How smoking affects fertility in both men and women


Up in smoke

How smoking affects fertility in both men and women

We all know that smoking is a bad habit and it can put us at risk of heart, vascular and lung disease, as well as cancer. But, did you know that according to the Centers for Disease Control and Prevention (CDC), smoking can lead to fertility problems in both men and women? Additionally, numerous studies have shown that smokers take longer to conceive – but that’s just the tip of the iceberg!

Cigarettes are so harmful because they contain over 7,000 chemicals, including formaldehyde, nicotine, cyanide and carbon monoxide. Needless to say, these chemicals are very harmful to the body and they can spread to all your internal organs. With regards to fertility, they can cause permanent damage to eggs, sperm and the genetic material they contain.

It comes as no surprise, therefore, that both male and female smokers have twice the risk of infertility as compared to non-smokers. According to the American Society for Reproductive Medicine (ASRM), available biological, experimental and epidemiological data shows that 13% of infertility cases may be attributable to smoking. Worse still, cigarettes are addictive and the more you smoke in a day, the higher your risk for fertility problems.


We know that a pregnant woman should never ever smoke, as it can cause miscarriage, pregnancy complications and birth defects. But a woman should be concerned about the effects of smoking well before she is pregnant. In women, cigarette smoke can accelerate the loss of eggs. This in turn leads to the early onset of menopause, which can be made faster by up to four years states the ASRM.

Smoking therefore adversely affects a woman’s chance of success if she undergoes IVF, as fewer eggs will be retrieved. Women smokers are also more likely to develop pregnancy complications like miscarriage, ectopic pregnancies and preterm labour. Cigarettes are equally harmful to men, as they cause hormonal imbalance, sperm abnormality, erectile dysfunction, as well as decrease sperm count, motility and ability to fertilise eggs.

But beyond that, men who smoke also put their non-smoking partners at risk.  Research has shown that non-smoking women, who are constantly exposed to second-hand cigarette smoke, can suffer from a higher risk of infertility as well.

Therefore, if you have plans of starting a family, it is best for you (and/or your partner) to kick the smoking habit immediately. Fortunately, it is believed that most of the negative effects of smoking can be reversed within about a year of quitting. However, it is important to bear in mind that once a woman’s eggs have been lost, they cannot be retrieved.

How alcohol affects fertility in both men and women



Damaging drink

How alcohol affects fertility in both men and women

You’ve probably heard of the saying, “Drink to your health,” but when it comes to safeguarding your fertility, moderation is definitely key in alcohol consumption. Women usually swear off alcohol once they find out they’re with child, but in truth, it is best for them to abstain from alcohol as soon as they’re ready to start a family. And it’s not just women who should keep tabs on their alcohol intake!

A growing number of scientific studies have shown that as little as one alcoholic drink a day can lead to detrimental effects in one’s chances at conceiving. For example, according to a study published in the American Journal of Epidemiology in 2004, alcohol can shorten a woman’s follicular phase and menstrual cycle.

Meanwhile, a 2009 study conducted at Harvard University found that in couples undergoing IVF, women who drank more than six units of alcohol per week were 18% less likely to conceive, while men were 14% less likely. This finding was supported by a study published in 2011 in the Annals of Epidemiology. Entitled ‘Alcohol, Smoking, and Caffeine in Relation to Fecundability, with Effect Modification by NAT2,‘ it concluded that alcohol intake was significantly associated with reduced fertility.


The study, which followed 319 women over an average of 8 menstrual cycles and 124 pregnancies, discovered that women who drink alcohol once a day can experience a 30% reduction in fertility, while those who took more than one alcoholic drink a day experienced a 50% reduction.

Another study published in 2011, entitled Effect of alcohol consumption on in vitro fertilization,’ published in the Journal of Obstetrics and Gynecology found that drinking before becoming pregnant can lower live birth rates by up to 21% in IVF patients.

This prospective cohort study involved multicycle analyses with final models adjusted for potential confounders that included cycle number, cigarette use, body mass index, and age. From the 2,545 couples studied, it was found that women who drink at least four drinks per week had 16% less odds of a live birth rate compared with those who consumed less alcohol.

Although there is a link between drinking and fertility, researchers still do not know exactly how alcohol impairs fertility, says Dr Anthony Rutherford, a consultant in reproductive medicine and Chairman of the British Fertility Society.

However, it is clear to researchers that alcohol doesn’t just affect female fertility. According to Dr Patrick O’Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists, “Excessive alcohol lowers testosterone levels and sperm quality and quantity in men. It can also reduce libido, and cause impotence.”


Fortunately, however, any damaging effects alcohol has on fertility can be quickly reversed by reducing alcohol intake or abstaining from it, as well as getting proper nutrition and leading a healthier lifestyle. Therefore, before you raise your glass next time, spare some thought over how it can stand in the way of your goals of starting a family.

Exercise and how it affects pregnancy rates



Getting it just right

Exercise and how it affects pregnancy rates

We all know that staying physically active is beneficial to our overall health and wellbeing. But did you know that the right amount of exercise can also improve your chances of conceiving? Here’s why.

Firstly, regular exercise is known to help optimise the reproductive system. It does this by stimulating the endocrine glands, which releases hormones that help your eggs to grow. Secondly, exercise can enhance your metabolism and circulation, which in turn optimises your egg production.

Thirdly, exercise can help you manage or achieve an ideal body weight. Since being overweight or obese can impair fertility in both men and women, weight management is widely known and used to prevent and treat infertility. And lastly, regular workouts also help to relieve stress, which in itself can inhibit fertility.

While regular moderate exercise can have positive effects on fertility and conception, the opposite is true for vigorous exercise.  According to a 2009 study in Human Reproduction, and a Harvard study of elite athletes, vigorous exercise is linked to reduced fertility and pregnancy rates. Therefore, when it comes to exercise and fertility, it is possible to have too much of a good thing.



While there are no guidelines for women to follow when it comes to workout intensity for fertility, there is a way to strike a balance. Studies have shown that women who exercised moderately for at least 30 minutes a day can reduce their risk of infertility due to ovulation disorders. Evidence also suggests that moderate regular exercise can positively influence assisted reproductive technology (ART) outcomes. But what is the right amount of exercise?

If you’re already at your ideal weight, it is safe to stick to your regular routine, but keep it to half an hour maximum per day. Studies had shown that vigorous aerobic exercise of more than 4 hours per week reduces the chance of pregnancy in women going through IVF. If your cycle is still irregular and you haven’t conceived after a few months, you might want to cut back on the intensity of your workouts. However, if you’re underweight, focus on gaining weight and increasing your body fat to the recommended amount of over 12%. If you exercise regularly, cut back on the frequency and opt for a less vigorous routine.

Meanwhile, if you’re overweight, work on cutting down on your calories with healthy eating. You can also increase your exercise routine gradually to achieve your ideal weight. Lastly, if you’re undergoing fertility treatments, it is best to avoid high-impact exercises, as they can be detrimental to your ovaries, which have been enlarged by fertility drugs.

Still have doubts on where to begin? Before you step up your exercise routine, start by speaking to your doctor. If you’ve been having trouble conceiving, your doctor will need to assess your condition first. This includes your age, cycles, ovulatory status, the condition of your uterus and tubes, as well as your partner’s sperm. Once certain conditions have been identified or ruled out, your doctor will be able to advise you on whether the underlying cause may be too little or too much exercise.

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A timely decision

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A timely decision

How age affects your chances of IVF success

Have you been seriously considering In vitro fertilisation or IVF treatment? If you have, it’s best that you understand how your age can affect your chances of success. This is so that you can make an informed decision on when to begin. But before we get into that, let’s take a brief look at IVF and what it entails.

For some couples facing fertility problems, IVF is a viable method that can help them to conceive. During IVF, a woman’s ovaries are stimulated and an egg is removed to be fertilised with sperm in a laboratory. Once fertilised, the egg becomes an embryo, and it is returned to the woman’s womb to develop.

Studies have shown that the success of IVF treatments can be affected by a woman’s age. This is because it’s an inescapable fact that a woman’s fertility declines as she grows older. So if you were to undergo IVF using your own eggs, your chances of conceiving would be higher if you were younger.

According to the Human Fertilisation and Embryology Authority (UK), in the most recent study conducted in 2010, on average, the percentages of live births resulting from women having IVF using their own fresh eggs are: 32.2% for women aged under 35, 27.7% for women aged between 35–37, 20.8% for women aged between 38–39, 13.6% for women aged between 40–42, 5.0% for women aged between 43–44 and 1.9% for women aged 45 and over.

As you can see from the statistics above, a woman’s fertility begins to decline at around age 30 and this exacerbates at about age 38. By the time she is 44, her chances of having babies via IVF with her own eggs is nearly nonexistent at less than 2%. This is why women above the age of 42 are generally discouraged from undergoing IVF, as the success rate is considered far too low.

Most IVF clinics also have an age limit for IVF treatments that use a woman’s own eggs. This is because the age of the eggs is crucial, not the age of the uterus. But, why is egg age so important? Two words – quality and quantity.


'It's my biological clock.'

‘It’s my biological clock.’

But what is egg quality? In fertility, an egg’s quality refers to its chromosomal status. As a woman’s age increases, the risk of chromosomal abnormalities in her eggs also rises. During IVF, we hope to obtain multiple healthy embryos, whereby the best ones will be selected for transfer into the mother’s uterus. But before embryos are transferred, we need to check their chromosomal status. Therefore, the embryos undergo Preimplantation Genetic Screening or PGS, which checks for chromosomal normalcy. On average, healthy embryos with normal chromosomes have a much higher potential for implantation and live birth.

Meanwhile, egg ‘quantity’ refers to how many eggs are left in a woman’s ovaries. As such, her egg quantity is often called her “ovarian reserve”. Although egg quantity doesn’t greatly impact the chances of a natural conception, in IVF, egg quantity may influence a woman’s response to ovarian- stimulating medications.

So if you’re considering IVF, don’t hesitate to ask questions and seek the advice of a fertility consultant. The information you receive can help you make a decision on when best to start your treatment.


Fertility on Ice – Learn about Egg Freezing



Fertility on ice

What you should know about egg freezing

We often hear of the expression “ticking biological clock,” but what does this actually mean for a woman? Well, here are the facts and figures. As a woman, you were born with about one to two million immature eggs or follicles, and these begin to die off as soon as you leave your mother’s womb.

By the time you’ve reached puberty, you’ll only have about 400,000 follicles left, and with each menstrual cycle, you’ll lose thousands more. Due to the loss of follicles throughout your reproductive life, when you’ve reached your mid 30s, your fertility would have sharply declined. And in your late 40s, any follicles that remain are unlikely to mature due to the hormonal changes brought on by menopause.

Now that you understand a little more about eggs, let’s find out why some women choose to freeze theirs and what it entails.

What is it?

Just as the name suggests, in egg freezing, a woman’s unfertilised eggs are frozen through a process called vitrification. This is done so that the eggs can be stored for many years. When a woman is ready, the eggs can be thawed and fertilised with sperm. Once the egg has developed into a healthy embryo, it can be transferred to the woman’s uterus for a chance of pregnancy.





Some women choose to freeze their eggs because they are currently not in the position to become pregnant and they want to preserve their healthiest eggs. One of the leading reasons for egg freezing is serious illness. For example, a woman who is undergoing cancer therapy may worry about the impact of the treatment on her fertility. As such, she may have her healthy eggs removed and frozen for future use before she undergoes treatment.

Other women, on the other hand, may be concerned about age-related infertility. Though a woman may be at her most fertile between her 20s and early 30s, for some women, childbearing is unavoidably delayed due to education, career or personal goals. Through egg freezing, a woman can store her healthy eggs for use in the future, enabling her to start a family when she is ready. A woman’s age when her eggs are frozen also affects her chances of conceiving later in life. For example, if she opts to freeze her eggs during her late 30s, her chances of pregnancy are significantly lower.


Much like the early stages of IVF, the egg freezing cycle takes about 10-12 days. The woman will give herself daily shots of hormone injections, which stimulate her ovaries and ripen her eggs. When her eggs have matured, they are removed using a special needle that is inserted through her vagina. An ultrasound is used to help guide the needle and the woman is sedated, so she will not feel any pain. Once retrieved, the eggs are immediately flash frozen.


Is it safe?

In a word – yes! To date, more than 300,000 children have been born worldwide from frozen embryos and studies conducted in recent years have shown that the use of frozen eggs does not increase pregnancy complications or birth defects.

If you’d like to learn more about egg freezing and the costs involved, don’t hesitate to speak to a fertility specialist.