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If your BMI is 26 to 27, you are somewhat overweight, but your weight should not inhibit your fertility;

If your BMI is 27.5 to 30, you should lose weight before getting pregnant.

If your BMI is above 30, your weight may be affecting your fertility—as well as your overall health. You need to take steps to gradually lose weight, following a low-fat, high-fiber diet rich in fresh vegetables and fruits.

Where you put those extra pounds also matters. Fat around the middle (the “apple” body shape) is worse for your health than fat around the hips and thighs (the “pear” body shape). A recent study of five-hundred healthy female patients in the Netherlands found that “apples” were only half as likely to get pregnant as “pears.” In addition, a waist-to-hip ratio of more than 0.8 for women or more than 1.0 for men is associated with increased risk of heart disease. To calculate your shape, measure your waist at its narrowest point and your hips at their widest, then divide the waist measurement by the hip measurement.

Quit Smoking

You already know that smoking is hazardous to your health. You already know it can cause lung cancer, cardiovascular disease, and a number of other serious health problems. But you may not be aware that it can also make it more difficult for you to get pregnant.

THE FERTILITY DIET

To lose weight—but not too fast—consume about fifteen hundred calories a day, with an emphasis on low-fat foods that enhance fertility. (Review the foods listed in Chapter 3, “Nutrition and Nutrition Supplements,” for a detailed list of foods that promote fertility.) The following food suggestions (prepared using low-fat cooking techniques) may also help:

BREAKFAST

Orange juice

Banana OR grapefruit OR orange

Whole-grain cereal with soy milk OR one-egg omelet containing red pepper and low-fat cheese

LUNCH

Skim milk

Turkey sandwich on whole-wheat bread with a single slice of low-fat cheese OR avocado salad

Green leafy salad

Yogurt

DINNER

Fish (twice a week), chicken (twice a week), tofu (twice a week), red meat or organ meat (once a week)—three ounce serving

Green vegetable

Brown rice OR new potatoes OR legumes (three times a week), yellow vegetable (four times a week)

Citrus fruit

SNACKS

Citrus fruits

Nuts: hazelnuts, cashews, peanuts, walnuts, soy nuts

If you are among the one in three men or women of childbearing age who smoke cigarettes, do yourself a favor and quit. If you need another reason to kick the habit, consider the evidence supporting a link between smoking and infertility:

Women who smoke have been found to be 3.4 times as likely as nonsmokers to take more than a year to get pregnant, according to a study of 678 women published in the Journal of the American Medical Association in 1985.

A 1992 study in the British medical journal The Lancet found a 31 percent difference in fertility rates between nonsmoking couples and couples in which both the man and the woman smoked.

Another study found that the fertility of light smokers (less than one pack—twenty cigarettes—a day) was 75 percent of that of nonsmokers; the fertility rate of heavy smokers (more than a pack a day) was 57 percent of that of nonsmokers.

Doctors have known for many years that women who smoke during pregnancy tend to have smaller fetuses and shorter gestation periods than nonsmokers.

Women who smoke during pregnancy miscarry more often. Women who smoke and do become pregnant are almost twice as likely to suffer miscarriage as women who don’t smoke, perhaps because smoking reduces estrogen levels.

Even a relatively modest smoking habit can cut short a woman’s reproductive life. Women who smoke a half-pack of cigarettes a day experience menopause an average of one year earlier than nonsmokers, and those who smoke one pack enter menopause two years earlier.

In men, as few as sixteen cigarettes a day can decrease sperm count and motility, increase the number of abnormal sperm, and make it less likely that the sperm will fertilize an egg. Evidence