Advise patients to maintain a healthy body weight, as a BMI of 30 kg/mNICE CG156 or over may increase time to conceive, and weight loss can improve fertility in women who are not ovulating. NICE CKS
Encourage women to take dietary supplementation with folic acid before conception and up to 12 weeks of gestation, at a dose of 0.4 mg per day, to reduce the risk of neural tube defects. NICE CKS
Advise women to avoid smoking, including passive smoking, as it can reduce fertility, and offer support for smoking cessation. NICE CKS
Inform men that smoking affects semen quality and that quitting smoking can improve their overall health. NICE CG156
Recommend limiting alcohol intake, with women advised to drink no more than 1-2 units once or twice weekly, and men to stay within the recommended safe limits of 3-4 units per day, avoiding excessive consumption. NICE CG156
Advise both partners to avoid excessive caffeine consumption, as there is no consistent evidence linking caffeinated beverages to fertility problems. NICE CKS
Encourage the use of loose-fitting underwear for men, as elevated scrotal temperature is associated with reduced semen quality, although the benefit of loose underwear is uncertain. NICE CG156
Support weight loss in overweight or obese women (BMI ≥30 kg/mNICE CG156) and men (BMI >29 kg/mNICE CG156) to improve fertility prospects. NICE CKS,NICE CG156
Advise women with low body weight (BMI <19 kg/mNICE CG156) and irregular or absent menstruation to gain weight, as this may improve their chances of conception. NICE CKS
Recommend screening for chlamydia and other sexually transmitted infections, and treat accordingly, to improve fertility outcomes. NICE CKS
Advise patients to avoid occupational hazards that could impair fertility, and seek specialist advice if concerned about occupational risks. NICE CKS
Encourage psychological support and counselling to manage stress related to infertility, as stress can affect libido and intercourse frequency, contributing to fertility issues. NICE CKS