Introduction: According to WHO data, about 17.5% of adults struggle with fertility problems, both women and men are equally affected. It can also be observed that over the past decades there has been a continuous increase in the number of people in need of infertility treatment, and this trend affects developed/industrialized countries much more. In these decades, our living conditions have also changed, which can be linked to the increase in the number of sterile relationships at several points. Objectives: We know from the literature that being overweight, smoking, alcohol consumption, high levels of untreated stress and even excessive vitamin consumption can negatively affect chances of fertility. The purpose of our study was to determine the extent of the known harmful lifestyle factors exist in couples undergoing infertility treatment. Methods: In our study, we assessed the lifestyle habits of couples applying for in vitro fertilization at our institute between 2020 and 2021, and compared our results descriptively with domestic statistics. 200 couples filled in the questionnaire. The age of the female respondents was 22–46 years, and the age of the men was 23–66 years. Results: 45% of women and 79.2% of men are overweight or obese. 24% of women and 54% of men drink alcohol at least once a week. Every fifth woman (19%) and every fourth man (26%) smoke regularly. In addition to this, only 21.5% of the respondents exercise at least 3 times a week. Our survey also covered our patients’ experience of stress. 27.8% of the participating women and 12.5% of the men claimed to be depressed, while 41% of the women and 15% of the men were stressed due to the difficulties of having children. Discussion and conclusion: According to our survey, the lifestyle risk factors discussed in detail in the literature are also typical in the lives of our patients, and this is a good indication for health awareness and importance of family planning education. The above factors may be partly due to cardiovascular and diabetes problems of the applicants presenting to our institute. Knowing the results, the high consumption of vegetables and fruits among the patients is surprising, and it is important to highlight that many of them use some form of vitamin preparation practically every day. Overall, it can be claimed that our patients have an unfavorable health picture, which fits the data of domestic statistics. Orv Hetil. 2024; 165(36): 1423–1432.
Bevezetés: A WHO adatai szerint a felnőttkorúak mintegy 17,5%-a küzd fertilitási problémákkal, mind a nők, mind a férfiak kb. egyformán érintettek. Az is megfigyelhető, hogy az elmúlt évtizedek során folyamatos emelkedés látható a meddőségi kezelésre szorulók számában, s ez a tendencia sokkal jobban érinti a fejlett/iparosodott országokat. Ezekben az évtizedekben életkörülményeink is átalakultak, ami több ponton is kapcsolatba hozható a meddő kapcsolatok számának növekedésével. Célkitűzés: A szakirodalomból tudjuk, hogy a túlsúly, a dohányzás, az alkoholfogyasztás, a nagymértékű kezeletlen stressz és akár a túlzott vitaminfogyasztás is képes negatívan befolyásolni fertilitási esélyeinket. Tanulmányunk célja annak vizsgálata, hogy a meddőségi kezelésben részt vevő pároknál milyen mértékben nyilvánulnak meg a szakirodalomból ismert potenciálisan káros életviteli tényezők. Módszer: Vizsgálatunk során az intézetünkben 2020 és 2021 között in vitro fertilizációs beavatkozásra jelentkező pároknál mértük fel életviteli szokásaikat, és eredményeinket leíró jelleggel összehasonlítottuk a hazai statisztikákkal. 200 pár töltötte ki a kérdőívet, a válaszadó nők életkora 22–46 év, a férfiaké pedig 23–66 év volt. Eredmények: A válaszadó nők 45%-a, míg a férfiak 79,2%-a túlsúlyos vagy elhízott. A nők 24%-a fogyaszt legalább heti egyszer alkoholt, a férfiaknak pedig az 54%-a. Rendszeresen dohányzik minden ötödik nő (19%) és minden negyedik férfi (26%). Mindezek mellett csak a válaszadók 21,5%-a sportol legalább heti 3 alkalommal. Felmérésünk kitért pácienseink stresszérzetére is. A részt vevő nők 27,8%-a és a férfiak 12,5%-a vallotta magát depressziósnak, míg a nők 41%-a és a férfiak 15%-a feszült a gyermekvállalási nehézségek miatt. Megbeszélés és következtetés: Felmérésünk szerint a szakirodalomban részletesen taglalt életviteli kockázati tényezők a mi pácienseink életében is jellemzőek, s ez jól jelzi az egészségtudatossági, illetve családtervezési edukáció fontosságát. A fenti tényezők hozzájárulhatnak az intézetünkben jelentkezők szív- és érrendszeri, valamint diabetológiai problémáihoz. Az eredmények ismeretében meglepő a betegek körében a nagyarányú zöldség- és gyümölcsfogyasztás, valamint fontos kiemelni, hogy sokan alkalmaznak gyakorlatilag minden nap valamilyen vitaminkészítményt. Összességében elmondható, hogy betegeinknél kedvezőtlen egészségügyi kép tapasztalható, mely illeszkedik a hazai statisztikák adataiba. Orv Hetil. 2024; 165(36): 1423–1432.
Kumar S, Thaker R, Verma V, et al. Occupational, environmental exposure and lifestyle factors: declining male reproductive health. J Gynecol Infertil. 2018; 1: 1–29.
Ilacqua A, Izzo G, Emerenziani GP, et al. Lifestyle and fertility: the influence of stress and quality of life on male fertility. Reprod Biol Endocrinol. 2018; 16: 115.
Ikyernum JA, Agbecha A, Hwande ST. Semen profile of men presenting with infertility at First Fertility Hospital, Makurdi, North-Central Nigeria. Clin Med Diagn. 2019; 9: 26–35.
Silvestris E, Lovero D, Palmirotta R. Nutrition and female fertility: an independent correlation. Front Endocrinol. 2019; 10: 346.
Herman T, Csehely Sz, Orosz M, et al. Prevalence and association of endocrine disorders in women participating in an in vitro fertilization program. [Endokrin kórképek előfordulása és társulása in vitro fertilizációs programban részt vevő nők körében.] Orv Hetil. 2022; 163: 712–719. [Hungarian]
Ubaldi FM, Cimadomo D, Vaiarelli A, et al. Advanced maternal age in IVF: still a challenge? The present and the future of its treatment. Front Endocrinol (Lausanne) 2019; 10: 94.
Kovács Z, Bálint B, Keszthelyi M, et al. The possibilities of fertility awareness methods in family planning. [A termékenységtudatosságon alapuló módszerek lehetőségei a családtervezésben.] Orv Hetil. 2024; 165: 851–858. [Hungarian]
Hungarian Central Statistical Office. Summary tables: healthcare, accident. [Központi Statisztikai Hivatal. Összefoglaló táblák: Egészségügy, baleset.] Available from: https://www.ksh.hu/stadat?lang=hu&theme=ege [accessed: 01. 06. 2024]. [Hungarian]
World Health Organization. Global Health Observatory data repository. Overweight/Obesity. Available from: https://apps.who.int/gho/data/view.main.REGION2480A?lang=en [accessed: 01. 06. 2024].
Uddandrao VV, Brahma Naidu P, Chandrasekaran P, et al. Pathophysiology of obesity-related infertility and its prevention and treatment by potential phytotherapeutics. Int J Obes. 2024; 48: 147–165.
Rachoń D, Teede H. Ovarian function and obesity – interrelationship, impact on women’s reproductive lifespan and treatment options. Mol Cell Endocrinol. 2010; 316: 172–179.
Jungheim ES, Moley KH. Current knowledge of obesity’s effects in the pre- and periconceptional periods and avenues for future research. Am J Obstet Gynecol. 2010; 203: 525–530.
Pasquali R. Obesity and androgens: facts and perspectives. Fertil Steril. 2006; 85: 1319–1340.
Moran LJ, Norman RJ, Teede HJ. Metabolic risk in PCOS: phenotype and adiposity impact. Trends Endocrinol Metab. 2015; 26: 136–143.
Escobar-Morreale HF. Surgical management of metabolic dysfunction in PCOS. Steroids 2012; 77: 312–316.
Alvarez-Blasco F, Botella-Carretero JI, San Millan JL, et al. Prevalence and characteristics of the polycystic ovary syndrome in over-weight and obese women. Arch Intern Med. 2006; 166: 2081–2086.
Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome. J Clin Endocrinol Metab. 2008; 93: 162–168.
Kort HI, Massey JB, Elsner CW, et al. Impact of body mass index values on sperm quantity and quality. J Androl. 2006; 27: 450–452.
MacDonald AA, Herbison GP, Showell M, et al. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update 2010; 16: 293–311.
Vermeulen A, Kaufman JM, Deslypere JP, et al. Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men. J Clin Endocrinol Metab. 1993; 76: 1140–1146.
Kerr JB, Millar M, Maddocks S, et al. Stage-dependent changes in spermatogenesis and Sertoli cells in relation to the onset of spermatogenic failure following withdrawal of testosterone. Anat Rec. 1993; 235: 547–559.
Dierich A, Sairam MR, Monaco L, et al. Impairing follicle-stimulating hormone (FSH) signaling in vivo: targeted disruption of the FSH receptor leads to aberrant gametogenesis and hormonal imbalance. Proc Natl Acad Sci USA 1998; 95: 13612–13617.
Leisegang K. Oxidative stress in men with obesity, metabolic syndrome and type 2 diabetes mellitus: mechanisms and management of reproductive dysfunction. Adv Exp Med Biol. 2022; 1358: 237–256.
Sadeghi N, Boissonneault G, Tavalaee M, et al. Oxidative versus reductive stress: a delicate balance for sperm integrity. Syst Biol Reprod Med. 2023; 69: 20–31.
Wood AM, Kaptoge S, Butterworth AS, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018; 391: 1513–1523. Erratum: Lancet 2018; 391: 2212.
Tan CH, Denny CH, Cheal NE, et al. Alcohol use and binge drinking among women of childbearing age – United States, 2011–2013. MMWR Morb Mortal Wkly Rep. 2015; 64: 1042–1046.
Klonoff-Cohen H, Lam-Kruglick P, Gonzalez C. Effects of maternal and paternal alcohol consumption on the success rates of in vitro fertilization and gamete intrafallopian transfer. Fertil Steril. 2003; 79: 330–339.
Wdowiak A, Sulima M, Sadowska M, et al. Alcohol consumption and quality of embryos obtained in programmes of in vitro fertilization. Ann Agric Environ Med. 2014; 21: 450–453.
Rossi BV, Berry KF, Hornstein MD, et al. Effect of alcohol consumption on in vitro fertilization. Obstet Gynecol. 2011; 117: 136–142.
Grover S, Mattoo SK, Pendharkar S, et al. Sexual dysfunction in patients with alcohol and opioid dependence. Indian J Psychol Med. 2014; 36: 355–365.
Condorelli RA, Calogero AE, Vicari E, et al. Chronic consumption of alcohol and sperm parameters: our experience and the main evidences. Andrologia 2015; 47: 368–379.
Guthauser B, Boitrelle F, Plat A, et al. Chronic excessive alcohol consumption and male fertility: a case report on reversible azoospermia and a literature review. Alcohol Alcohol. 2014; 49: 42–44.
Pendharkar S, Mattoo SK, Grover S. Sexual dysfunctions in alcohol-dependent men: a study from north India. Indian J Med Res. 2016; 144: 393–399.
Collins GG, Rossi BV. The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertil Res Pract. 2015; 1: 11.
Aghajanova L, Lindeberg M, Carlsson IB, et al. Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue. Reprod Biomed Online 2009; 18: 337–347.
Anasti JN, Flack MR, Froehlich J, et al. A potential novel mechanism for precocious puberty in juvenile hypothyroidism. J Clin Endocrinol Metab. 1995; 80: 276–279.
Wu LM, Liu YS, Tong XH, et al. Inhibition of follicular development induced by chronic unpredictable stress is associated with growth and differentiation factor 9 and gonadotropin in mice. Biol Reprod. 2012; 86: 121.
Wu LM, Hu MH, Tong XH, et al. Chronic unpredictable stress decreases expression of brain-derived neurotrophic factor (BDNF) in mouse ovaries: relationship to oocytes developmental potential. PLoS ONE 2012; 7: e52331.
Gao Y, Chen F, Kong QQ, et al. Stresses on female mice impair oocyte developmental potential: effects of stress severity and duration on oocytes at the growing follicle stage. Reprod Sci. 2016; 23: 1148–1157.
Nepomnaschy PA, Welch KB, McConnell DS, et al. Cortisol levels and very early pregnancy loss in humans. Proc Natl Acad Sci U S A 2006; 103: 3938–3942.
Alam F, Khan TA, Ali R, et al. SIRTI and cortisol in unexplained infertile females; a cross sectional study, in Karachi Pakistan. Taiwan J Obstet Gynecol. 2020; 59: 189–194.
Abriba SP, Osadolor HB. Evaluation of hormonal profile and some stress biomarkers in infertile couples in Abuja, Nigeria. Int J Res Med Sci. 2020; 8: 1514–1522.
Nargund VH. Effects of psychological stress on male fertility. Nat Rev Urol. 2015; 12: 373–382.
Hou G, Xiong W, Wang M, et al. Chronic stress influences sexual motivation and causes damage to testicular cells in male rats. J Sex Med. 2014; 11: 653–663.
Demirci T, Sahin E. The effect of chronic stress and obesity on sperm quality and testis histology in male rats; a morphometric and immunohistochemical study. Histol Histopathol. 2019; 34: 287–302.
Tohei A, Tomabechi T, Mamada M, et al. Effects of repeated ether stress on the hypothalamic-pituitary-testes axis in adult rats with special reference to inhibin secretion. J Vet Med Sci. 1997; 59: 329–324.
Ren L, Li X, Weng Q, et al. Effects of acute restraint stress on sperm motility and secretion of pituitary, adrenocortical and gonadal hormones in adult male rats. J Vet Med Sci. 2010; 72: 1501–1506.
Bhongade MB, Prasad S, Jiloha RC, et al. Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples. Andrologia 2015; 47: 336–342.
Li Y, Lin H, Li Y, et al. Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses. Fertil Steril. 2011; 95: 116–123.