University of Hull, Postgraduate Medical Institute, Hull and York Medical
School, Academic Department of Obstetrics and Gynaecology, Women's and
Children's Hospital, Hull Royal Infirmary, Hull, United Kingdom
Received 6 February 2003; revised
30 June 2003; accepted 30 June 2003. ; Available online 7 February
Objective = To evaluate the association
patterns and quantify the effects of lifestyle on time to pregnancy (TTP).
Design =Observational study.
Setting = Teaching hospitals
in Hull, United Kingdom.
Patient(s) = Two thousand and
one hundred twelve consecutive pregnant women.
Intervention(s) = A questionnaire
inquiring about TTP, contraceptive use, pregnancy planning, previous subfertility/pregnancies,
age, and lifestyle characteristics of either partner.
Main outcome measure(s) = We compared
TTP, conception rates, and relative risk of subfecundity between subgroups
with different lifestyle characteristics.
Result(s) = We found that TTP
was significantly longer if the woman or partner smoked >15 cigarettes/day
(P<.001 and .04, respectively), the partner consumed >20 alcohol
units/week (P<.001), the woman's body mass index was >25 kg/m2
(P<.001), their coffee and/or tea intake was >6 cups/day (P=.04),
or if they were socially deprived (P<.001). Each of these effects
remained unchanged after adjusting for the potential confounders. The relative-risks
of subfecundity with each of these variables ranged between 1.4 to 1.9
(1.4 to 3.6 after adjustment). The effects of coital frequency and recreational
drug use were insignificant. Couples who had >4 negative lifestyle variables
had a sevenfold longer TTP; their conception probabilities fell by 60%,
and they were 7.3-fold more likely to be subfecund than those without negative
Conclusion(s) = Lifestyle has a significant
and cumulative impact on fecundity. Dose-dependent effects occur with smoking,
alcohol, and tea/coffee consumption. Appropriate counseling could result
in substantial reductions in the referrals for fertility investigations
Author Keywords: Time to pregnancy;
fecundity; fertility; lifestyle; age; obesity; smoking; alcohol; coffee;
author. Reprint requests: Mohamed A. M. Hassan, M.Sc., Women's and Children's
Hospital, Hull Royal Infirmary, Anlaby Road, , Hull HU3 2JZ, , United Kingdom