Healthy Living

The leaflet is detailed below, or you can download the 'Healthy Living' leaflet in PDF.

In preparation for treatment

A healthy lifestyle can improve your fertility and can also increase your chances of successful treatment. There are some simple steps that can be taken to increase your chances of achieving a successful outcome.

Stop Smoking

The most important thing you can do if you smoke is - give up! Smoking cessation significantly improves chances for conception. Although long-term cigarette smoking can have an irreversible effect on ovarian function, if smoking is discontinued prior to the start of treatment, the harmful effect on treatment outcome can be reduced. Note: stopping smoking is essential if a referral for IVF is required. Useful support services include the NHS smoking helpline on 03001231044, the nursing staff at the Hewitt Centre, or your GP/practice nurse.

Achieve the correct body mass index

Weight can affect the fertility of both male and females. Women who have a normal body mass index (BMI) are more likely to conceive and to have a normal pregnancy than those who do not. It is important that you are both as near to your ideal BMI as possible. You should aim for a BMI of between 19 and 29.9 (ideally 21 to 25). If you wish to see a state registered dietician for individual advice, ask your GP or Practice Nurse to refer you to a community dietician. Note: a healthy BMI is essential if a referral for IVF is required.

You can check your BMI here using this helpful NHS calculator BMI calculator | Check your BMI - NHS | Please fill in your details (www.nhs.uk)

Alcohol, what are sensible limits?

Excessive alcohol reduces fertility & damages sperm. For general health purposes, the safe limits are up to 14 units per week for both men and women. It is better to have one to two units occasionally rather than saving them all up for one night! Following updated advice from the Department of Health, women should avoid alcohol completely pre-conceptually and in pregnancy, as no safe level of maternal drinking has been established. Furthermore, men trying for a baby should limit alcohol intake to no more than 6 units per week

Maintain a healthy diet and take Folic Acid

It is strongly recommended that women take 400mg of folic acid per day, 3 months before pregnancy and until 12 weeks after conception. Good dietary sources of folic acid include fortified breakfast cereals, fortified bread, sprouts, spinach, Bovril and oranges.

Take Regular Exercise

Regular exercise improves physical fitness, helps you to lose weight and decreases stress levels. Aim for some form of aerobic exercise three times per week; i.e. any activity that increases your heart rate and breathing, such as brisk walking, jogging, swimming, or sporting activities like football, tennis or squash. Even using stairs instead of using lifts/escalators and walking to the shops can make a difference and will improve your fitness.

Drink plenty of water

Our bodies need between 8 and 10 cups of fluid per day. Some studies suggest that excessive caffeine can reduce your fertility –Tea, Coffee, Cola and ‘energy’ drinks e.g. Red Bull are particularly high in caffeine – try caffeine free alternatives or drink water or squash. When you are having your treatment we will suggest that you cut down on caffeine by avoiding coffee and replacing some cups of tea with water.

Improve Sperm Quality

The normal activity of the sperm producing tubules in the testes can be affected by heat.  Intermittent overheating of the testes leads to a reduction in sperm production and/or a decrease in sperm activity (motility).  To improve your fertility you should: avoid hot baths, jacuzzis and saunas and change to having showers or lukewarm baths. You should also wear non-support, non-insulating cotton boxer shorts. Remember that sperm take 70 days to develop from their cells of origin, so any episode of testicular overheating could affect your fertility for over two months. Finally, there is also some evidence to suggest that taking zinc and vitamin E supplements may improve sperm quality.

Follow a Healthy Eating Plan

• Eat regular meals
• Enjoy your food
• Eat a wide variety of different foods
• Try to eat 5 portions of either fruit or vegetables each day

Why is healthy eating important?

It helps you to achieve and maintain a healthy body weight. It ensures your body has sufficient vitamins and minerals – essential for men & women trying to conceive. It ensures your body has enough energy for all your daily activities.

Eat More Fruit and Vegetables

• Fruit and vegetables are excellent sources of vitamins and minerals
• Aim for at least five portions of fruit and vegetables a day
• If you are trying to lose weight, fruit makes an excellent snack or dessert
• Choose fresh, frozen or tinned (avoid tinned fruit in syrup)

One portion is:

• 1 apple or pear or banana
• 1 slice of melon or pineapple
• 2 plums or satsumas
• 1 cup of strawberries/raspberries
• 2 tablespoons of vegetables (raw, cooked, frozen or canned)
• 1 dessert bowl of salad

Fill up on starchy foods

• This includes bread, cereals and potatoes
• Try wholegrain varieties where possible e.g. wholemeal bread, bran flakes etc.
• These are higher in vitamins and minerals and also help to fill you up -so you are less tempted to snack between meals

Meat Fish and Alternatives

• These foods are important for protein and iron as well as other nutrients
• Vegetarians should include pulses, beans or nuts to replace meat or fish
• Take care with fat content of meat or fish- especially if trying to reduce your weight

Dairy Products

• Milk, cheese, yoghurt or calcium-rich dairy alternatives are important for calcium, protein and other nutrients
• Choose low fat varieties as much as possible, for example, skimmed milk, cottage cheese or low fat yoghurt (especially if trying to lose weight)
• Low fat varieties have as much calcium as the regular versions

Occasional Foods

• Many snack and convenience foods contain lots of fat and sugar e.g. sweets, chocolate, biscuits, cakes, crisps and pastries.
• They are low in vitamins and minerals and high in calories, so should only be eaten occasionally.
• Added fats e.g. butter, oils and margarine should be used sparingly.

Take Folic Acid

• Good dietary sources of folic acid include fortified breakfast cereals, fortified bread, sprouts, spinach, Bovril and oranges.

Do I need to take any other supplements?

Please seek advice from a pharmacist before taking any other vitamin supplements or herbal remedies.

Want to know more?

• Ask your GP to refer you to a State Registered Dietician.
• Visit the ‘Eating for Pregnancy’ Website at www.eatingforpregnancy.co.uk

Other Factors

The use of certain medications, including anabolic steroids or recreational drugs such as marijuana can affect your sperm quality.  If you are taking any medication please discuss this with the unit staff.

Following investigation or treatment

If referral for In-Vitro Fertilisation (IVF) is required, an assessment will be made as to whether or not you meet your Clinical Commissioning Groups criteria for NHS funded treatment. Below is an example of some of the criteria that you will be assessed against.

• Age
• Smoking status
• Previous sterilisation or vasectomy
• Body mass index (BMI)
• Previous children
• Previous private cycles

If you do not meet the criteria for NHS funded treatment, you will be informed and your options for self-funded treatment will be discussed.

Cope With Stress

We know from couples undergoing fertility treatment that their experience can be an extremely stressful one.  This is understandable; especially if a couple believe that their future happiness depends upon a successful treatment outcome. Stress in such a situation is unavoidable.  However, it is not stress itself that causes problems but the way in which an individual responds to it.

Without positive ways of dealing with stress, a couple undergoing infertility treatment may experience some very negative symptoms such as:

• Insomnia
• Fatigue – constant lack of energy
• Anxiety
• Inability to concentrate for long periods
• Mood swings
• Depression

Staff at the unit want to help couples avoid the distress such symptoms bring about.  For this reason we recommend that you give some thought now as to the coping mechanisms you currently use to deal with stress.  Are they positive and likely to get you through treatment in good shape?  Or are they negative and therefore likely to make the situation worse?

Here are some ways of coping positively with stress that some couples have found helpful:

• Yoga
• Physical exercise – swimming, running etc.
• Learning how to relax – using tapes/podcasts, music, books, acupuncture, for example.
• Stress management courses – night school, information from GPs, libraries etc.
• Support – building your own network using friends, family and counsellors

Counselling is available at the Hewitt Centre, before, during and after treatment, should you require it. For further information or to arrange an appointment please contact the counselling service via 0151 702 4075 (Liverpool service) or 0151 702 4171 (Knutsford service).

 

Document Code: P-INFO-GEN-16	Version No: 14	Document Title: Healthy Living
Date of issue: 17.02.2023	Date of review: 17.02.2025	Owner: J Mutch	Author: J Mutch

Counselling at the Hewitt Fertility Centre 

The leaflet is detailed below, or you can download the 'Counselling at the Hewitt Fertility Centre' leaflet in PDF

Counselling at The Hewitt Fertility Centre

Fertility problems and their treatment can leave you feeling stressed, anxious or depressed and affect your close relationships. It’s quite common for people in this situation to have feelings of guilt about themselves, anger and jealousy towards others, and to feel a lack of control over what is happening. It can be difficult to share your thoughts and feelings with family and friends as they may not understand what you’re going through, or they might not be aware that you have a fertility problem. Relationships between partners can become strained if trying for a much-wanted baby is unsuccessful.

If any of this applies to you, it may help to talk things through with one of the Centre’s counselling team. We aim to provide you with a safe environment where you can freely explore your thoughts and feelings. We can also offer simple ideas for coping with stress and anxiety. The team is led by Patricia Lambert, our Senior Counsellor. We are all trained in counselling and are members of the British Infertility Counselling Association (BICA). We are not medical staff, but we do have an understanding of fertility problems and the various treatments provided for them. Counselling is available before, during and after treatment, regardless of the outcome. Counselling sessions usually last for an hour. The number of sessions you have will be decided between yourself and your counsellor; there is no pressure to continue with sessions if you feel they are not helpful. Some people just attend one session, some attend as and when they feel they need to and others have more regular appointments. Counselling is available for individuals or couples. We will be as flexible as we can with our appointments and try to arrange them at times to suit you. We can offer face to face or online sessions.

You may be worried that seeing a counsellor before your treatment starts or during a course of treatment will reflect badly on you and affect your ability to continue. This is not the case. We are not here to judge your suitability for fertility treatment. With very few exceptions (for example when someone is at risk of harm) counselling sessions are confidential and we do not share the details of them with anyone, including other members of clinic staff. We make notes of our sessions, but they are kept separately from clinic notes and no-one else sees them. We can explain more about confidentiality when you meet us for the first time.

If your treatment is funded by the NHS, there is no charge for counselling. Self-funding patients have two sessions of counselling included in the cost of their treatment; any further appointments are subject to a fee. For most of our patients counselling is an option they can choose to take up if they wish. Under certain circumstances you may be required to see a counsellor before your treatment continues, for example if treatment will involve the use of donated sperm, eggs or embryos or surrogacy. This is to ensure you understand all the implications of this course of action, both for yourselves and any children who may be born as a result.

You can ask any member of staff at the Hewitt Fertility Centre to refer you to the counselling service. You can also contact us directly to make an appointment or find out more about what we can offer by calling 0151 702 4075 or email: hewittcounsellingservices@lwh.nhs.uk

 

Document Code: COUN-INFO-P-6	Version No:1	Document Title: Counselling
Date of issue:12/12/2023	Date of review: 12.12.2025	Owner: R. Gregoire	Author: P. Lambert

 

 

Pre-conception Advice 

The leaflet is detailed below, or you can download the 'Pre-conception Advice' leaflet.

Diet

General advice

1. It is crucial to eat a healthy balanced diet when preparing to conceive.
2. Eat plenty of fruit and veg. Eating colourful fruit and veg is the best way to get plenty of antioxidants in your body. Leafy green veg are packed with excellent sources of vitamin C, iron, calcium, potassium and folate.
3. Include good sources or iron and calcium every day.
4. Have regular meals – breakfast lunch and dinner.
5. Drink around 2L of water a day, and drink more if you are being sick, it is hot weather or exercising.

Fats

Monounsaturated fats (nuts, avocado, olive oil) are an important part of a balanced diet and studies have shown that they can lead to higher fertility rates. We encourage you to replace saturated fats (fried foods, pastry, biscuits, cakes etc.) for monounsaturated fats, whilst being aware of portion sizes. Higher intake of trans fats has been shown to be associated with ovulatory disorders and infertility. The ingredient ‘partially hydronised oil’ is a trans-fat. Trans fats are found in foods like margarine, cookies, sweets, fried foods and many more.

Protein

Evidence suggesting that eating more plant sources of protein and fewer animal sources may help improve ovulatory infertility by 50%.  An increase in plant sources of protein have also been found to improve outcomes in fertility treatment. You can get minimally processed sources of protein from foods such as tofu, tempeh, beans, lentils, chickpeas, nuts and seeds. This source has some good advice on plant sources of protein - https://zoe.com/learn/vegetarian-protein-sources

Carbohydrates

In terms of carbohydrates, the intake of foods with high glycaemic index (e.g. white bread, white rice, cakes, cereals, fries) can increase insulin resistance, cholesterol and oxidative stress which can have a negative impact on fertility and ovarian function. A high intake of simple sugars (found in sugary drinks, sweets, desserts) is associated with lower chances of becoming pregnant. You should try to replace the carbohydrates mentioned above with complex carbohydrates (quinoa, wholegrain bread, lentils, and beans) as this can help boost your fertility.

Advanced glycation end-products

Advanced glycation end-products (AGE)s are compounds that form inside the body when sugars attach to protein molecules. There are receptors for AGEs in the uterus and ovaries. In Woman who are overweight an accumulation of AGEs in the uterine tissue can have a negative impact on fertility- it can take longer to conceive and can inhibit the implantation of fertilised egg into the endometrial tissue. You should reduce your intake of AGEs – this includes grilled, barbequed, toasted and fried foods. Try to use alternative methods like casseroling, slow cooking, steaming, poaching and microwaving. Using acidic marinade such as lemon juice and vinegar will reduce the formation of AGEs when the foods are cooked. Avoid highly processed foods, sugar sweetened beverages and consumption of free sugars.

Foods to avoid

Risk of Salmonella - Raw shellfish, unpasteurised milk, raw or undercooked eggs.

Risks of listeria - Soft ripened cheeses (Brie, Camembert and some goats cheese), blue veined cheeses, unpasteurised dairy products, pate, soft serve ice cream from vans or kiosks.

Contaminants e.g mercury, dioxins – shark, marlin, swordfish, limit tuna intake, limit oily fish intake (salmon, mackerel, sardines to no more than twice  week. 

Foods with Vitamin A – multivitamin supplements containing excess retinol form of vitamin A, fish liver oils containing more than 700mcg/day, liver and liver products e.g. pate, faggots.

Find more information on the NHS website for a healthy diet when planning for pregnancy: https://www.nhs.uk/pregnancy/keeping-well/have-a-healthy-diet/

Vitamins and Minerals

Vitamin D
Research shows vitamin D may be important for fertility. There are vitamin D receptors located in the ovaries, placenta and endometrium as well as in testicles and sperm. Recent studies show adequate vitamin D levels are associated with more positive pregnancy tests, clinical pregnancies and live births in woman undergoing fertility treatment. Vitamin D is especially important in winter months.  Dietary sources of vitamin D include oily fish, egg yolks, and fortified foods.  Current guidance is that everyone in the UK should take 10mcg supplement between the months October and March, vulnerable groups (pregnant and breastfeeding mothers) should take the supplement all year round.

Iron

Iron is the most common deficiency world-wide. Iron deficiency can lead to increased risk of problems with ovulation. Try to increase your intake of non-haem iron: legumes, grains, nuts, tofu, and dried fruit. It is important that you are also eating foods that helps your body absorb iron. Fruit and vegetable containing vitamin C (kiwi, oranges, broccoli, brussels sprouts) can help the body absorb iron. If you soak the grains and legumes prior to cooking this will help the absorption of iron.

Zinc and Folate

Folate deficiency increases the risk of neural tube defects. The guidelines for woman trying to conceive is 400mcg of folic acid daily. Those who are higher risk of neural tube defects may benefit from a higher dose of 5mg.

Zinc plays an important role in hormone balance and ovulation. Dietary sources of zinc include wholegrains, nuts and seeds as well as oysters and lean red meat.  To increase zinc and folate intake eat plenty of fruit and veg, particularly dark green leafy varieties, fortified cereal products and nuts and seeds.

Iodine

The body needs iodine for the production of thyroid hormones, which are essential for adequate brain and neurological development. Iodine stores should be sufficient prior to conception due to the role of iodine in egg maturation. The fetus relies on maternal iodine stores until around 18 weeks. Iodine requirements during pregnancy are 200mcg per day. Woman should try and build up their iodine stores several months prior to conception. Sources of iodine include fish (white fish contains more than oily fish) and dairy products. If you have plant based diet it is important to have milks which are fortified with iodine.

If you do not have sufficient iodine in your diet, a supplement should be considered ensuring that it does not exceed 150mcg daily. This should be taken in the form of potassium iodide or potassium iodate. Seaweed or Kelp Supplement should be avoided as the iodine content can vary considerably.

Other Supplements

Coenzyme Q10 has been shown to support fertility. It works as an antioxidant. 

Acetyl L-carnitine – contains antioxidants to help promote a healthy female reproductive system.

B vitamins (other than folic acid) – B Vitamins can help improve egg quality and prevent ovulatory infertility.

Lifestyle

Weight
Maternal pre-pregnancy weight is a strong predictor of fertility and pregnancy outcomes. Low BMI can result in irregular periods and a compromised immune system which can increase the risk of infection and inflammation.
Obesity is associated with irregular or decreased ovulation. In obese woman there is a reduced ability of the egg to implant into the womb. Obesity increases the risk of gestational diabetes, hypertension, preterm birth and caesarean section.
If you are living with obesity – if you can try to aim for 5-10% weight loss it can increase fertility. Weight loss to reach a healthy BMI will provide the most benefit. The ideal BMI is between 19 and 25 kg/m2. You can use this calculator on the NHS website to calculate your BMI: https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/

Caffeine

We advise you to avoid caffeine as too much caffeine can be harmful to a baby in the womb and can increase the risk of miscarriage. Caffeine can also impair your body’s absorption of iron and calcium. The safe amount of caffeine to have is 200mg per day which is 2 instant coffees or one cup of filter coffee.

Alcohol

When planning for pregnancy the safest option is to avoid alcohol.  Alcohol can lead to disruptions in the hormonal balance of the female reproductive system, can increase the risk of miscarriage and the risk of you baby developing foetal alcohol spectrum disorder.

Smoking

When trying to conceive you and your partner should quit smoking and avoid using e-cigarettes. There are several toxic substances in cigarette smoke that impact fertility. Smoking can lead to menstrual irregularities and lead to you having menstrual cycles where you fail to ovulate. The evidence suggests that if you smoke you chances of success with IVF is greatly reduced.

Exercise

Exercise is an important part of a healthy lifestyle. In moderation exercise can help to increase fertility. The advice is to exercise for 30 minutes a day. If you have not previously been exercising begin with no more than 15 minutes and increase gradually to 30 minutes. If you exercise regularly prior to pregnancy you are safe to continue. Over exercising can disrupt your periods.

Drugs

Recreational drug use can compromise fertility (including steroids/gym supplements, cannabis and cocaine).

Stress

It is unlikely that stress alone will cause infertility but stress can interfere with your ability to get pregnant. Try to make self care a priority. Try to get adequate sleep (7-9 hours per night).

 More information on NHS website can be found for planning your pregnancy

https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/

This leaflet can be changed into different languages and formats using the tools on the website. Please note when translating information into different languages via the website, some information may need clarifying for accuracy with a member of staff. This leaflet can be formally translated on request via our Patient Experience Team, although response times to have information translated can vary. To request formal translation services or if you would like to make any suggestions or comments about the content of this leaflet, please contact the Patient Experience Team on 0151 702 4353 or by email at pals@lwh.nhs.uk