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Lifestyle Advice for Couples with Infertility


a blog by Eric Levens, M.D., Shady Grove Fertility Center, August 19, 2010

Modifiable lifestyle practices have an important impact on a couple’s chances of having a healthy child. Diet, weight and other lifestyle habits, including alcohol consumption and caffeine intake, have been shown to directly impact pregnancy chances.

Awareness of the potential implications of these factors, particularly during early fetal development (weeks three to eight of pregnancy), provides an opportunity to prevent adverse pregnancy outcomes.


Fertility rates are clearly decreased among over- and underweight women. Obese (BMI > 35 kg/m2) and underweight (BMI < 19 kg/m2) women have a two- to four-fold increase in the amount of time that it takes to achieve conception1. Moreover studies have consistently shown that fertility treatments are less successful at the extremes of body weight; however, by normalizing weight, a woman increases her chances of pregnancy and live birth.

While body weight has been shown to impact pregnancy outcomes, there is little data to suggest that restrictive diets, such as vegetarian or low-fat diets, improve fertility. A well-balanced diet along with a prenatal vitamin containing folic acid is essential to a healthy pregnancy (see previous blog for more details).

It is critical that women who are pregnant or trying to conceive ensure that the fruits and vegetables they are consuming are thoroughly washed prior to eating in order to avoid infections such as salmonella, campylobacter and listeria, which may cause adverse pregnancy outcomes. In addition, women who are pregnant or pursing pregnancy should avoid soft cheeses, unpasteurized milk, undercooked meats and raw eggs to reduce the chances of becoming infected with one of these bacteria.

Another dietary concern in early pregnancy is methylmercury. Maternal methylmercury intake through the consumption of cold-water fish, such as shark, swordfish and mackerel, has also been shown to adversely affect fetal development and should be avoided during this time. Moreover, the intake of tuna should be limited to two 85 gram meals per week during both the preconception period and pregnancy.


The effect of alcohol on female fertility has not been clearly delineated. Some studies suggest that alcohol consumption adversely affects female fertility. One study of more than 7,000 women noted that the risk of infertility was increased nearly 60 percent among those women who consumed more than two alcoholic drinks per day2.

As a result, alcohol consumption should be limited when attempting conception and should stop altogether during pregnancy, as there is no safe level of alcohol consumption that has been established.


Most evidence has suggested that moderate caffeine consumption, one to two cups of coffee per day, before or during pregnancy does not adversely impact pregnancy outcomes or fertility chances. However, caffeine consumption of more than five cups of coffee per day has been associated with a 45 percent decrease in pregnancy. Moreover, miscarriage is increased among women who consume more than two cups of coffee per day.

In the end, there are important modifiable dietary considerations when attempting conception and in early pregnancy. Recognizing these dietary factors should help to improve your chances of a Fertile Future.


  1. Hassan, M. A. and S. R. Killick (2004). "Negative lifestyle is associated with a significant reduction in fecundity." Fertil Steril 81(2): 384-392.
  2. Eggert, J., H. Theobald, et al. (2004). "Effects of alcohol consumption on female fertility during an 18-year period." Fertil Steril 81(2): 379-383.
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