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At least one million infants have been born in the United States with the help of in-vitro fertilization (IVF) or other assisted reproductive technologies. Lifestyle factors including smoking, alcohol, recreational drugs, stress, lack of physical activity, and obesity in men and women, which may profoundly influence IVF success rates. Nevertheless, many women and men about to undergo fertility treatment make poor lifestyle choices that may possibly affect their chances of becoming pregnant. A follow-up systematic review was conducted in PubMED (MEDLINE) from 2005-2017 to evaluate the effects of male and female lifestyle habits on success rates of IVF. There was strong evidence that smoking affects almost every endpoint of IVF. There is also mounting evidence that obesity profoundly affects pregnancy, live birth rates, and is also associated with cancelled cycles. The literature on stress and IVF continues to be contradictory. The results were almost equally divided between four studies that found a negative effect of stress on number of oocytes, embryo transfer, and pregnancy, and three studies that reported no effect on IVF outcomes. The evidence for an association for exercise, alcohol, caffeine, and recreational drugs and IVF is inadequate based on a paucity of studies. In order to resolve this dilemma, national or international databases could be used to effectively and accurately capture lifestyle habits over time on thousands of couples undergoing IVF. This information could eventually help create guidelines for primary care physicians, specialists, and infertile patients. From a medical standpoint, it is probably advisable for men and women contemplating IVF to be encouraged to engage in healthy lifestyles. At this time, a structured educational program, ongoing wellness support, and therapeutic interventions (e.g., smoking cessation, relaxation techniques, substance abuse counseling) could be part of the comprehensive care received at fertility clinics in order to promote healthy lifestyle changes.
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