To What Extent Do Lifestyle Factors Affect Reproductive Health?

By (gynecologist), (gynecologist), (gynecologist), (embryologist) and (fertility counselor).
Last Update: 10/17/2018

Current lifestyle trends can have an extremely negative impact on both male and female fertility, or even become a cause of infertility.

For this reason, establishing healthier habits from the moment you consider having a baby is essential. Not only because it helps to conceive, but also because it contributes to normal fetal development and the birth of a healthy baby.

There exist three main risk factors in relation to lifestyle habits:

  • Unhealthy diet
  • Tobacco use
  • Alcohol consumption

These and other environmental factors might affect negatively the outcomes of fertility treatments. So, in conclusion, you better keep them in mind if you are trying to conceive.

Provided below is an index with the 9 points we are going to expand on in this article.

Eating habits

Unhealthy eating habits, such as including junk foods, are extremely damaging for both male and female fertility and can make the conception process more difficult. In fact, there is scientific proof that being over- and underweight can have a negative impact on reproductive health.

For this reason, and especially in couples who are trying to conceive (TTC) via fertility treatments like Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF), doctors and fertility specialists recommend to apply a series of changes in one's diet in order to lose or gain weight, depending on the case.


Overweight or obesity interfere affect the hormonal and metabolic mechanisms of females, and subsequently the menstrual cycle. This can lead to ovulation irregularities or even failure to release an egg monthly.

Obviously, pregnancy is possible only if ovulation occurs. So, in case this happens, the female would be diagnosed with infertility of endocrine nature.

The pregnancy chances in women with overweight (BMI>25) or obesity can be reduced by half, whether you are trying to conceive naturally or using fertility treatments. Moreover, the miscarriage rate is higher in these women.

This type of infertility, however, can be cured with a diet for weight loss. For this reason, it is imperative that women with obesity issues seek the help of a well-versed nutritionist before TTC.

Moreover, obesity during pregnancy carries multiple risks, including preeclampsia, gestational diabetes, maternal hypertensive disorder, preterm birth, etc.

On the other hand, children born from obese women have a higher risk of perinatal death (stillbirth), congenital and cardiovascular diseases, high blood pressure, glucose tolerance, and an increased likelihood of becoming obese as children.


On the other side of the coin, women with underweight, that is, with a BMI below 18, might experience menstrual disorders due to the lack of fat in the body.

Normally, these women experience a delay in their first menstrual period, known as menarche, and missed periods for long periods of time.


The negative impact of tobacco use on a person's overall health is more than obvious. Aside from increasing the risk for lung and cardiovascular diseases, it is a potentially damaging agent for the male and female reproductive systems.

Smoking doubles the risk of infertility, as it affects the gamete production process directly, that is, the process whereby egg and sperm cells are created.

Men who smoke have a decreased sperm quality. Moreover, tobacco can be harmful to sperm DNA.

As regards females, tobacco use can affect the ovarian reserve (egg count), and subsequently egg quality. It increases the ectopic pregnancy and miscarriage rates as well.

For all the reasons listed above, tobacco contributes to diminishing the chances of getting pregnant naturally as well as using reproductive technologies.

One can see most of the negative effects of smoking after just one year without tobacco. So, if you are considering starting a family, you should quit smoking as of now, and not only after getting a positive pregnancy test.

It should be noted that tobacco is especially harmful to the fetus if the woman decides to continue smoking during pregnancy. Children can have delayed growth, preterm birth, respiratory disorders, intrauterine fetal demise, and early neonatal death (ENND).

Read more: How Does Smoking Affect Pregnancy?

Alcohol consumption

Drinking is another factor that can have a negative impact on the reproductive health of the couple.

The following are some of the most remarkable undesirable effects of alcohol on fertility:

  • Menstrual cycle irregularities
  • Oocyte maturation failure
  • Decreased sperm quality and count
  • Sperm morphology abnormalities
  • Dramatic decrease of fertilization and implantation rates
  • Increased miscarriage rates

Special attention should be paid to the fact that alcohol is totally unadvisable during pregnancy, as it is harmful for the unborn child, and can cause serious alterations in fetal development, including the Fetal Alcohol Syndrome (FAS).

Other environmental factors

Although we have already listed the most important ones, there exist other environmental factors associated with daily habits that can lead to male and/or female infertility.

Moreover, when combined, these factors can affect the couple's reproductive health even more severely.


Even though the effects of stress are not so noticeable, high levels caused by personal or work circumstances can be the reason for infertility.

With a semen analysis, it is possible to detect a decrease in sperm quality in males who have been through a stressful time period for a long time.

In the case of women, stress and anxiety generate great frustration due to failure to get pregnant. This, in turn, can affect the outcomes of fertility treatments negatively.

As a matter of fact, stress is commonly the main reason why couples decide to abandon the process. For this reason, seeking psychological support is the key to succeeding in this type of procedure.


Although there exists no clinical evidence that drinking coffee moderately can affect one's reproductive potential, the most recommendable is to limit its intake to one daily cup of coffee in pregnant women or trying to conceive.

Great amounts of caffeine can increase the risk of miscarriage.

Toxic chemicals

The most detrimental toxic substances are street drugs, as they can cause genetic abnormalities in the gametes (eggs and sperm), as in the case of LSD (lysergic acid diethylamide). Marijuana consumption, for example, can affect spermatogenesis.

On the other hand, environmental toxics, such as pesticides or heavy metals derived from industrial production, may affect male fertility as well, since they hinder the normal development of spermatozoa.

According to Dr. Toño Lara, specialist in Obstetrics & Gynecology, alcohol, and drugs are not only harmful during pregnancy and while TTC, but also for life in general.

Healthy living

Most of the aspects explained throughout this article are part of our daily routine. For this reason, more often than not, we don't even realize how prejudicial they can be for our health.

Sometimes, minor changes in our eating habits, quitting smoking, or drinking moderately can help restore our fertility or allow you to achieve pregnancy sooner.

The majority of couples with fertility issues associated with external factors change their diet to improve their reproductive health. This is crucial, as several studies have confirmed the positive effects of following a balanced diet.

The so-called Mediterranean diet, which emphasizes the inclusion of plant-based foods, cereals, bread, and olive oil in our diet, is highly beneficial to treat ovulatory dysfunctions, enhances embryo development, and increases the pregnancy rates of fertility treatments.

On the other hand, exercising moderately has many benefits. Particularly, it helps to reduce the levels of stress, control weight, and feel comfortable with yourself, which improves one's self-esteem in turn.

FAQs from users

What is the maximum BMI to be accepted for IVF treatment?

By Marita Espejo Catena M.D., M.Sc., Ph.D. (gynecologist).

Obesity has been shown to decrease the spontaneous fertility of a couple by altering the male factor, that is, by the seminal quality and also by altering the ovarian function.
In addition, gestation rates after assisted reproduction treatments are also reduced when this factor (obesity) is present.
It is probably the female factor that is most affected by a high BMI because alterations in the ovarian cycle are induced that lead to ovulatory dysfunctions and, in addition, a greater number of spontaneous abortions.
Although there is no standardised criterion, a BMI in women equal to or greater than 32 kg/m2 may to interfere with the achievement of gestation.

How can habits like smoking, alcohol consumption, etc. affect fertility?

By Javier Domingo del Pozo M.D., Ph.D. (gynecologist).

Of course lifestyle is important. There are certain habits to which we don’t pay enough attention, and may affect a couple’s fertility. Obesity, stress, tobacco, alcohol, or drugs are factors that may affect the quantity and/or quality of the spermatozoa and oocytes, hence conditioning not only natural fertility, but also the success rates of assisted reproductive techniques.

What habits would you recommend to women who are currently on fertility treatment?

By Javier Domingo del Pozo M.D., Ph.D. (gynecologist).

All in all, a healthy lifestyle, as well as trying to manage the stress and anxiety that many times arise when one is going through fertility treatment. Before getting started, and not only when they are carrying it out, I would recommend that they reduce the consumption of tobacco or quit smoking. Also, avoiding unhealthy habits is crucial, too. Preventing obesity and low weight, and avoiding street drugs and alcohol are basic tips as well.

How does obesity influence the outcomes of fertility treatments?

By Javier Domingo del Pozo M.D., Ph.D. (gynecologist).

In the case of obesity, it comes with a series of endocrine and metabolic disorders that cause several gynecological alterations, including, but not limited to, hyperandrogenism (androgen excess), hyperinsulinism, and anovulation. In the case of anovulation, when a woman is undergoing a fertility treatment, it means longer ovarian stimulation protocols, higher doses of gonadotropins, higher drop-out rates due to poor ovarian response, lower implantation and pregnancy rates, and an increased miscarriage rate.

What habits do you recommend for males to boost their sperm quality?

By Javier Domingo del Pozo M.D., Ph.D. (gynecologist).

There is scientific proof that tobacco, alcohol, drugs, obesity and bad nutritional habits affect the quality of sperm, since diet that is poor in antioxidants like vitamins E, A, C, B-12, carnitine, arginine, selenium, etc., has a negative impact on the sperm's DNA. Also, a lack of folates, which are vital for the development of germ cells, is highly damaging.

To what extent do environmental factors affect fertility?

By Javier Domingo del Pozo M.D., Ph.D. (gynecologist).

There are several environmental pollutants that have a certain impact, especially on male fertility, such as the direct exposition to heat that takes place at some work environments, exposition to radiations, some pesticides and dioxins, etc. Also, the chemical substance Bisphenol A (BPA), which has a negative impact on fertility and is used in the production of certain materials of daily usage (such as plastics, gums, PVC...) that are difficult to avoid, as they are present for example in the layer that covers the inside of food cans.

Can drinking cause infertility?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Yes, it can. According to some doctors, it lowers testosterone levels in mens, and decreases the quality and the quantity of sperm. In fact, it some cases, it can affect libido in males and females, as well as cause impotence in men.

What exercises are considered conception-friendly?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Indeed, there exist several exercises considered conception-friendly because they can help women get ready for pregnancy. Yoga, cardio, swimming, weight training, or just walking can help you be more fertile. Don't forget that too strenuous exercises can be counterproductive, and put a serious damper on your future pregnancy plans.

What are the effects of running on fertility?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Research conduced to date suggests that, unlike in the case of males, female runners can put their fertility at risk in case of intense running. According to the American College of Sports Medicine, 44 percent of athletic women experience menstrual irregularities or have experienced amenorrea at some time. In any case, as long as it is practiced moderately, running is beneficial for your overall health.

In the case of males, those who run on a regular basis and stay at a healthy weight are more likely to maintain a good sperm count in comparison with obese men. However, they should take care of the clothes they use, as continuously heating the testicles or using very tight-fitting shorts, can affect male fertility.

Can a sedentary lifestyle cause infertility?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

A sedentary lifestyle is not beneficial in any way, especially for women than men. Several studies suggest that a sedentary lifestyle as a teenager can cause hormonal imbalances and anovulatory cycles, consequences more commonly seen in PCOS patients. In the case of men, those with a sedentary lifestyle tend to be overweight or even obese, which leads to low sperm quality. So, in short, to prevent infertility you should stay active and eat right.

Suggested for you

If you wish to learn more about male and female fertility, we recommend that you visit any of the following guides:

Also, for males who are trying to conceive and would like to make sure the sperm they produce is of optimal quality, do not miss this: Foods to Boost Sperm Quality.

We make a great effort to provide you with the highest quality information.

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De Wert G, Dondorp W, Shenfield F, Barri P, Devroey P, Diedrich K, Tarlatzis B, Provoost V, Pennings G. ESHRE Task Force on Ethics and Law 23: medically assisted reproduction in singles, lesbian and gay couples, and transsexual people. Hum Reprod. 2014; 29(9):1859-65.

Naina Kumar and Amit Kant Singh. Trends of male factor infertility, an important cause of infertility: A review of literature. Journal of Human Reproductive Sciences 2015; 8(4): 191–196

Piché ML, Babineau V, Robitaille J, Lachance É, Ruchat SM. Lifestyle-Related Factors Associated with Reproductive Health in Couples Seeking Fertility Treatments: Results of A Pilot Study. International Journal of Fertility and Sterility 2018;12(1):19-26

Reproducción Asistida ORG. Video: Factores de vida que afectan a la fertilidad (Lifestyle factors affecting fertility), by Toño Lara González, MD, Mar 6, 2014. [See original video in Spanish].

FAQs from users: 'What is the maximum BMI to be accepted for IVF treatment?', 'How can habits like smoking, alcohol consumption, etc. affect fertility?', 'What habits would you recommend to women who are currently on fertility treatment?', 'How does obesity influence the outcomes of fertility treatments?', 'What habits do you recommend for males to boost their sperm quality?', 'To what extent do environmental factors affect fertility?', 'Can drinking cause infertility?', 'What exercises are considered conception-friendly?', 'What are the effects of running on fertility?' and 'Can a sedentary lifestyle cause infertility?'.

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Authors and contributors

 Javier Domingo del Pozo
Javier Domingo del Pozo
M.D., Ph.D.
Bachelor's Degree in Medicine from the University of Alicante. Specialist in Obstetrics & Gynecology via M. I. R. at Hospital Universitario Materno-Infantil of Canarias, Spain. PhD in "Human Reproduction and Female Reproductive System Pathology" from the University of Las Palmas de Gran Canaria. Currently, he is the Director of the clinics IVI Las Palmas and IVI Tenerife. More information about Javier Domingo del Pozo
License: 353504174
 Marita Espejo Catena
Marita Espejo Catena
M.D., M.Sc., Ph.D.
Graduated in Medicine and Surgery from the University of Valencia in 1992. Specialist in Gynaecology and Obstetrics. Doctor in Medicine from the University of Valencia in 2000. Master in Assisted Human Reproduction by the Rey Juan Carlos University and IVI in 2008. Currently, she is the director of Instituto FIVIR. More information about Marita Espejo Catena
License: 464616497
 Toño Lara González
Toño Lara González
Bachelor's Degree in Medicine, with specialty in Gynecology & Obstetrics. Coordinator of Assisted Reproduction Techniques with extensive experience in the field of Reproductive Medicine, More information about Toño Lara González
License: 313102990
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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