The document discusses lifestyle factors that can impact fertility, including delaying childbearing, smoking, obesity, stress, and diet. It provides recommendations for improving fertility by not delaying treatment, quitting smoking, losing weight if obese, limiting stress, and eating a healthy diet. The document also discusses vitamins and foods that can support fertility, like lentils, garlic, honey, olive oil, and a Mediterranean-style diet.

1. La ricerca di un figlio non sempre è cosa
semplice
a volte l'attesa è lunga ……. e le aspettative
restano deluse

2. Lifestyle and infertility

3. What is the trend of modern
lifestyle?
Deferring childbearing and aging
Deferring treatment
Smoking
Obesity
Anorexia
Alcohol and caffeine
Environmental toxins
Psychological stress

4. Le abitudini alimentari possono
influire sulle possibilità di avere
un figlio?

5. HEALTHY EATING FOR
IVF
 PRE-IVF DIET
 DURING IVF CYCLE
 AFTER EMBRYO TRANSFER

6. THE BEST FERTILITY FOODS
LENTILS
GARLIC
HONEY

7. THE BEST FERTILITY FOODS
DIETA
MEDITERRANEA
TRADITIONAL
DUTCH

8. THE BEST FERTILITY FOODS
OLIV OIL
ICECREAM

9. VITAMINS
 VITAMIN B-12
 VITAMIN D
 VITAMIN C
 VITAMIN B-6
 IRON
 FOLIC ACID

10. Trend of modern lifestyle
What to do ?
.

11. practical recommendations
Aging
For patients:
Do not defer childbearing!
For professionals:
Do not defer fertility treatment!
Do not defer IVF treatment for women over 38!

12. Success rates of ART treatment by
maternal age
Review of data from the various IVF centers in the USA 2007 CDC Report

13. practical recommendations
Coffee
Quit drinking coffee?
Not necessarily.
Just do not
exaggerate!

14. Caffeine
High levels of caffeine consumption (> 5
cups/day)
Decrease fertility Bolumar et al., 1997
Increase the risk for miscarriage Signorello et al., 2004
Mild consumption of up to 200 mg caffeine per
day ( 2 cups)

15. practical recommendations
Smoking
 Quit smoking!
 Avoid passive smoking!
How relevant is this choice?
You will:
Reduce the conception delay by 1 year
Reduce the risk for miscarriage and ectopic pregnancy
Reduce to half the number of IVF attempts required to conceive
Delay menopause (by one to four years)
Be healthier

16. Smoking
Smoking vs Nonsmoking women
Relative risk of infertility increased 60% Clark et al., 1998
Increased miscarriage risk Natural conception Augood et al., 1998
Assisted conception Winter et al., 2002
Increased risk for ectopic pregnancy Saraiya et al., 1998
Conception delay over 1 year Augood et al., 1998
Hull et al., 2000
Require nearly twice the number of IVF cycles to conceive Feithinger et al., 1997
Each year of smoking - 9% increased risk of unsuccessful ART Klonoff-Cohen et al.,2001
Decreased IVF pregnancy rate for passive smokers as well Neal et al., 2005
Menopause occurs one to four years earlier Mattison et al., 1989
Baron et al., 1990
Higher gonadotropin dose requirements MacMahon et al., 1982
More diploid oocytes in the ovary Zenzes et al., 1995
Lower sperm count in male progeny Storgaard et al., 2003
Increased risk of trisomy 21 offspring Yang et al., 1999
Increased transmission of modified DNA to embryo Zenzes et al., 1999
Much of the risk may be reversed within a year of cessation Hughes et al., 2000

17. practical recommendations
Alcohol
Stop drinking alcohol during
regnancy!
No safe level of consumption to avoid
detrimental effect on fetal development
Avoid high consumption (>2 drinks/day)
when attempting pregnancy!

18. Alcohol
Moderate alcohol consumption
Detrimental effects on fetal development American Academy of Pediatrics, 2001
No evidence to indicate that adversely affects fertility Parrazini et al., 1999
Higher alcohol consumption (> 2 drinks/day)
Decreases fecundity Williams et al., 2009
Can reduce semen volume Li et al., 2011

19. practical recommendations
Psychological stress
More often an effect than a cause for infertility:
Prolonged infertility Too many treatment cycles
High psychological impact

20. Yoga
Meditazione
Esercizio fisico

21. "Destiny is not a matter of chance, it is a matter of choice.“
Winston Churchill
What if our choices or
our patients’ choices
could make a difference?
.

22.  We should be able to slow down this trend

23. practical recommendations
Obesity
Loose weight to:
Improve ovulation
Reduce requirement for fertility drugs
Reduce the risk for miscarriage and other complications during pregnancy
Look and feel better
Dilemma: Delaying treatment to allow loss of weight

24. obesity
30%–47% of overweight women have irregular menses Castillo-Martinez et al., 2003
Obesity decreases fecundity, even in ovulatory women Gesink Law et al., 2007
Ovulation and pregnancy rates improve after weight loss Clark et al., 1995
Obesity decreases IVF pregnancy rate Nichols et al., 2003
Obesity increases requirement for gonadotropins Fedorcsac et al., 2004
The risk for spontaneous abortion increases in overweight Wang et al., 2002
The risks for preeclampsia, gestational diabetes increase Dokras et al., 2006
The effect of BMI on sperm parameters is uncertain Li et al., 2011

25. practical recommendations
Anoressia
Affronta i problemi psicologici
Risolvi i problemi nutrizionali
Limita l’ attività fisica

26. perdita di peso
•
Problemi psicologici ansia,
stress
Problemi nutrizionali dieta drastica,
anoressia
Eccesso di attività fisica sport agonistici,
danza
Inibizione endocrina con bassissimo livello di

27. practical recommendations
Psychological stress
 Add some psychologic therapy during fertility visits
 Avoid persisting too long with low chance treatments
 Move quicker to IVF if woman is over 38 years old

28. Psychological stress
The most common reason for discontinuation of fertility treatment
Inversely related to pregnancy and life birth rate in IVF
More often an effect than a cause for infertility:
Prolonged infertility Too many treatment cycles
High psychological impact