The Effectiveness of Lifestyle Modification in Treating Infertility Due to Diminished Ovarian Reserve in a ۳۳ -Year -Old Woman and Treatment of Her Husband’s Varicocele

Diminished ovarian reserve is not a direct cause of infertility. However, factors such as stress and failure to maintain a healthy lifestyle can impact the hypothalamic-pituitary axis and the function of FSH and LH hormones on the ovaries, thereby reducing fertility. This condition is often marked by an increase in FSH and a decrease in AMH, leading to a diagnosis of premature ovarian failure. Patients are typically told that IVF is the only solution, especially as they age, lose valuable time, and become non-responsive to hormonal treatments. However, it has been proven that hormonal levels and ovarian reserve can improve without hormonal drugs, simply through lifestyle changes. Male factors also contribute significantly to infertility. A semen analysis is usually requested, and if parameters such as motility or morphology are poor, fertilization may not occur, or, if it does, it may result in miscarriage. Varicocele is graded into three levels, with grade ۲ and ۳ typically treated through surgery and lifestyle changes over a period of ۷۰ days. The case involves a ۳۳-year-old woman married for ۷ years. She is a midwife working in a high-stress, full-shift job in Asaluyeh—an area with extreme weather conditions. She has a choleric temperament and had been trying to conceive for two years. Her husband also worked in a refinery in Asaluyeh, constantly on rotating shifts in intense heat. Their marital relationship was strained due to life pressures and high expectations, both experiencing high stress and irregular sleep due to night shifts. The woman’s ovarian reserve test showed an AMH level of ۰.۰۳, and they were told that IVF was their only option and not to exhaust themselves due to their jobs. The man’s semen analysis showed very low motility, and a scrotal ultrasound revealed a grade ۲ varicocele.