Factors that affect success rate of IVF and how to improve it

New Delhi: Lifestyle factors are behavioural factors, circumstances and habits that are generally modifiable all affect the success rate of an IVF procedure. These factors are age, smoking, weight, diet, exercise, psychological stress, caffeine, smoking, alcohol consumption, and exposure to environmental pollutants. They not only contribute to subfertility but also affects overall health of the individual.

Lifestyle modification is the first line treatment for the patients trying either naturally or with ART.

How does age impact fertility?

Fertility decreases considerably with age in both females and males. As more and more people shift to metros, they become career oriented, and choose late marriages and delay planning pregnancy. In men, the testosterone hormone reduces with age thereby reducing sperm count and motility. After the age of 40, significant DNA damage in sperm and decline in viability has been reported.

Age has a greater impact on women compared to men, because women are born with a fixed number of eggs, their number keeps on depleting every cycle. With increase in age woman take more time to conceive.

A marked difference is seen in fertility by the time a woman reaches 35 years of age, due to the decrease in the number of eggs along with the deterioration in the quality of oocytes. In addition, there is an increase in the incidence of genetic abnormalities, that is risk of having abnormal baby and miscarriages. Over all, fertility significantly reduces as age advances.

Healthy weight boosts fertility

Obesity is associated with a range of adverse effects on health. Obesity and low body weight can impact the reproductive function by causing a hormonal imbalance, irregular cycles, ovulatory dysfunction and metabolic syndrome. Body Mass Index should be maintained between 19 and 25. Healthy weight can be maintained with balanced diet and regular exercise.

Healthy well balanced diet is very important for good tissue function. One is advised to include fresh fruit, vegetables, good proteins in their diet and to avoid junk and processed food. There are certain vitamins and food groups which have a greater impact on reproductive health than others. Antioxidants cause an increase in pregnancy rates by improving the egg quality and significant improving sperm parameters.

Fitness and fertility

Regular exercise or any kind of physical activity for at least 45 minutes to 60 minutes provides protection from obesity, cardiovascular disease, hypertension, diabetes, osteoporosis and psychological stress and also increases insulin sensitivity which improves ovarian function and the chances of conception.

Moderately physically active men have significantly better sperm morphology. However excessive exercise can negatively alter energy balance and affect the reproductive system.

Reduce stress while trying to conceive

Stress may affect the hormones, immune system and the autonomic nervous system. Couples who undergo cancelling and have family support generally have a higher rate of conception.

Activation of the hypothalamic - pituitary adrenocortical axis results increased secretion of cortisol. Elevated levels of cortisol have been associated with suppression of immune function, facilitation of central fat deposition and major depression.

Physical activity plays a key role in reducing and preventing the effects of stress. Exercise releases endorphins which elevate the mood and make one feel good.

Social engagement is the most quickest and efficient way to combat stress. One of the most effective ways to calm the mind is to communicate with someone.

Avoid unnecessary stress, alter the situation by expressing your feelings instead of bottling them up. Accept the things you can't change, take out time for fun and relaxation, adapt to a healthy lifestyle.

Effect of smoking, alcohol, and caffeine

In males smoking negatively affects sperm production, movement and morphology and is associated with an increased risk of DNA damage. In the females, the follicular environment is affected and there is reduction in ovarian reserve with the deterioration in the quality of oocytes. Menopause has been reported to occur 1-4 years earlier in chronic smokers due to rapid depletion of egg number. There may be an increase in the thickness of covering of the egg making it more difficult for sperm penetration. There may be a significant delay in conception in case of both active and passive smoking.

Alcohol is a known teratogenicity. It may be associated with rise in estrogen hormone which in turn reduces FSH secretion, suppressing egg formation and ovulation. Moderate levels of alcohol consumption have been associated with an increased risk of spontaneous abortion. In men, intake of excess alcohol causes testicular atrophy and loss of libido.

Large consumption of caffeine (500mg per day) has been associated with an increased risk of subfertility. It has also been associated with tubal factors and endometriosis and increased risk of spontaneous abortion.

Therefore, by adopting healthy lifestyle one can improve and have the optimum chances of conception.

(The author Dr. Ila Gupta, is Director, Ferticity Fertility Clinics, Delhi & Sr. Consultant Reproductive Medicine)