As anyone who’s tried to get pregnant without quick success will tell you, trying for a baby isn’t a “presto” moment at all. It’s month after month of hope and then disappointment when those telltale cramps arrive, followed by low-grade anxiety and, over time, an escalation to genuine fear and bitterness when everyone seems to be pregnant except you. We can control so much in our lives, but one of our biggest choices is left to chance.

Or is it? Boston University reproductive and perinatal epidemiologist Lauren Wise is the principle investigator of PRESTO, a sweeping web-based research study that examines how lifestyle factors like diet, exercise and medication impact fertility and pregnancy.

Her study has grown into the largest of its kind since launching in 2013. It’s the first one to enroll couples pre-conception using Internet-based methods (like social-media advertising), and it’s the largest pre-conception study of men in the entire world. Wise is also involved in a sister study, based in Denmark.

Her research is personal. Wise, who was older when she got pregnant for the first time, says she understands the agitation, uncertainty and shame that comes with trying to conceive.

“I [can’t] say for sure that my Jewish background has really shaped my interest in fertility, though I certainly know what it’s like to have a Jewish mother constantly asking you when you are going to get married and have kids! To the extent that our study recruitment methods recognize this challenge, by inviting participants to enroll in a very discreet manner via the Internet, I think my Jewish background has certainly helped,” she says.

Couples 21-45 can enroll online and commit to filling out a series of lengthy medical and lifestyle questionnaires every two months for a 12-month period or until they get pregnant. There are incentives, like the chance to win iPads and other goodies, with participation. Plus there’s catharsis, too, in helping to achieve answers to a process that often feels like a riddle, especially with age. Roughly one in eight couples has trouble getting pregnant, according to the Centers for Disease Control and Prevention. Infertility is defined as not getting pregnant after a year of unprotected sex (or six months after age 35).

“It was a question for me, and a lot of other women think about this: How important is it to start trying early, balancing a career, et cetera? I’m interested in women who delayed childbearing: What can they do to enhance fertility? Eat better? Anything modifiable? There are a lot of unanswered questions and we wanted to put some more careful research into it,” Wise says.

And, yes, Wise has unearthed some interesting results thus far. A few takeaways:

Men need to sleep
Men who reported less than six hours of sleep per night had the lowest fertility rates when compared with men who slept eight hours per night. “Good research shows that the majority of testosterone is released in men during sleep, which is affected if your sleep is disrupted,” she says. So if your husband wants to pass out on the couch while watching “The Walking Dead,” let him.
A healthy weight is crucial
Obesity is associated with reduced fertility. At the very least, try to maintain your weight (don’t gain) through a healthy diet and exercise when trying to conceive. Being too lean isn’t good, either: Women with BMIs less than 25 have reduced fertility if they engage in more than five hours of physical activity per week, according to the Danish study. (On the other hand, activity among obese women doesn’t seem to harm fertility.)

Put down the soda, please

Frequent consumption of sugar-sweetened beverages can harm male fertility.
Male fertility declines after 40
Women’s fertility declines after 35. Men, meanwhile, have a weaker decline after age 40. Male age can also impact neurologic outcomes like ADD and schizophrenia.
Antidepressant usage is OK
Welcome news for women who struggle with depression and anxiety: Wise and her team found no evidence that such medications harmed fertility; in fact, it offered a small boost (possibly because it alleviated symptoms). On the other hand, depressive symptoms can lower fertility.
“This is helpful for women who are taking antidepressants and are worried about how it might affect their fertility. It’s more underlying depression that can affect conception,” she says.
Wise is also studying how shorter menstrual periods might reduce fertility, as well as the use of aspirin and other pain relievers.
Want to learn more? Maybe even enroll? Visit PRESTO online.

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