‘Lifestyle’ and other factors

Here are some tips to help boost your fertility and prepare your body for pregnancy.

Folic acid 
It is recommended that all women take folic acid daily when they try to become pregnant and during the first 12 weeks of pregnancy. Folic acid reduces the risk of foetal malformations in the central nervous system.
In Denmark the health authorities recommend a daily dose of 400 micrograms folic acid.
If you have previously had a child (or a miscarriage) with malformations in the central nervous system (neural tube defects), it is recommended that you take 5 mg folic acid daily. This also applies if you use medicine against epilepsy.

Physical exercise
Physical exercise is good – in moderation. Very hard physical exercise or training may reduce the chance of becoming pregnant. Most likely, high heart rate for extended periods reduces fertility.
We recommend that exercise is kept at moderate intensity. This means that you should not go beyond 2/3 of your capacity equal to a level where you can easily keep up a conversation during exercise.

Alcohol 
The woman should consume no alcohol, when she tries to become pregnant. It is likely that even a small alcohol intake (1-5 units per week) may reduce fertility.

When a woman is pregnant she is advised not to drink alcohol at all.

Alcohol seems to affect the man’s fertility to a lesser degree. A daily consumption of up to 3 units does not seem to affect the sperm quality. A higher intake of alcohol may reduce the sperm quality.

Tobacco 
Smoking reduces the fertility in women and the sperm quality in men. Therefore it is advisable for both the woman and the man not to smoke at all.

We recommend – no smoking at all.

Medicine 
If you use medicine, you should consider whether the medicine may affect your chance of becoming pregnant or if it could harm the foetus/baby when you are pregnant. You may discuss this subject with your doctor. It may be possible to switch to another medicine, which will not affect your fertility or the foetus.
We recommend that you do not take medicine that is not strictly necessary for you and that you do not use herbal medicinal products, since too little is known about their possible effects on your fertility.

Coffee/caffeine 
Coffee, tea and cola contain caffeine. There is no indication that a moderate consumption of caffeine-containing beverages affects fertility. It is possible that a large consumption (more than five cups/glasses per day), may reduce the chance of becoming pregnant.

Body weight 
Both too low and too high body weight will reduce the chance of becoming pregnant. Overweight also increases the risk of complications during pregnancy and delivery. Normal body weight and too low or too high weight may be determined by the so-called ‘Body Mass Index’ (BMI).

BMI between 20 and 25 is optimal. The fertility may be reduced if BMI is below 19 or above 29. We recommend that the BMI should be between 19-29.

Environmental factors 
Most kinds of work will not affect the fertility. If you work with chemical substances such as organic solvents or pesticides or if you are exposed to radiation, your fertility may be affected. You may discuss this with your workplace or with your doctor.

Physical exercise 
Moderate physical exercise is good. Very hard physical exercise or training may reduce the chance of becoming pregnant. Most likely, high heart rate for extended periods reduces fertility. We recommend exercise – but at moderate or low intensity.

German measles (rubella) 
It is recommended that the woman have a blood test to determine if she has antibodies against German measles. If she is not immune, she should be vaccinated because it may cause serious foetal malformations if she is infected with german measles during pregnancy.

Sex 
We advise to maintain a normal sex life during fertility treatment, since it does not seem to influence the chance of becoming pregnant negatively.

Vitamin D
We recommend that vitamin d is measured in a blood test and that you take vitamin D if it is found to be too low (below 50 nmol/liter.

Absence from work 
You should expect not to go to work on the day of the oocyte pick-up and probably not the following day either.
On the day of the embryo transfer it may be advisable to rest at home after the transfer.

§ 56 agreement (for women with Danish social security) 
If your amount of sick leave is increased because of a long-lasting or chronic illness you make an arrangement with your employer and the county that will reduce your employer’s expenses during your sick leave. Your condition should result in at least 10 days of absence from work per year. You can find additional information at www.sundhed.dk.

Informing family and friends 
Studies have shown that it may be easier for couples to cope with the stresses of treatment if they tell their close ones about what they are going through. There may be individual variation on this matter but it appears to be a good idea to tell family and close friends about the treatment.