1. Factors Affecting Fertility

  1. Emre Seli MD2,3,4
  1. Enrique Soto MD and
  2. Alan B. Copperman MD

Published Online: 8 MAR 2011

DOI: 10.1002/9781444393958.ch1



How to Cite

Soto, E. and Copperman, A. B. (2011) Factors Affecting Fertility, in Infertility (ed E. Seli), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444393958.ch1

Editor Information

  1. 2

    Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA

  2. 3

    Division of Reproductive Endocrinology and Infertility, Yale University School of Medicine, New Haven, Connecticut, USA

  3. 4

    Oocyte Donation and Gestational Surrogacy Program, Yale University School of Medicine, New Haven, Connecticut, USA

Author Information

  1. Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, USA

Publication History

  1. Published Online: 8 MAR 2011
  2. Published Print: 23 MAR 2011

Book Series:

  1. Gynecology in Practice

Book Series Editors:

  1. Aydin Arici

ISBN Information

Print ISBN: 9781444333534

Online ISBN: 9781444393958



  • factors affecting fertility;
  • fecundability and time to pregnancy (TTP) - used in literature as markers of fertility;
  • factors, likely to play a role - in the ability that a patient or couple has to conceive;
  • body mass index (BMI) - objective marker for classifying underweight;
  • fecundability, lower at extremes of BMI - in patients trying to conceive spontaneously;
  • direct effect of being overweight and obese - assisted reproduction technologies (ART), less clear than for spontaneous pregnancies;
  • incidence of infertility - increasing with advancing maternal age;
  • ASRM guidelines, patients diagnosed with infertility - after 12 months or more, inability in achieving a successful pregnancy;
  • factors, role in fertility - age and weight of patient, consumption of tobacco, caffeine or alcohol;
  • alcohol, data reflecting - effect of alcohol on fertility


The overall health of a patient may affect her reproductive capability. Specific factors that may play an important role in fertility include the weight and age of the patient, as well as maternal consumption of tobacco, caffeine, or alcohol.

The following recommendations should be advised to patients attempting to conceive spontaneously or through reproductive assisted technologies (ART): (1) follow a healthy diet according to U.S. Department of Agriculture (USDA) guidelines, including folic acid supplementation of 400µg/day, (2) quit smoking, (3) limit caffeine consumption to 1–2 cups of coffee/day or equivalent, (4) avoid alcohol consumption greater than 2 drinks/day (quit completely once pregnancy confirmed). Additionally, weight loss and exercise should be advised for women who are overweight or obese.

Although the diagnosis of infertility is normally defined as 12 months of unsuccessful attempts at conception, earlier evaluation and treatment may be justified in some patients based on medical history and physical findings, or after 6 months in women over the age of 35.