Today our post for National Infertility Awareness Week focuses on self-care and how day-to-day living can be while cycling during fertility treatments. Dr. Ali Domar, executive director of the Domar Center for Mind/Body Health at Boston IVF, share with us these unique insights in this special post today.
One of themes I hear the most from women who are struggling with infertility is how hard it is to feel out of control. You feel out of control of your body since it won’t do what it is supposed to, you feel out of control of your life since you don’t know what the future will bring, and you feel out of control of your relationships since everyone else seems to be moving in a different direction from you. Since so many of my patients find this feeling of being out of control so intolerable, we tend to focus together on what in fact they can control.
Lifestyle habits can be controlled, and because of that, for many years, we have spent one of the ten sessions of the mind/body program for infertility on the impact of lifestyle habits on fertility. We made recommendations to decrease caffeine and alcohol consumption, to limit vigorous exercise, and to maintain a healthy weight. However, we received consistent feedback from patients that they knew this information already, so we switched the focus to the safety and efficacy of alternative and complementary treatments. We assumed that infertility patients knew what they needed to do to maximize their chance of conceiving a healthy baby.
Not so fast.
A couple of years ago, I realized that no one really knew what most infertility patients do in terms of lifestyle habits as they underwent IVF. There had been a couple of retrospective studies (when you ask patients after they cycle what they had done during their cycle) but since our memories aren’t always so reliable, this isn’t the most exact way of knowing for sure. Plus it is possible that patients who didn’t get pregnant might analyze everything they did or didn’t do during the cycle, and so might report more potentially adverse behaviors than women who conceived.
So we performed a research study, where we asked women who were undergoing an IVF cycle to report what their lifestyle habits were. When they enrolled in the study, we asked them about their habits for the previous five years as well as the previous month. Each participant then completed a daily survey for the 28 days of an IVF cycle.
When we started the study, we actually expected that patients would report excellent health habits. Boston IVF provides a lot of this information to our patients, both on the BIVF website as well as during individual conversations. However, the results were rather surprising*.
We included 118 women in the study. In the month before they did their IVF cycle, 92% exercised, 3% smoked, 73% drank alcohol, 76% drank caffeinated beverages, 14% took herbal remedies, and 30% underwent acupuncture. During their actual cycle, 100% exercised, 2% smoked, 49% drank alcohol, 77% drank caffeine, 12% took herbs, and 47% underwent acupuncture.
There is evidence that lifestyle habits can in fact impact fertility. Vigorous exercise, moderate to high caffeine consumption, nicotine, obesity, alcohol, and herbs are all associated with lower pregnancy rates in IVF patients. Thus, it is somewhat shocking that most of the women in the study had at least one lifestyle habit which might have reduced her chance of conceiving a baby.
But this creates a dilemma. How good do you need to be? Will one glass of wine significantly decrease your odds? How about one weekend hike? Or the huge mug of coffee you had to have to get you through one brutal late night at work?
To be honest, we don’t know the answer. We are doing a study right now, on thousands of IVF patients, to see what those thresholds might be. But in the meantime, it might make sense for you to take a look at what your lifestyle habits are, and think about making some changes before and during treatment, just so you will know forever that you did everything possible.
*Domar AD, Conboy L, Denardo-Roney J, Rooney KL. Lifestyle behaviors in women undergoing in vitro fertilization: a prospective study. Fertil Steril 2012; 97: 697-71.
About the Author
Alice D. Domar, Ph.D, is the executive director of the Domar Center for Mind/Body Health at Boston IVF, and an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. She is the author of six books, including Conquering Infertility and is on the National Board of RESOLVE.