The initial fertility consultation: recommendations concerning cigarette smoking, body mass index, and alcohol and caffeine consumption.

Obstetrician-gynecologists are frequently consulted by couples who are concerned about their fertility potential. During the initial fertility consultation, questions may arise concerning the potential impact of lifestyle choices on fertility. For the female partner, common exposures associated with a decrease in fertility are cigarette smoking, alcohol consumption of >4 drinks per week, and caffeine intake of >250 mg daily. For the female partner, a body mass index of >27 kg/m2 or <17 kg/m2 is associated with decreased fertility. On the basis of the evidence from epidemiologic studies, couples who are concerned about their fertility potential should stop the use of tobacco products. In addition, the female partner should limit alcohol consumption to no more than 4 drinks per week, decrease caffeine intake to no more than 250 mg daily, and adjust calorie intake and exercise levels to achieve a body mass index between 20 and 27 kg/m2.