded fertility treatment. A woman needs to have stopped smoking for three months before she can become eligible. The use of marijuana and other recreational drugs should also be avoided if you are planning to become pregnant. Marijuana has a detrimental effect on sperm quality.
If you stop smoking you can improve your chances of conception and having a healthy child. We can refer you to a smoke cessation programme if required.
There is little evidence that occasional or moderate alcohol consumption reduces either male or female fertility, but higher levels of alcohol consumption can have detrimental effects. We encourage women not to drink alcohol if they are trying to conceive. Alcohol is harmful in pregnancy.
We suggest that women experiencing fertility problems should limit their intake of caffeine to 100-130mg daily. An approximate average for one cup of coffee is 100mg of caffeine. Tea, chocolate and energy drinks also contain caffeine.
All women having fertility treatment will have bloods tests to confirm whether they are immune to rubella and negative for hepatitis, syphilis and HIV. Male partners also have their hepatitis and HIV status checked. This is a regulatory requirement to ensure the safety of couples and any children born from treatment.
Folic acid and iodine supplementation
Folic acid supplementation will reduce the chances of having a baby affected by spina bifida. Folic acid supplements should be started at least two months before treatment starts. If there is a possibility of pregnancy occurring naturally, you should already be taking folic acid. The recommended dose of folic acid is 800 micrograms (0.8 milligrams) per day. Folic acid can be stopped after 12 weeks of pregnancy.
Iodine supplements are recommended from the confirmation of pregnancy onwards. Iodine is essential for healthy brain development and foetal growth. Many New Zealanders have a diet mildly deficient in iodine. The recommended dose is 150 micrograms (0.150 milligrams) per day. Iodine supplements should be continued right through your pregnancy.
Both folic acid and iodine supplements are available over the counter at any chemist. We can also provide you with a prescription. You can download the Ministry of Health’s leaflet on folic acid and iodine in pregnancy here.
The stress associated with treatment needs to be acknowledged by both you and your partner. You should also be aware that people cope with pressure differently.
To help with the stress of fertility treatment:
- Consider learning relaxation techniques or enrolling in a programme of yoga or meditation.
- Think carefully about when you want to have treatment. You could, for example, choose a time when you can easily take a few days off work before and after the cycle.
- Don’t worry if you can’t take time off – the evidence that stress affects pregnancy rates is limited and most studies suggest that stress in itself has no effect on the chances of treatment being successful.
Medication and other medical problems
Some medications can affect the reproductive system. Medications for epilepsy, gout, arthritis and high blood pressure could affect sperm quality or your chances of a pregnancy. Talk to your doctor about any medication you or your partner are taking.
Some medical conditions can reduce your chances of conceiving. If you have any medical problems, it is important that these are assessed and your general health is optimised before you become pregnant.
For some women with fertility problems pregnancy may be associated with some additional risks. We can refer you to National Women’s Health pre-pregnancy and medical clinics, so that risks can be assessed and suitably managed.
The most important factor in determining a couple’s chance of conceiving - naturally or through fertility treatment - is the age of the female partner. Older women are also more likely to have other health problems that will make specialist care necessary during pregnancy.
Success rates for all fertility treatments decline with age and reduce quickly after 40. Public funding for fertility treatment is only available to women under 40.
Despite this, many older women do conceive with treatment and we see many women over 40 as part of our private service. Talking to us will give you a realistic view of whether treatment is likely to be effective. In some cases it is more appropriate to have in vitro fertilisation (IVF) and use eggs from another younger woman (egg donor).